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...

Tamiflu Resistance

Reuters reports that bird flu is proving resistant to Tamiflu:

"Manufacturers should think about producing an injectable form of Relenza because resistance to Tamiflu has been seen in Japan and Vietnam."

Thanks to JAD for the link.

From the Don't Eat the Guano files...

The New York Times reports that two groups of researches have independently identified the Chinese horseshoe bat as the natural reservoir for the SARS virus.

The bats apparently are healthy carriers of SARS, which caused severe economic losses, particularly in Asia, as it spread to Canada and other countries. In Asia, many people eat bats or use bat feces in traditional medicine for asthma, kidney ailments and general malaise.

Thanks to an unnamed source for the link.

Rise in Bird Flu Cases

Channel NewsAsia reports 57 suspected cases of avian influenza in Indonesians. Other sources report 54 cases; either number is an increase over the last count of 42 suspected cases.

The Coming Flu Pandemic

Via an anonymous source: ABC News reports on the coming flu pandemic.

The prospects have become so bleak that in planning meetings held in New York City, veteran emergency responders have walked away.
"They just don't know how we're going to get through," says Osterholm of those responders. "If we have a repeat of the 1918 life experience, I can't imagine anything to be closer to a living hell than that experience of 12 to 24 months of pandemic influenza."

Dog Flu II

The New York Times reports on canine flu, a H3N8 strain related to equine influenza:

Dr. Cynda Crawford, an immunologist at the University of Florida's College of Veterinary Medicine who is studying the virus, said that it spread most easily where dogs were housed together but that it could also be passed on the street, in dog runs or even by a human transferring it from one dog to another. Kennel workers have carried the virus home with them, she said.
How many dogs die from the virus is unclear, but scientists said the fatality rate is more than 1 percent and could be as high as 10 percent among puppies and older dogs.
Dr. Crawford first began investigating greyhound deaths in January 2004 at a racetrack in Jacksonville, Fla., where 8 of the 24 greyhounds who contracted the virus died.

Virtual Plague

The BBC reports on a virtual "corrupted blood" plague infecting the World of Warcraft. Despite attempts to eradicate the infection, the problem continues:

Blizzard tried to control the plague by staging rolling re-starts of all the servers supporting the Warcraft realms and applying quick fixes.
However, there are reports that this has not solved all the problems and that isolated pockets of plague are breaking out again.

Thanks to an unnamed source for the tip.

The Plague Mice

ABC News reports that at least three mice infected with Yersinia pestis have been missing from the Public Health Research Institute in Newark, NJ for at least two weeks. The FBI Joint Terror Task Force and the CDC are investigating.

"We're satisfied that there is no public safety risk, and there doesn't seem to be any nexus to criminal activity or terrorism," he added.
Nevertheless, federal authorities, including the FBI, have criticized the lab for lax procedures that resulted in a potential public health menace.
"This is the black death," said Richard Ebright, a microbiologist at Rutgers University. "This is the disease that killed a quarter of Europe's population."

Cows Eating People

Via ProMED-mail: The BBC reports on a new theory of the origin of Bovine Spongiform Encephalopathy--cows eating human remains.

Some raw materials for fertiliser and feed imported from South Asia in the 60s and 70s contained human bones and soft tissue, the Lancet reports.
Bone collectors could have picked up the remains of corpses deposited in the Ganges river to sell for export.
If infected with prion diseases, they could have been the source for BSE.

Post-Hurricane Diseases II

Despite their earlier optimism, the CDC reports five deaths from Vibrio vulnificus.

The patients, evidently evacuees, appear to have been infected with Vibrio vulnificus bacteria, a water-borne pathogen that is related to the bacteria that cause cholera and is common in water off the Gulf of Mexico.

Post-Hurricane Diseases

The CDC has an encouraging report on infectious disease after a hurricane:

Unless a disease is brought into a disaster area from elsewhere, any outbreaks that occur are almost always from diseases that were already in the disaster-affected area before the disaster struck.

