GIDEON blog » Epidemiology

Vaccination Coverage in Haiti

Steve Berger — Sun, 07 Mar 2010 18:42:49 +0000

Although vaccination coverage for major infectious diseases in Haiti was below that of other countries in the region, recent WHO estimates had shown some improvement in recent years. Most recent data are summarized in the following chart:

Also check out GIDEON’s free ebook: Infectious Diseases of Haiti

Leptospirosis in Queensland

Steve Berger — Sat, 20 Feb 2010 05:02:42 +0000

A recent ProMED warning to backpackers is well taken – leptospirosis is a common disease in the Pacific region. In the following graphs I’ve compared disease rates for Australia and New Zealand with those of the United States.

Leptospirosis rates in nearby New Caledonia are even more striking, and exceed those of salmonellosis, hepatitis A, hepatitis B, gonorrhea, and tuberculosis.

Tuberculosis in Haiti

Steve Berger — Sun, 07 Feb 2010 20:10:00 +0000

As pointed out by ProMED, tuberculosis rates in Haiti were already highest in the region before the current disaster. In the following graph, I’ve contrasted reports for Haiti with those of neighboring countries.

Don’t forget to check out GIDEON’s free e-book: Infectious Diseases of Haiti

E-book: Infectious Diseases of Haiti by GIDEON

Uri Blackman — Thu, 28 Jan 2010 08:53:31 +0000

When the humanitarian disaster in Haiti began to unfold, we accelerated development of a comprehensive book on the diseases of that country. This will be one in a series of E-books which present the status of all infectious diseases .. in all individual countries. This Ebook, Infectious Diseases of Haiti, will be offered free of charge to all Health Professionals concerned with the current disaster.

There are 347 forms of human infectious disease in the world today – and 198 of these (more than half) are known to occur in Haiti. Sadly, one of the “side effects” of living in a poor and disaster-ridden economy is a lack of useful facts regarding the local status of individual diseases. GIDEON (Global Infectious Diseases and Epidemiology Online Network) is a Web-based application which follows diseases – both on a global level and within each country. Data are updated daily and are derived from all relevant journals, websites, Health Ministry reports and publications of the World Health Organization. The electronic book (E-book) is generated from information in the GIDEON database, and will serve as the first comprehensive review of Infectious Diseases in Haiti. Similar E-books for any other country – or disease – will be available from GIDEON in the near future.

To download for free, click on the following link:
Infectious Diseases of Haiti by GIDEON (313 pages, 3.3MB, updated Mar 6, 2010)

Also available on Amazon Kindle for $1: Kindle version

Non-tuberculous Mycobacterial Infections

Steve Berger — Thu, 28 Jan 2010 03:23:35 +0000

Infection by non-tuberculous mycobacteria is commonly associated with cosmetic surgery, therapeutic injections and other invasive procedures. The following is a list of notable outbreaks:

Argentina:
2007 to 2007 – An outbreak (28 cases) of Mycobacterium immunogenum infection in Buenos Aires was associated with mesotherapy.

Brazil:
2002 to 2004 – An outbreak (14 cases) of mycobacterial wound infection associated with silicone breast implant surgery was reported in Campinas, Sao Paulo.
2003 – An outbreak (5 cases) in Sao Paulo of keratitis due to Mycobacterium immunogenum was associated with myopia surgery.
2004 to 2005 – An outbreak (311 cases) of Mycobacterium abscessus infections in Belem was associated with invasive procedures. Mycobacterium massiliense and M. bolletii were also identified in some cases.
2006 to 2007 – An outbreak (1,051 clinical cases) of Mycobacterium massiliense infections involving 63 hospitals in Rio de Janeiro state was related to contaminated instruments used in video-assisted surgery.
2008 – An outbreak (13 cases) of Mycobacterium fortuitum infections in Sao Paulo was associated with breast implant surgery.

Canada:
2002 – An outbreak (32 cases) of Mycobacterium abscessus infection in Toronto was reported from two acupuncture clinics.

Colombia
1996 (publication year) – An outbreak (232 cases) of Mycobacterium chelonae subsp. abscessus infection in Barranquilla was caused by contaminated lidocaine used in a single physician’s office.

Dominican Republic:
2003 – An outbreak (6 cases) of abdominal wall infections caused by Mycobacterium abscessus occurred among patients who had undergone liposuction at a single clinic in Santo Domingo.
2004 – An outbreak (12 cases) of M. abscessus infection were diagnosed among Americans who had visited various clinics in Santo Domingo for cosmetic surgery.

France:
1989 to 1993 – An outbreak (58 cases) of discitis due to Mycobacterium xenopi was reported in a hospital.
2006 to 2007 – An outbreak (16 cases) of subcutaneous Mycobacterium chelonae infections was associated with mesotherapy injections.
2008 (publication year) – An outbreak (8 cases) of mycobacteriosis was associated with a tattoo parlor.

Hong Kong:
1993 (publication year) – An outbreak of sternotomy infections due to Mycobacterium fortuitum was reported in cardiothoracic hospital.

