Thursday, August 25, 2011

Researchers say Nepal peacekeepers were source of Haiti cholera outbreak

Researchers led by the Translational Genomics Research Institute and the Technical University of Denmark have pinpointed the source of a cholera outbreak in Haiti that killed more than 6,000 people and sickened 300,000.

Using a technology called whole genome sequencing, which spells out the billions of chemical bases in DNA, researchers believe this provides the strongest evidence that Nepalese soldiers sent to assist Haiti after the January 2010 earthquake, brought the gastrointestinal disease to the island.

The study appeared Tuesday, Aug. 23, in mBio, a new online-only, open-access journal published by the American Society of Microbiology in partnership with the American Academy of Microbiology.

According to Paul Keim, Regents Professor of biology at Northern Arizona University, who served as a senior molecular biologist in the study, "The great similarity of Haitian cholera with Nepalese cholera is based upon the highest resolution DNA methods available, and point to a probable source of this devastating disease outbreak."

Researchers confirmed the source of the outbreak by comparing the DNA of 24 cholera samples (the bacterium Vibrio cholera) from five different districts in Nepal with 10 samples of cholera from Haiti. All 24 samples from Nepal matched the samples from Haiti. Some of the samples, the report said, “were almost identical.”

The use of this technique could be used to prevent future outbreaks of this sort. According to Lance Price, an associate professor at TGen and co-author of the new study, using this technology could prevent outbreaks like that in Haiti by screening responders to a disaster prior to deployment. He goes on to say, the study “was not about placing blame, it’s about preventing such disasters in the future.”

Wednesday, August 24, 2011

Virginia health officials warn of possible measles exposure on Amtrak train

An Amtrak train from Boston to Virginia may be the source of a measles exposure according to a Virginia Department of Health (VDH) news release issued on Sunday, August 21.

Health officials are issuing this warning out of caution. They say a passenger on the train had measles and suggest passengers on Amtrak’s Northeast Regional train #171 on Wednesday, August 17, 2011, check their vaccination status.

The VDH news release details the trip itinerary as follows:

The Northeast Regional train #171 originated in Boston, Mass., at 8:15 a.m. and made stops in Maryland (Aberdeen, Baltimore – Penn Station, BWI and New Carrollton), District of Columbia (Union Station) and Virginia (Alexandria, Burke Centre, Manassas, Culpeper, Charlottesville and Lynchburg). The train ended its run in Lynchburg at 8:36 p.m. Passengers who got off of train #171 before its arrival in Philadelphia need not be concerned.

They are recommending if passengers on that train notice the symptoms of measles, please call your primary health care provider to discuss further care. Call ahead before going to your doctor’s office or to an urgent care facility or the ER so the appropriate precautions can be put in place to keep from potentially infecting others.

Measles or rubeola, is an acute highly communicable viral disease that is spread through coughing, sneezing, and contact with secretions from the nose, mouth, and throat of an infected individual. The disease is characterized by Koplik spots in the cheek or tongue very early in the disease. A couple of days later a red blotchy rash appears first on the face, and then spreads, lasting 4-7 days. Other symptoms include fever, cough and red watery eyes. The patient may be contagious from four days prior to the rash appearance to four days after rash appearance.

The disease is more severe in infants and adults. Complications from measles which is reported in up to 20% of people infected include; seizures, pneumonia, deafness and encephalitis.

Measles is easily preventable through safe and effective MMR vaccine. The best protection against future measles cases is the on-time vaccination of all susceptible persons. Two doses are recommended for most individuals with the first dose given at age 12-15 months and the second prior to kindergarten entry (age 4-6 years).

For more information, the VDH provides the following contact numbers:
·    Virginia passengers with additional questions can contact their local health department or call the Prince William Health District at  703-792-6345      .
·    District of Columbia passengers can call 202-671-4222      .
·    Maryland passengers with additional questions should call their healthcare provider or their local health department.

Monday, August 22, 2011

Legionnaires’ disease cases triple in US in past decade

Health officials said Thursday that cases of Legionnaires’ disease in the United States have tripled in the past 10 years according to officials at the Centers for Disease Control and Prevention (CDC).

The CDC reported 3,522 cases of the respiratory infection in 2009. This is up significantly from the 1,110 cases reported in 2000. The incidence rate increased from 0.39 to 1.15 per 100,000 people during that span of time. 

