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Vol. X No. 25 ~ EINet News Briefs ~ Dec 14, 2007
*****A free service of the APEC Emerging Infections Network*****
APEC EINet News Briefs offers the latest news, journal articles, and notifications for emerging infections affecting the APEC member economies. It was created to foster transparency, communication, and collaboration in emerging infectious diseases among health professionals, international business and commerce leaders, and policy makers in the Asia-Pacific region.
In this edition:
1. Influenza News
- Global: Cumulative number of human cases of avian influenza A/(H5N1)
- Global: Donors pledge 406 million USD to fight avian influenza
- Poland: Avian influenza found on poultry farms and in wild birds
- Saudi Arabia (Al-Kharj): H5N1 avian influenza outbreak at an egg production farm
- Saudi Arabia: Suspected H5N1 avian influenza virus kills imported wild falcon
- Russia: H5N1 avian influenza found in Rostov region, 450,000 hens slated to be destroyed
- China (Jiangsu): Son dies from H5N1 avian influenza, father also falls ill
- Hong Kong: Grey Heron infected with H5N1 avian influenza
- Indonesia (Jakarta): 47-year-old man from Tangerang treated for H5N1 avian influenza
- Indonesia (Jakarta): Woman from Tangerang dies from H5N1 avian influenza
- Pakistan (Peshawar): H5N1 avian influenza claims two lives in Mansera
- Viet Nam (Bac Giang): H5N1 avian influenza hits poultry farm
- Nigeria: Authorities busy disinfecting poultry markets in preparation for festivities
2. Infectious Disease News
- Russia (Amur): Hunter develops tularemia
- China (Gansu): Plague claims one life in northern China
- China: Unsafe chemicals in canned meat, officials vow to tighten controls
- China: Brucellosis continues to spread
- Indonesia (Jakarta): Koja hospital overwhelmed by patients seeking diarrhea care
- Indonesia: Chikungunya hits four areas
- Papua New Guinea (Daru): November typhoid cases more than double
- Singapore: Salmonellosis found in Prima Deli chocolate cakes, 143 cases detected
- Canada (Alberta): Five young people suffer severe allergic reactions to MMR vaccine
- Canada (Alberta): Mumps outbreak continues
- USA (Nevada): Mumps make comeback in southern Nevada
- USA: Government officials announce food safety pact with China
- USA (Arizona): 14 people struck with powerful form of Salmonella
- USA (New York): More hepatitis cases follow Long Island needle scare
- USA and Canada: Metromint-flavored water may contain Bacillus cereus
- USA (Guam): Six-year-old child diagnosed with cholera
- USA (Kansas): Raw milk is the culprit in campylobacteriosis outbreak
- USA (Minnesota): Undiagnosed neurological illness in pork processing plant workers
- USA (New Mexico): Third hantavirus case this year
- AVIAN/PANDEMIC INFLUENZA
- Earth monitoring: Vigilance is not enough
- Phylogenetic analyses of highly pathogenic avian influenza virus isolates from Germany in 2006 and 2007 suggest at least three separate introductions of H5N1 virus
- A general model of prion strains and their pathogenicity
- Chikungunya in northeastern Italy: an outbreak summary
- Outbreak of Cutaneous Larva Migrans at a Children's Camp — Miami, Florida, 2006
- Second International Conference on Health and Biodiversity, Ireland, February 2008
- Second International Conference on Dengue/Dengue Hemorrhagic Fever, Thailand, October 2008
- 2008 International Conference On Biocontainment Facilities
- Occupational HIV Exposures
1. Influenza News
Global: Cumulative number of human cases of avian influenza A/(H5N1)
Economy / Cases (Deaths)
Total no. of confirmed human cases of avian influenza A/(H5N1), Dec 2003 to present: 339 (208).
Avian influenza age distribution data from WHO/WPRO:
WHO maps showing world's areas affected by H5N1 avian influenza (last updated 12.10.07):
WHO timeline of important H5N1-related events (last updated 12.5.07):
Global: Donors pledge 406 million USD to fight avian influenza
The latest pledges will bring the total promised by donors and multilateral development banks (MDBs) in the past two years to about 2.7 billion USD. A report released by the United Nations and the World Bank said a total of about 2.3 billion USD was pledged at conferences in Beijing in January 2006 and in Bamako, Mali, in December 2006.
