A man in Massachusetts has contracted rabies, the 1st time a human has contracted the disease in Massachusetts in 75 years. Public health officials said they believe the Barnstable County man who is over the age of 60 contracted the virus from a bat at his home. He is listed in critical condition at a Boston-area hospital. The man's family also may have been exposed, and they are receiving treatment. Health officials said the Barnstable County case does not pose a risk to the general public. Rabies is a viral disease that infects the central nervous system, ultimately causing disease in the brain and death. It can be fatal if treatment is not administered prior to the onset of symptoms. Early-stage symptoms include fatigue, headache and fever. It can progress to acute pain, violent movements, uncontrolled excitement, depression and hydrophobia. In 1983, a 30-year-old Waltham man died after being exposed to rabies, apparently from a dog bite in Africa. The man developed symptoms about 3 months after returning to the USA and was admitted to Waltham Hospital for treatment. He died on 28 Jan 1983, according to records from the U.S. Centers for Disease Control. [ProMed]

Scabies, a parasitic skin disease caused by Sarcoptes scabiei is traditionally a prevalent condition in developing countries, where healthcare systems have many deficiencies. Nevertheless, its worldwide spread and being extremely contagious makes it possible to find outbreaks in unsuspected places. In fact, as it was reported by healthcare workers from Febles Campos Hospital in Santa Cruz de Tenerife, at least five persons have been affected by a scabies outbreak, which has led to isolate two wards in the aforementioned hospital. The control measures consist in isolating affected persons, strengthening sanitary measures, and using scabicide compounds for treating patients. Healthcare workers from the hospital declared that the two isolated wards may accommodate 50 persons. Scabies is frequently found in travellers, it may reach every person in a given population, and it is a very frequent and easy to treat skin disease. Its main symptom is intense itching, which becomes more intense at evening and night time and also with heat. Itching occurs because of an allergic reaction from the body against the parasite. Small papular lesions, blisters, and even some ulcerative and crust-forming lesions may occur. The condition does not cause fever, unless there is a superimposed bacterial infection. Being quite contagious, therapy must be administered to every person in the household. The parasite may live up to 30 hours on clothing; consequently clothes must be disinfected with boiling water or exposing them to direct sunlight for around four hours. [ProMed]

The Louisiana Department of Health and Hospitals is warning residents about the dangers of the improper use of neti pots. The warning follows the state's 2nd death this year caused by Naegleria fowleri, the so-called brain-eating amoeba. A 51-year-old woman died recently after using tap water in a neti pot to irrigate her sinuses and becoming infected with the deadly amoeba. In June [2011], a 20-year-old man died under the same circumstances. Naegleria fowleri infects people by entering the body through the nose. A neti pot is commonly used to irrigate sinuses. Tap water is safe for drinking, but not for irrigating the nose. It's also important to rinse the irrigation device after each use and leave open to air dry. Naegleria fowleri infection typically occurs when people go swimming or diving in warm freshwater lakes and rivers. In very rare instances, Naegleria fowleri infections may also occur when contaminated water from other sources enters the nose when people submerge their heads or when people irrigate their sinuses with devices such as a neti pot. You cannot be infected with Naegleria fowleri by drinking water. Naegleria fowleri causes the disease primary amoebic meningoencephalitis, a brain infection that leads to the destruction of brain tissue. The initial symptoms include headache, fever, nausea, vomiting, and stiff neck. Later symptoms include confusion, lack of attention to people and surroundings, loss of balance, seizures, and hallucinations. After the start of symptoms, the disease progresses rapidly and usually causes death within one to 12 day. In the 10 years from 2001 to 2010, 32 infections were reported in the U.S. [ProMed]

On 29 Jun 2011, the Wyoming Department of Health was notified of 2 laboratory-confirmed cases of Campylobacter jejuni enteritis among persons working at a local sheep ranch. During June 2011, 2 men had reported onset of symptoms compatible with campylobacteriosis. Both patients had diarrhoea, and one also had abdominal cramps, fever, nausea, and vomiting. One patient was hospitalized for 1 day. Both patients recovered without sequelae. During that month, both patients had participated in a multiday event to castrate 1600 lambs. Both men reported having used their teeth to castrate some of the lambs. Among the 12 persons who participated in the event, the patients are the only 2 known to have used their teeth to castrate lambs. During the multiday event, a few lambs reportedly had a mild diarrheal illness. Neither patient with laboratory-confirmed illness reported consumption of poultry or unpasteurized dairy products, which are common sources of exposure to C. jejuni. The patients resided in separate houses and did not share food or water; none of their contacts became ill. Both patients provided stool specimens for laboratory testing; C. jejuni was isolated from each. Ranch owners and employees were advised to use standardized, age-specific techniques for lamb castration (for example, Burdizzo, rubber rings, or surgery) and to wash their hands thoroughly after contact with animals (3). [ProMed]

A 3rd baby at a hospital where 2 babies died in an Escherichia coli outbreak is suspected of having the potentially fatal infection. According to health officials the latest case is a baby who is carrying the bacteria without any signs of infection. The maternity unit at Singleton Hospital, in Swansea, south Wales, continues to be restricted to full-term babies following the deaths. Hopes that it could reopen in full to all pregnancies yesterday were put on hold. The baby has been a patient in the neonatal unit at the hospital within the past month. Further tests are now under way to confirm the cross infection. Officials of the hospital announced that 2 babies had died from an extended spectrum beta-lactamase (ESBL) E. coli infection on Nov 22, 2011. Health chiefs have stressed that ESBL E. coli is not the same as E. coli O157, which causes food poisoning. In most people ESBL E. coli does not cause harm but in vulnerable individuals, such as premature babies and the elderly, it can cause serious infections. An investigation into how the E. coli bug was transmitted is continuing. An independent investigation, reviewing the hospital's response to the outbreak, is to be carried out by Healthcare Inspectorate Wales. Extra precautions have been put in place at the hospital's maternity unit. Additional precautions were taken, including restricting visitors to the maternity unit, and visitors are asked to wash their hands and use hand hygiene gel. [ProMed]

James Cook University researchers have linked native mammals and pets to human cases of a dangerous fever normally associated with stock animals. Of the 15 cases of Q-fever reported nationally in October 2011, 10 were in Queensland. Traditionally, people in the meat industry were considered to be at risk of Q-fever. About 20 percent of those affected by Q-fever will be hospitalized, and 5 percent will develop chronic Q-fever, which can affect the heart. Q-fever was 1st described in Australia. It was called "Query fever" because the causative agent was initially unknown. Coxiella burnetii, the causative agent, was discovered in 1937. This organism is an agent that can be resistant to heat and desiccation and highly infectious by the aerosol route. A single inhaled organism may produce clinical illness. Indeed, in non-human primates, the dose to kill 50 percent of the primates was found to be 1.7 organisms. Cattle, sheep, and goats are the primary reservoirs of C. burnetii. Infection has been noted in a wide variety of other animals, including other species of livestock and domesticated pets. C. burnetii does not usually cause clinical disease in these animals, although abortion in goats and sheep has been linked to C. burnetii infection. Organisms are excreted in milk, urine, and feces of infected animals. Contact with contaminated wool is known to be a mode of transmission. [ProMed]