According to the Summary of Notifiable Diseases in the Morbidity and Mortality Weekly Report (MMWR) from May, factors contributing to this increase might include a true increase in disease transmission, greater use of diagnostic testing, and increased reporting.

CDC officials also think the increase may be partly because there are more older people. Elderly people account for most cases of Legionnaire's disease.

Health officials do report that because of more effective treatments, fatalities are down. In fact, just 8 percent of its victims died in the last decade, compared to 20 percent in the 1980s and 1990s. 

Sunday, August 21, 2011

Trinidad and Tobago PM, Kamla Persad-Bissessar diagnosed with dengue fever

Dengue fever, the mosquito-borne viral disease cares not one iota for position, wealth or class. It is an equal opportunity disease and no one is immune.

The proof of this was reported from the southern Caribbean country of Trinidad and Tobago on Monday. In a statement issued by the Office of the Prime Minister yesterday, it stated that Kamla Persad-Bissessar was diagnosed with dengue fever (classic type).

Persad-Bissessarsaid, “While I was consulting with the Minister of Health on how to enhance and intensify the education drive Government has embarked on to sensitize the population on dengue fever, I became a victim of it myself.”

She went on to warn citizens, "Let me also emphasize the need to immediately seek professional medical attention if you have any symptoms of dengue (which include fever, body pains and headaches) since treating the disease as an ordinary flu can cause more medical problems." 

Trinidad and Tobago Health Minister Fuad Khan suspects the Prime Minister mayhave contracted dengue on Friday during her walkabout in Port of Spain. Khan also says that Persad-Bissessar should back to “full capacity” in a couple of days.

Health Minister Dr Fuad Khan said the last check by his ministry revealed there were some 1,639 cases of people infected with dengue fever throughout the country. However, he warned that the figure has not yet taken into account cases for August and, therefore, the tally could be much higher.

Friday, August 19, 2011

Uganda Health Ministry: three million people at risk of river blindness

This is according to Dr. Nathan Kenya Mugisha, Director General of Health Services as he spoke at a Carter Center conference on river blindness in Kampala Monday.

Dr. Mugisha said that river blindness is epidemic in more than 30 districts with approximately 1.8 million people receiving treatment for the parasitic disease.

He went on to say, “The number of people suffering from the disease has grown because of the increase in the number of black flies that are hatching in forests surrounding the 30 districts.” He emphasized that many of the victims of the disease are sustenance farmers in rural areas of the country.

River blindness has affected agricultural development, causing hunger, poverty and increased school drop-out rates according to Mugisha.

Onchocerciasis is an infection caused by the parasite Onchocerca volvulus (worm), spread by the bite of an infected blackfly.

It is also called River Blindness, because the transmission is most intense in remote African rural agricultural villages, located near rapidly flowing streams.

Persons with heavy infections will usually have one or more of the three conditions: dermatitis, eye lesions, and/or subcutaneous nodules. Superficial skin biopsies will identify the parasite microscopically.

According to the Global Network of Neglected Tropical Diseases, 37 million people are infected with onchocerciasis or river blindness worldwide, the vast majority of people infected living in Africa. 110 million people in 35 countries are at risk of infection. Half a million people are severely visually impaired from this disease, with 270,000 blind.

Thursday, August 18, 2011

Japan extends soft loan of $65 million to Pakistan for polio eradication

Japan, on Monday, committed another $65 million, nearly 5 billion yen, to Pakistan so they can procure 165 million doses of oral polio vaccine and to increase compensation for health workers involved in the polio eradication program.

The $65 million is a significant portion of the $148 million Pakistan will receive for their polio eradication program. Other donors were UNICEF ($42 million) and the World Bank ($421 million).

Japanese Official Development Assistance (ODA) Loan Agreement is extended on soft terms with an interest rate of 0.01 per cent and repayment period of 40 years including grace period of 10 years according to a report in The Nation newspaper.

The objective of polio eradication project is to immunize children under 5 years, by procuring vaccines and providing services necessary for polio immunization activities, thereby contributing to the eradication of polio in Pakistan.

Polio is caused by the poliovirus types 1, 2 and 3. All three types cause paralysis, with wild poliovirus type 1 being isolated from paralysis cases most often.

