Sunday, September 25, 2011

The latest on the dengue fever outbreak in the Bahamas

The spike in dengue fever began in July and soon turned into a full-blown outbreak. In fact, in early August, the US Embassy in Nassau issued a dengue fever warning for US travelers to the islands.

Many of the Caribbean Islands are also battling dengue fever including Turks and Caicos and Trinidad and Tobago.

Two Northern Virginia children were sickened by dengue after vacationing there last month.
In a Washington Post report Friday, two children ages 14 and 10 were infected with the mosquito-borne virus last month:

A 14-year-old Lorton boy came down with a high fever last month and such severe muscle aches that he could barely walk, his mother said Friday. Another boy, Collin Allen, 10, of Springfield, had severe headaches, fever, nausea and a rash, became dehydrated and was hospitalized for three days in late August, his mother, Terri Allen, said. Both recovered.
The Post also reports that coincidentally, the boys were treated at the same pediatric practice, Children’s Medical Associates of Northern Virginia, within a week of each other.

One of the mothers was reportedly upset over this saying she was never warned. True enough; the CDC didn’t publish an outbreak notice until last Thursday.

The most recent estimates on the dengue fever outbreak are in the ballpark of 3,500 cases. However, the good news is, the Minister of Health, Hubert Minnis said the number of cases being reported from health facilities has decreased.

Dr. Minnis said on the Facebook page, Dengue Fever Outbreak in the Bahamas Community:

“I am presently travelling on official government business, but I am in constant contact with my Ministry of Health officials who remain diligent and dedicated to seeing that we continue to educate regarding prevention and are giving the proper care and attention to those affected. Please stay tuned to the news reports. We will continue to update as information becomes available."

The reactions from fans of the page have been mixed on the Ministry’s response.

Some on the page are not too happy with the government’s actions or inaction to the dengue outbreak. One person writes:  This situation has gone on for far to long with out any serious action by the Govt......where are the planes??? these little trucks driving around are a joke ...the fog is in the road but does it reach you back yard....No....

But another fan has a different view: OMG... now prey tell me why we need PLANES... WE LIVE IN SMALL COMMUNITIES..... I think that too many of you all watch TV, see what happens in BIG COUNTRIES like the U S A and think that we should do the same... REALIZE it or not....

Tuesday, September 20, 2011

King County, WA: two cases of suspected botulism in heroin users

Seattle & King County health officials said they are investigating two suspected cases of wound botulism in intravenous heroin users. Contaminated “black tar” heroin is the likely source of the infection according to a Public Health news release Wednesday.

Dr. Jeff Duchin, Chief of the Communicable Disease Epidemiology and Immunization Section for Public Health -- Seattle & King County said, "There is no way for a person on the street to tell if black tar heroin is contaminated, nor any way to clean it to make it safe. The best way for injection drug users to prevent getting the disease is not to use heroin, but for those who do, they need to be aware of the risk of botulism and seek medical attention immediately if they develop symptoms."

Wound botulism occurs when spores of Clostridium botulinum contaminate a wound, germinate and produce botulinum neurotoxin in the body. Most wound botulism cases have been among intravenous drug users.

Symptoms of wound botulism will present itself from a couple of days to two weeks after exposure. Symptoms include blurred vision and difficulty speaking or swallowing, associated with fatigue, dizziness and worsening weakness that can lead to paralysis.

According to the news release, the first King County resident is an adult female with a history of "black tar" heroin injection who presented to a King County hospital with slurred speech, double vision, and drooping eyelids at the end of August. About a week later, an adult male with a similar history of injection drug use was admitted with similar symptoms. Both worsened and required admission to an intensive care unit. Botulism is strongly suspected in both cases, and testing to confirm the diagnosis is pending at the Washington State Public Health Laboratory.

There have been four similar cases in the El Paso, Texas area among drug users since August 26, 2011, but the health department says there's no link to the King County cases.

Black tar heroin has been an issue in the US and Europe for years with outbreaks in California and Washington state in the past.