When the New Delhi conference opened 4 Dec 2007, the World Bank predicted a need for 1.2 billion USD to help countries battle avian flu over the next two to three years, according to a 6 Dec 2007 report by Agence France-Presse (AFP).
Peter Harrold, acting vice president of the World Bank, called the new pledges a "very encouraging response," AFP reported. "There is still a gap, but this is more than what we had anticipated," he said.
The United States had previously pledged 434 million USD to the avian flu fight. In New Delhi, US officials promised another 195 million USD, raising the total to 629 million USD. Of the 2.3 billion USD previously pledged for the avian flu battle, 1.7 billion USD (72%) has been committed and more than 1 billion USD (43%) has been paid out, according to the UN–World Bank report, which was released 29 Nov 2007 in advance of the conference. About 600 million USD remained uncommitted as of the end of June.
Long-term efforts needed:
John E. Lange, who headed the US delegation to the conference, said in a 4 Dec 2007 speech there, "While we have made progress in the years since the virus first appeared, we now need to shift some of our efforts from the 'emergency' phase of identifying and dealing with avian outbreaks to a greater emphasis on long-term capacity-building to improve both animal and human health systems as they relate to the H5N1 avian influenza virus and other emerging and re-emerging infectious and zoonotic diseases."
Lange also touched on the dispute with Indonesia over the sharing of H5N1 virus samples, though he didn't name the country. "We call on all countries to share virus samples freely, without encumbrances, for the benefit of global health," he said.
Other findings cited in the report:
At the end of the conference, the Indian government released a suggested planning template for countries to use in preparing for avian and pandemic flu. The "Vision and Road Map" includes 21 goals that India proposes countries try to accomplish by the end of 2008.
Poland: Avian influenza found on poultry farms and in wild birds
Poland has new outbreaks at two sites well separated from the five outbreaks reported recently in two areas northwest of Warsaw. The disease cropped up at a small farm near Elblag, near the Gulf of Gdansk in northeastern Poland. Ewa Lech, Poland's chief veterinary officer, calling the site "an entirely new location," said the farm has about 40 birds.
As for wild birds, the number of bird flu cases in Poland has risen to five. Vets pronounced three wild birds in the village of Krzykaly, northeast Poland, to be infected with the H5N1 virus. Three birds from the bird recovery centre in Krzykaly died of bird flu. The presence of the virus was confirmed in detailed medical examinations in the National Veterinary Institute in Pulawy, eastern Poland. There are more birds left in the recovery center, among them two cranes, a white stork and mute swan. As these are all protected species the decision whether to cull them will have to be consulted with the Minister of the Environment. A 10-km exclusion zone has been set out around the last bird flu focus. There are several chicken farms in the area with around 45,000 birds on them. No human has been infected, Polish authorities said.
With 230,000 metric tons of poultry exports in 2006, Poland is considered one of the major poultry suppliers in the European Union, which last week suspended imports from Poland for thirty days. Russia, Ukraine, Belarus and Hong Kong were among countries that imposed a ban on poultry imports from Poland. Police sealed off the Plock region, introducing check disinfection points for people and vehicles and banning transport of meat.
Saudi Arabia (Al-Kharj): H5N1 avian influenza outbreak at an egg production farm
Saudi Arabia: Suspected H5N1 avian influenza virus kills imported wild falcon
The Highly Pathogenic Avian Influenza H5N1 was diagnosed in the falcon, which died shortly after being admitted to a falcon hospital in Riyadh. No post-mortem examinations or diagnostic tests were carried out to establish the cause of death. The falcon showed non-specific signs, including low appetite, regurgitation and passing of green-colored liquids.
According to the report the diagnosis included high white cell count. Samples have been sent to the Friedrich-Loeffler Institute in Germany for further virus identification studies. The falcon was part of a large group of wild-caught sakers imported into the kingdom from Central Asia. According to reports, a large proportion of these falcons died showing similar symptoms.
Russia: H5N1 avian influenza found in Rostov region, 450,000 hens slated to be destroyed
According to earlier reports, 450,000 hens are slated to be destroyed in the Zernograd district, Rostov region because of the die-off of birds that began last week.