A total of 471 people have developed a wheat allergy after using a type of popular green face soap and some of them have become seriously ill since mid-november. The company selling the soap began recalling it and has said the soap now on the market is safe as it does not contain the agent that caused the allergic symptoms. According to the official citing an accident report by the company, 66 people among the total were taken to hospital after developing serious conditions including becoming unconscious. The company sold about 46.5 million units of the old type of the soap, touting it as the country's best-selling face wash in 2009. The Ministry of Health, Labor and Welfare has called on buyers of the old products not to use them and to return them to the maker. Separate from the company’s report, the ministry has received reports from medical institutions that 49 people have developed similar serious allergic symptoms. In 19 cases the ministry could not rule out the possibility that the use of the soap triggered the symptoms. Meanwhile, the National Consumer Affairs Center of Japan said it had received a total of 938 complaints as of mid-november 2011 about health damage caused by the soap. [ProMed]

A cluster of 2 confirmed cases of anthrax were reported in October 2011 from a small village with a population of 3400 people, in southeast Romania. One was a fatal case of cutaneous and anthrax meningoencephalitis, while the other had cutaneous anthrax. Both cases had been exposed to one Bacillus anthracis-infected cow via consumption of its meat or being involved in its slaughter. On 7 Oct 2011, a person in their 20s was admitted to a local hospital with fever (40°C), chills, malaise, pustular lesions on both forearms and respiratory arrest. After that, the patient developed meningitis symptoms and died on 9 Oct 2011. The cause of death was reported as cardiovascular and respiratory failure and septic shock due to disseminated infection with B. anthracis, confirmed by presence of the bacterium on the skin and in the bloody cerebrospinal fluid (CSF). A second person in their 20s was identified from the same village and subsequently confirmed as a case of cutaneous anthrax. The onset of symptoms in this case was 3 Oct 2011, and they included pustules on the left-hand index finger. The case was hospitalised on 7 Oct 2011 and received penicillin and ciprofloxacin intravenously. The patient responded well to the treatment; the general condition is now good, and the patient was discharged from hospital. In the epidemiological investigation, a B. anthracis-infected cow from the village where the cases lived, slaughtered on 28 Sep 2011 in a private backyard, was identified as the source of infection. [ProMed]

More than 20 cases of the life-threatening bacterial infection leptospirosis have been reported in Detroit-area dogs in the past 3 weeks. Experts diagnosed a specific strain of the disease, which can cause fatal damage to dogs and can be transmitted to humans. In most cases, the dogs were not vaccinated against leptospirosis, or they had an uncertain vaccination history. Because this particular type of leptospirosis is associated with contact with rats, stray dogs are typically thought to be at highest risk. However, what is particularly unusual about this outbreak is that the dogs affected are not stray animals, but people's pets. Many veterinarians have never seen this type in dogs because it was markedly reduced by vaccination. This particular strain of lepstospira bacteria can cause severe disease in humans and animals. It is commonly carried by rats but also can be transmitted dog-to-dog or dog-to-human. The bacteria infecting these animals can reside in their kidneys, and the host animal may or may not appear ill. They contaminate their environment with living leptospira when they urinate. Pets can become infected by sniffing this urine or by contacting standing water that becomes contaminated by rain and water runoff. The bacteria spread rapidly through an animal's blood stream, usually causing fever, depression and vomiting. [ProMed]

Swedish researchers have discovered a new tick-borne illness that can cause blood clots in the legs and lungs, with 3 cases having been reported in Sweden. A total of 8 cases of the disease have been reported so far, with patients in Germany, Switzerland, and the Czech Republic also having been infected. All of those affected by the disease suffer from a weakened immune system. The illness, which researchers call "neo disease" after the bacterium that causes it (Candidatus Neoehrlichia mikurensis) also brings about flu-like symptoms with long-lasting high fevers, coughing, and aches. The disease can be treated with antibiotics. The 1st case was discovered in the summer of 2009 after a 77-year-old man from Gothenburg came down with a high fever and lost consciousness. During his treatment, doctors discovered blood clots in his leg and lungs. The man's fever returned several times and doctors eventually found traces of an unknown bacterium in his blood. The disease, which is transmitted by ticks, had never before been reported in Sweden and it was unclear what caused the disease in humans. The 2 additional Swedes who have become ill due to the bacteria are in their 60s and 70s. According to researchers, 10 percent of ticks in southern Sweden carry the bacteria. [ProMed]

The Bay Area is the epicenter of a liver cancer epidemic. There are more cases of liver cancer in Santa Clara and San Francisco counties than anywhere in the United States. Largely caused by hepatitis B virus (HBV) infection, liver cancer is lethal. According to the World Health Organization (WHO), it kills nearly 750 000 people each year. The 5 year survival rate after diagnosis is just 15 per cent. The good news is that most cases of liver cancer can be prevented. There is an effective and safe vaccine for HBV that the Centers for Disease Control and Prevention and WHO call the 1st "anti-cancer" vaccine. HBV is also easily diagnosed with a simple blood test. The challenge is to educate, test and vaccinate as many people as possible, especially those at greatest risk. HBV, which can appear in either chronic or acute form, is responsible for 80 per cent of liver cancers. HBV is called a "silent killer" because most people with chronic infection often have no symptoms. By the time they realize they have the disease, it is too late for effective treatment. Sometimes people only find out about the disease when they are diagnosed with liver cancer. Untreated, HBV can also lead to cirrhosis and liver failure. HBV is transmitted much the same way as HIV. It is only transmitted through blood or semen, but it is 100 times more infectious than HIV. [ProMed]

An Australian man is gravely ill in hospital after eating 2 slugs as part of a dare. The rat lungworm parasite, also known as Angiostrongylus cantonensis, is passed to slugs from rodent droppings. Doctors believe that the 21-year-old contracted the rare rat lungworm parasite from the slugs. The disease, which is a type of meningitis, can lead to swelling of the brain and spinal cord and has been known to be fatal. It can also be caught from raw vegetables or fruit which have not been washed properly. Doctors said the man told them he had swallowed 2 slugs from a Sydney garden after a dare and had then fallen ill. He has spent the past month in hospital in Sydney but is expected to survive. One relative said that the man had spent some time in intensive care. The New South Wales health department said that slugs such as the giant African snail could infect humans with bacteria, viruses and parasites. Symptoms of the disease, which is not infectious, include headaches, a stiff neck, tingling or pain in the skin, fever, nausea, and vomiting. [ProMed]

