Typhoid Helga

Via ProMED-mail: Eurosurveillance reports on a tuberculosis outbreak at a Stockholm nursery school:

A female assistant at a nursery in a wealthy suburb of Stockholm was diagnosed with smear positive advanced pulmonary tuberculosis in August 2005. She had lost weight and been coughing for several months before diagnosis. The chest x ray showed bilateral cavitary lesions. Infection with an isoniazid-resistant strain of Mycobacterium tuberculosis was confirmed on culture.
All children and adults with a presumed exposure at the nursery were listed and examined. One three year old boywas found to be ill with fever, was admitted to hospital immediately, and diagnosed with primary tuberculosis with hilar adenopathy.
In total 141, children were exposed and of these, 35 (25%) had a TST ≥ 10mm and/or an abnormal chest x ray. Out of 20 children with an abnormal chest x ray, eight had bronchoalveolar infiltrates with hilar adenopathy and 12 hilar adenopathy only. One seven year old girl had a disseminated tuberculosis.

Pandemic Prep

Dr. Grattan Woodson provides detailed advice [pdf] for preparing for the coming bird flu pandemic.

This monograph is dedicated to, and written for my patients. I wrote it both to inform them about this health threat, and to provide them with some practical guidance on how they can survive the pandemic.

Tamiflu Resistance Paper

Via ProMED-mail: The BBC reports on the case of bird flu resistance to oseltamivir (Tamiflu) and Nature publishes a paper about it online.

Bird Flu in Europe?

The Guardian reports on three duck deaths in Romania that are suspected to be due to H5N1.

The Romanian government warned that it feared that the ducks were infected with the strain, and strong security measures were put in place in the village of Ceamurlia, in eastern Romania, where the birds died late last month. Restrictions were placed on the movement of people and animals into and out of the village near the Black Sea and there were plans to vaccinate people. Nearly all the domestic fowls in the village have been slaughtered.

Reuters reports on 2,000 turkey deaths in Turkey from bird flu, but details are scarce. The cause may not be H5N1.

Spanish Flu Rises Again

Nature reports on a CDC researcher's reconstruction of the Spanish Flu, killer of a hundred million people back in 1918 according to some estimates.

When they used the strain to infect mice they found it was extremely virulent, and after 4 days had generated 39,000 times more virus particles in the animals' lungs than a modern flu strain. "I didn't expect it to be as lethal as it was," says Tumpey.

Neither did those hundred million people...