China (Jiangsu): Son dies from H5N1 avian influenza, father also falls ill
The Ministry of Health in China has reported a new case of human infection with the H5N1 avian influenza virus in Jiangsu Province. The case was confirmed by the national laboratory 6 Dec 2007. The 52-year-old male is the father of the 24-year-old man who died from H5N1 infection 2 Dec 2007. He is one of the close contacts placed under medical observation by national authorities. He developed symptoms 3 Dec 2007 and was sent immediately to hospital for treatment.
To celebrate the 24-year-old's acceptance to a school of continuing education, his mother and father took him and his girlfriend to Nanjing's most bustling Confucian temple. At the temple's restaurant, the four of them ate Beggar's Chicken, which was surrounded by thick mud. According to analyzes, perhaps because the mud on the outside was too thick the chicken inside was not thoroughly cooked. On the second day after eating the chicken, the young man began feeling feverish. His body temperature rose quickly and he was taken for emergency treatment to Jiangsu Provincial People's Hospital. In the end, he could not be saved.
The odd thing is that although four people ate chicken (at the temple), only the two men fell ill and the two women are well. Reports say that the girlfriend ate a lot of chicken but is fine. Sources say that the 24-year-old's mother also has no similar symptoms but has been isolated for observation.
A comment on the Jiangsu cases from ProMED:
Hong Kong: Grey Heron infected with H5N1 avian influenza
The department will monitor the situation and review the closure period. The bird was found sick and was collected 5 Dec 2007 at the wetland compensation area of the MTR Lok Ma Chau Spurline. The bird was kept in a cage and died the next day. There are no chicken farms within three km of where the bird was found. The department will remind poultry farmers, bird shop owners, license holders of pet poultry and racing pigeons to strengthen precautionary and biosecurity measures. It will also conduct frequent inspections of poultry farms and wholesale markets, and will continue wild bird monitoring and surveillance.
Indonesia (Jakarta): 47-year-old man from Tangerang treated for H5N1 avian influenza
Joko Suyono, an official at the health ministry's bird flu center, said the 47-year-old man from Tangerang kept ducks at his home and had recently traveled to the cities of Medan in Sumatra and Pandeglang in West Java.
"Two tests have confirmed that he suffered from H5N1 and the agriculture ministry has taken samples from the ducks and is still investigating where he may have contracted the virus," Suyono said.
Contact with sick fowl is the most common way of contracting bird flu, which is endemic in bird populations in most parts of Indonesia. Mukhtar Ikhsan, an official at Jakarta's Persahabatan hospital, said the man was being treated in an emergency unit and was on a respirator.
Indonesia (Jakarta): Woman from Tangerang dies from H5N1 avian influenza
The two laboratory tests on the woman, who died 10 Dec 2007 at a hospital in Jakarta, showed that she was infected with the highly pathogenic virus. Two positive tests results on blood and tissue samples from a victim are needed before Indonesian authorities confirm a bird flu infection.
Muhammad Nadhirin, an official at the center, said that a team of experts had been dispatched to the victim's neighborhood. The team said that "the source of infection could be from poultry 100 meters away from the victim's house, but we're waiting for test results on whether the poultry is infected with the virus," Nadhirin said.
He said the victim, who had sold ornamental plants, bought plant fertilizer from the neighbor which may have been contaminated by the feces of infected birds. No birds, however, had died in the area in the past six months and the poultry appeared healthy, he added. The victim lived in the satellite city of Tangerang, just west of Jakarta, where three other bird flu deaths have been reported since October 2007.
Pakistan (Peshawar): H5N1 avian influenza claims two lives in Mansera
According to a spokesman of the Health Ministry, two brothers working in a poultry farm in Mansera suffered from flu that later turned out to be influenza H5N1. They were admitted to a local hospital in Peshawar where on 10 Dec 2007 they died. After the blood samples of both the brothers were sent for formal testing in a laboratory, it was found that both brothers died due to bird flu virus H5N1. I
The death is the first human case due to bird flu in Pakistan. The spokesman for the Health Ministry confirmed the death due to bird flu adding that both brothers were working in a poultry farm in Mansera and had direct links with the chickens that resulted in the transmission of the virus H5N1.