A total of 9 more cases and 3 more deaths have been reported since 3 Oct 2011 in the Listeria outbreak tied to cantaloupe, bringing the totals to 109 cases with 21 deaths according to the Centers for Disease Control and Prevention (CDC). Most of those sickened in the outbreak are over the age of 60, and the median age is 77. Nearly all patients for whom information was available -- 105 of 107 -- were hospitalized. CDC officials have called the outbreak the most deadly food-borne disease episode in a decade. Last week officials said they expected reports of cases to continue for several weeks, as the incubation time for listeriosis is up to 2 months. Cantaloupe grow on a vine on the ground and the rind can become contaminated with enteric pathogens by contact with contaminated soil, fertilizer, or water used for irrigation or washing. Contamination could also occur later during the distribution process. Cutting through the outer skin can then contaminate the pulp of cantaloupe, if washing of the outside is inadequate. It is therefore important to wash the melon thoroughly before cutting into it, since bacteria can grow on the rind. However, because Listeria multiple at refrigerator temperatures, inoculation of the pulp by even low numbers of the organism can result in high-grade contamination of refrigerated product. [ProMed]

An 8 month E. coli O157 outbreak across the UK left 250 people ill and one dead, but was not publicized at the time because its origins were unknown. After 6 months of investigations the infection was ultimately linked to people handling loose raw leeks and potatoes in their homes, said the Health Protection Agency. The cases began in December 2010 and continued until July 2011. In total 250 victims, 100 of them under 16, were left sick with vomiting and diarrhoea. Of those, 74 needed hospital treatment, including 4 who developed haemolytic-uremic syndrome which can lead to kidney failure. One unnamed patient, who had underlying health problems, died. Unlike other E. coli outbreaks it was not possible to identify a single source for the outbreak, such as a commercial or children's farm, or food producer. It was only after a 2nd round of in-depth interviews with 30 sufferers that investigators realized that victims were 40 times more likely to have been in a home where people handled leeks sold loose and 12 times more likely to have been in a household where potatoes were bought in or sold from sacks had been handled, compared with a control group of 62 unaffected people. Soil on the vegetables is thought to have been the likely source of the E. coli bacteria. [ProMed]

CDC is collaborating with public health officials in several states, including Colorado, and the FDA to investigate a multistate outbreak of listeriosis. Listeriosis is a serious infection usually caused by eating food contaminated with the bacterium Listeria monocytogenes. Investigators are using DNA analysis of Listeria isolated from patients to identify cases of illness that may be part of this outbreak. As of 20 Sep 2011, a total of 55 persons infected with the 4 outbreak-associated strains of Listeria monocytogenes have been reported from 14 states. All illnesses started on or after 4 Aug 2011. Listeriosis illnesses in several other states are currently being investigated by state and local health departments to determine whether they are part of this outbreak. Most ill persons are over 60 years old or have health conditions that weaken the immune system. Eight deaths have been reported. About 800 cases of Listeria infection are diagnosed each year in the USA, along with 3 or 4 outbreaks of Listeria-associated food borne illness. [ProMed]

The University of Chicago has suspended research in a lab after a scientist developed a skin infection from the same kind of bacteria being studied there. The scientist was hospitalized late in August 2011 and had surgery to remove the infected tissue but has been released. The incident happened 2 years after another UC scientist studying a weakened strain of plague contracted the disease and died. The university says the cases are drastically different. The new case involves a germ called Bacillus cereus that can cause food poisoning. The university says it isn't clear how the scientist got infected, but it has been disinfecting the lab as a precaution, and has contacted public health authorities. No one else has gotten sick. Bacillus cereus is a common cause of diarrhoea, especially in South East Asia. How this laboratory scientist got a skin infection raises questions about UC laboratory protocols and routine use of plastic gloves, and awareness of specific risks such that medical aid was sought at a relatively late stage -- the doctors believed it necessary to excise the infected tissue. [ProMed]

The dean and party secretary of the animal medical school at Northeast Agricultural University, Northeast China's Heilongjiang province, have been removed from their positions due to a group of staff and students being infected by a serious disease through the department's laboratory. Earlier in 2011, 27 students and a teacher were found infected with brucellosis, an infectious disease which can lead to significant incapacitation. They were sent to a local hospital for treatment. One student, a senior at the application technology department of the university, suffered from joint pain, fatigue, sweating and a high fever in January 2011. The symptoms were later diagnosed as brucellosis. The senior student and another 29 students did a sheep anatomy experiment in a lab of the animal medical department on 19 Dec 2010. The lab's equipment was in disarray, and the whole environment was unsanitary where the students conducted the anatomy. The mode of transmission here is unclear, but to have an attack rate of over 90 percent suggests that aerosolization occurred during the dissection. [ProMed]

The number of people infected by tick-borne diseases, such as encephalitis, has gone up this year. So far in August 2011, 66 cases of the deadly tick-borne encephalitis have been reported, which is more than during any other month in the past 4 years. It looks like there will be more cases in total in 2011. The season for tick-borne encephalitis started early. The weather plays a big role when it comes to spreading the disease since a mild winter and a warm summer usually means more ticks and also that people spend more time outdoors. In total this year 144 cases of tick-borne encephalitis have been reported already compared to the total of 174 for the whole of 2010. [ProMed]

A suspected case of canine rabies was notified to the official veterinary services of the district of Vendee, France on 6 Aug 2011. The dog was a 3-month-old Jack-Russell-type puppy that presented with behavioural changes consisting of progressive sleepiness on 1 Aug 2011 and later, with aggressiveness. The dog was admitted to a veterinary clinic on 6 Aug 2011 and died the following day. Rabies was suspected on admission, and the dog's body was sent shortly after death to the National Reference Centre for Rabies for biological diagnosis, where rabies was confirmed one day after receipt. The owners of the dog were a French family who spent holidays in Morocco. They found and adopted the stray dog. They travelled back to France with the dog by car and ferryboat. The dog was not vaccinated against rabies and conditions required for importation of dogs and entry into the European Union were not respected. In France, the dog did not wander unsupervised but was presented by a child of the family to several persons among her social contacts. All persons identified in France were contacted by the physician in charge from the anti-rabies clinic at the university hospital in Nantes to evaluate their individual risk of contamination with regards to the nature and date of contacts. [ProMed]

Oregon strawberries, an iconic crop that heralds summer and has long been a source of state pride, caused the nation's 1st Escherichia coli (O157:H7) outbreak ever traced to the fruit, killing one woman and sickening 16. The last of the berries was sold 1 Aug 2011, but health officials are worried that consumers might have stored some of them in the freezer or turned them into uncooked jam. The outbreak has sent 4 people to the hospital, including 2 people who suffered kidney failure. One of them, an elderly woman in Washington County, died of kidney failure. The 1st person became ill 10 Jul 2011 and the last one reported getting sick 29 Jul 2011. E. coli O157:H7 has an incubation period from 1 to 10 days. Strawberries had never before been implicated in an E. coli O157:H7 outbreak in the US, and state officials weren't sure at first what was making people sick. The 1st case appeared to be an isolated illness. Oregon Public Health officials put it in their files and moved on. Then lab results of 2 more cases, a married couple and then the health officials were investigating the cases. [ProMed]

