Two Pathology employees have contracted Q fever following a breach in laboratory protocol involving the bacterium. A 33-year-old man was diagnosed with the illness and has since recovered fully with treatment. A 31 year-old woman was also diagnosed and is in a satisfactory condition. Q fever is caught from infected animals, person-to-person spread was extremely unlikely, and the risk to the public is low. Approximately half of all people infected do not develop symptoms and, in the majority of others, illness is mild. Hospitalization and serious complications are rare. Infection usually occurs through inhalation of bacteria from animals and animal secretions or products, and the incubation period is usually between 2 and 4 weeks. The breach of laboratory protocols occurred 5 weeks ago and has been thoroughly investigated. The breach involved a live specimen being transported incorrectly in the Pathology's laboratory. At this stage, Pathology cannot confirm a definitive link between the breach in protocol and the positive test results. Pathology is also offering screening to any employee who may require it. Most people who contract Q fever recover fully with or without treatment. Acute and chronic Q fever can be treated with antimicrobial agents. [ProMed]

An extremely rare infection has been passed from an organ donor to at least one recipient in what is thought to be the 1st human-to-human transfer of the amoeba. Four people in 3 states received organs from a patient who died at the University of Mississippi Medical Center in November 2009 after suffering from neurological problems. Organs are routinely tested for HIV, hepatitis, and other more common infections, but occasionally rare ones slip through. Two of the recipients are critically ill, but the others haven't shown symptoms. CDC confirmed the presence of the organism, known as Balamuthia mandrillaris, in one of the recipients. Balamuthia mandrillaris is a microscopic parasite found in soil that causes encephalitis in humans, horses, dogs, sheep and nonhuman primates. Scientists think people get infected by breathing it in, but it can also pass into the blood through a cut or break in the skin. It can be especially dangerous to people undergoing organ transplants, whose immune systems are purposely weakened so their bodies don't reject their new organs. Human infections are very rare: only about 150 cases have been reported worldwide since the disease was 1st identified in 1990. [ProMed]

Dutch authorities, already battling an outbreak of the highly infectious disease, Q fever, have discovered contamination at 5 more farms and expect further outbreaks. Q fever is caused by a bacterium that is mostly transmitted to humans from goats and sheep, especially during delivery of young, and the number of human cases of the disease has risen to about 2200 currently from about 170 in 2007. A total of 60 farms in the country are now known to be affected and authorities plan to cull an extra 5000 goats on top of the 35 000. The culling of goats is set to begin on 21 Dec 2009, and will be done by lethal injection. For humans, Q fever causes flu-like symptoms treatable with antibiotics, but in rare cases it can be fatal. Six people who had other diseases or were weakened have died this year while having Q fever. Dutch authorities have toughened up measures to stop the disease spreading to humans following health advice, but Dutch farmers organisation LTO has opposed the plans, particularly the decision to kill healthy animals on contaminated farms. [ProMed]

The Kern County Department of Public Health in California has confirmed a test result positive for Yersenia pestis, the bacterium that causes plague, conducted on a domestic cat. A test on another cat in the same household is pending. Public Health officials are investigating these cases. There is no evidence of human infection at this time. Appropriate preventive steps including antibiotics have been recommended to protect those who may have been exposed to these cats. One of the symptomatic cats is responding well to antibiotics, but one of the cats has died. Plague, infection with the bacterium Y. pestis, is endemic throughout the southwest United States, including much of Kern County. Each year numerous mammals, including domestic cats, are identified with evidence of infection with Y. pestis. Cats are believed to be the domestic species most susceptible to plague. As in humans, 3 clinical syndromes have been described: bubonic, septicemic, and pneumonic. Cats can pose a risk of plague transmission to humans. Because of the potential for transmission to humans, cats suspected of having plague should be hospitalized and placed in isolation. Local and state public health officials should be notified immediately of cases of plague diagnosed in domestic cats. [ProMed]

The Food Standards Agency and Health Protection Agency (HPA) are investigating a recent increase in the number of cases of a certain type of Salmonella in England and Wales. The increase in cases of Salmonella enterica serotype Enteritidis phage type (PT) 14b, since mid-August 2009, was noted by the HPA as part of its monitoring of infectious diseases. A total of 443 cases of S. Enteritidis PT14b have been reported to the HPA in 2009, compared with 137 cases in 2008. 14 clusters of cases in England and Wales are currently being investigated to determine if there is a common source of infection. The clusters have been linked to a number of different catering establishments and a care home. Although there is no conclusive evidence yet, the clusters may be linked to eggs sourced from outside the UK and used in these establishments. Investigations are ongoing into a possible link to eggs sourced from an approved establishment in Spain, and the UK and Spanish authorities are working in close cooperation to investigate this. In the meantime, the Agency is reminding caterers and other food businesses how to cook and prepare eggs safely. Salmonella_ is one of the most common causes of food poisoning in the UK and is sometimes found in unpasteurised milk, raw meat and poultry, as well as eggs and products containing raw egg. [ProMed]

Northland District Health Board's Whangarei Hospital (New Zealand) is urging people with viral gastroenteritis-like symptoms not to visit patients in hospital, or to call ahead for advice if they do need to visit. Community acquired viral gastroenteritis has been identified within ward 16. Features of the illness are those of norovirus infection -- predominantly vomiting and diarrhoea. The hospital expects to receive laboratory results to confirm the contamination this week. About 10 patients and several staff are affected and ward 16 is closed to new medical admissions. Visitor restrictions are in place. Norovirus infection is a common cause of gastroenteritis. The most usual ways of catching it is contact with infected people, eating contaminated food (especially shellfish), or drinking untreated water. Symptoms are predominantly vomiting and diarrhoea which usually last about 48 hours. The most important way of preventing spread is thorough hand hygiene (washing hands for 20 seconds using soap and running water and drying for 20 seconds). [ProMed]

The Dutch Health ministry has called for research to investigate whether Coxiella burnetii infection (Q fever) causes premature births in humans. The disease has spread across a third of the Netherlands. Q fever in humans causes flu-like symptoms and can lead to pneumonia. In some cases it leads to death. In 2009 alone 2200 people have contracted it, most of them in the southern rural province of Brabant, and at least 6 people have died. To prevent further spread of the disease, goats are to be vaccinated. The results of this measure will not be visible until 2010. In areas with high numbers of human Q fever cases, the government even wants farms to be closed for a year and people at risk should be vaccinated. The government pointed out that in Australia 55 000 people had been vaccinated. There, the worst side effect had been itchiness. A publication of the University of New South Wales reported that vaccination of high risk groups (abattoir staff, farmers) with Q-vax resulted in a 50 percent decrease of Q fever infections in Australia from 2002 to 2006. Precautionary, in Australia only people who did not have antibodies against Q fever were vaccinated. [ProMed]

