Tuesday, November 30, 2010

Transplanting Plum Island to Kansas: is the country's food supply at risk?

The controversial animal disease research laboratory, Plum Island Animal Disease Center, located on the relatively remote island off the tip of Long Island will be moving to the heartland of America, Manhattan, Kansas, sometime on or around 2014.

The National Bio and Agro-Defense Facility (NBAF) will be planted on Kansas State University and according to the Department of Homeland Security (DHS), it will not be a laboratory of bioweapons saying that anthrax, plague, ebola and smallpox will NOT be studied there at the proposed state of the art BSL-4 lab. Ok, I’ll take the DHS at their word for the moment because my concern is not human pathogens, but animal pathogens.

There are eight animal and livestock diseases that will be studied at the facility; Nipah virus, Hendra virus, African swine fever, Rift Valley fever, Japanese Encephalitis virus, Foot and Mouth disease (FMD), Classical Swine fever and Contagious Bovine Pleuropneumonia.

So being in the heartland of America where there is hundreds of thousands if not millions of cattle and swine, based on previous safety and security issues from Plum Island and other facilities, how can we be sure that this will not devastate our food supply and economy?

I want to focus on Foot and Mouth Disease.

We know there were safety breaches at the old facility on Plum Island where even the Bush Administration acknowledged issues.

The most publicized was the 1978 where FMD was found in cattle outside the facility in holding pens. How devastating could something like this be to the livestock industry in Kansas and surrounding states?

And this does not include the numerous “in-house” incidents of contamination of FMD within the facility that Jay Cohen, undersecretary for Science and Technology acknowledged. FMD is so contagious that even a minor escape of the virus could be devastating to our livestock.

And these are just the cases that were reported. In Michael Carroll’s book, Lab 257, other safety mistakes are documented.

And Plum Island didn’t have the most impeccable record concerning security breaches either. In a Government Accountability Office (GAO) report, in July 2003, a year after Homeland Security had assumed control of Plum Island, eight foreign scientists were working in its biocontainment area without completed background investigations. The scientists were neither escorted nor monitored while in that sensitive area.

Working with BSL-4 pathogens requires extensive background checks and according to the USDA, background checks are done every 5 years. However, after a personnel record check it was found that a dozen employees, including several who work directly with serious pathogens hadn’t had a background check in over a decade.

And safety and security breaches happen at facilities outside the US also. Just a few years ago an outbreak of FMD is Surrey, England occurred and the strain of the virus was linked to a government laboratory near Pirbright.

There are a half dozen BSL-4 labs in the country. These labs handle the most dangerous pathogens known to man. However, only Plum Island is authorized to handle the extremely contagious in animals FMD.

In a DHS powerpoint presentation, safety and security for the new Kansas facility would be based on USDA and CDC regulations. But even with all the regulations in the world, things happen. Take the CDC itself as an example. Just a few years ago while a new BSL-4 facility at the CDC was being prepared for it’s unveiling, a lightning strike wiped out its power and the backup generators never came on. CDC officials maintained that even if the lab had been operating, there were enough safety controls to prevent pathogens from escaping. Does that make you feel more assured?

Other incidents have happened at facilities in Ft. Detrick, Seattle and Texas A&M.

What about employees accidentally transferring FMD out of the facility? At the current Plum Island location, employees are not allowed to have pets, cannot have contact with animals for one week after leaving the lab and other rules. Again, how assuring does this sound? At least at Plum Island, most employees live in the city. Employees at the future will certainly reside in a more rural setting.

So I guess the question is, is moving a facility working with Foot and Mouth Disease in the middle of livestock country the wisest option? I am not implying anything devious is afoot, but to err is human and certain errors could be devastating.

According to the USDA, Foot-and-mouth (FMD) disease is a severe, highly contagious viral disease of cattle and swine. It also affects sheep, goats, deer, and other cloven-hooved ruminants. FMD is not a threat to people and no human health risks are associated with the disease. FMD is caused by a virus. Signs of illness can appear after an incubation period of 1 to 8 days, but often develop within 3 days. There are seven known types and more than 60 subtypes of the FMD virus. Vesicles (blisters) followed by erosions in the mouth or on the feet and the resulting excessive salivation or lameness are the best known signs of the disease. FMD, however, can be confused with several similar diseases, including vesicular stomatitis and swine vesicular disease. Whenever mouth or feet blisters or other typical signs are observed and reported, laboratory tests must be completed to determine whether the disease causing them is FMD.

Though the virus has a relatively low mortality rate of 2-5%, to stop the rapid spread of the disease, slaughtering of large quantities of animals is required.

What is Scombroid fish poisoning?

With the recent recall of tuna from Beaver Street fisheries in Jacksonville, Florida, more people may have heard of the toxin. I want to talk about scombroid a little further.

Scombroid fish poisoning is an acute clinical syndrome caused by histamine toxicity from the ingestion of spoiled fish.

The fish most commonly implicated in scombroid fish poisoning surprisingly are those from the family Scombridae. This includes tuna, mackerel, skipjack, albacore and bonito. Some non-scombroid fish like mahimahi, herring, anchovies and sardines have also been implicated. These fish are found worldwide in temperate and tropical waters and occasionally polar waters.

Histamine is responsible for the symptoms of scombroid fish poisonoing. The fish do not have high levels of histamine at the time they are caught, instead they contain histidine. The histamine however is produced by the process of spoilage by several species of bacteria like E. coli, Klebsiella pneumoniae, Plesiomonas shigelloides, Serratia marcescens and numerous others. This happens when the fish reaches temperatures of 20-30C.

This often happens when refrigerated fish is allowed to warm for a period of time before cooking. The histamine is heat-stable and is not destroyed by cooking.

The symptoms may appear from a few minutes to several hours after ingesting the fish, but typically around 30 minutes.

At first you may feel a flushed and a hot sensation on the skin. Dizziness, headache, a burning sensation in the mouth and itching may occur. Gastrointestinal symptoms like diarrhea are also common but vomiting is not. The typical duration of the intoxication is 4 hours.

A skin rash appearing as sunburn may also happen.

In more severe cases, difficulty in swallowing and respiratory distress can occur. Deaths are rare with scombroid fish poisoning.

The diagnosis of scombroid fish poisoning is made based on symptoms that are pretty obvious. In addition, it’s common to see several people affected at one time. Laboratory testing on the patient is not useful in diagnosing scombroid. There is no specific treatment for scombroid, just treating symptoms and supportive care is available.

Monday, November 29, 2010

Denmark sees first case of infection with a NDM-1 bacterium

The enzyme NDM-1 first made news this past summer when physicians in the United Kingdom started seeing cases from patients who returned from getting medical procedures overseas.

Many other countries have already isolated bacteria with NDM-1 to include Australia, Belgium, Canada, Germany, Hong Kong, Japan, Kenya, the Netherlands, Norway, Oman, Singapore, Sweden, Taiwan, and the United States.

