Marburg Reaches the US

Via ProMED-mail: the CDC reports on an imported case of Marburg hemorrhagic fever in Colorado last year. A bat-cave tourist came home from Uganda in January 2008 and exhibited the less dramatic symptoms of Marburg. Tests for Marburg came back negative, but she was retested six months later at her own request and Marburg was confirmed, both then and in the original sample. (It seems the CDC has a big freezer.)

On January 22, 2009, CDC notified the World Health Organization and Uganda Ministry of Health of the imported MHF case. The Python Cave had already been closed to visitors in July 2008, during the response to the Dutch MHF case. CDPHE and CDC conducted a public health investigation during January--February 2009. Interviews were conducted with the patient and her spouse, the patient's medical records were reviewed, and a retrospective contact investigation was conducted to identify possible secondary transmission. A contact was defined as a person who had physical contact with the patient, her body fluids, or contaminated materials or was in the same room as the patient during her acute illness (January 4--19, 2008). Contacts included health-care workers (including health-care providers, housekeeping staff, and hospital laboratory staff), commercial laboratory staff, and social contacts.

No explanation for the six month delay in reporting to the WHO was provided, nor for the further year it took this information to appear on the CDC site. One imagines that it may be due to the fact that the victim, though now recovered, was quite ill with Marburg, including eleven days of hospitalization in "a community hospital," and no notable precautions were taken. The story has medical thriller written all over it. Or perhaps the bird flu/H1N1 story was considered to be enough for the public to panic about at the time.

PlagueBlog recommends against bat-cave tourism of any sort, locally or in Africa.

Tis the Season

It's time again for ProMED-mail's Internet-a-thon. You can make donations at their website.

Non-Plushy Giant Virus

Via twitter: the AFP reports that French scientists have discovered a (non-plushy) giant virus.

With a genome of 368,000 basic pairs, Marseillevirus is the fifth biggest virus ever sequenced and has a diametre of 250 nanometres (around 250 millionth of a millimetre, according the a report by Raoult's for the French National Centre for Scientific Research (CNRS).
The DNA of the giant virus contains material from different sources including plant and animal matter, bacteria and other giant viruses such as the Mimivirus, the report said.
"There is a mechanism of permanent creation going on in amoeba producing a new repertoire of viruses and predisposing giant viruses to become pathogens once they specialise", Raoult said.

Some interesting statements about Darwin follow, which one hopes are merely mistranslated.

Microevolutionary Defenses against Kuru

Via Twitter: Razib at ScienceBlogs reports on cannibals, kuru, and microevolution.

127V is extremely efficacious against fatality due to kuru. Looking through the pedigrees in a region of very high kuru exposure the researchers found that of the individuals who carried 127V, only 1 out of 36 in the parent generation died of kuru. By contrast, 33 of 218 parents from those carrying 127G only (the modal allele) had died of kuru (some of these presumably would also have carried the protective variant of 129). When the researchers looked at the 127V haplotype, the nature of the variation around this mutation implied that a common ancestor existed ~10 generations ago, with a 95% confidence interval 7 to 15 generations. That means that all of the copies of 127V extant today in the Fore descend from one particular copy present on the order of 250 years in the past within the population.

Double Dipping

Via ProMED-mail: the Charleston Daily Mail reports on a pediatrician who came down with swine flu twice.

Parsons says she's spoken with CDC representatives about the results, and they said the double infection isn't all that unbelievable.
"They said this happens every year with seasonal flu, so there's no reason to expect that it wouldn't happen with swine flu," Parsons said. "Every flu strain can change a little bit."
The pediatrician says there may have been a tiny change in the virus that stopped her immune system from recognizing it or her body never built up immunity to it.

Iron and MS

Via Twitter: The Globe and Mail reports on a researcher's personal obsession that led to an unexpected treatment for multiple sclerosis.

