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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/

Hepatitis A in Lebanon

Hepatitis A rates in Lebanon are similar to those reported in neighboring Israel during the 1990’s [see graph] 
HepAIsrLeb

In 1999 (arrow) Israel became the first country to introduce universal Hepatitis A vaccination, a policy which might help reverse the increasing incidence experienced by Lebanon. [1-3]

References:

1. Berger SA. Infectious Diseases of Lebanon, 2015. 389 pages, 54 graphs, 1,569 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-lebanon/

2. Berger SA. Hepatitis A: Global Status, 2015. 184 pages, 183 graphs, 1,775 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hepatitis-a-global-status/

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

Hand, Foot and Mouth Disease in Singapore

Rates of Hand, Foot and Mouth disease (HFM) in Singapore exceed those of all other reporting countries in Asia.  In fact, HFM is at least as common as varicella in Singapore [1,2].  See graph:

 

HFM

 

References:

1. Berger SA. Enterovirus Infections: Global Status, 2015. 102 pages, 67 graphs, 1,936 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/enterovirus-infections-global-status/

2. Berger SA. Infectious Diseases of Singapore, 2015. 460 pages, 112 graphs, 1,964 references. Gideon e-books, http://www.gideononline.com/ebooks/country/singapore/

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

Note appears on ProMED

Ross River Virus in Queensland

Queensland accounts for approximately 50% of Ross River virus infections reported in Australia. Notwithstanding an increase in incidence during January to February 2015, rates in Queensland have remained fairly constant for over two decades. [1,2] See graph

RRV

References:
1. Berger S. Infectious Diseases of Australia, 2015. 616 pages, 165 graphs, 3,941 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-australia/
2. Berger S. Australo-Pacific Arboviruses: Global Status, 2015. http://www.gideononline.com/ebooks/disease/australo-pacific-arboviruses-global-status/
3. http://www.gideononline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

Melioidosis in the United States

The following background data are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series [1,2] (primary references available on request)

The first case of melioidosis in the Western hemisphere was diagnosed in the United States in 1945 – an American who had worked in the Panama Canal Zone during 1927 to 1928.

Sporadic autochthonous cases (five reports to 2013) have been reported from Arizona, Georgia, Hawaii, Oklahoma, Ohio and California. The fifth case of autochthonous melioidosis was reported in Ohio in 2013. Imported cases have originated from Laos, Mexico, Viet Nam and Thailand. Two cases imported from Honduras were reported in Florida in 2005; and an American girl acquired the disease in Aruba in 2011 (publication year).

A case of pneumonia and septicemia caused by Burkholderia thailandensis has been reported in the United States.

It has been estimated that 225,000 seropositive Army personnel returned from Viet Nam, and may still be at risk for reactivation. 81 individual case reports (14 fatal cases) of melioidosis acquired in Vietnam were published during 1965 to 1969. In one case, a Vietnam veteran developed melioidosis 29 years after returning to the United States. In another instance, a veteran developed the disease 63 years following return from the Pacific region. Venereal transmission was reported from a Vietnam veteran to his wife in the United States. 38% of American Marines acquired seropositivity toward melioidosis following a two-week stay in Thailand (2006).

Animal infection:
1969 – Five cases of melioidosis in three separate outbreaks were diagnosed among imported nonhuman primates – two stump-tailed macaque monkeys (Macaca arctoides), a chimpanzee (Pan troglodytes), a pig-tailed monkey (Macaca nemestrina) and a rhesus monkey (Macaca mulatta).
2007 (publication year) Burkholderia pseudomallei was isolated from two pet green iguanas (Iguana iguana) in California
2013 (publication year) – A pigtail macaque (Macaca nemistrina) imported from Indonesia into the United States was found to have melioidosis.

References:
1. Berger SA. Melioidosis and Glanders: Global Status, 2015. 51 pages, 10 graphs, 754 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/melioidosis-and-glanders-global-status/
2. Berger SA. Infectious Diseases of the United States, 2015. 1,208 pages, 483 graphs, 13,730 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/

Note posted on ProMED

2015 series of GIDEON ebooks includes images

The 2015 GIDEON ebook series has been released with 423 ebooks.

New since 2014 edition:

Titles include:

Country series (231 volumes)
Disease series (188 volumes)
GIDEON Guide to Antimicrobial Agents
GIDEON Guide to Vaccines
GIDEON Guide to Medically Important Bacteria
GIDEON Guide to Medically Important Yeasts

Available at GIDEON ebooks and ebook distributors EBSCO, Overdrive, ebrary and Google Play.

Pertussis: Global Trends in Incidence and Vaccine Uptake

Recent pertussis outbreaks are of concern, but should not overshadow a dramatic decrease in disease rates documented during the past three decades. [1] In the following chart, I’ve compared regional trends in pertussis reporting and W.H.O. estimates of vaccine uptake [2] Note that vaccine coverage has changed little since 1990.

pertussis

References
1. http://www.gideononline.com/wp/wp-content/uploads/Gideon-Graphs.pps
2. Berger S. Pertussis: Global Status, 2013. 353 pages, 511 graphs, 648 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/pertussis-global-status/

Trichinosis: Cross-border Episodes

A recent trichinosis outbreak in Belgium related to Spanish boar meat reflects the continued high incidence of trichinosis in Spain. In fact, trichinosis rates in Spain are comparable to those which have not been encountered in the United States for more than 50 years [1,2] – see graph.
Trichinosis-Spain