A Vaccine Against All Flus

BBC News reports on a UK company that's developing a one-time vaccine against all flu strains:

Current flu vaccines work by giving immunity to two proteins called haemagglutinin and neuraminidase, which are found on the surface of flu viruses.
However, these proteins keep mutating which means doctors have to keep making new vaccines to keep up.
Scientists at Acambis' laboratory in the US, together with Belgian researchers at Flanders Interuniversity Institute for Biotechnology, are focusing their efforts on a different protein, called M2, which does not mutate, as well as other technology that they cannot disclose yet for commercial reasons.

Pig Strep

CNN reports on the mysterious outbreak of Streptococcus suis among humans in China:

While not uncommon in pigs, streptococcus suis is seldom seen in people and never dozens of cases all at once -- raising bigger questions about whether the germ has mixed with some other bacteria or virus.

Thanks to JAD for the tip.

Bird Flu Confirmed in Indonesia

Via ProMED-mail: Reuters reports that Indonesia has confirmed three deaths from avian influenza.

Last month, Indonesia reported its first human case in a poultry worker, but the man did not develop symptoms and is healthy.
The agriculture ministry has reported sporadic H5N1 virus outbreaks killing more than nine million fowl in 21 provinces, out of a total of 33, across the archipelago since late 2003.
Indonesian policy favours vaccinating animals rather than culling to stop the spread of bird flu, due to lack of funds to compensate farmers.
The World Health Organisaton has questioned the effectiveness of vaccines and say culling is the best weapon.
The virus has already jumped species in Indonesia and was discovered in pigs in May on densely populated Java island.

Tularemia on Martha's Vineyard

Via ProMED-mail: the Vineyard Gazette reports an unusual case of oropharyngeal tularemia contracted by a landscaper on Martha's Vineyard who handled a dead rabbit.

Tularemia is a powerful but rare bacterial disease. Rabbits are the most common carriers in addition to rodents such as squirrels, voles and muskrats, but a bite from a dog tick is the most typical way the disease is transmitted to people.
On the Vineyard, though, the pneumonic cases have dominated, making the Island the only place in the United States to experience an outbreak of pneumonic tularemia.

Q Fever

The AP reports on a mysterious case of Q fever in Texas.

From the Don't Kiss The Chickens department....

Via ProMED-mail: the CDC has revised their bird flu travel warning again.

Avoid all direct contact with poultry, including touching well-appearing, sick, or dead chickens and ducks. Avoid places such as poultry farms and bird markets where live poultry are raised or kept, and avoid handling surfaces contaminated with poultry feces or excretions.

Record Red Tide in Maine

The AP reports that Maine has joined Massachusetts with record red tide levels:

Toxin levels in some shellfish tested in Maine have reached record highs as the red tide maintains its grip.
The red tide outbreak is also reaching into waters where it has never appeared before.
Marine experts say a number of gulls and ducks have been dying along the Maine coast -- possibly from eating tainted clams and mussels.

Boston TB Scare

Via ProMED-mail: Channel 5 reports on a tuberculosis scare involving a surgical intern and possibly 1600 exposed patients at four local hospitals. State health officials are investigating.

Anyone who thinks they may have been exposed should contact their physician, the hospital or the Boston Public Health Commission at 617-534-5611.

Mad Cow News

Via ProMED-mail: Portugal reports its first case of variant Creutzfeldt-Jakob disease, not surprising for the country ranked third in mad cows. The United States thinks about reporting its second mad cow.

Elephant Ebola

ProMED-mail has some interesting speculation about elephants being the unknown natural reservoir of Ebola, Marburg, and other filoviruses.

The WHO has the lastest numbers on the Marburg epidemic:

As of 5 June, the Ministry of Health in Angola has reported 423 cases of Marburg haemorrhagic fever. Of these cases, 357 were fatal. The vast majority of cases have occurred in Uige Province, where 412 cases and 346 deaths have been reported.

Ebola and Marburg Vaccine

Thanks to Veronica for this breaking news: vaccines have been developed for Ebola and Marburg.

New vaccines against two killer viruses, Ebola and Marburg, have been proven 100 percent effective in monkey tests, scientists reported on Monday.

Red Tide

On the disaster watch, ProMED-mail reports red tides in both Florida and Massachusetts. The record red tide recently spread from Cape Cod to Martha's Vineyard.