This is the first report of human cases of H5N1 avian influenza in the Indian Sub-continent. Confirmation of the diagnosis by an independent laboratory is pending. No information is provided in this report on the presence of disease in poultry or of the occurrence of non-fatal cases of human avian influenza.
Viet Nam (Bac Giang): H5N1 avian influenza hits poultry farm
Nigeria: Authorities busy disinfecting poultry markets in preparation for festivities
Ahead of the Eid-el Kabir and Yuletide celebrations, which are characterized by an increase in poultry consumption, officials of the National Avian Influenza Control program in Yobe State have begun fumigating of poultry markets, stores and cages to reducie the chances of spreading avian influenza virus and associated diseases.
The desk officer in charge of animal health in the Yobe State office, Dr. Yusuf Iliyasu, who led the team of health officers to kick start the project at the Damaturu poultry market, said the initiative was to reduce risk of viral, bacteria and fungal infections "due to massive movement of poultry for celebrations of Sallah, Christmas and New Year’s expected to commence soon."
He said the avian influenza office had received large stocks of medicines that would be used to disinfect markets, stores, cages, slaughter slabs and vehicles that transport poultry from within and outside Yobe State.
Dr. Iliyasu, who described the fight against bird diseases as "an open project for everybody," said his office had trained poultry dealers in Damaturu and other locations on how to disinfect their businesses. He added that efforts are underway to construct a modern poultry "dressing center," also known as abattoir, so as to "discourage consumers from carrying live poultry to their houses to slaughter by themselves."
2. Infectious Disease News
Russia (Amur): Hunter develops tularemia
A case of tularemia, also known as rabbit fever, has been registered in the Amur region for the first time in over 50 years, the regional sanitary and epidemiological commission said at a meeting on 7 Dec 2007. The diagnosis was confirmed on a hunter of the Selemdzhin district, who was bitten by a sable. Regional sanitary doctors plan to begin vaccination of a risk group that includes hunters, foresters and geologists of the Selemdzhin and Mazanovsky districts.
China (Gansu): Plague claims one life in northern China
China's northwest Gansu Province reported its second plague case in 2007, China's Ministry of Health said 10 Dec 2007. The patient died, the ministry said. Gansu also reported China's first plague case of 2007 in September. Plague cases in northern China near the Mongolian border are usually in marmot hunters who get it from bites from their infected fleas or from contact with infected blood while skinning the marmots.
China: Unsafe chemicals in canned meat, officials vow to tighten controls
Shanghai-based Maling Food Co. issued a statement saying it had sent top executives to Hong Kong to assist with an investigation into allegations that a shipment of its meat was contaminated with the antibiotic nitrofurans, which is thought to cause cancer.
The investigation comes amid a slew of findings of potentially unsafe foods and other products. Chinese officials have vowed to tighten controls on food processors, slaughterhouses and other suppliers to help improve safety. China closed more than 6,000 slaughterhouses and created a database of 23,052 slaughterhouses across the country as part of its campaign to improve food safety. Various scandals both at home and abroad over products tainted with chemicals and other toxins have prompted renewed vigilance over widespread violations of safety standards, such as adding water to dead pigs to raise their weight.
Maling is one of China's best-known food companies, with shares in its Shanghai Maling Aquarius Co. traded on the Shanghai Stock Exchange. The company issued a statement earlier this week saying it did not plan to recall lunch meat sold in the Chinese mainland because it was produced separately. But a report said the product had been pulled from local supermarket shelves. That report quoted a Maling safety official saying the pork might have been contaminated before it reached the factory. The export suspension applies to all of Maling's canned food products, which include meat, seafood, fruits and vegetables.
China: Brucellosis continues to spread
Statistics from the Ministry of Health show that China's prevention and control of human brucellosis is in serious circumstances, and occurrence in cow and sheep producing regions is a grave concern. A trend has emerged in which the disease is spreading from herding and semi-herding regions to farming regions and even urban areas. Other than Chongqing, Guizhou and Hainan, all provinces and centrally administered municipalities have reported human brucellosis.
