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Hand, Foot and Mouth Disease in Singapore

Highest rates of Hand, foot and mouth disease (HFM) in Asia are reported by Singapore and Macao.  In fact, the incidence of HFM in Singapore is even higher than that of the more familiar dengue fever. [1,2]

HFM1

 

 

HFM2

Reference:

  1. Berger SA. Infectious Diseases of Singapore, 2016. 461 pages, 112 graphs, 2073 references. Gideon e-books, http://www.gideononline.com/ebooks/country/singapore/
  2. See Gideon Graphs Tool at: http://www.gideononline.com/wp/wp-content/uploads/Gideon-Graphs.pps

 

Lyme Disease in the United Kingdom

The following background data on Lyme disease in the United Kingdom were abstracted from Gideon www.GideonOnline.com and the Gideon e-book series.  [1,2] Primary references are available on request.

Time and Place:

Lyme disease is reported from East Anglia, Scotland, Wales, Yorkshire and Northern Ireland.  Highest incidence is associated with popular holiday destinations such as Exmoor, the New Forest, the South Downs, parts of Wiltshire and Berkshire, Thetford Forest, the Lake District, the Yorkshire moors and the Highlands and Islands of Scotland.  “Hot spots” for the disease include the New Forest and the Southwest region.  45% of reports originate in three contiguous counties in southern England:  Hampshire, Wiltshire and Dorset.  This area includes foci in and near the New Forest and Salisbury Plain. Other counties with a relatively high incidence include Devon and Somerset in southwestern England; and Norfolk in East Anglia.

Incidence:

Reporting rates in the United Kingdom are approximately 39% of true incidence (2011).  Case reports peak in the third quarter of each year, which accounts for 48% of all cases.

In the following graphs, I’ve contrasted case numbers and rates per 100,000 in the United Kingdom, with those reported in Ireland and the United States.  Note that highest disease incidence in the United Kingdom is reported from England and Wales;  and highest rates per 100,000 from Scotland.  Reported rates in the United States are approximately 2.5-fold those of Scotland.

lyme

Infections due to Borrelia burgdorferi, B. afzelii and B. garinii are identified.

Borrelia valaisiana and B. afzelii have been identified in ticks in Scotland.

 

Prevalence surveys:

23% of patients referred to an infectious disease unit for suspected Lyme disease (2006 to 2010)

2.3% of dog ticks in the United Kingdom (2009)

4.2% of ticks (Ixodes ricinus) in England (2014 publication)

0.5% of pet-dog ticks (2012 publication)

0% of tick larvae, 2.14% of nymphs and 0% of adults in South London parks (2015 publication)

8.6% of ticks in the Scottish Highlands (both B. afzelii and B. burgdorferi, 1997)

37% of ticks in wooded areas of southern Wales

8.6% of Highland ticks in Scotland (Borrelia burgdorferi, 1997)
5.6% of questing tick nymphs in Scotland (Borrelia burgdorferi, 2012 publication)
11.9% of grey squirrels in Scotland (Sciurus carolinensis, 2015 publication)

Seroprevalence surveys:

2.5% to 4.0% of blood donors in South England

0% to 0.5% of blood donors in the inner-city

25% of forestry workers in endemic areas (1989 publication)

14.3% of farmers in Northern Ireland (1990 publication)

6.5% of individuals in the Scottish Highlands (2004 to 2006)

23% of wild deer in England and Wales (2012 publication)

Reservoirs:

Grey squirrels (Sciurus carolinensis Gmelin) and pheasants (Phasianus colchicus Linneaus) 18 are important hosts for Ixodes ricinus, and may serve as amplifying hosts for Borrelia burgdorferi in this country.

Seropositive horses are found in most parts of the U.K.

Note featured on ProMed

References:

  1. Berger SA. Lyme Disease: Global Status, 2016. 87 pages, 67 graphs, 1037 references. Gideon ebooks, http://www.gideononline.com/ebooks/disease/lyme-disease-global-status/
  2. Berger SA. Infectious Diseases of the United Kingdom, 2016. 1317 pages, 971 graphs, 4,932 references. Gideon ebooks,

Infectious Diseases of the United Kingdom

2016 Edition of GIDEON eBooks

Since initial publication in 2010, the popularity of GIDEON ebooks has continued to grow. A WorldCat search demonstrates how many libraries across the globe now purchase the series for reference .