The toxic algae bloom already has forced officials to shut down shellfish beds from Maine to Cape Cod so that people do not eat infected clams, mussels and oysters.
The closures off Edgartown meant the outbreak, possibly caused by an unusually cold and wet winter and spring, was continuing south, scientists said.
"It's an unprecedented closure," said Shelley Dawicki, spokeswoman at the Woods Hole Oceanographic Institution. "We don't know how far it's going to spread." [AP]

Bird Flu Blog

Via ProMED-mail: Avian Flu, a blog devoted to the coming bird flu pandemic, joins Fludemic on the flu-blogging beat.

Ebola in the Congo

The BBC reports nine deaths and a quarantine in effect in the Congo town of Etoumbi. The epidemic has been attributed to consumption of bushmeat, and is not the first in the region. In 2003, 120 people died in one Ebola epidemic.

Marburg Tops 300

The WHO reports a current total of 311 Marburg deaths in Angola out of 337 cases (92% mortality). On the bright side,

No cases have been reported outside Uige for the past five weeks.

Bird Flu Jumps to Pigs

Via ProMED-mail: Reuters and the AP report that an Indonesian researcher found the H5N1 strain of influenza in pigs living near infected birds.

Pigs, which are genetically similar to people, often carry the human influenza virus. Experts worry that pigs infected with both bird flu and its human equivalent could act as a ``mixing bowl,'' resulting in a more dangerous, mutant virus that might spread to people more easily - and then from person to person.

Dog Flu

Yesterday the Metro reported that dog racing at Wonderland (Boston, MA) had been shut down due to a mysterious canine epidemic. Autopsies on three dogs indicated pneumonia.

Today the CDC is on the case as well as the Boston Herald, warning locals that they and their pets may also be in danger.

Plagueblog recommends against living in close proximity to animals. Get some fish instead.

Marburg Numbers Rise

CIDRAP News reports an unexpected increase in the number of Marburg cases and deaths in Angola:

The tally yesterday stood at 313 cases, including 280 deaths, with another 208 people under observation, the World Health Organization (WHO) and the Angolan health ministry announced yesterday, according to a report by Agence France-Presse (AFP). The WHO had reported 275 cases with 255 deaths as of Apr 27, which included only 9 new cases in the preceding week.

More Marburg

The AP reports a death toll of 257 in Angola's Marburg outbreak. The story also mentions the first recovery:

But while the number of fatalities had risen, Espirito-Santo said that for the first time an infected patient had recovered and was discharged from an isolation ward at the Uige provincial hospital.

Exploding Frogs in Germany

Via ProMED-mail: the BBC reports on mysterious exploding German frogs:

Thousands of the amphibians have died in recent days in a pond in Hamburg's Altona district, with their bodies swelling to bursting point.
The toads' entrails are propelled for up to a metre (3.2ft), in scenes that have been likened to science fiction.
Scientists are baffled. Possible explanations include a unknown virus or a fungus in the pond.

Polio in Yemen

The New York Times reports on a polio outbreak in Yemen, possibly related to the current outbreak in Saudi Arabia.

CCHF in Islamabad

The Daily Times reports on a 12-year-old with Crimean-Congo Haemorrhagic Fever (CCHF) in Islamabad.

Marburg Update

Agence France-Presse reports the latest Marburg numbers: 235 dead out of 257 known cases.

An additional 513 people are under surveillance, it added.
WHO experts said last week that there was no end in sight for the epidemic, the worst outbreak ever of the virus first detected in 1967 when German laboratory workers in Marburg were infected by monkeys from Uganda.

From the Yes This IS Your Grandfather's Influenza department...

CNN reports on the unwise distribution of 1957's Asian flu (A, H2N2) to 4,000 laboratories worldwide for testing.

The samples, part of a package of pathogens sent to laboratories to test their ability to identify them, were last seen in nature in the United States in 1968, Gerberding said. Anyone born since then would presumably have no immunity to the virus, she said.
Gerberding said authorities were still trying to determine how many laboratories got the samples of the virus, called Influenza A H2N2.

Thanks to an unnamed source, who also mentioned The Unsung Vaccinologist:

Joining Merck in 1957, he mobilized the production of 20 million doses of flu vaccine, protecting the country from one of the last great flu pandemics.