Mexico is frequently the source of black tar heroin, which is a thick gummy substance, and because of this, it needs to be diluted. Many experts believe the source of the botulism is in the “cutting agent” which is believed to be things like dirt and honey.

According to Seattle & King County Public Health, Not using heroin is the best way to prevent botulism, but for those who continue to use, other ways to reduce the risk include:

 Ensure that all works and skin are clean.
·         Don't use "black tar" heroin, which cannot be cleaned. "Cooking" the drug does not kill botulism    bacteria.
·        Don't share needles, syringes, filters, cookers, or water.
·        Always use a new sterile syringe.
·        If reusing a syringe, clean it well with bleach.
·        Get a tetanus shot every five years.

Veracruz, Mexico health officials report two fatal cases of DHF

The Secretary of Health for Veracruz, Mexico, Pablo Anaya reported that there have been two reported fatalities from dengue hemorrhagic fever (DHF).

According to Anaya, “Two patients died and two others are under study for DHF, a serious illness. The deaths occurred in Poza Rica and Veracruz."  He goes on to say the other two possible cases are located in the municipalities of Cosamaloapan and Coatzacoalcos, south of Vercruz.

The number of cases of dengue fever has declined dramatically in 2011 (24) as compared to the previous year (269).

Four different dengue viruses (DEN-1, DEN-2, DEN-3 and DEN-4) are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person catches a different type dengue virus after being infected by another one sometime before. Prior immunity to a different dengue virus type plays an important role in this severe disease.

Symptoms of DHF include all the symptoms of classic dengue (high fever, up to 105°F, severe headache, pain behind the eye, severe joint and muscle pain, nausea and vomiting and a rash) 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.

According to the A.D.A.M. Medical Encyclopedia, because Dengue hemorrhagic fever is caused by a virus for which there is no known cure or vaccine, the only treatment is to treat the symptoms.

·         A transfusion of fresh blood or platelets can correct bleeding problems
·         Intravenous (IV) fluids and electrolytes are also used to correct electrolyte imbalances
·         Oxygen therapy may be needed to treat abnormally low blood oxygen
·         Rehydration with intravenous (IV) fluids is often necessary to treat dehydration
·         Supportive care in an intensive care unit/environment

Sunday, September 18, 2011

Follow-Up: Minnesota Medical Association’s House of Delegates reject routine chlamydia tests for all young adults

In a follow-up story from Sept 16, The Duluth News Tribune reports:
The Minnesota Medical Association’s governing board voted on Friday not to recommend routine testing of all young adults for chlamydia.
In rejecting the resolution, the 200-member House of Delegates followed the lead of a subcommittee that heard arguments on Thursday during the MMA’s two-day annual meeting at the Duluth Entertainment Convention Center. The proposed resolution called on the MMA to “support annual screening for chlamydia among all males and females in the 15-25 age range with repeat screening at the discretion of the physician.”
That would have gone beyond national guidelines, which recommend annual screening only for sexually active females ages 15 to 25.
And it went too far for the subgroup, which the MMA refers to as a reference committee.

“Concerns were expressed that cost-effectiveness is not proven for screening men and that the resolution goes beyond what is currently recommended by experts,” the committee said in its report to the House of Delegates.

The House of Delegates’ decision was by “consensus,” and no tally was available, said Scott Smith, spokesman for the MMA.

Saturday, September 17, 2011

Female kakapo, Purity, dies from rare salmonella infection

A rare, female, New Zealand bird that was found dead two weeks ago, died from a salmonella infection according to Department of Conservation officials Friday.

The two-year-old, Purity, was found dead on Codfish Island.

According to a report in the Southland Times today, Kakapo Recovery Programme manager Deirdre Vercoe Scott said it was the first time salmonella had been recorded in a kakapo.

The investigation into how Purity was infected with the deadly bacteria and the identity of the specific strain is ongoing.

Scott says, "At the moment, the most likely cause is probably a new infection brought by birds or people."

In humans, Salmonella is an organism, which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain.