This viral infection is primarily spread from person to person through the fecal-oral route. However, in places where sanitation is very good, transmission though throat secretions may be considered more important.

Polio is recognized in about 1 percent of infections by flaccid paralysis, while over 90 percent of infections are unapparent.

Paralysis of poliomyelitis is usually asymmetric and the site of paralysis depends on the location of nerve cell destruction on the spinal cord or brain stem. Legs are affected more often than the arms. Paralysis of the respiration can be life threatening.

Most cases of polio are in children under the age of three.

With immunization, by the end of 2007, polioviruses were limited to only four countries who had not succeeded in interrupting transmission; Afghanistan, India, Nigeria and Pakistan.

Prevention of polio is through immunization, through the live oral poliovirus vaccine (OPV) or the inactivated poliovirus vaccine (IPV).

The Daily Times reports, from 1996 to 2010, Japan has provided approximately 87 million USD in total for the procurement of Oral Polio Vaccines in collaboration with the UNICEF, aiming to wipe out polio from Pakistan. In addition, Japan has sent medical experts to Pakistan for the expansion of routine immunization activities since 2006.

Wednesday, August 17, 2011

Army confirms employee who died was diagnosed with Legionnaires’ disease

Army officials at Redstone Arsenal in Huntsville, Alabama said in a press briefing Monday that an employee who died was diagnosed with Legionnaires’ disease four days prior to his death.

They say that the man, identified as 64-year-old Mark Mueller by WHNT News 19, is the only confirmed case though other employees have shown symptoms and have been tested for the bacterial infection.
Redstone officials do stress that there is no outbreak at this time.

The source of the Legionella bacterium is still unknown and the Army doesn’t believe it to be the building where Mueller worked.  Ventilation systems and other components showed no trace of the bacterium.

Though Building 5681 is fully operational, WHNT reports that officials say they are granting a liberal leave policy to anyone who is not comfortable reporting to work. Approximately 500 people work at that facility. It is connected with the Apache Helicopter program.

Legionnaires’ disease gained national notoriety in 1976 when the Centers for Disease Control and Prevention (CDC) discovered it during an epidemic of pneumonia among American legion members at a convention in Philadelphia.

The causative organism is the bacteria, Legionella pneumophila. The legionella bacteria are found throughout nature, because of this most people become exposed to it but few develop symptoms.

The primary place in nature it’s found is water sources particularly at warmer temperatures; lakes, rivers and moist soil.

It is also found in man-made facilities (frequently the source of outbreaks) such as air-conditioning ducts and cooling towers, humidifiers, whirlpools and hospital equipment.

People get exposed through inhaling infectious aerosols from these water sources. There is no transmission from person to person.

The infection can appear in two clinical forms: Legionnaires’ disease and Pontiac fever.

Both conditions are typified by headache, fever, body aches and occasionally abdominal pain and diarrhea.
Legionnaires’ disease is the cause of pneumonia where a non productive cough is typical. Fatality rates of this form of the infection are around 15 % even with improvements in treatment.

Pontiac fever is a self limiting flu-like illness that does not progress to pneumonia or death. Diagnosis is usually made by typical symptoms in a outbreak setting.

Diagnosis of Legionnaires’ disease depends on identifying the bacteria in microbiological culture, detecting the antigen in urine samples or a fourfold increase in antibody titer.

Certain health conditions make you more susceptible to infection to include increasing age, smoking, chronic lung disease, malignancy and diabetes mellitus.

Legionnaires’ disease is treatable with antibiotics.

To following things can be done as preventive measures: cooling towers should be drained when not in use and cleaned to remove scale and sediment and biocides can be used to limit bacterial growth. Tap water should not be used in respiratory therapy devices.

Monday, August 15, 2011

Mims, FL teen, Courtney Nash, passes away after losing battle with brain amoeba

The Florida teen who contracted the nearly always fatal brain amoeba, Naegleria fowleri last week, died yesterday afternoon.

The 16-year-old contracted a rare brain infection after swimming in the St. Johns River near the Brevard-Volusia line.

She was admitted to Arnold Palmer Hospital for Children in Orlando. 

The disease caused by this waterborne parasite is called primary amoebic meningoencephalitis or PAM and is nearly always fatal.

