Zoonotic Diseases

Diseases discussed here have a history of use as an agent for biological warfare, either in the U.S. or abroad. Its use may have been experimental or actual, and any detrimental consequences upon humans, animals or the environment may have been intentional or not, depending on the circumstances, the point in time, and the nature of the disease.

Wednesday, September 29, 2010

Deathcount Rises from 2 to 10 / Suspect CCHF

UNDIAGNOSED FATAL ILLNESS - PAKISTAN (02): (KHYBER-PAKHTUNKHWA)


***************************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: Tue 28 Sep 2010

Source: Express Tribune [edited]







10 die of mysterious disease in Dir

-----------------------------------

A total of 10 people have died of an unknown disease in Lower Dir

while another 15 have been shifted to a hospital with the same

symptoms. According to locals, the disease broke out around 15 days

ago, with symptoms of severe temperature and body ache which resulted

in death within 2 weeks. Doctors say the symptoms of the disease are

similar to dengue [fever]. The blood samples of the affected persons

have been sent to the National Institute of Health in Islamabad; 3

critically ill patients have been shifted to Khyber Teaching Hospital,

Peshawar, where they are being kept in an isolation ward.



One [suspected] dengue patient was diagnosed with the Crimean-Congo

hemorrhagic fever (CCHF) virus infection in Karachi, causing alarm in

the city.



--

Communicated by:

ProMED-mail Rapporteur Mary Marshall



[The description of the symptoms of the illness responsible for the 10

fatalities and 15 hospitalised cases in Lower Dir is not sufficient to

suggest a diagnosis. Dengue fever appears to have been excluded, but

CCHF virus infection remains a possibility. It is unclear at present

if there is any similarity between this outbreak and the deaths of

patients at the Ayub Hospital Abbottabad, also in Khyber-Pakhtunkhwa

(see the preceding ProMED-mail report, archive number 20100927.3505).

Further information would be welcomed.



Dir is a town in Upper Dir District, Khyber-Pakhtunkhwa province

(formerly North-West Frontier Province), Pakistan. It lies at the foot

of the Lowarai Pass, the main motor road to Chitral, on the Dir River,

a tributary of the Panjkora River. The HealthMap/ProMED-mail

interactive map of Pakistan can be accessed at:

. - Mod.CP]



[see also:

Undiagnosed fatal illness - Pakistan: (NW) 20100927.3505

Crimean-Congo hem. fever - Pakistan (03): (PB) 20100923.3440

Crimean-Congo hem. fever - Pakistan (02): (KI) 20100917.3372

Crimean-Congo hem. fever - Pakistan ex Afghanistan: RFI 20100629.2161]

...................cp/ejp/jw

*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.

Tuesday, September 28, 2010

MSNBC Covers-Up De-Pop Plan

http://www.infowars.com/msnbc-in-cover-up-of-manifestly-provable-population-control-plan/

UNDIAGNOSED FATAL ILLNESS - PAKISTAN: (KHYBER-PAKHTUNKHWA)

Symptoms similar to Crimean-Congo hemorrhagic fever, a known biological weapon; http://www.globalsecurity.org/wmd/intro/bio_congo-att.htm

*********************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: Mon 27 Sep 2010

Source: PakTribune [edited]







2 people -- a young doctor and a Chinese engineer -- have died from a

mysterious disease, while a schoolboy was stated to be in a critical

condition at the Ayub Teaching Hospital (ATH) for the last one week,

official sources said.



The sources in the health department revealed that [these] patients

brought to the ATH from the flood-affected areas showed a decrease in

their blood clotting ability. The sources said the patients initially

suffered fever and headache followed by fits, and later their blood

platelets decreased.



The sudden death of a young resident medical officer, Dr H., caused by

the mysterious viral infection, has raised concern among the senior

doctors as well as the administration of the ATH. Deputy Medical

Superintendent of the Casualty Department of the ATH, Dr Junaid

Sarwar, told this [reporter] that Dr H. contracted fever in Bisham.

Later, investigation revealed that his platelet count dropped to the

range of 135 000 compared to the normal range of 150 000 to 300 000.

His fever was finally controlled on Sunday [19 Sep 2010], and he

rejoined the office. But on Tuesday [21 Sep 2010], he [collapsed] in

the washroom of the college hostel. He was rushed to the hospital's

emergency unit.



Another medical officer said that the ailing doctor's blood pressure

at that time was as low as 80/30, and emergency treatment was provided

to him. "Dr H. was conscious but suffering from severe headache at

that time. He fell unconscious after a few minutes and developed

regular fits," he recalled.



Medical specialists were immediately called; who recommended an MRI,

which diagnosed brain haemorrhage. The young doctor later died.



The younger brother of Dr H. has been showing the same symptoms for

the past few days. In a similar case, a Chinese engineer working in

Allai in Battagram district remained hospitalised at the Ayub Teaching

Hospital for a couple of days and later expired.



--

Communicated by:

ProMED-mail



[The Ayub Teaching Hospital or ATH is a public sector, non-profit

tertiary level teaching hospital in Abbottabad, Khyber-Pakhtunkhwa

(previously the North-West Frontier Province), Pakistan. Established

in 1998, it has one of the largest 24-hour emergency centers in

Khyber-Pakhtunkhwa and caters to much of eastern Khyber-Pakhtunkhwa,

the Northern Areas of Pakistan, as well as certain parts of Azad

Kashmir ().