Now doctors out of Denmark are reporting the first case in the Danish country.

According to reports, the patient is a 57-year-old woman who was hospitalized in Bosnia-Herzegovina with septicemia in July. She was later transferred to Denmark where she had been living for some 15 years for treatment.

The enzyme known as NDM-1 (New Delhi metallo-β-lactamase 1) is carried in certain gram negative bacteria like E. coli and Klebsiella, and makes the bacterium resistant to the carbapenem class of antibiotics.

Many cases of infection with a NDM-1 bacterium have been implicated in patients that traveled to India or Pakistan for certain medical procedures like cosmetic surgery and imported the infection back in their home country. However, some reports say this is not the case anymore.

However, India has previously come out saying that this is propaganda to destroy the flourishing medical tourism industry in the country.

Currently patients seen with infections with bacteria that are NDM-1, most have been able to be treated with a course of several antibiotics, however scientists have found some strains resistant to all available antibiotics.

Infection experts say the best way to keep this from spreading is good infection control procedures like surveillance, handwashing and disinfecting equipment, rapidly identifying the bacteria and isolation of the patient.

According to reports out of Europe, NDM-1 is reported to have been found in 77 cases in 13 European countries. Of the 77 cases, seven people have died.

Sunday, November 28, 2010

BSL-3 Laboratory opens at the University of Wyoming

Since the 9/11 attacks and the creation of the Department of Homeland Security (DHS), biosafety level-3 and -4 labs have been sprouting up all over the country and the latest will be on the grounds of the University of Wyoming (UW) in Laramie.

The $25 million biosafety level 3 (BSL-3) laboratory will allow researchers “to work to help diagnose or identify diseases such as brucellosis and plague in a safe manner for the community as well as for our faculty and staff members." This is according to Frank Galey, UW College of Agriculture and Natural Resources Dean and head of the Wyoming Brucellosis Coordination Team.

According to a University of Wyoming press release, the 20,000 square-foot addition contains a 1,280 square-foot BSL-3 lab, a 2,600 square-foot BSL-2 lab plus other work rooms. The 5,860 square-foot renovation of the existing Department of Veterinary Sciences building, which houses the Wyoming State Veterinary Laboratory, includes modifications of the existing BSL-2 lab and conference and administrative offices.

Researchers at UW will be seeking solutions through improved modeling, testing, diagnosis, treatment and vaccine development," says UW President Tom Buchanan.

There are 4 levels of biosafety based on how dangerous the organism is and the level of containment. The Centers for Disease Control and Prevention (CDC) establishes these levels.

A biosafety level 1 (BSL-1) environment is used for working with well-characterized agents not known to consistently cause disease in healthy adult humans, and of minimal potential hazard to laboratory personnel and the environment for example non-pathogenic E. coli.

A BSL-2 is suitable for work involving agents of moderate potential hazard to personnel and the environment such as MRSA, Salmonella and influenza A.

A BSL-3 is appropriate for clinical, diagnostic, teaching, research, or production facilities in which work is done with indigenous or exotic agents which may cause serious or potentially lethal disease after inhalation. Examples of agents in this level are TB, anthrax and Rickettsia rickettsii.

The highest level is the BSL-4. This is used for working with dangerous and exotic agents that pose a high individual risk of aerosol-transmitted laboratory infections, agents which cause severe to fatal disease in humans for which vaccines or other treatments are not available like smallpox, Ebola and Marburg viruses.

To read more on this topic-- Biosafety in Microbiological and Biomedical Laboratories (BMBL) 5th Edition

Saturday, November 27, 2010

Purdue women’s forward, Drey Mingo, hospitalized with meningitis

The Purdue women’s basketball team will not be flying to Cancun, Mexico to play in the Caribbean Challengethis Thanksgiving.

Boilermaker redshirt junior, Drey Mingo, was hospitalized on Tuesday with a confirmed case of meningitis. The exact type of meningitis has not been specified, but according to an ESPN report, Mingo was in critical but stable condition.

According to a school release, team members and coaches had received prophylactic antibiotics to prevent the disease, which can be transmitted by way of exposure to coughing or saliva or other direct contact.

Meningitis can be very serious; as a matter of fact certain types of bacterial meningitis can be rapidly fatal without early treatment. It is one of the conditions considered to be a medical emergency that is related to infectious diseases. It is an infection within the subarachnoid space or throughout the meninges. Depending on the offending organism, meningitis is considered either septic (bacterial) or aseptic (viral).

The respiratory tract is the primary portal of many causes of meningitis, hence factors that predispose someone to pneumonia also do so with meningitis; alcoholism, diabetes, splenectomy and immunosuppression.

In bacterial meningitis, the following symptoms are typical: high fever, severe headache, stiff neck, photophobia (sensitivity to light), skin rashes and seizures. Quick treatment is paramount to prevent serious complications and death.

Permanent deafness, neurological problems and hydrocephalus are all sequelae.

Aseptic meningitis is associated with viral infections and is usually self-limiting. Some symptoms are like those in bacterial meningitis.

How can you prevent getting meningitis?

Some of the organisms that cause meningitis are spread via respiratory means. If you have close contact with someone with the disease, your risk is increased.

Handwashing is the key to preventing just about every contagious disease. Avoid certain types of foods if you are pregnant or immunocompromised because of the risk of Listeria.

There is a vaccination for Haemophilus influenza type B and pneumococcal meningitis as part of the immunization schedule for children less than two.

For adults older than 65, there is a pneumococcal vaccine that is recommended by the CDC.

For school age children, there is a vaccine for meningococcal meningitis. For your child to live in a college dormitory it is mandatory in many states.

Friday, November 26, 2010

Philippines DOH: 4 Filipinos contract HIV daily

While the HIV is declining in the majority of the world, the Philippines are seeing a surge of cases in 2010.

According to a new report by the Joint United Nations Program on HIV/AIDS (UNAIDS), new HIV infections have fallen by nearly 20% globally in the last 10 years, from 3.1 million people newly infected in 1999 to 2.6 million newly infected 10 years later.

AIDS-related deaths are down by nearly 20% in the last 5 years. In 2004, 2.1 million people died from AIDs-related illnesses compared to 1.8 million last year. And the total number of people living with HIV is stabilizing.

But this is in stark contrast to what is happening in the Philippines. The country is on course to double the number of cases from 2009. In 2009, there were 835 cases while so far this year there has been 1,305 cases in the first 10 months.

Some say the problem may be linked to condom-use, or should I say, the lack of condom use. While the Catholic Church considers condom use a sin, this may discourage Filipinos from the use of condoms.

According to Father Joel Jason, head of the Archdiocese of Manila’s Commission on Family and Life, “Using condoms is an offense against God. If you are abstinent and faithful, you won’t catch AIDS”. This is in contrast to what the Pope said just this past Tuesday.

