Sunday, April 29, 2012

FDA: Levaquin approved for treating pneumonic plague using animal rule

The US Food and Drug Administration (FDA) approved Friday the use of the antibiotic, Levaquin (generic: levofloxacin), to treat patients with the deadly pneumonic plague in the event of a bioterror event.
Levaquin is already approved for the treatment of a wide array of infections to include urinary tract infections, respiratory and sinus infections and skin infections. In addition, the fluoroquinolone antibiotic is already approved as a prophylactic measure in the event of a anthrax bioterror event.
The regulatory agency approved the antibiotic using a rarely used animal rule called the Animal Efficacy Rule.
According to an FDA statement:
The animal efficacy rule allows evidence to support a drug's approval to be based entirely on animal studies to provide a regulatory pathway in instances where it is not feasible or ethical to conduct trials in humans. Plague is a rare disease, with only 1,000 and 2,000 cases a year around the world, and hence would not be possible to conduct adequate efficacy trials in humans.
Levaquin’s approval was based on an efficacy study conducted in African green monkeys that were infected with the plague bacterium in a laboratory setting. The study found 94 percent of the monkeys given Levaquin survived.
The plague is caused by the bacterium, Yersinia pestis. There are three forms of human plague:  bubonic (affecting the lymph nodes), pneumonic (lungs) and septicemic (blood stream).
Pneumonic plague is probably the most serious form of plague. Here the bacteria infect the lungs and cause pneumonia. It is contracted when the bacteria is inhaled (primary) or develops when bubonic or septicemic plague spreads to the lungs. Pneumonic plague is a rare form of plague accounting for about 1% of all plagues.
Primary plague pneumonia has a short incubation period of 1-3 days, after which there is sudden onset of flu-like symptoms including fever, chills, headache, generalized body pains, weakness, and chest discomfort.
A cough develops with sputum production, which may be bloody, and increasing chest pain and difficulty in breathing. As the disease progresses, hypoxia (low oxygen concentration in the blood) and hemoptysis (coughing up blood) are prominent. The disease is invariably fatal unless antimicrobial therapy commences within 24 hours of exposure.
Pneumonic plague is contagious and can be transmitted person to person. People with primary pneumonic plague generate large quantities of infectious aerosols that pose a significant risk to close contacts. It is highly communicable under appropriate climate conditions, overcrowding and cool temperatures.
Fleas typically serve as the vector of plague. Human caseshave been linked to the domestic cats and dogs that brought infected fleas into the house.
According to the CDC, Streptomycin, gentamicin, the tetracyclines, and chloramphenicol are all effective against pneumonic plague.
Levaquin is produced by Janssen Pharmaceuticals, a unit of Johnson & Johnson. 

Saturday, April 28, 2012

Delta flight delayed over monkeypox fears

Monkeypox  Photo/CDC

For passengers on Delta Flight 3163, it felt like something out of a Hollywood movie: a passenger with an unknown rash, members of the Centers for Disease Control and Prevention (CDC) investigating the scene and the use of the word “quarantine” while the plane remained on the tarmac.
This is exactly what happened at Chicago’s Midway Airport Thursday as the flight from Detroit to Chicago was quarantined for nearly three hours because a woman returning from Uganda had a suspicious rash on her body.
After the two-plus hours of melee, passenger fears were quelled when it was determined that Minnesota resident, Lisa Sievers, only had a bug bite and suffered from scabies.
Unlike it’s eradicated cousin smallpox, which is strictly a human disease, monkeypox not only spreads from animal to animal but also from animals to humans.
is a relatively rare virus found primarily in central and western Africa. The disease is caused by Monkeypox virus. It is closely related to the smallpox virus (variola), the virus used in the smallpox vaccine (vaccinia), and the cowpox virus.
Infection with monkeypox is not as serious as its cousin, smallpox, however human deaths have been attributed to monkeypox.
According to the CDC, the symptoms of monkeypox are as follows: About 12 days after people are infected with the virus, they will get a fever, headache, muscle aches, and backache; their lymph nodes will swell; and they will feel tired. One to 3 days (or longer) after the fever starts, they will get a rash. This rash develops into raised bumps filled with fluid and often starts on the face and spreads, but it can start on other parts of the body too. The bumps go through several stages before they get crusty, scab over, and fall off. The illness usually lasts for 2 to 4 weeks.
People at risk for monkeypox are those who are bitten by an infected animal or if you have contact with the animal’s rash, blood or body fluids. It can also be transmitted person to person through respiratory or direct contact and contact with contaminated bedding or clothing.
There is no specific treatment for monkeypox.