Hospitals in the south west of France have reported a growing number of poisoning cases from people who have picked inedible mushrooms. Health authorities in Aquitaine and the Midi-Pyrenees say many of the people affected are tourists who have benefited from the abundance of early mushrooms in 2011 but have not taken the necessary precautions. Some 30 cases of poisoning have been reported in the Tarn-et-Garonne in recent days and 21 in the Lot. Symptoms include abdominal pain, vomiting, and diarrhoea. Recovery is normally quick, after 24 hours of rehydration. It is important that mushroom-pickers seek advice from a pharmacist if they are not sure whether their collection is safe to eat. The Lot prefecture says you should also avoid putting mushrooms in plastic bags because they rot quicker and avoid picking near busy roads. Weather conditions in the past months have caused an abundance of early mushrooms. Health authorities point out that it is tempting to pick mushrooms, but it is essential to know them to avoid poisoning. Since 1 Jul 2011, 388 cases of poisoning have been reported. [ProMed]

The number of cases of Clostridium difficile infection reported by hospitals across Ireland has increased by more than 26 per cent in the 1st 6 months of 2011. The significant rise in cases of the potentially life-threatening healthcare-associated infection is being closely monitored. Some 1013 cases of the infection, which can spread rapidly in hospitals, were reported to the national Health Protection Surveillance Centre between January and June 2011 compared to 801 cases over the same period in 2010. Last year's figures represented a falling trend, down from 1090 cases in the 1st half of 2009, but this trend has now been reversed. Clostridium difficile-associated disease (CDAD) is a spectrum of potentially fatal illnesses that includes diarrhea, pseudomembranous colitis, and toxic megacolon. Clostridium difficile is the most common cause of bacterial diarrhea and pseudomembranous colitis in hospitalized patients, and antimicrobial drug therapy is the most important risk factor associated with the acquisition of C. difficile. Recent outbreaks of C. difficile-associated diarrhea with increased severity, high relapse rate, and significant mortality, have been related to the emergence of a new, hypervirulent C. difficile strain in North America, Japan, and Europe. [ProMed]

Bovine TB has been identified in pigs kept on 3 farms in Wales in recent months, highlighting the fact that pigs are also susceptible to the disease. According to the Welsh Assembly, investigations are underway to establish whether any other pig herds linked to the incidents are infected. Animal health officials say that pigs kept outdoors in areas where TB is prevalent in cattle and wildlife are likely to be at increased risk of exposure to infection than those which are housed. Compared with infected cattle, however, pigs are far less likely to transmit infection to other animals. Although pigs can be skin tested, TB testing of pigs is not undertaken routinely, with slaughterhouse surveillance being the main way of detecting the infection. The carcasses of all slaughtered pigs are routinely examined by Food Standards Agency staff at abattoirs and Veterinary Laboratories Agency premises when lesions suspected of being due to TB are detected in a carcass. Further infected pigs have been identified on the farms concerned by follow up TB testing. There is a legal obligation on herd owners and vets to report any suspected cases of TB to their local animal health office. [ProMed]

A horse was put down in Australia after contracting the deadly Hendra virus -- the 9th animal to die in an outbreak which has exposed almost 50 people in 2 states. Passed from fruit bats (flying foxes) to horses and highly fatal to humans, a 2nd case of Hendra virus was confirmed on a New South Wales farm where 1 animal has already died and 9 people were exposed to the virus. "Results of laboratory tests yesterday [13 Jul 2011] revealed the surviving horse -- which was showing signs of illness for more than 24 hours -- was carrying the Hendra virus," said chief NSW veterinarian Ian Roth, on Thursday [14 Jul 2011]. "It is believed that the horse became infected with Hendra virus following very close contact with the original infected horse." At least 48 people have been exposed to Hendra virus in the past month in an outbreak which has spread from Cairns to within 500 kilometres (300 miles) of Sydney, worrying the city's thoroughbred race trainers. No humans have yet been infected. Hendra has killed 4 of the 7 people who have contracted it since it was first identified 1994, but human infections are rare. Named after the Brisbane suburb in which it was discovered, Hendra virus is thought to be unique to Australia and is spread from infected bats via half-chewed fruit or water and food contaminated by their urine and droppings. [ProMed]

An international research team has discovered a strain of Neisseria gonorrhoeae resistant to all currently available antibiotics. This new strain is likely to transform a common and once easily treatable infection into a global threat to public health. The researchers successfully identified a heretofore unknown variant of the bacterium that causes gonorrhea. Analysis this new strain, dubbed H041, allowed researchers to identify the genetic mutations responsible for the bacterium's extreme resistance to all cephalosporin-class antibiotics-the last remaining drugs still effective in treating gonorrhea. Since antibiotics became the standard treatment for gonorrhea in the 1940s, this bacterium has shown a remarkable capacity to develop resistance mechanisms to all drugs introduced to control it. Gonorrhea is one of the most common sexually transmitted diseases in the world. In the US alone, according to the Center for Disease Control and Prevention (CDC), the number of cases is estimated at 700 000 annually. Gonorrhea is asymptomatic in about 50 percent of infected women and approximately 2-5 percent of men. When symptomatic, it is characterized by a burning sensation when urinating and pus discharge from the genitals. If left untreated, gonorrhea can lead to serious and irreversible health complications in both women and men. [ProMed]

A 27-year-old French woman suffered a severe earlobe infection with cowpox virus, a relative of the smallpox virus, as a result of contact with infected pet rats. The woman bought 2 pet rats, imported from the Czech Republic, which quickly got sick and died. A few days after the rats died, she sought care for an inflammatory lesion on her left earlobe. The woman was treated unsuccessfully with antibiotics, and the lesion spread to the skin of her neck and cheek. Eventually, she was hospitalized and underwent surgery to excise extensive necrotic tissue at the site of the original lesion and smaller ones on one finger and her abdomen. The doctors sent specimens to a diagnostic laboratory, which, after a series of tests, identified the pathogen as cowpox virus. It was later learned that other pet rats from the same store had also fallen ill and died. Wild rodents, not cows, are now considered the true reservoir for cowpox virus, and in recent years, several human cowpox infections have resulted from contact with pet rats, though humans are more commonly infected through contact with cats, which are incidental hosts. It is speculated that the cessation of smallpox vaccination may partly explain the reemergence of cowpox in humans, as the vaccine probably induced some immunity to other orthopoxviruses. [ProMed, Severe Ear Chondritis due to Cowpox Virus Transmitted by a Pet Rat. By Antoine Elsendoorna et al., Journal of Infection online, 24 Jun 2011, www.sciencedirect.com/science/article/pii/S0163445311003902]