The top 10 provinces and autonomous regions by number of cases are Inner Mongolia, Heilongjiang, Shanxi, Hebei, Shaanxi, Jilin, Liaoning, Xinjiang, Henan, and Shandong, which together account for 98.15 percent of reported cases nationally. By the end of September 2007, there were a total of 18,116 brucellosis cases in 2007 nationally, an increase of 2.6 percent over 2006's 17,644 cases.
Brucellosis is considered to be a Category B bioterrorism agent which is, in nature, acquired as a zoonotic infection by humans. Its manifestations are protean, including undulant fever, with positive blood and/or bone marrow cultures, and it is a cause of localized disease in many organ systems including skeletal, urinary tract, central nervous system, liver, cardiac and lung.
Indonesia (Jakarta): Koja hospital overwhelmed by patients seeking diarrhea care
The city-run hospital had received as many as 350 diarrhea patients since 27 Nov 2007. Most of them came from Lagoa and Rawa Badak subdistricts. As of 29 Nov 2007, nine patients had died.
"All of them were children under one year old," Koja vice director Caroline K said. The hospital on 29 Nov 2007 treated 76 patients, 67 children, and nine adults. As of last week it had transferred some 100 patients to other hospitals.
Atmajaya Hospital in Pluit treated 54 children with diarrhea on 29 Nov 2007. It has been receiving cases from Koja since 27 Nov 2007. "There are 14 patients who have recovered and none of them died," said Sri, spokeswoman at Atmajaya. Tanjung Priok Port Hospital, which began receiving patients from Koja on 27 Nov 2007, had 24 diarrhea patients, mostly children.
"All of them were treated in the emergency room," said Norma, a nurse. As of 2 Dec 2007, the Sukapura Jakarta Islamic Hospital in Cilincing had treated about 70 patients with the ailment, which is believed to have caused the death of a nine-month-old baby last week. Most of the patients come from Cilincing, Koja and Rawa Badak areas.
Papua New Guinea (Daru): November typhoid cases more than double
Singapore: Salmonellosis found in Prima Deli chocolate cakes, 143 cases detected
So far, 106 people have reported getting food poisoning after eating the cakes; six had to be hospitalized, but have since been discharged. They tested positive for S. Enteritidis. The effects are felt usually six to 72 hours after eating contaminated food.
The MOH was first notified of a food poisoning incident on 23 Nov 2007. As more cases of food poisoning were reported, investigations showed that the common food item in the various incidents were Prima Deli chocolate cakes bought as early as 19 Nov 2007. Preliminary results suggest Salmonella is the likely culprit.
Prima Food has been told to stop the production of all chocolate cakes and to recall all these cakes from distribution and sale. Meanwhile, food handlers are being screened and investigations are being conducted to determine the source of the contamination. In the latest update, the MOH and AVA said that the number of cases has jumped to 143, of which 11 had to be hospitalized; all have been discharged, except one. Four more food handlers at the Prima Deli factory have also tested positive for the bacteria.
Canada (Alberta): Five young people suffer severe allergic reactions to MMR vaccine
Alberta has suspended a province-wide campaign to vaccinate young people against mumps after five people suffered serious allergic reactions for reasons that are still unknown.
Dr. Karen Grimsrud, acting chief medical officer of health, said on 11 Dec 2007 that about 62,800 people between the ages of 17 and 26 have been vaccinated across the province since the program began in November 2007. Only two to five serious reactions are expected in one million vaccinations, said Grimsrud.
"Obviously, our level of concern was great, and this is above what we would expect to be a normal rate of anaphylaxis in MMR (measles-mumps-rubella)," she said after the decision to suspend the program was made in conjunction with Health Canada.
Anaphylaxis is a serious reaction that can cause wheezing, swelling of the throat and collapse. All five people, who all had a history of allergic reactions, were treated immediately and have fully recovered.
Grimsrud stressed that most of these reactions would happen immediately and at most 24 hours after the vaccine, so the tens of thousands of people who have recently been vaccinated are safe. Millions of doses of the vaccine have been administered in Canada since 1988, and there have been only 21 reports of anaphylaxis following immunization.
