In Greece, 3 people died in July and August 2012, as a result of being bitten by mosquitoes carrying the West Nile fever virus. According to Greek health care services 44 others are also infected. Most cases were reported in the suburbs east and south of Athens and in the north, near the town of Naoussa. Health experts think that the number of people infected may be even higher. The experts say that the patients complain of slight ailments such as cranial or joint pain, or show no symptoms. The inhabitants of the regions concerned were advised to protect themselves against insect bites. The West Nile virus is largely widespread, particularly in Africa, Asia and North America. More and more cases have also been recorded in southern and eastern Europe. According to the German Robert Koch Institute, about 20 per cent of patients infected develop a feverish flu-like illness, while one in 150 may incur more severe disease, including meningitis. [ProMed]

There has been an alarming increase in the Northern Territory of Australia of people infected with deadly bacteria found in the soil. An infectious disease expert has aggregated data from the last 23 years and has found a significant spike in cases of people infected with melioidosis. The bacteria (Burkholderia pseudomallei) enter the body often through cracks in feet. They can also become airborne when soil is disturbed. The organism infects the blood, leads to pneumonia, and has a high mortality rate of 15 per cent. Since 1989, there have been 783 cases, with 107 deaths. However, data analysis showed that 252 of the 783 cases and 30 deaths occurred over the last 3 years. It used to be that only 25 people were diagnosed with the bacterium each year but that's jumped to almost 90 a year over the last 3 years, with most cases recorded in Darwin. The expert said at a conference that immunocompromised people mainly became infected, for example people suffering from chronic alcoholism, diabetes, or those being treated for cancer. He believes there has been an increase in Darwin because of increased construction, which mobilizes the bacteria and exposes people to more soil. The influx of indigenous people to  Darwin because of the intervention is also believed to contribute to the spike as well as increased rainfall. About 50 per cent of people diagnosed with the bacteria are Aboriginal. [ProMed]

Healthcare professionals detected an outbreak of mumps in the Aviles Health area that is currently affecting young persons in their early 20s (23 years old on average). Up to August of 2012, 131 cases of mumps have been reported in Asturias, approximately 80 more cases compared to those reported for the whole year 2011. Healthcare professionals pointed out that the disease has been affecting mainly male subjects more than 20 years old that did not have mumps during their childhood or who had never been vaccinated with the triple [measles, mumps and rubella] vaccine. Even so, these mumps outbreaks have not reached a level comparable with an epidemic that occurred in this region in 2002, when more than 1500 cases were diagnosed. The vaccine may protect up to 85 per cent of immunized persons, consequently, some may develop the disease, but in a milder form. Mumps is caused by a virus that is transmitted from person to person through respiratory droplets (i.e. by sneezing), or by direct contact with articles that have been contaminated with infected saliva. Mumps occurs more frequently in children between 2-12 years of age who have not been vaccinated, but the infection may occur at any age. The incubation period lasts between 12 and 24 days. According to healthcare experts, the most frequent symptoms are the following: pain in the face, fever, headache, sore throat, parotid gland inflammation, and temple or mandible inflammation. There is no specific therapy for mumps. [ProMed]

The Ugandan Ministry of Health has reported an outbreak of Ebola hemorrhagic fever in the Kibaale District of western Uganda. As of 31 Jul 2012, there have been 38 cases and 16 deaths. Five cases have been laboratory confirmed. Ebola hemorrhagic fever is a rare and deadly disease. The disease is native to several African countries and is caused by the Ebola virus. It is spread by direct contact with blood and/or body fluids of a person infected with Ebola virus. It is also spread by contact with a contaminated object or infected animal. Symptoms include fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhoea, vomiting, and stomach pain. Skin rash, red eyes, and internal and external bleeding may be seen in some patients. There is no vaccine for Ebola and no specific treatment. Although travellers are at low risk for the disease, it is important to take steps to prevent Ebola infection. Practice good hygiene. Do not handle items that may have come in contact with an infected person's blood or body fluids. Health care workers who may be exposed to people with the disease should wear protective clothing, including masks, gloves, gowns, and goggles. [ProMed]

Kansas officials have begun notifying about 460 former patients of a hospital that they may have been exposed to hepatitis C by a travelling hospital technician accused of causing an outbreak of the disease in New Hampshire. Federal prosecutors in New Hampshire announced that David Kwiatkowski was charged with obtaining controlled substances by fraud and tampering with a consumer product. Kwiatkowski allegedly infected patients with hepatitis C while working at a New Hampshire hospital. Health officials have begun notifying about 460 patients the lab treated during that time, advising them on how to get free testing for the disease, which is a blood-borne viral infection that can cause liver damage and chronic health problems. Kwiatkowski, who grew up in Michigan, worked as a "traveller" sent by staffing agencies to hospitals around the country, usually for temporary jobs. In announcing the federal drug charges in New Hampshire, a U.S. Attorney called him a "serial infector" who has worked in at least 6 states since 2007. Kwiatkowski is accused of stealing anaesthetic drugs from the lab, injecting himself and contaminating syringes that were later used on patients, 30 of whom have been diagnosed with the same strain of hepatitis C that Kwiatkowski carries. Though he told investigators he was diagnosed in May 2012, authorities said there is evidence that he has had the disease since at least June 2010. [ProMed]