The Brevard County Health Department says Naegleria fowleri is commonly found in the upper layer of sediment in the bottom of lakes and ponds with mud floors. They also can be present in poorly maintained swimming pools and hot tubs. This infection cannot be spread from person to person or contracted from a properly maintained swimming pool.

Symptoms of an infection include headache, fever, nausea and vomiting, stiff neck, confusion, lack of attention to people and surroundings, loss of balance and bodily control, seizures and hallucinations. The public is urged to contact a medical professional immediately if experiencing any of these symptoms.

The threat of infection, although rare, increases during the summer months when the water temperature rises.  The amoeba invades the brain and the disease progresses rapidly usually resulting in death within 3 to 7 days.

Friday, August 12, 2011

Florida teen in serious condition with suspected case of Naegleria

The Brevard County Health Department issued a health advisory Thursday after a 16-year-old girl was hospitalized with a “probable” case of primary amoebic meningoencephalitis (PAM).

The teen is believed to have contracted the parasite while swimming in freshwater near her home in the town of Mims.

She is currently being treated at Arnold Palmer Hospital, in Orlando.

Naegleria fowleri is a relatively rare, pathogenic amoeba is found in warm or hot freshwater like lakes, rivers and hot springs. It is also possible to get it from dirty unchlorinated or under-chlorinated swimming pools. This parasite is found worldwide and in the United States, it is found in mainly in the southern-tier states, including Florida. There were 6 cases reported to the CDC in 2007, 3 being reported from Florida.

People typically get it by swimming, jumping or playing in freshwater and get the water up their nose. From there the parasite travels to the brain and spinal cord and necrotizes or basically eats brain tissue. Primary amoebic meningoencephalitis (PAM) has a very rapid progression.

Typical symptoms may start after a day or two; headache, fever, nausea and vomiting. Later symptoms may include seizures, irrational behavior, hallucinations and finally coma and death. The course of the disease typically last about a week. Because the symptoms are very similar to bacterial meningitis, PAM may not even be considered in the diagnosis.

Unfortunately, treatment is usually unsuccessful with only a handful of people surviving infection.

You should always assume there is some risk when swimming in freshwater. The location and number of amoeba present in a body of water varies from time to time. The Centers of Disease Control and Prevention recommends these four steps to reduce your risk of infection:

• Avoid water-related activities in bodies of warm freshwater, hot springs, and thermally-polluted water such as water around power plants.
• Avoid water-related activities in warm freshwater during periods of high water temperature and low water levels.
• Hold the nose shut or use nose clips when taking part in water-related activities in bodies of warm freshwater such as lakes, rivers, or hot springs.
• Avoid digging in or stirring up the sediment while taking part in water-related activities in shallow, warm freshwater areas.

Thursday, August 11, 2011

Case of imported dengue fever confirmed near Ocala, FL

The Florida Department of Health (DOH) warned citizens about protecting themselves from mosquitoes in a press release Tuesday. The warning is a response to a confirmed case of imported dengue fever in Marion County.

The patient contracted dengue fever while traveling abroad.

Dr. Nathan Grossman, director of the Marion County Health Department requested the Marion County Board of County Commissioners conduct a mosquito spray in the area south of Ocala after receiving confirmation of a case of dengue fever.

The mosquito spraying is a precautionary measure. Dr. Grossman says the risk of transmission of this potentially lethal virus is very low, however steps to reduce transmission still need to be implemented.

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.

Dengue fever of multiple types is found in most countries of the tropics and subtropics particularly during and after rainy season.

The World Health Organization (WHO) estimate 100 million cases annually, this includes 100-200 cases reported to the Centers for Disease Control and Prevention (CDC), mostly in people that have traveled abroad.

There are four types of dengue virus: DEN-1, DEN-2, DEN-3 and DEN-4.

People get the dengue virus from the bite of an infected Aedes mosquito. It is not contagious from person to person.

There are three types of dengue fever in order of less severe to most: the typical uncomplicated dengue fever, dengue hemorrhagic fever (DHS) and dengue shock syndrome (DSS).

The symptoms of classic dengue usually start within a week after being infected. They include very high fever, up to 105°F, severe headache, pain behind the eye, severe joint and muscle pain, nausea and vomiting and a rash.

