Monday, August 12, 2013

DHHS Identifies First Jamestown Canyon Virus And Powassan Virus Cases In New Hampshire

PRESS RELEASE

August 1, 2013

Concord, NH – The New Hampshire Department of Health and Human Services (DHHS) is announcing that a male from Hillsborough County tested positive for the Jamestown Canyon virus (JCV) and the Powassan virus, the first time either of these vector-borne diseases has been identified in the State. JCV is transmitted by infected mosquitoes and Powassan is transmitted by infected ticks.


“While this is our first announcement of Jamestown Canyon virus and Powassan virus in New Hampshire,” said Dr. José Montero, Director of Public Health at DHHS, “these have been in the U.S. for a while and Powassan was found in Maine and Vermont previously so this is not entirely unexpected. There are many mosquito- and tick-borne illnesses and unfortunately we are probably going to continue to see cases of them, which makes prevention steps all the more important. The same precautions we now take for Lyme and West Nile and EEE are effective against these viruses as well. So, as people enjoy New Hampshire we are urging them to use an effective repellent and do regular tick checks.”

Because these viruses are very rare, there is not a lot known about the illness they cause, where they are located in the environment, and how many people may have already been infected. JCV is a mosquito-borne pathogen that circulates widely in North America primarily between deer and a variety of mosquito species, but it can also infect humans. Reports in humans thus far of JCV are unusual and have been confined to the Midwestern and northeastern states. Most reported illnesses caused by Jamestown Canyon virus have been mild, but moderate-to-severe central nervous system involvement has been reported.

Powassan virus infection is caused by an arbovirus, which is similar to the mosquito-borne West Nile virus, but it is transmitted to people by infected ticks. Fewer than 60 cases of the disease have been detected in the United States and Canada since its discovery in 1958. In New Hampshire, Ixodes scapularis, or the blacklegged tick or more commonly deer tick, is capable of transmitting the virus to people. A tick needs to be attached to a person for a sufficient amount of time before it can cause disease. The time interval for Powassan virus is not known, but it is likely shorter than the time needed for Lyme disease (24–48 hours). Some people who are infected may experience mild illness or no symptoms. Powassan virus can also infect the central nervous system and cause brain inflammation.

Residents and visitors to New Hampshire should protect themselves and their family members by using an effective mosquito repellant that contains 30% DEET, wearing long sleeves and pants at dawn and dusk when mosquitoes are most active, and removing standing water from around your house so mosquitoes do not have a place to breed. Repellents with picaridin, IR3535 and some oil of lemon eucalyptus and para-menthane-diol products also provide protection.

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Dr Patricia Quinlisk discusses cyclospora outbreak in Iowa--July 20, 2013

Interview with Dr Patricia Quinlisk on Cyclospora. Dr. Quinlisk is from the Iowa Dept. of Public Health Medical Director and State Epidemiologist

























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Sunday, July 14, 2013

Potential Hot Spot for Avian Flu Transmission Identified in Western Alaska

From USGS News Release:

ANCHORAGE, Alaska — Low-pathogenic avian influenza viruses with Eurasian genes have been found among birds in the Yukon-Kuskokwim Delta of western Alaska, supporting the theory that the area is a potential point of entry for foreign animal diseases such as the more highly pathogenic H5N1 strain, according to a new study by U.S. Geological Survey scientists.

The Yukon-Kuskokwim Delta is an important breeding ground for many bird species and is located where multiple migratory flyways converge, providing opportunities for avian pathogens to spread. Among these pathogens are H5N1 avian influenza, which occurs in both low-pathogenic and the more dangerous highly pathogenic forms.  

After the outbreak of the highly pathogenic H5N1 strain of avian influenza in wild birds of China in 2005, the USGS and the U.S. Fish and Wildlife Service, in cooperation with the Yukon-Kuskokwim Health Corporation,  the Kawerak Tribal Corporation and other partners, conducted four years of testing wild migratory birds in western Alaska for the highly pathogenic H5N1 strain. 