VIDEO: Miss Universe 2011, Leila Lopes joins END7 campaign

The reigning Miss Universe and Angolan beauty has joined the fight against seven Neglected Tropical Diseases (NTD), which infect one in six people across the globe.
Miss Universe 2011, Leila Lopes joined the END7 campaign Thursday, whose goal is to raise awareness of seven devastating parasitic and bacterial diseases and to eliminate them by the year 2020.
The seven NTDs cause a wide spectrum of devastation ranging from blindness as in the case of trachoma and onchocerciasis, elephantiasis in the case of lymphatic filariasis and hookworm in the case malnutrition and anemia. The other NTDs targeted in this campaign are schistosomiasis, ascariasis and trichuriasis.  
Angola native, Lopes, is aiming to put the plight of seven million of her fellow Angolans firmly in the spotlight, seven million children stricken with one or more of these debilitating diseases.
According to Charity News, Lopes said Thursday,
"NTDs are neglected because most people haven't heard of them.
"When someone has an NTD they can lose their strength and their ability to work or go to school.
"The worse thing about NTDs is that kids and their parents get them by doing everyday things. Like playing outside, swimming and doing laundry..."
The END7 campaign, which was launched in January, says that for a mere 50 cents, one person can be treated for these seven debilitating disease for a whole year.
The campaign says 1 in 6 people worldwide, including over half a billion children, have these parasitic and bacterial diseases living and breeding in their bodies.
END7 is a campaign to see the end of 7 diseases by 2020. The Bill & Melinda Gates Foundation is the primary funder. The campaign is led by the Global Network for Neglected Tropical Diseases (, an initiative of the Sabin Vaccine Institute.
Lopes joins British actor, Bill Nighy in backing the END7 campaign.
For more infectious disease news, information and merchandise, visit Outbreak News

Wednesday, April 25, 2012

Cat scratch bacteria may be linked to rheumatoid arthritis according to study

Cats can spread B. henselae to people. Most people get CSD from cat bites and scratches. Kittens are more likely to be infected and to pass the bacterium to people. 
Photo credit: 
Mrmiscellanious via Wikimedia Commons 

Research published in the May 2012 issue of Emerging Infectious Diseases show there may be an association between the bacterial agent of cat scratch disease and various rheumatoid illnesses.
According to a North Carolina State University news release Monday, university researchers and a Maryland rheumatologist tested blood samples from 296 patients for evidence of Bartonella infection. The patients had previously been diagnosed with conditions ranging from Lyme disease to arthritis to chronic fatigue. Since rheumatic symptoms have sometimes been reported following cat scratch disease, the researchers wanted to see if these patients tested positive for B. henselae.
Of the 296 patients, 62 percent had Bartonella antibodies, which supported prior exposure to these bacteria. Bacterial DNA was found in 41 percent of patient samples, allowing investigators to narrow the species of Bartonella present, with B. henselae, B. kohlerae and B. vinsonii subsp. berkhoffii the most prevalent. 
Dr. Ed Breitschwerdt from NC State said of the findings, “Based upon this one study we can’t definitively say that a subset of rheumatoid illnesses have an infectious origin. However, our results thus far do implicate Bartonella as a factor in at least some cases. If the link between Bartonella and rheumatoid illnesses is valid, it may also open up more directed treatment options for patients with rheumatoid illnesses.”
Bartonella is a bacterium that is maintained in nature by fleas, ticks and other biting insects.
Cat scratch disease (CSD) is a bacterial disease caused by Bartonella henselae. Most people with CSD have been bitten or scratched by a cat and developed a mild infection at the point of injury. Lymph nodes, especially those around the head, neck, and upper limbs, become swollen. Additionally, a person with CSD may experience fever, headache, fatigue, and a poor appetite. Rare complications of B. henselae infection are bacillary angiomatosis andParinaud's oculolandular syndrome.

Two men killed in Ghana anthrax outbreak

Two people have died and two others are being treated for anthrax in the northeastern Ghana town of Bawku.
According to a report from the Ghana Broadcasting Corporation Tuesday, the death of the two occurred at Googo after consuming a dead animal believed to have been infected with the disease. Another two persons have been admitted at the hospital for suspected Anthrax symptoms.
The bacterial infection has also killed at least 20 cows in the farming community in the Bawku West District of the Upper East Region.
Health officials say the situation is under control and veterinary officials have moved to quarantine and vaccinateanimals in the area.
Bawku West District Chief Executive, Hon. Moro Adam Anabah said the 20 dead cows have been buried and affected ones are vaccinated to prevent a major outbreak in the area.
Bawku is a town in the upper northeast corner of Ghana, straddling the border with Burkina Faso.
Anthrax is an infectious disease due to a type of bacteria called Bacillus anthracis. Infection in humans most often involves the skin, gastrointestinal tract, or lungs.
PubMed Health says anthrax commonly affects hoofed animals such as sheep, cattle, and goats, but humans who come into contact with infected animals can get sick from anthrax, too.
There are three types of anthrax with differing degrees of seriousness:
Cutaneous anthrax: this occurs when the spore (or possibly the bacterium) enters a cut or abrasion on the skin. It starts out as a raised bump that looks like an insect bite. It then develops into a blackened lesion called an eschar that may form a scab. Lymph glands in the area may swell plus edema may be present. This form of anthrax responds well to antibiotics. If untreated, deaths can occur if the infection goes systemic. 95% of cases of anthrax are cutaneous. The CDC states there are 1-2 cases annually in the US.
Gastrointestinal anthrax: this follows the ingestion of contaminated meats. It is characterized by stomach pain, severe bloody diarrhea, bloody vomit and an inflammation of the intestinal tract. Up to half of those infected will perish from this form of disease. This is a very rare type of anthrax.
Inhalation anthrax: also known as “woolsorter’s disease”, happens due to inhaling the spores. After incubating for less than a week; fever, aches, vomiting are early symptoms. After the initial symptoms, a short period of improvement (less than a day) may occur. It then progresses to severe respiratory distress. Shock and death soon follow. Later stages of this infection have nearly a 100% chance of death even with antibiotics.
Most people with anthrax are treated with antibiotics. Several antibiotics are effective, including penicillin, doxycycline, and ciprofloxacin.