HIV is the human immunodeficiency virus. It is the virus that can lead to acquired immune deficiency syndrome, or AIDS.

HIV damages a person’s body by destroying specific blood cells, called CD4+ T cells, which are crucial to helping the body fight diseases.

AIDS is the late stage of HIV infection, when a person’s immune system is severely damaged and has difficulty fighting diseases and certain cancers.

Thursday, November 25, 2010

Study: transmission patterns of 2009 H1N1 and seasonal H3N2 similar

This is according to a group from the Mount Sinai School of Medicine in New York City. The study is published in the online edition of the Journal of Virology.

Aerosol transmission of a seasonal H3N2 influenza virus is most efficient under cold, dry conditions and in temperate regions of the world activity peaks inthe mid-winter.However, with the 2009 H1N1 pandemic, an unusually high level of influenza virus activity over thespring and summer months was followed by a widespread epidemic which peaked in late October, months earlierthan usual.

To determine if the transmission patterns of the two viruses, researchers ran several aerosol transmission experiments to compare an earlier study that showed aerosol H3N2 transmission depended on cold and dry conditions.

Experimentally infected guinea pigs were placed with uninfected animals in the same environmental chamber.

The researchers found that both viruses transmit well at 65 percent relative humidity and 68 degrees. When the relative humidity was increased to 80 percent, there was no transmission of the 2009 H1N1 virus and only 25 percent of exposed guinea pigs contracted the H3N2 virus. Dry conditions with warmer temperatures also led to low levels of viral transmission. Neither virus transmitted when conditions were warm and humid.

Based on the above data, researchers conclude that the differences in the timingof outbreaks relative to the seasons are most likely not due to intrinsic differences in transmission between the pandemicH1N1 and seasonal H3N2 influenza viruses, instead it’s probably due to the population’s lack of pre-existing immunity, in other words, a large availability of susceptible hosts.

Wednesday, November 24, 2010

Six people die in Micronesia after eating endangered sea turtle

Six people, including 4 children died after consuming hawksbill turtle at a feast on the Chuuk State island of Murilo. In addition, more than 90 people became ill after eating the marine turtle.

The deaths were the result of chelonitoxism, a form of food poisoning caused by toxins in the turtle meat. Children are exceptionally susceptible to this affliction and there is no antidote for treatment.

The hawksbill turtle (Eretmochelys imbricata) and the green sea turtle (Chelonia mydas) are the two species known for chelonitoxism. Other species may also be implicated.

This type of food poisoning is rare and this is probably due to the fact that sea turtle are protected and eating sea turtle meat is taboo in some groups.

This type of food poisoning when it’s mild is characterized by a rapid onset of gastrointestinal symptoms and other non-specific symptoms. Recovery is usually complete within a week.

In the more moderate food poisoning, patients may experience a burning mouth and throat sensation. Neurological symptoms may also be manifest. This form usually takes a few weeks to recover from.

In the most severe form of the condition, multiorgan involvement is possible and the patient may lapse into a coma. The death rate is very high in this form, particularly in children.

There is no specific treatment for chelonitoxism, only supportive care is available. Cooking of the turtle meat does not destroy the toxin. The severity of the poisoning is also dependant on the amount of turtle meat consumed.

The hawksbill turtle is protected under the Convention on International Trade in Endangered Species.

Tuesday, November 23, 2010

Japanese drug company Eisai to provide free filariasis medicine

In a first for a Japanese pharmaceutical company, the CEO of Eisai, Haruo Naito announced a partnership between the company and the World Health Organization (WHO) to provide free of charge medication used in the treatment of the parasitic disease, lymphatic filariasis.

According to the agreement, Eisai will provide free of charge 2.2 billion tablets of diethylcarbamazine (DEC) to the WHO to be used to eliminate lymphatic filariasis in endemic countries.

The agreement is for Eisai to provide the drug for a six year period between 2012 and 2017. Production of the medicine is planned at Eisai's Vizag Plant in India.

Read more about lymphatic filariasis: “Travel Health: Lymphatic filariasis”

Monday, November 22, 2010

Bristol Palin receives suspicious “anthrax letter” at DWTS set

Reminiscent of the 2001 anthrax letters that were addressed to members of Congress and various media outlets which killed 5 and infected 17, an unidentified white powder was received at the Dancing with the Stars set addressed to none other than Bristol Palin.

Staff at CBS immediately contacted authorities which responded to an evacuated studio. Lab analysis of the powder turned out to be talcum powder.

In addition, part of the package reportedly contained a piece of hate mail for the former Alaska Governor’s daughter.

Some believe this is a reaction to Miss Palin’s controversial advancement to the top three of the dancing reality show.

The investigation continues…

Sunday, November 21, 2010

Canadian study links E. coli to several long term health issues

There may more problems from contracting the gastrointestinal pathogen E. coli than previously suspected according to a study done by researchers from Victoria Hospital in London, Ontario.

The researchers used data from the Walkerton Health Study where a city water system became contaminated with E. coli and Campylobacter in 2000 and an outbreak ensued.

In order to determine the long term health risks from the outbreak, researchers performed a prospective cohort study to evaluate the risk for hypertension, renal impairment, and cardiovascular disease within eight years of getting gastroenteritis from drinking the contaminated water.

Of the 1977 participants in the study, 54% experienced acute gastroenteritiswhile about a third sought medical attention.

Surveys, laboratory assessments and physical examinations were performed on the participants to track their health on an annual basis.

The study then compared those participants who experienced acute gastroenteritis to those that didn’t and the following was determined: Those who had gastroenteritis were 1.3 times more likely to develop hypertension, 3.4 times more likely to develop renal impairment and 2.1 times more likely to have a myocardial infarction, stroke, or congestive heart failure.

The researchers conclude that based on the data that gastroenteritis from drinking water contaminated with E coli O157:H7 and Campylobacter were associated with an increased risk for hypertension, renal impairment, and self reported cardiovascular disease.

Saturday, November 20, 2010

Philippines Department of Health signals alarm over rabies

The Philippines Department of Health (DOH) has reported 264 cases of rabies in the country so far this year. Of the 264, 206 people died from the lethal virus. Most cases of rabies in the Philippines are associated with dog bites.

264 cases sound high, but it is actually a sign of good progress in the island nation considering in 2008 there were 5658 documented cases!

Many cases are seen in schoolchildren during school vacation where they may play with unvaccinated animals.

With this in mind, The DOH is concerned of a surge of cases during the Christmas season when children will once again be out of school.

Worldwide in 2008, the Top 10 countries in cases of rabies were as follows:

India – 244,478
Bangladesh – 22,900
China – 13,995
Philippines – 5,658
Vietnam – 5,183
Pakistan – 2,843
Sri Lanka – 2,042
Myanmar – 1,683
Thailand – 1,377
Indonesia – 1,208

Rabies is an acute viral infection that is transmitted to humans or other mammals usually through the saliva from a bite of an infected animal. It is also rarely contracted through breaks in the skin or contact with mucous membranes.