The number of cases of syphilis is rising in Germany – particularly among gay men in urban areas. For years the illness was believed to have been under control in Germany, but new figures show a 22 per cent rise in the number of new cases last year compared with the previous year. The numbers had been stable for the past years and in 2010 were even relatively low. 3700 new cases were recorded in 2011, particularly in big cities such as Cologne, Frankfurt am Main, and Berlin. Gay men are particularly at risk of contracting the disease, however,  it is not believed that this reflects any behavioural trends. It's mainly men who have sex with men who are affected. The problem is that although condoms can help protect against the disease, syphilis causes boils and lesions on the skin that are highly contagious. German health campaigners are particularly concerned by the links between HIV and syphilis and are calling for educational campaigns to encourage people to get tested more frequently. Those who often have different sexual partners should have a blood test once or twice a year. Modern medicine can deal with syphilis much better than in the past, when patients were treated with injections of poisonous mercury. Now, if caught early enough, the bacterial illness can be treated with penicillin. [ProMed]

Officials of a Hospital in Washington said one of their own workers may have exposed hundreds of people to whooping cough, and now they're notifying employees and patients to get help immediately. The hospital has been "ground zero" for the treatment of pertussis, or whooping cough. But this week it became ground zero for a new potential outbreak. The head of infectious disease at the hospital said a hospital employee went to the staff clinic by end of June complaining of a nasty cough. He was sent home as a precaution. A few days later his test results came back positive for whooping cough. He probably had it for about 2 weeks or slightly more. That means the employee had 2 weeks of direct contact with patients and fellow employees at the hospital. Officials believe at least 53 employees have been exposed to the illness, but that number could end up being more than 300 after factoring in patients and visitors. The hospital has been proactive. If they had direct exposure, then they automatically require them to be put on antimicrobials. The worker in question thought he had been proactive, too. He was vaccinated against pertussis, but it wasn't effective. According to health officials sometimes the vaccination just doesn't work. [ProMed]

A dead harbour porpoise that washed up in Maine in January turned out to be carrying a disease-causing bacteria that could have sickened the people who handled the animal. The case serves as a reminder of the potential for infection when rescuing or handling marine mammals, and the importance of using proper protection to avoid exposure to diseases. The bacteria found in the porpoise, called Brucella, causes flu-like symptoms in people, including fever, sweats, headache, back pain and weakness, which can persist for years. Sometimes, the bacteria cause severe infections of the brain, bone, heart, liver or spleen. After the carcass of the porpoise was recovered on 29 January 2012, a university faculty member, 2 students and a community volunteer performed a necropsy on the animal. Although the team members wore gloves, they did not wear any protection over their noses and mouths to prevent themselves from breathing in the bacteria. Brucella can become airborne during a necropsy. Subsequent lab testing on samples from the porpoise revealed it was infected with Brucella. Because the 4 people who performed the necropsy did not wear respiratory protection, they were considered at high risk for Brucella infection, and were required to take antibiotics for 3 weeks, check themselves daily for fevers, and undergo weekly blood tests performed by health personnel. After 24 weeks, none of the individuals had become ill. [ProMed]

Health officials announced that laboratory tests have confirmed norovirus infection as the cause of the gastrointestinal outbreak that affected 106 students attending a sport camp at the University of Notre Dame earlier in June. 29 of those students were treated and released from local emergency departments for the intestinal illness. Norovirus is a very contagious virus, and is the most common "stomach bug" in the United States. Norovirus can be spread by an infected person, contaminated food or water, or by touching contaminated surfaces. Symptoms of norovirus infection usually occur 12-48 hours after exposure, and include diarrhea, stomach pain, nausea, and vomiting. Most people recover in 1-3 days, but remain contagious for up to 2 weeks after recovery. Hand washing is the most effective way to prevent the spread of norovirus infection. Wash hands with warm water and soap for at least 20 seconds, and be sure to wash hands after using the bathroom, after changing a diaper, after taking care of someone else who is sick, and before eating or preparing/handling food. After throwing up or having diarrhea, immediately clean and disinfect contaminated surface using a chlorine bleach solution or other disinfectant registered as effective against Norovirus Those who are ill should stay home, preferably at least 3 days after symptoms resolve. [ProMed]

