Infectious Diseases Today

Outbreak News This Week Radio Show is back on the air

2014-11-15T07:27:00.002-08:00

The talk radio program on infectious diseases is back in the Tampa Bay area. Starting this November, the Outbreak News This Week Radio Show has returned to the Tampa airwaves with “all the news about worms and germs”.

Show host, Microbiologist and Editor of the the news site, Outbreak News Today, Robert Herriman returns with all the latest news and information about infectious diseases on a new station on the AM dial–860 AM WGUL.

In addition, just like his previous show, Herriman will have on a great assortment of expert guests from all levels of government, medicine, academia and personal stories of people dealing with the outcomes of these infectious agents.

The Outbreak News This Week Radio Show airs every Sunday at 5 PM ET on 860 AM WGUL. If you are out of the Tampa Bay area, you can listen online at the WGUL website.

If you miss a show, be sure to listen to past shows on the Outbreak News This Week podcast page HERE.

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Separate circulating vaccine-derived polioviruses confirmed in South Sudan and Madagascar

2014-11-15T07:23:00.001-08:00

In separate and unrelated events, circulating vaccine-derived polioviruses (cVDPVs) have been confirmed in South Sudan and Madagascar.

South Sudan

In South Sudan, 2 cases due to cVDPV type 2 (cVDPV2) have been confirmed. The strains were isolated from 2 acute flaccid paralysis (AFP) cases in Unity state, with onset of paralysis on 9 September and 12 September 2014, respectively. In Unity state, as many as 33% of children remain under-immunized against poliovirus. Both cases are from an internally-displaced persons camp in Unity state. Unity state has been affected by civil unrest, leading to population displacements and declining vaccination coverage in most of the areas.

In 2014, South Sudan has been participating in regional Horn of Africa outbreak response, given the risk posed by an ongoing wild poliovirus type 1 (WPV1) outbreak affecting the region (with cases in 2014 in parts of Somalia and Ethiopia). Two National Immunization Days (NIDs) were conducted in April (with trivalent oral polio vaccine – OPV) and May (with bivalent OPV). In response to confirmation of the cVDPV2, NIDs were held on 4 November with trivalent OPV and further Subnational Immunization Days (SNID) covering the 3 states with civil unrest (Unity, Upper Nile and Jonglei) are planned for 2 December 2014 and January 2015 with trivalent OPV. The objective is to rapidly stop the cVDPV2 in the internally-displaced persons camp and prevent further spread, while further boosting immunity to type 1 polio and minimize risk of re-infection from other parts of the Horn of Africa.

Madagascar

In Madagascar, cVDPV type 1 (cVDPV1) has been confirmed after the virus was isolated from 1 case of AFP (onset of paralysis on 29 September 2014) and 3 healthy contacts. The most recent supplementary immunization activities in Madagascar were conducted in December 2011/January 2012. SNIDs are planned for December, with NIDs to be held in January 2015. An estimated more than 25% of children remain under-immunized against poliovirus in the country. Madagascar was previously affected by a cVDPV2 outbreak in 2001/2002 (resulting in 5 cases) and in 2005 (resulting in 5 cases). A VDPV was also isolated during a research study among healthy children in Toliara I in 2011. Concerted outbreak response each time rapidly stopped those events. However, repeated emergence of separate cVDPV events underscores the risk of these events occurring in populations which are not fully immunized and of the importance of maintaining high levels of vaccination coverage.

WHO risk assessment

Circulating VDPVs are rare but well-documented strains of poliovirus which can emerge in some populations which are inadequately immunized. Due to the small risk of cVDPVs, use of OPV must be stopped to secure a lasting polio-free world. OPV will be withdrawn in a phased manner, beginning with the removal of type 2-containing OPV. The type 2 component contained in trivalent OPV accounts for 90% of all cVDPV cases.

In South Sudan, given that the cases detected are in an internally-displaced persons camp which can be accessed for vaccination, the World Health Organization (WHO) assesses the risk of international spread of the cVDPV2 from South Sudan to be low. However, the risk of international spread would increase if other areas are infected by the cVDPV2. With regard to Madagascar, given the history associated with previous cVDPVs, WHO assesses the risk of international spread from Madagascar to be low.

WHO advice

It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for AFP cases in order to rapidly detect any new virus importation and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.

WHO’s International Travel and Health recommends that all travelers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel.

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Uganda declared Marburg virus free

2014-11-15T07:19:00.000-08:00

On 11 November 2014, the Government of Uganda declared that Uganda was free of the Marburg virus. This declaration was made at the National Media Centre by the Minister of State for Primary Health Care, Hon. Sarah Achieng Opendi.

On 4 October 2014, WHO was notified by the Government of Uganda of a case of Marburg virus disease. The case was a male health professional that developed symptoms on 11 September. On 17 September, the patient was admitted to a district health facility in Mpigi. He was later transferred to a hospital in Kampala. On 28 September, the case passed away and was buried on 30 September in Kasese district.

A national task force with 5 sub committees (surveillance/epidemiology, case management, social mobilization, psychosocial, and coordination) oversaw the outbreak response. A total of 197 case contacts were listed and followed up for 21 days. Thirteen contacts developed Marburg-like symptoms but all tested negative for the virus. Suspected Marburg cases were managed in 4 isolation facilities in Kampala, Wakiso/Entebbe, Mpigi, and Kasese districts. Psychosocial support was provided to contacts and family members of the deceased. The public was sensitized about Marburg and viral haemorrhagic fevers.

Since there have been no active cases of Marburg for 42 days, the outbreak is considered to be contained.

Heightened surveillance activities will be maintained to identify potential outbreaks in the future. Public awareness campaigns will also continue in view of the ongoing Ebola virus disease outbreak in West Africa.

The response was supported by WHO, UNICEF, USAID, World Vision, Uganda Red Cross, Médecins Sans Frontières (MSF), the African Field Epidemiology Network (AFENET) and the US Centers for Disease Control and Prevention (CDC).

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Global MERS update

2014-06-14T05:19:00.000-07:00

The following is the latest update on the global Middle East Respiratory Syndrome coronavirus (MERS-CoV) outbreak from the ECDC.

Since April 2012 and as of 13 June 2014, 828 cases of MERS-CoV have been reported by local health authorities worldwide, including 318 deaths.