Symptoms of DHF include all the symptoms of classic dengue plus severe damage to the blood vessels. Bleeding from the nose, gums or under the skin are common. This form of dengue can be fatal.

Symptoms of DSS include all of the above symptoms plus; fluid leaking outside of blood vessels, massive bleeding and shock. This form of the disease usually happens in children experiencing their second infection.

Two-third of all fatalities occurs among children.

There is no treatment for dengue, just treat the symptoms. Persons who think they have dengue should use analgesics (pain relievers) with acetaminophen and avoid those containing aspirin. They should also rest, drink plenty of fluids, and consult a physician.

There is not a vaccine for dengue fever.

Prevention of dengue fever is best accomplished by eliminating mosquito breeding sites by getting rid of standing water.  The Marion County Health Department recommends:

DRAIN standing water:
• Drain water from garbage cans, buckets, pool covers, coolers, toys, flowerpots or any other
containers where sprinkler or rainwater has collected.
• Discard old tires, drums, bottles, cans, pots and pans, broken appliances and other items that
aren't being used.
• Empty and clean birdbaths and pet's water bowls at least once or twice a week.
• Protect boats and vehicles from rain with tarps that don’t accumulate water.
• Maintain swimming pools in good condition and ensure they are appropriately chlorinated. Empty  plastic swimming pools when not in use.

COVER your skin with:

• CLOTHING - If you must be outside when mosquitoes are active, cover up. Wear shoes, socks, long pants and long sleeves.
REPELLENT - Apply mosquito repellent to bare skin and clothing. Always use repellents
according to the label. Repellents with 10-30% DEET, picaridin, oil of lemon eucalyptus, and
IR3535 are effective.
• Use mosquito netting to protect children younger than 2 months old.
COVER doors and windows with screens:
• Keep mosquitoes out of your house. Repair broken screening on windows, doors, porches, and patios.

Possible Hepatitis A transmission at North Carolina Olive Garden

The Cumberland County Public Health Department said in a news release Monday that employees or visitors of a Fayetteville, NC Olive Garden in late July-early August may have been exposed to hepatitis A through a restaurant employee.

More specifically, if you worked at or visited the Olive Garden, located on 234 North McPherson Church Road, anytime on July 25, 26, 28, 29, 31 and Aug. 1, 2 and 8.

According to Health Department Director, Buck Wilson, “It is important that those persons working or visiting the restaurant on these dates receive an injection of Hepatitis A immune globulin or vaccine immediately.” Both immune globulin (also called gamma globulin) and Hepatitis A vaccine can prevent infection with Hepatitis A virus if given within 14 days of exposure.

The news release says that those possibly exposed can receive the appropriate prophylaxis at the Cumberland County Public Health Department, 1235 Ramsey Street, at a walk-in clinic starting Tuesday, Aug. 9, at 9 a.m. The walk-in clinic will continue until further notice daily from 8 a.m. to 5 p.m.

The usually mild Hepatitis A virus (HAV) is most commonly transmitted through the ingestion of fecally contaminated food and water. Outbreaks have been seen involving shellfish and raw produce like strawberries and onions, but in this country food borne HAV is usually associated with contamination of food by infected food handlers. It has also been seen in day care centers and in male homosexual and bisexual practices. Americans that travel to endemic countries are also at significant risk. This list is by no means exhaustive.

Infection with HAV in children in developed countries is usually very mild, sometimes showing no symptoms. However in adults the symptoms may include fever, tiredness, nausea and abdominal discomfort followed by jaundice and dark urine. Mild disease may last a couple of weeks; however more severe disease may cause debilitating disease for up to a year. Complete recovery of HAV infection is the rule with no chronic disease.