Scientists have discovered a new gene in influenza virus that helps the virus control the body's response to infection. Although this control is exerted by the virus, surprisingly it reduces the impact of the infection. The findings will help researchers better understand how flu can cause severe infections, as well as inform research into new treatments. Just finding this gene in the first place is important, but the find is even more significant because of the role it seems to play in the body's response to flu. Researchers found when the new virus gene was active, mice infected with flu subsequently recovered. When the new gene did not work properly, the immune system was found to overreact. This made the infection worse, and did not help destroy the virus any quicker. The study looked at how the gene affected the behaviour of "Spanish flu", a virulent strain of influenza that caused a pandemic in 1918. Scientists discovered the new gene some 30 years after the flu genome was first decoded. The flu virus has a very, very small genome - just 12 genes. [ProMed]

An employee misusing drugs is the most likely cause of an outbreak of hepatitis C among patients who were treated at a Hospital's cardiac catheterization lab in New Hampshire. A total of 20 people, including a hospital worker, have been diagnosed with the same strain of the liver-destroying virus since the state began investigating the outbreak in May 2012. A health official said drug diversion generally involves someone using a syringe to inject themselves with medication meant for patients and then re-using the syringe on patients. Hepatitis C is a viral infection transmitted by blood. It causes inflammation of the liver that can lead to chronic health issues. The investigation began in mid-May 2012 when 4 patients were diagnosed with an identical strain of the virus, and the only link officials could find was that all had been treated at the same lab. The lab was closed for a week in late May 2012 but was allowed to re-open after the authorities determined there was no evidence that disposable equipment was being misused, that no permanent equipment was contaminated, and that there was no further risk of transmission via lab employees. [ProMed]

Health officials are still trying to track down the source of an E. coli outbreak that killed a 21-month-old child and sickened 2 others. Sites in several states are now under investigation. Health officials said they have been able to rule out a petting zoo. Rumours had circulated that the child was exposed to E. coli at the zoo, but doctors said they were able to rule that out. Officials said the 21-month-old died from complications from the bacterial infection at the end of May 2012. A state officer of Public Health, said the same strain of E. coli sickened 2 other children in the New Orleans area and is linked to a multi-state outbreak. Experts said this particular strain of the bacterium is more dangerous than others. It sickened 3 people in 2010 and 3 others in 2011. Doctors said this strain of E. coli infection usually results from consuming contaminated food or water, or from contact with infected animals or people. Officials advised people to avoid eating undercooked beef and unpasteurized milk products. People should also thoroughly wash vegetables before eating and always wash their hands. This particular type of E. coli infection can cause severe abdominal cramps, bloody diarrhoea, and vomiting. Healthy adults can usually recover within a week, but young children and older adults can develop a life-threatening form of kidney failure. [ProMed]

A 78-year-old man from New Mexico is the 1st human case of plague in the USA in 2012. Health officials report the yet unnamed man is currently hospitalized in stable condition. According to a New Mexico Department of Health press release they confirmed the man as having the plague, or Yersinia pestis infection. The Department of Health takes action when a plague case occurs to ensure the safety of the immediate family, neighbours, and health care providers. Plague is an infectious disease caused by the bacterium Yersinia pestis. It is found in animals throughout the world, most commonly rats but other rodents like ground squirrels, prairie dogs, chipmunks, rabbits, and voles. Fleas typically serve as the vector of plague. Human cases have been linked to the domestic cats and dogs that brought infected fleas into the house. Bubonic plague is the most common form of plague. In this form, the bacteria typically enter the body through the bite of an infected flea or rodent. Here the bacteria infect the lymphatic system. After a few days to a week, the person will experience fever, chills, weakness, and swollen lymph glands. These are called buboes. Plague activity usually begins to increase in the spring and continues into the summer months. About 14 per cent (1 in 7) of all plague cases in the United States are fatal. [ProMed]

A case of rabies has been confirmed in London, the Health Protection Agency (HPA) has said. The potentially fatal disease was confirmed in a patient after being bitten by a dog in South Asia. The patient, whose age and gender were not given, is receiving hospital treatment. All relevant contacts have been followed up, the HPA said. It added there was no risk to the public, including those at the hospital where the patient was being treated. Rabies is usually transferred through saliva from the bite of an infected animal, with dogs being the most common transmitter of rabies to humans. Despite there being tens of thousands of rabies cases each year worldwide, there have been no documented laboratory confirmed cases of human-to-human spread. Therefore the risk to other humans or animals from a patient with rabies is considered negligible. More than 55 000 people are thought to die from rabies each year, with most cases occurring in South and South-East Asia. A rabies expert of the HPA said that only 4 cases of human rabies acquired from dogs, all from abroad, had been identified in the UK since 2000. [ProMed]