The signs and symptoms exhibited by the deceased doctor were similar

to those of Crimean-Congo hemorrhagic fever, and a hospital such as

the Ayub Hospital might be expected to make such a diagnosis rapidly

and take immediate steps to avoid nosocomial infection. It is not

stated whether the deceased doctor, his brother and the deceased

Chinese engineer had any contact with infected livestock or with each

other. Clarification and further information is awaited.



The HealthMap/ProMED-mail interactive map of Pakistan can be accessed

at: . - Mod.CP]



[see also:

Crimean-Congo hem. fever - Pakistan (03): (PB) 20100923.3440

Crimean-Congo hem. fever - Pakistan (02): (KI) 20100917.3372

Crimean-Congo hem. fever - Pakistan ex Afghanistan: RFI 20100629.2161]

.............................................mpp/cp/msp/jw

*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.

############################################################

############################################################

Monday, September 27, 2010

HANTAVIRUS UPDATE 2010 - AMERICAS (33): CHILE (CENTRAL)

What is it? Open the link below to learn more about it and to see where the US was playing with this virus for use as a biological weapon) -
http://www.news-medical.net/health/What-is-Hantavirus.aspx

HANTAVIRUS UPDATE 2010 - AMERICAS (33): CHILE (CENTRAL)


*******************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: Sun 26 Sep 2010

Source: La Tercera, Chile [in Spanish, trans. Mod.TY, edited]







Cases of [hantavirus infection] 40 percent higher than in 2009

--------------------------------------------------------------

After 4 years during which it seemed that hanta [virus infections]

were controlled, based on the low number of cases, today the

situation has again become relevant [to public health]. To date,

there are 49 people infected with the disease [virus], "a figure

greater than what is expected for this period," according to the

Ministry of Health (MINSAL) epidemiological report. Of these, 17 died.



Given this, the authorities issued an alert to the assistance

network, "During the next months an expected seasonal increase will

begin for this disease. Because of this, the health teams must be

alert for early indications," the document stated.



The chief of Epidemiological Surveillance of MINSAL, Maritza Garcia,

explained that although the numbers are still lower than those

registered in an epidemic year (in 2001 there were 81 cases),

mortality is high and represents 35 percent of infections. This

increase [in the number of cases of hantavirus infection] is due to

an increase in the rodent population that transmits the disease

[virus] (the long-tailed pygmy rice rat [_Oligoryzomys

longicaudatus_]). "If this is a year of more rain, if the quila

plants [a perennial bamboo that grows in the humid temperate forests

of Chile and Argentina] are flowering more or if there is greater

availability of grain, on which the rodents feed, the disease spreads more.



She also added that when the disease [incidence] decreases, people

tend to relax their preventive measures, which also affects [the risk

of] infection.



The regions where the most cases have occurred are Biobio (14

[cases]) and Maule (9). In that respect, the Biobio health SEREMI

[Regional Ministerial Secretariat] epidemiologist, Cecilia Soto, said

that 93 percent of the infected individuals are males. "The

environmental conditions are by far an important factor, such as

firewood collection." Osvaldo Palma, of the Maule health SEREMI,

said, on the other hand, that despite "the earthquake, where many

families decided to remain living in their destroyed houses, this

year [2010] we have not had a substantial increase in cases."



[Byline: Ana Maria Morales]



--

Communicated by:

ProMED-ESP





[Cases of infection by a hantavirus continue and are increasing in

this region of central Chile. Although not stated, the hantavirus

involved in this and previous cases doubtless is Andes virus.



An image of the long-tailed pygmy rice rat (_Oligoryzomys

longicaudatus_), the sigmodontine rodent host of Andes hantavirus,

can be seen at .



A map of Chile showing the administrative divisions including Biobio

and Maule regions can be seen at .

A HealthMap/ProMED-mail interactive map of Chile can be accessed at

. - Mod.TY]



[see also:

Hantavirus update 2010 - Americas (27): Chile (OH) 20100701.2198

Hantavirus update 2010 - Americas (24): Chile, USA, susp 20100509.1509

Hantavirus update 2010 - Americas (23): Chile (BI) 20100506.1476

Hantavirus update 2010 - Americas (21): Chile, Argentina 20100427.1357

Hantavirus update 2010 - Americas (20): Chile (AR) 20100422.1305

Hantavirus update 2010 - Americas (19): Chile (LL) 20100422.1297

Hantavirus update 2010 - Americas (18): Chile (ML) 20100420.1285

Hantavirus update 2010 - Americas (16): Argentina, Chile 20100407.1125

Hantavirus update 2010 - Americas (15): Chile, Bolivia 20100402.1050

Hantavirus update 2010 - Americas (14): Chile (AI, LG) 20100329.0990

Hantavirus update 2010 - Americas (13): Chile 20100322.0915

Hantavirus update 2010 - Americas (07): Chile 20100215.0534

Hantavirus update 2010 - Americas (06): Chile 20100213.0515

Hantavirus update 2010 - Americas (05): Chile, conf. 20100210.0467

Hantavirus update 2010 - Americas (04): Chile, susp., RFI 20100209.0448

Hantavirus update 2010 - Americas (02): Chile 20100119.0210

Hantavirus update 2010 - Americas (01): Chile 20100108.0097]

...................................ty/mj/mpp



*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.