Cross-border incidents of trichinosis are relatively uncommon. The following chronology, including cases related to importation or human travel, is abstracted from Gideon (primary references available on request)

1975 – An outbreak (125 cases) of trichinosis in France was traced to horse meat imported from Poland.
1976 (publication year) – An outbreak (6 cases) in Paris was associated with travel to Egypt.
1985 – Outbreaks (1,073 cases, 2 fatal) in France were caused by horse meat imported from Germany and the United States.
1986 (publication year) – An outbreak (20 cases) among Gurkha soldiers serving in Hong Kong was associated with a barbecue.
1986 – An outbreak (2 cases) was reported among French-Vietnamese nationals who had eaten pork sausages at a diplomatic reception in Laos.
1990 – An outbreak (90 cases) among Southeast Asian refugees in the United States and Canada was associated with uncooked commercial pork served at a wedding in Des Moines, Iowa. This was the fourth outbreak reported since 1975 among Southeast Asian refugees in North America.
1992 – The world’s first case of human infection by Trichinella pseudospiralis was reported in New Zealand – probably acquired in Tasmania, Australia.
1982 – An outbreak (1,000 cases or more) was reported in the southern region of Lebanon – including six cases hospitalized in Israel.
1993 – An outbreak (538 cases) in France was traced to the meat of a single horse imported from Canada.
1994 – An outbreak (7 cases) in France was associated with horsemeat imported from Mexico.
1995 (publication year) – An outbreak (8 cases) in Germany and the former Yugoslavia involved family members who had shared smoked ham.
1995 to 1996 – A single case of trichinosis was reported in Japan – acquired during travel to Poland.
1997 – A Japanese traveler acquired trichinosis from smoked bear meat while in China.
1998 – An outbreak (404 cases, 37 hospitalized) in the France was related to consumption of meat from horse which had been imported from Yugoslavia.
1998 – An outbreak (92 cases, 0 fatal) in Italy was ascribed to imported Polish horsemeat.
1998 to 1999 – An outbreak (44 cases) in Germany was ascribed to raw smoked sausage (mettwurst) imported from Spain.
1999 – An outbreak (8 cases) among Yugoslavian immigrants in the United Kingdom was ascribed to salami imported from Serbia.
2000 (publication year) – An outbreak (25 cases) was reported among travelers returning to Singapore from a neighboring country.
2000 – An outbreak (8 cases) in England and Wales was ascribed to ingestion of imported meat products.
2001 – An outbreak (7 cases, none fatal) among Eastern European immigrants living in Rome was ascribed to imported pork sausage.
2002 – An outbreak (3 cases) in Germany was caused by infested smoked wild boar meat imported by travelers from Romania.
2002 – An outbreak (30 cases, 0 fatal) was reported among Thai workers in the Israel who had ingested the meat of a wild pig.
2003 (publication year) – An outbreak in Germany was reported among members of a family from Bosnia.
2003 (publication year) – A Japanese national acquired trichinosis in Kenya.
2004 – An expatriate developed Trichinella britovi infection in France from barbecued leg of jackal (Canis aureus) eaten in Algeria.
2004 – Two of the three cases of Trichinosis reported in the Czech Republic had been acquired in Poland and Macedonia.
2004 – An expatriate from New Zealand acquired trichinosis in Laos.
2004 – An outbreak (7 cases) of trichinellosis was reported Danes who had eaten home-made sausage purchased in Romania.
2004 (publication year) – An outbreak (2 cases) was reported in the Netherlands among family members who has consumed infested pork in Montenegro.
2005 – An outbreak (9 cases) of Trichinella nativa infection among French hunters in Canada was caused by contaminated bear meat. Eight additional cases were reported among persons in France who shared imported meat.
2006 – An outbreak (49 cases) in China was related to meat imported from Laos.
2007 – An outbreak (214 cases) in Poland was ascribed to contaminated raw sausage. Five cases in Germany, two in Ireland and 1 in Denmark were related to travel in the area of the outbreak.
2007 – An outbreak (21 cases) of Trichinella britovi infection among persons in Spain and Sweden was related to Spanish wild boar sausage.
2007 – An outbreak (3 cases) in Germany was caused by contaminated cured sausage eaten in Romania.
2008 – An outbreak (4 cases, 0 fatal) of trichinosis in Italy was reported among persons who had ingested infested pork in Romania.
2008 – An outbreak (8 cases) of human trichinosis associated with ingestion of raw soft-shelled turtles (Pelodiscus sinensis) was reported in Taiwan, including two cases exported to Japan. The pathogen in this case may have been Trichinella papuae.
2009 – An outbreak (3 cases) of trichinosis was reported among French nationals who had ingested warthog ham in Senegal.
2009 – An outbreak (5 cases) was reported among French tourists who ingested the meat of a grizzly bear while on a boating trip in Canada.
2009 – An outbreak of trichinosis among boar hunters in Bosnia was associated with a case hospitalized in Switzerland.
2010 – A case in Scotland was ascribed to ingestion of meat imported from France.
2011 (publication year) – A Thai worker acquired Trichinella papuae trichinosis from wild boar meat in Malaysia.

References:
1. Berger SA. Infectious Diseases of Spain, 2014. 623 pages, 194 graphs, 3,844 references. Gideon e-books. http://www.gideononline.com/ebooks/country/infectious-diseases-of-spain/
2. Berger SA. Trichinosis: Global Status, 2014. 90 pages, 73 graphs, 894 references. Gideon e-books. http://www.gideononline.com/ebooks/disease/trichinosis-global-status/

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