Sophisticated genetic fingerprinting confirmed that a laboratory experiment was the source of a bacterial infection that sickened a graduate student on Boston University's medical campus. The genetic tests 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 analysis erased any doubt about what caused the researcher to become sick in October 2009 and intensified investigations into precisely how he was exposed to a germ known as Neisseria meningitides, 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. Investigators will examine what kind of protective gear the researcher was wearing, what kind of training he received, and how thoroughly he was supervised. The city strengthened its regulation of labs after 3 BU scientists became infected with tularemia in 2004, an episode that revealed sloppy lab practices and a failure to report those illnesses in a timely fashion. The researcher was working in a biosafety level-2 lab. [ProMed]

South Australia (SA) is experiencing its worst whooping cough (pertussis) outbreak on record and babies are the main victims of the potentially fatal and highly infectious disease. Babies are most vulnerable as they are too young to be fully immunized, and rely upon "herd immunity", the high immunisation of those around them. SA Health has received almost 3500 reports in 2009, compared with 859 at the same time in 2008 and 318 in 2007. National statistics show the rate in SA is twice as high as the national average. A 4 week old baby who died in March 2009 was the 1st fatality from the disease in a decade. Since then it is understood 2 other children have died. SA had recorded the highest number of notifications since records started being kept in 1991, and warned that people needed to be vigilant about vaccinations to protect vulnerable children. [ProMed]

Harvard University Medical School is locking down its New Research Building, installing new surveillance cameras and imposing tighter security after researchers in the pathology department of the Boston building drank poisoned coffee and were hospitalized. The 6 victims - a group of scientists and students at Harvard Medical School -- used a communal, single-serve coffee machine on the 8th floor near their pathology lab 26 Aug 2009. Seconds later all 6 reported symptoms such as dizziness and low blood pressure. One victim's ears were ringing and another passed out. All 6 were taken to Beth Israel Deaconess Medical Center, where they were treated and released. One was held overnight for observation. The coffee maker was removed for testing. Harvard University Police, as well as Boston police and fire units, responded to the poisoning, and immediate testing by hazardous material crews found no traces of poison. But a later test revealed that the presence of sodium azide, a common preservative used in labs, is what sickened the researchers. Sodium azide is listed as a 'potentially deadly chemical that exists as an odorless white solid. [ProMed]

More than 1800 patients treated by one nurse at a South Florida hospital may have been exposed to HIV [human immunodeficiency virus] and hepatitis [B and C virus infection]. Broward General Medical Center said early October that a nurse reused saline bags and tubing during cardiac stress tests involving the injection of fluids. The hospital has sent letters to all 1851 people who may've been affected between January 2004 and early September 2009. Hospital officials say the risk of exposure is low, but all affected patients should be tested for HIV and hepatitis B and C virus infection. The nurse, who has not been identified, resigned and was reported to the Board of Nursing. The hospital discovered the problem after a patient noticed the nurse misusing the equipment and anonymously called in. The risk of transmission of infection in this incident would seem to be low since apparently the 1st patients were exposed as long ago as 2004 and no cases of infection have been identified up to the present. [ProMed]

New data from U.S. studies seems to confirm that only one dose of H1N1 vaccine will be needed to protect adults and seniors and that giving seasonal and pandemic flu shots at the same time should be fine, the head of the National Institute of Allergy and Infectious Diseases said Friday 9 Oct 2009. Testing showed that adults and seniors who received a 2nd dose of the pandemic vaccine didn't get much additional benefit from the 2nd shot. The response to one dose in both groups was already sufficiently strong to suggest that the vaccine should offer good protection. Preliminary data from another study looking at whether it was safe to give both seasonal and pandemic flu shots at the same were also revealed. Both vaccines protect against an H1N1 virus -- though the viruses are sufficiently different it is thought vaccine against one would not protect against the other. There were theoretical concerns, though, that giving 2 flu vaccines at once might interfere with the immune system's ability to generate a good response to all the viruses covered in the shots. It was stated that there were no unusual side-effects seen in the people who received the 2 vaccines together. [ProMed]

More than 40 million people in the Chinese mainland are attacked by animals annually, a recently released Ministry of Health report said. The number was calculated from the amount of rabies vaccine administered every year. The Ministry of Health also said China is one of the countries most threatened by rabies. In recent years, an average of more than 2400 people in China have died from rabies infections annually. Only India has a higher number of rabies-related fatalities. Most rabies deaths in the past 5 years occurred in the Guangxi Zhuang Autonomous Region and the southern provinces of Guizhou, Guangdong, Hunan and Sichuan, accounting for 60.85 percent of the total, the Ministry of Health report said. The number of cases in the central and northern parts of China also increased in the last few years. It also noted that rabies infections mostly occurred in rural areas among males, children under the age of 15, and people over the age of 50. Rabies is an acute infectious disease which can be contracted by both human and dogs, and is often spread through dog bites. [ProMed]

The tiger mosquito, or Aedes albopictus, is the insect vector of dengue and chikungunya viruses, diseases prevalent in warmer countries. One recalls the chikungunya epidemic that struck La Reunion during 2005, with over 5000 reported cases. This disease is characterized especially by high fever and joint pain. This insect was discovered the 1st time in late July 2009 during one of the identifications that were made from routine traps. The Directorate of Health is monitoring the progression of this insect wherever it advances along its road routes. Breeding sites are those containing stagnant water where mosquitoes lay their eggs. Until now, only traps in Aiton, Savoy, and Manissieux in eastern Lyon, the Lyon-Chambery motorway, have revealed the presence of the famous tiger mosquito. The traps are installed along the roads by which the insect spreads. It comes mainly from Italy, where it has been rapidly expanding in recent years. The larvae and eggs are most often carried by water in truck and car tires. They can then hatch during warm weather. [ProMed]