############################################################

############################################################

EEE / Equine Infections / Human Death

*Note: NO Infected Mosquitos Found
EASTERN EQUINE ENCEPHALITIS - USA (31): (NEW YORK), EQUINE, HUMAN


***********************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: 24 Sep 2010

Source: Syracuse.com [edited]







Two more horses in Onondaga County have tested positive for eastern

equine encephalitis, the county Health Department announced Friday

[24 Sep 2010] afternoon.



The horses, which were kept on Lamson Road in Lysander, became ill

and died on 17 Sep 2010, officials said.



So far, 3 cases of EEE have been confirmed this year [2010] in the

county, officials said. The 1st horse, which was stabled on Oswego

Road in Lysander, was euthanized on 10 Sep 2010.



An Onondaga County resident infected with the virus died earlier this

month [September 2010], the 4th human EEE death in Central New York since 1971.



County health officials Friday [24 Sep 2010] also announced that no

EEE was found among mosquitoes trapped last week and tested this week.



Although EEE cases are rare, the virus is one of the most serious

mosquito-borne diseases. About 1/3rd of people infected with it die.

Most survivors suffer significant brain damage. There is no specific

treatment for EEE, nor is there a human vaccine.



Symptoms can range from a mild flu-like illness to sudden fever,

muscle pains and a headache that's often followed quickly by seizures

and coma. Symptoms can appear within 5-15 days after the bite of an

infected mosquito. EEE is diagnosed through blood or spinal fluid.



Fresh water swamps like the Cicero Swamp are breeding grounds for

EEE-infected mosquitoes. The county conducted aerial spraying of the

swamp earlier this month [September 2010].



Dr. Cynthia Morrow, county health commissioner, urged people to

continue to remain vigilant and to take measures to reduce exposure

to mosquitoes.



She advised residents to use insect repellent, wear long-sleeve

shirts and long pants outdoors, and refrain from outdoor activity

during prime mosquito feeding times at dawn and dusk.



--

Communicated by:

ProMED-mail



[Although this article states that EEE cases are rare, clearly that

is in humans. This year [2010] has seen many equines affected with

this mosquito-borne disease. Mosquitoes transmit the disease to

horses and to people. Horses cannot transmit the disease to other

horses or to humans.



Horses can be given a preventative vaccine, and owners should

consider a spray or wipe-on product manufactured for the horse to

keep flies and mosquitoes off of the animals.



Human beings are encouraged to use mosquito repellant, avoid the

mosquito-prime times of dusk and dawn, to wear long sleeves when out

at these times, and to clean up any location of standing water that

may be a source of mosquito breeding. - Mod.TG]



[It is noteworthy that earlier this month (September 2010), there was

a human fatality from EEE in Onondaga County NY (see prior

ProMED-mail posting Eastern equine encephalitis - USA (27): (NY)

human 20100905.3188), and late last month (August 2010), there was a

report on an equine case of EEE in neighboring Oswego County NY.



For a map of New York State showing counties, see

. - Mod.MPP]



[see also;

Eastern equine encephalitis - USA (30): (AL, NE, OH) equine 20100918.3375

Eastern equine encephalitis - USA (29): (MI) 20100914.3311

Eastern equine encephalitis - USA (28): (MI,FL) 20100907.3202

Eastern equine encephalitis - USA (27): (NY) human 20100905.3188

Eastern equine encephalitis - USA (26): (MI, FL) equine, human 20100901.3115

Eastern equine encephalitis - USA (25): (MA) human 20100830.3089

Eastern equine encephalitis - USA (24): (NY, MI) equine, cervid 20100827.3045

Eastern equine encephalitis - USA (23): (MI) 20100824.2975

Eastern equine encephalitis - USA (22): (VA, MA) 20100820.2911

Eastern equine encephalitis - USA (21): (GA) equine 20100819.2893

Eastern equine encephalitis - USA (20): (FL), fatal 20100818.2871

Eastern equine encephalitis - USA (19): (MI) equine, human susp 20100817.2850

Eastern equine encephalitis - USA (18): (MA) equine, human 20100816.2836

Eastern equine encephalitis - USA (17): (FL) equine 20100815.2813

Eastern equine encephalitis - USA (16): (MI) 20100814.2790

Eastern equine encephalitis - USA (15): (FL) sentinel avian 20100810.2728

Eastern equine encephalitis - USA (14): (FL), equine, sentinel avian

20100807.2691

Eastern equine encephalitis, equine - USA (13) (FL, MA) 20100806.2675

Eastern equine encephalitis - USA (12): (MA) 20100803.2620

Eastern equine encephalitis - USA (11): (FL) fatal, human, equine 20100731.2569

Eastern equine encephalitis - USA (10): (MA, MI) 20100728.2529

Eastern equine encephalitis - USA (09): (FL) fatal 20100723.2469

Eastern equine encephalitis - USA (08): (LA) 20100716.2374

Eastern equine encephalitis - USA (07): (FL) 20100715.2363

Eastern equine encephalitis - USA (06): (FL, GA) 20100710.2312

Eastern equine encephalitis - USA (05): (FL) 20100708.2274

Eastern equine encephalitis - USA (04): (FL) 20100630.2178

Eastern equine encephalitis - USA (03): (FL) 20100627.2146

Eastern equine encephalitis - USA (02): (FL) sentinel avian 20100623.2101

Eastern equine encephalitis - USA: (FL) 20100527.1755]

.........................................sb/tg/msp/mpp



*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.

############################################################

############################################################

Thursday, September 23, 2010

New Enterobacteriaceae Resistant Isolate Enters U.S.