According to the Control of Communicable Diseases Manual, all mammals are susceptible to rabies. Raccoons, skunks, foxes, bats, dogs, coyotes and cats are the likely suspects. Other animals like otters and ferrets are also high risk. Mammals like rabbits, squirrels, rodents and opossums are rarely infected.

What type of symptoms will it cause in humans?

Initially, like in many diseases, the symptoms are non-specific; fever, headache and malaise. This may last several days. At the site of the bite there may be some pain and discomfort. Symptoms then progress to more severe: confusion, delirium, abnormal behavior and hallucinations. If it gets this far, the disease is nearly 100% fatal.

Many island countries have eradicated rabies (Australia, Japan, New Zealand, and the United Kingdom for example) by use of vaccination and control measures. Maintaining a rabies-free status requires strict quarantine regulations.

Being an island nation, the Philippines could also eradicate the virus by following the same methods.

Friday, November 19, 2010

Cholera from Haiti makes it into Florida

The Florida Department of Health has announced that a woman who recently returned from Haiti has been diagnosed with cholera.

The cholera epidemic that has been ravaging Haiti has thus far has killed 1,110 people and hospitalized 18,383 according to the Haitian Health Ministry.

Florida State Surgeon General Ana M. Viamonte Ros said in a written statement that "We are working with our health care partners to ensure appropriate care of this individual and prevent the spread of this disease within the community."

There should be no great cause for concern however since the actual spread of cholera in the United States is minimized given the availability of adequate sanitation and clean water.

Cholera is an acute bacterial intestinal disease characterized by sudden onset, profuse watery stools (given the appearance as rice water stools because of flecks of mucus in water) due to a very potent enterotoxin. The enterotoxin leads to an extreme loss of fluid and electrolytes in the production of diarrhea. It has been noted that an untreated patient can lose his bodyweight in fluids in hours resulting in shock and death.

It is caused by the bacterium, Vibrio cholerae. Serogroups O1 and O139 are the types associated with the epidemiological characteristics of cholera (outbreaks).

The bacteria are acquired through ingestion of contaminated water or food through a number of mechanisms. Water is usually contaminated by the feces of infected individuals. Drinking water can be contaminated at the source, during transport or during storage at home. Food can get contaminated by soiled hands, during preparation or while eating.

Beverages and ice prepared with contaminated water and fruits and vegetables washed with this water are other examples. Some outbreaks are linked to raw or undercooked seafood.

The incubation for cholera can be from a few hours to 5 days. As long as the stools are positive, the person is infective. Some patients may become carriers of the organism which can last for months.

Cholera is diagnosed by growing the bacteria in culture. Treatment consists of replacement of fluids lost, intravenous replacement in severe cases. Doxycycline or tetracycline antibiotic therapy can shorten the course of severe disease.

Thursday, November 18, 2010

London College develops prototype parasite detector

A group of undergraduates from the Imperial College of London won numerous awards at the International Genetically Engineered Machine Competition for a prototype device that detects the parasite Schistosoma in water supplies.

The device, aptly called Parasight, is designed to detect Schistosoma parasites in water so people can avoid these water sources.

Parasight does this by use of a modified normal environmental bacterium, Bacillus subtilis which has been modified to detect protease that is excreted from the Schistosoma parasite. The protease leaves a specific peptide on the surface of the Bacillus basically telling the bacterium the parasite is present. This triggers a chemical reaction in the water turning it yellow letting the user of the Parasight know that Schistosoma is present in the water.

Currently only very time consuming and expensive methods are available to check for Schistosoma in water samples, which makes it’s out of reach for poor nations that are endemic for the parasite.

Schistosomiasis is an acute or chronic disease, produced by parasites called Schistosoma. It is not a single disease, but a disease complex initiated by several different species of schistosomes. The three most important human species are Schistosoma mansoni, S. haematobium and S. japonicum.

Geographically, the 3 species are found in Africa (S.mansoni and S. haemotobium), the Middle East (S. haemotobium), the Arabian Peninsula, Brazil, Suriname, Venezuela and the Caribbean (S. mansoni) and China, the Philippines and parts of Indonesia (S. japonicum).

The schistosomes are found in fresh water. This water gets contaminated by infected people working in the rice field, fisherman in the lake or children playing who indiscriminately defecate or urinate in the water.

Schistosomes have a very complicated life cycle. The eggs in the feces or urine hatch and the ciliated miracia swim to the specific snail species where it penetrates and goes through a couple of stages in the snail. After a period, thousands of the infective stage are released and swim around looking for a human to infect.

The free-swimming cercariae are capable of penetrating the unbroken skin of the human host.

In the human the adult schistosomes eventually end up in the blood vessels of the intestines (S. mansoni and S. japonicum) or bladder (S. haemotobium). Here they produce eggs which are the cause of the disease.

The drug of choice is praziquantel for infections caused by all Schistosoma species.

Tuesday, November 16, 2010

Suspected foodborne Chagas outbreak in Venezuela

The Corporation for Labor and Human Development in Health, Corposalud, confirmed an outbreak of Chagas where 6 people became infected and a two year old child died. The five survivors are relatives of the child.

The outbreak occurred in the Andean region Junin municipality near the Columbian border.

Officials at Corposalud suspect the outbreak was caused by food contaminated with the parasite since the patients did not present with scratches or bites.

Director of Corposalud, Juan de Dios Delgado said that the residents of Junin should be alert to symptoms of abdominal pain, malaise, and fever, which might indicate a possible infection, and consult the closest health center to determine whether they have the disease. He also urged people to use potable water and follow the correct hygienic measures when handling food and in the areas where it is prepared in order to stop the spread of the disease.

Chagas disease, caused by the protozoan Trypanosoma cruzi, is responsible for a greater disease burden than any other parasitic disease in the New World. Infection occurs when the triatomine vector defecates during its blood meal and fecal material containing the parasite is inoculated through the bite wound or mucous membranes.

The oral mode of transmission of Chaga’s disease is being increasingly recognized in the region. It is associated with the contamination of fresh food or beverages with intestinal contents of triatomid (kissing) bugs.

Monday, November 15, 2010

Nigeria to get guinea worm certificate of eradication next year

Chief consultant epidemiologist in the Federal Ministry of Health, Henry Akpan, said on Wednesday that the World Health Organization (WHO) will present Nigeria with the certificate of eradication in 2011.

It has two years since Nigeria had a case of guinea worm infestation, with the case being reported on November 10, 2008. This is really quite the achievement considering Nigeria was as recently as 1988, the guinea worm leader globally. That year the country reported over 653,000 cases.

Nigeria implemented numerous intervention measures to achieve the elimination of this parasitic disease. Things like health education, cloth filters, free treatment and an improved water supply were instrumental in the eradication.