The number of people diagnosed with hepatitis C in the Lothians has reached record levels. A total of 333 people were diagnosed with the condition in 2011 -- more than twice as many as a decade ago. Cases have risen from 276 in 2010, and 202 in 2009. The spread of hepatitis C has been called the Silent Epidemic, because sufferers can in some cases have virtually no symptoms for up to a decade. Early symptoms, which include depression, fatigue, skin problems, insomnia, pain and digestive disorders, are also often misattributed to other causes. 20 per cent of sufferers clear the virus from the body within 6 months of infection, but the rest develop a long-term condition which can lead to cirrhosis of the liver or liver cancer. In February 2012, patients in the Lothians were among the 1st to be offered the option of 2 new drugs which it is hoped will help cure more people. There are more than 3700 people living in the Lothians who are known to have hepatitis C. The best-known risk factor for hepatitis C infection is intravenous drug use, but steroid users and those who have had tattoos done abroad or at unlicensed events are also at risk. [ProMed]

The attack by a rabid bear was ended by an Albemarle County farm worker that fired from the roof of a Gator utility vehicle. The killed bear is the first-ever recorded case of a rabid bear in Virginia and only the second case on the East Coast that state officials are aware of. Police believe the bear was drawn by the movement of two men, who were using the vehicle to move stones on a large farm. The roughly 120-pound female bear first attacked the vehicle itself, biting one of the tires, before pursuing the men. One of the men climbed into the bed of the Gator, then onto its roof, taking a shotgun loaded with birdshot with him. The other man left the cab, but when the vehicle started to roll downhill, he leaned back into the cab to set the parking brake. The bear had come into the cab and was climbing into the bed when the man atop the Gator put his shotgun to her head and pulled the trigger. No one was injured in the attack or directly exposed to the rabies virus. The bear was decapitated, and its head sent to a state lab, where it tested positive for rabies. But authorities doubt there are any more rabid bears out there. Rabies is transmitted through contact with saliva, brain matter or spinal fluid of infected animals. The infected tissue must contact an open wound or mucous membranes to infect a new host. The virus alters the behaviour of afflicted creatures, making them more likely to bite. Health officials will try to type the rabies in question in the hopes of figuring out what sort of animal it came from. People encountering a bear should keep a respectful distance and enjoy watching it from afar, according to the department. [ProMed]

A young research associate killed by a highly virulent strain of meningococcal disease is believed to have contracted the bacteria from the San Francisco lab where he was working on a vaccine against it. US Centers for Disease Control and Prevention experts are seeking to confirm what they already suspect: that the researcher, 25, died Saturday in an unusual case of a scientist being fatally infected with an agent from his own laboratory. The CDC stated that someone getting sick and dying from the organism they're working with in the lab is exceedingly rare. Meanwhile, dozens of people, including relatives, close friends, medical personnel who treated the researcher and some of his co-workers at the research department of the San Francisco Veterans Affairs Medical Center were being given antibiotics as a precaution. Since the 1960s, vaccines have been available for some strains of meningococcal disease. But scientists in the San Francisco lab have spent more than 20 years trying unsuccessfully to develop a vaccine against serogroup B, the strain that killed the researcher. The researcher died of multiple organ failure caused by meningococcal infection and septic shock, less than a day after becoming ill. The disease can come on quickly with symptoms including high fever, headache, stiff neck, vomiting, rash, confusion and fatigue. About 1000 Americans each year suffer from meningococcal disease, and an estimated 10 to 15% die from it. [ProMed]

Hundreds of inmates of the Kent County Jail became sick earlier in April 2012 with a gastritis-type illness in an apparent case of food poisoning. Tests revealed a bacterium found in the rice and cheese served to the inmates. Clostridium perfringens is the most common kind of bacterial food poisoning. It can make one ill in as little as 6 hours with diarrhoea and stomach cramps. When large quantities of food that carries the bacterium are stored at a too warm temperature for too long, problems may develop. That's why most of the outbreaks happen in institutions like jails, schools, nursing homes and places that need to keep food warm. If there are live bacteria on the food that didn't get killed during the cooking process, then a long period of warming is the perfect incubation for it. Once the live bacterium is ingested, a toxin is produced that makes one ill. Clostridium perfringens is an anaerobic, Gram positive, spore-forming rod. It is widely distributed in the environment and frequently occurs in the intestines of humans and many domestic and feral animals. Spores of the organism persist in soil, sediments, and areas subject to human or animal faecal pollution. The common form of C. perfringens poisoning is characterized by intense abdominal cramps and diarrhoea which begin 8-22 hours after consumption of foods containing large numbers of the bacterium. The illness is usually over within 24 hours but less severe symptoms may persist in some individuals for 1 or 2 weeks. A few deaths have been reported as a result of dehydration and other complications. [ProMed]

