Archive for the ‘Outbreaks’ Category

Campylobacteriosis in Iceland

Wednesday, August 6th, 2014

A recent posting in ProMED belies the fact that Iceland reports the lowest rates of campylobacteriosis in that region of Europe. [1-2] See graph [3] Note that an earlier outbreak (436 cases) was reported in 1999.

IcelandCampy

References:
1. Berger SA. Infectious Diseases of Iceland, 2014 371 pages, 75 graphs, 1,455 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-iceland/
2. Berger SA. Campylobacteriosis: Global Status, 2014 104 pages, 96 graphs, 1,073 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/campylobacteriosis-global-status/
3. Gideon graph tool at http://www.gideononline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Outbreaks of Non-tubercuous Mycobacterial Infection in the United States

Wednesday, July 23rd, 2014

The following chronology of nosocomial mycobacteriosis 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.

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.
1998 – An outbreak (6 cases) of Mycobacterium mucogenicum bacteremia among bone marrow transplant and oncology patients in Minnesota was related to contaminated water.
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.
2001 – An outbreak of Mycobacterium chelonae keratitis in California was associated with laser in situ keratomileusis (LASIK).
2001 to 2002 – An outbreak of Mycobacterium simiae in a Texas hospital was related to contaminated tap water.
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.
2008 – An outbreak (4 cases) of Mycobacterium mucogenicum bloodstream infections was reported among patients with sickle cell disease, in North Carolina.
2009 (publication year) – An outbreak (6 cases) of Mycobacterium chelonae infection was associated with a tattoo establishment.
2009 – An outbreak (2 cases, 1 confirmed) of Mycobacterium haemophilum skin infection was associated with a tattoo parlor in Washington State.
2011 (publication year) – An outbreak (3 cases) of Mycobacterium bolletii/M. massiliense furunculosis was associated with a nail salon in North Carolina.
2011 (publication year) – An outbreak of Mycobacterium abscessus infection was associated with outpatient rhytidectomies.
2011 – An outbreak (2 cases) of Mycobacterium haemophilum infection was reported among persons receiving tattoos in the Seattle, Washington region. {m 201108122444}
2011 (publication year) – An outbreak (11 cases) of Mycobacterium porcinum infection in a Texas hospital was related to contamination of drinking water.
2011 to 2012 – An outbreak (19 cases) of Mycobacterium chelonae infection involving multiple states was associated with contaminated ink used in tattoo parlors.
2011 to 2012 – An outbreak (15 cases) of infection by rapidly-growing mycobacteria was reported among pediatric hematopoietic cell transplant in a Minnesota hospital.
2013 – An outbreak (2 cases) of non-tuberculous mycobacterial infection was associated with fractionated CO2 laser resurfacing procedures performed at a clinic in North Carolina.
2013 to 2014 – An outbreak (19 cases) wound infection was reported among Americans who had traveled to the Dominican Republic for cosmetic surgery – including 12 due to Mycobacterium abscessus and 2 Mycobacterium fortuitum
2014 – An outbreak (15 cases, 4 fatal) of Mycobacterium abscessus infection in a South Carolina hospital was associated with contact of equipment with contaminated tap water.

References:
1. Berger SA. Infectious Diseases of the United States, 2014. 1145 pages, 478 graphs, 12,294 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. Non-Tuberculous Mycobacteria: Global Status, 2014. 61 pages, 31 graphs, 584 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/non-tuberculous-mycobacteria-global-status/

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Bacterial Diarrhea in Australia

Wednesday, February 26th, 2014

Notwithstanding recent outbreaks among men-who-have-sex-with-men, the incidence of shigellosis in Australia has remained remarkably constant for over eighty years. In the following graph I’ve contrasted disease rates in Australia and New Zealand with those reported in the United States. [1-3]

ShigANU

In fact, most other forms of bacterial diarrhea have become far more common than shigellosis in Australia – see graph:

AustDiarrhea

References:
1. Berger SA. Infectious Diseases of Australia, 2014. 575 pages, 163 graphs, 3,658 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-australia/
2. Berger SA. Shigellosis: Global Status, 2014.
162 pages, 199 graphs, 1,076 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/shigellosis-global-status/
3. Gideon graph tool – http://cdn.gideononline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Hepatitis A in Asian Russia

Saturday, December 14th, 2013

Reprted rates of Hepatiis A for Uzbekistan and bordering countries are strinkingly similar, and somewhat higher of those for the Russian Federation. [1,2] See graph [3]:

HepAUzbek

References:
1. Berger SA. Infectious Diseases of Uzbekistan, 2013. 354 pages, 74 graphs, 69 references.
http://www.gideononline.com/ebooks/disease/hepatitis-a-global-status/
2. Berger SA. Hepatitis A: Global Status, 2013. 169 pages, 182 graphs, 1274 references. http://www.gideononline.com/ebooks/disease/hepatitis-a-global-status/
3. Gideon Graph Tool, see tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

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Typhoid Fever Outbreaks in the United States

Monday, May 6th, 2013

The following background data are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2]

60 outbreaks of typhoid were reported during 1960 to 1999 – 54 of these (total 957 cases, 4 fatal) following exposure within the United States. Five drinking water-associated outbreaks of typhoid were reported during 1971 to 2006.

The best known clusters of typhoid fever in history were those ascribed to Mary Mallon (“Typhoid Mary”), a chronic carrier who was responsible for 9 outbreaks (54 cases, 4 fatal) in the New York area during 1900 to 1915.

A chronology of notable outbreaks:
1843 – Outbreaks of typhoid were reported in New York City and Boston.
1898 – An outbreak of typhoid was reported in Florida.
1909 – An outbreak of typhoid was reported in an “infant asylum” in Baltimore, Maryland.
1911 – An outbreak of typhoid was reported in Yakima, Washington.
1913 (publication year) – An outbreak of typhoid was reported in Illinois.
1913 (publication year) – An outbreak of paratyphoid fever in Massachusetts was ascribed to contaminated milk.
1936 (publication year) – An outbreak in Philadelphia, Pennsylvania was associated with a supper.
1937 (publication year) – An outbreak was reported in Michigan.
1947 – An outbreak (4 cases) of typhoid in Alaska was associated with a commercial air flight.
1953 (publication year) – An outbreak of typhoid was reported in rural New York.
1956 – An outbreak of typhoid was reported in the Midwest.
1959 – An outbreak of typhoid was reported among migrant workers in Virginia.
1964 – An outbreak of typhoid fever was reported in Atlanta, Georgia.
1967 – An outbreak (31 cases) was reported among students at a university in California.
1970 – An outbreak (81 cases) of typhoid was reported among passengers aboard a British ship traveling to Canada and the United States.
1972 to 1973 – An outbreak (1,515 cases, 39 fatal) was reported in Mexico City in 1972; with an additional 667 cases during January to June 1973. A related outbreak (80 cases) was reported in the United States.
1973 – An outbreak (230 cases) of typhoid in Dade Country, Florida may have originated from water contaminated by a typhoid carrier.
1981 – An outbreak (80 cases) of typhoid at a restaurant in Texas was associated with contaminated “barbacoa” (a mixture of muscle, lips, ears, tongue, and eyes from steamed bovine heads).
1981 – An outbreak (6 cases) on an Indian reservation was linked to a typhoid carrier.
1981 – An outbreak (18 cases, 0 fatal) of typhoid in Michigan was assumed to be related to a typhoid carrier.
1986 – An outbreak at a restaurant in Maryland was caused by contaminated shrimp. {p 3384930}
1989 – An outbreak (43 cases) of typhoid at a hotel in New York was ascribed to contaminated orange juice.
1990 – An outbreak (17 cases) of food-borne typhoid followed a family gathering in Washington State. {p 2120571}
1990 – An outbreak (24 cases, 16 confirmed) was associated with a family picnic in Maryland.
1998 to 1999 – An outbreak (16 cases or more) of typhoid in Florida was ascribed to frozen mamey (a tropical fruit) imported from Honduras and Guatemala.
2000 – An outbreak (7 cases) in Indiana, Ohio and Kentucky occurred among men who have sex with men.
2000 – An outbreak (7 cases) of typhoid in New York City was traced to an infected restaurant employee.
2005 – An outbreak (2 cases) of typhoid in New York City was related to a carrier from Haiti.
2009 – An outbreak (3 cases) of typhoid was reported in Tennessee.
2010 – An outbreak (12 cases) of typhoid in California and Nevada was ascribed to ingestion of contaminated mamey fruit pulp imported from Guatemala.