In a paper published by the USGS and the USFWS scientists no highly pathogenic forms of avian influenza were found in more than 24,000 samples tested from 82 species on the Yukon-Kuskokwim Delta from 2006 to 2009, however, 90 low-pathogenic strains of the virus were obtained from these Alaskan samples.  Low-pathogenic avian influenza viruses are common among wild birds and do not cause mortalities to the degree often seen with highly pathogenic forms of the virus, said USGS research geneticist Andrew Reeves, lead author of the paper. The significance of this study is that it demonstrates that viruses with genes of Eurasian origin can enter North America via migratory birds. 

In addition, researchers discussed how low pathogenic virus samples from birds further from Asia contained fewer genes attributable to Eurasian strains.  

"This finding supports a 'dilution-by-distance' idea we've hypothesized in other studies," Reeves said. "Birds sampled further from Asia, such as in the lower-48 United States, very rarely contain avian influenza viruses with Eurasian genes, but in Alaska they are more common."  

"Many of the bird samples used in the study were provided by subsistence hunters in 11 villages throughout the Yukon-Kuskokwim Delta who collected samples from many species, including ducks, geese, swans and shorebirds," said Kim Trust of the USFWS.  

"Without our partners in western Alaska, we would not have the robust data set that supports the findings in this paper," Trust said.  

Reeves added that the current study provides support for retaining the Yukon-Kuskokwim Delta as a high-priority region for the surveillance of potentially harmful avian pathogens. 

The paper in the Journal of Wildlife Diseases, "Genomic analysis of avian influenza viruses from waterfowl in western Alaska, USA," by Andrew Reeves, John Pearce, Andrew Ramey, Craig Ely, Joel Schmutz, Paul Flint, Dirk Derksen and Hon Ip of the USGS and Kimberly Trust of the USFWS, is available online.

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Saturday, July 13, 2013

A Conversation About MERS Coronavirus: Dispatch Radio

With the latest case count of Middle East respiratory syndrome coronavirus (MERS-CoV) now standing at 80, there has been a great deal of attention given to this relatively new viral outbreak.