The 2016 edition has expanded all content, graphs, maps and references based on extensive updates in the GIDEON web application. This latest edition has the largest content of all prior editions:

  • 423 ebooks
  • 121,603 total pages
  • 34,726 images and graphs
  • 684,799 references
  • 2 GB in total file size

Every library in the world should carry at least two of our volumes:

  • The largest ebook (over 1,500 pages), Infectious Diseases of the World – provides a summary of every human infectious disease in the world including disease distribution maps.
  • Infectious Diseases of [your own country] – provides unique extensive background on every infectious disease relevant to that country.

Other valuable references include:

  • Global status of [every infectious disease] – the perfect reference source for every Public Health Department or researcher.
  • Detailed and up-to-date information on every anti-infective drug and vaccine – important references for every pharmacy.
  • A complete encyclopedia on all human bacteria and yeasts – a must for any laboratory or health-care student.

Available for purchase through:

Tick-Borne Encephalitis in the Czech Republic

Rates of Tick-borne encephalitis (TBE) in the Czech Republic are similar to those reported by Austria during the 1970’s. [1,2]   Following the institution of mass vaccination by Austria in 1981, TBE rates decreased to levels experienced in neighboring countries. [3] Enhanced administration of TBE vaccine might also prove effective for the Czech Republic.
TBECzech

References:

1. Berger SA. Tick-Borne Encephalitis: Global Status, 2015. 65 pages, 45 graphs, 564 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/tick-borne-encephalitis-global-status/

2. Berger SA. Infectious Diseases of the Czech Republic, 2015. 497 pages, 143 graphs, 2,097 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-czech-republic/

3. http://www.gideononline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Diphtheria in Latvia

Following a regional epidemic during the 1990’s, Latvia has continued to experience a high incidence of diphtheria. [1]  This phenomenon is difficult to explain on the basis of poor vaccine uptake. The following graph compares W.H.O. estimates of vaccination (DPT3) coverage with diphtheria rates reported in Estonia, Latvia and Lithuania. [2]

DiphtheriaLatvia

References:

1. Berger SA. Infectious Diseases of Latvia, 2015. 436 pages, 103 graphs, 1,497 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-latvia/

2. Berger SA. Diphtheria – Global Status, 2015. 333 pages, 445 graphs, 374 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/diphtheria-global-status/

3. http://www.gideononline.com/wp/wp-content/uploads/Gideon-Graphs.pps

 

Note featured on ProMED

 

Malaria in Brunei

Recently ProMED reported that two tourists from Singapore acquired Plasmodium knowlesi malaria in Brunei.

Malaria rates reported by both Brunei and Singapore have been strikingly similar since the 1990’s (see graph below) and Singapore has reported both autochthonous and imported cases of P. knowlesi infection since 2007.  During the 1950’s, Brunei reported low levels of malaria from the interior regions and coast adjacent to mountainous areas.  The predominant infecting species and vector were P. falciparum and Anopheles leucosphyrus, respectively. [1]

BruneiMalaria

Brunei was officially declared “malaria-free” by WHO in 1987.  A single publication reported a case of P. knowlesi malaria in this country in 2013.

Although official sources do not routinely recommend malaria prophylaxis for travelers, the recent report in ProMED suggests careful review of the current status of the disease in Brunei.

Reference:

Berger SA. Infectious Diseases of Brunei, 2015. 374 pages, 60 graphs, 1,448 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-brunei/

Update: Appeared in ProMED

Arthropod-borne Viruses of Senegal

A recent outbreak of suspected viral infection in Kedougou Region (http://www.promedmail.org/direct.php?id=3626668) highlights the complexity of establishing a specific etiological agent in West Africa.  At least twenty arthropod-borne viruses are associated with known or suspected human infection in Senegal.  The following alphabetical list is abstracted from Gideon www.GideonOnline.com and the Gideon e-book series [1]   (Primary references are available from Dr. Berger on request)

Bagaza – Bagaza virus has been recovered from mosquitoes in Senegal (Aedes fowleri, Culex neavei, Cx. Poicilipes and Mansonia, Mimomyia hispida, M. lacustris, M. splendens and Aedeomyia africana.

