Scholarly article on topic 'ProMED update'

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Academic research paper on topic "ProMED update"

International Journal of Infectious Diseases (2008) 12, 567—568


ProMED update

A review of emerging diseases reported on ProMED-mail

Fiona J. Cooke, Daniel S. Shapiro

Leptospirosis, SriLanka

The number of cases of leptospirosis reported from Sri Lanka has risen dramatically during September 2008 (ProMED-mail archive number 20080922.2984). According to the chief of the Government Epidemiology Unit, Dr Praba Palihawadana, ''The number of leptospirosis cases reported up to the end of August 2008 was 3825, with only 117 deaths. But the number of patients reported mainly from paddy farming districts increased to 4500 by 20 September 2008, with deaths increasing to 150 during this period. The reported number of 33 deaths in 20 days is a serious matter.''

Dr Palihawadana said the largest number of cases had been reported from paddy farming areas, while a significant increase in new cases had been reported from the districts of Colombo, Gampaha Kalutara, Matale, Kandy, Kurunegala, Matara, Kegalle and Kurunegala. She also pointed out that people could be infected not only through water contaminated by rat urine, but also from water contaminated by the urine of infected cattle, goats, dogs and cats, which act as carriers of the disease. The public, especially paddy farmers, were warned to be extra vigilant when working in paddy fields. In addition, farmers in affected districts have been advised to take weekly doxycycline as prophylaxis.

E. coli VTEC Non-O157, Oklahoma, USA

An outbreak of E. coli O111 has occurred in Oklahoma, USA. According to reports from 15 September 2008 (ProMED-mail archive number 20080916.2904), the total number of cases was approaching 300. Oklahoma state health officials reported 291 confirmed cases over the previous weekend, which marked a huge increase in the number of cases. Of the 291 people affected, 227 are adults and 46 are children. Approximately 70 people had been hospitalised and there was one mortality. The outbreak has been linked to people who ate at the Country Cottage restaurant in Locust Grove, Oklahoma, and further investigations are ongoing.

Novel cardioviruses detected in humans

At the beginning of September 2008, ProMED-mail summarised the first few papers in the literature about cardioviruses infecting humans (ProMED-mail archive numbers 20080910.2824 and 20080911.2845). Charles Y. Chiu and colleagues described the partial characterisation of novel human cardioviruses associated with gastrointestinal tract infections in humans, and published their findings in the Proceedings of the National Academy of Sciences (''Identification of cardioviruses related toTheiler's murine encephalomyelitis virus in human infections'' PNAS 2008; 105 (37) 14127, available at:

Cardioviruses comprise a genus of picornaviruses that cause severe illnesses in rodents. The work by Chiu et al. suggests that there is a diverse group of novel human Theiler's murine encephalomyelitis virus-like cardioviruses that have gone largely undetected to date, and are found primarily in the gastrointestinal tract. These viruses can be shed asymptomatically, and have potential links to enteric and extra intestinal disease. As discussed in ProMED, this work demonstrates the power of a pan-viral DNA microarray technique designed to detect known and novel viruses in clinical specimens, on the basis of homology to conserved regions of known viral sequences. Previously the 'Virochip' has been used successfully to detect novel pathogens such as the severe acute respiratory syndrome (SARS) coronavirus and other disease-producing agents. Other recent publications support the characterisation by Chiu of several diverse human cardioviruses in feacal samples (Emerg Infect Dis 2008;14(9):1398-1405; Emerg Infect Dis 2008;14(5):834-836; J Clin Microbiol 2007;45(7):2144-2150). These papers suggest that these human cardioviruses are probably globally distributed, having been detected in North America (Canada and USA), South America (Brazil) and Europe (Germany). However, no association with a particular disease condition has been established so far.

E-mail addresses: (F.J. Cooke), (D.S. Shapiro).

1201-9712/$32.00 doi:10.1016/j.ijid.2008.09.001

ProMED update

Trichinellosis outbreak in the Chukchiautonomous region of Russia

An outbreak of trichinellosis (trichinosis) has occurred in the Nunligran village, Providenskiy area of the Chukchi autonomous district (ProMED-mail archive number 20080919.2954). A total of 8 people were infected with Trichinella after eating walrus (Odobenus rosmarus) meat. Of those, 2 died and 3 are in the district hospital.

Outbreaks of trichinellosis due to the consumption of fermented or undercooked walrus meat have been documented among Inuit in not only Russia, but also in Greenland, Alaska (USA), and Canada. Trichinella nativa, a species that is quite resistant to cold temperatures, is the typical cause of trichinellosis in the arctic. Clinical symptoms may be indistinguishable from those of trichinellosis due to Trichinella spiralis, although diarrhea may be quite prominent in cases due to T. nativa.

Rabies in vampire bats and human exposure in Uruguay

A farmer in Paso del Cerro, Uruguay, was attacked by a vampire bat (Desmodus rotundus) on 7 September 2008. He was taken to the Institutode Higiene in Montevideo where he received prophylactic therapy against rabies (ProMED-mail archive number 2008091.2867). The results of laboratory tests performed on the vampire bat that attacked the farmer were reportedly positive for rabies virus. As a result, there is a concern that there may be a colony of vampire bats infected with rabies in the dense Rivera forest. A few months ago, a site in Rincon de Dinis was reported to be inhabited by infected vampire bats. Paso del Cerro is located near Rincon de Dinis, so it is presumed that some vampire bat colonies may remain.

A specialized area within the Agriculture Ministry will initiate a vampire bat extermination campaign.

Rabies in vampire bats has been limited to non-urban areas, though a recent case report (Ferraz C, Achkar SM, Kotait I. First report of rabies in vampire bats (Desmodus rotundus) in an urban area, Ubatuba, Sao Paulo state, Brazil. Rev Inst Med Trop Sao Paulo 2007;49(6):389-90) in which a rabid vampire bat was recovered in an urban area of Brazil in 2006 indicates that there is the potential for a more important public health issue than is the case when the rabid bats are in less densely populated rural areas. Non-rabid vampire bats have been found to feed on both animals and humans in rural areas. Death due to rabies that has been transmitted from vampire bats to humans is well documented, and significant outbreaks killing dozens of people have occurred.