Sunday, October 30, 2011

NC health officials report possible link between E.coli outbreak and State Fair

The investigation continues on the E.coli outbreak that has affected residents in six North Carolina counties.
According to North Carolina Department of Public Health press release Friday, they are investigating 26 cases related to the E. coli outbreak. Ten cases are confirmed E. coli cases; 16 cases are still being investigated. At least five people have been hospitalized from the infection.
The six counties that have reported E.coli infections include, Wake (14), Sampson (6), Cleveland (1), Durham (1), Franklin (1), Johnston (1), Orange (1) and Wilson (1).
Currently, the investigation points to a possible link between the people infected and the North Carolina State Fair. Patient interview information shows that 23 of the 26 persons involved in the investigation report having attended the State Fair in Raleigh. 
The North Carolina Department of Public Health says the next part of the investigation will include contacting randomly selected State Fair attendees by email to participate in a survey. Participants will not be asked to provide social security numbers or financial information at any time during the survey process.
Enterohemorrhagic E. coli (EHEC) can cause severe foodborne disease. It is transmitted to humans primarily through consumption of contaminated foods, such as raw or undercooked ground meat products, leafy greens, unpasteurized juices and raw milk.
EHEC produces toxins, known as verotoxins or Shiga-like toxins because of their similarity to the toxins produced by Shigella dysenteriae. 
Symptoms of the diseases caused by EHEC include abdominal cramps and diarrhea that may in some cases progress to bloody diarrhea.  The infection may lead to a life-threatening disease, such as hemolytic uremic syndrome (HUS). HUS is characterized by acute renal failure, hemolytic anemia and thrombocytopenia. It is estimated that up to 10% of patients with EHEC infection may develop HUS, with a case-fatality rate ranging from 3% to 5%.
The very young, seniors and persons with weak immune systems are the most susceptible to foodborne illness.
Each year in the United States, E. coli infections cause approximately 265,000 illnesses and about 100 deaths. Approximately 40 percent of these infections are caused by the strain E. coli O157:H7, a strain that is part of the shiga toxin-producing group of E. coli bacteria (STEC). The other 60 percent of E. coli cases are caused by non-O157:H7 shiga toxin-producing E. coli (STEC).

Saturday, October 29, 2011

CDC issues dengue fever outbreak notice for travelers to the Marshall Islands

The Centers for Disease Control and Prevention (CDC) issued a dengue fever outbreak notice Friday for the Marshall Islands.

The cases have been predominately seen in the capital city of Majuro. The Marshall Islands outbreak has also prompted a dengue fever advisory on the island of Guam.

The CDC offers the following recommendations for travelers to reduce their risk for contracting dengue fever:

·         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.

·         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.

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

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

·         Protect babies less than 2 months old by using a carrier draped with mosquito netting with an elastic edge for a tight fit.

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

·         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.)


Wednesday, October 26, 2011

CDC issues recommendations for travelers to Greece

In light of a recent Eurosurveillance report concerning malaria in Greece, the Centers for Disease Control and Prevention (CDC) issued new anti-malarial recommendations for US travelers to certain parts of Greece on Monday.

According to the referenced report, since September 27, 2011, a total of 20 malaria cases have been reported in persons with no history of travel to a malaria-endemic area. An additional 16 cases have been identified in persons from malaria endemic countries in whom importation versus local transmission of malaria could not be determined. All cases were confirmed to be Plasmodium vivax. 

The majority of cases are being reported from Laconia district in the south of Greece.

According to the CDC recommendations, they are recommending that travelers to Laconia district in Greece take anti-malarial medicines to prevent malaria. Recommended antimalarials include one of the following: atovaquone-proguanil (Malarone ®), chloroquine, doxycycline, mefloquine, or primaquine. Note that primaquine is contraindicated in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency. If primaquine is chosen, the traveler must be screened for G6PD deficiency prior to use.

Other areas of the country where there have been limited cases (Evia/Euboea, Eastern Attiki, Voitia, and Larissa), anti-malarials are not recommended at this time. 

In addition, measures to prevent mosquito bites should be taken in any area with malaria. These include using insect repellent when outdoors, and staying in an air-conditioned or well-screened area, or sleeping under an insecticide treated bed net during the peak biting period for mosquitoes (dusk and dawn).

Tuesday, October 25, 2011

NJ officials warn of dangers of novelty contact lenses as Halloween approaches

With Halloween just around the corner, the New Jersey Division of Consumer Affairs issued a consumer alert Tuesday warning the public of the health dangers of novelty contact lenses, which include serious eye infections.