Bangui – Bangui virus was identified in mosquitoes in the Senegal River basin in 1988.

Bunyamwera – Bunyamwera virus has been identified in mosquitoes in the Barkedji region.

Chandipura – Chandipura virus has been identified in mosquitoes in the Barkedji region, and in phlebotomines in the Kedougou district.

Chikungunya – Outbreaks of Chikungunya were reported in Senegal in 1966, 1977, 1982, 1988, 1992, 1996 and 1997.  In 2006, a cluster of six cases in France was reported among travelers returning from Senegal. The virus has been found in a variety of local mosquito species, notably Aedes furcifer-taylori, Ae. luteocephalus, Ae. dalzieli and Stegomyia (Aedes) aegypti. Additional vectors may include Ae. vittatus, Anopheles rufipes and An. coustani.

Dengue – An outbreak of dengue was reported in Senegal during 1927 to 1928; and circulation of the virus was subsequently confirmed in 1974 and during 1999 to 2000. An epizootic among monkeys was reported in 1981; and the first human case was reported in 1983 (from Casamance). Several human and monkey infections were reported in 1990. In 2009, a dengue outbreak (196 cases, 1 fatal) was reported – the first reports of human dengue in Senegal for two decades. Italy reported a case of dengue hemorrhagic fever, imported from Senegal, and cases of dengue fever have been confirmed among French military personnel serving in this country.

Gabek Forest – Gabek Forest virus, a Phlebovirus, has been identified in sandflies (Phlebotomus species) in Senegal (1990 to 1995).

Koutango – Koutango virus (similar to Spondweni virus) has been identified in mosquitoes (Culex neavei) in the Barkedji region.

LeDantec – LeDantec virus is a rhabdovirus which is distinct from the vesicular stomatitis group 1. A single case of infection was reported in Senegal in 1965.

Ngari – Ngari virus has been identified in mosquitoes in the Barkedji region.  Two cases of Ngari virus infection were reported from Dakar,

O’nyong nyong – Although specific data are lacking for Senegal, circulation of O’nyong nyong virus is reported in this region of West Africa.

Rift Valley fever (RVF) – RVF virus was first isolated in West Africa in 1974, from Aedes (Aedimorphus) dalzieli in Senegal. Highest seroprevalence rates are found in the northwest and northcentral regions. Serological studies suggest that the disease was active in Diawara and Bakel (Eastern region) in 1998. Outbreaks were reported among goats, sheep and / or cattle in 2002, 2003, 2013 and 2014.  Carriage by mosquitoes and seroprevalence among sheep in the northern region increased during the 1990’s. Rift Valley virus was identified in mosquitoes in Barkedji in 1993, and re-emerged in 2002. A single isolated case of human Rift Valley fever was confirmed in a school teacher in Kedougou in 2012.

Rift Valley fever virus – seroprevalence surveys:

22.3% of Peul people of the North-central region

15.3% of the population in the Senegal River basin (1995 to 1996)

5% of children born after 1987, vs. 25.3% of the older population in Podor District (1999 publication)

5.2% of individuals in Diawara (1999)

2.9% of small ruminants tested in the Ferlo region (2003)

24.4% of sheep and goats in the Senegal River basin in 1988, 19.3% in 1989

17.2% of ungulates in the Senegal River Basin (1990)

3.8% of wild rodents, notably Rattus rattus, Mastomys huberti, A. niloticus and M. erythroleucus (2000 publication)

Semliki Forest – Semliki Forest virus has been recovered from mosquitoes (Aedes vittatus) and ticks (Rhipicephalus guilhoni) in Senegal.

Tataguine – Antibody toward Tataguine virus is found in 57% of the population.