Cases and deaths by region:

Middle East:

Saudi Arabia: 700 cases/287 deaths
United Arab Emirates: 71 cases/9 deaths
Qatar: 7 cases/4 deaths
Jordan: 18 cases/5 deaths
Oman: 2 cases/2 deaths
Kuwait: 3 cases/1 death
Egypt: 1 case/0 deaths
Yemen: 1 case/1 death
Lebanon: 1 case/0 deaths
Iran: 3 cases/1 death

Europe:

UK: 4 cases/3 deaths
Germany: 2 cases/1 death
France: 2 cases/1 death
Italy: 1 case/0 deaths
Greece: 1 case/0 deaths
Netherlands: 2 cases/0 deaths

Africa:

Tunisia: 3 cases/1 death
Algeria: 2 cases/1 death

Asia:

Malaysia: 1 case/1 death
Philippines: 1 case/0 deaths

Americas:

United States of America: 2 cases/0 deaths

Twenty one cases have been reported from outside the Middle East: the UK (4), France (2), Tunisia (3), Germany (2), USA (2), Italy (1), Malaysia (1), Philippines (1), Greece (1), Netherlands (2) and Algeria (2). In France, Tunisia and the UK, there has been local transmission among patients who had not been to the Middle East, but had been in close contact with laboratory-confirmed or probable cases. Person-to-person transmission has occurred both among close contacts and in healthcare facilities.

Image/Philippines DOH

Bedbugs: What are they and how to check for infestations

2014-06-12T15:07:00.000-07:00

According to the Centers for Disease Control and Prevention (CDC) and the U.S. Environmental Protection Agency (EPA), the United States is experiencing an alarming increase in the number of bedbug populations. In addition to being found in private residences, such as apartments and single-family homes, bedbugs are increasingly affecting restaurants, hotels, hospitals, and schools and day care centers.

Cimex lectularius/CDC

Bed bugs are small insects that feed on human blood. They do not transmit diseases, but their bites can leave itchy red welts on their victims. Adult bed bugs appear reddish-brown and have a flattened, oval shape. They are wingless and look about the size of an apple seed. They are big enough to be seen, but they hide in cracks in furniture, floors, walls, suitcases or clothing.

Most bed bug bites are initially painless, but they may turn into large, itchy skin welts. These wounds do not have a red spot in the center like lea bites. Some people don’t develop welts at all and can carry bugs without knowing it.

Although bed bugs are a nuisance, they are not known to spread disease.

“Although bedbugs don’t usually require serious medical attention, they can cause a great deal of anxiety and restless nights,” said board-certified dermatologist Seemal R. Desai, MD, FAAD, who maintains a private practice in Plano, Texas and serves as clinical assistant professor of dermatology at University of Texas Southwestern Medical Center. “The most common sign of bedbugs is having bite marks on your body, which can sometimes turn into itchy welts.”

To help find bedbugs before they find you (and your belongings), Dr. Desai recommends looking for the following signs near places where you sleep:

A sweet, musty odor: If you notice a sweet, musty odor in your hotel room, cruise ship cabin, or other sleeping area, there may be a heavy bedbug infestation in the room. Bedbugs produce chemicals to help them communicate, although not everyone will notice the smell.
Specks of blood on bedding, mattresses, or upholstered furniture: Look carefully at your blankets, sheets and mattress pads, and then check the mattress and box spring. Are there specks of blood anywhere, especially near the seams? If so, there could be a bedbug infestation. You should also check for specks of blood on all upholstered furniture, including couches and headboards.
Exoskeletons: Bedbugs have an outer shell that they shed and leave behind. Do you see shell-like remains on the mattress, mattress pad or beneath couch cushions?
Tiny, blackish specks: If you see blackish specks on the bedding, mattress, or headboard, it could be bedbug excrement.
Eggs: After mating, female bedbugs lay white, oval eggs in cracks and crevices. Keep in mind that these will be small, as a bedbug is only about the size of an apple seed.

“Most people who get bedbugs do so while traveling, making it critical to keep an eye out for infestations,” said Dr. Desai. “If you do get bedbugs and have many bites or a bite that looks infected, see a board-certified dermatologist. A dermatologist can treat an infection and help relieve the itch.”

How can I get rid of Bed Bugs?
Non-chemical eradication methods like vacuuming, steaming, laundering and sealing mattresses in plastic can help, but these methods usually do not completely eradicate a bed bug population. Also, bed bugs have become resistant to some types of insecticides, making it difficult to get rid of them. For this reason, you will probably need to consult a licensed pest control company, which should:

• Inspect your home to confirm the presence of bed bugs.
• Find and eliminate their hiding places.
• Treat your home with special cleaning and/or pesticides if necessary.
• Make return visits to make sure bed bugs are gone.

CDC

Nymph/CDC

4,000 pounds of beef products recalled because the dorsal root ganglia may not have been completely removed

2014-06-12T14:46:00.000-07:00

WASHINGTON, June 11, 2014 – Fruitland American Meat, a Jackson, Mo. establishment is recalling approximately 4,012 pounds of fresh beef products because the dorsal root ganglia may not have been completely removed, which is not compliant with agency regulations that require their removal in cattle 30 months of age and older, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The products subject to recall include:

40-lb. cases containing two, roughly 20-lb. cryovac packages of bone-in “Rain Crow Ranch Ribeye” bearing the establishment number “EST. 2316” inside the USDA mark of inspection with the following production dates: 9/5/13, 9/10/13, 9/11/13, 9/26/13, 10/2/13, 10/3/2013, 11/8/13, 11/22/13, 12/17/13, 12/26/13, 12/27/13,1/16/14, 1/17/14, 1/23/14, 1/31/14, 2/13/14, 2/14/14, 2/21/14, 2/28/14, 3/8/14, 3/20/14, 4/4/14 or 4/25/14 printed on the box.
Quartered beef carcasses stamped with the USDA mark of inspection and establishment number “EST. 2316.”

The products were produced and packaged on various dates between September 2013 and April 2014. The bone-in ribeye roasts were the source material of concern.

Fruitland American Meat advises that the bone-in ribeye roasts were distributed to a restaurant in New York, NY, and a Whole Foods distribution center in Connecticut which services its stores in New England. The quartered carcasses were distributed to an FSIS-inspected establishment in Missouri for further processing and distribution, and to a restaurant in Kansas City, Mo. All products would have been processed into smaller cuts with no identifying consumer packaging.

The problem was discovered by FSIS during a review of company slaughter logs. The problem may have occurred as a result of the way some company employees were recording information and determining the age of various cattle. Dorsal root ganglia, branches of the nervous system located in the vertebral column are considered specified risk materials (SRMs) and must be removed from cattle 30 months of age and older in accordance with FSIS regulations. SRMs are tissues that may contain the infective agent in cattle infected with Bovine Spongiform Encephalopathy (BSE), as well as materials that are closely associated with these potentially infective tissues. Therefore, FSIS prohibits SRMs from use as human food to minimize potential human exposure to the BSE agent.