In rare circumstances, infection with salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

It can infect and cause symptoms in a variety of other animals.

As of this writing, experts do not believe that this is a problem throughout the kakapo population, just an isolated incident.

Friday, September 16, 2011

Minnesota doctors to vote on new Chlamydia screening policy

The Minnesota Medical Association’s House of Delegates will be voting today, Sept 16, on a resolution that would support annual Chlamydia screening on every male and female age 15 to 25.

This will be taking place during the Minnesota Medical Association’s Annual Meeting in Duluth.

The resolution is being considered because the number of cases of the sexually transmitted infection has skyrocketed in the past decade. The number of cases in 2010 was 15,000, tripling the number from 12 years ago. Candy Hadsall of the Minnesota Department of Health, who supports the resolution, calls the situation a “Chlamydia epidemic”.

However, some at the meeting think the policy is going too far. Dr. Sally Trippel of the Mayo Clinic agreed that chlamydia is a serious problem, but she said the resolution overreached.

The Duluth News Tribune reported some of the arguments, pro and con:

“This resolution is asking the MMA House of Delegates to create a new guideline,” Trippel said. “And I would argue that that’s not the purpose of the House of Delegates. We don’t have the expertise.”

Both the U.S. Preventive Services Task Force and the Centers for Disease Control and Prevention guidelines recommend screening sexually active females ages 15 to 25, Trippel said. Screening males hasn’t been proven cost-effective in existing studies, she said.

Dr. Amy Gilbert of St. Paul, who presented the resolution for the MMA’s public health committee, already had acknowledged that issue.

“We have to confess that the data on the benefits of screening males is not as strong,” Gilbert said. “It comes from more of a felt sense that … by screening males we would catch more and eliminate more chlamydia from the population.”

Dr. Terence Cahill of Blue Earth, chairman of the committee, said such screenings put doctors in an uncomfortable position, especially in rural communities. “I have to call the parent and explain why I’m screening their child for a sexual disease,” he said. “This proposal would have us screening for a disease that a significant number of people don’t have or aren’t likely to have.”

Chlamydia trachomatis, specifically types D through K, are responsible for sexually acquired genital infections in adults and perinatally transmitted infections in newborns and infants.

Like gonorrhea, chlamydia can be transmitted during oral, vaginal and anal sexual contact with an infected partner.

Sometimes Chlamydia is called the “silent disease” because so many people have it and don’t know it. Asymptomatic infection in men is as high as 25%, in women 70%! If symptoms do appear, it’s usually within 1-3 weeks.

When symptoms are present in men, it’s sometimes difficult to distinguish from gonorrhea; urethral discharge, itching and burning during urination. In women, symptoms are also similar to gonorrhea with discharge and bleeding being most common.

Men or women who have receptive anal intercourse may acquire chlamydial infection in the rectum, which can cause rectal pain, discharge, or bleeding. Chlamydia can also be found in the throats of women and men having oral sex with an infected partner.

Pelvic inflammatory disease (PID) and epidyimitis, in women and men respectively, are the most common complications with untreated chlamydia.

Rarer complications include: Bartholinitis, proctitis and Fitz-Hugh-Curtis syndrome.

In pregnant women, there is some evidence that untreated chlamydial infections can lead to premature delivery. Babies who are born to infected mothers can get chlamydial infections in their eyes and respiratory tracts. Chlamydia is a leading cause of early infant pneumonia and conjunctivitis (pink eye) in newborns.

The diagnosis of chlamydia has undergone many changes over the years. Culture and antigen testing is not as sensitive as the newer more expensive molecular methods available today. The choice of diagnostic test may be decided on cost in some settings for now.

Chlamydia can be treated with the antibiotics Doxycycline (twice daily for 7 days) or Azithromycin in a single dose. Erythromycin is the drug of choice for infants and Azithromycin for pregnant women.

It is common practice to treat for gonorrhea also when diagnosed with chlamydia. Co-infections are relatively common.

The CDC recommends yearly chlamydia testing of all sexually active women age 25 or younger, older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women.