Novelty contact lenses are non-corrective lenses, worn directly on the eye and designed to change the eye’s appearance. However, a properly licensed medical practitioner or optometrist should prescribe the wearing of these lenses.

There are very serious infectious agents that can cause keratitis, conjunctivitis and even permanent vision loss when wearing novelty and corrective lenses.

Keratitis, or an infection of the cornea, typically follows some sort of trauma to the cornea. 

Keratitis is an emergency situation because loss of vision can occur within 24 hours. There may be a decrease in vision and the presence of discharge is variable. Most causes of keratitis are bacterial (65-90%) with Pseudomonas aeruginosa and Staphylococcus aureus being most common. The most common viral pathogen is HSV.

An increasingly more common cause of keratitis is the amoeba, Acanthamoeba. This is most common in users of soft and extended wear contact lenses.

Conjunctivitis or “pink eye” is by far the most common type of eye infection.  Bacterial conjunctivitis is frequently caused by Haemophilus influenzae and Streptococcus pneumoniae. Both organisms are responsible for outbreaks of conjunctivitis. Symptoms depend on the offending organism but can include swelling, redness, and discharge.

The US Food and Drug Administration (FDA) regulate novelty lenses as medical devices, similar to corrective lenses. The FDA has received reports of corneal ulcers, eye infections, and permanent vision loss resulting from the use of decorative contact lenses.

In addition, the New Jersey Division of Consumer Affairs also reminds retailers that the sale of novelty contact lenses is a fourth-degree crime under New Jersey law, subject to significant penalties, unless they are sold by a licensed ophthalmic dispenser or a licensed medical practitioner or optometrist.

Everyone wants to have fun dressing up on Halloween, but the health risks of wearing these lenses is just not worth it.
 


Sunday, October 23, 2011

WHO: with flooding in Thailand comes an infectious disease risk

The floods in Thailand have been immense and experts say this could go on up to six more weeks. Hundreds of people have been killed, mostly from drowning, and tens of thousands have sought safety and refuge at crowded evacuation centers.

Now the World Health Organization has announced what many have expected, that hundreds of thousands may be at risk for infectious/communicable diseases.

The WHO proclaimed this warning Saturday though no outbreaks have been reported to date.

Maureen Birmingham, acting United Nations Resident Coordinator in Thailand told AFP:

The spread of communicable diseases such as diarrhea, respiratory illness and conjunctivitis among displaced flood victims in shelters was a key concern.

In addition, flood-affected people also faced an increased risk of skin fungal infections and leptospirosis, a bacterial infection spread through contaminated water.

Diarrheal diseases are the number one cause of illness and death in emergencies that produce massive flooding.

Inadequate quality and quantity of water, substandard and insufficient sanitation facilities and overcrowding are the problems. Common sources of diarrheal disease (bacterial, parasitic or viral) outbreaks are polluted drinking water sources (from contaminated surface waters getting into incompletely sealed wells), shared water containers, water that is stored and contaminated by fecally soiled hands and contaminated foods.

Leptospirosis is a bacterial disease that can be transmitted by contact with animal-urine contaminated water.

Flooding facilitates the spread of the organism, because of the amount and proximity of rodents to humans on shared higher ground. It may be several weeks before symptoms appear before we know if this disease is an issue.

Then of course, there are the infectious diseases from overcrowding. When people are displaced from their homes and end up in crowded situations, many disease outbreaks can occur, particularly respiratory transmitted diseases like influenza.

Saturday, October 22, 2011

Possible resurgence of polio in Madagascar

The UN Children’s Fund, UNICEF, has called for urgent action Friday in the wake of an polio outbreak involving three children in southern Madagascar.

The children were discovered to be infected after testing during UNICEF’s Mother and Child Health week. The three children tested positive for the potentially crippling viral disease, however, all three were asymptomatic.

Although the children are currently not showing symptoms of polio, UNICEF spokesman Daniel Timme said symptoms of the disease could make itself known at anytime.

UNICEF points to disruptions in the vaccination programs in Madagascar as being the possible cause of the reemergence of polio in the island nation.

The BBC reported Saturday:

The political crisis in Madagascar since 2009 has interrupted vaccination programmes across the country.
Shortages of fuel for refrigerators to store the vaccines, and the closure of 250 clinics, have reduced vaccination rates to less than 40% in the south.

Vaccination levels need to be kept at 80-90% to prevent the spread of the disease.

Thursday, October 20, 2011

Minnesota: recall of organic eggs linked to Salmonella outbreak

The Minnesota Department of Agriculture (MDA) said in a news release Wednesday that they, in conjunction with the Minnesota Department of Health (MDH), are investigating a Salmonella outbreak that has infected 6 people which has been traced back to recalled organic eggs from the Larry Schultz Organic Farm in Owatonna.