Every animal received ante-mortem inspection by an FSIS Public Health Veterinarian. This involves observing each animal at rest and in motion and there is no indication that any of the cattle slaughtered displayed any signs of BSE.

FSIS and Fruitland American Meat have received no reports of adverse reactions due to consumption of these products. Anyone concerned about a reaction should contact a healthcare provider.

FSIS routinely conducts recall effectiveness checks to verify recalling firms notify their customers of the recall and that steps are taken to make certain that the product is no longer available to consumers. When available, the retail distribution list will be posted on the FSIS website at www.fsis.usda.gov/recalls.

Consumers and media with questions about the recall should contact company sales manager James Fortner at 573-243-3107.

Oritavancin's potential

2014-06-07T06:45:00.001-07:00

MRSA Image/CDC

DURHAM, N.C. – In the battle against stubborn skin infections, including methicillin-resistant Staphylococcus aureus (MRSA), a new single-dose antibiotic is as effective as a twice-daily infusion given for up to 10 days, according to a large study led by Duke Medicine researchers.

Researchers said the advantage of the new drug, oritavancin, is its potential to curtail what has been a key driver of antibiotic resistance: a tendency for patients to stop taking antibiotics once they feel better. In such instances, the surviving bacteria may become impervious to the drugs designed to fight them.

“The prolonged activity is what makes oritavancin distinctive,” said G. Ralph Corey, M.D., lead author of the study published June 5, 2014, in the New England Journal of Medicine (NEJM). “This drug has a long half-life, which allows for a single-dose treatment.”

Corey, a professor of medicine and infectious diseases at Duke University School of Medicine, led a three-year study of oritavancin that encompassed two large clinical trials enrolling nearly 2,000 patients. Findings from the trials will be presented to the U.S. Food and Drug Administration as part of the drug’s approval application.

Results reported in the NEJM are for the first of the two clinical trials, which included 475 patients randomized to take the investigational drug, and 479 patients following a typical regimen of vancomycin, including two infusions a day, for seven to 10 days.

Researchers found that the single intravenous dose of oritavancin was as effective as vancomycin in shrinking the size of the lesion and reducing fever. Both were also similar in rates of requiring a rescue antibiotic.

The new antibiotic also performed similarly to vancomycin in reducing the area of the wound by 20 percent or more within the first 48-72 hours of treatment, and in curing the patients of infection, including those infected with MRSA.

“Having a single-dose drug could potentially prevent hospitalizations or reduce the amount of time patients would spend in the hospital,” Corey said.

In addition to Corey, study authors include Heidi Kabler of Sunrise Hospital and Medical Center in Las Vegas; Purvi Mehra and William O’Riordan of Sharp Chula Vista Medical Center in Chula Vista, Calif.; Sandeep Gupta of MV Hospital and Research Center in Lucknow, India; J. Scott Overcash of Sharp Grossmont Hospital in San Diego; Ashwin Porwal of Inamdar Multispecialty Hospital in Pune, India; Philip Giordano of Orlando Health in Orlando, Fla.; Christopher Lucasti of Somers Point, N.J.; and Antonio Perez, Samantha Good, Hai Jiang and Greg Moeck of The Medicines Company.

The study was funded by The Medicines Company, which owns and is seeking to market oritavancin. Corey was a paid consultant to The Medicines Company and the principle investigator of the SOLO trials, the three-year study of oritavancin.

China: 433 H7N9 avian influenza cases reported on the mainland

2014-06-07T06:01:00.001-07:00

The Hong Kong Centre for Health Protection (CHP) of the Department of Health (DH) today (June 4) received notification of four additional human cases of avian influenza A(H7N9) in Jiangsu (two cases) and Shandong (two cases) from the National Health and Family Planning Commission.

The two patients in Jiangsu are a man and a woman, both aged 51, who are now hospitalised for treatment. The two cases in Shandong involve a man aged 61 who had poultry exposure and died and a man aged 33 who is hospitalised for management.

A total of 433 human cases of avian influenza A(H7N9) have been confirmed in the Mainland, including Zhejiang (138 cases), Guangdong (108 cases), Jiangsu (56 cases), Shanghai (41 cases), Hunan (23 cases), Fujian (22 cases), Anhui (17 cases), Jiangxi (eight cases), Shandong (five cases), Beijing (four cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one imported case from Zhejiang) and Hebei (one case).

Image/Cynthia S. Goldsmith and Thomas Rowe

Florida DOH reminds public of dangers of Naegleria fowleri

2014-06-05T17:56:00.000-07:00

The Florida Department of Health cautions those who swim frequently in Florida’s lakes, rivers and ponds during warm temperatures about the possible presence of Naegleria fowleri. Contact with this amoeba is rare, but the organism targets a person’s brain and usually results in death. Adverse health effects on humans can be prevented by avoiding nasal contact with the waters, since the amoeba enters through the nasal passages.

Naegleria fowleri seen under direct fluorescent antibody
(DFA) stain/CDC

Though there are only 34 reported cases in Florida since 1962, Naegleria fowleri can cause Primary Amebic Meningoencephalitis (PAM) disease which usually leads to death once infected. As a precaution, health officials recommend the following:

• 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.
• Please note exposure to the amoeba may also occur when using neti pots to rinse your sinuses of cold/allergy-related congestion or conducting religious rituals with tap water. Use only boiled and cooled, distilled, or sterile water for making sinus rinse solutions for neti pots or performing ritual ablutions.

If you experience any of these symptoms after swimming in any warm body of water, contact your health care provider immediately: headache, fever, nausea, disorientation, vomiting, stiff neck, seizures, loss of balance, or hallucinations. It is essential to seek medical attention right away, as PAM usually becomes fatal within five days of exposure.

Remember, this disease is rare and effective prevention strategies can allow for a safe and relaxing summer swim season.

DHHS Identifies First Jamestown Canyon Virus And Powassan Virus Cases In New Hampshire

2013-08-12T17:51:00.000-07:00

PRESS RELEASE

August 1, 2013

Concord, NH – The New Hampshire Department of Health and Human Services (DHHS) is announcing that a male from Hillsborough County tested positive for the Jamestown Canyon virus (JCV) and the Powassan virus, the first time either of these vector-borne diseases has been identified in the State. JCV is transmitted by infected mosquitoes and Powassan is transmitted by infected ticks.