A woman in her 60s from northern Minnesota has died from a brain infection due to Powassan (POW) virus infection. POW virus is transmitted through the bite of an infected tick. Health officials say this death serves as a reminder of the vital importance of preventing tick bites. Powassan disease is caused by a virus and is not treatable with antibiotics, so preventing tick bites is crucial. When a tick infected with POW virus attaches to a person, it might take only minutes of tick attachment for the virus to be transmitted. POW virus infection was first detected in Minnesota in 2008, in a Cass County child who was exposed near home. In 2009-2010, 5 additional POW cases were identified in Minnesota. POW virus was first described in 1958 in Powassan, Ontario. Since then, about 60 cases have been identified in North America. Most of these cases were from eastern Canada and the northeastern USA until the last decade, when cases began to be reported from Michigan, Wisconsin, and now Minnesota. POW virus is related to West Nile virus (WNV). Like WNV, POW virus can cause severe disease of the central nervous system, involving inflammation of the brain (encephalitis) or the lining of the brain and spinal cord (meningitis). People with POW may have fever, headache, vomiting, weakness, confusion, loss of coordination, speech difficulties, and memory loss. Signs and symptoms occur within 1 to 5 weeks of an infectious tick bite. [ProMed]

An Australian doctor was charged by end of May 2011 with endangering his patients' lives after police alleged he infected nearly 50 women with hepatitis C at an abortion clinic. A 61-year-old doctor, who worked as an anesthesiologist at a Melbourne clinic, was charged with 54 counts each of conduct endangering life, negligently causing serious injury, and recklessly causing serious injury. The most serious charge carries a maximum sentence of 15 years in prison. He was released on 250 000 Australian dollars bail when he appeared briefly in Court. Hepatitis C can cause serious liver problems, including cirrhosis and cancer. It is spread through the blood. Police have not released details on how they believe the disease was transmitted. The anesthesiologist had his registration suspended in February 2010. Under his bail conditions, he must not work in any medical or health-related field and must not contact staff at a number of medical centers where he previously worked, including the abortion clinic. He was also required to surrender his passport. Health officials tested more than 4000 of his patients during their investigation, and found 49 who were infected with a strain of the virus genetically linked to his. [ProMed]

Health officials said on 16 Jun 2011 that 8 children have been admitted to hospital in northern France after eating beef burgers infected with a strain of E. coli, fanning fears of a wider outbreak. The officials said the bacterium was not related to the lethal strain of E. coli that has killed 39 people and made 3000 ill, most of them in northern Germany. Privately owned German discount chain Lidl has withdrawn boxes of frozen beef patties, which regional health authorities said were behind the French infections. The boxes were sold under the brand "Steaks Country" and had expiry dates of 10 through 12 May 2011, officials said. On Wed 15 Jun 2011, 5 children, aged between 20 months and 8 years and from different towns in the Nord-Pas-de-Calais region, were taken to a hospital in the city of Lille after suffering bouts of bloody diarrhea. One was quickly released, but 4 were still being treated at the hospital. 3 are being treated with hemodialysis, a method of removing waste products from the blood in the case of kidney failure. On Thu 16 Jun 2011, 3 children were admitted to hospital, the health official said. One of the victims' condition was life-threatening, a medical source told Reuters. Health Minister Xavier Bertrand said a search was under way to determine the origin of the outbreak and stricter controls would be enforced at production sites. [ProMed]

In 2010 nearly 30 000 Americans were diagnosed with Lyme disease and Pennsylvania leads the nation in the number of confirmed cases. According to Allegheny County Health Department, the number of cases among Allegheny County residents has been hovering in the 20-30 a year range for some time but how the disease is being contracted is changing. In the past, the infections were mainly acquired on trips outside our region but in recent years more and more infections are being acquired locally. The tick that transmits Lyme disease, which is the deer tick, is now the most commonly found tick on people and pets here in Allegheny County. The Centers for Disease Control confirms that the illness continues to spread. In 2009 there were 4950 confirmed cases of Lyme disease in Pennsylvania. Lyme disease can usually be treated with antibiotics with the patient suffering no long-term effects but if not treated while in its early stages it can have lasting impacts on the central nervous system. Many people with Lyme disease originally believe they have a mild case of the flu until the telltale red "bullseye" rash begins to appear. People usually come in contact with deer ticks while walking through high grasses or through leaf litter. Staying on paths or in clearings will help to avoid contact with the ticks. [ProMed]

The number of people reported sick in Germany from a food borne bacterial outbreak that has already killed 16 spiked over the last 24 hours, with nearly 100 more people suffering from severe and potentially fatal symptoms, according to the national disease control centre. The german agriculture minister, said scientists were trying to find the source of the unusual strain of the entero-haemorrhagic E. coli bacteria (E. coli O104), which is believed to have been spread within Europe on tainted vegetables and to discover where, in the chain from farm to grocery store, the contamination occurred. Hundreds of tests have been done and the responsible agencies have determined that most of the patients who have been sickened ate cucumbers, tomatoes and leaf lettuce, primarily in northern Germany. German officials initially pointed to a few cucumbers from Spain, but further tests showed that those vegetables, while contaminated, did not cause the outbreak. Spanish cucumbers are not the source of the E. coli O104 outbreak: a bacterium has been found, but not of the type O104, which led to the outbreak. Germany's national health agency, the Robert Koch Institute, said 470 people are now suffering from the syndrome, in which an E. coli toxin attacks the kidneys, sometimes causing seizures, strokes and coma. Germany typically sees a maximum of 50 to 60 of such cases in a year. [ProMed]

German health authorities have registered over 400 confirmed or suspected cases of a potentially lethal bacterial disease since mid-May 2011. The reports represent a dramatic rise in comparison with the last 10 years, in which 800 to 1200 cases occurred annually. The condition is caused by a strain of enterohemorrhagic E. coli (EHEC), which is often food borne and can lead to severe digestive problems. The 1st symptom is diarrhea, and, in more severe cases, this is typically followed by blood in the stool and massive cramping. While an average case runs its course in around a week, acute instances of the ailment can lead to kidney failure and even death. Symptoms generally take several days to show up after coming in contact with the EHEC bacteria. In May 2011, Hamburg has already registered over 40 cases of the more severe form of illness brought on by EHEC instead of the normal number of 10 cases. So far, 1 death has been confirmed from this month's outbreak. A number of other patients infected with EHEC are currently in critical condition. As it was announced this week cucumbers from Spain are the source of the recent E. coli [O104] outbreak in northern Germany. German authorities have advised people not to eat cucumbers and generally be careful with raw vegetables. [ProMed]

According to local health authorities the deadly Ebola hemorrhagic fever has broken out in Uganda, killing one person and leaving over 30 others being monitored by health officials. The epicenter of the outbreak is in the central Ugandan district of Luwero, located about 50 km north of the capital Kampala. A 12-year-old girl in developed symptoms of ebolavirus infection, and when she was admitted at a military hospital in the district, laboratory tests confirmed that it was an ebolavirus infection. Ebolaviruses are highly contagious and cause a range of symptoms including fever, vomiting, diarrhea, generalized pain or malaise, and in many cases, internal and external bleeding. The girl died soon after her admission to the hospital, and about 30 people with whom she had contact are being asked to avoid contact with the public, as health officials monitor them for about 21 days. The 30 people have not yet developed any symptoms of ebolavirus infection, but if they do, they will be isolated from the public. The detected viral subtype kills 60 percent of infected people. According to the World Health Organization tight border controls are not yet necessary, although the immigration officers should be on alert. With some people reluctant to disclose their exact areas of origin for fear of being inconvenienced and perhaps quarantined, it remains a challenge how the immigration staff will handle the situation. [ProMed]