Tuesday, April 24, 2012

Vietnam mystery disease concerns WHO, Australian virologist believes it’s HFMD

Although they have not been asked to help in the investigation of the “mystery disease” that has killed 19people in one Vietnamese province, officials with the World Health Organization (WHO) say they are concerned over the situation.
Wu Guogao, the WHO’s chief officer in Hanoi told the AFP Monday, "We are concerned about this. WHO is very aware of this case". He goes on to say, "It is difficult to say the exact cause at this stage".
The mysterious disease, which causes a horrible rash on the hands and feet and causes liver failure in about 10% of those afflicted, has reemerged in the mountainous areas of Quang Ngai province. In total, over 170 people have been infected.
However, not everyone thinks this is such a mystery.
Queensland University of Technology virologist, Prof John Aaskov said it’s almost certainly hand, foot and mouth disease caused by enterovirus 71 (EV 71) or coxsackie virus type A.
The infectious disease expert says the fatality rate seen matches with the fatality rate of EV 71 and the virus has been an issue in Vietnam and China for many months.
Locals in Quang Ngai province have resorted to other means to protect themselves from the disease such as rituals and such. Villagers have even resorted to barricading those infected in their homes to prevent spread. Aaskov compares these actions to what was seen during the plague in Europe centuries ago.
He said improving hygiene is the key to preventing the disease.
As far as getting the WHO involved, Aaskov said it would probably not achieve very much, but it will cost a lot of money.
He believes the Vietnamese will get a handle on the situation.

USDA confirms Mad Cow in California dairy cow

The United States Department of Agriculture (USDA) announced today the fourth confirmed case of bovine spongiform encephalopathy (BSE), or Mad Cow disease in the United States. The infected animal was a dairy cow from central California.
There has not been a confirmed case here in six years.
According to a USDA statement Tuesday, USDA Chief Veterinary Officer John Clifford said the cow was detected as part of their “targeted surveillance system”. In addition, Dr. Clifford makes clear that the animal was never presented for slaughter for human consumption, so at no time presented a risk to the food supply or human health. 
He also says that the safeguards the US has in place is very effective at protecting human and animal health.
"Evidence shows that our systems and safeguards to prevent BSE are working, as are similar actions taken by countries around the world. In 2011, there were only 29 worldwide cases of BSE, a dramatic decline and 99% reduction since the peak in 1992 of 37,311 cases. This is directly attributable to the impact and effectiveness of feed bans as a primary control measure for the disease.
The USDA’s veterinary lab in Ames, IA performed the confirmatory testing on the animal which turned out to be an atypical BSE, a form not usually due to animals eating infected feed.
Lab reports are being shared with World Animal Health (OIE)labs in Canada and England for review.
Clifford says individual case should not affect US trade in beef and beef products. In addition, he notes that milk does not transmit BSE.
Since 2003, three other cases have been detected in the United States: Washington State in 2003, Texas in 2004 and Alabama in 2006.
According to the USDA, BSE is a progressive and fatal neurologic disease of cattle believed to be caused by an unconventional transmissible agent, an abnormal prion protein. BSE belongs to a family of diseases known as transmissible spongiform encephalopathies (TSEs) that includes scrapie in sheep and goats, chronic wasting disease in deer, elk and moose, and in humans, classic and variant Creutzfeldt-Jakob disease (CJD) among other syndromes.
Clinical signs in cattle include behavioral changes, coordination problems, weight loss and decreased milk production. The incubation period from time of infection until the onset of clinical signs averages three to six years.
BSE is not contagious. The primary source of infection is feed contaminated with the infectious prion agent, such as meat-and-bone meal containing protein derived from rendered infected cattle. 