For more information see the CDC website

Monday, August 8, 2011

Penn State researchers developing microwaves to kill malaria

Researchers from Penn State’s Materials Research Institute and College of Medicine are collaborating to develop a process to destroy malaria parasites in the blood using low-power microwaves according to a Friday news release.
Malaria is a massive killer of young children, particularly in Africa, which is showing resistance to many antimalarial drugs.
Dinesh Agrawal, professor of materials at Penn State said of the research, “The first phase successfully demonstrated that the way microwaves heat the malaria parasite causes it to die without harming normal blood cells. Microwave interactions are unique. The parasite has extra iron ( Fe3+) that enhances the microwave energy absorption by the parasite. As a result, it is postulated that the parasite gets heated preferentially and is killed without affecting the normal blood cells.”
The second phase will use a larger system and test the process in mouse models. If those tests are successful, Agrawal says, the next step will be to design and build a system to treat human beings. He says that might look like the scanners at the airport.
The research is funded through a Gates Foundation Grand Challenges Explorations grant, which is an initiative of the Bill and Melinda Gates Foundation that allows for research that is typically too bold to attract funding from other sources.

Sunday, August 7, 2011

Washington Vibrio parahaemolyticus outbreak linked to raw oysters

At least 22 people have become ill after eating raw oysters in Washington State according to a Thursday Washington State Department of Health (WSDH) news release.
The illnesses, caused by the bacterium Vibrio parahaemolyticus, have been connected to both raw oysters from commercial harvesting (18) and recreational (4).
The WSDH offers the following steps to avoid vibriosis:

  1. Put oysters on ice or refrigerate them as soon as possible after harvest.
  2. If a receding tide has exposed oysters for a long time, don’t harvest them.
  3. Always cook oysters thoroughly. Cooking oysters at 145° F for 15 seconds destroys vibrio bacteria. Rinsing fully-cooked oysters with seawater can recontaminate them.                                        
For commercial harvesters, special control measures are in place from May through September to keep people from getting sick if they eat raw oysters. Shellfish companies must quickly refrigerate oysters after they’re harvested. They’re required to keep detailed harvest and temperature control records to show that the oysters were handled properly.

The US Centers for Disease Control and Prevention says Vibrio parahaemolyticus is a bacterium in the same family as those that cause cholera. It lives in brackish saltwater and causes gastrointestinal illness in humans. V. parahaemolyticus naturally inhabits coastal waters in the United States and Canada and is present in higher concentrations during summer.
V. parahaemolyticus causes watery diarrhea often with abdominal cramping, nausea, vomiting, fever and chills. Usually these symptoms occur within 24 hours of ingestion. Illness is usually self-limited and lasts 3 days. Severe disease is rare and occurs more commonly in persons with weakened immune systems.

Saturday, August 6, 2011

Saskatchewan sees an increase in Shigella infections

Saskatchewan health officials said in a news release Thursday that over the past several months, they have seen an increase in infections caused by the Shigella bacteria.
According to the release, Saskatchewan normally records between 10 and 15 cases a year, mostly related to foreign travel. Over the last four months, Saskatchewan has recorded 13 cases. The majority of these cases were found in children and were not linked to overseas travel except in one case. In many of the cases, the strain of the Shigella bacteria is similar, which would indicate ongoing person-to-person and household-to-household spread in Saskatchewan.
They go on to say that, most of the cases have been in central Saskatchewan in and around the Prince Albert area. While investigations are ongoing, no linkages to a particular food item or event have been identified.
Saskatchewan Deputy Chief Medical Health Officer Dr. Saqib Shahab noted the importance of handwashing in preventing the spread of Shigella: "The most important thing to remember is for everyone, even if they feel well, to wash hands often and frequently, especially after using the washroom.  Some people infected with Shigella may have no or very mild symptoms but they can still pass the illness to others without knowing it".
Shigellosis is an acute bacterial disease of the intestines caused by several species of the bacterium, Shigella. It is typified by loose stools, frequently containing blood and mucus (dysentery), accompanied by fever, vomiting, cramps and occasionally toxemia.
It can cause bacillary dysentery because of the invasive ability of the organism that may result ulcerations and abscesses of the intestines.
It rarely spreads to the bloodstream.
More severe complications may include convulsions in children, Reiter's syndrome and hemolytic uremic syndrome depending on the species of Shigella implicated.
This diarrheal disease is found worldwide with the vast majority of cases and deaths being in children. Outbreaks usually occur where there are crowded conditions and where personal hygiene is poor: prisons, day care centers and refugee camps are three examples.