On the Saturday, July 6 Dispatch Radio program, I had the opportunity to talk to Professor of Microbiology and Immunology at Columbia University, Dr. Vincent Racaniello, about MERS.
Listen to the podcast here. The interview starts at the 23:10
There has been a lot of comparisons between the MERS coronavirus and the related Severe acute respiratory syndrome (SARS) that sickened over 8000 and killed 775 a decade ago. I asked Dr. Racaniello to explain the difference between the two viruses concerning  ability to cause disease, how lethal they are and human-to human transmission.
Racaniello says SARS appeared in China in 2003, infected thousands, killed nearly 800 and “then for reasons we still don’t understand, it disappeared.”
That virus [SARS] was not bad at spreading among people, 10% lethality, which is high. About a year ago, a new coronavirus emerged in the Middle East, the MERS coronavirus.
“So far it’s not particularly good at spreading person-to-person, with about 80 infected, Racaniello adds.
However, he does point out that the data is not really available to clearly answer that.
With the numbers of MERS cases at 79 (at the time of the show), I asked Racaniello if he thought the numbers may be higher due to undetected cases.
“Absolutely, he said. I think that the 79 cases are the ones where the people have got very sick, they’ve gone into hospitals and they’ve been diagnosed with this virus infection.
“With most viruses, many, many people get infected and have either mild symptoms, so they never go to a health care provider, or they have no symptoms at all and we have no way of detecting that for the MERS coronavirus yet because we don’t have the right diagnostic test.
“But as soon as those are developed, then we can go out into populations and say, how many people are in fact infected, and it could be that thousands of people have been infected with very little disease, which of course would bring the mortality rate pretty far down.”
Concerning the source of MERS, some have attributed it to bats, at least one report suggested a link with camels. “The bat story comes from the fact that when you sequence the genetic information of viruses and tell which are related to other viruses.
“The closest relative of this virus, aside from other coronaviruses that infect humans, is a virus isolated from a bat in 2008. It suggest, but it doesn’t prove, the virus may have originated in bats. SARS coronavirus originated in bats as well.
“Bats harbor a lot of diverse coronaviruses so it wouldn’t be unusual the virus jumped from bats, he said. People in general don’t really contact bats very frequently, so the idea that there is an intermediate animal went through. In the case of the SARS coronavirus, we think the virus went from a bat, to a Palm civet then to people, and it could be that in this case with the MERS coronavirus, it originated in bats, and it may being going through camels, as there has been reports of individuals getting sick after being close to camels.”
However, Racaniello points out that there are many cases where patients don’t have a contact history with animals of any kind. “So you have to wonder if the virus isn’t spreading in people already”, he adds.
I asked Racaniello about the diverse conclusions and statements from scientists from the Pasteur Institute in France who suggest that MERS-CoV does not yet have pandemic potential, and the statement in May by  WHO Director-General Dr Margaret Chan at the 66th World Health Assembly (WHA) who stated, “The novel coronavirus is a threat to the entire world.”
Who is closer?
“I think the Pasteur scientists are probably closer, Racaniello answers. Listen, it’s infected 80 some people, in the scheme of the world, this is not very much.
“As far as we know, this virus can’t spread efficiently among people so that’s why we say it doesn’t have pandemic potential.”
Racaniello does note that Dr. Chan is speaking as head of WHO and has to be very cautious. “If this virus somehow changed, it could acquire pandemic potential, so she’s sending out a message to health organizations globally that we need to keep an eye on this virus and get ready in case it should get more serious.”
The question, What is the threat of MERS entering the United States and are we prepared? was posed to the professor.
“That’s a very interesting question, I think it might of already come into the US, with global travel being as easy as it is. It’s very easy to imagine that someone has been infected in the Middle East, has no fever, no symptoms, has flown to the US shedding virus on the plane and within the US.
“So far, we don’t have any evidence that’s happening, but it certainly could be going on and we wouldn’t be able to detect it, especially if people haven’t been sick yet.
“It’s quite likely that the virus is here already, or will soon be brought into the US. Then the question would be, what would happen?
“Like we’ve seen in the Middle East, mainly really sick people have been infected with this virus, so you could imagine the same happening to a very sick person here in the US. You might get a few cases here of infection and that would trigger a lot of panic I think.”
Racaniello says, “Unfortunately, we don’t have any therapeutics for it–we don’t have a vaccine, we don’t have any antiviral drugs, the best we could do is try to limit people traveling and interacting with one another. But as you probably could guess would be virtually impossible.”
Without vaccines or antiviral drugs, it’s really hard to stop viral spread.
“I would guess if this virus came in to the US in a form that could transmit effectively among people, it would spread pretty efficiently. The good news is that hasn’t happened yet, even with global travel”, Racienello said.
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Sunday, June 30, 2013

Conjunctivitis increases reported in Japanese schoolkids due to eyeball licking (Video)

Japanese schoolteachers have been concerned of late because an increased number of middle school children have been showing up to class wearing eyepatches and sporting a raging case of conjunctivitis, or "pink eye", according to Daily Mail report June 13.

Image/Video Screen Shot
What is being called the new "second base", the new eyeball-licking trend called “worming", or technically “oculolinctus” is the latest expression between, let's say, two people who really like each other.
Definition: Oculolinctus refers to achieving sexual gratification from licking a person's eyeballs.
It's all the craze in Japan; however, this strange fetish doesn't come without risks.
It has led to a surge in cases of eye infections and can even cause blindness, doctors have warned,” the report said.
‘Nothing good can come of this,’ Dr David Granet, a San Diego ophthalmologist, told The Huffington Post. ‘There are ridges on the tongue that can cause a corneal abrasion. And if a person hasn't washed out their mouth, they might put acid from citrus products or spices into the eye.’
Dr Phillip Rizzuto, from the American Academy of Ophthalmology, added that eyeball licking can cause blindness as the bacteria found in the mouth can damage eye tissue.
Conjunctivitis is a common eye condition worldwide. It causes inflammation (swelling) of the conjunctiva -- the thin layer that lines the inside of the eyelid and covers the white part of the eye. Conjunctivitis is often called "pink eye" or "red eye" because it can cause the white of the eye to take on a pink or red color. The most common causes of conjunctivitis are viruses, bacteria, and allergens.
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Texas: Guatemalan man, detained by Immigration, dies from rabies

A Guatemalan man being held in custody by U.S. Immigration and Customs Enforcement (ICE) since a month ago, has died from rabies, believed to be contracted prior to crossing the border,according to an ICE press release June 12.