India:
1995 – An outbreak (45 cases) of post-operative wound infections due to Mycobacterium abscessus was ascribed to contaminated water.
2006 (publication year) – An outbreak (145 cases) of Mycobacterium cheloniae port site infections in Bangalore was associated with contaminated laparoscopic equipment.

Israel:
2003 – An outbreak (15 cases) of “Mycobacterium jacuzzii” infection was associated with breast implant surgery.
2008 (publication year) – An outbreak (5 cases) of Mycobacterium mucogenicum bacteremia in a paediatric haematology-oncology ward was related to a contaminated faucet.

Mexico:
1991 (publication year) – An outbreak of post-rhinoplasty nasal cellulitis due to Mycobacterium chelonae was reported in Mexico City.

Peru
2004 to 2005 – An outbreak (35 cases) in Lima of persistent cutaneous abscesses due to Mycobacterium chelonae was associated with mesotherapy sessions.

Republic of Korea:
2001 – An outbreak (40 cases) of Mycobacterium abscessus infection was associated with an acupuncture clinic.
2007 (publication year) – An outbreak (12 cases) of Mycobacterium massiliense infections was associated with intramuscular injection of an antimicrobial agent (ribostamycin).
2008 – An outbreak (109 cases) of Mycobacterium abscessus infection was ascribed to contaminated glutaraldehyde disinfectant used in acupuncture.

Spain:
2009 (publication year) – An outbreak (39 cases) of Mycobacterium fortuitum infection in Rioja was associated with mesotherapy administered by a beauty salon.

United States:
1987 – An outbreak (17 cases) of Mycobacterium chelonae otitis media was caused by contaminated water used by an ENT practice in Louisiana.
1988 – An outbreak (8 cases) of foot infections due to Mycobacterium chelonae subspecies abscessus infections were associated with a jet injector used in a podiatric office.
1989 to 1990 – An outbreak (16 cases) of sputum colonization by Mycobacterium fortuitum was reported among patients on an alcoholism rehabilitation ward in Washington, D.C.
1991 (publication year) – An outbreak (6 cases) of Mycobacterium fortuitum infection in Washington was associated with contaminated electromyography needles.
1995 to 1996 – An outbreak (87 cases) of postinjection abscesses due to Mycobacterium abscessus in several states was ascribed to an adrenal cortex extract. 1999 – An outbreak (10 cases) of intra- and periarticular Mycobacterium abscessus infection in Texas was caused by contaminated benzalkonium chloride used for injection.
2000 to 2001 – An outbreak (110 cases) of skin infections due to Mycobacterium fortuitum was caused by contaminated footbaths in California nail salons.
2002 – An outbreak (14 confirmed and 11 suspected cases) of soft tissue infections due to Mycobacterium abscessus followed injections of cosmetic substances administered by unlicensed practitioners in New York City.
2002 – An outbreak (115 cases or more) of cutaneous infection by Mycobacterium fortuitum was associated with a contaminated footbath in a nail salon in California.
2002 (publication year) – An outbreak (34 cases) of Mycobacterium chelonae soft tissue infection in California was associated with liposuction.
2002 to 2003 – An outbreak (4 cases) of Mycobacterium chelonae infection among patients undergoing rhytidectomies in New Jersey was caused by a contaminated methylene blue solution.
2003 – An outbreak (3 cases) of Mycobacterium goodii infection was associated with surgical implants in a Colorado hospital.
2004 – An outbreak (12 cases) among Americans of soft tissue infections caused by Mycobacterium abscessus following cosmetic surgery performed at various clinics in the Dominican Republic.
2004 – An outbreak (143 cases) of mycobacterial skin and soft tissue infection (presumed M. fortuitum) was reported among persons attending nail salons in California.
2009 (publication year) – An outbreak (6 cases) of Mycobacterium chelonae infection was associated with a tattoo establishment.

Venezuela:
2005 – An outbreak (70 cases) of Mycobacterium cosmeticum infection was related to “mesotherapy” injections for fat removal.

Update: Appeared in ProMED

Pogosta Disease

Steve Berger — Fri, 15 Jan 2010 04:27:51 +0000

Time and Place:
- Pogosta disease was first described in the Pogosta region of Northern Karelia in 1974.
- The disease is reported from all parts of Finland, however, North Karelia remains the region with highest incidence, with rates as high as 80 per 100,000.
- Extensive epidemics were recorded in 1974, 1981 (thousands of cases), 1988 and 1995.
- Incidence peaks during August to September.
- Disease incidence follows a seven-year cycle.
- Highest rates are reported in the age group 45 to 65.

Graph Notes:
1. 2,183 laboratory-confirmed cases were reported during 1981 to 1996 (average rate 2.7 per 100,000 per year).
Individual years:
1995 – Cases were distributed throughout the country, with highest incidence in central Finland, Savo and North Karelia.
2003 – Included 105 cases in Lansi-Suomi and 50 in Ita-Suomi.