97 people have reported cases of cryptosporidiosis since last month's outbreak at Edgewater Resort and Water Park in Duluth, according to the Minnesota Department of Health (MDH). 22 of those cases have been confirmed in laboratories. The confirmed cases probably represent only a fraction of the people who were actually sickened by the parasite. The investigation of the outbreak is still in progress. Although pools were closed on 26 March, there could be people becoming ill 2 weeks after that date, and their symptoms last anywhere from one to 2 weeks. Another unrelated cryptosporidiosis outbreak in another town in Minnesota last month resulted in 36 reported cases, with one case being confirmed in a laboratory. The symptoms of cryptosporidiosis include stomach cramps, fevers or diarrhea. It can be contracted by swimming in infected water, contact with animals or even drinking raw unpasteurized milk. In 2011, there were 305 laboratory-confirmed cases of cryptosporidiosis, according to preliminary MDH numbers. One person was hospitalized in each of the outbreaks. The infection certainly can be more dangerous to those who are immune-compromised, which are children, very elderly people and pregnant individuals. Health officials said that people who have been sick with diarrhea in the previous 2 weeks should avoid swimming in recreational waters. [ProMed]

In a collaborative study between the Oregon Public Health Division, the Minnesota Department of Health, and the US Centers for Disease Control and Prevention (CDC), it was found that gastroenteritis in long-term care facilities (LTCFs) may be caused by sapovirus, an organism not routinely tested. The findings underscore the need for multiorganism testing during gastroenteritis outbreaks, as the exact etiology of the outbreak can be difficult to discern on the basis of clinical profile alone. Using data from the Oregon and Minnesota public health departments, the researchers investigated 2161 gastroenteritis outbreaks between 2002 through 2009. Of these, 142 outbreaks were found to be norovirus-negative, and 93 of these were further tested for other gastrointestinal viruses including sapovirus, astrovirus, adenovirus, and rotavirus. Sapovirus was identified in 21 outbreaks, with 66 percent of these occurring in LTCFs. Close to half of these cases occurred in 2007 alone. Using data from 14 of the 21 outbreaks, for which clinical data on 141 to 269 patients were available, symptoms appeared to last from 24 to 105 hours and the clinical profile included vomiting, diarrhoea and fever. The researchers note that the clinical findings are similar to the criteria used to evaluate norovirus outbreaks in settings where laboratory resources are limited. They fopund, however, that sapovirus and norovirus outbreaks are clinically and epidemiologically similar enough to be indistinguishable without laboratory testing. [ProMed, Lee LE et al: Sapovirus outbreaks in long-term care facilities, Oregon and Minnesota, USA, 2002-2009. Emerg Infect Dis. 2012; 18(5); available at <http://wwwnc.cdc.gov/eid/article/18/5/11-1843_article.htm>]

A Legionnaires' disease outbreak in Auckland claimed its 1st life on April 4, 2012 night, with a public health specialist predicting more may die. Secretive Auckland council bureaucrats refused to tell the public which city buildings have been urgently "shock-dosed" with chemicals this week against the disease. There are 11 cases of the disease confirmed by Auckland Public Regional Health Services from a mid-February 2012 outbreak. The Property Council alerted its members, requesting building owners or managers with water-powered / water-cooled air conditioning systems to immediately chemically treat their systems in order to kill any Legionella bacteria that may be present. It takes between 2 and 14 days for Legionnaires' disease to get a grip, which makes it difficult to pinpoint a source and say how widespread the outbreak could go. Typically in New Zealand, one person dies from every 20 cases of Legionnaires' disease reported annually. Overseas, it can be as high as one in 5. The chances of catching Legionnaires' disease are 3 in 100 000 and it cannot be transmitted from person to person. It can only be caught by breathing air-borne contamination from water-powered / water-cooled air conditioning systems and is hard to catch. There was an outbreak in Christchurch in 2005, and it was quite big, and people were dying. They tried very hard to find the source, and, unfortunately, more people kept on getting sick, and they never really found a cause. [ProMed]