According to immigration officials, the timeline of events related to 28-year-old Federico Mendez-Hernandez is as follows:
Mendez-Hernandez was taken into custody on May 9 by US Border Control on the Rio Grande and custody was transferred to on May 12. At the time he was captured, he showed no signs or symptoms of illness.
Approximately nine days after being apprehended, Mendez-Hernandez began to show some symptoms consistent with rabies and was ultimately taken to Christus Spohn Memorial Hospital in Corpus Christi.
Last Friday, laboratory analysis performed by the Centers for Disease Control and Prevention (CDC) confirmed Mendez-Hernandez had rabies.
It is unclear exactly how, when or where he contracted the lethal viral disease, information acquired via laboratory testing reveals he had a canine rabies virus variant common in Central America.

Federal and Texas health officials are interviewing people with contact with Mendez-Hernandez to determine rabies risk, such as contact with bodily fluid like saliva and tears to determine the need for post exposure rabies prophylaxis, despite there never being a confirmed person-to-person transmission of rabies.
According to the World Health Organization (WHO), Rabies is a zoonotic disease (a disease that is transmitted from animals to humans) that is caused by a virus. It is known to be present on all continents except Antarctica and infects domestic and wild animals.
Rabies is spread to people through close contact with infected saliva via bites or scratches. The main route of rabies transmission to humans is the bite of rabid dogs. Most of the deaths occur in the absence of post-exposure prophylaxis. Rabies is nearly always fatal when left untreated.
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Purdue scientists have a jump on MERS coronavirus treatment going back to SARS

Image/Maureen Metcalfe; Azaibi Tamin
Researchers from the West Lafeyette, Indiana university have a "leg up" on developing a treatment for the new Middle East respiratory syndrome coronavirus, or MERS-CoV, thanks to work they did on a related virus in the past, according to a Purdue news release June 17.

The research team of Andrew Mesecar and Arun Ghosh, who previously created a compound that prevents replication of the virus that causes SARS, are testing compounds that could lead to potential treatments for the new MERS-CoV virus. Because of their previous research and expertise, the process will be reduced to months instead of years.
"MERS-CoV and SARS are similar, yet distinctly different coronaviruses," Mesecar said. "Our understanding of the prime targets for treatment of the SARS virus and the molecular inhibitors we have designed against it give us a good head start in finding a potential treatment for MERS-CoV."
"While MERS-CoV appears to be more virulent than SARS, molecular scaffolds and design concepts that we developed against SARS are very beneficial and timely," Ghosh said. "Using our expertise in structure-based design and drug development, our team has already synthesized a number of specific MERS-CoV inhibitors."
Globally, from September 2012 to date, WHO has been informed of a total of 77 laboratory-confirmed cases of infection with MERS-CoV, including 40 deaths.
Coronaviruses are a large family of viruses that includes viruses that may cause a range of illnesses in humans, from the common cold to SARS and animal diseases.
MERS-CoV is not the same coronavirus that caused SARS.
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Sunday, March 10, 2013

New rapid test can detect Group B strep colonization in 6 1/2 hours: Study


HOUSTON – (March 8, 2013) – A more rapid laboratory test for pregnant women to detect potentially deadly Group B strep (GBS) has been successful at identifying GBS colonization in six and a half hours, according to the results of a study from The University of Texas Health Science Center at Houston (UTHealth).

The more rapid test could be helpful for the 13 percent of patients who experience pre-term labor before they are screened for GBS, which usually occurs between 35 and 37 weeks of gestation. The current standard test takes 48 hours. Antibiotics can be administered at the time of delivery to kill the bacteria.

“This new test could change the management of patients who present to labor and delivery with threatened preterm labor and aren’t expected to deliver right away,” said Jonathan Faro, M.D., Ph.D., assistant professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at The University of Texas Medical School at Houston, part of UTHealth. “It would likely gain use in this patient population, which is a small number, but still very significant clinically. We could target this population and this would help cut down on overuse of resources and minimize our contribution to the increased level of bacterial resistance.”