Akpan, however, cautioned that in order to secure the certification by WHO, there have to be 36 consecutive months of zero guinea worm disease cases reported, in addition to meeting other criteria, which include nationwide publicity and knowledge about guinea worm disease, cash rewards, adequate safe water supplies in the villages at risk of the disease, and maintenance of nationwide certification with regard to standard guinea worm disease surveillance.

Guinea worm disease is a parasitic disease of the subcutaneous and deeper tissue. It is caused by the roundworm, Dracunculus medinensis.

Most countries where this disease is endemic are in Africa; Ghana, Mali, Niger, and Sudan. It has been eradicated from 20 formerly endemic countries through a vigorous eradication program.

The adult female worm in an infected person migrates to the skin’s surface and a blister is produced. Upon contact with water, the blister ruptures and the adult releases larvae into the water.

In the stagnant fresh water the larvae are ingested by copepods (a tiny crustacean). People later swallow the infected copepods from drinking water from infected step wells, ponds and other surface water.

From here the larvae migrates and penetrate the stomach and intestinal wall then they mature into adults. The female mates and grows to full maturity and subsequently migrates to the subcutaneous tissues (frequently the legs and feet) and the cycle continues.

The adults can grow up to one meter in length. The emerging worm is removed by rolling it on a stick a few centimeters each day.

Symptoms typically include burning and itching of the skin in the area of the lesion, and frequently fever, nausea, vomiting, hives accompany the blister formation.

Some of the more serious problems of guinea worm disease are after the blister ruptures, secondary bacterial infections can occur. Tetanus infections can also happen at the site of the lesion.

After a person gets infected with Dracunculus it takes about a year for disease to occur. Because there is no acquired immunity to the infection, people can get reinfected repeatedly.

Sunday, November 14, 2010

Hepatitis B outbreak at a North Carolina assisted living facility

North Carolina health officials said that 8 residents of the Glen Care of Mount Olive assisted living center in Wayne County have contracted hepatitis B virus (HBV). Of the eight, five residents have died since August and the other three have survived. All five residents who died were over the age of 63.

It is likely that the transmission of the virus occurred when employees used the same glucose monitors. All 8 residents underwent glucose monitoring at the center. The investigation showed that glucose monitors were stored together and were not labeled or disinfected after use.

Hepatitis B could be transmissible in this manner and blood does not have to be visible.

Officials at Glen Care deny the suggestion that employees would used the same pen on multiple patients. They suggest that the virus was brought in from the outside of by residents of the facility sharing drinks or having sex.

State health officials have issued a correctible plan to the center to tighten up infection control practices including washing instruments with a bleach solution instead of just soap and water.

According to the CDC, Hepatitis B is a contagious liver disease that results from infection with the Hepatitis B virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis B is usually spread when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact with an infected person or sharing needles, syringes, or other drug-injection equipment. Hepatitis B can also be passed from an infected mother to her baby at birth.

Hepatitis B can be either acute or chronic. Acute Hepatitis B virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis B virus. Acute infection can — but does not always — lead to chronic infection. Chronic Hepatitis B virus infection is a long-term illness that occurs when the Hepatitis B virus remains in a person’s body. Chronic Hepatitis B is a serious disease that can result in long-term health problems, and even death.

The best way to prevent Hepatitis B is by getting vaccinated.

17 poisoned by ciguatera toxin after eating barracuda in Vietnam

The Nha Trang Pasteur Institute reported that 17 people were poisoned with ciguatera toxin after eating barracuda.

Barracuda is just one of the 400+ species of fish implicated in this food borne illness that's relatively common in several areas of the world. The food borne illness is called ciguatera food poisoning.

This toxin is the result of the accumulation of marine algae and the toxins they produce passing up the food chain. These marine algae hang on to dead coral and seaweed. They are then eaten by herbivore fish which are subsequently eaten by predatory reef fish which concentrates the toxin in its tissue. People get this food borne toxin from eating these contaminated larger fish. The reef fishes are more likely to get contaminated during storms and other turbulence.

After eating the affected fish (by the way the fish does not get sick from the toxin and actually tastes good) in as little as a couple of hours symptoms may appear. Gastrointestinal symptoms like diarrhea, nausea and vomiting tend to appear early. Then a feeling of weakness and hypertension may occur in addition to complaints of intense itching.

Some mild to severe neurological symptoms are common with ciguatera; dizziness, impaired coordination, blurred vision and even coma may be seen in severe cases.

An unusual characteristic that is common in ciguatera is temperature reversal. This may be seen from 2 to 5 days after eating the fish. Hot objects seem cold and cold objects can give a shock-like sensation. There have been serious injuries because a person was unable to recognize extremely hot sensations. Other odd symptoms are food may taste metallic and teeth may seem painful or loose.

The gastrointestinal symptoms usually resolve in a couple days; however neurological symptoms may last for months or years. Symptoms may come back after ingesting certain foods and drinks; alcohol, caffeine, nuts and fish.

There are no laboratory tests to diagnose this disease and it's based on clinical symptoms and a history of eating an offending fish. Some studies have shown that IV mannitol is effective in providing relief and recovery if taken within the first 72 hours of intoxication. Other than that most treatment is for the various symptoms the person may have.

So how can you prevent getting this potentially serious toxin? Prevention can be difficult since the toxin in the fish cannot be killed by cooking and there is no offensive odor or appearance to the fish. So the only way to truly try to prevent this intoxication is to avoid eating large reef fish or getting your fish through a reputable supplier.

Friday, November 12, 2010

ViroStat introduces new monoclonal antibodies for detection of Trichomonas

ViroStat, Inc of Portland, Maine has introduced a new set of monoclonal antibodies for two sexually transmitted parasites, Trichomonas vaginalis and Trichomonas foetus.

The monoclonal antibodies can be used in the rapid detection of these parasites. Validated applications of these antibodies include immunoflourescence staining, ELISA and lateral flow.

Trichomonas foetus is a sexually transmitted pathogen of several animal species including cattle and cats and leads to reproductive failure in these animals.

Trichomonas vaginalis is the most common pathogenic protozoan infection in humans in developed countries. It is spread through contact with vaginal and urethral discharges during sexual intercourse.

Its high prevalence in carriers is associated with adverse outcomes during pregnancy. Diagnosis of this parasite commonly involves visual examination of microscopic smears (wet mount). Culture methods are also available; however turnaround time may take several days.

In North America alone it is estimated that in excess of 8 million new cases are reported annually. The World Health Organization (WHO) estimated that 180 million infections are acquired annually worldwide.

Artesunate proves superior to quinine in treating falciparum malaria

According to a study by Professor Nicholas White of Mahidol University in Thailand and his colleagues published in the Lancet points to the use of artesunate for the treatment of severe falciparum malaria over the current drug of choice, quinine.