World Meningitis Day: April 24, 2012

Photo/Confederation of Meningitis Organisations

Today is the fourth annual “World Meningitis Day”.
With the goal of stopping meningitis worldwide, World Meningitis Day was established as a day to raise awareness about this devastating and potentially life-threatening disease.
On Tuesday 24 April 2012, the Confederation of Meningitis Organisations (CoMO) and its global members are encouraging individuals, families and communities to learn the signs and symptoms of meningitis, the importance of urgent treatment of the disease, and that prevention is available through vaccination against some forms of meningitis as part of its fourth annual World Meningitis Day.
There have been already, and will be today, events throughout the globe to support this effort.
CoMO will start the campaign, “Join Hands Against Meningitis” today. The goal of the campaign is to unite one million people around the world, the same number who will suffer bacterial meningitis this year, to show their support to stop meningitis worldwide.
To do this people will be able to join hands with others across the globe via a virtual online community.
There are many other events to show your support for this cause. Check out CoMO’s  list of local member organisations to see if there is a World Meningitis Day event in your country that you can attend and support.
In addition to the events for Tuesday, there were events leading up to World Meningitis Day. This past Sunday in Los Angeles, singer and actress, Tiffany Thornton performed a concert at the Roxy to raise meningitis awareness. Ms. Thornton’s personal story with the disease caused her to become spokesperson for the organization, “Voices of Meningitis” last year.
Monday night at the New York Athletic Club, the National Meningitis Association, Inc. (NMA) held the “Give Kids A Shot!” Gala to raise awareness about meningitis.
The gala featured the reigning Mrs. Ethnic World International 2012 (Mrs. Jamaica), Daisi Pollard SepĂșlveda, a meningitis survivor herself. Ms. SepĂșlveda wore the signature “Meningitis dress” designed by Laurie Elyse of Laurie Elyse Collection featuring the real stories and photographs of lives touched by meningitis.  The dress was auctioned off last night in a silent auction.
In addition, take a moment to watch CoMO’s informational video, “If I'd Known Then What I Know Now..." , for more information on symptoms of meningococcal meningitis on the left panel.

Sunday, April 22, 2012

Sri Lanka’s dengue total exceeds 10,000 so far in 2012


The number of cases of the mosquito borne disease, dengue fever, continues to grow in Sri Lanka.
According to a report in the Sri Lankan news source, The Nation, as of Thursday April 19, the total cases has reached 10,042 with 42 fatalities.
This is up from the 9,317 dengue cases and 38 deaths reported just 8 days earlier. Sources say the numbers are expected to increase daily.
The health ministry has recently ramped up measures to get the outbreak under control by appointing 24 additional Public Health Inspectors to carry out dengue control and awareness programs.
Specifics about the outbreak according to the latest Epidemiology Report include:
The Municipal Council area of Colombo reported 704 suspected dengue cases, while other areas of the Colombo District reported a total of 1774 cases with 12 deaths, bringing the total to 2478 and 17 deaths.
Other districts that had reported over 500 cases were Gampaha, 1953 cases and 7 deaths; Kalautara, 663 cases and 3 deaths; Kandy, 605 cases with 4 deaths; and Hambantota with 528 cases. 
What is dengue fever?

Friday, April 20, 2012

HPV-related cancers in men and women reach 26,000 annually: CDC

Photo/CDC-James Gathany

Cancers associated with infection with the human papillomavirus (HPV) total 26,000 each year in the United States according to data published in the April 20 issue of the Morbidity and Mortality Weekly Report (MMWR).
The Centers for Disease Control and Prevention (CDC) researchers say of the 26,000 annual HPV-caused cancers, 18,000 occur in females and 8,000 occur in males.
Cervical cancer, long known to be associated with HPV infection in women, is the most common cancer with 11,500 annual cases reported.
However, lesser known cancers, some found exclusively in men are also reported: 7,400 cases of mouth or throat cancer, 4,500 cases of anal cancer, 1,600 cases of vulvar cancer, 500 cases of vaginal cancer and 400 cases of penile cancer that are due to the HPV virus.
The CDC reports that although most HPV infections clear within 1–2 years, those that persist can progress to precancer or cancer.
As far as percentages, HPV causes nearly 100 percent of cervical cancers, while it causes about two-thirds of mouth/throat cancers, 93% of anal cancers, and more than a third of penile cancers.
HPV infection can be prevented through immunization. Two vaccines are available, Cervarix and Gardasil.
The MMWR report is based on an analysis of data reported in 2004 through 2008 to the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute.