Fighting for his wife's health, Dr. Zamboni looked for answers in the medical literature. He found repeated references, dating back a century, to excess iron as a possible cause of MS. The heavy metal can cause inflammation and cell death, hallmarks of the disease. The vascular surgeon was intrigued – coincidentally, he had been researching how iron buildup damages blood vessels in the legs, and wondered if there could be a similar problem in the blood vessels of the brain.
Using ultrasound to examine the vessels leading in and out of the brain, Dr. Zamboni made a startling find: In more than 90 per cent of people with multiple sclerosis, including his spouse, the veins draining blood from the brain were malformed or blocked. In people without MS, they were not.
He hypothesized that iron was damaging the blood vessels and allowing the heavy metal, along with other unwelcome cells, to cross the crucial brain-blood barrier. (The barrier keeps blood and cerebrospinal fluid separate. In MS, immune cells cross the blood-brain barrier, where they destroy myelin, a crucial sheathing on nerves.)
More striking still was that, when Dr. Zamboni performed a simple operation to unclog veins and get blood flowing normally again, many of the symptoms of MS disappeared.

BU's Leaky Biolabs

Via ProMED-mail: the Boston Globe reports on another BU researcher who accidentally brought his work home with him.

The genetic tests, conducted at the state laboratory in Jamaica Plain, compared a blood sample from the researcher with bacterial matter recovered from the lab where he was working on BU’s South End campus. “The bottom line,’’ said Dr. Anita Barry, top disease tracker at the Boston Public Health Commission, “is they matched.’’
The analysis erased any doubt about what caused the researcher to become sick last month and intensified investigations into precisely how he was exposed to a germ known as Neisseria meningitidis, which can cause meningitis.
The city’s biological lab safety division will review safety procedures in BU’s medical labs, to ensure that the school is doing everything possible to minimize researchers’ exposure to pathogens, Barry said.

I thought they did that last time.

PlagueBlog recommends moving to the suburbs before the new BU biolab opens downtown. And by "suburbs" I mean Maine.

Accidental Vaccinia

Via ProMED-mail: the CDC reports on a case of vaccinia infection in an immunocompromised woman who handled rabies vaccine bait, in which a genetically modified version of variola's little sister is used. There's much more on the story and the history of vaccinia at ScienceBlogs.

Atypical Scrapie

Via ProMED-mail: the New Zealand Ministry of Agriculture and Forestry reports on a case of atypical scrapie.

MAFBNZ Principal International Adviser Dr Stuart MacDiarmid says global knowledge about atypical scrapie/Nor 98 is evolving. The widely accepted mainstream scientific view is that it occurs spontaneously or naturally in very small numbers of older sheep in all sheep populations around the world.
"This positive detection of atypical scrapie/Nor 98 in a sheep from New Zealand's national flock reinforces that view. Every country that has conducted sufficient surveillance for atypical scrapie/Nor 98 has found it in their flocks. This includes most Scandinavian and EU countries, the UK, the USA and Canada," he says.
The detection does not change New Zealand's status as free from scrapie.

Mad Elk and Mad Fish

Via ProMED-mail: last month, the New York Times reported on the spread of CWD among elk via fecal-oral transmission, due to preclinical shedding of prions.

Dr. Aiken said prions tended to bind to clay in soil and to persist indefinitely. When deer graze on infected dirt, prions that are tightly bound to clay will persist for long periods in their intestinal regions. So there is no chance chronic wasting disease will be eradicated, he said. Outside the laboratory, nothing can inactivate prions bound to soil. They are also impervious to radiation.

Also, Practical Fish Keeping reported last month on a study of mad cow and scrapie transmissibility to fish:

The authors found that while the bream never displayed clinical signs of spongiform encephelopathies during the study period, the brains of TSE-fed fish sampled two years after challenge showed signs of neurodegeneration and accumulation of deposits that reacted positively with antibodies raised against sea bream PrP. The control groups, fed with brains from uninfected animals, showed no such signs.

Swine Flu Shots vs. Seasonal Flu Shots

Via ProMED-mail: temperatures are still high in Canada, where the Globe and Mail reports that two and a half provinces have rebelled against seasonal flu shots in reaction to as-yet-unpublished research showing that a seasonal flu shot makes people more susceptible to swine flu.

The hodge-podge of vaccination strategies comes after a controversial, unpublished study suggested that people under 50 are twice as likely to contract the H1N1 virus if they have received a seasonal flu shot compared to unvaccinated people.
With no data revealing the optimal way of rolling out vaccines against the looming double threat of seasonal flu and the pandemic swine flu virus, the abrupt changes by provinces and territories could create disarray in inoculation programs, with fewer people turning up for either shot, potentially resulting in more cases of severe illness.
New Brunswick's public health authorities, skeptical about the science behind the Canadian study, have moved up seasonal flu shots for all their residents to October before proceeding to the pandemic vaccine campaign. Meanwhile, Quebec and Nunavut are deferring their seasonal flu campaigns until after their H1N1 mass vaccination clinics.