The open-label, randomized trial included 5,425 children with severe falciparum malaria – by far the most dangerous of four types of malaria affecting humans in several African countries. Of the children, 2,713 were treated with artesunate and 2,713 with quinine. There were 230 deaths (8.5 percent) in the artesunate group and 297 deaths (11 percent) in the quinine group.

According to the above numbers, the death rate was over 22 percent lower with children treated with artesunate, plus serious side effects like convulsions or coma were noted less frequently.

The major obstacle to getting this new drug out to those who would benefit from it is that artesunate does not good manufacturing standards certification, a blockade keeping many children from getting this effective treatment.

According to the CDC, Malaria is a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness. Four kinds of malaria parasites have long been known to infect humans: Plasmodium falciparum, P. vivax, P. ovale, and P. malariae.

P. falciparumis the type of malaria that is most likely to result in severe infections and if not promptly treated, may lead to death.

Thursday, November 11, 2010

The severe problem of Hepatitis C in Egypt

Egypt, known for the pyramids and the Sphinx, also has a much less desirable notable; it has the highest incidence rate of hepatitis C in the world.

The numbers are actually astounding. More than 500,000 new cases are reported annually and 7 out of 1000 Egyptians get infected per annum.

According to the Egyptian National Committee on Viral Hepatitis, 9.8 per cent of Egyptians are HCV infected, but “unofficial” sources like physicians believe the number is closer to 15 or 20 percent.

What is the explanation for this dramatic prevalence, especially a viral infection that infects only about 2 percent of the world’s population?

According to findings of a recent study published in the Proceedings of the National Academy of Sciences, Egypt and other Middle Eastern and North African countries suffer from a high amount of unnecessary injections and transfusions with reuse of needles and syringes.

It actually goes back several decades when doctors in the Nile River area used injectable treatments for the treatment and control of schistosomiasis. Certainly unsterilized, reused needles were a problem back then.

In addition, especially with the rural Egyptian poor, medications of questionable efficacy and superstitious medical practices have worsened the cases.

Hepatitis C is a contagious liver disease that results from infection with hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C is usually spread when blood from a person infected with hepatitis C virus enters the body of
someone who is not infected.

Hepatitis C can be either "acute" or "chronic". Acute hepatitis C virus infection is a short-term illness that occurs within the 1st 6 months after someone is exposed to hepatitis C virus. For most people, acute infection leads to chronic infection. Chronic hepatitis C is a serious disease than can result in long-term health problems, or even death. There is no vaccine for hepatitis C.

Wednesday, November 10, 2010

California sea lions dying of leptospirosis off Oregon’s coast

Autopsies on dozens of California sea lions that have found off of Oregon’s coast have suggested that they may have died from the bacterial infection, leptospirosis.

According to Oregon State University’s Jim Rice, they are getting daily calls about sick or dead sea lions.

These findings do set off an alarm concerning a threat to human health. Pet dogs for example can pick up the disease through contact with sick or dead sea lions. Rice strongly recommends that people visiting coastal areas avoid sea lions and keep their dogs on a leash.

Rice goes on to describe what a leptospirosis striken sea lion appears, “typically, sea lions with leptospirosis are quite emaciated and lethargic.”

In addition, California sea lions that are infected with leptospirosis show the unusual behavior of drinking water. Healthy sea lions get the water they need through the food they eat.

Leptospirosis is a spirochetal bacterial infection caused by the bacterium Leptospira interrogans. Exposure to fresh water and wet soil contaminated by the urine of an infected animal, rats are most common, is where humans typically pick up the infection.

It is commonly considered an occupational disease for those who work outdoors or with animals. Recreational activities which involve exposure to fresh water contaminated with infected animal urine are also a risk for leptospirosis.

Tuesday, November 9, 2010

The aftermath of Typhoon Juan and recent flooding may be waterborne diseases

The northern parts of the island of Luzon have gone through a lot in the past several weeks with a super typhoon making landfall there and more recently, torrential rainfall which resulted in flooding and landslides.

Now with these problems basically finished and subsided, health officials in Northern provinces are now concerned with waterborne illness.

This concern really came to light with a report that a 13 year old boy from Isabela province has been diagnosed with leptospirosis.

Provinces particularly hard hit by rain and flooding include Isabela, Cagayan, Aurora, Quirino and Kalinga.

Leptospirosis and diarrheal diseases are common infectious disease issues after intense flooding like that experienced in Northern Luzon.

Malaria imported from Ghana among airline employees

In the recent issue of Morbidity and Mortality Weekly (MMWR), there is a report of 4 cases of malaria from employees of the same airline that had traveled to Ghana in late August/early September and brought the disease back into the United States.

The employees, 2 flight attendants and 2 pilots, not all on the same flight, spent somewhere between 48 to 80 hours in Accra, Ghana. All stayed in the same hotel and spent time outdoors in the evening and night hours.
All four were discovered to have Plasmodium falciparum malaria upon returning to the US. Fever, headache, nausea, vomiting and diarrhea were common symptoms.

Three were diagnosed through finding the parasite in blood smears while one was diagnosed through PCR.

The extent of the illnesses ranged from being discharged 2 days post-treatment to both pilots being in respiratory distress and requiring intubation. Everyone was discharged within 15 days.

The airline which provided paid malarone prophylaxis, was not utilized by any of the 4 employees.

This case proves that even short stays in malaria endemic areas there is a real risk for malaria transmission.

Monday, November 8, 2010

CDC makes sudden change to website concerning Lone Star Ticks

On October 21st I put out an article pointing out an observation I noted comparing two CDC websites; “CDC: contradictions on the association between Lyme disease and the lone star tick”.

The crux of the article was that on their parasites website “Division of Parasitic Diseases and Malaria section” it was noted that the lone star tick, Amblyomma americanum, did transmit the agent of Lyme disease, Borrelia burgdorferi.

As a matter of fact, I cut and paste this statement off the web site: “In North America, A. americanum transmits Francisella tularensis (tularemia), Ehrlichia chaffensis (ehrlichiosis), Borrelia burgdorferi(Lyme disease), and Rickettsia rickettsii (Rocky Mountain spotted fever, or RMSF).“ Only the bold was added by me.

The contradiction I discovered was on their web site “Division of Vector-Borne Infectious Diseases”, it was quite clear that they were saying that the Lone Star Tick DOES NOT transmit Lyme disease.

Well, sometime between October 21st and the beginning of November, the CDC quietly and inconspicuously removed Borrelia burgdorferi(Lyme disease) from the parasites (ticks) website.

It now says: In North America, A. americanum transmits Francisella tularensis (tularemia), Ehrlichia chaffensis (ehrlichiosis), and Rickettsia rickettsii (Rocky Mountain spotted fever, or RMSF).

Was the removed content just an error or a typo? Maybe. If nothing else it’s just one more piece of ammunition for Lyme advocates in their case for the association between Lone Star Tick and Lyme disease.