“While this is our first announcement of Jamestown Canyon virus and Powassan virus in New Hampshire,” said Dr. José Montero, Director of Public Health at DHHS, “these have been in the U.S. for a while and Powassan was found in Maine and Vermont previously so this is not entirely unexpected. There are many mosquito- and tick-borne illnesses and unfortunately we are probably going to continue to see cases of them, which makes prevention steps all the more important. The same precautions we now take for Lyme and West Nile and EEE are effective against these viruses as well. So, as people enjoy New Hampshire we are urging them to use an effective repellent and do regular tick checks.”

Because these viruses are very rare, there is not a lot known about the illness they cause, where they are located in the environment, and how many people may have already been infected. JCV is a mosquito-borne pathogen that circulates widely in North America primarily between deer and a variety of mosquito species, but it can also infect humans. Reports in humans thus far of JCV are unusual and have been confined to the Midwestern and northeastern states. Most reported illnesses caused by Jamestown Canyon virus have been mild, but moderate-to-severe central nervous system involvement has been reported.

Powassan virus infection is caused by an arbovirus, which is similar to the mosquito-borne West Nile virus, but it is transmitted to people by infected ticks. Fewer than 60 cases of the disease have been detected in the United States and Canada since its discovery in 1958. In New Hampshire, Ixodes scapularis, or the blacklegged tick or more commonly deer tick, is capable of transmitting the virus to people. A tick needs to be attached to a person for a sufficient amount of time before it can cause disease. The time interval for Powassan virus is not known, but it is likely shorter than the time needed for Lyme disease (24–48 hours). Some people who are infected may experience mild illness or no symptoms. Powassan virus can also infect the central nervous system and cause brain inflammation.

Residents and visitors to New Hampshire should protect themselves and their family members by using an effective mosquito repellant that contains 30% DEET, wearing long sleeves and pants at dawn and dusk when mosquitoes are most active, and removing standing water from around your house so mosquitoes do not have a place to breed. Repellents with picaridin, IR3535 and some oil of lemon eucalyptus and para-menthane-diol products also provide protection.

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Dr Patricia Quinlisk discusses cyclospora outbreak in Iowa--July 20, 2013

2013-08-12T17:47:00.000-07:00

Interview with Dr Patricia Quinlisk on Cyclospora. Dr. Quinlisk is from the Iowa Dept. of Public Health Medical Director and State Epidemiologist

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Potential Hot Spot for Avian Flu Transmission Identified in Western Alaska

2013-07-14T07:38:00.000-07:00

From USGS News Release:

ANCHORAGE, Alaska — Low-pathogenic avian influenza viruses with Eurasian genes have been found among birds in the Yukon-Kuskokwim Delta of western Alaska, supporting the theory that the area is a potential point of entry for foreign animal diseases such as the more highly pathogenic H5N1 strain, according to a new study by U.S. Geological Survey scientists.

The Yukon-Kuskokwim Delta is an important breeding ground for many bird species and is located where multiple migratory flyways converge, providing opportunities for avian pathogens to spread. Among these pathogens are H5N1 avian influenza, which occurs in both low-pathogenic and the more dangerous highly pathogenic forms.

After the outbreak of the highly pathogenic H5N1 strain of avian influenza in wild birds of China in 2005, the USGS and the U.S. Fish and Wildlife Service, in cooperation with the Yukon-Kuskokwim Health Corporation, the Kawerak Tribal Corporation and other partners, conducted four years of testing wild migratory birds in western Alaska for the highly pathogenic H5N1 strain.

In a paper published by the USGS and the USFWS scientists no highly pathogenic forms of avian influenza were found in more than 24,000 samples tested from 82 species on the Yukon-Kuskokwim Delta from 2006 to 2009, however, 90 low-pathogenic strains of the virus were obtained from these Alaskan samples. Low-pathogenic avian influenza viruses are common among wild birds and do not cause mortalities to the degree often seen with highly pathogenic forms of the virus, said USGS research geneticist Andrew Reeves, lead author of the paper. The significance of this study is that it demonstrates that viruses with genes of Eurasian origin can enter North America via migratory birds.

In addition, researchers discussed how low pathogenic virus samples from birds further from Asia contained fewer genes attributable to Eurasian strains.

"This finding supports a 'dilution-by-distance' idea we've hypothesized in other studies," Reeves said. "Birds sampled further from Asia, such as in the lower-48 United States, very rarely contain avian influenza viruses with Eurasian genes, but in Alaska they are more common."

"Many of the bird samples used in the study were provided by subsistence hunters in 11 villages throughout the Yukon-Kuskokwim Delta who collected samples from many species, including ducks, geese, swans and shorebirds," said Kim Trust of the USFWS.

"Without our partners in western Alaska, we would not have the robust data set that supports the findings in this paper," Trust said.

Reeves added that the current study provides support for retaining the Yukon-Kuskokwim Delta as a high-priority region for the surveillance of potentially harmful avian pathogens.

The paper in the Journal of Wildlife Diseases, "Genomic analysis of avian influenza viruses from waterfowl in western Alaska, USA," by Andrew Reeves, John Pearce, Andrew Ramey, Craig Ely, Joel Schmutz, Paul Flint, Dirk Derksen and Hon Ip of the USGS and Kimberly Trust of the USFWS, is available online.

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A Conversation About MERS Coronavirus: Dispatch Radio

2013-07-13T14:57:00.002-07:00

With the latest case count of Middle East respiratory syndrome coronavirus (MERS-CoV) now standing at 80, there has been a great deal of attention given to this relatively new viral outbreak.

On the Saturday, July 6 Dispatch Radio program, I had the opportunity to talk to Professor of Microbiology and Immunology at Columbia University, Dr. Vincent Racaniello, about MERS.

Listen to the podcast here. The interview starts at the 23:10

There has been a lot of comparisons between the MERS coronavirus and the related Severe acute respiratory syndrome (SARS) that sickened over 8000 and killed 775 a decade ago. I asked Dr. Racaniello to explain the difference between the two viruses concerning ability to cause disease, how lethal they are and human-to human transmission.

Racaniello says SARS appeared in China in 2003, infected thousands, killed nearly 800 and “then for reasons we still don’t understand, it disappeared.”

That virus [SARS] was not bad at spreading among people, 10% lethality, which is high. About a year ago, a new coronavirus emerged in the Middle East, the MERS coronavirus.

“So far it’s not particularly good at spreading person-to-person, with about 80 infected, Racaniello adds.

However, he does point out that the data is not really available to clearly answer that.

With the numbers of MERS cases at 79 (at the time of the show), I asked Racaniello if he thought the numbers may be higher due to undetected cases.

“Absolutely, he said. I think that the 79 cases are the ones where the people have got very sick, they’ve gone into hospitals and they’ve been diagnosed with this virus infection.