Alberta officials have been in contact with federal health officials since the first three cases were reported on 26 Nov 2007. When the fifth case came to light on 10 Dec 2007, they decided to act. All five cases came from one lot of vaccine, but two other lots were also produced from the same bulk products. Alberta had purchased about 200,000 of the 250,000 doses from the three lots made by MerckFrosst Canada, and it was decided to suspend the use of those vaccines, severely limiting the supply in the province. They have warned other provinces that may have bought the other 50,000 not to use those lots.
The province is still conducting vaccinations for one-year-old children from unaffected lots, said Grimsrud. But all vaccinations for young adults and children in kindergarten have been suspended in order to conserve the doses. Other provinces have also been contacted to ask for extra doses to tide the province over until health officials can find a new supplier, said Grimsrud. The province still hopes to re-launch vaccinations for young adults in the 2008, but will only be able to do that when a safe supply has been found.
In the Chinook Health Region, which covers the Lethbridge area, most of the 38 confirmed and 21 suspected cases are connected to the University of Lethbridge and Lethbridge College. In the Calgary area, 57 cases have been reported between January and October 2007; 43 of those cases were identified in October 2007 alone. Six of the recent cases were players on the University of Calgary's Dino's hockey team. Health officials are now warning all hockey players in the city not to share water bottles or mouth guards.
The province is offering free mumps immunizations in two phases: first to post-secondary students, then to everyone in the high-risk population between the ages of 17 and 26. People in this age group received only one dose of the mumps vaccine when they were children, which is now thought to have worn off. Those born before 1970 are assumed to have been exposed to the mumps virus at some point in their life and are therefore immune. Children younger than 17 have been vaccinated twice.
This is drawing a concern from the Southern Nevada Health District. The health department says these recent cases prove the virus is in circulation locally. The health district says in terms of mumps, six cases are more than they would want to see in the county. The department is asking people to get vaccinated. And even if they have been vaccinated, there is still a small chance of getting the virus.
USA: Government officials announce food safety pact with China
The agreement announced by the US Department of Health and Human Services (HHS) also provides for increased information sharing between the two countries and better access for US officials to inspect food processing sites in China, HHS officials said.
The pact was triggered by a series of tainted-import incidents in recent months, including chemically contaminated pet food and seafood containing unauthorized drugs. HHS simultaneously announced an agreement with China to enhance the safety of Chinese drugs and medical devices exported to the United States.
Asserting that the accords will make "scores" of imported household items safer, HHS Secretary Mike Leavitt said, "The agreements satisfy our firm principle that any country that desires to produce foods for American consumers must do so in accordance with American standards of quality and safety. To help accomplish this, the two documents apply a three-pronged strategy of registration, certification and verification."
USA (Arizona): 14 people struck with powerful form of Salmonella
Workers inside the state health lab have been tracking the outbreak since late October 2007. They are growing samples of the Salmonella bacteria taken from those people who have been ill from the germ to see if they have the same genetic fingerprint as the Salmonella that has made people sick in California, Nevada and Idaho, said Ken Komatsu, Arizona Department of Health Services epidemiologist.
"This particular strain has a fairly high rate of hospitalization," Komatsu said. "Half of our cases have been hospitalized."
The latest outbreak is showing another unusual characteristic. Komatsu said the ability of the strain to resist antibiotics may partly explain why so many people who are getting it need hospital care. It is also unusual because cases are more likely to occur in summer than late fall or winter. Experts said they think the outbreak started when many people bought and ate some kind of food product that was sold by a chain store. The product involved has not yet been identified.
USA (New York): More hepatitis cases follow Long Island needle scare
The Nassau County Health Department says recent tests have found six hepatitis B cases and six hepatitis C cases among Dr. Harvey Finkelstein's patients. State Health Department spokeswoman Claudia Hutton says that because the virus can mutate in people's bodies, it's too late for genetic tests to establish whether the infections stemmed from Finkelstein's needle technique.
Health officials have said an earlier investigation showed the Long Island anesthesiologist infected at least one person with hepatitis by plunging syringes more than once into vials of medicine, contaminating the drugs. Finkelstein has said he has stopped doing so.
The 12 new cases of hepatitis described in this report are a considerable increase over the five cases identified in June 2007, although none can be unequivocally related to the original incident.