It almost smells conspiratorial, maybe Jesse Ventura can look into this. Just kidding...

Sunday, November 7, 2010

Let the porn resume…"Patient Zeta's" contacts test HIV negative

Nearly a month after a porn actor tested positive for the Human Immunodeficiency Virus (HIV), the cameras will start rolling again among many studios in the industry.

Pornography giant, Vivid Entertainment announced they will resume this Monday after “exhaustive” testing on all contacts with a male porn star tested negative.

The actor, “Patient Zeta”, tested positive for the virus on October 9th and essentially shut down the industry.

The Adult Industry Medical Healthcare Foundation (AIM) in Sherman Oaks, California is the clinic that handles the porn industry’s sexually transmitted infection testing. AIM officials had completed testing of “Patient Zeta’s” sex partners, "from both personal and professional life," and that all tested HIV-negative "on two occasions, using multiple testing methods."

AIM’s announcement continues by saying, “It has been established that Patient Zeta acquired the virus through private, personal activity and there was no transmission of the HIV virus from Patient Zeta to anyone else."

However the LA County Public Health Department notes that AIM did not provide test results or protocols to their office.

So based on the AIM results, the multi-billion dollar industry will resume filming ASAP, with at least one company already starting yesterday.

According to the Centers for Disease Control and Prevention’s (CDC) website, HIV is:

•HIVis the human immunodeficiency virus. It is the virus that can lead to acquired immune deficiency syndrome, or AIDS. CDC estimates that about 56,000 people in the United States contracted HIV in 2006.
HIV damages a person’s body by destroying specific blood cells, called CD4+ T cells, which are crucial to helping the body fight diseases.

HIV is spread primarily by:

•Not using a condom when having sex with a person who has HIV. All unprotected sex with someone who has HIV contains some risk. However:
•Unprotected anal sex is riskier than unprotected vaginal sex.
•Among men who have sex with other men, unprotected receptive anal sex is riskier than unprotected insertive anal sex.
•Having multiple sex partners or the presence of other sexually transmitted diseases (STDs) can increase the risk of infection during sex. Unprotected oral sex can also be a risk for HIV transmission, but it is a much lower risk than anal or vaginal sex.
•Sharing needles, syringes, rinse water, or other equipment used to prepare illicit drugs for injection.
•Being born to an infected mother—HIV can be passed from mother to child during pregnancy, birth, or breast-feeding.

Saturday, November 6, 2010

Malaria outbreak among indigenous Amazonians kills 17

At least 17 tribes people from remote Amazon villages have died because of malaria recently, this includes children.

According to Dr. Miguel Hernandez, regional health director of Amazonas has confirmed, by interview that the 17 deaths occurred among people of Yanomamo tribe. The number 17 however is much lower than earlier estimates.

Earlier two indigenous medical people had determined the death toll to malaria to be at 50.

A team of medical specialists went to the remote area and confirmed 60 cases of malaria and people of the village were treated for malaria, diarrhea and respiratory infections.

The Yanomamo are a large population of indigenous Amerindian people in South America. They reside in the Amazon rainforest, among the hills that line the border between Brazil and Venezuela.

Malaria is considered the most important parasitic disease affecting humans.

This protozoan parasite belongs from the genus Plasmodium. There are many species of Plasmodium that infect vertebrates, but the following 4 are most important to humans; P. falciparum, P. vivax, P. malariae and P. ovale. The vector for transmitting malaria is the female Anopheles mosquito.

Human malaria is considered a tropical disease with most cases found in Southeast Asia, China, India, Africa, and parts of the Middle East, Mexico, Central and South America.

Costco, government agencies warn of Bravo Farms Gouda

The Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and Costco Wholesale Corp. are jointly warning consumers to avoid eating a cheese that was being sold and sampled at Costco.

The product in question, Bravo Farms Dutch Style Gouda cheese, has been linked to an outbreak of E. coli O157:H7. To date at least 25 people have been infected with the foodborne illness, all in western states (Arizona, California, Colorado, New Mexico, and Nevada).

There are no deaths reported however 9 people have been hospitalized and a possible a case of hemolytic uremic syndrome (HUS).

Costco, the CDC and the FDA are telling people to return the cheese (Costco Item 40654) to where they purchased it or to dispose of the cheese in a way that animals can’t get to it.

So what kind of disease does E. coli O157:H7 cause? Well other that the grossly bloody diarrhea that is frequently seen with this infection, this organism has been directly linked with causing hemolytic uremic syndrome.

Hemolytic uremic syndrome is likely linked to a shiga toxin produced by the bacteria. It causes a group of different problems (a syndrome) or symptoms in the patient.

Though not completely understood, the following physiological reactions can occur:

First it causes the hemolysis of red blood cells. This is due to clotting problems caused by the clotting produced by platelets which clog up the capillaries and don’t allow the blood to flow freely.

Secondly, it can cause kidney failure where waste products build up in the blood because the ability of kidney to filter the blood becomes impaired. Most persons with HUS recover within a few weeks, but some suffer permanent damage or die.

To prevent getting infected with E. coli O157:H7 at home:

• Wash hands with warm, soapy water for at least 20 seconds before and after handling raw meat and poultry. Wash cutting boards, dishes, and utensils with hot, soapy water. Immediately clean spills.
• Keep raw meat, fish, and poultry away from other food that will not be cooked. Use separate cutting boards for raw meat, poultry, and egg products and cooked foods.
• Consumers should only eat ground beef or ground beef patties that have been cooked to a safe internal temperature of 160 deg F (71 deg C).
• Color is NOT a reliable indicator that ground beef or ground beef patties have been cooked to a temperature high enough to kill harmful bacteria such as E. coli O157:H7.
• The only way to be sure ground beef is cooked to a high enough temperature to kill harmful bacteria is to use a thermometer to measure the internal temperature.
• Refrigerate raw meat and poultry within 2 hours after purchase or one hour if temperatures exceed 90 deg F (32.2 deg C).

Thursday, November 4, 2010

Millions of Ethiopians treated for trachoma and malaria during MalTra week

The blinding eye disease trachoma and the mosquito borne parasite malaria have plagued parts of Ethiopia, particularly the Amhara region where there are more trachoma cases than anywhere else in the world.

But a campaign in Amhara known as MalTra (malaria and trachoma) will send thousands of health workers out to treat villagers in the western part of Ethiopia. Thanks to a joint effort by the Lion’s Club International, the Carter Center and others, plus a very generous donation of enough antibiotic to treat 10 million people for trachoma from Pfizer, millions will get treated for this #1 cause of blindness in the world plus malaria detection and treatment.

According to the Global Network of Neglected Tropical Diseases, Trachoma is an infectious disease of the eye caused by the bacterium Chlamydia trachomatis, and is the world’s leading cause of preventable blindness. More than 84 million people in 56 countries worldwide have active trachoma, and an estimated eight million have lost their sight due to complications from the disease.