The number of people contracting the mosquito-spread infection has dramatically increased in Western Australia and Tasmania. Although not fatal, many health authorities are warning travellers to be aware of mosquitoes and the Ross River virus (RRV). A significant rise in people contracting the disease has reportedly been caused by recent flooding and consequent swarms of mosquitoes in Western Australia. The Australian Medical Association (AMA) has already reported 632 cases in Western Australia and Tasmania in 2012, which is more than double for the same period last year. Due to heavy rainfall in several states and severe flooding in New South Wales and Queensland, vast areas of stagnant water have formed acting as the perfect breeding grounds for mosquitoes. Health authorities are urging travellers in the affected regions to be vigilant in protecting themselves against mosquito bites. Ross River virus infection is never fatal. However there is great variability in the severity of the symptoms: about 1/3 of people are unaware that they are infected. Any symptoms tend to start 3 - 11 days after an infective bite, when people feel weak, fatigued, they develop aches and pains, and there may be swelling and stiffness of the joints. Some experience a rash on the arms legs and body which settles in 7 - 10 days. Travellers should be wary that the virus is not restricted to Australia. RRV cases have been reported in Indonesia, Papua New Guinea and some Pacific Islands. [ProMed]

Sacramento County communicable disease investigator Vanessa S, who interviews every resident diagnosed with syphilis, suspects a surprising culprit for the recent rise: smartphones. Social networks and smartphones have made it easier for people seeking casual sex to find willing partners. Some GPS-powered apps enable people to broadcast their location to others seeking "hookups" in their vicinity. Most are gay males, but some heterosexual men and women report using digital networks, too. Some of the increase also likely comes from the fact that clinicians are growing more aware of the problem and conducting more syphilis tests. County and state officials have been notifying doctors to be on the lookout. In its primary and secondary phases, which occur over weeks or months, syphilis typically causes a single sore wherever the bacterium entered the body and a rash on the hands and feet. The symptoms are often mild and painless, and the sore may be hidden inside the genitals, anus, or mouth, so many patients don't realize they're infected. Those early symptoms resolve on their own. Then the germ remains in the body, inactive and invisible, for as long as 10 or 20 years. The infection can ultimately rebound and attack internal organs, including the brain. Syphilis is easily detected with a blood test and cured with antibiotics, though the damage done may not be reversible. The disease is contagious only in its earliest stage, via skin-to-skin contact with the sore. Condoms can prevent its spread if they cover the site of the sore. Cases of syphilis reported annually in the United States declined dramatically in the 1940s to a low in 2000. [ProMed]

Syphilis seems like a bygone disease, but it's coming back, particularly in Sacramento (California). New cases of the vicious sexually transmitted disease have been rising steadily for several years, locally and nationally. But Sacramento County has seen an even more pronounced spike since summer 2011. Local doctors diagnosed 41 cases of primary and secondary syphilis (the early, less damaging phase of the disease) in the 1st half of 2011. In the 2nd half, they identified 65 cases, an increase of 60 per cent. That's according to preliminary numbers from the California Department of Public Health, where officials expect Sacramento's totals to rise by at least 10 cases once the tallies are finalized in May 2012. Taken together, the 106 new cases in 2011 were twice as many as Sacramento saw the year before, and the county's highest annual total in at least a decade. They constitute the latest chapter in a return of the disease to the county, where only 4 syphilis cases were reported during 2001. Sacramento's primary and secondary syphilis infection rate of 7.4 cases per 100 000 residents is now 25 per cent higher than the state wide average. Nationally, the infection rate more than doubled in the decade ending in 2010, up from 2.1 to 4.5 cases per 100 000 residents. Syphilis is caused by a bacterium (Treponema pallidum). The bug can pass from person to person during vaginal, anal, or oral sex. If untreated, it can resurge years or decades after the initial infection and cause paralysis, blindness and -- famously -- dementia. [ProMed]

Auckland is facing a hepatitis A outbreak with 19 cases confirmed, including some schoolchildren. Hepatitis A is usually a mild illness in children with complete recovery and no ongoing health effects, but it affects teenagers and adults more seriously. Hepatitis A virus is excreted through faeces and can be spread from person to person or by swallowing food or water that has been contaminated. Symptoms in children usually include fever, an upset stomach, and feeling tired and generally unwell. Many children don't show signs of the infection, but very occasionally they will develop jaundice -- a yellowing of the skin and the whites of the eyes. The best way to prevent the spread of the infection is careful hand washing with soap and proper drying, especially after using the toilet and before eating. The time between infection and the appearance of the symptoms is between 2 and 6 weeks and the average incubation period is 28 days. In developing countries, and in regions with poor hygiene standards, the incidence of infection with this virus is high and the illness is usually contracted in early childhood. There is no specific treatment for hepatitis A. Several hepatitis A vaccines are available internationally, however, no vaccine is licensed for children younger than one year of age. Nearly 100 percent of people will develop protective levels of antibodies to the virus within one month after a single dose of the vaccine. Millions of people have been immunized with no serious adverse events. [ProMed]