VERONA INTEGRON-ENCODED METALLO-BETA-LACTAMASE CARRYING

ENTEROBACTERIACEAE - USA ex GREECE: FIRST REPORT

What is Enterobacteriaceae? - http://en.wikipedia.org/wiki/Enterobacteriaceae
More info from CDC; http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5924a5.htm?s_cid=mm5924a5_w
Update: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm59e0921a1.htm?s_cid=mm59e0921a1_w

********************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: Tue 21 Sep 2010

Source: CDC. MMWR Morb Mortal Wkly Rep 2010; 59 (early release); 1-1 [edited]







In July 2010, CDC was notified of a patient with a

carbapenem-resistant _Klebsiella pneumoniae_ strain that produced a

Verona integron-encoded metallo-beta-lactamase (VIM) carbapenemase

(1) not reported previously among _Enterobacteriaceae_ in the USA.

The patient was a woman from the USA who became ill with diarrhea

during a Mediterranean cruise and was hospitalized in Greece, where

she received a diagnosis of sepsis and _Clostridium difficile_ infection.



After 12 days in 2 hospitals in Greece, she was transferred to a

hospital in the USA for continued management of sepsis and acute

renal failure. On admission, blood was drawn for culture through a

central venous catheter that had been placed while the patient was

hospitalized in Greece. The blood subsequently grew

carbapenemase-producing _Klebsiella pneumoniae_ exhibiting the VIM

resistance mechanism, which has been described previously in Greece

but not in the USA. Further testing showed the isolate to be non

susceptible to all antimicrobials usually used to treat _Klebsiella_.

Despite the resistance of the _Klebsiella_ strain, the patient

recovered sufficiently to be discharged after 26 days in the American

hospital. A search for other patients colonized with the same isolate

was conducted by screening 22 patients whose hospital stays

overlapped with this patient; no carbapenem-resistant

_Enterobacteriaceae_ (CRE) were detected.



This report of a VIM-producing CRE follows a June 2010 report of 3

cases of New Delhi metallo-beta-lactamase (NDM-1)-producing

_Enterobacteriaceae_ (2). However, the most common mechanism of

carbapenem resistance among _Enterobacteriaceae_ in the USA remains

the production of the _Klebsiella pneumoniae_ carbapenemase (KPC).

KPC-producing _Enterobacteriaceae_ are widespread in the USA and

other countries (3). Cases of CRE are a significant, emerging public

health problem regardless of the mechanism of carbapenem resistance,

and procedures to rapidly recognize and report CRE cases to infection

prevention personnel should be in place in all acute and

long-term-care facilities. Facilities that have not identified cases

of CRE should undertake periodic laboratory reviews to identify

cases. Patients with CRE should be managed using contact precautions,

and patients exposed to CRE patients (such as roommates) should be

screened with surveillance cultures (3). State and local health

departments should promote adoption of current prevention guidance

and monitoring of the prevalence of these organisms in their jurisdictions (3).



Public health officials and health-care facility staff can consult

with the Division of Healthcare Quality Promotion at CDC on the best

practices for identifying and preventing transmission of these

organisms (e-mail: ).



References

----------

1. Vatopoulos A: High rates of metallo-beta-lactamase-producing

_Klebsiella pneumoniae_ in Greece -- a review of the current

evidence. Euro Surveill 2008; 13(4): 1-6 [available at

].

2. CDC: Detection of _Enterobacteriaceae_ isolates carrying

metallo-beta-lactamase -- United States, 2010. MMWR 2010; 59(24): 750

[available at

].

3. CDC: Guidance for control of infections with carbapenem-resistant

or carbapenemase-producing _Enterobacteriaceae_ in acute care

facilities. MMWR 2009; 58(10): 256-60 [available at

].

--

Communicated by:

ProMED-mail





[The Verona integron-encoded metallo-beta-lactamase carbapenemases

(VIM-1 and VIM-2) were initially identified in carbapenem-resistant

_Pseudomonas aeruginosa_ in the Mediterranean basin. The VIM-1 gene

was originally cloned from a _P. aeruginosa_ strain from an outbreak

in the ICU of the University Hospital in Verona, Italy, hence the name.



Bacteria containing this enzyme have a very broad substrate range

including the carbapenems and most other beta-lactams. The enzymes

are encoded on mobile gene cassettes which have been inserted into an

integron. The integrons easily spread between organisms, playing a

major role in the spread of antimicrobial resistance in gram-negative bacilli.



This resistance gene is the 3rd to be highlighted in the news over

the past 6 weeks. - Mod.LL]



[see also:

NDM-1 carrying Enterobacteriaceae - worldwide ex India, Pakistan (02)

20100914.3325

NDM-1 carrying Enterobacteriaceae - worldwide ex India, Pakistan 20100817.2853

NDM-1 carrying Enterobacteriaceae - N America, UK ex India 20100815.2812

E. coli ST131 - USA: emerging drug-resistant pathogen worldwide 20100803.2607

Antimicrobial resistance monitoring - USA: 2007 report 20100506.1471

2007

----

E. coli, ESBL - UK 20071106.3614

2004

----

E. coli, ESBL - UK (Shropshire) (02) 20040718.1952

E. coli, ESBL - UK (Shropshire) 20040715.1920

2003

----

Acinetobacter, drug resistant - Iraq: RFI 20030417.0934

2002

----

Gram negative bacilli, ESBL - UK (Scotland) 20020527.4333]

...................................mpp/ll/mj/mpp



*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.