Thursday, September 15, 2011

CDC issues a dengue outbreak notice for the Bahamas

The US Centers for Disease Control and Prevention (CDC) released an Outbreak Notice on Thursday, Sept 15, offering information and travel advice for US citizens travelling to the islands.

With more than 3,200 cases of the mosquito borne viral infection reported in the past two months, The Bahamas government issued a dengue advisory, which  resulted in  the US Embassy in Nassau issuing an emergency message  for US citizens in the Bahamas related to dengue.

In addition, there have been several cases of the dangerous dengue hemorrhagic fever reported on the islands.

The CDC offers the following advice for travelers to the Bahamas:

Travelers can reduce their risk of infection with dengue by protecting themselves from mosquito bites. The mosquitoes that spread dengue bite mostly at dusk and dawn but may bite at any time during the day, especially indoors, in shady areas, or when the weather is cloudy.

Travelers should follow the steps below to protect themselves from mosquito bites:

·         Where possible, stay in hotels or resorts that are well screened or air conditioned and that take measures such as spraying with insecticide to reduce the mosquito population.

·         When outdoors or in a building that is not well screened, use insect repellent on uncovered skin. If sunscreen is needed, apply before applying insect repellent.

o    Look for a repellent that contains one of the following active ingredients: DEET, picaridin (KBR 3023), Oil of Lemon Eucalyptus/PMD, or IR3535. Always follow the instructions on the label when you use the repellent.

o    In general, repellents protect longer against mosquito bites when they have a higher concentration (percentage) of any of these active ingredients. Products with less than 10% of an active ingredient may offer only limited protection, often no longer than 1-2 hours. DEET-based products with concentrations above 50% do not offer a marked increase in protection time.  

o    The American Academy of Pediatrics approves the use of repellents with up to 30% DEET on children older than 2 months.

o    Protect babies less than 2 months old by using a carrier draped with mosquito netting with an elastic edge for a tight fit. For more information about the use of repellent on infants and children, please see the “Insect and Other Arthropod Protection” section inTraveling Safely with Infants and Children and the “Children” section of CDC’s Frequently Asked Questions about Repellent Use.

o    For more information on the use of insect repellents, see the information on the Mosquito and Tick Protection webpage.

·         Wear loose, long-sleeved shirts and long pants when outdoors.

o    For greater protection, clothing may also be sprayed with a repellent containing permethrin or another EPA-registered repellent. (Remember: don't use permethrin on skin.)

If you return from a trip abroad and get sick with a fever, you should seek medical care right away. Be sure to tell the doctor or other health care provider about your recent travel.

You may see the following symptoms if infected with dengue fever:

·         fever
·         headache
·         pain behind the eyes
·         joint and muscle pain
·         rash
·         nausea/vomiting
·         mild bleeding, such as nose or gum bleeding or easy bruising

Usually dengue is a mild illness, but it can lead to severe dengue, which can be fatal if not treated. People who have been infected with dengue in the past, even if they did not have symptoms or feel sick, are at increased risk of getting severe dengue if they are infected again. 

People with dengue fever that progresses to severe dengue usually experience warning signs within 48 hours of their fever ending. Anyone with dengue who experiences these warning signs should go to a doctor or emergency room immediately:

·         Severe abdominal pain or persistent vomiting
·         Red spots or patches on the skin
·         Bleeding from nose or gums
·         Vomiting blood
·         Black, tarry stools (feces, excrement)
·         Drowsiness or irritability
·         Pale, cold, or clammy skin
·         Difficulty breathing

There is no specific medicine to cure illness caused by dengue viruses. People who think they have dengue should use pain relievers with acetaminophen (such as Tylenol) to lessen discomfort and reduce fever. Avoid drugs that contain ibuprofen, naproxen, and aspirin. People with dengue should also rest, drink plenty of fluids, and talk to a doctor about their symptoms.

In some cases of severe dengue, hospitalization to replace lost fluids may be needed. Early recognition and treatment of severe dengue can reduce the risk of death.