Usutu – Zoonotic infection by Usutu virus has been identified in Senegal.

Wesselsbron – Seropositive humans were documented in Senegal during 1972 to 1975; and the virus itself has been identified in mosquitoes (Aedes vexans) in the Barkedji region.

West Nile – Seroprevalence rates for West Nile virus of 78.3% to 92% have been reported among horses. Infection of wild birds and dogs has also been identified. Vector mosquito species in this country are thought to include Culex neavei, Cx. tritaeniorhynchus, Cx. modestus, Cx. perfuscus group, Cx. poicilipes, Aedes vexans, Mimomyia hispida, Mi. lacustris, Mi. splendens, Aedeomyia africana and Mansonia uniformis

Yellow fever – Epidemics of yellow fever were reported in Senegal in 1768, 1769, 1778 to 1779 (50 deaths among Caucasians), 1814, 1816, 1828, 1830, 1837, 1840 to 1841, 1844, 1852, 1858, 1863, 1866, 1872, 1900 to 1901 (225 fatal cases) and 1923 to 1927. Aedes furcifer, A. metallicus and A. luteocephalus are involved in the wild vertebrate transmission cycle in this country. Yellow-fever activity among mosquitoes in Senegal has been used to monitor potential human disease in West Africa. Infected mosquitoes were identified during 1976 to 1979, 1983, 1987, 1989, 1990, 1992, 1993 and 2010.  Chronology of recent Yellow fever outbreaks in Senegal:

1965 – 243 cases were reported in Diourbel.

1965 to 1966 – 2,000 to 20,000 cases and 200 to 2,000 deaths were estimated.

1979 – Two French tourists contracted fatal yellow fever in Senegal.

1995 – Cases reported in Ribo-Escale and Guente-Pate Districts (vicinity of Koungheul).

1996 – Highest number of cases for any country (30.2% of the world’s total), including an epidemic centered at Kaffine town. {p 9855398}

2001 – Three cases were reported in Kedougou District (Health Ministry report not included in WHO data).

2002 – An outbreak (78 cases, 11 fatal) was reported – with 18 cases in Diourbel and Ziguinchor regions, and 60 cases in Touba, Mbacke and Bambey districts, Diourbel region; Gossas and Fatick districts, Fatick region; Tambacounda district in Tambacounda region; Louga, Koulda and Dakar regions.

2005 – Activity was reported in Tambacounda region (Goudiri, Kadira)

2010 – Two Senegalese fishermen acquired yellow fever in Gambia.

2011 – Three cases were reported in Kedougou and Saraya Health districts, near the borders with Mali and Guinea Conakry.

Zika – There is evidence for the occurrence of yearly epizootics of Zika virus infection in Senegal. In 2008, two American scientists contracted Zika in the country. Natural infection has been identified in two local primate species, Cercopithecus aethiops and Erythrocebus patas; and in 1.82% of mosquito pools (2011).

Zinga – Zinga virus, a variant of RVF virus, has been identified in humans and mosquitoes in Senegal.

 

Reference:

  1. Berger SA. Infectious Diseases of Senegal, 2015. 449 pages, 55 graphs, 1,864 references.  Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-senegal/

Tularemia Deaths in the United States

Although tularemia is more common than plague in the United States, the case-fatality rate is higher for the latter.  Deaths reported for both diseases have changed little in five decades, with the number of tularemia deaths similar to the number of plague deaths in most years.  See graphs

Plague Tularemia

Tularemia Deaths

Reference:

  1. Berger SA. Infectious Diseases of the United States, 2015.  1,208 pages, 483 graphs, 13,730 references. Gideon e-books, www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/

A Chronology of Legionellosis Outbreaks in the United States

The following chronology of significant legionellosis outbreaks in the United States is abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2]   (Primary references available on request)

1949 – An outbreak of presumed Pontiac fever among steam-condenser cleaners was confirmed retrospectively.

1957 – An outbreak (78 cases, 2 fatal) of legionellosis at a packing plant in Austin, Minnesota was confirmed retrospectively.