Thursday, April 19, 2012

CDC: Measles cases in U.S. highest in 15 years

If you go back just 12 short years ago, we rarely heard of the viral disease measles in the US, in fact, measles was declared eliminated at the beginning of the new millennium.
How times have changed.
During a CDC telebriefing on measles in the United States Thursday, Apr 19, Anne Schuchat, MD, Director, Office of Infectious Diseases, National Center for Immunization and Respiratory Disease addressed the press on the latest article in Friday’s edition of the Morbidity and Mortality Weekly Report (MMWR) titled Measles-United States 2011.
Dr. Schuchat said, “During 2011, 222 measles cases and 17 measles outbreaks were reported to CDC from 31 different states.  The most measles we have seen in this country since 1996, when we had 508 measles cases”.
This is significantly higher than the median number of cases (60) seen here for the first decade of the century.
There have been 27 cases reported thus far in 2012.
Schuchat explained that are a couple of key factors to the recent increase. 1) Importation of the disease from foreign travel and 2) susceptible unimmunized people.
A vast majority of the measles cases in the US are due to the former according to Director Schuchat. She notes:
 200 of the 222 measles cases were associated with importations from other countries.  In 22 cases, we weren't able to determine the source.  When we say associated with importations, that includes people who themselves traveled or imported the virus, as well as the cases that were spread or linked to those importations.  There were 72 actual importations from other countries, and nearly half of them were from the European region.
Europe was hit especially hard from measles where greater than 37,000 cases were reported.
As far as having a susceptible unimmunized people, Schuchat said, in the U.S., we are fortunate to benefit from very high levels of vaccination coverage.  More than 90 percent of the country's children have been vaccinated against measles.  But measles is extremely infectious, and it's very good as a virus in finding those few people who aren't immunized or protected.  Some people are too young to be vaccinated and can't be protected.  And others may have not gotten around to getting vaccinated yet or may have actually refused or declined to be vaccinated.  So what happened in 2011 was that many of the people who became ill from measles had actually declined or exempted from vaccine.
Most of the measles cases or 86 percent were not vaccinated against measles, or they did not know if they were vaccinated.  65 percent had not been vaccinated, and 21 percent, most of them adults, didn't know whether they had been vaccinated or not.  

Red Cross: Vietnam HFMD outbreak now at 28,000 cases, 18 dead

The virulent strain of the childhood disease, hand, foot and mouth disease (HFMD) called EV71 continues to spread in Vietnam and fears of record childhood fatalities are concerning public health officials.
According to a statement from a senior official from the International Federation of Red Cross and Red Crescent Societies (IFRC) in AlertNet Wednesday, the disease has already infected over 28,000 children in the Southeast Asian country this year, killing 18.
This is up from the 21,000 cases and 16 deaths reported a week ago.
The IFRC reports eighty percent of the children who died from the hand, foot and mouth disease (HFMD) disease are under three the Red Cross said. Sixteen of the children are from the south of the country.
In a large scale outbreak in Vietnam in 2011, more than 100,000 people were sickened by hand, foot and mouth disease (HFMD) with nearly 200 children dying from the common childhood infection.
HFMD is typically a benign and self-limiting disease. Most common in young children, it presents as fever, oral lesions and rash on the hands, feet and buttocks. The oral lesions consist of rapidly-ulcerating vesicles on the buccal mucosa, tongue, palate and gums. The rash consists of papulovesicular lesions on the palms, fingers and soles, which generally persist for seven to 10 days, and maculopapular lesions on the buttocks.
The strain of HFMD in the Vietnam epidemic, EV71, can be fatal and is spreading among children under five according to the World Health Organization.
EV-71 has been implicated in HFMD outbreaks in Southeast Asia over the several years. EV 71 is a non-polio enterovirus.
Complications associated with HFMD caused by the more pathogenic EV-71 strain include encephalitis, aseptic meningitis, acute flaccid paralysis, pulmonary edema or hemorrhage and myocarditis. Most deaths in HFMD occur as a result of pulmonary edema or hemorrhage.

Wednesday, April 18, 2012

FDA: ultrasound gel contaminated with Pseudomonas and Klebsiella

Photo/Joseph Cabellero, US Navy

The US Food and Drug Administration (FDA) is alerting health care professionals and facilities to NOT use certain lots of Other-Sonic Generic Ultrasound Transmission Gel as it was discovered to be contaminated with two bacterial pathogens.
The non-sterile gel, used in ultrasound procedures, is manufactured by Newark, NJ company, Pharmaceutical Innovations
According to a FDA Medical Device Alert Wednesday, the alert affects the following lots of the non-sterile gel manufactured from June to December 2011: 060111, 090111 and 120111. They are sold in 250 mL bottles and 5 liter dispensing containers.
The alert says the agency received a report from a hospital that 16 patients had developed colonization or infection with the bacteria Pseudomonas aeruginosa.  Each of these patients were examined with transesophageal ultrasound probes using Other-Sonic Generic Ultrasound Transmission Gel. Upon investigation, the ultrasound gel was found to be contaminated with the bacteria Pseudomonas aeruginosa and Klebsiella oxytoca.
The FDA collected and tested unopened bottles from the reporting hospital and Pharmaceutical Innovations microbial testing revealed significant amounts of Pseudomonas aeruginosa and Klebsiella oxytoca. This result suggests that the source of this contamination occurred during the manufacturing process.
US Marshalls, on behalf of the FDA, seized  all lots of the gel product manufactured between June 2011 and December 2011. The seizure was performed because the ultrasound gel presents serious health risks to patients, particularly vulnerable ones.
Pseudomonas aeruginosa is a free-living bacterium, commonly found in soil and water. Pseudomonas aeruginosa is an opportunistic pathogen, meaning that it exploits some break in the host defenses to initiate an infection. 
It can cause urinary tract infections, respiratory system infections, dermatitis, soft tissue infections, bacteremia, bone and joint infections, gastrointestinal infections and a variety of systemic infections, particularly in patients with severe burns and in cancer and AIDS patients who are immunosuppressed. 
Klebsiella species are normally found in the intestinal tract. They can cause serious infections like pneumonia, wound infection and  bloodstream infections.