Shaken Baby Syndrome

Radley Balko at Reason Online reports on growing doubts about "shaken baby syndrome":

The phrase shaken baby syndrome entered the pop culture lexicon in 1997, when British au pair Louise Woodward was convicted of involuntary manslaughter in the death of Massachusetts infant Matthew Eappen. At the time, the medical community almost universally agreed on the symptoms of SBS. But starting around 1999, a fringe group of SBS skeptics began growing into a powerful reform movement. The Woodward case brought additional attention to the issue, inviting new research into the legitimacy of SBS. Today, as reflected in the Edmunds case, there are significant doubts about both the diagnosis of SBS and how it's being used in court.
In a compelling article published this month in the Washington University Law Review, DePaul University law professor Deborah Teurkheimer argues that the medical research has now shifted to the point where U.S. courts must conduct a major review of most SBS cases from the last 20 years. The problem, Teurkheimer explains, is that the presence of three symptoms in an infant victim—bleeding at the back of the eye, bleeding in the protective area of the brain, and brain swelling—have led doctors and child protective workers to immediately reach a conclusion of SBS. These symptoms have long been considered pathognomic, or exclusive, to SBS.

If you're really interested, you can dig up some ideas about alternate causes of SBS at this blog.

Mattel Exempted Itself from Lead Testing

Via Purple Pawn: The LA Times reported late last month that Mattel had lobbied itself out of third-party lead testing of its products.

"It's really ironic that the company that was a principal source of the problem" is now getting favorable treatment from the government, said Michael Green, executive director of the Center for Environmental Health in Oakland.
Mattel is getting a competitive advantage, Green said, because smaller companies must pay independent labs to do the tests. Testing costs can run from several hundred dollars to many thousands.

Medical Isotope Shortage

Via Orthoprax: the Journal of the American Medical Association reports on the ongoing "critical" shortage of medical isotopes (^99mTc) due to a reactor shutdown in Canada.

The shortage was expected to be exacerbated by the temporary closing of the Netherlands reactor for a month-long maintenance inspection from July 18 to August 18. Because the isotopes have a relatively short half life, they cannot be stockpiled.
Canadian authorities said they were working with medical isotope distributors and others to maximize the use of existing isotope supplies and with other international producers to increase isotope production and to coordinate shutdowns and other operations.

Since the journal article was written, the reopening of the Ontario reactor has been pushed into 2010, causing some trouble for the company that sells the isotopes, the Canwest news service reports:

Life sciences company MDS Inc. said Wednesday it has agreed to sell its analytical technologies division to Danaher Corp. for $650 million in cash and is also looking to unload its pharma business.
The Mississauga, Ont.-based company cited the recession and the prolonged shutdown of the National Research Universal reactor in Chalk River, Ont., as its reasons for the sales, which will allow MDS to focus on its isotope business, MDS Nordion.
Stephen DeFalco, chief executive at MDS, said the company still expects the reactor to restart in spring 2010.

A Cure for MS?

Via a mailing list: Science Daily reports that multiple sclerosis has been reversed in mice.

The new treatment, appropriately named GIFT15, puts MS into remission by suppressing the immune response. This means it might also be effective against other autoimmune disorders like Crohn's disease, lupus and arthritis, the researchers said, and could theoretically also control immune responses in organ transplant patients. Moreover, unlike earlier immune-supppressing therapies which rely on chemical pharamaceuticals, this approach is a personalized form of cellular therapy which utilizes the body's own cells to suppress immunity in a much more targeted way.
GIFT15 was discovered by a team led by Dr. Jacques Galipeau of the JGH Lady Davis Institute and McGill's Faculty of Medicine. The results were published August 9 in the prestigious journal Nature Medicine.
GIFT15 is composed of two proteins, GSM-CSF and interleukin-15, fused together artificially in the lab. Under normal circumstances, the individual proteins usually act to stimulate the immune system, but in their fused form, the equation reverses itself.

A caveat: this appears to be an early-stage treatment that may not reverse existing damage to the nerves.