The new test, developed by NanoLogix, can also detect antibiotic sensitivities for women who are allergic to penicillin, saving the additional 48 hours the standard test for antibiotic sensitivity takes, Faro said.


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Sunday, December 23, 2012

Norovirus confirmed as cause of outbreak that sickened 85 in Thunder Bay

Image/CDC

Thunder Bay health officials report that the gastrointestinal outbreak that sickened at least 85 people linked to three events catered by Maltese Grocery has been laboratory confirmed as norovirus, according to a Thunder Bay District Health Unit news release Dec. 21.
"We are very sorry for everyone who has been affected and we take full responsibility," say Lisa and Dave Maltese, owners of Maltese Grocery. "We are working with the Health Unit and have taken every precaution to ensure this does not happen again. We thank our customers and friends for their ongoing support through this difficult time."
The grocery store suspended it’s catering operations late last week after initial reports of illnesses in people attending social events catered by the Thunder Bay establishment.
Health officials say now that they determined the source of the outbreak, which appears to be a food handler, Maltese Grocery will be reopening catering operations. The grocer has a good inspection record and has been fully cooperative throughout the investigation.
CBC News reports that Maltese Grocery is making some additional changes to its cleaning and hand-washing procedures, including the use of new chemicals and sanitizers.
"We are confident in the steps that have been taken by Maltese Grocery," says Abby Mackie, senior public health inspector.
Earlier in May, another Thunder Bay establishment, This Old Barn, was linked to a norovirus outbreak that sickened 136 people who dined at a Mother’s Day Buffet.
Noroviruses are a group of viruses that cause the “stomach flu,” or gastroenteritis in people.
The symptoms include nausea, vomiting, diarrhea, and some stomach cramping. Sometimes people additionally have a low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. The illness often begins suddenly, and the infected person may feel very sick. In most people, the illness is self-limiting with symptoms lasting for about 1 or 2 days. In general, children experience more vomiting than adults do.
Norovirus is spread person to person particularly in crowded, closed places. Norovirus is typically spread through contaminated food and water, touching surfaces or objects contaminated with norovirus and then putting your hand or fingers in your mouth and close contact with someone who is vomiting or has diarrhea.
The Health Unit would like to remind the public of the importance of proper hand washing techniques as one of the most effective ways to prevent the spread of illness-causing germs. Taking 15 seconds to wash with soap and water will reduce your risk of getting a cold, the flu and other common infections.
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Europe measles cases return to pre-2010 levels: ECDC

Image/CIA

The EU has returned to similar numbers of measles cases as seen before the large outbreaks of 2010 and 2011.

The new December Measles and Rubella Monitoring report by ECDC shows that the total number of measles cases in the EU is 7,016 for 2012 compared to some 30,000 for 2011.

Individually, 12 of 29 EU/EEA countries had less than one case of measles per million population in the last 12 months, low enough to meet the WHO elimination target set for 2015. 
However, five countries: France, Italy, Romania, Spain and the United Kingdom accounted for 94% of the reported cases, according to an European Centre for Disease Prevention and Control news release Dec. 21.

Here are some other measles developments from the surveillance report:

  • The 29 contributing EU/EEA countries reported 7,016 cases of measles from January to October 2012 and 8,795 cases during the last 12-month period from November 2011 to October 2012.
  • The number of reported cases is substantially lower in 2012 compared with the same period in 2011, but the aggregated EU/EEA notification rate for the last 12-month period continues to exceed the elimination target of less than one case per million population.
  • Of the cases reported in the last 12-month period for which vaccination status was available, 82% were unvaccinated.
  • Fifteen percent (1,279) of the cases were under one year of age; of these, 97% were reported as unvaccinated.
  • Of the 2,254 cases aged 1–4 years, targeted by vaccination programs in all European countries, 77% were reported as being unvaccinated.
  • There were no measles-related deaths reported during the last 12 months but 10 cases were complicated by acute measles encephalitis.

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