References:
1. Berger SA. Infectious Diseases of the United States, 2013. 1119 pages, 470 graphs, 11030 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. Typhoid and Enteric Fever: Global Status, 2013. 258 pages, 401 graphs, 728 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/typhoid-and-enteric-fever-global-status/

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Vaccination Uptake in Afghanistan

Tuesday, January 1st, 2013

Although childhood vaccination has registered considerable success during the past three decades, Afghanistan continues to lag behind other nations in the region. In the following charts I have contrasted WHO estimates of vaccine uptake in Afghanstan with those of bordering countries. [1-3]

Afghan-Vaccines

References:
1. Berger SA. Infectious Diseases of Afghanistan, 2012. 326 pages, 37 graphs, 1239 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/pertussis-global-status/
3. Gideon Graph Tool, see tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

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Scrub Typhus in China

Friday, November 30th, 2012

The following background data are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2]

Time and Place:
Although “chigger fever” may have been described in China as early as 313 C.E., the disease was first reported in Kunming (Yunnan Province) in 1942. Foci of scrub typhus exist in Jiangsu, Liaoning, Shandong, Fujian, Zhejiang, Jiangsu, Jelin, Jenan, Heilongjiang, Hainan, Hunchun, Tibet, Hang Zhou City and Tianjin City. The disease was first reported in Hubei Province in 1997. Newly-discovered foci were reported in the Nan Peng Lie Islands in 2002 and in Fuyang City, Anhui Province in 2008.

Epidemics occur approximately every 20 years, with variable clinical severity (the most severe disease reported from Shanxi Province). In most of the country, cases tend to appear in May 14 , peak during June and July, and decrease in August. Peak incidence in Sichuan and Yunnan occurs in August; September to November in Shandong. Most cases of scrub typhus in Hong Kong are reported in adults, and during the summer and fall.

Yearly incidence data are not available for China as a whole; however, reports from Hong Kong and other regional countries suggest that rates of scrub typhus have been increasing since the 1980′s – see graph [3]

Additional geographic notes:
Fujian – Over 1% of persons on Pingtan Island developed scrub typhus during the 1950′s, with a case-fatality rate of 13.6%. 28 cases were reported on the island during 2000 to 2005.
Guangzhou – Over 500 cases were reported during 1952 to 1954, 5.4% fatal.
Hainan – Over 10,000 cases were reported during 1956 to 1985.
Hong Kong – 136 cases (0 fatal) of scrub typhus were reported in Hong Kong during 1999 to 2008
Shandong – 1,291 cases were reported during 2006 to 2010 – 49.5% above age 55, and m/f = 1/1.02. 480 cases were reported from Feixian County during 1995 to 2006; and 56 cases of pediatric infection were reported in Fei County during 1993 to 2004.