Not Your Grandfather's Influenza After All

Via ProMED: News1130 reports that swine flu may not be coming back in a more virulent form in the fall, because the Spanish Flu may not have done so.

Virologist Dr. Jeffery Taubenberger, along with co-author and medical historian Dr. David Morens, argues there is no firm evidence that the 1918 virus ratchetted up in virulence in a fall wave - because there is no solid proof outbreaks of illness in the U.S. in the spring of 1918 were caused by the same virus.
Their commentary, published in this week's issue of the Journal of the American Medical Association, suggested changes in virulence or transmissibility of the current pandemic virus are not inevitable. In fact, they wrote, there are reasons to hope for "a more indolent pandemic course and fewer deaths" than seen in many previous pandemics.

Superbug Enzyme in Britain

Via an unnamed source: the BBC reports on a new "superbug" in the UK, a shared antibiotic-eating enzyme imported from India.

The enzyme, called New Delhi Metallo-1, has so far been found attached to bacteria that has caused urinary tract infections and respiratory infections.
It is of particular concern because it can jump from one strain of bacteria to another meaning it could attach itself to more dangerous infections that can cause severe illnesses and blood poisoning making them almost impossible to treat.
The NDM-1 enzyme destroys a group of antibiotics called carbapenems which are mainly used in Britain for severe infections and are tightly controlled because they are one of the few groups of antibiotics that remain useful against bacteria that have already developed resistance to the commonly used drugs.

Plague in China

Via an unnamed source: the BBC reported last week on the rising plague death toll in China.

A BBC correspondent in Beijing, Michael Bristow, says that unlike in the past the authorities are being very open about this outbreak.
Local officials in north-western China have told the BBC that the situation is under control, and that schools and offices are open as usual.
But to prevent the plague spreading, the authorities have sealed off Ziketan.

Today the WHO reported on the situation, which seems to be under control:

According to the epidemiological investigation, the source of this outbreak was a wild marmot, which had contact with the dog of the index case. Ziketan is in an area of natural plague bacteria circulation amongst animals and at the present time it is the active season for plague transmission amongst animals. No drug resistance of the bacterium has been found so far and the 3 death cases have been attributed largely to delayed treatment.

Beware the Bitter Lupini

Via ProMED-mail: the Brisbane Times reports on two cases of lupini bean poisoning in Australia.

They suffered blurred vision, light-headedness, lethargy and had difficultly walking.
"Fortunately, neither of the two women who presented to hospital became seriously ill," says Nevada Pingault, an epidemiologist at WA Health's Communicable Disease Control Directorate.
"But lupin poisoning can be fatal."
An investigation revealed a quantity of bitter lupins had been milled into flour to meet a local shortage in supply.

Flu Ship

On the Typhoid Traveller front, via an unnamed source, the BBC reported on Friday that large numbers of crew on a cruise ship in the south of France were suffering from a flu-like illness.

It has now gone on to Marseille. The authorities there say neither passengers nor crew will be allowed to disembark until further tests have been carried out on their health.
"Based on the results, a decision will be made on whether or not passengers can disembark," a statement from the local prefecture, or local government, said.

Refrigerate After Opening

Via twitter: Wired reports on a company that's making beer from Eocene yeast recovered from amber.

Lambert and Cano had toyed with the idea for 12 years. Before Ambergene went under, the company made a batch on a lark. "We called it Jurassic Amber Ale or T-Rex Lager or something, and it was pretty good," Cano says. It was served at his daughter's wedding, and they even sent some to the Jurassic Park 2 cast party. That experiment had Cano and Lambert itching to release a beverage commercially. But they wanted it to be something respectable.

Needless to say, PlagueBlog recommends against eating anything that's over 40 million years old. In fact, only under the most extraordinary circumstances should you eat anything over 4 years old.

Fido Fricassee

ProMED-mail reports five recent cases of trichinosis "due to consumption of stray dog meat," with a total of nine cases this year.

PlagueBlog recommends against eating housepets, and especially not strays. You don't know where they've been.

Rabid Foxes

Via an unnamed source: WBZ reported a rabid fox attack Tuesday in Worcester. The victim was a 76-year-old woman who'd been gardening. The good Samaritan who held off the fox until the police shot him was also bitten. The fox was apparently known to police:

They believe this was the same fox that had been seen in the neighborhood the night before. One man was bitten, and two cats were also attacked.