A University of Chicago researcher studying the genetics of the plague bacteria died last week from an infection he may have gotten in the laboratory. The researcher, a 60-year-old molecular genetics professor died on September 13, 2009 at a University Hospital. An initial autopsy showed that the researcher "showed no obvious cause of death" except for the presence of the weakened strain of the plague bacteria Yersinia pestis in his blood. It is not known to cause illness and has been used in some countries as a vaccine to protect against the plague. It has been approved by CDC for lab studies. University officials said there does not appear to be a public health threat related to the death. There have been no illnesses reported by those who came into contact with him. As a precaution, the University of Chicago notified the researcher's close contacts once the bacteria had been identified in his blood. Lab researchers who work with the bacteria would typically wear gloves, a lab coat and protective goggles, and the bacteria would be disposed of in a biohazard bag and heated for about 2 hours. [ProMed]

When the coughing stops is probably a better sign of when a swine flu patient is no longer contagious, experts said after seeing new research that suggests the virus can still spread many days after a fever goes away. The Centers for Disease Control and Prevention (CDC) has been telling people to stay home from work and school and avoid contact with others until a day after their fever breaks. The new research suggests they may need to be careful for longer – especially at home where the risk of spreading the germ is highest. Swine flu also appears to be contagious longer than ordinary seasonal flu, several experts said. The study shows that people are not contagious for a day or 2, but probably contagious for about a week. More than one million Americans have been infected and nearly 600 have died from it, the CDC estimates. Researchers in Canada took nose and throat swabs from 43 patients with lab-confirmed flu and dozens of other sick family members. On the 8th day after symptoms first appeared, 19 to 75 percent showed signs of virus remaining in their noses, depending on the type of test used. Some still harboured virus as long as 16 days later. [ProMed]

Some experts say Q fever, which has already killed 5 people in the Netherlands, is not getting enough attention compared to pandemic influenza. Some experts think the silence about Q fever, which can cause permanent heart problems, is misguided. North Brabant has a high concentration of sheep and goat farms, which the authorities say are the source of Q fever. The disease first surfaced in 2007, but the agriculture ministry said it won't know exactly which farms are infected before the end of 2009. There are no plans to exterminate entire farms as was done for diseases like classical swine fever or foot-and-mouth disease. Neither will the ministry name the infected farms. Instead the farmers themselves will be asked to present a plan for making their farms disease-free. Spores of the bacteria can survive for a long time and can be carried by the wind. The ministry hopes to counter the disease through compulsory vaccination, the controlled processing of manure and checks on animal transports. [ProMed]

Children were 14 times more likely to be sickened by swine flu than adults 60 and older, the age group that is typically the most at risk for influenza, according to a US study of the disease. Children ages 5 to 14 became ill with swine flu, also known as influenza pandemic H1N1 2009 virus, at a rate of 147 per 100 000 people, according to the study of 1557 confirmed illnesses, including 7 deaths, in Chicago from April to July 2009, months when the flu virus usually doesn't spread. The findings were reported by the US Centers for Disease Control and Prevention (CDC) in Atlanta. US health officials are planning a vaccination campaign that will focus on those who are disproportionately affected by H1N1, which include children, pregnant women, and adults with underlying health conditions. A separate study released from New Zealand showed swine flu targeted younger people and dominated other virus strains after circulating for just one month during the winter. The number of viruses identified as 2009 pandemic influenza rapidly overtook the number identified as seasonal influenza. [ProMed]

Canadian soldiers are bringing home from dusty Afghanistan a powerful, drug-resistant bacterium that health officials have been worrying about for several years. Three Canadian soldiers who recently returned from Kandahar carrying Acinetobacter baumannii are under quarantine at a civilian hospital in Quebec City. Two civilian patients who came in close contact with the soldiers have also been isolated for fear they may have contracted the bug. The usually hospital-acquired germ, commonly found in soil and water, strikes weakened immune systems, especially in those recovering from wounds. It has been known to cause conditions such as pneumonia, meningitis as well as blood, urinary tract and wound infections. Some people carry the bacteria on their skin without showing symptoms. Two years ago, the Public Health Agency of Canada warned Canadian hospitals that outbreaks could happen after wounded soldiers returned home from Afghanistan either sickened by the strain, or simply carrying it in their system. A 2007 report in the publication Wound Care Canada said incidences of the strain have increased in American military hospitals. A spokeswoman of the hospital said it had treated between 15 and 20 soldiers carrying the organism since 2007. [ProMed]

Hematophagous bats, also known as "vampire bats" are carriers of a virus that causes diseases such as severe acute respiratory syndrome (SARS), Brazilian researchers reported. The Research Support Foundation of the State of Sao Paulo, which funded the project, announced early August that the work of the University of Sao Paulo identified the presence of such viruses in vampire bats (Desmodus rotundus). This type of bat, which feeds on blood of animals and can bite humans, in addition to transmitting diseases such as rabies, can also be a vector for transmitting the diseases caused by Corona viruses can cause intestinal problems, respiratory, and even the cerebral problems in birds and mammals, including humans. This virus became notorious in 2003, when it was discovered that it was the virus responsible for SARS {Severe Acute Respiratory Syndrome). According to a Faculty of Veterinary Medicine and Zootechnology of the University of Sao Paulo, the vampire bats were the hosts in which the coronavirus emerged for the 1st time. Until now, genetic studies indicate that the virus is very similar to the corona virus carried by bovines and to the virus that causes colds in humans. The viruses were found in samples from organs such as lung, liver and intestines of the bats. [ProMed]

Two pregnant women gave birth prematurely after eating contaminated chicken wraps that were sold in their thousands on Virgin Blue flights from Brisbane and the Gold Coast, triggering a national public health alert. The airline confirmed on Aug 6, 2009 that up to 5000 flights in May and June 2009 could have carried the snacks laced with potentially deadly Listeria monocytogenes bacteria. Five Queenslanders are known to have contracted listeriosis food poisoning after consuming the wraps, including the 2 women who gave birth prematurely, a known complication of the illness. Both women and their babies survived. Virgin Blue said it withdrew the chicken wraps at the end of June 2009, but health authorities say more cases could emerge, given that the incubation for Listeria poisoning is up to 70 days. Queensland Health is warning pregnant women who fear they could be victims of the food scare to see their doctor. Queensland Health says there has been a spike in listeriosis cases in 2009, with 9 recorded in Queensland and 56 across Australia. Listeriosis symptoms include fever, headache, tiredness, aches and pains, diarrhea, nausea, and abdominal cramps. More severe cases may lead to meningitis or septicemia. [ProMed]