Sunday, September 11, 2011

Sedgwick County, Kansas: probable case of Naegleria fowleri

In what is the first known case of primary amoebic meningoencephalitis (PAM) in the state of Kansas, the Sedgwick County Health Department was notified by the Centers for Disease Control and Prevention (CDC) of the presence of the deadly amoeba, Naegleria fowleri in a sample from a resident who died.

Health Department officials said Thursday that the victim’s infection likely occurred while swimming in Winfield City Lake in Cowley County.

Naegleria fowleri  is a relatively rare, pathogenic amoeba 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.

People typically get infected 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. The disease is known as primary amoebic meningoencephalitis (PAM) and it 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.

Fortunately, it’s a pretty rare disease, with only approximately 30 cases in the past decade. 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. 

Chinese woman sentenced to prison for killing her son suffering from syphilis

A woman from Chongquig city in western China was sentenced Monday to 15 years in prison for feeding rat poison biscuits to her 16-month-old son who was suffering from congenital syphilis.

The crime occurred last November when the 20-year-old mother purchased the rat poison and fed the tainted biscuits in an effort to bring an end to the boy’s pain from the severe disease. "I couldn't bear to see my son's condition worsening and I only wanted to help him terminate the pains," the woman reportedly told the court. 

Prosecutors in Chongquig city say a major motive behind the killing was the mounting medical bills from his treatments.

Congenital syphilis is a severe, disabling, and often life-threatening infection seen in infants. A pregnant mother who has syphilis can spread the disease through the placenta to the unborn infant.

Congenital syphilis is caused by the bacterium Treponema pallidum, which is passed from mother to child during fetal development or at birth. Nearly half of all children infected with syphilis while they are in the womb die shortly before or after birth.

According to Medline, the symptoms in older infants and young children include:

  • ·         Abnormal notched and peg-shaped teeth, called Hutchinson teeth
  • ·         Bone pain
  • ·         Blindness
  • ·         Clouding of the cornea
  • ·         Decreased hearing or deafness
  • ·         Gray, mucus-like patches on the anus and outer vagina
  • ·         Joint swelling
  • ·         Refusal to move a painful arm or leg
  • ·         Saber shins (bone problem of the lower leg)
  • ·         Scarring of the skin around the mouth, genitalia, and anus

FDA warns about botulism risk with La Ruche tapenade

Though there is no indication that any of these products has been imported into the U.S., the US Food and Drug Administration issued a news release Saturday warning consumers not to eat tapenade or spreadable dried tomato paste manufactured by the French food company La Ruche.

French health officials earlier reported an outbreak of botulism, which has afflicted eight people in France after consuming products manufactured by the French food company.

The products implicated  were sold under the brand names "Les delices de Marie-Claire," "Terre de Mistral" and Les Secrets d'Anais."

French authorities have ordered production halted at the company's facility in France and have directed that all products sold under those brand names be recalled.

The FDA has increased its monitoring of shipments from this area of the world and has issued a bulletin to its Field Offices today to be vigilant in this area.

Food borne botulism is a severe intoxication caused by eating the preformed toxin present in contaminated food.

Food borne botulism occurs when the bacterium Clostridium botulinum is allowed to grow and produce toxin in food that is later eaten without sufficient heating or cooking to inactivate the toxin. Botulinum toxin is one of the most potent neurotoxins known.

Growth of this anaerobic bacteria and the formation of the toxin tend to happen in products with low acidity and oxygen content and low salt and sugar content. Inadequately processed, home-canned foods like asparagus, green beans, beets, and corn have been commonly implicated. However, there have been outbreaks of botulism from more unusual sources such as chopped garlic in oil, chili peppers, improperly handled baked potatoes wrapped in aluminum foil and home-canned or fermented fish.

Garden foods like tomatoes, which used to be considered too acidic for the growth of Clostridium botulinum, is now considered a potentially hazardous food in home canning. Though more common in home-canned foods, it happens only occasionally in commercially prepared foods.