############################################################

############################################################

Tuesday, September 21, 2010

GAO to Investigate FBIs' 2001 Anthrax Investigation

ANTHRAX, HUMAN, 2001 - USA (06)
AmeriThrax: The FBI's Version; http://www.fbi.gov/anthrax/amerithraxlinks.htm

*******************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: 20 Sep 2010

Source: SecurityInfoWatch.com/The Frederick News-Post, Maryland [edited]







GAO to review FBI's Ivins investigation

---------------------------------------

Investigation will seek to resolve unanswered questions surrounding

the 2001 anthrax attacks. The Government Accountability Office [GAO]

has launched an investigation into the scientific methods used by the

FBI to determine that Fort Detrick researcher Bruce Ivins was the

sole perpetrator of the 2001 anthrax attacks.



U.S. Rep. Rush Holt, who represents the New Jersey district from

which the letters were mailed, requested GAO's involvement as early

as 2007, but renewed his efforts after the FBI announced it had

closed its Amerithrax investigation last February [2010]. Holt and 4

other lawmakers originally proposed a list of 10 questions for GAO to

help answer, including how the anthrax spores used in the attacks

compared to anthrax produced in this country and in locations around

the world, what amount of time and material would go into creating

the quantity of anthrax spores used in the attacks, and why the FBI

had not yet been able to close the case.



The FBI questioned Ivins, a researcher at the U.S. Army Medical

Research Institute of Infectious Diseases, throughout the entire

investigation, but named him as the suspect only after he committed

suicide in July 2008.



Many of Ivins' former co-workers and several lawmakers -- including

Sen. Chuck Grassley, one of the 4 who helped Holt pursue the GAO

investigation and who has been a vocal critic of the FBI's work on

the case -- are still not convinced the FBI adequately proved Ivins'

guilt. "The American people need credible answers to many questions

raised by the original attacks and the subsequent FBI handling of the

case," Holt said in a news release. "I'm pleased the GAO has

responded to our request and will look into the scientific methods

used by the FBI."



Specifically, the GAO investigation will seek to answer 3 main questions:

- What forensic methods did the FBI use to conclude Ivins was the

sole perpetrator, and how reliable are those methods?

- What scientific concerns and uncertainties still remain regarding

the FBI's conclusion?

- What agencies monitor foreign containment labs, and how do they

monitor those labs?



Holt had also requested that several House of Representatives

committees question the FBI's methods and results, and he has called

for a commission similar to the one that looked into the government's

response to the 11 Sep 2001 attacks. Neither effort has made much

progress thus far. "It's still a priority for him," said Holt

spokesman Zach Goldberg. "He continues to get supporters for it, but

it hasn't gotten traction in the larger Congress, which is certainly

disappointing. He still feels that this is something that needs to be

looked at for a variety of reasons -- that the families deserve

answers to a myriad of questions."



Rep. Roscoe Bartlett, who represents Western Maryland, was not part

of the group that signed the letter to GAO but has been working to

get more answers since the FBI closed the Amerithrax case. "I welcome

the forthcoming investigation by the Congress' General Accounting

Office of a series of important unanswered questions about the FBI's

investigation," Bartlett said. "These questions have undermined the

credibility of the FBI's conclusions."



The GAO investigation will be the 1st congressionally directed review

of the FBI's case; another review, done by the National Academy of

Sciences, was requested by the FBI itself 2 years ago.



The NAS investigation is scheduled to wrap up by the end of [this]

year. In GAO's letter to Holt confirming it would look into the FBI

investigation, Ralph Dawn Jr., GAO managing director of congressional

relations, wrote that to avoid any overlap between the 2 groups'

investigations, they would 1st review the NAS study before

determining the scope of the GAO one. Goldberg said the GAO would

start its investigation soon, if it hadn't begun already. He said the

GAO hadn't announced a timeline for its investigation but said that

Holt wasn't worried about rushing things along. "Of course (Holt)

wants it to be comprehensive and not rushed in any way," Goldberg

said. "The important thing is that the questions get addressed."



[Byline: Megan Eckstein, The Frederick News-Post, Maryland)



--

Communicated by:

ProMED-mail





[The NAS committee has maintained an admirable silence and without

leaks. The release date for their report is not known but expected to

be sometime in the Fall and before Christmas. I suspect that this

efficiency is partly to blame for US Representative Holt's move to

get the GAO involved. We will not know the thoroughness of the NAS

investigation until its report is out. - Mod.MHJ]



[see also:

Anthrax, human, 2001 - USA (05) 20100424.1326

Anthrax, human, 2001 - USA (04) 20100324.0933

Anthrax, human, 2001 - USA (03) 20100305.0727

Anthrax, human, 2001 - USA (02): FBI case closed 20100219.0575

Anthrax, human, 2001 - USA 20100125.0281

2009

----

Anthrax, human, 2001 - USA (03): NAS review 20090507.1707

Anthrax, human, 2001 - USA (02): evidence 20090227.0817

Anthrax, human, 2001 - USA: review 20090104.0033

2008

----

Anthrax, human, 2001 - USA (12): comment 20080928.3074

Anthrax, human, 2001 - USA (11): review 20080924.3019

Anthrax, human, 2001 - USA (10): evidence 20080828.2696

Anthrax, human, 2001 - USA (09): evidence 20080819.2591

Anthrax, human, 2001 - USA (08): evidence, drugs 20080818.2566

Anthrax, human, 2001 - USA (07): letters, evidence 20080812.2492

Anthrax, human, 2001 - USA (06): letters, evidence 20080811.2488

Anthrax, human, 2001 - USA (05): letters, evidence 20080807.2428

Anthrax, human, 2001 - USA (04): letters, evidence 20080806.2412

Anthrax, human, 2001 - USA (03) 20080805.2406

Anthrax, human, 2001 - USA (02): letters, evidence 20080805.2392

Anthrax, human - USA 2001: letters, new suspect 20080803.2371]

...................sb/mhj/ejp/mpp



*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.