Thousands of bats in a cave in Uganda are infected with a Marburg virus, a cousin of Ebola virus, researchers said in July 2009, strengthening the theory the mammals are natural carriers of the deadly viruses. A study by researchers at the Special Pathogens Branch at the U.S. Centers for Disease Control and Prevention (CDC) and at other laboratories in South Africa, Switzerland and Uganda found live virus in 5 percent of the bats tested in the cave, where miners were infected with a Marburg virus in 2007. The finding of active virus infection in approximately 5 percent of R. aegyptiacus bats and their population exceeding 100 000 in Kitaka cave in Uganda suggests there are likely over 5000 Marburg virus-infected bats in this cave, which is only one of many such cave populations throughout Africa. Researchers have long suspected bats were the natural reservoirs of Ebola viruses and Marburg viruses -- both lethal viruses in the same family, the Filoviridae. Ebola viruses can kill between 50 percent and 90 percent of patients, while Marburg is a bit less deadly. A natural reservoir is an animal that carries and transmits an infection without becoming ill. [ProMed]

Penguins and malaria are not 2 organisms you would normally associate with each other, yet biologists have found the malaria parasite in an endangered penguin species. Researchers took blood samples from 362 Galapagos penguins already listed as being threatened with extinction on 9 islands in the Galapagos archipelago. All of the birds appeared healthy, but the tests revealed that 19 of the penguins (5%) carried the Plasmodium parasite, which causes malaria. The infected birds were spread across the archipelago, suggesting the parasite is not restricted to one small colony of penguins. Galapagos penguins move around the islands, so the parasite is likely to spread further. Most penguin species are very susceptible to Plasmodium and avian malaria is a real problem in zoos. The mosquitoes that can carry Plasmodium arrived on the archipelago in the 1980s, presumably on incoming boats or flights. Researchers have been concerned that the parasite may take hold but had not found any evidence of it until now. [ProMed]

Maine health officials report back-to-back increases in confirmed or probable cases of Lyme disease in 2007 and 2008. The Maine Center for Disease Control and Prevention said there were more than 900 cases of the tick-borne illness in humans in 2008, an increase of 72 percent. In 2007, there was a 57% increase, the Maine Center for Disease Control and Prevention said. Lyme disease is caused by bacteria that are transmitted to humans through the bite of an infected deer tick. Most common in southern and coastal Maine, Lyme disease is gradually moving up the state. While the disease often causes symptoms such as joint pain and fatigue, it's much more serious for some people. For some, it brings fevers and meningitis-type symptoms. Sometimes, it's difficult to confirm a diagnosis. The problem is, most people don't remember a tick attachment and not everyone gets a rash. Lyme disease is distributed focally within the United States: it is considered endemic in 8 northeastern (Connecticut, Delaware, Maryland, Massachusetts, New Jersey, New York, Pennsylvania, and Rhode Island) and 2 upper Midwestern (Wisconsin and Minnesota) states, where 93 percent of cases were reported during 2003-2005. Lyme disease surveillance in Maine began in 1989 and the number of Lyme disease cases has increased steadily since 2000. [ProMed]

A Denver hospital has asked every patient who had surgery there over a 6-month period to come in for a blood test amid allegations that a former technician exposed up to 6000 people to hepatitis C. The 26-year-old technician is accused of injecting herself with painkillers meant for patients, then filling the used syringes with saline solution. She was arrested and appeared in court to be advised of the charges. Thousands of patients at 2 hospitals were exposed and 9 have tested positive for hepatitis C. The former technician started working at Rose Medical Center in 2008. She was suspended on mid-April 2009 after authorities began investigating her and was fired by the end of April 2009 after testing positive for a painkiller. She then went to work to another Surgery Center in Colorado Springs until early July 2009. Health officials said the technician took a blood test before starting her job in October 2008 and tested positive for hepatitis C. The technician, who remains in custody, will be in court again for a preliminary hearing on charges of tampering with a consumer product, creating a counterfeit controlled substance, and obtaining a controlled substance by deception or subterfuge. If convicted of all charges, she faces a maximum of 34 years in prison. [ProMed]

The Canadian Food Inspection Agency is warning people in London, Ontario (about 200 kilometres south west of Toronto), not to eat a certain ground beef product after 3 children in the area have become ill with an Escherichia coli infection. Over the last 5 days, the Middlesex-London Health Unit has received reports of 3 children with E. coli O157:H7 infection. In 2 of the cases, the common food consumed was a spiced ground beef product. The agency said the source of the 3rd child's infection is currently unknown. The most important thing is the need to cook ground beef adequately. The meat is certainly not sterile, and bacteria will persist in undercooked areas. This is especially true for organisms like E. coli O157:H7 that require only a small number of ingested bacteria to cause disease. Hints to prevent this illness related to ground beef are: 1) because ground beef can turn brown before disease-causing bacteria are killed, use a digital instant-read meat thermometer to ensure thorough cooking. Ground beef should be cooked until a thermometer inserted into several parts of the patty, including the thickest part, reads at least 71°C; 2) if you are served an undercooked hamburger or other ground beef product in a restaurant, send it back for further cooking; 3) avoid spreading harmful bacteria in your kitchen. Keep raw meat separate from ready-to-eat foods. Wash hands, counters, and utensils with hot soapy water after they touch raw meat. [ProMed]

A 14 year old boy from North Carolina is in hospital with a rare infection that cost him part of his nose and 5 teeth after swimming in a local lake. Doctors at University of North Carolina Hospitals in Chapel Hill are treating the boy for an infection caused by a bacterium called Chromobacterium violaceum, which was found in Hope Mills Lake. The Centers for Disease Control and Prevention says that fewer than 150 cases have been reported worldwide since 1927. The patient's father said his son is in serious condition but that antibiotics are beginning to clear the infection from the teen's blood. Doctors had to remove the left side of his nose and palate, and his father said he lost 5 teeth. Chromobacterium violaceum infection is typically found in tropical areas and was first described in 1905 as an infection in dead and dying water buffalo in the Philippines. The 1st human case was described from Malaysia in 1927. Most cases are reported during the summer months and are commonly associated with water exposure. The infection may be more likely to occur in patients who are immunodeficient. Most infections are associated with multiple cutaneous and visceral abscesses and may be associated with concomitant septic shock. [ProMed]