Typically in a few hours to several days after you eat the contaminated food you will start to show the classic symptoms; blurred vision, dry mouth, and difficulty in swallowing.

Gastrointestinal symptoms may or may not occur. If untreated, the paralysis always descends through the body starting at the shoulders and working its way down. The most serious complication of botulism is respiratory failure where it is fatal in up to 10% of people. It may take months before recovery is complete.

If the disease is caught early enough it can be treated with antitoxin. If paralysis and respiratory failure happen the person may be on a ventilator for several weeks.

Saturday, September 10, 2011

Zambia reports 120 human cases of anthrax from consuming infected hippo

The Zambia Ministry of Health reported Friday that 120 people have been infected with anthrax in the Chama District in Eastern Province.

MOH Spokesperson Dr. Kamoto Mbewe says all the patients involved in the outbreak had a history of having consumed or touched infected hippo meat.

Breeze News reports that Senior Veterinary Officer, Arthur Mubolomena confirmed at least three people had died in the outbreak.

Dr. Mumbolomena says that suspected anthrax has killed dozens of hippos in Luangwa River since the outbreak began some two weeks ago.

Mbewe says areas bordering Chama or anyone who has consumed hippo meat in the recent past may be affected. However, he adds the public should not panic because the disease was treatable and that the Ministry had sufficient stocks of drugs.

People who had come in contact or had eaten hippo meat in recent weeks and developed skin swellings like insect bites which later become blister or which eventually ulcerated, should quickly seek medical attention said Mwebe.

Tamil movie director, Selvaraghavan, bedridden with typhoid

The Indian film director responsible for the critically acclaimed dramatic story, Kadhal Kondein, has been bedridden with a case of typhoid fever.

As was reported Saturday in, Selvaraghavan has been working inhuman hours to finish Mayakkam Enna.

The director is being treated with antibiotics and a strict diet and is being taken care of by his wife, Gitanjali.

Typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi. Salmonella Typhi lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed S.Typhi in their feces.

You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding S. Typhi or if sewage contaminated with S. Typhi bacteria gets into the water you use for drinking or washing food. Therefore, typhoid fever is more common in areas of the world where handwashing is less frequent and water is likely to be contaminated with sewage.

Tuesday, September 6, 2011

Vermont reports first human cases of West Nile since 2003

Though the West Nile virus (WNV) has been detected most years in the New England state, it has been primarily seen in the mosquito vector, horses and dead birds.

For the first time since 2003, Vermont has a confirmed West Nile virus in a human, in fact two humans.

In a Friday Department of Health news release, the Vermont Department of Health  (VDH) has received two reports of infection in people in recent weeks. 

The specifics of the cases are found in the release:

One case currently under investigation is in a resident of Addison County. The person was hospitalized but is recovering. Earlier this summer, a Franklin County resident was found to be infected when their blood donation tested positive for West Nile virus. Donated blood is routinely tested for the virus and when found to be positive, as in this case, it is discarded.

West Nile virus is a mosquito-borne disease that can cause encephalitis, a brain inflammation. West Nile virus was first detected in North America in 1999 in New York. Prior to that it had only been found in Africa, Eastern Europe, and West Asia.

According to the Centers for Disease Control and Prevention (CDC), approximately 80 percent of people (about 4 out of 5) who are infected with WNV will not show any symptoms at all.

Up to 20 percent of the people who become infected have symptoms such as fever, headache, and body aches, nausea, vomiting, and sometimes swollen lymph glands or a skin rash on the chest, stomach and back. Symptoms can last for as short as a few days, though even healthy people have become sick for several weeks.

About one in 150 people infected with WNV will develop severe illness. The severe symptoms can include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. These symptoms may last several weeks, and neurological effects may be permanent.

There is no specific treatment for WNV infection.