Pasteurella / Pneumonia , Ovine / Big Horn Sheep - Washington

Pasteurella / Pneumonia as a Biological Weapon; http://www.iom.edu/~/media/Files/Report%20Files/2007/Long-Term-Health-Effects-of-Participation-in-Project-SHAD-Shipboard-Hazard-and-Defense/PASTEURELLAFRANCISELLATULARENSIS.ashx

PNEUMONIA, OVINE - USA (11): (WASHINGTON) BIGHORN SHEEP


*******************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: Sat 18 Sep 2010

Source: The Seattle Times, Yakima Herald-Republic report [edited]







Deadly illness spreading among bighorn sheep

--------------------------------------------

State wildlife biologists made the gut-wrenching decision last spring

[2010] to kill dozens of sick bighorns west of the Yakima River

Canyon in hopes of keeping a pneumonia outbreak from reaching the

herd across the river.



It didn't work. Roughly two-thirds of the lambs born this spring

[2010] east of the canyon are believed to have died. And although

biologists haven't verified deaths among the adults, hunters on a

special-permit hunt on that side of the river last week reported

seeing adult rams coughing.



Tissue samples from the rams killed by those hunters will be

disease-tested at Washington State University, but the findings are

expected to take weeks. Until then, state Department of Fish and

Wildlife biologists only know what they see. And it doesn't look good.



"Something bad is going on," said Jeff Bernatowicz, a Yakima-based

sate wildlife biologist. "If the lambs are dying, hey, the signs are

there -- the warning signs are flashing in front of us. Almost

without a doubt the bacterium has jumped the river and is now on the

east side."



The initial breakout on the west side of the canyon began in December

[2009], when at least 10 bighorns died from pneumonia, most of them

north of Umtanum Creek.



State wildlife managers decided to remove the remaining wild sheep

showing signs of the illness to keep the outbreak from infecting

nearby herds, potentially resulting in a mass die-off similar to

those in nearby states.



State biologists and others from the US Department of Agriculture

Wildlife Services removed 69 bighorns on the west side of the canyon,

most of them showing obvious signs of illness.



But the biologists also removed several seemingly healthy adults, and

those animals also were found to be infected with _Pasteurella_, a

bacterial parasite typically found in the lungs of pneumonic bighorns.



"What we found was west of the river, every single animal looked like

it had been exposed," Bernatowicz said. "There wasn't a single one

that hadn't been.



"The culling was designed to remove the sick animals and keep the

healthy ones, and the hope was by doing that the lambs would survive.

The theory was if you removed the animals that were actually shedding

the bacteria, the lambs would have a better chance."



But even that didn't work. In the herd west of the canyon --

estimated at about 200 bighorns before last winter's [2009-10]

outbreak -- all but 4 of this year's [2010] lambs have already died.

"And there's no guarantee they'll survive," Bernatowicz said.



The same thing may ultimately happen with the herd east of the

canyon, which has been holding at about 100 sheep. This year's aerial

surveys of the bighorns in the Selah Butte area east of the river

have seen a steady lamb decline.



A 22 May 2010 survey found 32 lambs along with 71 ewes. That meant

roughly 45 of the herd's lambs had ewes, "just about exactly normal,"

according to Bernatowicz.



On 7 Jul 2010, the aerial spotters found 47 ewes -- the others were

believed to be hiding at the 1st sound of the approaching helicopter

-- and 20 lambs, which still represented a healthy lamb-to-ewe ratio.



But on 2 Sep 2010, the 58 ewes spotted had only 9 lambs with them.



State biologists aren't likely to know for weeks how deadly an impact

the disease will have to those adults, or whether any of the lambs

will survive.



Still, even with the disease still spreading, there is still room for

optimism, Bernatowicz said.



"The good thing is we still have 200 animals out there, west and east

(of the river). That's quite a few animals to be working with,"

Bernatowicz said. "It isn't like it's been knocked down to 20 or 30.

So if this thing gets turned around and they start producing lambs

again that survive, we could still be in pretty good shape."



[Byline: Scott Sandsberry]



--

Communicated by:

ProMED-mail





[While no one wishes to see the sheep suffer, it seems there should

be a better way of controlling the disease than herd culling, which

may not be working either.



An important update regarding the causative agents in these outbreaks

in bighorn sheep is in ProMED-mail post 20100815.2814. Readers are

encouraged to read this post. - Mod.TG]



[ProMED-mail would like to thank Peter Cyrog, DVM for submitting a

similar newswire on this current outbreak. - Mod.MPP]



[The state of Washington can be located on the HealthMap/ProMED-mail

interactive map at .