Monday, April 16, 2012

Toronto man first human case of rabies in the city in 81 years

In what is a very rare case, a Toronto man is the first human case of rabies in the city since 1931 according to a CBC report Monday.
The 41-year-old man reportedly contracted the deadly virus in the Dominican Republic where he worked tending bar.
He reportedly visited a Dominican resort clinic three times after the onset of symptoms one month ago. His condition worsened as he had trouble swallowing and hydrophobia.
The CBC reports he arrived back in Toronto last week and was taken to Toronto Western hospital after exhibiting erratic behavior at Pearson International Airport. Samples from the unidentified man have been confirmed positive for the rabies virus.
The source of the rabies exposure is unknown.
In Canada, human rabies cases are rare with only three cases reported in the country since 2000, all three cases involved bat bites.
In Ontario, the last case seen was in 1967, while in Toronto, the last time human rabies was seen was 1931.
Public health officials say that the man’s family has received rabies vaccine as a precaution although human to human transmission is considered extremely rare. Dr. Elizabeth Rea with Toronto Public Health says, ‘There are no documented cases that we know of, of one person who has rabies being able to transmit it to another person”.
The man is currently undergoing an experimental treatment for rabies since it is too late for post- exposure rabies vaccination. (Read more about the Milwaukee Protocol)
Rabies is an acute viral infection that is transmitted to humans or other mammals usually through the saliva from a bite of an infected animal. It is also rarely contracted through breaks in the skin or contact with mucous membranes.
According to the Control of Communicable Diseases Manual, all mammals are susceptible to rabies. Raccoons, skunks, foxes, bats, dogs, coyotes and cats are the likely suspects. Other animals like otters and ferrets are also high risk. Mammals like rabbits, squirrels, rodents and opossums are rarely infected.
Initially, like in many diseases, the symptoms of rabies are non-specific; fever, headache and malaise. This may last several days. At the site of the bite there may be some pain and discomfort. Symptoms then progress to more severe: confusion, delirium, abnormal behavior and hallucinations. If it gets this far, the disease is nearly 100% fatal.
According to the US Centers for Disease Control and Prevention (CDC), Rabies postexposure vaccinations consists of a dose of human rabies immune globulin and four doses of rabies vaccine given on the day of the exposure, and then again on days 3, 7, and 14. The vaccine is given in a muscle, usually in the upper arm. This set of vaccinations is highly effective at preventing rabies if given as soon as possible following an exposure.

Sunday, April 15, 2012

Rotavirus infection may depend on a person’s blood type according to study

Photo/CDC-Byron Skinner

Whether or not you become infected with the gastrointestinal pathogen, rotavirus, may depend on your blood type according to researchers from the Baylor College of Medicine (BCM).
According to the research published Sunday in the journal, Nature, Baylor scientists say some strains of rotavirus find their way into the cells of the gastrointestinal tract by recognizing antigens associated with the type A blood group.
According to Dr. B. V. Venkataram Prasad, professor of biochemistry and molecular biology at BCM, a structure of the P14 strain of rotavirus provided a clue.
In strains of rotavirus that infect animals, the top of a spike on the virus attaches to the cell via a glycan (one of many sugars linked together to form complex branched-chain structures) with a terminal molecule of sialic acid. The same did not appear to be true of virus strains that infect humans, and scientists believed the human rotavirus strains were bound to glycans with an internal sialic acid molecule, but they did not know how this occurs.
A glycan array analysis was performed to see to see which glycans interacted with the top of the virus spike, also known as VP8.
The only glycan to interact with the virus spike was type A histo-blood group antigen. The finding surprised Prasad because histo-blood group antigen A does not have sialic acid.
According to researcher Dr. Mary Estes, professor of molecular virology and microbiology at BCM, "These studies are significant because they provide a novel mechanism of transmission for a rotavirus strain that jumps from ungulates (such as horses, zebras, pigs, sheep) into humans."
The authors found humans infected with the P14 strain had type A blood, but more studies are needed to confirm the connection.
According to the Centers for Disease Control and Prevention, Rotavirus is the most common cause of severe diarrhea among children, resulting in the hospitalization of approximately 55,000 children each year in the United States and the death of over 600,000 children annually worldwide. The incubation period for rotavirus disease is approximately 2 days.
The disease is characterized by vomiting and watery diarrhea for 3 - 8 days, and fever and abdominal pain occur frequently. Immunity after infection is incomplete, but repeat infections tend to be less severe than the original infection.
Prevention of rotavirus is through vaccination. There are two different rotavirus vaccines are currently licensed for use in infants in the United States. The vaccines are RotaTeq® (RV5) and Rotarix® (RV1).