“With most viruses, many, many people get infected and have either mild symptoms, so they never go to a health care provider, or they have no symptoms at all and we have no way of detecting that for the MERS coronavirus yet because we don’t have the right diagnostic test.

“But as soon as those are developed, then we can go out into populations and say, how many people are in fact infected, and it could be that thousands of people have been infected with very little disease, which of course would bring the mortality rate pretty far down.”

Concerning the source of MERS, some have attributed it to bats, at least one report suggested a link with camels. “The bat story comes from the fact that when you sequence the genetic information of viruses and tell which are related to other viruses.

“The closest relative of this virus, aside from other coronaviruses that infect humans, is a virus isolated from a bat in 2008. It suggest, but it doesn’t prove, the virus may have originated in bats. SARS coronavirus originated in bats as well.

“Bats harbor a lot of diverse coronaviruses so it wouldn’t be unusual the virus jumped from bats, he said. People in general don’t really contact bats very frequently, so the idea that there is an intermediate animal went through. In the case of the SARS coronavirus, we think the virus went from a bat, to a Palm civet then to people, and it could be that in this case with the MERS coronavirus, it originated in bats, and it may being going through camels, as there has been reports of individuals getting sick after being close to camels.”

However, Racaniello points out that there are many cases where patients don’t have a contact history with animals of any kind. “So you have to wonder if the virus isn’t spreading in people already”, he adds.

I asked Racaniello about the diverse conclusions and statements from scientists from the Pasteur Institute in France who suggest that MERS-CoV does not yet have pandemic potential, and the statement in May by WHO Director-General Dr Margaret Chan at the 66th World Health Assembly (WHA) who stated, “The novel coronavirus is a threat to the entire world.”

Who is closer?

“I think the Pasteur scientists are probably closer, Racaniello answers. Listen, it’s infected 80 some people, in the scheme of the world, this is not very much.

“As far as we know, this virus can’t spread efficiently among people so that’s why we say it doesn’t have pandemic potential.”

Racaniello does note that Dr. Chan is speaking as head of WHO and has to be very cautious. “If this virus somehow changed, it could acquire pandemic potential, so she’s sending out a message to health organizations globally that we need to keep an eye on this virus and get ready in case it should get more serious.”

The question, What is the threat of MERS entering the United States and are we prepared? was posed to the professor.

“That’s a very interesting question, I think it might of already come into the US, with global travel being as easy as it is. It’s very easy to imagine that someone has been infected in the Middle East, has no fever, no symptoms, has flown to the US shedding virus on the plane and within the US.

“So far, we don’t have any evidence that’s happening, but it certainly could be going on and we wouldn’t be able to detect it, especially if people haven’t been sick yet.

“It’s quite likely that the virus is here already, or will soon be brought into the US. Then the question would be, what would happen?

“Like we’ve seen in the Middle East, mainly really sick people have been infected with this virus, so you could imagine the same happening to a very sick person here in the US. You might get a few cases here of infection and that would trigger a lot of panic I think.”

Racaniello says, “Unfortunately, we don’t have any therapeutics for it–we don’t have a vaccine, we don’t have any antiviral drugs, the best we could do is try to limit people traveling and interacting with one another. But as you probably could guess would be virtually impossible.”

Without vaccines or antiviral drugs, it’s really hard to stop viral spread.

“I would guess if this virus came in to the US in a form that could transmit effectively among people, it would spread pretty efficiently. The good news is that hasn’t happened yet, even with global travel”, Racienello said.

Check out The Virology Blog

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Conjunctivitis increases reported in Japanese schoolkids due to eyeball licking (Video)

2013-06-30T18:43:00.000-07:00

Japanese schoolteachers have been concerned of late because an increased number of middle school children have been showing up to class wearing eyepatches and sporting a raging case of conjunctivitis, or "pink eye", according to Daily Mail report June 13.

Image/Video Screen Shot

What is being called the new "second base", the new eyeball-licking trend called “worming", or technically “oculolinctus” is the latest expression between, let's say, two people who really like each other.

Definition: Oculolinctus refers to achieving sexual gratification from licking a person's eyeballs.

It's all the craze in Japan; however, this strange fetish doesn't come without risks.

See video here

It has led to a surge in cases of eye infections and can even cause blindness, doctors have warned,” the report said.

‘Nothing good can come of this,’ Dr David Granet, a San Diego ophthalmologist, told The Huffington Post. ‘There are ridges on the tongue that can cause a corneal abrasion. And if a person hasn't washed out their mouth, they might put acid from citrus products or spices into the eye.’

Dr Phillip Rizzuto, from the American Academy of Ophthalmology, added that eyeball licking can cause blindness as the bacteria found in the mouth can damage eye tissue.

Conjunctivitis is a common eye condition worldwide. It causes inflammation (swelling) of the conjunctiva -- the thin layer that lines the inside of the eyelid and covers the white part of the eye. Conjunctivitis is often called "pink eye" or "red eye" because it can cause the white of the eye to take on a pink or red color. The most common causes of conjunctivitis are viruses, bacteria, and allergens.

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Texas: Guatemalan man, detained by Immigration, dies from rabies

2013-06-30T18:38:00.000-07:00

A Guatemalan man being held in custody by U.S. Immigration and Customs Enforcement (ICE) since a month ago, has died from rabies, believed to be contracted prior to crossing the border,according to an ICE press release June 12.

According to immigration officials, the timeline of events related to 28-year-old Federico Mendez-Hernandez is as follows:

Mendez-Hernandez was taken into custody on May 9 by US Border Control on the Rio Grande and custody was transferred to on May 12. At the time he was captured, he showed no signs or symptoms of illness.

Approximately nine days after being apprehended, Mendez-Hernandez began to show some symptoms consistent with rabies and was ultimately taken to Christus Spohn Memorial Hospital in Corpus Christi.

Last Friday, laboratory analysis performed by the Centers for Disease Control and Prevention (CDC) confirmed Mendez-Hernandez had rabies.

It is unclear exactly how, when or where he contracted the lethal viral disease, information acquired via laboratory testing reveals he had a canine rabies virus variant common in Central America.

Federal and Texas health officials are interviewing people with contact with Mendez-Hernandez to determine rabies risk, such as contact with bodily fluid like saliva and tears to determine the need for post exposure rabies prophylaxis, despite there never being a confirmed person-to-person transmission of rabies.

Rhode Island family brings rabid raccoon in their home, 18 people affected (Video)

According to the World Health Organization (WHO), Rabies is a zoonotic disease (a disease that is transmitted from animals to humans) that is caused by a virus. It is known to be present on all continents except Antarctica and infects domestic and wild animals.