There was a similar fox showdown in Pennsylvania in May.

More Recalls

Via an unnamed source: WBZ reports that Dunkin Donuts is temporarily cutting off the Dunkaccinos due to salmonella contamination at their chocolate supplier.

Via twitter: the AP reports that Shaws, Star, and Big Y are recalling some tuna steaks sold last week due to histamine.

Symptoms may include tingling or burning sensation in the mouth, rash on the face and upper body, hives and itching of skin, nausea, vomiting or diarrhea.

Don't Flu Party

Via an unnamed source: British doctors feel the need to warn people against holding flu parties. Flu partiers want immunity while the virus is still mild, but doctors there are instead trying to contain the outbreak.

Update (July 1st): Schott's Vocab also covers "vigilante vaccination."

Where's the beef?

I went to see Food, Inc. with my unnamed sources last week, and one of them has already found a topical CNN report of yet another E. coli recall.

The beef products were produced on April 21 and were distributed nationally and internationally, the USDA said. Boxes of the recalled product bear the establishment number "EST. 969" inside the USDA mark of inspection, the identifying package date of "042109" and a time stamp ranging from "0618" to "1130," the statement said.
It added that some of the beef products might have undergone further processing and might not have the "EST. 969" marking on products for sale directly to consumers.
The USDA urged customers with concerns to contact their point of purchase of the beef products.

In other words, God only knows whether the smoking beef is in your freezer right now.

E. coli Cookie Update

Thanks to an unknown source for yesterday's CDC update to the E. coli cookie dough situation:

As of Monday, June 22, 2009, 70 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 30 states. Of these, 41 have been confirmed by an advanced DNA test as having the outbreak strain; these confirmatory test results are pending on the others. The number of ill persons identified in each state is as follows: Arizona (2), California (3), Colorado (5), Connecticut (1), Delaware (1), Georgia (1), Hawaii (1), Iowa (2), Illinois (5), Kentucky (3), Massachusetts (4), Maryland (2), Maine (3), Minnesota (6), Missouri (2), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (2), Virginia (2), Washington (5), and Wisconsin (1).

As advised by the CDC, PlagueBlog reminds you that you should not eat raw food products that are intended for cooking or baking before consumption, no matter how yummy they may appear.

The Pandemic in Boston

Declared a pandemic on Thursday, swine flu has already claimed its first casualty outside the Americas and its first death in Massachusetts.

On the bright side, at least we aren't warehousing the ill in a tent camp on Summit Hill...yet. (Massachusetts news via Universal Hub.)

Flu Mask

Via GeekPress: a mask spotted by Movin' Meat.

The Smoking Bat

Via ProMED-mail: SciDev.Net reports on a study tracing the 2007 Ebola outbreak in the Congo to the consumption of fruit bats.

For the new study, researchers led by Eric Leroy from the International Centre for Medical Research in Franceville, Gabon, interviewed locals about the background of the Ebola cases. They were told that the annual migration of the fruit bat Hypsignathus monstrosus was particularly large in 2007.
Bats are an important source of protein in the area as wild animals are in short supply. They are often shot and then sold covered in blood.
The researchers believe the source of the 2007 outbreak was a man who bought bats at market. He survived, experiencing only a low fever, but his four-year-old daughter died after developing a sudden fever accompanied by vomiting. A family friend who prepared the girl's body for burial was subsequently infected and went on to infect 11 members of her family, all of whom died.

Swine Flu VII: Already a Pandemic

Via ProMED-mail: Bloomberg.com reports that novel influenza A (H1N1) has already met the WHO's vacillating standards for a flu pandemic, and has also been vastly underreported.

One in 20 cases is being officially reported in the U.S., meaning more than 100,000 people have probably been infected nationwide with the new H1N1 flu strain, according to the Centers for Disease Control and Prevention. In the U.K., the virus may be 300 times more widespread than health authorities have said, the Independent on Sunday reported yesterday.

Most disturbing are the prospects for ongoing summer transmission:

“While we are seeing activities decline in some areas, we should expect to see more cases, more hospitalizations and perhaps more deaths over the weeks ahead and possibly into the summer,” Anne Schuchat, CDC’s interim deputy director for science and public health program, told reporters on a May 22 conference call.