Environmental testing confirmed the presence of SalmonellaEnteritidis which matches the strain found in the six patients.

According to the news release, the six individuals, both children and adults, became ill between August 12 and September 24. They are all are residents of the seven-county metropolitan area.

Three of the patients were hospitalized but have since recovered. Five of the six individuals infected reported eating eggs from the Larry Schultz Organic Farm purchased at grocery stores or co-ops.

Larry Schultz Organic Farm is cooperating with the MDA investigation and has issued a voluntary recall of the products.

The MDA reports:

Eggs affected by this recall were distributed to restaurants, grocery stores, food wholesalers and foodservice companies in Minnesota, Wisconsin and Michigan.

Eggs from Larry Schultz Organic Farm are packaged under the following brand names: Lunds & Byerly’s Organic, Kowalski’s Organic, and Larry Schultz Organic Farm. Eggs are packed in bulk and varying sizes of cartons (6-egg cartons, dozen egg cartons, 18-egg cartons). Full product descriptions and a list of grocery stores where these products were sold can be found at www.mda.state.mn.us.Cartons bearing Plant Number 0630 or a “Sell by” date are not included in this recall.

Consumers are advised to cook eggs thoroughly before eating in order to destroy any Salmonella or other bacteria. Consumers who believe they may have purchased these shell eggs should not eat them but should return them to the store where they were purchased for a full refund.

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.

Monday, October 17, 2011

One dead, two sick from Legionnaires’ disease in Plant City


The Hillsborough County Health Department (HCHD) announced Monday that three residents of the Meadows at Countrywood retirement mobile home park in Plant City were confirmed infected with Legionnaires’ disease. One of the residents has died from the bacterial infection.

The Hillsborough County Health Department has closed the pool and hot tub in the mobile home park while the investigation continues.

According to HCHD spokesperson, Steve Huard, "We're trying to determine if the folks who have Legionnaires were in the same area. At the same time anything that would link them back to a source so we can discover what caused the illness."

In addition, Huard said none of the three lived in the same home.

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 characterized 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 an 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.

According to the Centers for Disease Control and Prevention (CDC), “Each year, between 8,000 and 18,000 people are hospitalized with Legionnaires’ disease in the U.S. However, many infections are not diagnosed or reported, so this number may be higher.”  There is a 5% to 30% of mortality rate for those infected.


Sunday, October 16, 2011

WHO Western Pacific Region lays out food safety strategy

The Member States of the World Health Organization’s Western Pacific Region met in Manila last week and established a food safety strategy which is designed to reduce both the disease impact of food contamination and the economic impact it has on a nation.

In a press release Friday, the Western Pacific Regional Food Safety Strategy (2011-2015) defines key actions required to improve food control systems covering the entire food chain from farm to table. It also aims to strengthen collaboration among countries and regional partners towards increased health security through improved food safety systems.

The Western Pacific Regional Food Safety Strategy will provide countries in the region with the structure to:

 improve food control and coordination throughout the food chain;
·         devise a risk-based regulatory framework;
·         improve availability of food safety data to better guide policy and risk analysis;
·         develop inspection services;
·         introduce food safety training and education; and
·         Establish the capacity to detect, assess and manage food safety incidents and emergencies.

Dr. Shin Young-soo, WHO regional director for the Western Pacific, said more than 200 diseases are now spreading through food.

Unsafe food causes many acute and lifelong diseases, ranging from diarrheal disease to various forms of cancer, with more than 200 diseases being spread through food,” he said.

In addition, the economic impact of food contamination and food-borne disease has been demonstrated in New Zealand (six foodborne diseases in 2009 cost the country more than NZ$ 161 million) and China (Melamine contamination in 2008), the two examples cited.

Friday, October 14, 2011

Locally acquired dengue fever in Palm Beach County


The Palm Beach County Health Department (PBCHD) received confirmation Thursday of a locally acquired case of the mosquito borne infection, dengue fever.
In response to this news, the PBCHD issued a mosquito borne disease advisory to the public in a press release yesterday.
There have been several cases of dengue fever in Florida in recent months in MartinHillsboroughMarion , BrowardMiami-Dade counties plus numerous cases in Key West.

According to the press release, this is the first locally acquired case in Palm Beach County although eight others have been reported this year and acquired out of the country.



Wednesday, October 12, 2011

Legionella pneumophila confirmed in Plim Plaza Hotel water

In a following up story to last week’s Legionella outbreak at an Ocean City, Maryland hotel, the Maryland Department of Health and Mental Hygiene (DHMH) Laboratories Administration testing confirmed Wednesday the presence of Legionella bacteria in water collected at the Plim Plaza Hotel.