An inventory completed last month showed researchers of the USAMRIID at Fort Detrick had more than 9,200 more vials of disease samples than they had on record. The U.S. Army Medical Research Institute of Infectious Diseases searched all 335 of its refrigerators and freezers for the inventory, said Col. Mark Kortepeter, the institute’s deputy commander. The institute’s commander ordered the inventory Feb. 4, and the process was completed May 27. Overall, the institute holds more than 70,000 samples of so-called select agents, or diseases the government believes pose a severe threat to human health. The inventory process uncovered samples dating back several decades, and included vials of the pathogens that cause anthrax, ebola and rift valley fever. The vast majority of the found samples were likely working stock accumulated by researchers over several decades. Researchers determined that about half of the 9,200 samples had no further scientific value and destroyed them. The institute halted most of its research while it performed the inventory, but is now up and running again. [http://www.fredericknewspost.com/sections/news/displayUpdate.htm?StoryID=91568]

The Western Australia sky is raining dead birds in what is becoming a regular, and mysterious, event for the region. More than 200 ibises, ravens, ducks, gulls and a pelican were found dead or convulsing near Perth, raising fears of a mass poisoning. The discovery comes less than a year after the mystery deaths of 200 gulls only a few kilometres away, and 2 years after thousands of birds fell from the skies over the coastal town of Esperance after being poisoned by lead carbonate. The latest poisoning has been caused by the pesticide Fenthion, which is used both for domestic and industrial purposes and which is known to be highly toxic to birds. The Department of Environment and Conservation (DEC) has opened an investigation into whether it was a deliberate bird poisoning or caused by someone dumping large quantities of the pesticide. Fenthion is an organophosporous insecticide used in horticulture to control pests such as fruit fly and aphids and pest birds such as weaver birds. It is also sold for domestic use to control fleas on dogs and in domestic fruit fly sprays. [ProMed]

An 8-year-old New Mexico boy has died and his 10-year-old sister was hospitalized after both contracted bubonic plague, the 1st recorded human plague cases in the USA so far in 2009. New Mexico health officials did not immediately say on Thursday June 4, 2009 how the brother and sister contracted the infectious disease, but they are conducting an investigation at the family's residence to determine if there is any risk to other people. Plague is generally transmitted to humans through the bites of infected fleas, but also can be transmitted by direct contact with infected animals, including rodents, rabbits, and pets. Fleas collected from the area are being sent to the CDC for testing. Health workers also canvassed the neighbourhood to tell other residents that plague had been confirmed in the area. The CDC says an average of 10 to 15 persons contract the plague each year in the USA. Modern antibiotics are an effective treatment. [ProMed]

Ebolavirus, a filovirus, causes fever, vomiting, diarrhoea, and sometimes bleeding. There is no treatment or vaccine and 25-90% of infected people die. The virus is transmitted by direct contact with infected blood, body fluids, and tissues. New findings have emerged from data collected in the remote Kasai-Occidental and Kasai provinces of the Democratic Republic of Congo which experienced a large Ebola hemorrhagic fever outbreak in 2007 in which 186 people died. Some members of the research team helped discover in 2005 that fruit bats are a natural reservoir of the Ebola virus. For the new study, researchers interviewed locals about the background of the Ebola virus infection 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 4 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. Researchers say their study suggests infection is only transmitted after prolonged contact with an infected person, meaning it may be easier to contain an outbreak than was previously believed. [See the following publication: EM Leroy et al. Human Ebola outbreak resulting from direct exposure to fruit bats in Luebo, Democratic Republic of Congo, 2007. Vector-borne and Zoonotic Diseases, 28 Mar 2009, www.liebertonline.com/doi/abs/10.1089/vbz.2008.0167]

Parents in Wales are again warned to make sure their children have the MMR (measles, mumps, rubella) jab as the number of cases tops 200. Health chiefs fear one of the biggest measles outbreaks in Wales will become fatal after figures showed 207 people are suffering from the virus. Several people have been treated in intensive care units after the worst outbreak of the disease in years. MMR is a safe vaccine that protects children from the most severe viral rash illness of childhood. There is strong evidence that worldwide, as many as one in 500 children who catch measles will die, and another one in 500 will suffer permanent brain damage. The people most at risk of catching measles are children of school age or children between the ages of one and 4 who are not up-to-date with their vaccinations. After completing a 2-dose course of the MMR vaccine -- which also offers protection against mumps and rubella -- 99 per cent of children will be protected against measles. [ProMed]

Missouri's tick season officially got under way late in April with the year's 1st confirmed case of a potentially life-threatening tick-borne disease. The first illness involved a woman in her 80s from south of St. Louis. The woman contracted the disease known as ehrlichiosis, which can cause renal failure if left untreated. Ehrlichiosis is transmitted by the lone star tick and symptoms begin with a sudden onset of fever and headache. Patients often report fatigue and muscle aches as well as other flu-like symptoms. The illness can be treated with antibiotic doxycycline in both adults and children. State health department statistics show that the number of tick-borne illnesses in Missouri grew to 668 in 2008, up nearly 100 compared with 2007. That gave Missouri a rate of 11 tick-borne illnesses for every 100 000 Missourians. The most commonly reported tick-borne diseases in Missouri are Rocky Mountain spotted fever, ehrlichiosis, and tularemia. Tick checks are especially important for people over the age of 50, who have a higher risk of becoming seriously ill and being hospitalized if they are bitten by an infected tick. [ProMed]

The number of cases of Q fever reported among humans in the Netherlands has risen 'explosively' over the past few weeks according to a newspaper report. The paper says over 200 cases have been notified in recent days. Q fever was rarely known among humans in the Netherlands until 2007, when 168 cases were reported. In 2008, there were more than 1000 infections in the Netherlands. The infection is spread by livestock, which shed the bacteria in urine, faeces, birth products and milk. The bacteria can reach humans after faeces and dirty straw are used as fertilizer and blown about. The disease, which leads to spontaneous abortion in sheep and goats, causes flu-like symptoms in humans but can lead to lung infections. The pathogenic organism of Q fever is infectious with a very low inoculum and may be aerosolized over a distance. Coxiella burnetii, the causative agent, can be resistant to heat and desiccation and is highly infectious by the aerosol route. A single inhaled organism may produce clinical illness. Cattle, sheep, and goats are the primary reservoirs of C. burnetii. Other modes of transmission to humans, including tick bites and human-to-human transmission, are rare. [ProMed]

