The following background information on Scrub typhus in India is abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1]

Rickettsia tsutsugamushi is one of seven Rickettsia and Rickettsia-like organisms which have been associated with human infection in India (the others are Rickettsia sibirica, Rickettsia conorii subsp. indica, Candidatus Rickettsia kellyi, Rickettsia typhi, Rickettsia prowazekii and Coxiella burnetii)

Epidemics of scrub typhus were previously reported among troops stationed in the north and east.

Risk factors include living close to bushes and wood piles, work on farms, observation of rodents at home and at work, and raising domestic animals (Darjeeling, West Bengal, 2009 publication)

Exported cases:
- Three cases of imported scrub typhus were reported in the United States during 1983 to 1988 – all originating in India.
- In 2002, a Belgian traveler developed scrub typhus following a trip to India.

17 fatal cases were reported in Himachal during 2001 to 2002.
- 21 cases (3 fatal) were reported in Himchal Pradesh during 2004.
- Nine cases were confirmed in Uttarakhand (2010 publication)
- 29 cases were reported from a hospital in Manipal, Karnataka during 2009.

Prevalence surveys:
24.1% of febrile hospitalized patients in Vellore (2006 publication)
15% of children below age 14 hospitalized for fever in Tamil Nadu (2003 to 2004)
14.3% of children hospitalized with fever and at least one suggestive feature of rickettsial infection (central India, 2011 publication)
37.5% of febrile malaria-negative patients in Tamil Nadu in 2004, and 9.2% in 2005
47.5% of patients hospitalized for acute undifferentiated febrile illness in Vellore, Tamil Nadu (2010 publication)

The principal vector is Leptotrombidium deliense.
- Schoengastiella ligula mites infesting shrews (Suncus murinus) were identified as vectors during an outbreak in Kurseong, Darjeeling.
-
Notable outbreaks:
2001 to 2002 – An outbreak (28 cases, 3 fatal) was reported in Tamil Nadu.
2003 – An outbreak (225 cases, 19 fatal) was reported in Himachal Pradesh.
2006 to 2008 – An outbreak (50 cases) was reported in Pondicherry.
2007 – An outbreak (38 cases) was reported in Bishnupur district, Manipur.
2009 to 2010 – An outbreak (80 cases, 5 fatal) was reported in Meghalaya.
2011 – Outbreaks were reported in Himachal Pradesh (200 cases, 13 fatal) and Nagaland (9 cases, 3 fatal).

References:
1. Berger SA. Infectious Diseases of India, 2011. 480 pp, 65 graphs, 3503 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-india/

Reproduced on ProMED

Notwithstanding an ongoing outbreak in northern Bohemia, the Czech Republic has managed to reduce mumps to levels comparable to those of the United States. In the following graph, I have contrasted rates per 100,000 population for these two countries:

Graph generation system outlined in [1])

Note that a precipitous decline in mumps in the Czech Republic followed the introuction of widespread MMR vaccination in 1987. [2,3]

1. Gideon Graphs module tutorial Gideon Graphs
2. Berger SA. Infectious Diseases of the Czech Republic, 2011. 424 pp, 139 graphs, 1192 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-czech-republic/
3. Berger SA. Mumps: Global Status, 2011. 157 pp, 187 graphs, 390 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/mumps-global-status/

Reproduced by ProMED

Mexico offers a useful paradigm for the impact of canine rabies control on human disease. The attached graph contrasts reports of dog rabies vs. rates per 100,000 humans in this country. [1,2]

References:
1. Berger SA. Infectious Diseases of Mexico, 2011. 446 pp, 128 graphs, 1655 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-mexico/
2. Berger SA. Rabies: Global Status, 2011. 366 pages, 546 graphs, 1056 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/rabies-global-status/

The attached graph summarizes successive waves in the occurrence of Influenza H5N1 among individual countries. Incidence peaked in Thailand in 2004, Vietnam in 2005 and Indonesia in 2006; while most reports during 2009 to 2010 originated from Egypt. [1]

References:
1. Berger SA. Infectious Diseases of the World, 2011. 987 pp, 383 graphs, 12,492 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-world/

Mike Homer passed away yesterday from CJD (Creutzfeldt-Jakob disease). CJD is a rare neurological disease, which can be infectious, but wasn’t in this case.

Mike was one of my senior managers at Netscape, who I always held in high regard. I’m saddened by this event and hope this will help accelerate research into a cure for the disease.

(In addition to its decision support application dealing with Infectious Diseases, Microbiology and Toxicology, GIDEON Informatics, Inc as part of GIDEON Labs, maintains a second service – www.VIPatients.com – which follows the diseases and deaths of all famous persons throughout history. The user can review all diseases of a specific VIP, or generate a list of famous persons by Profession, Disease, Year – or any combination. The following is based on data generated from the site).

On December 31, the Media will once again recount all of the wars, earthquakes, divorces, births, rapes, sporting records …. Inevitably, a long list of famous persons will have passed on: most “after a long illness,” “suddenly” or “of natural causes.” 427 famous folk died of specified misfortunes in 2008. For the purpose of this research, “famous” is defined as “well recognized by the general public at large.”

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Predictably, 2009 will be greeted with endless publications which recount the divorces, disasters, political events, athletic records and famous deaths of 2008. Sadly, the routine misfortunes which visit most of the world will be largely neglected. Individual countries are burdened by major outbreaks of infectious disease on an almost daily basis; but few people in the West hear of these episodes unless they are sensationalized by the Media (Ebola) or are seen as a threat to other developed nations (Avian influenza).

Although the current outbreak of Avian influenza (“bird flu”) began in 2003, and has continued well into 2008, the numbers of reported cases and deaths has actually been decreasing since, 2006. A total of only 387 cases, and 245 deaths, from this infection have been reported to date. In other words, the chance of dying from a lightning bolt or scorpion sting in one of the infected countries is far greater than the chance of acquiring bird flu.

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Steve Stallman recently interviewed Uri Blackman, GIDEON’s CEO, in SCribe magazine, which was mentioned in the Technology Council of Southern California blog. The interview provides some background on the company and the benefit of GIDEON to its users:

What is the main value proposition you offer?
Originally, we focused on compiling the entire world’s data for Infectious Diseases in one easy to use location combined with medical decision support. Now we have taken this to the next level by adding other medical domains on our platform. We help identify the diseases, their global footprints, and provide specific information on treatments. Medical professionals now have one clear source to get the most up to date information, which can change by the minute. This often makes them aware of things they never thought of and helps them make the best decision possible.