1965 – An outbreak (81 cases) at a psychiatric hospital in Washington, D.C. was confirmed retrospectively.

1968 – An outbreak of relatively mild legionellosis was associated with a Health Department building in Pontiac, Michigan (thus, “Pontiac fever”).

1974 – An outbreak during a convention of the Independent Order of Odd Fellows in Philadelphia was reported retrospectively in 1978.

1976 – An outbreak (221 cases, 34 fatal) during an American Legion convention in Philadelphia was traced to a contaminated hotel air conditioning system (thus, “Legionnaires’ disease”).

1977 – Outbreaks were reported in Vermont (16 cases, 14 fatal) and Tennessee (27 cases, 3 fatal).

1977 – An outbreak (6 cases) was reported at a medical center in Ohio.

1977 to 1978 – An outbreak (49 cases, 15 fatal) was reported in a medical center in California.

1978 – An outbreak (44 cases) at a hospital in Tennessee was associated with a contaminated air conditioner cooling tower.

1978 – An outbreak (8 cases) was reported at a country club in Georgia.

1979 (publication year) – An outbreak (39 cases) in Indiana may have been related to a local cooling tower.

1979 – An outbreak (13 cases) was associated with a hotel in Wisconsin.

1980 (publication year) – An outbreak of nosocomial legionellosis was reported at a hospital in Pittsburgh, Pennsylvania.

1980 – An outbreak (14 cases) was reported among building site workers in San Francisco, California.

1980 – Outbreaks (85 cases in 2 outbreaks) were reported at a medical center in Burlington, Vermont.

1981 – An outbreak (29 cases, 1 fatal) of community-acquired legionellosis was reported in Iowa.

1981 – An outbreak (34 cases) of Pontiac fever was associated with a whirlpool at a social club in Vermont.

1981 – An outbreak (317 cases) of Pontiac fever due to Legionella feeleii was reported in an automobile plant.

1981 – An outbreak (12 cases) was associated with a single hotel on St. Croix (US Virgin Islands).

1982 – An outbreak (14 cases) of Pontiac fever in Michigan due to Legionella pneumophila serogroup 6 was related to a whirlpool.

1982 – An outbreak (7 cases) in a hospital in New York was associated with a contaminated hot water system.

1983 – An outbreak (15 cases) at a hospital in Rhode Island was associated with a cooling tower.

1983 to 1984 – An outbreak (5 cases) of waterborne Legionella bozemanii infection in New York was reported among immunosuppressed patients.

1984 – An outbreak of Pontiac fever was associated with a cooling tower in an office building in Manhattan, New York.

1985 – An outbreak (14 cases, 3 fatal) followed a church banquet in Michigan.

1986 – An outbreak (27 cases, 2 fatal) was associated with a retail store in Maryland.

1986 – An outbreak (26 cases, 2 fatal) in Wisconsin was associated with a cooling tower.

1988 – An outbreak (34 cases) of Pontiac fever due to Legionella anisa in a California hotel was related to a contaminated fountain.

1989 – An outbreak (33 cases, 2 fatal) of legionnaire’s disease was caused by a contaminated mist machine in a retail store in Louisiana.

1989 – An outbreak of Legionella dumoffii sternal-wound infections in a California hospital was due to postoperative topical exposure to contaminated tap water.

1992 – An outbreak (5 cases) was associated with conventions held at a hotel in the Orlando, Florida, region was ascribed to a contaminated fountain the hotel lobby.

1992 – An outbreak was reported in an intensive care unit.

1993 – Outbreaks (45 cases in 3 outbreaks) in Massachusetts (11 cases), Rhode Island (17 cases) and Michigan (17 cases) were associated with contaminated cooling towers.

1994 – Outbreaks (50 cases) reported during nine cruises aboard a single ship were ascribed to an on-board whirlpool spa.

1994 – An outbreak (28 cases) was reported at a hospital in Connecticut. 81

1994 – An outbreak (29 cases) in Delaware was related to contaminated hospital cooling towers.

1996 – An outbreak (15 cases) was associated with exposure to a hot tub on display in a store in Virginia.