Marburg Tops 200

ISN Security Watch reports 203 Marburg deaths in Angola as of yesterday, and also describes some of the negative reactions of the populace to foreigners in space suits who are only trying to help.

Health workers also said local residents lacked sufficient information about the disease and that hospitals were failing to observe basic rules of hygiene that could help stem the epidemic.

Asthma and Genetic Damage

Via GNXP: a study suggests that smoking can permanently damage the DNA of your offspring and future generations. See Maternal and Grandmaternal Smoking Patterns Are Associated With Early Childhood Asthma* by Yu-Fen Li, PhD, MPH; Bryan Langholz, PhD; Muhammad T. Salam, MBBS, MS; and Frank D. Gilliland, MD, PhD.

From the don't-eat-the-downers files

Via ProMED-mail: several NY sources report on at least 5 deer infected with Chronic Wasting Disease, a transmissible spongiform encephalopathy. One of the deer was served at a Verona Fire Department annual dinner (apparently while the brain was languishing at a lab someplace). This means that the state department of health has a few CWD exposures to track, to see whether CWD really poses no threat to humans.

The Gene for FASPS

National Geographic News reports that scientists have found the mutation that causes familial advanced sleep phase syndrome (FASPS).

The researchers are not yet certain how the gene mutation works to shift people's sleep time. But laboratory experiments suggest mutation slows the activity of a protein called casein kinase I delta (CKIdelta). "The next step is to figure out why," Fu said.

More Marburg

The WHO reports a new death toll of 173 out of 200 Marburg cases in Angola.

Disease Roundup

Several new and/or interesting outbreaks via ProMED-mail:

• Agence France-Presse reports that the Marburg death toll in Angola has hit 155, not counting the suspected Marburg death of a South African who left Luanda about a week ago. The virus continues to rage uncontrolled.
• Reuters reports on two more suspected cases of bird flu (not counting the woman who drank duck blood from earlier this week) as well as a doctor who died of apparent SARS, all in Vietnam.
• Folha de S.Paulo reports [in Portuguese] on a Brazilian outbreak of the parasite Diphyllobothrium latum in patients who ate raw, smoked, or undercooked fish. Patients consumed their sushi and sashimi at several establishments across Sao Paulo.
• UPI reports on a French woman who may have had variant CJD 20 years before the mad cow epidemic began.
• The AP reports that North Korean birds are sick with a different strain of bird flu (H7) than the highly fatal one which has spread to humans in other parts of Southeast Asia (H5).
• Agence France-Presse reports on the continuing spread of the rare Chlamydia infection lymphogranuloma venereum (LGV) among homosexual European males.
• NYNewsday reports on a rash of E. coli infections acquired from petting-zoo animals. PlagueBlog recommends avoiding contact with animals before their internal temperature has reached 160°F. Use a meat thermometer if necessary.

And don't travel to Angola.

Marburg Marches On

The current Marburg death toll is 146. Rumor has it that the disease was spread to so many victims under 5 by hypodermic needles reused for vaccinations. It's not the kind of news the WHO will be spreading far and wide, if it turns out to be true.

Marburg in Italy?

Although the two suspected Marburg cases in Portugal have been ruled out, AFP reports on nine patients quarantined in Italy and two suspected cases in the Congo.

Malwarlaria

Slashdot reports on the spread of a PC-to-human virus, Malwarlaria.B.:

First discovered in the Far East in early 2004 Malwarlaria.A spread in cats and other whiskered creatures as they walked across the keyboards of infected PCs. Infected animals showed flu-like symptoms, slight hair-loss and the appearance of some darkened patches of skin, giving rise to Malwarlaria's other name, the 'Gorbachev virus.'
The mutated version, Malwarlaria.B, causes a similar reaction in humans.

Record Marburg Outbreak

The WHO reports 132 cases of Marburg virus in Angola (127 of them fatal) breaking the previous record outbreak in the Congo. As this is an extremely high death rate (96%) even for Marburg, it seems likely that some survivors are going unrecorded.