According to researchers, a ban on the veterinary use of a painkiller in South Asia appears to be preventing vultures from being poisoned there. Many vultures have been killed by eating livestock carcasses that were contaminated with the drug. The crash in vulture populations was so severe that the 3 endemic species are now threatened with extinction. A recent study reveals the 1st signs that the ban has reduced vulture poisonings. The governments of India, Nepal and Pakistan banned the use of diclofenac for livestock in 2006. But by this time, 3 vulture populations had crashed by over 97 percent. The researchers set out to assess the effectiveness of the ban by measuring the concentration of the drug in livestock carcasses. They took samples from the livers of 5000 cattle carcasses. Some samples were gathered one year before the ban, some immediately after its implementation, and some between 2007 and 2008. This revealed that the proportion of cattle carcasses in India contaminated with the drug declined by approximately 40 percent between 2006 and 2008. In animal carcasses that were contaminated, the concentration of the drug was significantly lower. The drug, an anti-inflammatory, is used to reduce pain and swelling in injured and diseased cattle. For religious reasons, it is not the practice in India to kill dying cattle to relieve their suffering. So owners give the painkiller to cattle and buffaloes when they are very close to death. [ProMed, www.plosbiology.org/article/info%3Adoi%2F10.1371%2Fjournal.pbio.0040066]

People infected with leprosy in the USA often have the same previously unknown strain of the microbe Mycobacterium leprae that is also carried by armadillos. Though it's been known for decades that armadillos can harbour leprosy, the discovery of the overlapping strain strengthens the long-held assumption that armadillos can infect people directly. Recently researchers reported that many infected people in the Deep South contracted leprosy while close to home -- not in some exotic locale where the disease is more common. The only possible infectious agents would be an armadillo or person. Some of the infected people had even handled armadillos, the only animal known to harbour leprosy. The findings all point to animal-to-person spread. Roughly 6 to 10 percent of tested armadillos in Alabama and Mississippi have leprosy. Other studies place the rate as high as 20 percent in the wild. It remains unclear how an armadillo would transmit leprosy. However, it's well-known that leprosy spreads among people. Leprosy remains very rare in the USA, with about 150 new cases each year. The disease is curable, but can require more than a year of antibiotics. [ProMed]

The center for disease control (CDC) is collaborating with public health officials in many states to investigate a multistate outbreak of Salmonella enterica serotype Typhimurium infections associated with exposure to clinical and teaching microbiology laboratories. Investigators are using DNA analysis of bacteria obtained through diagnostic testing to identify cases of illness that may be part of this outbreak. As of 20 Apr 2011, a total of 73 individuals infected with the outbreak strain of Salmonella have been reported from 35 states. 14 percent of patients have been hospitalized and one death has been reported. The numbers of new cases have declined substantially during the past several months, and reports associated with this outbreak strain appear to have returned to the expected baseline of approximately 0 to 4 cases reported per week. In an epidemiologic study conducted during February and March 2011, 32 ill persons answered questions about exposures during the days before becoming ill. Investigators compared their responses to those of 64 persons of similar age previously reported to state health departments with other illnesses (controls). Preliminary analysis of this study has suggested exposure to clinical and teaching microbiology laboratories is a possible source of illness. Illnesses have been identified among students in microbiology teaching laboratories and employees in clinical microbiology laboratories. [ProMed]

A previously healthy 35-year-old woman was admitted by end of March 2011 to the emergency room at a hospital in Madrid, Spain, because of sepsis and respiratory distress. She had just returned from an 11 month long leisure travel through Africa, starting April 2010 from South Africa and ending March 2011 in Morocco. She also visited Madagascar, Namibia, Botswana, Angola, Sao Tome, Cameroon, Gabon, Nigeria, Benin, Burkina Faso, Mali, Senegal, and Mauritania. Just after her arrival in Madrid, she developed sepsis and severe respiratory distress. Blood cultures demonstrate Burkholderia sp. sensitive to some antibiotics. The patient was diagnosed with possible melioidosis and treated with high doses of intravenous antibiotics, with marked improvement. She is still admitted at the hospital receiving intravenous antibiotics and waiting for the final identification of the bacterium. Neither special high-risk activities for contracting melioidosis were identified, nor were underlying disease or immune suppression detected. Her husband who travelled with her is asymptomatic. Burkholderia pseudomallei exists as an environmental saprophyte living in soil and surface water in endemic areas (Southeast Asia and northern, tropical Australia), particularly in rice paddies. [ProMed]

The native red squirrel population of Northern Ireland is facing a fresh threat in the shape of a fatal disease. Squirrel pox, which is carried by the non-native grey squirrel, has been confirmed as the cause of death for a native red squirrel. It has destroyed native red squirrel populations in other parts of the UK. The decline of red squirrels in the UK is blamed primarily on the effects of squirrel pox as well as the loss of habitat and competition from grey squirrels. Squirrel pox is a viral disease affecting red squirrels, killing them within 15 days of infection. It is carried by grey squirrels, which show no symptoms of disease, so that they continue to thrive and breed while carrying the virus. It is thought to have been brought into Britain with grey squirrels introduced into southern England from America in the early 20th century. Several pox-like disease outbreaks in red squirrels were recorded over the decades, but the virus was 1st confirmed during a disease outbreak in East Anglia in the 1980s and it has since worked its way steadily northwards. [ProMed]

A man is in hospital with the potentially fatal Legionnaires' disease after using the leisure centre at a 4-star hotel in Dundee. Some 66 staff and visitors at the Landmark Dundee have also experienced flu-like sickness. The man who was confirmed positive for the disease is being treated in the Hospital. The health authority has carried out investigations at the hotel after staff and guests reported feeling unwell. Health officials said that before the single confirmed case, there was no evidence of Legionella infection in any samples taken. To date, 66 people who work in or have visited Landmark Dundee are known to have experienced flu-like illness, which has, for the majority, been short-lived and managed symptomatically at home. Legionnaires' disease, a potentially fatal form of pneumonia, is caused by types of bacteria commonly found in the environment. People can become infected when they breathe in air that contains Legionella bacteria which have been dispersed into the air in very fine droplets of water. Most people exposed to these common bacteria do not become ill, and the disease cannot be spread from person to person. Contaminated water is usually the source of infection. [ProMed]