A Yakima River map can be seen at

. - Sr.Tech.Ed.MJ]



[see also:

Pneumonia, ovine - USA (10): (MT) bighorn sheep 20100827.3047

Pneumonia, ovine - USA (09): (MT) bighorn sheep 20100815.2814

Pneumonia, ovine - USA (08): (MT) bighorn sheep 20100814.2794

Pneumonia, ovine - USA (07): (NV) 20100228.0668

Pneumonia, ovine - USA (06): (WA) 20100210.0459

Pneumonia, ovine - USA (05): (MT) bighorn sheep 20100205.0391

Pneumonia, ovine - USA (04): (MT), bighorn sheep 20100124.0272

Pneumonia, ovine - USA (03): (MT), bighorn sheep 20100124.0262

Pneumonia, ovine - USA (02): (MT), bighorn sheep 20100117.0197

2009

----

Pneumonia, ovine - USA: (NV) bighorn sheep 20100109.0105

2008

----

Pasteurella pneumonia, Big Horn sheep - USA: (MT) 20080119.0248

2004

----

Pasteurella pneumonia, Big Horn sheep - USA (ID)(02) 20040415.1040

Pasteurella pneumonia, Big Horn sheep - USA (ID) 20040414.1010

1996

----

Pasteurella pneumonia, Big Horn Sheep - USA (5) 19960130.0221

Pasteurella pneumonia, Big Horn Sheep - USA (4) 19960129.0209

Pasteurella pneumonia, Big Horn Sheep - USA (3) 19960126.0187

Pasteurella pneumonia, Big Horn Sheep - USA (2) 19960126.0186

Pasteurella pneumonia, Big Horn Sheep 19960124.0168]

...................................sb/tg/mj/mpp



*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.

############################################################

############################################################

Monday, September 20, 2010

ANTHRAX, HUMAN, BOVINE - BANGLADESH (18): 65 NEW CASES REPORTED

***********************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





[1]

Date: 20 Sep 2010

Source: Iedcr.org [edited]







Government of the People's Republic of Bangladesh Institute of

Epidemiology, Disease Control and Research (IEDCR) Mohakhali, Dhaka-1212:



Number of Cutaneous Anthrax cases from 18 Aug to 20 Sep 2010:



Districts / Total / Change since last posting / In last 24 hours (20

Sep 2010) / Upazillas

(1) Pabna / 58 / 0 / 0 / Bera (11), Santhia (30), Faridpur (17)

(2) Sirajganj / 212 / 2* / 0 / Shadjadpur (56), Belkuchi (54),

Kamarkhanda (92), Ullapara* (10)

(3) Kushtia / 49 / 3* / 1 / Daulotpur (46), Bheramara* (3)

(4) Tangail / 26 / 0 / 0 / Ghatail (14), Gopalpur (12)

(5) Meherpur / 81 / 2 / 1 / Ganghi* (79), Mujibnagar (1) [data from

above URL - Mod.MHJ]

(6) Manikganj / 8 / 0 / 0 / Shaturia (8)

(7) Shatkhira / 1 / 0 / 0 / Sadar (1)

(8) Lalmonirhat / 107 / 31 / 0 / Sadar* (78), Aditmari* (29)

(9) Rajshahi / 8 / 1 / 0 / Chaghat (7), Tamore* (1**)

(10) Narayangonj / 9 / 0 / 0 / Araihajar (9)

(11) Laxmipur / 25 / 25 / 0 / Kamalnagar* (25)

(12) Chittagong / 1 / 1 / 0 / City* (1)

Total: 585 (2)

** Imported from Sirajganj



--

Communicated by:

ProMED-mail



[An increase of 65 apparently new cases since 16 Sep 2010. - Mod.MHJ]



******

[2]

Date: 19 Sep 2010

Source: Bdnews24.com [edited]







Government health officers have detected the 1st case of human

anthrax in Feni on Sunday [19 Sep 2010]. A 50-year-old resident of

Joynagar village under Mohamaya Union of Chagalnaia Upazila was found

to have anthrax during primary tests.



According to government officials, 583 cases [sic] have been detected

until Sunday [19 Sep 2010], with 63 new cases in the last 3 days.



Family members said the woman fell ill after eating beef that her son

had purchased from the local Chandgazi Bazar on 24 Aug 2010. A

boil-like skin lesion appeared on her right thigh. She was treated by

a village doctor and later in a private clinic. Upazila health and

family planning officer Mohammed Khairul Islam and Upazila livestock

officer Nurul Afsar went to the house on Sunday [19 Sep 2010] noon

after learning about the case and confirmed that she had contracted anthrax.



Khairul Islam said that enquiries were underway to ascertain whether

there were any more anthrax patients in the area.



On the previous day, beef traders in Chittagong claimed that their

trading had quartered due to the scare.



--

Communicated by:

ProMED-mail



[This upazila does not appear in the official 20 Sep 2010 statistics.

- Mod.MHJ]



******

[3]

Date: 20 Sep 2010

Source: Bdnews24.com [edited]







Government health officers have detected the 1st case of human

anthrax in Chuadanga. One man, 35, was identified to be infected with

anthrax at Mahmujumma village of the Sadar Upazila on Monday [20 Sep 2010].



Chuadanga Sadar Upazila medical officer Dr Wajed Ashraf Delwar told

bdnews24.com that they were informed of villagers' suspicion about a

father, 30, his wife, 26, and their son, 6, of Boalia village and of

the 35-year-old man of Mahmujumma village of being infected with

anthrax. On such information, a medical team along with district

civil surgeon Dr Lokman Hakim and livestock officer DD Ajoy Roy

visited the spot.



