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.

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

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.

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

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.

A recent case in the Lake Fondi region reminds us that the potential for malaria transmission persists in Europe. In fact, sporadic reports of cryptic, airport- and locally-acquired malaria have appeared in the Italian literature in recent years. The following review of malaria in Italy was abstracted from GIDEON.

Historical background

• Malaria was eradicated from Sardinia during 1946 to 1950, through massive application (267 metric tons) of DDT.
• A single endemic case (Plasmodium vivax in Palma di Montechiaro, Sicily) was reported in 1956; with sporadic cases in the area of Palermo during 1962.
• The country was declared ‘malaria-free’ in 1970.
• A single case of autochthonous malaria (P. vivax) was reported in Maremma (Tuscany) in 1997 – Anopheles labranchiae was implicated as the vector.

Although disease rates have increased in recent years, imported malaria continues to be less common than in neighboring France and Switzerland.

(more…)

A recent outbreak in Manila belies the fact that reported rates of leptospirosis in the Philippines had actually decreased in recent years. See graph:

The following additional background data are abstracted from GIDEON www.GideonOnline.com (primary references available on request):

Leptospirosis was first reported n the Philippines in 1932.
– 65 cases were documented in literature published during 1932 to 1970; 390 during 1971 to 1973; approxomately 840 during 1998 to 2001.
– Leptospirosis is common in flood-prone areas of urban setting such as Metro Manila.
– The average age of patients is 32 years, 87% of cases were males and 70% are outdoor workers.
– The case fatality rate is 12 to 14 percent.
– Rates in Cabatuan, Iloilo are estimated at 147 cases per 100,000 population (2007 publication).

Prevalence surveys:
5% of aseptic meningitis cases in Manila (1989 publication)

Seroprevalence surveys:
43.6% of rice farmers in Central Luzon (1988 publication)
0% of dogs (RMAT, 1970 to 1973)

The following serovars of Leptospira interrogans have been demonstrated among patients in the Manila area: poi, tarassovi, manilai, pyrogenes, australis, grippotyphosa, javanica and automnalis.

Notable outbreaks:
1976 to 1983 – An outbreak of leptospirosis was reported on a penal farm in Sablayan, Mindoro.
1999 – An outbreak (17 cases) of leptospirosis involved participants in an ‘iron-man contest’ – from Germany, Hong Kong and the Philippines.

Update: Posted in ProMED

A recent outbreak in Vilnius reminds us that Lithuania had reported the highest rates of trichinellosis in the Baltic region until 1999. Since 2000, disease rates in the area have been similar.

(This chart was generated using a user-driven Gideon menu, which contains over 35,000
base graphs.)

A recent outbreak in Australia serves as a classic exercise in Epidemiology. Although Queensland and New South Wales account for most cases of Ross River disease, rates per 100,000 are consistently highest in Northern Territory.

Update: Referenced in ProMED

A recent outbreak in Guanajato reminds us that brucellosis remains a very common disease in Mexico. In fact, current rates are comparable to those of Greece, and similar to rates that existed in the United States during the 1930′s and 1940′s. See graph:

The following background data on brucellosis in Mexico are abstracted from Gideon

Time and Place:
- Highest rates are found in Queretaro, Coahuila, Guanajuanto, Nuevo Leon, Chicuahua, Jalisco, Tamaulipas and Michoacan.
- 163 fatal cases were reported during 1978 to 1982
- Mortality rates were 0.04 per 100,000 in 1992; 0.01 per 100,000 in 1996 .

Seroprevalence surveys:
3.42% nationwide, ranging from 0.24% in Morelos, to 13.5% in Mexico State (1992 publication)
0.71% of blood donors in northeastern Mexico (2009 publication)
0.238% of equines in Tamaulipas (Brucella abortus, 2006 publication)
9.8% of goats on farms (Brucella melitensis). (Michoacan, 2007 publication)

Infecting species:
- Brucella melitensis, B. abortus and B. canis are found in Mexico.
- The predominant species is Brucella melitensis. (1968 to 1991)

Reservoirs:
- The caprine seropositivity rate was 20.7% in 1947.
- Highest rates of caprine disease are reported in Coahuila, Chihuahua, Jalisco and Zacatecas.
- Highest rates of bovine disease are reported in Chihuahua, Hidalgo and Guanajuato.
- 11.8% of stray dogs in Mexico City are infected by Brucella canis.

Vehicles:
- Most infections are acquired from unpasteurized milk, fresh cheese and other dairy products – primarily from goats (There are over 9 million goats in Mexico).
- More than 35% of cow milk is consumed unpasteurized – more than 85% of goat milk.

Update: Posted in ProMed