From January to March 2011, 39 cases of tularemia were diagnosed in 3 counties in central Norway. 34 reported use of drinking water from private wells. Since the incubation period for tularaemia may be up to 3 weeks, and time from symptoms until seroconversion might be up to 6 weeks, more cases may follow. An increased rodent (lemming) population and snow melting may have led to contamination of the wells with infected rodents or rodent excreta. Tularemia is a zoonotic disease caused by the bacterium Francisella tularensis. Several vectors may be involved in transmitting the disease to humans, commonly rodents and hares, but infection may also be transmitted via insect bites. Tularemia is a notifiable disease in Norway and during the past 10 years, 3 outbreaks were reported in Norway and all were associated with water sources in areas where dead lemmings had been observed previously. From 2001 to 2010, between 3 and 66 cases of tularaemia were reported annually in the whole country, with an increase from 16 to 32 cases on average. Every well owner should make the necessary effort to prevent small rodents from entering the well water by carefully covering every opening and plugging every small hole where the rodents can enter. In case of proven or suspected contaminated wells, the water should be disinfected before further use. [ProMed, www.eurosurveillance.org/ViewArticle.aspx]

There have been 52 cases of Ross River fever reported in the Barwon South Western region so far in 2011. At the same time last year, no cases of the virus had been reported in the area. Barwon Health has said Ross River fever is not normally found this far south and was generally confined to northern NSW and Queensland. Although not life-threatening, it can cause a severe arthritis. Health Department figures show this year's numbers are even more dramatic along the Murray River. The Loddon / Mallee region has recorded 233 cases of the virus so far this year, compared to none for the same time last year. Heath Officials said the wet weather during the summer months had contributed greatly to mosquito numbers. Residents along the Murray River were warned in February 2011 about another mosquito-borne disease, the deadly Murray Valley encephalitis virus. This encephalitis had been detected in sentinel chickens. The death of a northwest Victorian man in a Melbourne hospital last week remains a suspected case of Murray Valley encephalitis. [ProMed]

A transplant patient contracted AIDS from the kidney of a living donor, in the 1st documented case of its kind in the U.S. since screening for HIV began in the mid-1980s. It turns out the donor had unprotected gay sex in the 11 weeks between the time he tested negative and the time the surgery took place in 2009. In a report this case, the Centers for Disease Control and Prevention recommended that organ donors have repeat HIV tests a week before surgery. The CDC also said would-be organ donors should be told to avoid behaviour that can increase their chances of infection. Living organ donors in the U.S. are routinely tested for infectious diseases such as hepatitis and HIV. But the organization that oversees organ transplants in the U.S. does not have an explicit policy on when such screening should be done. That's left up to transplant centers. Neither the donor nor the recipient knew he or she had HIV until about a year after the transplant, according to the CDC report. The recipient developed AIDS, perhaps because he or she was on drugs that suppress the immune system to prevent organ rejection, while the donor did not, health officials said. Both are receiving HIV treatment. [ProMed]

An outbreak of trichinellosis was detected in Huesca, an autonomous community of Aragon, affecting 5 men and one woman, all residents of Huesca and aged between 52 and 58 years. They ate sausages from the meat of a wild boar that one of them had hunted and which was not subjected to the required veterinary control. The 6 people began feeling ill on 5 Feb 2011. They consulted the San Jorge de Huesca hospital and were not admitted at first, but their condition deteriorated, and they were readmitted days later. One of them, a 54-year-old man, died beginning of March. According to Aragon public health officials, the brother of the deceased remains in serious but stable condition in the intensive care unit; the 3 other men are in stable condition, and the woman has been released. Public health officials have indicated that the source of the outbreak was the wild boar meat. The rest of the meat was identified and taken for testing and to prevent further cases of the disease. The main reservoirs of the trichinellosis parasite are domestic animals such as pigs or wild animals such as wild boars or foxes. Transmission of the disease occurs through consumption of raw or insufficiently cooked meat or meat products infected with the larvae of the Trichinella worm. This outbreak underlines that trichinellae are found in wild animals also in Western Europe. As is the case here, acute trichinellosis may be life-threatening. Sausage is a particularly common source of human infection because the meat is often not heated to a high enough temperature to kill the parasite when smoked. [ProMed]

Several cases of Q fever have been confirmed during the last 4 months in Hallenberg (Germany) and neighbouring municipalities as well as in Bromskirchen in Hesse. To date, a total of around 40 people have been infected, of which about half live in Arnsberg and in the district Waldeck-Frankenberg. The results of previous studies indicate that the infection originates from sheep flocks, where the causative agent of Q fever was confirmed. The pathogen has been confirmed in several flocks of sheep from both "Lander" (Hesse and North Rhine-Westphalia) and is transmitted to humans via direct contact or contaminated dust. Immediately after the Arnsberg and the Waldeck-Frankenberg authorities detected an increase of Q-fever infection in humans, the competent national authorities became involved. The veterinary authorities have put restrictions upon the flocks of sheep shown to be infected, have notified the owners and have imposed further protective measures. The sheep will be vaccinated to reduce the shedding of the pathogen. This requires that the vaccine, which is not currently licensed in Germany, is temporarily approved by the competent local authorities. Q fever occurs worldwide and is a common bacterial infection mainly transmitted by sheep, goats and cattle. Human-to-human transmission is very unlikely. An acute infection usually begins with high fever, chills, muscle pain and severe frontal headache. High risks have been established for pregnant women. Acute Q fever can be treated with a specified antibiotic. [ProMed]

On 18 Sep 2009, the Chicago Department of Public Health (CDPH) was notified by a local hospital of a suspected case of fatal laboratory-acquired infection with Yersinia pestis, the causative agent of plague. The patient, a researcher in a university laboratory, had been working along with other members of the laboratory group with a pigmentation-negative attenuated Y. pestis strain. The strain had not been known to have caused laboratory-acquired infections or human fatalities. Other researchers in a separate university laboratory facility in the same building had contact with a virulent Y. pestis strain that is considered a select biologic agent; however, the attenuated strain is excluded from the National Select Agent Registry. The university, the Illinois Department of Public Health and the CDC conducted an investigation to ascertain the cause of death. They issued a report that summarizes the results of that investigation, which determined that the cause of death likely was an unrecognized occupational exposure (route unknown) to Y. pestis, leading to septic shock. Y. pestis was isolated from premortem blood cultures. Molecular analyses identified the clinical isolate as a attenuated strain of Y. pestis. Postmortem examination revealed no evidence of pneumonic plague. Researchers should adhere to recommended biosafety practices when handling any live bacterial cultures, even attenuated strains. [ProMed; www.cdc.gov/mmwr/preview/mmwrhtml/mm6007a1.htm]

The 1st human cowpox virus infection in the United States has been documented in an unvaccinated laboratory researcher, according to a report by investigators from the US Centers for Disease Control and Prevention (CDC) in Atlanta. Current recommendations by the CDC's Advisory Committee on Immunization Practices include vaccination of laboratory workers who handle cultures or animals infected with non-highly attenuated orthopoxviruses that infect humans, including cowpox virus. This researcher was offered a vaccination but declined, because he was not intentionally conducting work with an orthopoxvirus. The unvaccinated lab worker became infected in July 2010 while working with a nonhuman pathogenic poxvirus and developed a suspicious, painful, ulcerated lesion on a finger that lasted approximately 3 months. In October 2010, biopsy specimens of the suspected orthopoxvirus were submitted to the CDC for testing. Orthopoxvirus DNA was also found in environmental swabs of several surfaces in the laboratory and a freezer room, although no live virus was recovered from the swabs. The patient described noticing a small cut at the site of the lesion a few days before lesion onset. There have been several cases in Europe of human cowpox cases in people who have had close contact with pet cats or rats. It is important to stick to good laboratory practice rules: wear protective gloves; frequently disinfect hands and surfaces; and avoid working directly with these agents if you are pregnant, immuno-compromised, diabetic etc.. [ProMed]