It is transmitted primarily by fecal-oral person to person means. It can also occur through contaminated food or water. Those that are primarily responsible for transmission are those that fail to wash their hands thoroughly after defecation.
Because Shigella is resistant to gastric acid, a person can get infected with as little as 10 organisms.
After getting infected symptoms usually appear 1-3 days later. It can be transmitted during the acute phase of infection till approximately four weeks after illness when the organism is no longer present in the feces. Asymptomatic carriers can also infect others.
Diagnosis is confirmed through bacteriological culture of feces. Treatment of shigellosis may include fluid and electrolyte replacement if there are signs of dehydration.
Antibiotics can shorten the course of infection, the severity of illness and the period of time a person may excrete the pathogen. Because of some antibiotic resistance, an antibiotic susceptibility test should be performed to determine which antibiotic would be effective.
Saskatchewan health advisepeople experiencing diarrhea, especially with fever, painful cramps, and mucus and/or blood to:
  • Contact a doctor who will arrange for assessment and treatment;
  • Stay home from work or school, and visiting friends and relatives, until at least 48 hours after the diarrhea has stopped. This is especially important for those who work in an occupation such as food service, childcare, eldercare or healthcare;
  • Frequent and thorough hand washing with soap and running warm water, especially after using the toilet. This is the single most important way to stop the spread of Shigella; and
  • Avoid preparing food for others.

Friday, August 5, 2011

Tick-borne anaplasmosis seen in increasing numbers in Albany (video)

Health providers are warning the public about the presence of a bacterial infection seen in the Albany Capital region that is transmitted by the same vector that transmits Lyme disease and Babesia.
Infectious disease specialists in the Albany, NY area have reported seeing an increase in the tick-borne bacterial infection anaplasmosis, according to a Monday WNYT report.
According to Dr. Alan Sanders, "If i were to see a case or 2 a year it would be expected in the last decade and a half. And we've already seen 12 cases, just in about 4 or 5 weeks, so far."
The organism that causes this disease is called Anaplasma phagocytophilum. It is an intracellular pathogen that is part of the Rickettsia (the same group of bacteria that cause Rocky Mountain spotted fever amongst other diseases) family.
Formerly known as human granulocytic ehrlichiosis, and as the former name of the disease implies, it’s an infection of the white blood cells.
People get this infection through the bite of an infected tick. Depending on the part of the United States you are, the tick species is different: the eastern part of the country is the black-legged tick, Ixodes scapularis, and in the western part of the country, Ixodes pacificus, is usually involved.
These are deer ticks that are also involved in the transmission of Lyme disease.

According to the Centers for Disease Control and Prevention (CDC), there are about 600-800 cases of anaplasmosis are reported to CDC each year. States reporting the highest incidence of anaplasmosis in 2006 were Minnesota, Wisconsin, New York, New Jersey, and Connecticut.
The disease is also seen throughout other parts of North America, Europe and Asia.
After a period of a couple of days to a few weeks, most people infected with Anaplasma show influenza- like symptoms (fever, malaise, headache, nausea, vomiting, diarrhea and respiratory symptoms such as a cough). Symptoms tend to be more severe in those that are immunosuppressed and the elderly.

Thursday, August 4, 2011

Meningococcal meningitis outbreak at Australia’s James Cook University

A memorial service was held Saturday for an 18-year-old medical student studying at James Cook University in Townsville in north Queensland who died from the deadly bacterial infection, meningococcal meningitis.
In addition, a second medical student at the university has also contracted the lethal infection and is currently being treated with antibiotics.
According to an ABC News report, Dean of Medicine and Dentistry, Professor Richard Murray said the people who have been in close contact with the men have been interviewed and given antibiotics.
So far this year there have been 38 cases in Queensland; but it is believed this is the first death.
Queensland Premier Anna Bligh said the cases of meningitis are very concerning. She goes on to say, "It is very worrying. It is tragic to see a young 18-year-old lose their life to this awful disease. That's why Queensland Health is, as of right now, out tracing every contact that they can so that we can understand where this disease may be operating."
Meningococcal meningitis is caused by the bacterium, Neisseria meningitidis, which causes the most severe form of bacterial meningitis. Meningitis is an infection of the membranes covering the brain and spinal cord. It can also be found in the bloodstream. This particular type of meningitis is very severe and can result in death if not treated promptly. Even in cases where treatment has been given, the fatality rate is around 15%.
The symptoms of bacterial meningitis are sudden, with fever, stiff neck, body aches and headaches. As the disease progresses other symptoms may include nausea, vomiting, photophobia and seizures. A petechial rash seen on the trunk and lower extremities, bleeding complications, multi-organ failures and shock are usually final signs. This disease has the ability to kill within hours of getting it.