USA and Canada: Metromint-flavored water may contain Bacillus cereus
Soma Beverage Co., LLC., of San Francisco is voluntarily recalling all bottles of Metromint-brand flavored water (peppermint, spearmint, orange mint and lemon mint) with a "Best Before" date prior to 21 Dec 2008 and produced at its California facility because they may be contaminated.
No confirmed illnesses in California associated with Metromint have been reported. An illness complaint in Illinois is possibly linked to consumption of this product. The Canadian Food Inspection Agency (CFIA) is also urging consumers to steer clear of two types of Metromint water. The CFIA says two of those flavors, spearmint and peppermint, were distributed across Canada.
Illness caused by Bacillus cereus may be either a vomiting or a diarrheal type. The vomiting type is characterized by nausea and vomiting within 30 minutes to six hours after consumption of contaminated foods. Duration of symptoms is generally less than 24 hours. The diarrheal type usually includes onset of abdominal cramps and watery diarrhea six to 15 hours after consumption of contaminated food. Symptoms may last for 24 to 48 hours.
USA (Guam): Six-year-old child diagnosed with cholera
USA (Kansas): Raw milk is the culprit in campylobacteriosis outbreak
Kansas allows raw milk to be sold within the state, but health officials warn people of the health risks that come with consuming raw milk. Campylobacteriosis is an intestinal infection caused by the bacterium Campylobacter. Infection often causes diarrhea, fever, abdominal pain, nausea, headache and muscle pain.
In the first outbreak in southwest Kansas, 68 people became ill after eating cheese made from raw (unpasteurized) milk donated by a local dairy for a community celebration; 19 people were ill enough to seek medical attention, and two people were hospitalized. Of these persons four tested positive for Campylobacter jejuni; no other food items served at the event were associated with illness. The second outbreak is linked to a dairy in south-central Kansas that sells raw milk directly to consumers. As of 30 Nov 2007, 19 cases of campylobacteriosis had been reported. Each person reported drinking raw milk purchased from the dairy.
Although most people with campylobacteriosis recover within seven to 10 days, rare complications such as reactive arthritis, hemolytic uremic syndrome and Guillian-Barre syndrome can develop. Pasteurization is the only effective method for eliminating disease-causing bacteria in raw milk and milk products.
USA (Minnesota): Undiagnosed neurological illness in pork processing plant workers
Department investigators have been pouring over the cases. They have determined that the workers experienced an inflammatory response to some kind of trigger. But they have not yet identified the trigger. It could be an infectious agent within the plant, or even a chemical exposure.
Officials do not know what is causing the illnesses. But they say there is no evidence that the general public or the food supply is at risk. Investigators are still trying to interview some of the sick workers, but they say at least five of the cases appear to be consistent with an uncommon disease called chronic inflammatory demyelinating polyneuropathy, or CIDP, an autoimmune disease, meaning that the immune system mistakenly attacks peripheral nerves. Commissioner Sanne Magnan says generally the workers' symptoms include a feeling of numbness and heaviness in the lower extremities, along with a strong sense of fatigue. All 11 employees worked in the same room at the plant. It's an area where meat and other tissues are extracted from the heads of slaughtered hogs.
Kelly Wadding, president and CEO of Quality Pork Processors, said the company has taken several precautions to make sure that other workers are not exposed to whatever is causing the illnesses. Quality Pork Processors is Austin's second-largest employer, behind Hormel Foods, with some 1,300 employees. It slaughters and processes up to 16,000 hogs a day for Hormel and several other companies. Officials say there is no evidence that those products are affected in any way by the illnesses at the Austin plant.
USA (New Mexico): Third hantavirus case this year
"People are usually exposed to hantaviruses around their homes, especially when they clean out enclosed areas that have lots of mouse droppings," said Dr. Paul Ettestad, the Department of Health’s state public health veterinarian. Hantavirus causes a deadly disease transmitted by infected rodents through urine, droppings or saliva. People can contract the disease when they breathe in aerosolized virus. The deer mouse is the main reservoir for hantavirus in New Mexico.
Early symptoms of hantavirus infection are fever and muscle aches, possibly with chills, headache, nausea, vomiting, diarrhea, abdominal pain and cough. Symptoms develop one to five weeks after rodent exposure. Although there is no specific treatment for hantavirus infection, chances for recovery are better if medical attention is sought early.