The bacterium, Legionella pneumophila, was isolated in water collected from various locations at the hotel.  

Initially, the health department’s investigation identified three individuals who stayed at the hotel who were hospitalized with legionellosis.

Now the investigation identified three additional cases of Legionnaires' disease in people who had stayed at the hotel, bringing the total confirmed cases to six, with one fatality.

According to the DHMH press release, although the hotel is currently closed for the season, anyone who was a guest at the Plim Plaza hotel in the month of September and is experiencing pneumonia-like symptoms should contact his or her health care provider to determine whether testing or treatment is recommended.

Monday, October 10, 2011

Two children die from bird flu on Bali

Officials from the Indonesian Health Ministry reported Monday that two young siblings from the resort island of Bali, Indonesia have died from H5N1 avian influenza, or as its more commonly known, bird flu.

The siblings, ages 5 and 10, from the Bangli district on Bali, died Sunday at Sanglah hospital.
The children were hospitalized and treated for at least two days. Throat and blood samples collected on the children were confirmed positive for H5N1 by the Health Ministry’s laboratory.

These are the first fatalities from bird flu in Indonesia in over a year. On Bali, these are the first deaths since 2007.

According to a Jakarta Globe report, Putu Sumantra, the head of the Bali Animal Husbandry Office, said the source of the H5N1 infection was unknown.

“The two patients did have a history of contact with dead poultry, but when we went to the location, we only found one live chicken remaining that belonged to the victims. After a rapid test, the results were negative for H5N1,” he said.

According to the World Health Organization, Indonesia has had 146 human deaths from bird flu, the highest in the world.

Sunday, October 9, 2011

Human Eastern Equine Encephalitis and West Nile confirmed in Massachusetts

The Massachusetts Department of Public Health (DPH) announced Friday that two people have been confirmed infected with two different mosquito borne viruses.

According to the news release, the first case is an elderly woman from out-of-state who spent time visiting Bristol County has been confirmed to have eastern equine encephalitis (EEE). This individual was previously reported as a suspect case being investigated, and EEE virus infection was subsequently confirmed by the Centers for Disease Control and Prevention in Atlanta. The patient spent several weeks in Bristol County prior to becoming ill on August 25th. 

She spent two weeks in a hospital and was discharged to a rehabilitation facility where she continues to improve.

The other case is a woman between the ages of 49 and 64 from Essex County was diagnosed with West Nile Virus (WNV). She became ill on October 3 and was hospitalized. Her condition has improved and she is expected to be discharged to a rehabilitation facility soon.

Health officials have warned the public that mosquito activity is still significant thanks to an unusually warm fall and flooding from heavy rains this year. In addition, they say the presence of mosquitoes will last until the first hard frost of the year.

These are the second case (EEE) and the fourth case (WNV) of 2011 in Massachusetts.
Eastern Equine Encephalitis is a mosquito-borne virus that is quite rare in the United States, with only 5-10 cases reported annually according to the Centers for Disease Control and Prevention (CDC). EEE virus is one of several mosquito-transmitted viruses that can cause inflammation of the brain (encephalitis).

It is not transmitted from person to person.

People at highest risk of getting this infection are those who live in or visit woodland habitats, and people who work outside or participate in outdoor recreational activities, because of greater exposure to potentially infected mosquitoes.

Symptoms usually start from a few days to more than a week after getting bit by an infected mosquito. These include a sudden onset of headache, high fever, chills, and vomiting. The disease can progress to disorientation, seizures, and coma. It is fatal in approximately 30 percent of the cases.

There is no specific treatment for this infection and a vaccine is not available for prevention.
West Nile virus is a mosquito-borne disease that can cause encephalitis, a brain inflammation.
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.

The MDPH offer the following recommendations to protect themselves from mosquito borne illnesses:

 Avoid Mosquito Bites

·         Be Aware of Peak Mosquito Hours. The hours from dusk to dawn are peak biting times for many mosquitoes. Consider rescheduling outdoor activities that occur during evening or early morning.

·         Clothing Can Help Reduce Mosquito Bites. Wearing long-sleeves, long pants and socks when outdoors will help keep mosquitoes away from your skin.

·         Apply Insect Repellent When Outdoors. Use a repellent with DEET (N, N-diethyl-m-toluamide), permethrin, picaridin (KBR 3023), oil of lemon eucalyptus [p-methane 3, 8-diol (PMD)] or IR3535 according to the instructions on the product label. DEET products should not be used on infants under two months of age and should be used in concentrations of 30% or less on older children. Oil of lemon eucalyptus should not be used on children under three years of age.