Popcorn Lung Update

"Diacetyl, the chemical that makes food taste like artificial butter flavor" [The Pump Handle] is back in the news, with a not-so-open-to-the-public OSHA meeting of the SBREFA panel. The future of diacetyl use in the food industry remains unclear.

Wikipedia has more on Bronchiolitis obliterans or popcorn lung. The tale of the single civilian victim appeared previously on PlagueBlog. (PlagueBlog recommends against eating your weight in artificially-flavored popcorn in any given year.)

Vaccinia: An Adverse Event

Via ProMED-mail: the CDC reports* on an adverse event following military smallpox vaccination. The patient survived, though the linked report may cause the reader to doubt that he would, or would want to.

Progressive vaccinia (PV), previously known as vaccinia necrosum, vaccinia gangrenosum, or disseminated vaccinia, is a rare, often fatal adverse event after vaccination with smallpox vaccine, which is made from live vaccinia virus (1). During recent vaccination programs potential cases of PV were investigated, but none met standard case definitions (2). PV has not been confirmed to have occurred in the United States since 1987 (3). On March 2, 2009, a U.S. Navy Hospital contacted the Poxvirus Program at CDC to report a possible case of PV in a male military smallpox vaccinee. The service member had been newly diagnosed with acute mylegenous leukemia M0 (AML M0). During evaluation for a chemotherapy-induced neutropenic fever, he was found to have an expanding and nonhealing painless vaccination site 6.5 weeks after receipt of smallpox vaccine. Clinical and laboratory investigation confirmed that the vaccinee met the Brighton Collaboration and CDC adverse event surveillance guideline case definition for PV (4,5). This report summarizes the patient's protracted clinical course and the military and civilian interagency governmental, academic, and industry public health contributions to his complex medical management. The quantities of investigational and licensed therapeutics and diagnostics used were greater than anticipated based on existing smallpox preparedness plans. To support future public health needs adequately, the estimated national supply of therapeutics and diagnostic resources required to care for smallpox vaccine adverse events should be reevaluated.

* Keep in mind that this is PlagueBlog. When I say adverse, I mean adverse. Click at your own risk.

Rabies Pandemic Brewing in Arizona

Via ProMED-mail: National Geographic reports on a more virulent strain of rabies brewing in Arizona.

Evolving faster than any other new rabies virus on record, a northern-Arizona rabies strain has mutated to become contagious among skunks and now foxes, experts believe.
The strain looks to be spreading fast, commanding attention from disease researchers across the United States.
It's not so unusual for rabid animals to attack people on hiking trails and in driveways, or even in a bar—as happened March 27, when an addled bobcat chased pool players around the billiards table at the Chaparral in Cottonwood.
Nor is it odd that rabid skunks and foxes are testing positive for a contagious rabies strain commonly associated with big brown bats.
What is unusual is that the strain appears to have mutated so that foxes and skunks are now able to pass the virus on to their kin—not just through biting and scratching but through simple socializing, as humans might spread a flu.
Usually the secondary species—in this case, a skunk or fox bitten by a bat—is a dead-end host. The infected animal may become disoriented and even die but is usually unable to spread the virus, except through violent attacks.

Swine Flu VI: A Vaccine

Via ProMED-mail: as this flu season draws to a messy end, Scientific American blogs about the prospects for a swine flu (Influenza A H1N1 etc.) vaccine for next season. Reuters reports that the WHO is optimistic about such a shift, although it is unclear what impact swine flu will have on regular seasonal flu vaccine production.

Marie-Paule Kieny, WHO director of the initiative for vaccine research, said the agency is discussing with drug companies whether and when to stop making seasonal flu vaccine production and shift to making one for the new H1N1 strain.

See my twitter updates for the latest swine flu news.

Swine Flu V: Sequence Analysis

Via ProMED-mail: sequence analysis indicates that swine flu may be entirely domestic and porcine, despite previous reports linking it to human and bird flus as well as Asian swine flu strains.

"...the NA and M genes are most closely related to corresponding genes from influenza viruses isolated in swine population in Eurasia."
However, the NA and M genes from 2 swine virus isolates from America are also closely related to the novel H1N1 virus (A/swine/Virginia/670/1987, A/swine/Virginia/67a/1987), if a reasonable nucleotide substitution rate is accepted. Thus, H1N1 from Mexico may be a swine flu virus strain of entirely American origin, possibly even of relatively ancient origin.