Prevalence surveys:
16.13% of mice in Xinyang, Henan Province (2007 publication)

Seroprevalence surveys:
36.1% of healthy persons in Xinjiang Uygur Autonomous region (1980′s)
31.8% of persons on Hainan Island (1983)
6.3% of healthy farmers in Yiyuan County, Shandong Province (2005 to 2007)
1.8% to 39.8% of farm workers near Tianjin (2007 to 2009)

Reservoirs:
The local reservoirs are Rattus flavipectus, R. niviventer, R. losea, R. rattus, R. norvegicus, R. confucianus and Apodemis agrarius. Rodents and mites coinfected by Hantavirus and Orientia tsutsugamushi have been identified in endemic areas. A known mite vector, Leptotrombidium scutellare, has been identified on 30 species of rodents in Yunnan.

Vectors:
The local vectors are Leptotrombidium pallidum, L. deliense (Hong Kong), L. scutellare (Shandong Province and Yunnan Province) and L. gaohuensis (Zhejiang Province). L. intermedium has also been identified as a possible vector.

Published outbreaks:
1986 – An outbreak (138 cases) of scrub typhus was reported in Menying County, Shandong Province.
2007 (publication year) – An outbreak (19 cases) was reported in Henan Province.

References:
1. Berger SA. Infectious Diseases of China, 2012. 685 pages, 261 graphs, 3848 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-china/
2. Berger SA. Australo-Asian Spotted Fevers: Global Status, 2012. 41 pages, 14 graphs, 392 references, Gideon e-books, http://www.gideononline.com/ebooks/disease/australo-asian-spotted-fevers-global-status/
3. Gideon Graph Tool, see tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

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Chikungunya in the Philippines

Saturday, September 29th, 2012

The following background is abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2]

Most cases of Chikungunya in the Philippines are reported in the center and south of the country.
– Epidemics were reported in 1954, 1956, 1968 and 1985 to 1986.
– In 1986, an outbreak (3 cases) of Chikungunya was reported among U.S. Peace Corps volunteers stationed in the Philippines (Mindanao, Cebu and Mashbate).
– In 2009, several Filipino tourists acquired Chikungunya in Thailand.
– Cynomolgus monkeys (Macaca fascicularis) are implicated as reservoirs in this country.

Seropositivity toward a related agent, Getah virus, has been reported among humans on Palawan, without signs of overt infection.
– Getah virus has also been identified in Nueva Ecija Province.

References:
1. Berger SA. Infectious Diseases of the Philippines, 2012. 389 pages, 74 graphs, 1588 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-philippines/
2. Berger SA. Chikungunya and Zika: Global Status, 2012. 43 pages, 12 graphs, 1154 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/chikungunya-and-zika-global-status/

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Hantavirus Infection and Travel

Thursday, September 6th, 2012

Although French tourists might well be concerned regarding travel to some areas of the United States, American tourists in France are at higher risk for acquring Hantavirus infection – see graph [1-4]

In fact. there have been Europe accounted for 8 of the 13 published travel-related episodes of Hantavirus infection, and the Americas region for only 5 episodes:

Travel-related Hantavirus Infections from Europe:
1999 – A Belgian national acquired HFRS (nonfatal) while camping in France.
2002 – Hantavirus infection was reported among British military personnel in Slovenia.
2002 – An Italian traveler acquired HFRS (nonfatal) in Central Europe.
2003 – A Spanish trucker acquired HFRS (nonfatal) in Central Europe.
2005 – A Swedish traveler acquired HFRS (nonfatal) in Croatia.
2006 – A German traveler acquired HFRS (nonfatal) in Serbia.
2011 (publication year) – Two Czech nationals acquired hantavirus infection during a stay in a mountain hut in northern Slovakia.
2012 – A German tourist in Ireland was found to have Hantavirus infection.

Travel-related Hantavirus Infections from the Americas:
1998 (publication year) – A patient in Chile died of Hantavirus pulmonary syndrome acquired in Bolivia.
2001 – A French tourist acquired Hantavirus pulmonary syndrome (nonfatal) in Chile.
2002 – An imported case of Hantavirus pulmonary syndrome (Andes virus, nonfatal) from Chile was reported in the United States.
2006 – A patient in Canada died of Hantavirus pulmonary syndrome acquired in Bolivia.
2008 – An English tourist died in Chile of presumed Hantavirus infection acquired in Argentina.