It is being reported that an outbreak of canine brucellosis on a puppy farm in Ireland could pose a serious public health risk as the disease can be passed on to humans. Two animal welfare organisations have reported that the puppy farm in question is home of up to 300 puppies. The farm's owner has refused to sign an undertaking not to move the dogs off-site before an official inspection can take place to investigate the extent of the problem. Canine brucellosis is transmissible to humans and can cause liver damage and arthritis. Brucellosis in humans is a potentially life-threatening disease and is difficult to treat. There are several varieties of brucellosis, all caused by bacteria of the genus Brucella. Humans can catch Brucella bacteria through contact with the body fluids of infected dogs, especially semen, urine, and vaginal fluids. Dogs can be infected with B. canis without showing any signs or symptoms, and infection can only be diagnosed with specific blood tests. Human infection with B. canis seems to require close contact with infected dogs or contact with bacterial cultures. The virulence of this organism for humans may be low. Approximately 30 cases have been reported worldwide since the 1960s. [ProMed]

The Global Polio Eradication Initiative began in 1988. By 2006, indigenous transmission of wild poliovirus (WPV) type 2 infection had been interrupted globally, and indigenous transmission of type 1 and 3 (WPV1 and WPV3) infection had been interrupted in all but 4 countries worldwide (Afghanistan, India, Nigeria, and Pakistan). Despite this success in controlling indigenous transmission, during 2002-2006, 20 previously polio-free countries in Africa and Asia had importations of WPV1 originating from Nigeria, and 3 polio-free countries in Africa had WPV1 importations originating from India. By the end of 2007, control efforts in all countries except Angola, Chad, Democratic Republic of the Congo, Niger, and Sudan had stopped transmission of WPV1 caused by these importations. However, during 2008-2009, multiple importations of WPV from countries with ongoing transmission resumed in Africa. An importation event is defined as detection of one or more polio cases in a country resulting from WPV transmission that genetic analysis shows to have 1st circulated in another country. During January 2008 - March 2009, 32 importations of WPV1 and WPV3 resulted in 96 polio cases in 15 African countries. Recent findings of WPV in sewage samples in Switzerland and Egypt, where no polio cases have been detected since 1984 and 2004, respectively, confirm that long-distance importations can occur and that high levels of vaccination coverage limit local transmission. [ProMed]

A new strain of Clostridium difficile has been linked to the deaths of 13 patients, and another 17 are being treated for the infection as doctors battle to control an outbreak at Eastbourne District Hospital. The particularly virulent new strain of C. difficile responsible for the outbreak, known as ribotype 027, can produce 20 times as much toxin as others, is known to cause a higher mortality rate, and is resistant to several drugs used to combat the infection. Most of the victims are frail and elderly patients and some of those who died had only been treated for fractures and had been expected to make a full recovery. In total there have been 62 cases of C. difficile since the beginning of 2009 at Eastbourne District General Hospital, and the Health Protection Agency has been called in to assist in containing the infection. The bug, which can take hold in the gut of patients who have been treated with antibiotics for other conditions, causes diarrhoea and in severe cases inflammation of the bowel. It is usually spread by healthcare workers who fail to wash their hands properly with soap and water -- not just alcohol gel -- between patients, and its spores can contaminate floors, bedpans, and door handles where they can survive for days. The latest data from the Health Protection Agency shows that there were 7061 cases of _Clostridium difficile_ in patients aged over 65 in hospitals in England between July and September 2008. In the same period in 2007 there were 10 884 cases. [ProMed]

New Jersey officials have advised nearly 3000 people who share a doctor to get tested after 5 cancer patients who visited the physician were found to have hepatitis B. Two cases of hepatitis B were confirmed in late February 2009 and health officials recently learned of 3 more cases. Ocean County decided to send a letter to all of the doctors patients dating back to 2002. The letter warns them of the risk and suggests they be tested for the liver diseases hepatitis B and hepatitis C and for HIV, the virus that causes AIDS. Hepatitis B is transmitted through exposure to infected blood, often by sexual contact or infected needles. The doctors office treats patients with blood disorders and cancer, some of whom receive chemotherapy there. The evidence that's available suggests the infections could be linked to the method the clinical staff used to administer injectable medications, such as chemotherapy. The doctor faces suspension of his medical license in connection with the outbreak and for other alleged health code violations. According to a report by the state epidemiology division, the doctor has infection control violations dating to 2002. Ocean County health officials said no new cases have been reported since the alert was issued. [ProMed]

The researcher who may have been exposed to the deadly ebolavirus was declared healthy and released from isolation at a German hospital Thursday (2 Apr 2009), having been spared the horrific symptoms of the disease. The woman had accidentally pricked her finger 3 weeks before with a needle used to inject Ebola into mice. It was not known if the virus actually entered her bloodstream, but she was given an experimental vaccine just in case. The vaccine had never been tested on humans. Scientists don't know if the vaccine saved her or if she was simply lucky not to get the disease during an excruciating 21-day waiting period. Doctors said they would now study her immune response for evidence of whether she actually contracted the virus, and whether the vaccine helped her defeat it. The vaccination only contained proteins capable of inducing antibodies against surface Ebola proteins. If she was building antibodies to other proteins, then they must have stemmed from a true infection. There are 2 other known accidents involving researchers who came into direct contact with a similar strain of Ebola. A Russian researcher died, and a British scientist became ill but survived. [ProMed]

In France a technician of the Afssa (Agence francaise de sécurité sanitaire des aliments) was preparing DNA in their Level 3Laboratory by transferring a colony of anthrax from a culture to distilled water in a glass vial, which was then heat-inactivated for DNA processing. They normally submerge this glass tube in boiling water for 20 minutes and then check that there are no surviving cells or spores by plating out a loopful on sheep blood agar and reading the plate after 24 hours. Due to new regulations in the Level 3 Laboratory, they had just gone over to dry heating the glass vial and supernatant on a hot plate at 99°C for 20 minutes. Vials were then centrifuged and the supernatant recovered. As before, a check loopful was plated out on sheep agar for each supernatant, but because of the many hundreds of times this had been done before without anything growing, i.e.the culture had always been killed, the technician took the 6 vials of heated supernatant out of the Level 3+ lab and went to the Level 2 DNA laboratory before she had read the check plates the next day. The technician opened the vial after centrifugation in a safety cabinet. The exposure, if any, was trivial, but the personnel in the Level 2 laboratory were given antibiotics. [ProMed]