1987 to 1996 – An outbreak (25 cases) of nosocomial legionellosis among transplant cases may have begun as early as 1979.

1995 – An outbreak (22 cases) in Pennsylvania was associated with contaminated hospital cooling towers.

1998 – An outbreak (45 cases) of Pontiac fever was ascribed to a whirlpool at a Wisconsin hotel.

1998 – An outbreak (11 cases, 3 fatal) was associated with a hospital in New York.

1999 – An outbreak (29 cases) in Delaware was ascribed to contaminated cooling towers.

1999 – An outbreak (22 cases of Pontiac fever and 2 of Legionnaire’s disease) was reported at a hotel in Georgia.

1999 – An outbreak (3 cases) was reported among workers at a postal facility in Illinois.

1999 – An outbreak (5 cases, 3 fatal) occurred among patients at a hospital in Maryland.

2000 – Cases of Legionella longbeachae infection were acquired from potting soil in California, Oregon, and Washington.

2000 – An outbreak (20 cases) of Pontiac fever was associated with a hotel whirlpool in Wisconsin.

2000 – An outbreak (15 cases) of Pontiac fever was reported in a sugar beet processing plant in Minnesota.

2000 (publication year) – An outbreak (12 cases) of Legionella micdadei infection was reported among transplant recipients at a hospital.

2001 – An outbreak (10 cases, 4 confirmed, 1 fatal) at an automobile plant in Cleveland, Ohio was traced to a contaminated cooling tower.

2001 to 2008 – An outbreak (35 cases) was reported among residents of a condominium complex in Las Vegas, Nevada.

2002 – An outbreak (16 cases) was reported at a prison in Connecticut.

2002 – An outbreak (5 confirmed cases) was reported at a nursing home in Pennsylvania.

2002 – An outbreak (14 cases) was reported at a building complex in Vermont. 106

2002 – An outbreak (117 cases) of Pontiac fever due to Legionella anisa was reported among patrons at a restaurant in Tennessee.

2002 – An outbreak (68 cases) of Pontiac fever was reported at a hotel spa in Illinois.

2002 – An outbreak (3 cases) was reported among Danish tourists to St. Croix (US Virgin Islands).

2003 to 2004 – An outbreak (8 cases) at a hotel in Maryland was associated with potable water.

2004 – An outbreak (107 cases of Pontiac fever and 6 of legionnaire’s disease) was reported among guests at a hotel in Oklahoma.

2004 – An outbreak (7 cases) of legionellosis was reported at a long term care facility.

2005 – An outbreak (3 cases) of legionellosis was reported at a resort condominium in Maryland.

2005 – An outbreak (12 cases)  at a hospital in New York was ascribed to a contaminated cooling tower.

2005 – An outbreak (2 cases) occurred among men attending an American Legion convention at a hotel in Pennsylvania.

2005 – An outbreak (15 cases, 1 fatal) in South Dakota was related to an ornamental fountain in a restaurant.

2008 – An outbreak (10 cases) was reported at a senior citizen housing facility in New York.

2008 – An outbreak (8 cases, 3 fatal) was reported at a hospital in New Jersey.

2008 to 2010 – An outbreak (9 cases) of legionellosis was reported at a resort in Cozumel, Mexico among tourists from the United States and the Netherlands.

2009 (publication year) – An outbreak (2 cases) of legionellosis in a hospital was related to a contaminated ornamental water fountain.

2009 – An outbreak (4 cases) was reported at a hospital in Georgia.

2009 to 2010 – Outbreaks (52 cases in 12 outbreaks) were associated with contaminated lakes, streams or reservoirs.

2010 – An outbreak (8 cases) in Wisconsin was associated with a decorative fountain in a hospital.

2010 – Outbreaks were reported at an Air National Guard base in Michigan (31 cases) 130 131 and a hospital in Wisconsin (6 cases).

2010 to 2011 – An outbreak (5 cases) was reported among tourists at two resort hotels in the US Virgin Islands.