References:
1. Berger SA. Infectious Diseases of France, 2012. 731 pages, 289 graphs, 2760 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-france/
2. Berger SA. Old-World Hantaviruses: Global Status, 2012. 64 pages, 49 graphs, 641 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/old-world-hantaviruses-global-status/
3/ Berger SA. Hantavirus Pulmonary Syndrome: Global Status, 2012. 30 pages, 16 graphs, 463 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hantavirus-pulmonary-syndrome-global-status/
4. Gideon Graph Tool, see tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

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Campylobacter Infection in New Zealand

Saturday, August 25th, 2012

The following review of Campylobacter infection in New Zealand is abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2] Primary references are available on request

Campylobacter infection is the most common reportable cause of bacterial diarrhea in New Zealand.. In fact, the incidence of campylobacteriosis exceeds that of any other reportable disease in New Zealand, accounting for 42.5% of all notified cases of infectious disease in 2010 (see graph [3] )

Rates of campylobacteriosis in New Zealand exceed those of the other major English-speaking countries (see graph 3] )

Time and Place:
– Highest rates are reported during late spring and early summer (November to January).
- Rates on South Island are correlated with lower socio-economic level, proportion of persons ages 25 to 44 and density of fresh food outlets.
- The Far North and much of the rural North Island report relatively low disease incidence during summer, with minimal inter-seasonal variation.
- A higher summer incidence and more seasonality variation is found in some North Island cities (Auckland, Hamilton, Napier) and some area of the South Island.
- The highest summer incidence and inter-seasonal variation is reported in Christchurch, Dunedin, much of the South Island, Wellington and Upper Hutt.

Graph Notes:
– Disease incidence varied from 1,915 cases in 1984, to 15,873 in 2006.
– Decreasing disease rates after 2007 were ascribed to disease control among poultry. – 17 fatal cases were reported during 1997 to 2011 – including 5 in 2002.
– 2,056 patients were hospitalized for Guillain-Barre syndrome (GBS, often associated with Campylobacteriosis) during 1988 to 2010.
- During this period, rates of GBS declined by a factor of 13%, following control of campylobacteriosis in poultry.
– During 1997 to 2011, between 10 outbreaks (1997) and 57 outbreaks (1999) have been registered per year.

Prevalence surveys:
6.8% of dairy calves (Campylobacter jejuni, Manawatu region, 2002)
44.8% of broiler chicken carcasses (2008 publication)
89% of domestic backyard chicken flocks in Canterbury (2011 publication)
0.34% of raw milk samples (2012 publication)
85% of surface water samples in Canterbury (2009 publication)

Seroprevalence surveys:
48% of ewes (Campylobacter fetus fetus, 2006 to 2009)

Notable outbreaks:
1987 (publication year) – An outbreak (19 cases) of campylobacteriosis in Christchurch was related to contamination of the water supply.
1990 – An outbreak (44 cases) of Campylobacter enteritis occurred at a camp near Christchurch.
1997 (publication year) – An outbreak (19 cases) was related to contamination of a town water supply.
1990 – An outbreak (99 cases) of Campylobacter enteritis occurred at a camp near Christchurch – drinking water was identified as the source.
2005 (publication year) – An outbreak (3 cases) in Christchurch was associated with consumption of pre-cooked sausages.
2006 – An outbreak (100,000 cases estimated) was associated with contaminated chicken.

References:
1. Berger SA. Infectious Diseases of New Zealand, 2012. 413 pages, 136 graphs, 1534 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-new-zealand/
2. Berger SA. Campylobacteriosis: Global Status, 2012. 96 pages, 95 graphs, 823 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/campylobacteriosis-global-status/
3. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

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