Marburg Outbreak Nears Record Death Toll

Approximately 121 persons have died of Marburg virus in Angola since the current outbreak began, rivaling the record outbreak in the Congo between 1998 and 2000, in which 123 people died. A Portuguese national is currently hospitalized in Luanda and another died in Portugal on Saturday, soon after returning from Angola.

Marburg Virus Confirmed in Angola

Reuters reports that the mysterious Angolan hemorrhagic fever has been confirmed to be Marburg virus, a relative of Ebola.

Angola's Mystery Hemorrhagic Fever

Ebola has been ruled out as the hemorrhagic fever that has killed at least 77 people in Northern Angola since first appearing in November. A post on the ProMED-mail list suggested plague, but the geography of the outbreak makes plague spread from the Congo unlikely. Some reports claim that the victims have mainly been children under 5.

Consumption consumption

The New York City Department of Health and Mental Hygiene warns against consumption of some Mexican cheeses--namely, those contaminated with Mycobacterium bovis (bovine tuberculosis), which can cause illness and (rarely) death in humans.

The Health Department has identified 35 cases of tuberculosis caused by M. bovis in city residents between 2001 and 2004. In one of those cases, a 15-month-old child who died in March 2004 was later determined to have died from complications due to M. bovis infection.

Anthrax Scares

The CDC has the latest on recent anthrax incidents.

On March 10th, routine samples from an air sampling device at the Pentagon Remote Delivery Facility were collected and preliminary tests, reported to the Department of Defense (DoD) on March 14, indicated the possibility of the presence of Bacillus anthracis. Also, on March 14th, an alarm at a separate Defense office in the Skyline complex indicated the possibility of the presence of a biohazard. As a result, employees in close proximity to the mail handling at these two facilities and the United States Postal Service (USPS) V-Street feeder facility were placed on a 3-day course of prophylactic antibiotics.

Unidentified Hemorrhagic Fever in Angola

Via ProMED-mail: Prensa Latina reports that at least 56 Angolans, including 2 nurses, have died of an as-yet-unidentified hemorrhagic fever:

A medical source from Huige hospital told journalists they have termed this illness gastric hemorrhage. It begins with fever symptoms for two days and then the patient begins to cough up blood, falls into a coma, and dies within four days, he explained.

Typhoid Tran

The AP reports that a second nurse is showing symptoms of bird flu after treating a bird-flu patient in Vietnam:

The 21-year-old man is at the center of a cluster of bird flu cases that include his 14-year-old sister and 80-year-old grandfather, who has the virus without showing any symptoms.

Reuters reports on other asymptomatic cases.

Flesh-Eating Disease in Flagstaff

Via ProMED-mail: the Arizona Republic reports on two related cases of necrotizing fasciitis:

A patient with flesh-eating bacterium spread the infection to a health care worker at Flagstaff Medical Center, leaving both people hospitalized in serious condition.
The state Department of Health Services has asked doctors at the hospital to monitor other workers for symptoms, even though they don't think it has spread.
The DHS said the Flagstaff case represents the first documented case in Arizona of invasive Group A streptococcus spreading from a patient to a health care worker.
Officials at the medical center don't know how the disease was spread.

A Growing Family

The New York Times reports on the discovery of two new retroviral members of the H.T.L.V. family, kissing cousins to HIV.

The viruses, found in rural Cameroon among people who hunt monkeys and other primates, were probably transmitted from the animals through blood from bites and scratches received in hunting, butchering and keeping the primates as pets, the scientists said at the 12th Annual Retrovirus Conference, which ended here on Friday.

Polio in Ethiopia

The ongoing African polio epidemic has reached Ethiopia, with one confirmed case and another suspected, Reuters reports.. It all started in Nigeria:

Africa's polio epidemic erupted after a 10-month halt in immunization in Kano where Muslim elders said the vaccines were part of a Western plot to spread HIV and infertility, according to WHO officials. Nigeria, Africa's most populous country, recorded 763 cases in 2004, accounting for 2/3 of the toll. It resumed immunization in July 2004.

Cryogenic Bacteria

The Environment News Service reports on frozen microbes: they weren't infectious, but bacteria unearthed from the Alaskan tundra five years ago came to life in the lab after 32,000 years at -4° Celsius. It's taken the past five years to prove that it's a new species.