Swine Flu IV: The Return of the Typhoid Traveller

Via Healthmap on Twitter: ABC Australia reports on the search for fellow passengers of three New Zealander students with swine flu.

There are more updates on the pig farming connection, Israel's cases, Connecticut's suspected cases, and California's deaths and state of emergency in my twitter feed.

Swine Flu III: Mexico Timeline

Via Effect Measure by way of The Pump Handle: the blog Biosurveillance reports on Veratect's extensive timeline of swine flu in Mexico, starting with an incident in Canada on March 30th.

At Veratect, we operate two operations centers based in the United States (one in the Washington, DC area and one in Seattle, WA) that provide animal and human infectious disease event detection and tracking globally. Both operations centers are organizationally modeled after our National Weather Service using a distinct methodology inspired by the natural disaster and meteorology communities. Our analysts handle information in the native vernacular language and have been thoroughly trained in their discipline, which include cultural-specific interpretation of the information.
[...]
March 30
Veratect reported that a 47-year-old city attorney for Cornwall was hospitalized in a coma at Ottawa General Hospital following a recent trip to Mexico. Family members reported the individual voluntarily reported to the hospital after gradually feeling ill upon returning from his trip on 22 March.

Of special note are the pig farming connection on April 6th, the Semana Santa [Holy Week] connection under the heading "Large mass gatherings", and Veratect's new Twitter feed.

Swine Flu II

Although no pigs have become ill and no patients have reported contact with pigs, the new swine/avian/human influenza mix coming out of Mexico has been dubbed "swine flu." Since Mexican health officials first admitted the problem on Thursday, swine flu has been detected in California, Texas, Kansas, New York City, and Nova Scotia. Suspected cases are currently under investigation in British Columbia, France, Spain, Israel, and New Zealand, mainly in tourists returning from Mexico. No fatalities have been reported outside of Mexico (where the case count now stands at approximately 1500 with over 80 fatalities).

The Associated Press reports that the WHO has declared the outbreak in North America to be a "public health emergency" with "pandemic potential."

The CDC has a page up summarizing the current investigation.

A ProMED poster notes that like this one, the Spanish Flu first appeared at the end of the flu season, but came back with a vengeance for the next one:

The 1st cases of that agent showed up in May 1918 in an army base in Kansas -- it went quiet over the summer -- and started ravaging the globe in early fall that year.

Also, someone is maintaining a Google map of the outbreak.

Swine-Bird Flu

Via an unnamed source: The BBC reports on a rash of deaths in Mexico from a new strain of flu with both swine and bird elements.

Fifty-seven people had died in Mexico City from flu-like symptoms, [WHO spokeswoman Fadela Chaib] said, and another three in San Luis Potosi in central Mexico. There are around 800 suspected cases, she said.
Health Minister Jose Angel Cordova said the virus had "mutated from pigs and then at some point was transmitted to humans".
The strain of flu had been confirmed in at least 16 deaths, with 44 others being tested, the government said.
It urged people to take preventative measures such as not shaking hands or sharing crockery.
In the US, experts say the seven people who fell ill across two states were suffering from a new form of swine flu that combined pig, bird and human viruses.
"This is the first time that we've seen an avian strain, two swine strains and a human strain," Dave Daigle, a spokesman for the CDC, told AFP.
The CDC said none of the seven victims had been in contact with pigs, which is how people usually catch swine flu.

Norovirus Lockdown

Via an unnamed source: the Boston Globe reports that a norovirus outbreak has closed Babson College in Wellesley, Mass.

About 100 students have fallen ill since Wednesday. The decision to close the school was made [Sunday] after the virus escalated amongst the students, said Dr. Marcia Testa-Simonson, vice chair of the Wellesley Board of Health.
[...] The school is closed and students who live on campus are asked to stay on campus. The school is aiming to reopen Wednesday, said Mary Suresh, director of the Wellesley Health Department.

Scabies at Logan

Via an unnamed source: WBZ TV reports on a small scabies outbreak among TSA workers at Logan Airport in Boston.

TSA officials say all their workers wear gloves so the public should not be concerned about getting scabies.
It is still unclear how the employees got scabies in the first place.
According to the CDC, scabies is caused by an infestation of the skin by human itch mites that burrow under the skin and lay eggs.

