outbreak
lborkowski | July 5, 2011One of the disturbing aspects of the recent E. coli outbreak in Germany was the apparent lack of sufficient hospital surge capacity to handle a sudden influx of seriously ill patients. Der Spiegel reported:
On Monday, hospitals all over northern Germany struggled to treat thousands of patients suffering from the effects of the bacteria. More than one-third of the people infected with E. coli have also come down with a life-threatening complication known as hemolytic-uremic syndrome (HUS) which attacks the blood, kidneys and brain, and has left doctors racing to save lives. Ambulances have…
tsmith | June 22, 2011I left off yesterday with the initial discovery of "Vero toxin," a toxin produced by E. coli (also called "Shiga toxin" or "Shiga-like toxin"). Though this may initially seem unconnected to hemolytic uremic syndrome (HUS), the discovery of this cytotoxin paved the way for a clearer understanding of the etiology of this syndrome, as well as the mechanisms by which disease progressed. By the early 1980s, several lines of research pointed toward E. coli, and particularly O157:H7, as the main cause of HUS.
A 1982 Centers for Disease Control and Prevention MMWR report found a rare E. coli…
tsmith | June 21, 2011As I mentioned yesterday, the epidemiology of hemolytic uremic syndrome (HUS) was murky for several decades after it was first defined in the literature in 1955. In the ensuing decades, HUS was associated with a number of infectious agents, leading to the general belief that it was a "multifactorial disease"--one that had components of genetics and environment, much like we think of multiple sclerosis today, for example.
Several HUS outbreaks made people think twice about that assumption, and look deeper into a potential infectious cause. A 1966 paper documented the first identified outbreak…
tsmith | June 20, 2011It appears that the E. coli O104 sproutbreak is starting to wind down, with more than 3,500 cases diagnosed to date and 39 deaths. Though sprouts remain the key source of the bacterium, a recent report also documents that human carriers helped to spread the organism (via H5N1 blog). In this case, it was a food service employee working at a catering company, who spread infection to at least 20 people before she even realized she was infected.
As with many infectious diseases, there are potential lingering sequelae of infection, which can occur weeks to years after the acute infection has…
tsmith | June 10, 2011Via H5N1, German officials are calling it for sprouts:
Germany on Friday blamed sprouts for a bacteria outbreak that has left at least 30 dead and some 3,000 ill, and cost farmers across Europe hundreds of millions in lost sales.
"It's the sprouts," Reinhard Burger, the president of the Robert Koch Institute, Germany's national disease centre, told a news conference on the outbreak of enterohaemorrhagic E. coli (EHEC) in northern Germany.
"People who ate sprouts were found to be nine times more likely to have bloody diarrhoea or other signs of EHEC infection than those who did not," he said,…
tsmith | June 9, 2011Maryn McKenna has a great update today on the E. coli situation, looking at where we are as far as unanswered questions about the outbreak and the strain. It's been a messy day; more evidence seems to point to the sprout farm, but CIDRAP also notes that another contaminated cucumber was found in the compost bin of a family sickened by the bacterium (this one had the correct serotype--O104), but it's impossible to tell at this point whether the cucumber was the source of that bacterium or it ended up there from one of the sickened family members. Twists and turns abound in this investigation…
tsmith | June 6, 2011Well, Sunday the said we'd have some results on the sprout tests for E. coli O104:H4. Well, so far the results are negative.
The 1st tests from a north German farm suspected of being the source
of an _E. coli_ [O104:H4] outbreak are negative, officials say. Of 40 samples from the farm being examined, they said 23 tested negative.
Officials had said earlier that bean sprouts produced at the farm in Uelzen, south of Hamburg, were the most likely cause of the outbreak. The outbreak, which began 3 weeks ago and is concentrated in Hamburg, has left 22 people dead. Initially, German officials had…
tsmith | June 5, 2011The E. coli story is moving quickly. A news report out today suggests that sprouts might be the culprit (though it should be emphasized that the outbreak strain hasn't been isolated from these vegetables yet):
Mr Lindemann said epidemiological studies all seemed to point to the plant nursery in Uelzen in the state of Lower Saxony, about 100km (62m) south of Hamburg - though official tests had not yet shown the presence of the bacteria there.
"Further evidence has emerged which points to a plant nursery in Uelzen as the source of the EHEC cases, or at least one of the sources," he said.
"The…
tsmith | June 3, 2011Mike has has a great new post up looking at some molecular analyses of the current European outbreak strain. For anyone who hasn't been paying close attention to what's happening across the pond, there's an ongoing outbreak of enterohemorrhagic E. coli (EHEC)--the type of E. coli that includes O157:H7, which has been associated with outbreaks of disease associated with food. The most infamous outbreak was the 1993 Jack-in-the-Box disaster, associated with undercooked hamburgers contaminated with the organism, but there have also been outbreaks associated with contaminated vegetables (such as…
tsmith | June 2, 2011At the new blog Puff the Mutant Dragon, there's a great pair of posts looking at the history of plague, with a focus on outbreaks that have occurred here in the US.