Saturday, April 14, 2012

Oregon E.coli outbreak linked to raw milk from a Clackamas County farm

Photo/Janice Carr-CDC

An outbreak of E.coli O157:H7 that has sickened four kids and landed three in the hospital has been linked to raw milk consumption according to Oregon health officials.
According to an Oregon Public Health news release Friday, all of the children consumed raw unpasteurized milk obtained from Foundation Farms in Clackamas County.
Health officials say that two of the children, both less than 15 years old, have developed hemolytic uremic syndrome, which can be associated with acute renal failure.
Oregon Public Health Division state epidemiologist, Katrina Hedberg, M.D., M.P.H. warns, “Raw milk can carry harmful bacteria that can make you very sick or kill you. Pasteurized milk has many health benefits. Raw milk is not any healthier than pasteurized milk and can carry illness‐causing bacteria”.
Customers of Foundation Farms are advised to discard raw milk from this farm.
The World Health Organization (WHO) says Escherichia coli is a bacterium that is commonly found in the gut of humans and warm-blooded animals. Most strains of E. coli are harmless. Some strains however, such as 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 and raw milk.
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%.
Raw milk is not allowed to be sold in retail stores in Oregon. Foundation Farms distributed the milk to 48 households that were part of a herd‐share, so the distribution of the potentially tainted milk is limited.
The farm has voluntarily ceased its milk distribution. The investigation is ongoing.

Friday, April 13, 2012

CDC warns of skin infections caused by Orf in non-traditional settings


The zoonotic parapox virus, Orf, which is commonly seen in sheep and goats, can cause nasty skin lesions in humans who handle infected animals. Typically, when people become infected with Orf, it is due to occupational exposure.
However, occupational risks are not the exclusive source of human infection. In the Friday, April 13 issue of the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR), the federal health agency warns that Orf can be and is transmitted through household exposure.
In the report, the CDC describes four cases of human orf contracted by non-traditional ways from 2009 to 2011.
The cases include a 63-year-old woman who punctured her hand with a bone from a recently slaughtered goat at home and a 42-year-old man who handled a lambs head during a Muslim religious holiday. In addition, a 35-year-old man who cut his thumb with a knife used to kill a lamb for Easter and 28-year-old pregnant woman who cut her hand on a bone while preparing lamb’s head.
The CDC says that Orf should be part of the differential diagnosis on patients with ulcerative skin lesions and a history of household animal slaughter. In addition, the diagnosis of Orf would prevent unnecessary antibiotic treatment that may otherwise be prescribed.
People who observe certain religious ceremonies who practice animal slaughter should also be considered in the diagnosis.
In the editor’s note, they say, “in ethnically diverse communities, health-care providers might be unaware of patients having this type of animal contact and of the seasonal increases in contact associated with religious events”. 
Persons who handle sheep or goats at home should be counseled to wear nonpermeable gloves, especially when wounds or rash are present. Injuries that occur during animal slaughter or processing should be cleansed thoroughly with soap and water.
Currently there is no approved treatment for human orf infections.

UK health agency reports 665 cases of pertussis in the first quarter


The number of laboratory confirmed cases of pertussis, or whooping cough, for the first quarter of 2012 reported in England and Wales is 665.
This is an astounding number as compared to the 1040 cases reported during all of 2011. Only 421 cases were reported in 2010.
According to a UK Health Protection Agency press release Friday, the increase in whooping cough is a continuation from the second half of last year and is being seen all across England.
England has seen an increase during this period in cases in very young children who have the highest risk of severe complications and death.
Dr Mary Ramsay, head of immunization at the HPA said,
“Whooping cough can be a very unpleasant infection. Anyone showing signs and symptoms – which include severe coughing fits accompanied by the characteristic “whoop” sound in young children but as a prolonged cough in older children and adults – should visit their GP.
Vaccination is the most effective way to protect people from this infection and uptake of thevaccine is very good. Parents should ensure their children are up to date with their vaccinations so that they are protected at the earliest opportunity. The pre-school booster is also important, not only to boost protection in that child but also to reduce the risk of them passing the infection on to vulnerable babies, as those under four months cannot be fully protected by the vaccine.
Whooping cough is caused by the bacterium, Bordetella pertussis. This vaccine-preventable disease is spread through direct contact with respiratory discharges via the airborne route.
Pertussis goes through a series of stages in the infected person; initially a irritating cough followed by repeated, violent coughing. The disease gets its nickname by coughing without inhaling air giving the characteristic high-pitched whoop. Certain populations may not have the typical whoop like infants and adults.
It is highly communicable, especially in very early stages and the beginning of coughing episodes, for approximately the first 2 weeks. Then the communicability gradually decreases and at 3 weeks it is negligible, though the cough my last for months.
Pertussis is an endemic disease found worldwide.
Those that are not immunized are susceptible to this disease. Young infants and school aged children (who are frequently the source of infection for younger siblings) are at greatest risk.
More on Pertussis Vaccination