A Perth council has issued a warning about mosquito-borne Ross River virus after it emerged that in the area more people have contracted the virus in the past 2 months than in all of 2011. In a statement, the City of Cockburn said it had 62 reported cases of Ross River virus in the area since 1 Jan 2012, almost triple the 21 cases reported in 2011. There has been a similar rise across the state in the past 2 months, with 511 cases state-wide since the start of 2012. This is more than the total number of cases in all of 2010, when there were just 245. At the same time last year, there were just 245 cases of the virus reported state-wide. Health officials have warned residents to take extra precautions in preventing mosquito bites, especially during sunset and for 3 hours after sunset. The City's Environmental Health officers have carried out trapping adult mosquitoes to determine potential breeding sites and are taking action to reduce mosquito numbers and potential disease risk. According to the Department of Health, symptoms can include skin rashes, sore and painful joints, tiredness, fever and headaches. It starts between 3 - 21 days after a mosquito bite, and can last for several months. Fever, nausea and skin rashes usually disappear within the 1st 2 weeks of the illness developing, but the joint, muscle and tendon pain can last for much longer. There is no cure for Ross River virus, and the only prevention is to avoid being bitten by mosquitoes carrying the disease. [ProMed]

There's more to cat excrement than meets the eye, and it may have the potential to cause disease in sea otters and humans alike. A young cat can shed up to 100 million oocysts -- little egg-like structures -- in its feces. All it takes is one oocyst to cause an infection of Toxoplasma gondii. Largely, the parasite is asymptomatic in humans, but it can sometimes cause problems for infants born to infected mothers – including hearing loss, mental disability and blindness. People with compromised immune systems, especially those who have HIV/AIDS, may also develop serious complications. Researchers are trying to understand why marine mammals in the Pacific Northwest started dying of protozoal diseases starting in 2000; before then, there weren't any documented cases. Cat feces may be part of the explanation: when humans settle near shorelines, it can accentuate land-to-sea pollution. The Toxoplasma gondii oocysts from cats can get into the ocean through storm runoff. From there, it can get into mussels and other bivalves that sea otters eat. Humans who eat raw shellfish may likewise be at risk. Up to 25 percent of Americans are infected with toxoplasmosis, and in some parts of Europe it's as much as 50%. Humans carry it throughout their lives. It's not known why there are more people who have the infection in Europe, although dietary habits (eating raw meat/fish) be a factor. Over the past decades it has become clear that there are several genotypes of Toxoplasma gondii, and that different genotypes differ in pathogenicity in humans. [ProMed]

The recent outbreak of sickness linked to a local farm ranks among Pennsylvania's 3 most severe outbreaks of disease linked to raw milk in the past 5 years. The Pennsylvania Department of Health reported on Mon 13 Feb 2012 that raw milk produced a farm was linked to 65 cases of campylobacteriosis in 4 states: 56 in Pennsylvania, 4 in Maryland, 3 in West Virginia, and 2 in New Jersey. Since 2006, Pennsylvania has had at least 7 disease outbreaks linked to raw milk consumption. Campylobacter bacteria have caused most of the outbreaks, and salmonella caused the remainder. More than 250 people became ill. Raw milk bottled around 16 Jan 2012 has been blamed for the recent outbreak. The Pennsylvania and Maryland health departments told consumers on 27 Jan 2012 to dispose of milk produced from 1 Jan 2012. The milk producing company voluntarily stopped selling raw milk for 11 days and resumed sales on 7 Feb 2012 after a Pennsylvania Department of Agriculture inspection re-approved the dairy's operations. The company sells 130 000 servings of raw milk a month from Pittsburgh to Philadelphia. Many consumers drive from out of state to purchase the untreated milk, which cannot be sold legally in their state. Raw milk produced in Pennsylvania is labelled with a warning about possible health risks associated with its consumption. Farms selling raw milk also post the warning. [ProMed]

6 cases of Legionnaire's disease have been linked to the Best Western Hotel in Albany, New York. The guests who became ill stayed at the hotel between September and December 2011. Tests confirmed Monday, January 30, 2012 that higher than normal levels of Legionella bacteria were present in the hotel's water system. Of note, the Department of Health has not closed the hotel, which means that the Department of Health has determined that current guests are not at risk based upon the remedial measures that were taken. Legionnaire's disease is a severe form of pneumonia. It is usually caused by breathing in the mist from hot tubs, showers or air conditioning units contaminated by Legionella. Symptoms include fever, chills, muscle aches and a high fever. It usually develops 2 to 14 days after exposure. The disease often crops up in hotels and water parks where people are exposed to water spray. The 6 Best Western guests who became ill have recovered. The Best Western hotel will flush its water system on Sunday, February 5, 2012 under the supervision of county officials. The state and county health departments also have instructed the hotel to inform current and prospective customers about the problem, and the county is contacting guests who have recently stayed at the hotel. The hotel also has raised the temperature of the water to help kill off the bacteria. The disease is usually mild and most people recover. [ProMed]