Rabies is spread to people through close contact with infected saliva via bites or scratches. The main route of rabies transmission to humans is the bite of rabid dogs. Most of the deaths occur in the absence of post-exposure prophylaxis. Rabies is nearly always fatal when left untreated.

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Purdue scientists have a jump on MERS coronavirus treatment going back to SARS

2013-06-30T18:32:00.000-07:00

Image/Maureen Metcalfe; Azaibi Tamin

Researchers from the West Lafeyette, Indiana university have a "leg up" on developing a treatment for the new Middle East respiratory syndrome coronavirus, or MERS-CoV, thanks to work they did on a related virus in the past, according to a Purdue news release June 17.

The research team of Andrew Mesecar and Arun Ghosh, who previously created a compound that prevents replication of the virus that causes SARS, are testing compounds that could lead to potential treatments for the new MERS-CoV virus. Because of their previous research and expertise, the process will be reduced to months instead of years.

"MERS-CoV and SARS are similar, yet distinctly different coronaviruses," Mesecar said. "Our understanding of the prime targets for treatment of the SARS virus and the molecular inhibitors we have designed against it give us a good head start in finding a potential treatment for MERS-CoV."

"While MERS-CoV appears to be more virulent than SARS, molecular scaffolds and design concepts that we developed against SARS are very beneficial and timely," Ghosh said. "Using our expertise in structure-based design and drug development, our team has already synthesized a number of specific MERS-CoV inhibitors."

Globally, from September 2012 to date, WHO has been informed of a total of 77 laboratory-confirmed cases of infection with MERS-CoV, including 40 deaths.

Coronaviruses are a large family of viruses that includes viruses that may cause a range of illnesses in humans, from the common cold to SARS and animal diseases.

MERS-CoV is not the same coronavirus that caused SARS.

CDC Advises Pilgrims to Hajj and Umrah on how to protect against MERS Coronavirus and other injuries and illness

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New rapid test can detect Group B strep colonization in 6 1/2 hours: Study

2013-03-10T16:06:00.000-07:00

HOUSTON – (March 8, 2013) – A more rapid laboratory test for pregnant women to detect potentially deadly Group B strep (GBS) has been successful at identifying GBS colonization in six and a half hours, according to the results of a study from The University of Texas Health Science Center at Houston (UTHealth).

The more rapid test could be helpful for the 13 percent of patients who experience pre-term labor before they are screened for GBS, which usually occurs between 35 and 37 weeks of gestation. The current standard test takes 48 hours. Antibiotics can be administered at the time of delivery to kill the bacteria.

“This new test could change the management of patients who present to labor and delivery with threatened preterm labor and aren’t expected to deliver right away,” said Jonathan Faro, M.D., Ph.D., assistant professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at The University of Texas Medical School at Houston, part of UTHealth. “It would likely gain use in this patient population, which is a small number, but still very significant clinically. We could target this population and this would help cut down on overuse of resources and minimize our contribution to the increased level of bacterial resistance.”

The new test, developed by NanoLogix, can also detect antibiotic sensitivities for women who are allergic to penicillin, saving the additional 48 hours the standard test for antibiotic sensitivity takes, Faro said.

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Norovirus confirmed as cause of outbreak that sickened 85 in Thunder Bay

2012-12-23T21:05:00.000-08:00

Image/CDC

Thunder Bay health officials report that the gastrointestinal outbreak that sickened at least 85 people linked to three events catered by Maltese Grocery has been laboratory confirmed as norovirus, according to a Thunder Bay District Health Unit news release Dec. 21.

"We are very sorry for everyone who has been affected and we take full responsibility," say Lisa and Dave Maltese, owners of Maltese Grocery. "We are working with the Health Unit and have taken every precaution to ensure this does not happen again. We thank our customers and friends for their ongoing support through this difficult time."

The grocery store suspended it’s catering operations late last week after initial reports of illnesses in people attending social events catered by the Thunder Bay establishment.

Health officials say now that they determined the source of the outbreak, which appears to be a food handler, Maltese Grocery will be reopening catering operations. The grocer has a good inspection record and has been fully cooperative throughout the investigation.

CBC News reports that Maltese Grocery is making some additional changes to its cleaning and hand-washing procedures, including the use of new chemicals and sanitizers.

"We are confident in the steps that have been taken by Maltese Grocery," says Abby Mackie, senior public health inspector.

Earlier in May, another Thunder Bay establishment, This Old Barn, was linked to a norovirus outbreak that sickened 136 people who dined at a Mother’s Day Buffet.

Noroviruses are a group of viruses that cause the “stomach flu,” or gastroenteritis in people.

The symptoms include nausea, vomiting, diarrhea, and some stomach cramping. Sometimes people additionally have a low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. The illness often begins suddenly, and the infected person may feel very sick. In most people, the illness is self-limiting with symptoms lasting for about 1 or 2 days. In general, children experience more vomiting than adults do.

Norovirus is spread person to person particularly in crowded, closed places. Norovirus is typically spread through contaminated food and water, touching surfaces or objects contaminated with norovirus and then putting your hand or fingers in your mouth and close contact with someone who is vomiting or has diarrhea.

The Health Unit would like to remind the public of the importance of proper hand washing techniques as one of the most effective ways to prevent the spread of illness-causing germs. Taking 15 seconds to wash with soap and water will reduce your risk of getting a cold, the flu and other common infections.

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Europe measles cases return to pre-2010 levels: ECDC

2012-12-23T10:48:00.000-08:00

Image/CIA

The EU has returned to similar numbers of measles cases as seen before the large outbreaks of 2010 and 2011.

The new December Measles and Rubella Monitoring report by ECDC shows that the total number of measles cases in the EU is 7,016 for 2012 compared to some 30,000 for 2011.

Individually, 12 of 29 EU/EEA countries had less than one case of measles per million population in the last 12 months, low enough to meet the WHO elimination target set for 2015.

However, five countries: France, Italy, Romania, Spain and the United Kingdom accounted for 94% of the reported cases, according to an European Centre for Disease Prevention and Control news release Dec. 21.

Here are some other measles developments from the surveillance report:

The 29 contributing EU/EEA countries reported 7,016 cases of measles from January to October 2012 and 8,795 cases during the last 12-month period from November 2011 to October 2012.
The number of reported cases is substantially lower in 2012 compared with the same period in 2011, but the aggregated EU/EEA notification rate for the last 12-month period continues to exceed the elimination target of less than one case per million population.
Of the cases reported in the last 12-month period for which vaccination status was available, 82% were unvaccinated.
Fifteen percent (1,279) of the cases were under one year of age; of these, 97% were reported as unvaccinated.
Of the 2,254 cases aged 1–4 years, targeted by vaccination programs in all European countries, 77% were reported as being unvaccinated.
There were no measles-related deaths reported during the last 12 months but 10 cases were complicated by acute measles encephalitis.