Seroprevalence surveys:
1.7% of ’suspected rubella’ in Finland (1973 to 1989)
11% of persons suspected of having viral infection – 17% in western Finland, 9% in northern and southern Finland
0.6% of women of childbearing age (1992)
5.2% of humans (Sindbis virus, 1999 to 2003)
27.4% of resident grouse (Tetrao urgallus, T. tetrix, Bonasa bonasia, Lagopus lagopus) in 2003, 1.4% in 2004

The principal vectors are mosquitoes (Culex and Culiseta species), and the presumed reservoirs are tetranoid and migratory birds.
- During an epidemic in 1981, 65% of black grouse and capercaillie were found to be seropositive.

Leptospirosis in Ireland

Steve Berger — Wed, 06 Jan 2010 04:51:44 +0000

A recent death in Ireland highlights the fact that the incidence of leptospirosis in this country has been increasing in recent years. In fact, during the past decade, leptospirosis rates have expanded well beyond those of those of the United Kingdom, including those for adjoining Northern Ireland. See graph:

Update: Published in ProMED

Hepatitis A in Australia

Steve Berger — Tue, 22 Dec 2009 05:07:08 +0000

The incidence of Hepatitis A in Australia has decreased dramatically in recent decades – from a high of 12,876 cases in 1962, to only 274 cases in 2008.

Since the 1970’s, rates of Hepatitis A in Australia have been strikingly similar to those of the United States (see graph):

Graph notes:
1.3. During 1991 to 1997, highest rates (52 per 100,000) were reported in the Northern Territory.
2. During 1991 to 2006, rates in New South Wales declined from 18.9 per 100,000 to 1.4 per 100,000.
Individual years:
1991 – 46.7% from New South Wales.
1994 – 39.7% from Northern Territory and 25.1% from Queensland.
1996 – 45.6% from New South Wales.
1997 – 47.3% from New South Wales.
1998 – 44.9% from Queensland and 37.8% from New South Wales.
2005 – 15.4% from Queensland and 25.5% from New South Wales.
2009 – Increasing rates in Victoria and South Australia appear to have been associated with ingestion of contaminated semi-dried tomatoes.

No fatal cases were reported during 1991 to 1997; 8 during 1998 to 2000.

570 cases were reported from eastern Sydney during 1991 to 1992, of which 58% were men who have sex with men.
– 236 cases were reported from south-eastern Sydney during June 1997 to May 1998 – over 60% of male cases acquired through homosexual contact; 118 during June 1998 to May 1999 – 29% through homosexual contact.

Seroprevalence surveys:
41.1% of Australians, 68.8% in the Northern Territory (1998)
75% of HIV-posititive MSM (2007 publication)
48% of homeless persons in Sydney (2003 to 2005)
3.0% of STD clinic patients (Canberra, 2000 to 2002)
37% of prisoners in New South Wales (1994)

Since 1993, hepatitis A has been the most common cause of infectious disease death among indigenous children in northern Queensland.
– Clinically apparent and severe hepatitis A are more common among indigenous children than their non-indigenous counterparts
– A vaccination program for this population was introduced in 1999.
– During 2003 to 2006, disease rates were 8.1 per 100,000 among indigenous people vs. 1.7 per 100,000 in other populations.

Notable outbreaks:
1970 (publication year) – An outbreak of Infectious hepatitis was reported in an institution.
1980 (publication year) – An outbreak (15 cases) was reported in a home for mentally-retarded children in Sydney. {p 6929674}
1991 – An outbreak (495 cases) in Melbourne involved men who have sex with men.
1993 – An outbreak (11 cases) was reported at a center for young people with developmental disabilities.
1996 (publication year) – An outbreak (7 cases) at a hospital in North Queensland may have been related to handling of contaminated bile.
1997 – An outbreak (7 cases) occurred among boys using a domestic spa in Melbourne.
1997 – An outbreak (270 cases or more) in New South Wales was traced to raw oysters.
1998 – An outbreak (45 cases) in Sydney was ascribed to illicit drug use.
2003 – An outbreak (10 cases) in Tasmania, Victoria and Queensland occurred among people who had been on tour in the Northern Territory.
2003 – An outbreak (21 cases) at a youth camp in central Australia was associated with ingestion of contaminated coleslaw.
2008 – An outbreak (15 cases) was associated with a cafe in Melbourne, Victoria.
2009 – An outbreak (200 cases) in Victoria was associated with consumption of semi-dried tomatoes.

Hepatitis A in Tajikistan

Steve Berger — Tue, 08 Dec 2009 04:57:31 +0000

An impending outbreak in Khujand belies the fact that reported rates of Hepatitis A in Tajikistan and neighboring countries have actually decreased in recent years. See graph

Malaria in Georgia

Steve Berger — Sun, 29 Nov 2009 04:40:12 +0000

Although autochthonous cases continue to be reported, malaria rates in Georgia and surrounding countries have decreased considerably since 1999. With the exception of Russia, all of the countries which border Georgia had reported higher rates in recent years.