Though the risk of WNV is low, the VDH recommends taking the following precautions:

·         Wear long sleeves and pants and avoid outdoor activities at dusk and dawn when mosquitoes are active.
·         Use insect repellents that are safe and effective against mosquitoes. Products with a registration number from the Environmental Protection Agency on the label have been evaluated for safety and effectiveness. Repellents containing DEET in concentrations up to 30%, picaridin, oil of lemon eucalyptus or IR3535 can be used to prevent mosquito bites.
·         Install or repair screens on windows and doors to keep mosquitoes out.
·         Horses are also susceptible to West Nile virus infection. There is a vaccine available for horses, and horse owners should discuss vaccination with their veterinarians.

Sunday, September 4, 2011

Hong Kong health officials report more scarlet fever cases

The Hong Kong Centre for Health Protection (CHP) reported Tuesday, at least two more cases of scarlet fever in the country.

According one of the CHP news releases, they are investigating a suspected case of scarlet fever complicated with septic shock involving a 15-month-old girl.

The timeline of her illness started Aug 22 when she presented with fever, chickenpox and sandpaper rash. She was admitted to Princess Margaret Hospital on August 29. As she developed tachycardia, she was today transferred to the Pediatric Intensive Care Unit of the hospital.

The infant is in serious condition.

A report from the news source, The Standard, says Centre for Health Protection controller Thomas Tsang Ho-fai said enhanced surveillance of the childhood disease, in place since June 24, will be extended until September 30.

The ongoing investigation reveals no travel history and asymptomatic home contacts.
In addition, in a second news release also dated Aug 30, the CHP is investigating a case of severe Group A Streptococcal infection involving a 63-year-old woman.

According to the release, the patient developed fever, chills and rigors, dizziness, abdominal pain, vomiting and diarrhea on August 27 and was admitted to Princess Margaret Hospital on the same day. She was transferred to the Intensive Care Unit the next day due to shock with decreased blood pressure and increased heart beat. Antibiotic treatment was given.

The patient is currently in critical condition. The patient's blood specimen grew Streptococcus pyogenes (Group A) in laboratory test.

Scarlet fever is one form of group A strep disease which can follow strep throat.

In addition to the symptoms of strep throat, a red rash appears on the sides of your chest and abdomen. It may spread to cover most of the body.

The rash appears as tiny, red pinpoints and has a rough texture like sandpaper. If you press the rash it loses color and turns white. You may also see dark red lines in the folds of skin.

In addition, you may get a bright strawberry-red tongue and a rosy face, while the area around the mouth remains pale. Skin on the tips of the fingers and toes often peel after you get better.

You may also have fever, nausea and vomiting in more severe cases.

You get scarlet fever the same way you get strep throat; through direct contact with throat mucus, nasal discharge and saliva from an infected person.

Scarlet fever is usually diagnosed by doing a throat culture or a rapid strep antigen test. Treatment, like with strep throat, is with antibiotics.

Saturday, September 3, 2011

UN agency warns of possible avian influenza comeback

In a media release Monday, the Food and Agriculture Organization of the United Nation (FAO) warned about a possible resurgence of the very deadly H5N1 avian influenza.

In addition, they warn of a mutant variant of the virus (H5N1 - which has been seen in China and Vietnam, which is showing the ability to resist existing vaccines.

Today, H5N1 is endemic in six countries: Bangladesh, China, Egypt, India, Indonesia and Vietnam, however the FAO warns against complacency saying no country can consider itself safe and the health risks to humans is unpredictable.

For example, migratory bird movements have caused H5N1 to show up in poultry or wild birds in countries that had been virus-free for several years like Israel and the Palestinian Territories, Bulgaria, Romania, Nepal and Mongolia.

World Health Organization numbers show the H5N1 virus has infected 565 people since it first appeared in 2003, with 331 of those infected dying from the lethal disease. The latest fatality occurred in a child in Cambodia two weeks ago.

According to the FAO media release, since 2003 H5N1 has killed or forced the culling of more than 400 million domestic poultry and caused an estimated $20 billion of economic damage across the globe before it was eliminated from most of the 63 countries infected at its peak in 2006. Outbreaks dropped dramatically from 2003 to 2008 but have steadily increased the last three years.