Up to 10-20% of older children and young adults carry this organism in the mouth and nose, though the carriage rate will vary with age and closeness of population. The majority of people that carry this bacterium have no clinical disease. The organism is spread person to person through respiratory secretions from the nose and mouth (coughing, sneezing and kissing). Experts are unsure why some people advance to meningitis disease while many do not.
Crowded living conditions facilitate the spread of the organisms and places like military barracks and college dormitories are well documented areas of concern with this disease.
What can you do to protect your family? You should get family members vaccinated if they fall into one of these categories prescribed by the CDC:
• If you have a high risk child from 2 to 10 years old.
• It is recommended to vaccinate children 11-18 years old.
• If you are a military recruit
• Other medical conditions (an absent or damaged spleen)
• Traveling to a country where the disease is common.
If you have close contact with someone with meningococcal meningitis, see your doctor for prophylactic antibiotics.
Meningococcal meningitis is a devastating disease with epidemic potential. This disease is considered a medical emergency and if you have the classic symptoms see your health care professional. It can be treated with antibiotics, but without delay.
Around 11,500 students study at JCU Townsville, including over 1,500 international students. The campus is located in the suburb of Douglas, in a 386-hectare natural bush and parkland setting, 13 kilometers (8 miles) from the central business district.

Wednesday, August 3, 2011

Several cases of campylobacteriosis in North Carolina associated with raw milk

The US Food and Drug Administration (FDA) said in a news release Saturday they were working with officials in North Carolina and South Carolina to investigate an outbreak of campylobacteriosis in three people who consumed raw milk from Tucker Adkins Dairy in York, S.C.
The three confirmed cases and another five probable cases are from three different households and each case reports that prior to becoming ill they consumed raw milk that was obtained from Tucker Adkins Dairy on June 14, 2011. 
The FDA recommends that consumers only drink pasteurized milk.  Raw milk is unpasteurized milk from hoofed mammals, such as cows, sheep, or goats. Raw milk may contain a wide variety of harmful bacteria – including Salmonella, E. coli O157:H7, Listeria, Campylobacter and Brucella -- that may cause illness and possibly death. Public health authorities, including FDA and the Centers for Disease Control and Prevention, have expressed concerns about the hazards of drinking raw milk for decades.
The FDA recommends that consumers only drink pasteurized milk, and those who may have raw milk produced by Tucker Adkins Dairy should dispose of that product.
What is Campylobacter? It is a bacterium that can also be found, with not quite the frequency as in chicken, in healthy cattle, birds, raw milk, and contaminated water.
Most cases of campylobacteriosis are associated with eating raw or undercooked poultry meat or from cross-contamination of other foods by these items. Infants may get the infection by contact with poultry packages in shopping carts. It is also possible to be infected from the feces of an infected pet cat, dog or farm animal. It is the leading cause of bacterial diarrhea in the United States, more than Salmonella and Shigella combined.

It doesn’t take a lot of this organism to get you ill. In some studies it showed that as little as 500 organisms can cause disease in some individuals. The Centers of Disease Control and Prevention says that you can get infected from one drop of juice from raw chicken meat.
Campylobacter jejuni, the species most often implicated in infection causes diarrhea, which may be watery or sticky and can contain blood and white blood cells. Other symptoms often present are fever, abdominal pain, nausea, headache and muscle pain. The illness usually occurs 2-5 days after ingestion of the contaminated food or water. Illness generally lasts 7-10 days, but relapses are not uncommon (about 25% of cases).
There can be complications associated with campylobacteriosis; they include arthritis and neurological disorder Guillain-BarrĂ© syndrome. It is estimated that the latter is seen in one out of every 1000 cases of Campylobacter.
Most cases of Campylobacter are self-limiting and do not require treatment. However, severe cases can be treated with antibiotics to shorten the length of the disease.
The raw milk associated with the illness was in one-gallon containers and was distributed in North Carolina by a courier. It is unknown whether the raw milk may have been distributed in other states.