Commenters at Slashdot note that bacteria have been revived after 25 million years.

Rabies Roundup

Just a few interesting rabies stories from ProMED-mail: two patients died of rabies transmitted by organ transplants in Germany, a hunter died of rabies in Siberia, and a woman was bitten by a rabid coyote right here in Massachusetts.

Bird Flu Warnings

The front-page story in the Boston Metro today was this AP report on the "very high threat" of a bird flu epidemic.

Julie L. Gerberding, head of the Centers for Disease Control and Prevention, said scientists expect a flu virus that has swept through chickens and other poultry in Asia to genetically change into a flu that can be transmitted from person to person.

Pneumonic Plague

Thanks to another unnamed source for the pneumonic plague link. I also heard about it at the plague panel at Boskone this weekend, but I haven't had a chance to blog it until now. The outbreak among diamond miners in the Congo has been going on since December, but the WHO has only recently gotten involved. According to the BBC article, there are at least 60 dead and 350 infected.

Don't Eat the Apes

Via ProMED-mail, of course: Study links Ebola outbreaks to animal carcasses.

Specifically, the researchers found that Ebola infections in wild animals such as gorillas, chimpanzees, and occasionally duikers (a diminutive antelope species), move across the human-wildlife divide through hunters taking either sick animals or carcasses for meat. Hunters can then spread the disease to families and hospital workers, creating the conditions for an epidemic in the process.

Mad Goat

I've gotten behind on reporting, but I did get a friendly tip on the mad goat [ProMED] last week.

Britain said on Tuesday [8 Feb 2005] that a goat confirmed as having the brain-wasting disease scrapie in 1990 may have had mad cow disease. [...]
In January 2005 mad cow disease, formally known as bovine spongiform encephalopathy (BSE), was found in a goat in France, the 1st time the brain-wasting affliction that ravaged European cattle herds and killed at least 100 people had been diagnosed in another animal.

Stuffed Plague

What's the perfect gift for the plague-blogger who has everything? Giant Microbes! Thanks to my personal Epidemic Santa for the Black Death and company.

The Bard and the Pox

Steve Baragona of the Infectious Diseases Society of America argues against a recent article in Did Shakespeare have Syphilis?

Quahogs vs. Botulin

The Associated Press reports that quahogs are surprisingly resistant to botulism:

Researchers who injected the clams with enough botulism toxin to kill 1,000 people found the shellfish somehow neutralized the enzyme, which is considered a potential bioterror agent.

Tularemia (Lab Exposure)

The dirty bomb scare here in Boston is distracting from another bit of terrorism-related news: three researchers at BU were infected with tularemia in, apparently, at least two separate lab accidents. The cases, which have been attributed to violations of safety procedures, were discovered by November but were concealed from the public during hearings about BU's planned high-security bioterrorism research lab.

These are not the people I want juggling vials of smallpox in South Boston.

Unprepared

A bioterrorism preparedness exercise shows that we're unprepared for smallpox.

Tsunami Tetanus

Tetanus has taken health care workers in Indonesia by surprise, according to this report from Banda Aceh.

Tsunami-borne Measles

I wasn't expecting measles to be the first flashy disease of the tsunami-set, but as usual, ProMED-mail has set me straight. Both Indonesia and India report cases.

Scanning for Schizophrenia

The Scotland Sunday Times reports on a new method to detect schizophrenia up to three years before onset.

Researchers at Edinburgh University believe their test — which measures IQ, memory, motor skills and verbal learning — can be used to take action against the illness, which typically strikes people aged between 17 and 30, from being triggered.

Hepatitis C Outbreak in Maryland

Via ProMED-mail: The Baltimore Sun reports a nosocomial outbreak of hepatitis C caused, strangely enough, by a contaminated batch of technetium-99m, a radioactive isotope used in diagnostic procedures.

The one fatality so far is a healthy 79-year-old man who went to a cardiology clinic in October and died at Christmas. Health officials are unsure how the isotope became so contaminated that all patients who received it have tested positive for hepatitis C, but they do believe the contamination took place at the pharmacy that prepared the isotope, rather than the cardiology clinic.

Mad Cow II

More weekend news: a second Canadian mad cow leads to concern about the lifting of the US ban on Canadian cattle imports.