To protect against hantavirus, avoid contact with mice and other rodents. Other important steps are:
- UN: http://www.un-influenza.org/: latest news on avian influenza. Also, http://www.irinnews.org/Birdflu.asp provides information on avian influenza.
- WHO: http://www.who.int/csr/disease/avian_influenza/en/index.html
- UN FAO: http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/special_avian.html
- OIE: http://www.oie.int/eng/info_ev/en_AI_avianinfluenza.htm
- US CDC: http://www.cdc.gov/flu/avian/index.htm
- The US government’s web site for pandemic/avian flu: http://www.pandemicflu.gov/
- Health Canada: information on pandemic influenza: http://www.influenza.gc.ca/index_e.html Updates on Saskatchewan avian influenza outbreak
- CIDRAP: http://www.cidrap.umn.edu/: Read the series, “The Pandemic Vaccine Puzzle”.
- PAHO: http://www.paho.org/English/AD/DPC/CD/influenza.htm
- US Geological Survey, National Wildlife Health Center Avian Influenza Information:
(UN; WHO; FAO, OIE; CDC; Health Canada; CIDRAP; PAHO; USGS)
During September 30–December 1, 2007, World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System collaborating laboratories in the United States tested 24,897 respiratory specimens for influenza viruses, and 559 (2.2%) were positive. Of these, 515 (92%) were influenza A viruses, and 44 (8%) were influenza B viruses. One hundred thirty-five (26%) of the 515 influenza A viruses were subtyped; 112 (83%) of these were influenza A (H1) viruses, and 23 (17%) were influenza A (H3) viruses. Influenza virus-positive tests have been reported from the District of Columbia (DC) and 32 states in all nine surveillance regions since September 30.
To date, CDC has antigenically characterized 27 influenza viruses; 19 (70%) of these were influenza A (H1) isolates, five (19%) were influenza A (H3) isolates, and three (11%) were influenza B isolates. Other isolates received since September 30 are being grown and characterized. All of the 19 influenza A (H1) viruses were A/Solomon Islands/3/2006-like, a recent antigenic variant of A/New Caledonia/20/99 and the strain recommended by WHO as the influenza A (H1) component for both the 2007-08 Northern Hemisphere influenza vaccine and the 2008 Southern Hemisphere influenza vaccine. Two influenza A (H3) isolates were A/Wisconsin/67/2005-like, the strain included in the 2007-08 Northern Hemisphere vaccine formulation. Three influenza A (H3) isolates were antigenically similar to A/Brisbane/10/2007, the strain recommended as the 2008 A (H3) component of influenza vaccines for the Southern Hemisphere.
One case of novel influenza A infection was reported from Michigan during the week ending November 3, 2007; a child aged 18 months was infected with swine influenza A (H1N2) virus in August 2007 after attending an agricultural event where swine were exhibited. The child walked through a barn containing pigs but was reported to have had no direct contact with the animals. The child recovered from the illness; no contacts of the child were reported to be ill.
For the week ending December 1, 2007, pneumonia and influenza (P and I) was listed as an underlying or contributing cause of death for 6.1% of all deaths reported through the 122 Cities Mortality Reporting System. This percentage is below the epidemic threshold of 6.4% for that period. During the 2007-08 influenza season, the weekly percentage of deaths attributed to P and I has ranged from 5.7% to 6.1%. The percentage of deaths attributed to P and I exceeded the epidemic threshold for three consecutive weeks during September 30-October 20 but has remained below the epidemic threshold since the week ending October 27.
No influenza-associated pediatric hospitalizations have been reported from NVSN this season. During September 30–November 24, 2007, the preliminary laboratory-confirmed influenza-associated hospitalization rate reported by EIP for children was within the expected range for this time of year. For children aged 0–17 years, the influenza-associated hospitalization rate was 0.006 per 10,000. For children aged 0–4 years and 5–17 years, the rates were 0.01 and 0.003 per 10,000, respectively.
One influenza-associated pediatric death occurring during the 2007–08 season has been reported to CDC through the National Notifiable Diseases Surveillance System. The death occurred in Texas during the week ending November 10, 2007, and was reported to CDC during the week ending December 1.