It's unclear to PlagueBlog how the gloves that failed to protect the TSA workers are supposed to have protected the public.

90% Mortality Rates

Via ProMED-mail: The Hartford Courant reports a 90% mortality rate for the state's bats from white-nose syndrome.

Jenny Dickson, the Connecticut Department of Environmental Protection wildlife biologist supervising the detection and control of white-nose syndrome in the state, said Tuesday that visits to two sample caves in Litchfield County in the past two weeks revealed veritable bat catacombs. Dickson's team of wildlife experts found thousands of dead bats floating like dead fish in standing water, or stacked on top of each other along the flat ledges of the cave walls.
"It was grim, and you don't have to be a scientist to realize the implications for the environment inside those caves," said Dickson. "This is a massive, unprecedented die-off, with significant potential impacts on nature, especially insect control."

Bats from all over the Northeast migrate through Connecticut, so expect more mosquitoes this summer.

In other 90% mortality news, a German researcher pricked herself instead her intended mouse victim with a needle full of Ebola-Zaire last week. She's still in isolation, showing no symptoms and being treated with an experimental vaccine. See the AAAS blog for more information.

Norovirus in Massachusetts

Via Universal Hub: the Massachusetts Office of Health and Human Services reports a rise in norovirus infections in the state.

The Massachusetts Department of Public Health (DPH) has seen a significant number of gastrointestinal illness outbreaks across the state this winter, which are likely caused by norovirus infections. Noroviruses are a group of particularly strong viruses that cause nausea, vomiting, and diarrhea in people who get infected.
Noroviruses are easily spread through food, by person-to-person contact, or though contact with contaminated surfaces such as countertops and door knobs. The virus is spread through an infected person’s stool or vomit -- contamination that can be spread further without careful attention to hand washing and environmental cleaning.

There's a list of tips for avoiding infection, but they may not go far enough. In particular, PlagueBlog recommends avoiding dirty diapers and oysters altogether. There is no safe handling procedure for such items.

Cold on the Trail of the Tylenol Killer

Via Universal Hub: Boston.com reports that the FBI and state police searched a Cambridge condo today in connection with the 1982 Tylenol tampering deaths.

The first-floor condominium belongs to James W. Lewis, 62, of 170 Gore St., who spent 12 years in federal prison for trying to extort $1 million from the painkiller's manufacturers but was never charged in the murders. The authorities spent most of the day inside the six-story blonde brick building and also searched a storage facility at an undisclosed location in the city.
The Chicago office of the FBI said in a statement late today that agents, the Illinois State Police, and several local police departments were "conducting a complete review of all evidence developed in connection with the 1982 Tylenol murders," which prompted dramatic changes in the way almost all food and medical products are packaged.

Bubonic Justice

Via ProMED-mail: UPI reports that at least 40 al-Qaeda militants have died in a plague outbreak near Algiers.

Al-Qaida leaders said they fear the plague has spread to other cells or to Taliban fighters in Afghanistan.
The epidemic began in the hideouts of the al-Qaida in the Land of the Islamic Maghreb in Algiers, sources told The Sun. The group fled to Bejaia and Jijel provinces.

As they say, Allah hu Akbar.

Anthrax Redux

Via ProMED-mail: The New York Times reports on the life and spores of the late Dr. Bruce Edwards Ivins.

Focused for years on the wrong man, the bureau missed ample clues that Dr. Ivins deserved a closer look. Only after a change of leadership nearly five years after the attacks did the bureau more fully look into Dr. Ivins’s activities. That delay, and his death, may have put a more definitive outcome out of reach.
Brad Garrett, a respected F.B.I. veteran who helped early in the case before his retirement, said logic and evidence point to Dr. Ivins as the most likely perpetrator.
“Does that absolutely prove he did it? No,” Mr. Garrett said. With no confession and no trial, he said, “you’re going to be left not getting over the top of the mountain.”

And doubts will persist:

In November, four of Dr. Ivins’s closest co-workers wrote a glowing obituary of their “valued collaborator” for Microbe, the leading microbiology journal. It did not mention the anthrax accusations and was a singular protest by the four scientists against the F.B.I.’s conclusion.
“His colleagues and friends will remember him not only for his dedication to his work,” the obituary said, “but also for his humor, curiosity and great generosity.”