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For more Outbreak News, visit the Global Dispatch

Second hand smoke increases children’s risk to meningitis: Study

2012-12-10T20:38:00.000-08:00

Passive or second hand smoke (SHS) has been linked to a plethora of conditions in the non-smoker to include heart disease, lung cancer and SIDS. Research from the United Kingdom now suggests that SHS significantly increases the risk of invasive meningococcal disease in children, according to a University of Nottingham press release Dec. 10.

The paper, “Second hand smoke exposure and the risk of invasive meningococcal disease in children: systematic review and meta-analysis” was published today in the online journal, BMC Public Health.

Researchers from the University of Nottingham’s UK Centre for Tobacco Control Studies identified 18 studies from four databases, which assessed the effects of SHS on the risk of invasive meningococcal disease in children.

What they found was children exposed to second-hand smoke risk had double the risk of invasive meningococcal disease. For children under five this risk was even higher, and for children born to mothers who smoked during pregnancy the risk tripled.

According to Dr. Rachel L. Murray, Professor of Health Policy and Promotion at the University of Nottingham, “While we cannot be sure exactly how tobacco smoke is affecting these children, the findings from this study highlight consistent evidence of the further harms of smoking around children and during pregnancy, and thus parents and family members should be encouraged to not smoke in the home or around children.”

Invasive meningococcal disease remains an important cause of serious morbidity and mortality in children and young people. In addition to being a major cause of bacterial meningitis, it can also cause severe illness when bacteria invade the blood, lungs or joints.

According to the release, meningococcal disease is particularly prevalent in children and young adults, and nearly 1 in 20 affected individuals will die despite medical attention. One in 6 will end up with a severe disability, including neurological, behavioral and hearing disorders.

The researchers conclude that SHS exposure, and particularly passive fetal exposure to maternal smoking during pregnancy, significantly increases the risk of childhood invasive meningococcal disease. It is likely that an extra 630 cases of invasive meningococcal disease annually in children under 16 are directly attributable to SHS exposure in UK homes.

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Taiwan: Hundreds of chickens destroyed in response to avian influenza outbreak

2012-12-09T21:08:00.000-08:00

Some 631 chickens were destroyed at one Taiwanese farm in an effort to prevent further spread of an outbreak of highly pathogenic avian influenza virus (HPAI), according to a World Organization for Animal Health (OIE) immediate notification report Dec. 7.

The outbreak occurred on a farm in Ma-Gong City in Peng-hu prefecture.

The owner of the farm called in Taiwanese veterinary experts to check on an unusually high number of bird deaths in November.

The farm had more than 800 susceptible chickens, in which 200 had already died. The remaining 631 birds were culled as a precautionary measure.

Laboratory analysis by the Animal Health Research Institute revealed positive findings for HPAI serotype H5N2 using reverse transcription - polymerase chain reaction (RT-PCR) and intravenous pathogenicity index (IVPI) test.

According to the report, a clinical and epidemiological investigation of three surrounding poultry farms was conducted. No other cases were detected.

According to the World Health Organization, Avian influenza (AI) is an infectious viral disease of birds (especially wild water fowl such as ducks and geese), often causing no apparent signs of illness. AI viruses can sometimes spread to domestic poultry and cause large-scale outbreaks of serious disease. Some of these AI viruses have also been reported to cross the species barrier and cause disease or subclinical infections in humans and other mammals.

AI viruses are divided into two groups based on their ability to cause disease in poultry: high pathogenicity or low pathogenicity. Highly pathogenic viruses result in high death rates (up to 100% mortality within 48 hours) in some poultry species. Low pathogenicity viruses also cause outbreaks in poultry but are not generally associated with severe clinical disease.

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Localized fungal infections seen in increasing numbers from tainted steroid

2012-12-09T20:50:00.000-08:00

Exserohilum rostratum/CDC

It is being reported that localized, injection site fungal infections are being reported from some state health departments in increasing numbers. Michigan health officials have reported scores of such infections since the beginning of the multistate outbreak linked to contaminated methylprednisolone acetate (MPA) injection, according to a Michigan Department of Community Health update Dec. 7.

In Michigan, officials have reported 131 epidural abscesses, 36 meningitis plus epidural abscess and one epidural abscess plus peripheral joint fungal infection.

Moreover, Michigan is not alone. The Tennessee Department of Health (TDH) has reported a total of 23 people have been identified as having new, localized infections since Thanksgiving.

According to a statement by TDH Commissioner John Dreyzehner, MD, MPH, “As of today, we have identified 23 persons who have developed these less serious infections at or near the site of their MPA injections. The early identification of these infections, made possible by a strong collaborative effort by clinicians, our department and the CDC, has helped several individuals get effective treatment at an earlier stage, thereby fending off a more serious illness.”

Dreyzehner says he cannot tell with certainty how long they can expect to identify new cases of localized infections. “Nationally", he says, "the longest reported infection occurred 120 days after last injection.”

The latest data on the Multistate Fungal Meningitis Outbreak Investigation from the Centers for Disease Control and Prevention is 541 cases reported from 19 states. 36 of these infections have ended in death as of Dec. 3.

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Brazil reports first case of ‘Mad Cow disease’ in a cow that died two years ago

2012-12-09T20:46:00.000-08:00

In a case, that has left U.S. cattle producers critical of the government’s reliance on foreign countries and the World Organization for Animal Health (OIE), Brazil has reported its first case of bovine spongiform encephalopathy (BSE or mad cow disease), two years after the cow died, according to an R-CALF USA, the Ranchers-Cattlemen Action Legal Fund news release Dec. 7.

What happened in Brazil to cause such a delay?

According to the OIE notification report, in Dec. 2010, Brazilian veterinary officials were called to check on a 13-year-old cow exhibiting limb stiffness in the city of Sertanopolis, Parana state. However, when they arrived, the bovine was dead.

Suspecting rabies, as it is not uncommon to see this disease in cattle and other herbivores, the animal was tested, which turned out negative.

Since it appeared to be a neurologic disease, a sample was sent to an accredited lab to rule out BSE. In April 2011, the histopathological test was reported as negative.

According to the OIE report, a sample was then sent to the National Reference Laboratory, National Agricultural Laboratory (LANAGRO-PE), Recife, Pernambuco, for BSE diagnosis and it tested positive on 15 Jun 2012 by immunohistochemical test—a full 18 months after the death of the cow. It was again confirmed for BSE at the UK OIE lab this month.