Trachoma strikes poor, rural communities -- mainly in Africa and Asia -- where crowded living conditions and limited access to clean water, proper sanitation, and quality health care are part of daily life. Trachoma is primarily transmitted by contact with eye discharge from an infected person’s hands, clothing or personal effects (towels, handkerchiefs, etc.); the discharge can also be carried on the feet of flies. The disease spreads rapidly through close personal contact and often runs rampant in areas where people live in close proximity. It is not uncommon for whole communities to be afflicted. Trachoma infections are very closely linked to extreme poverty.

Wednesday, November 3, 2010

WHO: dengue a major threat in Pacific, Laos and Philippines “badly hit”

The World Health Organization (WHO) announced at a meeting in Malaysia that dengue fever has become a major threat to global public health particularly in the Western Pacific region where even places where dengue wasn’t previously seen, is now present and growing.

The number and size of outbreaks of dengue has increased dramatically. The number of cases in the Western Pacific region has more than doubled in the past decade and two countries have been hit quite badly by dengue; Lao People’s Democratic Republic and the Philippines.

70 percent of the 2.5 million people at risk for dengue fever worldwide live in the Asia Pacific region.

WHO officials stated at the meeting that the growth of dengue is due to several reasons to include; increased temperatures and rainfall which encourages mosquito breeding, increases in population densities, international travel and better surveillance.

They noted that the evidence is lacking that global warming or climate change is the cause, climate change does play a role in mosquitoes in general.

WHO’s Regional Director for the Western Pacific, Dr Shin Young-soo called on governments to display strong leadership and commitment, greater advocacy and investment, and better clinical management of cases.

At the local level there are several things that can be done to minimize dengue; eliminating mosquito breeding sites, such as water jars, building sites and discarded garbage are steps that the individual can take.

Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. This disease used to be called “break-bone fever” because it sometimes causes severe joint and muscle pain that feels like bones are breaking. People get the dengue virus from the bite of an infected Aedes mosquito. It is not contagious from person to person.

Tuesday, November 2, 2010

Olympic gold-medal rower Andy Holmes dies from suspected Weil’s disease

He hasn’t rowed competitively in 17 years but Andy Holmes threw his hat back in the ring competing in the 50 to 55 age group class in September’s BostonRowing Marathon in the UK.

However, several days after the race, Holmes, aged 51, became feverish and altogether unwell to the point where he had to be admitted to a hospital near his home. He continued on a downward track until one week prior to his death he was placed on life support in the intensive care unit for severe liver disease.

It is suspected that Holmes, father of 5 and twice Olympic gold medalist in rowing (1984 and 1988) contracted a waterborne bacterium while rowing the 30+ miles from Lincoln to Boston on the River Witham this past September 19th. However, there is no way to know for sure exactly which body of water he may have contracted the disease.

It is believed he contracted Weil’s disease, a severe, life-threatening form of leptospirosis.

According to officers at the Boston Rowing Club, "Part of any rower's training is being warned about water safety. If you fall into water you must wash thoroughly and if you think you have ingested any water seek medical advice."

Leptospirosis is a spirochetal bacterial infection caused by the bacterium Leptospira interrogans. Exposure to fresh water and wet soil contaminated by the urine of an infected animal, rats being the most common, is where humans typically pick up the infection.

It is commonly considered an occupational disease for those who work outdoors or with animals. Recreational activities which involve exposure to fresh water contaminated with infected animal urine are also a risk for leptospirosis.

Weil’s disease is the more severe phase of leptospirosis where the person may have kidney or liver failure (jaundice) or meningitis.

Monday, November 1, 2010

Tularemia the cause of Colorado prairie dog deaths

A die-off of prairie dogs in the Broomfield, Colorado area which began about a month ago is now believed to be caused by the bacterial infection, tularemia.

After much speculation that the die-off was due to the plague, last week tularemia was laboratory confirmed in a rabbit from the area making experts lean to the strong possibility that this could be the cause of the prairie dog demise.

The disease tularemia is caused by the bacterium Francisella tularensis. This bacterium is found in nature in rabbits, rodents, beavers, squirrels and several domestic and farm animals.

People commonly get infected from the bites of infected ticks (wood, dog) and deer flies.

Hunters are at risk of infection following skinning, dressing and eating infected animals.

Drinking contaminated water has been implicated in tularemia infection. People also contract it through inhaling dust and hay that have rodent feces and carcasses.

There have been cases where people got infected from a domestic cat. It is believed that cats get the organism from contaminated prey and their mouth and claws become infected.

Certain animal associated occupations are also associated with the disease; farmers, veterinarians, sheep herders and shearers.

The disease in people depends on how it’s acquired. After infection, incubation can be a couple of days to weeks, with non-specific symptoms like fever, chills, headache, sore throat and diarrhea.

The way the organism enters the body frequently dictates the disease and degree of systemic involvement. The infection tularemia can be divided into six syndromes:

• Ulceroglandular
This the most common form of tularemia which is characterized by ulcers at the site of the tick bite.
• Glandular
No skin lesions in this infection. Enlarged lymph nodes are present and may require surgical drainage.
• Oculoglandular
This is an infection of the conjunctiva usually by splashes or aerosols.
• Oropharyngeal
The lesion is found in the throat because of ingestion of contaminated water or food.
• Typhoidal
This infection is also due to ingestion of contaminated food and water. This is the only form of tularemia where diarrhea is a prominent characteristic.
• Pneumonic
With a high mortality in this syndrome, this type is most frequently seen in animal associated occupations.

Diagnosis of tularemia is based on detection of antibodies. Culture is possible with appropriate safety precautions and specialized media. Laboratory acquired infections do happen.

Tularemia is treatable with antibiotics (streptomycin and gentamicin).

There is no person to person transmission of this bacterium. F. tularensis is of concern as a possible agent of bioterrorism and biowarfare.

You can prevent tularemia by avoiding insect bites by using repellents and wearing long sleeves. You should also cook wild animals thoroughly before eating.

The Broomfield Public Health and Environment Division have advised residents of the area the following preventive measures:

1.Residents, pet owners, area workers and visitors to avoid handling and coming into contact with animals that could potentially be infected, such as wild rodents, squirrels and rabbits.
2.Keep pets, especially cats and dogs, indoors to limit exposure to ticks. If outdoors with your pets, keep them out of heavily wooded areas.
3.Avoid areas inhabited by wild rodents. If you enter such areas, wear insect repellent containing DEET.
4.Keep pets on a leash at all times to prevent them from running loose in fields where they might come in contact with rodents, rabbits and hares.
5.Never touch sick or dead animals with your bare hands. If an animal must be moved, use a long-handled shovel to place it in a garbage bag, and place the bag in an outdoor garbage can.
6.Avoid drinking unpurified water from streams or lakes and prevent pets from doing the same.