Mosquito-Proof Your Home

·         Drain Standing Water. Mosquitoes lay their eggs in standing water. Limit the number of places around your home for mosquitoes to breed by either draining or discarding items that hold water. Check rain gutters and drains. Empty any unused flowerpots and wading pools, and change water in birdbaths frequently.

·         Install or Repair Screens. Keep mosquitoes outside by having tightly-fitting screens on all of your windows and doors.


Saturday, October 8, 2011

Ten more people die from dengue in Lahore, deliberate release by CIA suspected

Health authorities in Lahore, Punjab report 10 more fatalities to dengue fever Friday. This brings the total dengue fever deaths in the city to 171.

On what some may consider a more conspiratorial note, in a PakTribune report last week, some experts in Pakistan feared that some kind of biological experiment or deliberate release of virus by American Central Intelligence Agency (CIA) has caused spread of dengue fever in the country.

The Pakistan Medical Association (PMA) has called on security agencies to investigate fears of deliberate spread of dengue virus in Pakistan. 

They note the CIA as having a long history of using biological weapons, using Cuba and Afghanistan as two examples.


Delaware health officials confirm first case of human tularemia in 8 years

In a Delaware Health and Social Services press release Friday, health officials report that a 45-year-old Kent County man was laboratory-confirmed for the bacterial infection, tularemia.

Confirmation was performed by the Delaware Public Health Laboratory. This is the first human case of tularemia in Delaware since 2003.

Also known as rabbit fever and deer fly fever, this disease of the Northern hemisphere most often occurs during the summer months and mid-winter and correspond with vectors and hunting season respectively.

The majority of the cases in the United States are found in the south and south-central states.

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.

There is a vaccine for tularemia which is used extensively in Russia, but in the U.S. it is limited to certain high risk occupations.

After infection and recovery of tularemia, typically, a long lasting immunity is achieved and reinfection is rare.

According to Delaware health officials, the man is hospitalized and responding to treatment.




Friday, October 7, 2011

University of Oklahoma student tests positive for meningococcal meningitis


Health officials from the Oklahoma Department of Health confirmed Thursday that an OU student did contract the very serious bacterial disease, meningococcal meningitis.
The only information on the patient the health department would disclose was the individual is a “young adult” who resided off-campus.
University officials say they have a standard operating procedure for suspected cases of meningitis, which includes contacting the State Health department, ensuring the student gets medical care and prophylactic antibiotics are available for close contacts.
Catherine Bishop, OU vice president of public affairs said, “The recommendation from the State Health Department, which we are following, is to treat close household contacts or anyone who spent a significant amount of time with the person in the last seven days where eating, drinking and kissing may have been involved.”
In addition, Bishop said no one else at the university is known to have, or is suspected of having, the disease.

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.
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.


Thursday, October 6, 2011

The Navy to assist Escambia County with syphilis outbreak


Escambia County, Florida has seen the highest rates of the sexually transmitted infection in three decades and the Navy will join the health department in determining the root of this outbreak.
The Naval Hospital Pensacola announced Tuesday that they would join the Escambia County Health Department in the battle against syphilis.
At least 69 people have contracted syphilis in 2011, which equals the number from all of 2010. Even more concerning, this is a 176 percent increase over the 2005-2009 average of 25 cases per year.
Approximately 33% of the syphilis cases have occurred around the Naval Air Station. However, Navy Public Health Officer, Cmdr. Dr. Michael Acromite said this does not reflect upon the population at the Naval Air Station as they have only reported one syphilis case this year.
The Escambia County has started a educational campaign called "Don't Hook Up with Syphilis" which encourages syphilis testing.
The Naval Hospital Pensacola will be teaming up with the local health department with syphilis education and screening.

Three Plim Plaza Hotel guests hospitalized for legionellosis

Three people who were guests at the Plim Plaza Hotel in Ocean City, MD were hospitalized for legionellosis a week after staying at the hotel according to the Maryland Department of Health and Mental Hygiene (DHMH) and the Worcester County Health Department.

DHMH health officials said in a news release Wednesday that all three individuals were hospitalized, but none died. It is not confirmed that the guests acquired the illness at the hotel, and the investigation is ongoing.

Hotel management have relocated current guests and closed the hotel.

As of Wednesday the investigation has shown that water samples from the hotel are being cultured at the Maryland State Health lab. Preliminary reports suggest the presence of Legionella bacteria in hotel water, however final culture results are not expected until the end of next week, at the earliest. 

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.