Brazil authorities say the delay in testing was due to a low-prioritization of this particular sample based on several reasons.

This chain of events has brought criticism from R-CALF USA who report, even though the OIE considers Brazil as having a “negligible BSE risk”, that approximately 67 million pounds of Brazilian beef were imported into the United States since the Brazilian BSE suspect was identified.

“That means the U.S. imported enough beef from Brazil in 2011 and 2012 to feed over 1 million Americans their annual consumption of beef,” said R-CALF USA CEO Bill Bullard.

“None of that Brazilian beef imported into the U.S. during the past two years was subject to BSE mitigations that are supposed to apply to countries where BSE is known to exist, meaning U.S. consumers have been subjected to an unnecessary and avoidable risk of mad cow disease from Brazil,” Bullard added.

"This failure by Brazil to provide timely notice of its disease problem clearly demonstrates that USDA’s ongoing reliance on foreign countries and the OIE to protect U.S. citizens from unsafe imports is absolutely foolish and without basis, and is another example of why we need country-of-origin labeling,” Max Thornsberry, D.V.M. and Chair of R-CALF USA’s Animal Health Committee concluded.

According to the Centers for Disease Control and Prevention, BSE (bovine spongiform encephalopathy) is a progressive neurological disorder of cattle that results from infection by an unusual transmissible agent called a prion. The nature of the transmissible agent is not well understood.

Macao woman who had brain surgery in Hong Kong likely has Creutzfeldt-Jakob Disease

Currently, the most accepted theory is that the agent is a modified form of a normal protein known as prion protein. For reasons that are not yet understood, the normal prion protein changes into a pathogenic (harmful) form that then damages the central nervous system of cattle.

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FDA warns the public of salmonella risk with certain Nature’s Deli dog treats

2012-12-08T21:01:00.000-08:00

Image/FDA

Federal health officials are warning consumers of a popular dog treat that may be tainted with Salmonella. The warning comes after the distributor of the dog treats declined to perform a voluntary recall at this time,according to a Food and Drug Administration (FDA) news release Dec. 6.

One lot of affected product, Nature’s Deli Chicken Jerky Dog Treats, packaged and distributed by Kasel Associates Industries Inc. of Denver, Co., was recalled in early October after routine testing revealed the presence of Salmonella.

The affected lot during the October recall of the dog treats is lot number BEST BY 091913 DEN. This lot was distributed to 57 Sam's Club locations in the following states: CO,IA,ID,IL,KS,MO,MT,NE,OK,SD,UT and WY.

However, the Nature’s Deli product lot the FDA is warning about now comes after a retail sample of Nature’s Deli Chicken Jerky Dog Treats lot code BESTBY061913DEN taken by the Colorado Department of Agriculture tested positive for Salmonella in November.

Kasel did not include this additional lot in the recall and declined to recall it now.

According to the FDA, The product is sold in 3.0 lb. packages labeled as Nature’s Deli Chicken Jerky Dog Treats. The product is packaged in flexible plastic, which is yellow, blue, green and red, with black and white print writing. The packaging also has a digital photo of a dog on the front panel, and transparent sections to view the product inside. Lot code BESTBY061913DEN is located on the reverse side of the packaging in the transparent section immediately following the term “All American Dog.”

The affected products are sold at Costco stores in the Denver, Colo., area. Costco is working with FDA and has removed all of the affected products from its shelves. The company will also contact customers who may have purchased the product to provide additional instructions.

Salmonella is a pathogen to both humans and animals. There is a risk for humans handling the contaminated dog food if poor hand washing techniques are not performed or surfaces in contact with the dog food are not properly cleaned.

In humans, Salmonella 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.

Pets, including dogs, with Salmonella can become lethargic and have diarrhea or bloody diarrhea, fever and vomiting. The clinical features of canine salmonellosis vary on strain, amount ingested and dog host factors.

Many dogs however are asymptomatic carriers of the bacteria and may shed Salmonella for up to 100 days after being infected. This can become a risk for family members and anyone with confirmed salmonellosis without a known risk of exposure, the family pet should be tested regardless of symptoms.

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Injectable bath salts linked to invasive strep A cluster in Maine

2012-12-07T20:55:00.000-08:00

Image/CDC

Health officials in Maine are investigating a cluster of invasive Group A Streptococcal (GAS) infections in patients who have reported a history of injecting bath salts,according to a Maine Center for Disease Control and Prevention (Maine CDC) health advisory Dec. 6.

In addition, physicians and other health providers are being advised to be on the lookout for the symptoms of invasive GAS among intravenous (IV) drug users.

There have been four cases of invasive GAS infection in drug users ages 23 to 37.

All cases reported injecting bath salts, two had Streptococcal Toxic Shock Syndrome (STSS), all required hospitalization, one required intensive care, and one had necrotizing fasciitis according to the alert.

All four patients were from two Maine counties, Aroostook and Penobscot.

Health providers who suspect invasive GAS in an IV drug user should perform skin, wound, and/or blood cultures and consider prompt antibiotic treatment for patients presenting with symptoms of GAS (including cellulitis) and STSS.

Streptococcus pyogenes, or beta streptococcus group A is a very common pathogenic bacterium in humans.

Probably the most common disease caused by Streptococcus pyogenes is pharyngitis, or strep throat. Strep throat is very common in school-aged children, particularly in the winter and spring months. Untreated strep throat can lead to more serious complications like rheumatic fever; however, this is relatively uncommon.

It is also a cause of several skin infections such as impetigo and cellulitis. Impetigo is a characterized by a crusty lesion frequently found on the mouth area. Cellulitis typically occurs after a wound or burn where the bacteria enters and spread through the skin and lower tissues.

More serious, potentially life-threatening infections caused by Streptococcus pyogenes include necrotizing fasciitis (commonly called flesh-eating bacteria) and toxic shock syndrome.

Approximately 25% of patients with necrotizing fasciitis and more than 35% with STSS die.
In addition, Streptococcus pyogenes can cause scarlet fever, septicemia and pneumonia. The death of Muppets creator Jim Henson was a result of an infection with Streptococcus pyogenes.

“Bath Salts” are an increasingly popular drug which goes by a number of names including "Ivory Wave," "Purple Wave," Vanilla Sky," and "Bliss."

The drug is a chemical synthetic stimulant, most commonly methylenedioxypyrovalerone (MDPV), but others like mephedrone and methylone are known to cause intoxication in users, and the effects include paranoia, delusions, suicidal tendencies and chest pains. The drug is taken by oral, smokable, snortable means and now to achieve a quicker high, injection is becoming more common.

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