Bubonic Plague in America, Part I: LA Outbreak
Bubonic Plague in America, Part II: Undercover Science
I'll also link them in my Black Plague series.
tsmith | May 30, 2011In the United States, we tend to take our clean drinking water for granted. Even though there are periodic concerns which bubble up about pharmaceuticals or other chemicals in our water supply, we typically believe--with good reason--that we have little to fear when it comes to contamination from microbes. Our drinking water, while far from perfect, is heads and shoulders above what it once was--something many of us forget or have never realized. There have been notable breakdowns, such as the 1993 outbreak of Cryptosporidium in Milwaukee that sickened over 400,000 individuals, but these days…
tsmith | May 24, 2011We've had pertussis and mumps, so it was only a matter of time.
State health officials declared a "public health emergency" Tuesday after a test confirmed a case of measles in an unvaccinated Dallas County baby who apparently picked up the disease in India.
They said people who might have been exposed included passengers on an Americans Airline flight from Chicago to Des Moines May 11 and people who were at Mercy Medical Center or a Mercy pediatric clinic in downtown Des Moines May 14.
Dr. Patricia Quinlisk, medical director for the Iowa Department of Public Health, said many Americans…
tsmith | May 16, 2011Via H5N1 and other sources, there's at least one new Ebola case in Uganda:
The rare and deadly Ebola virus has killed a 12-year-old Ugandan girl and health officials said on Saturday they expected more cases.
The girl from Luwero district, 75 km (45 miles) north of the capital Kampala, died on May 6, said Anthony Mbonye, the government's commissioner for community health, in the first outbreak of the virus in Uganda in four years.
"Laboratory investigations have confirmed Ebola to be the primary cause of the illness and death. So there is one case reported but we expect other…
tsmith | April 29, 2011Maryn McKenna has an excellent post on 2008's measles outbreak in Arizona. 14 confirmed patients, 8,321 individuals tracked down, 15,120 work hours lost at 7 Arizona hospitals due to furloughs of staff who were not appropriately vaccinated, and almost $800,000 spent by 2 hospitals just to contain the disease--and it all could have been prevented.
tsmith | July 28, 2010At his new digs, PalMD discusses recent news revealing the presence of dengue virus in the Florida Keys--the first appearance in the state in almost 75 years. Dengue is a mosquito-borne virus that can cause serious disease, including a hemorrhagic manifestation, and the current outbreak is pitting public health professionals against the tourism industry in the Keys. It's also brought to public attention the closing of CDC's vector-borne disease branch due to funding difficulties. The intersection of these--viral emergence, politics, and economic interests--has the potential to cause a huge…
tsmith | May 4, 2009Back to the grind this week unfortunately, but the swine flu/H1N1 story is still developing and still fascinating. The most recent numbers show 286 confirmed US cases in 36 states.
There are many remaining questions on the evolution and epidemiology of this strain--and many pundits sure they know what's going to happen next. Mike takes one of them down--Wendy Orent, who I've blogged about previously. Orent is claiming (based on a black/white version of the evolution of virulence in pathogens) that the spread of this strain is attenuating the virus, and that future outbreaks will be…
tsmith | May 3, 2009Over at DailyKos, DemfromCT has an excellent post explaining why it may be beneficial for schools to close temporarily, even if they only have one confirmed case of swine influenza: H1N1: Why Do Schools Close, And When Do They Open?
DarkSyde also has one up on the basic biology and evolution of the flu.
Nick Kristof discusses our lack of attention to public health and what it means in the event of a pandemic in today's NY Times.
[Updated: and via the comment theads, this post which further discusses what I mentioned here regarding testing--and how the confirmed cases are only the tip…
tsmith | April 30, 2009I've been seeing a lot of comments mocking the current outbreak of H1N1, and a lot of people (and journalists) who don't understand what "big deal" is about the "snoutbreak" of swine influenza, or don't get what the raising of the World Health Organization's pandemic alert phase up to 5 means. I noted here what the alert level meant, but wanted to discuss it a bit more in a full post; after the jump.
So, some comments I've seen thrown about:
This is all just media hype! Lies about the Mexican cases! The WHO just revised their numbers down to 26 cases and 7 deaths! Why should I believe…
tsmith | April 29, 2009It was only a matter of time:
Iowa Gov. Chet Culver says the state has two probable causes of swine flu.
Speaking Wednesday at a Statehouse news conference, Culver told reporters that officials would know Thursday if the cases are swine flu.
Officials say one case was from a California resident who visited Scott and Clinton counties last week. The other was a woman who returned from Mexico and traveled through Johnson, Des Moines and Muscatine counties.
State Medical Director Patricia Quinlisk says both of the people infected were now recovering.
Should know by tomorrow if they are confirmed…
tsmith | April 29, 2009Brandon Keim at WiredScience has a new article on swine flu genomics.
"This is what we call a reassortment between two currently circulating pig flu viruses," said Andrew Rambaut, a University of Edinburgh viral geneticist. "Why it's emerged in humans is anyone's guess. It hasn't been seen before in pigs as far as I know."
***
"The new neuraminidase gene that came in from Eurasian swine is one we've never before seen circulating in humans," said Rambaut. "That's one of the reasons it's spreading rapidly. Very few people will have any immunity to this particular combination, which is what…