Tsunami Disease Outbreaks

Via ProMED-mail: The WHO reported on Sunday that communicable diseases were being seen in tsunami refugee camps.

Acute Eosinophilic Pneumonia

From HealthDay News via MedicineNet: Government Studies Rare Pneumonia Outbreak Among Iraq Troops.

[...] acute eosinophilic pneumonia (AEP), is so rare that the entire medical literature contains only about 150 published accounts of it, according to lead study author Dr. Andrew F. Shorr, chief of the pulmonary clinic at Walter Reed Army Medical Center in Washington, D.C. And none of that literature has accounts of the disease striking in clusters, as it apparently did in Iraq.
There seems to be no explanation for the unusual cluster, which included two deaths, except for one salient fact -- all of the patients were smokers, and nearly all of them were new to the habit.

Flu Quiz

The Delaware Coast Press posts a flu quiz from Delaware state health officials.

Tsunami News

Via ProMED-mail: Reuters reports on the potential for post-tsunami epidemics. The biggest concern is the spread of waterborne diseases.

Flu Pandemic Warning of the Week

This week's dire forecasts of flu pandemic decimation come from the Association of Southeast Asian Nations. No new mortality rate was mentioned in the MedBroadcast article, though the WHO's previous estimate of up to 7 million dead was repeated.

Quahog Parasite Unknown

Via ProMED-mail: Cape Cod is suffering an outbreak of QPX disease (quahog parasite unknown). The quahog, Mercenaria mercenaria, is a clam native and beloved to Southeastern New England. Although harmless to quahog consumers, QPX has no known cure and threatens to devastate grants around the Cape.

Polio Outbreak in the Sudan

Via ProMED-mail, as usual: a massive polio outbreak in Sudan has WHO officials concerned that poliomyelitis may spread from there into the Middle East.

Nobody Expects the Bubonic Plague

Via ProMED-mail: A Pueblo, Colorado man dies of plague.

Local health department Director Chris Nevin-Woods [...] said the man had an open wound on one of his hands and probably was exposed while skinning an infected rabbit that he had shot.

Michigan Mystery Bug

Via ProMED-mail: a flu-like illness has broken out in a nursing home in Troy, Michigan. WXYZ News reports:

The outbreak occurred in the Alzheimer's unit, which has been quarantined. There are 39 people who live there, and 16 have fallen ill with the same flu like symptoms.
Paramedics were on the scene, suited up in biohazard in uniforms. Sick patients have been evacuated from the building to three area hospitals.
The outbreak started Wednesday night. 4 people became ill with flu like symptoms such as nausea, vomiting, and diarrhea. All of these people were taken to the hospital, where one man went into cardiac arrest and died.

New Improved Scrapie

Via ProMED-mail: a new strain of scrapie has been detected in Great Britain, with some cases occurring among the most scrapie-resistant sheep. This bodes ill for the National Scrapie Plan to breed TSE-resistant sheep.

Fatal Familial Insomnia

A Wired article (Sleep Disorders Traced to Genes) reminded me of Fatal Familial Insomnia (FFI) and introduced me to a sleep disorder, Delayed Sleep Phase Syndrome:

Patients typically are unable to fall asleep before 2 a.m. and have extreme difficulty waking early (e.g., by 7 a.m.). People with DSPS are sometimes called "night owls" or are described as "not being morning people." If they are able to sleep a full 7 to 8 hours (e.g., until 10 a.m.), they feel rested and function normally.

I'm typically unable to get to bed before 2 a.m., but I don't think that qualifies without the accompanying insomnia.

So back to FFI. It's exciting because it's a prion disease like the transmissible spongiform encephalopathies, but it mainly affects the thalamus, leading to insomnia-related death before the rest of the brain is seriously involved. Here's an overview of FFI by Ann M. Akroush.

I also found a couple of interesting journal articles available on-line: Fatal familial insomnia- clinical, neuropathological, and genetic description of a Spanish family -- Tabernero et al. 68 (6)- 774 -- Journal of Neurology, Neurosurgery, and Psychiatry (full text), and an abstract of Fatal insomnia in a case of familial Creutzfeldt-Jakob disease with the codon 200(Lys) mutation -- Chapman et al. 46 (3)- 758 -- Neurology.