The accidental exposure of a scientist to Ebola virus on 12th March 2009 has triggered a series of teleconferences by Ebola scientists on 2 sides of the Atlantic united around a single goal: to help save the life of their colleague, an unnamed virologist at the Bernard Nocht Institute for Tropical Medicine in Hamburg, Germany, who pricked herself in the finger during an experiment. No approved treatments exist for Ebola virus infection, but at the sessions, researchers and physicians discussed the results from a raft of recent studies, some not yet published, into treatments that could prevent or slow the disease, which has a mortality rate of up to 90 percent. In the end, the patient and her doctor opted not for an experimental drug but for a new type of living vaccine that has never been tested in humans but has been shown in monkeys to help fight the virus even when given after exposure. An injury from a virus-laden syringe often doesn't lead to infection and disease, because the amount of virus entering the body is small. But the researcher's doctors want to reduce the risk as much as they can. The vaccine is based on vesicular stomatitis virus, a pathogen of cattle, horses, and pigs, whose glycoprotein has been replaced with that of an Ebola virus. In 2003, researchers showed that a single shot of the virus offers protection in monkeys (Science, 14 November 2003, p. 1141). In a 2008 study, researchers showed that when given 20 minutes after a lethal shot of Ebola-Sudan virus, half of the monkeys got sick, but all survived. With Ebola-Zaire virus, the subtype to which the researcher in Hamburg was exposed, 5 out of 8 monkeys survived the virus. The last known lab exposure to an Ebola virus, at USAMRIID in 2004, also involved mice. While a scientist tried to inject one of the animals using a hypodermic needle that had previously been used on other mice, the animal kicked the syringe, causing the needle to pierce the person's left-hand gloves, resulting in a small laceration. That researcher did not become infected, however. [ProMed]

A member of the Hamburg Tropical Institute has received a needle stick injury and possibly has been infected with a dangerous pathogen. The woman is being treated in Hamburg University Hospital on suspicion of Ebola virus infection. The victim worked in the Bernhard Nocht Institute for Tropical Medicine, where on March 12 while working in the high security wing received a needle stick injury despite wearing protective clothing. The woman has been transferred to an isolation unit for treatment of the potentially highly contagious disease. So far the patient has shown no signs of illness. Risk of transmission of infection has been discounted. In consultation with an international team of experts and the patient herself an experimental vaccine was administered which has not been used previously humans. Ebola virus is transmitted by direct contact with body fluids. The disease progresses to internal bleeding, and onset of death is rapid. There is no cure: 50 to 90 percent of those infected die. In the case of the type of Ebola virus responsible for the Hamburg incident, mortality can be as high as 90 percent. In the most recent major outbreaks in the Congo and in Uganda, hundreds of people died. [ProMed]

Scientists say they have solved the mystery of what killed the hundreds of seabirds that washed onto Monterey Bay, California's shores in late 2007. Their answer identifies a previously unrecognized cause of death. First several false leads were eliminated. The episode occurred around the same time as a nearby oil spill and the aerial spraying of a pesticide. But the birds' water-logged feathers, coated with an unknown substance, provided a clue that more unusual forces were at work. Their investigation produced the real culprit: sudsy foam that stripped the natural waterproofing from the birds' feathers. A red tide -- a major algae bloom that can harm wildlife and humans – had produced the previously unknown substance, they found. Such tides have occurred before, but 2007's was particularly large and formed just as big waves churned the choppy waters and many migrating birds had arrived. Though the bad timing may be why 2007 was the 1st time birds were affected. Red tides, which are sometimes linked to nutrient pollution and warming waters, are increasing both in Monterey Bay and around the world. [ProMed and www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0004550]

The U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) has suspended research involving select agents and toxins after a spot inspection found four vials of Venezuelan equine encephalitis (VEE) that weren't in its electronic database. Some 350 researchers and technicians are affected by the stoppage, which began on 6 February and could last 3 months or longer as officials open up every freezer and refrigerator to take stock of all hazardous biomaterials. The lab, the largest U.S. defense facility for work on deadly pathogens, has been under intense scrutiny since the Federal Bureau of Investigation (FBI) named former USAMRIID researcher Bruce Ivins as the perpetrator of the 2001 anthrax letter attacks. Last month, all lab administrators were ordered to file a Serious Incident Report if they discovered materials that did not have a corresponding record in the lab's computerized inventory. Traditionally, such materials would have been added to the inventory without any disruption in the workflow. Officials expect to find materials in addition to those listed in the database because of human errors made when the lab switched from a paper to a computerized system in 2005. [Science, 2009, Vol. 323, p 861]

Baxter International Inc. in Austria unintentionally contaminated samples with the bird flu virus that were used in laboratories in 3 neighbouring countries, raising concern about the potential spread of the deadly disease. The contamination was discovered when ferrets at a laboratory in the Czech Republic died after being inoculated with vaccine made from the samples early February 2009. The material was intended for use in laboratories, and none of the lab workers have fallen ill. The incident is drawing scrutiny over the safety of research using the H5N1 bird flu strain that's killed more than three-fifths of the people known to have caught the bug worldwide. Some scientists say the 1977 Russian flu, the most recent global outbreak, began when a virus escaped from a laboratory. The virus material was supposed to contain a seasonal flu virus and was contaminated after human error. Labs have been sanitized, potentially contaminated materials have been destroyed, and employees were tested and considered not to be at risk. According to the manufacturer the vaccine has been destroyed. [ProMed]

On 23 Jan 2009, the Government of the Philippines announced that a person thought to have come in contact with sick pigs had tested positive for Ebola Reston Virus (ERV) antibodies. On 30 Jan 2009 the Government announced that a further 4 individuals had been found positive for ERV antibodies: 3 farm workers at the 2 farms that are currently under quarantine because ERV infection was found in pigs and one butcher from a slaughterhouse. The Philippine Department of Health has said that the people who tested positive appear to be in good health and have not suffered from any significant illnesses in the past 12 months. The investigation team reported that it was possible that all 5 individuals had been exposed to the virus as a result of direct contact with sick pigs. The use of personal protective equipment (PPE) is not common practice among these animal handlers. From these observations and previous studies of ERV, the virus has shown it can be transmitted to humans, without resulting in illness. However, the evidence available relates only to healthy adults and it would be premature to conclude the health effects of the virus on all population groups. The threat to human health is likely to be low for healthy adults but is unknown for all other population groups, such as immuno-compromised persons, persons with underlying medical conditions, pregnant women and children. [ProMed]