2011 – An outbreak (200 cases, estimated) of presumed Pontiac fever was reported among guests from multiple countries attending a social gathering in California, U.S.A.

2011 – An outbreak (11 cases, 1 fatal) at a hospital in Ohio was related to contaminated water.

2011 – Outbreaks were associated with hotels in Nevada (6 cases) 138 and Maryland (3 cases, 1 fatal) ; and a shredder in New York State (5 cases).

2011 – An outbreak (3 cases, 1 fatal) was reported in Florida.

2011 to 2012 – An outbreak (22 definite and probable cases, 6 fatal) in a hospital in Pittsburgh, Pennsylvania was related to a potable water system.

2012 – An outbreak was reported in Oregon.

2012 – Outbreaks were associated with hotels in New York State (6 cases) , Pennsylvania 145 and Chicago, Illinois (10 cases, 3 fatal) 146 147 ; a hospital in Pittsburgh, Pennsylvania ; and a contaminated water system at a condominium complex in Maryland.

2013 – Outbreaks were reported in Ohio (retirement community, 39 cases, 6 fatal) , Alabama (nursing home, 11 cases, 0 fatal) , Milwaukee, Pennsylvania (6 cases related to an outpatient-lobby fountain) , Wisconsin (31 cases) and Detroit, Michigan (35 cases).

2014 (publication year) – An outbreak (29 cases) Legionnaire’s disease and Pontiac fever was reported at a military base.

2014 (publication year) – Outbreaks (2 outbreaks) were reported in a geriatric center and high-rise residence for seniors in New Jersey.

2014 – Outbreaks were reported in a hematology / oncology unit in Alabama (9 cases, 2 fatal) , a nursing and rehabilitation facility in North Carolina (8 cases) and a softball tournament in Alabama (40 cases).

2015 – An outbreak (3 cases) was associated with a motel in Washington State.

2015 – An outbreak (100 cases, 10 fatal – to August 7) in New York City was associated with contaminated cooling towers.

 

References:

  1. Berger SA. Infectious Diseases of the United States, 2015. 1208 pages, 483 graphs, 13370 references. Gideon ebooks, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
  2. Berger SA. Legionellosis: Global Status, 2015.  99 pages, 110 graphgs, 1009 references. Gideon ebooks, http://www.gideononline.com/ebooks/disease/legionellosis-global-status/

Fifth Disease in Japan

The following background material on Fifth Disease in Japan is abstracted from Gideon www.GideonOnline.com and reference 1   Primary references are available on request to the author.
Epidemics of Parvovirus B19 infection occurred in Japan every ten years prior to 1980, and every five years since 1981.  Most cases occur during spring and summer, with highest rates among children ages 5 to 9 years.   See graph:

japan1

Parvovirus B19 infection causes an estimated 107 fetal deaths and 21 hydrops fetalis cases per year (2014 publication)
Eight cases of transfusion-associated Parvovirus B19 infection were reported during 1999 to 2008.

Prevalence surveys:
10% of nonimmune hydrops fetalis cases (1994 publication)

Seroprevalence surveys:
67.9% of healthy residents of Kyushu and Okinawa (IgG, 2013 publication)

2% of children ages 0 to 9 in 1973 and 16% in 1984

67% ages 20 to 29 in 1973 and 20% in 1984

80% ages 30 to 39 in 1973 and 56% in 1984

33% of pregnant women in Miyagi Prefecture in 1987, and 46% in 1997

Published outbreaks:
1977 to 1981 – Outbreaks of erythema infectiosum were reported – including 395 cases in one district of Tokyo.
1985 (publication year) – An outbreak of erythema infectiosum was reported.
1986 to 1987- Outbreaks of erythema infectiosum were reported.
1993 (publication year) – An outbreak of erythema infectiosum was reported among hospital staff members.
2000 (publication year) – An outbreak (10 cases) of nosocomial Parvovirus B19 infection was reported.

References:
1. Berger S. Infectious Diseases of Japan, 2015. 632 pages, 166 graphs, 3,706 references. Gideon e-book series, http://www.gideononline.com/ebooks/country/infectious-diseases-of-japan/

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