Bird Flu Transmission in Russia

ProMED-mail is skeptical about reports of two cases of human-to-human transmission of bird flu in St. Petersburg.

Everyone's a skeptic until the first 20 million die.

vCJD News

Via ProMED-mail: concerns are rising about the transmission of mad cow disease (variant Creutzfeldt-Jakob Disease a.k.a. vCJD) through blood transfusions and also about wider genetic susceptibility to the disease than previously expected. Experiments with transgenic mice also point towards universal human susceptibility to some form of vCJD.

For a chattier introduction to genetic vCJD susceptibility and transmission through the blood supply, see this August BBC report.

Bird Flu in France?

I've been hoping for more news on the bird flu case in France (via ProMED-mail, with a reminder from Fludemic), but Google is giving me no new news.

Nontuberculous Mycobacteria

Some San Jose residents have gotten more than they bargained for from their pedicurists. The Bay City News reports on at least 40 cases of serious skin infections, probably caused by nontuberculous mycobacteria growing in whirlpool foot baths. Whirlpools are bad news in general, bacteriologically speaking; once you add in the natural nastiness of feet, trouble is bound to follow.

Bogus Botox Botulism

Via ProMED-mail: four Florida residents have been hospitalized with suspected botulism. Health officials suspect that one of the victims administered a Botox knock-off to himself and the others as an anti-wrinkle treatment. See the full story from the South Florida Sun-Sentinel.

Botulism is normally caused by toxins produced by the bacteria Clostridium botulinum.

Trichinosis

ProMED-mail reports on three cases of trichinosis in Russia, caused by consumption of infected pork.

Trichinosis (a.k.a. trichinellosis) is a parasitic disease caused by the trichina worm, Trichinella spiralis. There's a whole Trichinella page devoted to T. spiralis. The CDC factsheet on trichinosis is scary:

When a human or animal eats meat that contains infective Trichinella cysts, the acid in the stomach dissolves the hard covering of the cyst and releases the worms. The worms pass into the small intestine and, in 1-2 days, become mature. After mating, adult females lay eggs. Eggs develop into immature worms, travel through the arteries, and are transported to muscles. Within the muscles, the worms curl into a ball and encyst (become enclosed in a capsule).

Apparently, you can "[f]reeze pork less than 6 inches thick for 20 days at 5° F to kill any worms," but this approach doesn't work for game. Microwaves are not enough to kill the parasite.

Survector

Anti-depressants are outside of my purview, but I enjoyed Jeff Percifield's history of Survector. Get your own Survector from amineptine.com.

Mad Cow #2

Everybody reports on the discovery of a second mad cow in the US. The origin of the cow and the circumstances of its death have not been revealed. Here's the New York Times article.

Mystery Disease in China

The in China is, of course, redundant. Although India has a good number of mystery diseases, it's the ones from China that tend to, say, wipe out Europe. This week's mysterious respiratory disease has infected 28 at a children's hospital. Health authorities have ruled out SARS, Influenza A, and Influenza B. Read all about it at Reuters.

HPV Vaccine

MedBroadcast reports on the new vaccine against human papilloma virus, the STD responsible for most cases of cervical cancer.

Inevitable and Overdue

Medbroadcast reports on a two-day conference on infectious diseases at which the flu was the starring disease. An influenza pandemic is "inevitable and overdue."

Based on the experience of the three pandemics of the 20th century, a third or more of the globe's population would be expected to fall ill. A pandemic, even one caused by a mild strain, would be expected to kill millions, experts warn.
The spectre of a pandemic with the extraordinarily virulent H5N1 strain is making for sleepless nights in the community of influenza researchers.

Feeling No Pain

Medbroadcast reports on a young girl with congenital insensitivity to pain with anhidrosis (CIPA), a genetic defect.

SARS Civets

Via Medbroadcast: China bans civets. This relative of the mongoose is being blamed for SARS. If you find yourself in China, you may neither kill nor eat a civet.

Plague in Qinghai

China Daily reports that a plague outbreak in northwest China is now under control. Out of 19 cases, eight people died. Wild marmots may have been responsible.