Swiss federal health authorities issued an alert about the measles outbreak in the canton of Vaud, reminding people that the virus causes serious illness and vaccinations are the only protection against the potentially deadly disease. Since the start of 2009, 50 new cases have been declared in Switzerland in the canton of Vaud -- the number of cases seen in a total year when there is not an epidemic. Four new schools were affected when brothers and sisters of the 17 students with measles from the Rudolf Steiner School in Crissier also fell ill. Children and teenagers who have not been vaccinated and who have had contact with anyone with measles must by law be sent home for 3 weeks. Bern noted that since November 2006 Switzerland has seen 3400 cases of measles, with one death end of January in Geneva, 250 hospitalizations and 500 complications that included 143 cases of pneumonia and 8 cases of encephalitis. Six people have died in Europe from measles in recent years. [ProMed]

Experts of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) have been warning of the dangers of tick-borne encephalitis (TBE). Now, hikers are among those in danger, because tick numbers have been climbing higher. The year 2008 marked the 1st time that ticks infected with the TBE virus were detected at more than 1500 meters above sea level, one of the consequences of global warming. The ISW-TBE has been calling for vaccination against TBE to become a standard preventive measure for everybody travelling to endemic regions. For travellers, failing to undergo preventive vaccination may have far-reaching consequences. TBE, a viral disease transmitted by ticks affects the central nervous system. Its diverse forms of expression range from minor neurological dysfunction to impaired concentration, depression, severe paralysis, or even death. Since 1990, more than 157 500 cases of TBE have been registered in Europe, corresponding to 8755 cases annually. Its climatic conditions make Austria a high-risk country for TBE. Because vaccination coverage in Austria is exceptionally high, the number of TBE cases has come down from 677 in 1979 to 86 in 2008. Once infected, there is no specific treatment available. [ProMed]

An Hib (Haemophilus influenzae type b) meningitis outbreak has killed one Minnesota infant and sickened 4 others. Before a vaccine became available in 1992, some 20 000 U.S. children under age 5 got severe Hib infections every year, resulting in about 1000 deaths. Minnesota hadn't had a Hib death since 1991. Now the state is facing its biggest outbreak since 1992. One of the 5 Minnesota Hib meningitis cases was in a 5-month-old child too young to have finished its 1st series of Hib shots. Another case was in a child who got all the shots but who turned out to have an immune deficiency. The other 3 cases -- including the death -- were in infants whose parents refused to vaccinate them. The CDC is warning all parents of young children to make sure their kids have finished their primary Hib vaccination. There has been a Hib vaccine shortage since December 2007, when Merck shut down its vaccine manufacturing plant because of possible bacterial contamination. Merck made about half the Hib vaccine used in the U.S. Minnesota data suggest that the Hib vaccine shortage is playing a role in the present outbreak. A quick study shows that 18 percent of 7-month-old Minnesota kids who got other vaccines did not complete their primary Hib vaccination. Before the shortage, widespread Hib vaccination kept infection rates low enough to protect even unvaccinated kids -- a phenomenon called "herd immunity." [ProMed]

Levels of drug-resistant tuberculosis (TB) in China are nearly twice the global average and almost 10 per cent of cases are resistant to the most effective 1st-line drugs. China has an estimated 4.5 million cases of people with TB, the 2nd largest number of TB cases in the world after that of India and is struggling with high levels of drug-resistant TB, which is costly and difficult to treat. In a survey involving 10 provinces between 1996 and 2004, researchers found that multi-drug resistant (MDR) TB made up 9.3 per cent of all cases, 5.4 per cent of new cases, and 25.6 per cent of previously treated cases. All 3 figures were markedly higher than global MDR-TB figures, which stand at 4.8 per cent for all cases, 3.1 per cent for new cases, and 19.3 per cent for previously treated cases. Regular TB requires a 6 to 12 months course of treatment, but many patients tend to give up because of side effects or a careless attitude. But this comes with a serious risk, as they may develop drug resistance and require stronger drugs the next time round, which may be too expensive or simply unavailable. [ProMed]

Award-winning milk firm Trioni, a Welsh farming success story, has suffered a devastating setback after its dairy herd was hit by bovine TB. Some 335 cows from its dairy herd of 390 are to be slaughtered in an attempt to stop the disease in its tracks. Some 230 youngstock have already been culled. The family-run business, which makes the Daioni range of organic flavored milk, has insisted production levels will not be affected. It has also stressed the TB outbreak poses no health risk to consumers, as all its milk is pasteurized. The company is working with the State Veterinary Service and Assembly Government to control the outbreak. Trioni developed its Daioni ("goodness" in Welsh) range of organic milk drinks as an alternative to the fizzy sugary drinks generally available for children and launched them in 2003. The multi award-winning business has expanded its customer base to include the Welsh Rugby Union and a number of Premiership football teams. It also exports to several countries. [ProMed]

From 2003 to 2007, type 1 polio originating in northern Nigeria spread to cause outbreaks in 20 previously polio-free countries, including across west Africa, the Horn of Africa, and as far away as Indonesia and Yemen. The outbreaks in these 20 countries resulted in 1517 cases and cost upwards of USD 500 million in international emergency outbreak response funds. In 2008, northern Nigeria is experiencing an outbreak of wild poliovirus type 1 [WPV1], which has spread internationally into nearby countries in West Africa. Since April 2008, cases due to type 1 polio genetically linked to viruses from northern Nigeria have been detected in Benin, Burkina Faso, Ghana, Niger, Mali and Togo. In 2008, Nigeria accounts for 80 percent of type 1 polio cases in the world. The risk of additional importations into these West African countries depends fully on the quality of outbreak response activities in Nigeria and the re-infected countries themselves. [ProMed]

2 Zimbabwean soldiers have been killed by the deadly Ebola virus that has killed 11 people in western Congo. A total of 35 people have been infected in Kaluemba, Western Kasai province, where the epidemic began in late November 2008, health officials of the Democratic Republic of the congo confirmed on 1 Jan 2009. The government of Congo reports suspected cases of the highly contagious disease identified in the Congo DR had infected 2 Zimbabwean soldiers who both died within 24 hours. Last year, Ebola killed at least 187 people in the same region. Area villagers have recently reported diarrhoea and vomiting of blood according to Medecins Sans Frontieres. These doctors are monitoring 102 people who have been in contact with those infected. According to the World Health Organisation, as of 31 Dec 2008 so far only three of 12 fatalities in the outbreak of hemorrhagic fever-like illness in the Mweka District of Kasai province have been confirmed by laboratory testing to be cases of Ebola hemorrhagic fever. [ProMed]