A total of 4 people who were in flood-ravaged village in central Queensland in the past few weeks have been confirmed to have a severe bacterial infection. The infection is commonly transmitted to humans by allowing water that has been contaminated by animal urine to come in contact with unhealed breaks in the skin, the eyes, or with the mucous membranes. Leptospirosis is caused by exposure to Leptospira bacteria, in fresh (not salty) water, wet soil, or vegetation that has been contaminated by urine of animals chronically infected with one of the several hundred serovars of the spirochete Leptospira interrogans. Rodents, dogs, cattle, and pigs are the usual reservoirs for this organism. Leptospirosis occurs worldwide and frequently follows flooding after heavy rains. Leptospirosis is an occupational hazard for people who work outdoors or with animals; for example, workers in wet agricultural settings (such as rice field workers), ranchers, slaughterhouse workers, trappers, loggers, sewer workers, veterinarians, fishery workers, dairy farmers, or military personnel. Also leptospirosis is a risk during recreational activities, such as camping, fresh water swimming, canoeing, kayaking, rafting, golfing, and trail biking, that involve exposure to water in lakes, rivers, or ponds contaminated by urine from leptospire-infected animals Most patients with leptospirosis have a non-specific mild, flu-like illness. Some patients develop severe disease with myocardial, pulmonary, renal, or hepatic involvement. Severe infection may be fatal in 5-40 percent of cases. [ProMed]

By end of December 2010 a chlorine gas leak caused the evacuation of an Oregon National Primate Center building (USA) along with a response from firefighters and a Hazardous Materials Team. The incident happened around 9am when Primate Center employees reported a chemical leak. Fire fighters and a rescue team arrived minutes later. They requested additional resources from the Fire Department and also the regional hazardous materials response team. Firefighters entered the building known as the Animal Services ABSL3 building and found two 4′ tall chlorine cylinders strapped to a cart. They shut off the flow of chlorine and began monitoring the air quality inside the building. The Hazardous Materials Team later removed the two tanks from the building and continued to monitor the air quality inside the building’s hallways. Primate Center Health and Safety workers say they were preparing to disinfect a laboratory area with chlorine when one worker said she heard an unusual pop from the chlorine tank’s regulator as she opened the tank’s valve and then began smelling chlorine gas. She quickly activated the building’s safety system, evacuated fellow workers and sheltered the primates in place. The safety systems include an air flow ventilation system that prevented the leaked chlorine gas in the hallway from entering any of the rooms occupied by the primates. No one was injured. [http://theportlander.com/2010/12/29/chemical-spill-oregon-primate-center/]

A 38 year old mother of 3 in Brgy (Philippines) died in January 2011, the 1st recorded person to die of rabies this year. The woman, together with her sister, was bitten by a puppy, about 3 months old, in June 2010. Her sister had shots of an anti-rabies vaccine, but the victim did not. According to a health coordinator, the victim hesitated to seek medication right after she was bitten. The victim was already having aerophobia and hydrophobia when she was brought to a Hospital on the beginning of January 2011. The victim complained of body pains on January 1. On January 6, the patient suffered from severe pain on her right leg and the next day, she had difficulty swallowing. Symptoms of rabies infection are fever, headache, general weakness and discomfort. Meanwhile, passive and active vaccines (immunoglobulin and vaccine) were already injected to the members of the victim's family who were believed also to have been exposed to the virus. People bitten by dogs and other animals must not hesitate in seeking early medical treatment from the nearest hospital. [ProMed]

The Ministry of Health is warning passengers on an Emirates flight from Dubai to Auckland last week to watch for symptoms of measles after one passenger was found to have the measles. A passenger who disembarked in Melbourne has been confirmed as a case of measles. Many other passengers on the flight continued on to Auckland. People sitting in a row close to the affected passenger are potentially at risk as measles is easily spread through the air. The Ministry has sent information about the Emirates flight to public health units around the country. However there are still around 20 people who sat in the rows nearest the infected passenger whose current locations in New Zealand were not known. Health officials said the symptoms those passengers need to watch out for are fever, runny nose, and sore eyes followed about 2 days later by a red blotchy rash. Some people develop further complications such as diarrhoea or a middle ear infection. New Zealand had 3 outbreaks in 2009 / 2010, each started by people who were infected overseas. The Ministry recommends that anyone aged under 40 who has not had measles in the past, should ensure they have been vaccinated. [ProMed]

The Ministry of Health is warning members of the public against eating unfit and unopened ackees. The Ministry's surveillance unit has detected 35 cases of ackee poisoning from 1 Dec 2010 to 12 Jan 2011.The government said that special attention should be paid to ensure that householders use only fit and well opened ackees. Ackees should also be properly cleaned by removing the seed and the pink or reddish membrane, then washed before cooking to prevent possible poisoning especially because of the high levels of toxins that may be contained in the unripe fruit. Ackees should be cooked by themselves while other foods, including salted fish, should be cooked separately. The water that is used to boil the ackee should be discarded immediately and should not be ingested or reused for cooking other foods such as ground provisions and rice. If not properly ripened, ackee contains high levels of a toxin called hypoglycin which can potentially lead to death if consumed. Symptoms of ackee poisoning include vomiting, stomach cramps / abdominal pain, dizziness, diarrhoea and sweating. If persons are experiencing these symptoms they should seek medical attention immediately and should have a sweet drink while on their way to the health centre or hospital. All incidents of ackee poisoning have been from ackees cooked at home. There has been no incident involving tinned ackees. [ProMed]

The disease known as monkeypox has raged in the north and south of Equateur province. At least 3 health zones are affected. For example, in the Bikoro health zone, 114 people have contracted the disease and 5 have died. According to the WHO Equateur provincial branch, the Bikoro health zone has broken the record with 114 cases. According to the WHO/Equateur regional medical officials, laboratory tests on specimens from patients that were sent to the National Institute for Biomedical Research in Kinshasa, confirmed that the cause was monkeypox virus. It is still unclear how many have been infected overall in Equateur. To deal with this epidemic, medical advice is for observation of hygiene rules. The medical officer also asked farmers in the affected health zones not pick up dead animals in the forest, including monkeys, squirrels, and pangolins that transmit this disease to humans. A recent investigation suggests that monkeypox virus, to which the smallpox vaccine also provides immunity, is now at least 20 times as common as it was shortly after the eradication of smallpox and the relaxation of immunisation. [ProMed]