Thursday, April 12, 2012

Alachua County, FL chickenpox outbreak


The outbreak of the vaccine-preventable disease,chickenpoxwhich started back in February at a charter school, has grown to 65 cases according to a Gainesville Sun report.
This has caused the Alachua County Health Department to bar 20 unvaccinated children from returning to an Alachua Learning Center until at least April 25 to stop the viral infections spread.
The ban, which began Monday, will last until 20 days after the last case is diagnosed.
Exceptions to the ban include parents getting a medical or religious exemption from the requirements.
Chickenpox is a common, usually benign childhood disease caused by the varicella-zoster virus (VZV), a member of the herpes family. This virus causes two distinct diseases; varicella (chickenpox) is the primary infection, and later when VSV reactivates, herpes zoster (shingles).
Chickenpox is highly contagious and is spread by coughing and sneezing, by direct contact and by aerosolization of the virus from skin lesions. You can also get it by contact with the vesicle secretions from shingles.
The disease is characterized by fever and a red, itchy skin rash of that usually starts on the abdomen, back or face and then spreads to nearly all parts of the body. The rash begins as small red bumps that appear as pimples or insect bites. They then develop into thin-walled blisters that are filled with clear fluid which collapse on puncture. The blisters then breaks, crusts over, and leaves dry brown scabs.
The chickenpox lesions may be present in several stages of maturity and are more abundant on covered skin rather than exposed. Lesions may also be found in the mouth, upper respiratory tract and genitals.
Chickenpox is contagious from 1-2 days before the rash forms and continues until all the lesions are crusted over (usually about 5 days)
This disease is more serious in adults than in children. Complications of chickenpox are rare, but include pneumonia, encephalitis and secondary bacterial infections.
Infection with this virus usually gives lifelong immunity, though second attacks have been documented in immunocompromised people. The viral infection remains latent, and disease may recur years later as shingles.
If your child does get chickenpox, you can help relieve the discomfort that comes with this illness by doing the following:
• Using cool wet compresses or giving baths in cool or lukewarm water every 3 to 4 hours for the first few days. Oatmeal baths, available at the supermarket or pharmacy, can help to relieve itching. (Baths do not spread chickenpox.)
• Patting (not rubbing) the body dry.
• Putting calamine lotion on itchy areas (but don't use it on the face, especially near the eyes).
• Giving your child foods that are cold, soft, and bland because chickenpox in the mouth may make drinking or eating difficult. Avoid feeding your child anything highly acidic or especially salty, like orange juice or pretzels.
• Asking your doctor or pharmacist about pain-relieving creams to apply to sores in the genital area.
• Giving your child acetaminophen regularly to help relieve pain if your child has mouth blisters.
• Asking the doctor about using over-the-counter medication for itching.
Never use aspirin to reduce pain or fever in children with chickenpox because aspirin has been associated with the serious disease Reye’s syndrome, which can lead to liver failure and even death.
As much as possible, discourage kids from scratching. This can be difficult for them, so consider putting mittens or socks on your child's hands to prevent scratching during sleep. In addition, trim fingernails and keep them clean to help lessen the effects of scratching, including broken blisters and infection.

Friday, April 6, 2012

CFIA: hepatitis A alert/recall issued over frozen berries


The Canadian government food safety agency is warning the public against eating Western Family brand frozen berries due to the possibility of hepatitis A contamination.
According to a Canadian Food Inspection Agency (CFIA) health alert Thursday, Vancouver company, Overwaitea Food Group has instituted a recall on Western Family brand Pomeberry Blend berries.
This is part of an ongoing investigation by the British Columbia Centre for Disease Control into an increase in hepatitis A in the province.
The affected product is sold frozen in 600g packages bearing UPC 0 62639 31347 0. All lot codes are affected according to the CFIA.
The frozen berries were distributed in British Columbia, Alberta, and Ontario and may also have been distributed to other provinces.
Hepatitis A is a viral infection of the liver. Symptoms may include fever, fatigue, loss of appetite, nausea, vomiting and abdominal discomfort. Jaundice, a yellowing of the skin and eyes, may occur a few days after symptoms appear. Anyone with these symptoms should contact a health care provider. The incubation period, or time between exposure and symptoms, is typically 28 days. It is possible for hepatitis A to be active but not show symptoms for up to 7 days. Symptoms usually last one to two weeks but can last longer. Young children with hepatitis A often have no symptoms.
Hepatitis A is spread person-to-person and through a fecal-oral transmission route, and typically occurs when a person eats food or drinks a beverage contaminated by someone with the virus. The virus is not spread by coughing, sneezing or by casual contact. Severe complications from hepatitis A are rare and occur more often in people who have liver disease or a weakened immune system.
Thorough hand washing after visits to the restroom, before touching food or drink and after changing a diaper are the best way to control the spread of hepatitis A.
For more information consumers and industry can call the CFIA at             1-800-442-2342       / TTY            1-800-465-7735       (8:00 a.m. to 8:00 p.m. Eastern time, Monday to Friday).
For more information on Hepatitis A, see the CDC’s page “Hepatitis A Information for the Public”.