One person has died and at least 50 more have fallen ill from salmonellosis which may be linked to watermelons imported from Brazil. The outbreak, which began in December 2011, is believed to involve packs of ready-to-eat sliced watermelon. Health chiefs say the public can protect themselves by washing all types of fruit and vegetables. Watermelon samples tested positive for Salmonella enterica serotype Newport. However, many are unlikely to wash packs of ready-to-eat fruit, which have become enormously popular and are often sold as a healthy lunchtime snack. 70 percent of the victims are female and include a 6-month-old baby and pensioners. Confirmed cases are: England (26), Wales (3), Northern Ireland (1), Scotland (5), Republic of Ireland (5) and Germany (15). The watermelon sampled was imported from Brazil and between 10 and 15 of the victims reported eating the fruit in the 2 to 3 days before they fell ill. Brazil is the largest supplier of imported watermelons sold in the UK accounting for around 12 percent of the total, which equates to around 6100 tons. As Salmonella Newport is often associated with cattle or horses, contamination from animal manure used as fertilizer is a potential source. [ProMed]

The husband of a federal member of parliament (MP) is recovering in the hospital after contracting the dangerous soil-borne disease melioidosis. The MP says her husband went to see a doctor because a cut on his leg was not healing. She thinks he caught melioidosis while mowing the lawn, despite being vigilant. It is very concerning that a little scratch can result in something as serious as melioidosis. The Northern Territory Centre for Disease Control says there have been 24 cases of meliodosis this wet season, including 2 deaths. Melioidosis occurs mainly affecting people who have direct contact with soil and water. Many have an underlying predisposing condition such as diabetes, renal disease, cirrhosis, thalassemia, alcohol dependence, immunosuppressive therapy, chronic obstructive lung disease and cystic fibrosis. Melioidosis may present at any age, but peaks in the 4th and 5th decades of life, affecting men more than women. In addition, although severe fulminating infection can and does occur in healthy individuals, severe disease and fatalities are much less common in those without risk factors. In acute severe melioidosis, there is characteristically the rapid progression of respiratory failure that is due to acute respiratory distress syndrome (ARDS) and/or pneumonia. [ProMed]

Acute diarrhoea is among the diseases monitored in France since 1990. According to the data disseminated by the Sentinel network France, it was noted that in metropolitan France, the incidence of cases of acute diarrhoea detected in consultation of general medicine has slightly exceeded the epidemic threshold. The cases were of 300 cases for 100 000 inhabitants for a threshold of 282 cases. According to data from the network, it was found that 6 regions had markedly exceeded the epidemic threshold and which are the Aquitaine with 308 cases, the Alsace with 319 cases, Provence-alps-Cote-d'Azur with 327 cases, Lower Normandy 339 cases, Languedoc-Roussillon with 571 and the area which is at the head of this epidemic, and the Nord-Pas-de-Calais with 884 recorded cases. It has been reported that 43 percent of the sick persons were men with an average age of 28 years. The gastroenteritis is contagious in the majority of cases when it is viral, bacterial or parasitic. The gastroenteritis is a very common illness and most of the people can easily run the risk of being affected. This risk is due to a bad hygiene and to some inappropriate actions in the handling of food. [ProMed]

An HIV-positive man in Michigan turned himself in to authorities on 26 Dec 2011 and confessed to sleeping with 3000 men and women and intentionally attempting to spread the disease to kill people. As it stands the 51-year-old man has only been arraigned on 2 counts of penetrating a partner who did not know he was positive. One female victim said the he was a sociopath and a predator. It's unclear whether the subject's lawyers will attempt an insanity defence. Sexual penetration with HIV is considered a felony in Michigan but the subject had recently been remanded to a mental hospital after several suicide attempts. Files from the hospital indicate he is sexually aroused by causing pain to females. Attorney Richard Zambon told that he plans on exploring all options in his client's defence. On another note, clearly this man needs to be removed from society. [ProMed]

New South Wales Health (NSW, Australia) is warning residents and visitors in the southern and western part of NSW to take extra precautions to protect themselves against mosquitoes following the detection of the Murray Valley encephalitis (MVE) virus in NSW. The MVE virus has been detected in sentinel chickens located in the south of the state and also in the west of the state. Positive MVE findings in chickens are relatively rare in NSW. The important message is to avoid mosquito bites and be alert to any symptoms. The increased risk of human cases is related to increasing numbers of mosquitoes that carry the virus and can transmit it to birds and occasionally people. Mosquito numbers increase with warmer temperatures and rainfall. MVE activity was seen last summer and autumn in sentinel chickens and in mosquitos and 2 human cases of MVE infection were detected in NSW. There have been no human MVE cases reported so far summer 2011 in NSW and no MVE detections from mosquito trapping. [ProMed]