Ajoy Roy told bdnews24.com that they found the 35-year-old man to be

infected. After conducting tests, they said the wife and son had

gotten scabies.



"However, we could not check [the 30-year-old father], as he is

currently in Dhaka. The 35-year-old man left Dhaka after eating beef

at a relative's house. He started showing signs of the disease after

he reached home," the livestock officer added.



--

Communicated by:

ProMED-mail



[Another new upazila, but apparently an imported case from Dhaka, so

infected meat has apparently reached the capital. - Mod.MHJ]



[see also:

Anthrax, human, bovine - Bangladesh (17) 20100917.3373

Anthrax, human, bovine - Bangladesh (16) 20100915.3346

Anthrax, human, bovine - Bangladesh (15) 20100914.3323

Anthrax, human, bovine - Bangladesh (14) 20100910.3279

Anthrax, human, bovine - Bangladesh (13) 20100908.3236

Anthrax, human, bovine - Bangladesh (12): Id alert 20100907.3224

Anthrax, human, bovine - Bangladesh (11): widespread 20100905.3191

Anthrax, human, bovine - Bangladesh (10): (KU, TA) 20100902.3140

Anthrax, human, bovine - Bangladesh (09): (SR, PB) 20100831.3109

Anthrax, human, bovine - Bangladesh (08): (SR, PB) 20100828.3066

Anthrax, human, bovine - Bangladesh (07): (SR) 20100827.3044

Anthrax, human, bovine - Bangladesh (06): (SR) 20100826.3009

Anthrax, human, bovine - Bangladesh (05): (SR) conf. 20100825.2996

Anthrax, human, bovine - Bangladesh (04): (SR) susp. 20100824.2970

Anthrax, human, bovine - Bangladesh (03): (PB) susp. 20100823.2944

Anthrax, human, bovine - Bangladesh (02): (SR) 20100820.2914

Anthrax, human, bovine - Bangladesh: (TA) susp, RFI 20100421.1291]

.................................................mhj/msp/mpp



*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.

############################################################

############################################################

Friday, September 17, 2010

Bioterrorism: In Lies We Trust

http://topdocumentaryfilms.com/in-lies-we-trust/

CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (02): (KARACHI)

CCHF as Bioweapon; http://www.millennium-ark.net/News_Files/NBC/Bio.Bugs.Congo.html


CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (02): (KARACHI)


**********************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: Thu 16 Sep 2010

Source: Dawn, local news [edited]







Another Congo fever case reported in 2 weeks

--------------------------------------------

A young tannery worker who was admitted to the city government-run

Abbasi Shaheed Hospital (ASH) for the treatment of dengue fever has

tested positive for viral Crimean-Congo haemorrhagic fever (CCHF)

virus infection as well. It was the 2nd such case of CCHF reported

from the city hospitals during the short span of 2 weeks, said

medical circles, adding that the 1st patient had been discharged from

a private hospital after his recovery.



Reports about 2 deaths from CCHF in July [2010] and the preceding

months this year set alarm bells ringing and the city and health

practitioners and relevant authorities have stressed the need [to

undertake] urgent preventive measures.



The medical superintendent of the ASH, Dr Hamid Zaheer, told the Dawn

[newspaper] on Wednesday [15 Sep 2010] that a 23-year-old patient, a

resident of Sector 9/E, Orangi Town, [had been] brought to the

hospital with pain, high-grade fever and respiratory problems. "As I

have been told by doctors, the patients bled 2 days back, following

which in addition to initial tests and symptomatic treatment, some

serological tests were conducted and it was known by Tuesday [14 Sep

2010] that the patient had tested positive both for dengue fever

[virus] and CCHF [virus] infections. Initially he was kept in the

intensive care unit, but now [he is being treated] in an isolation

ward of the hospital, while the doctors and paramedics have also been

asked to observe the appropriate protocol while [treating] the

patients in question," Dr Zaheer stated.



Of the 5 patients tested positive for the viral disease [CCHF} since

March [2010], 2 have survived, while one is under treatment at the

ASH.



The death of a patient, in his mid-thirties, a resident of Bismillah

Colony, Landhi, was confirmed by the Indus Hospital, Korangi, in July

[2010]. This patient was a butcher by profession -- said to be one of

the most vulnerable jobs to contract the highly infectious disease.

The occupation of the other patient who died from CCHF in May was not

known.



Some of the experts after knowing about the CCHF [cases] in July had

highlighted the need to undertake a retrospective study of CCHF

patients, [to determine] their occupations and their contact with

other people during the period of incubation of the virus, and to

determine the sensitivity of lab results and [communication of] a

timely update by the hospitals on the cases to the health authorities.



The deputy medical superintendent of the ASH, Dr Javed Akhtar, said

that the [23-year-old patient currently being treated], a worker at

tannery, was admitted to the hospital on Sat 11 Sep 2010 and was kept

in the Medical-III [ward] initially and then was transferred to the

medical intensive care unit (ICU) in view of his deteriorating

condition.



The laboratory of the Aga Khan University Hospital (AKUH) informed

the hospital on Tue 14 Sep 2010 of positive test results for dengue

fever virus infection and CCHF virus infection, and as a result the

patient was transferred to an isolation ward.



Relatives of of the patient had also been debarred from meeting him,

the doctor said, adding that the patient was being provided with

blood platelets, which had critically decreased. Replying to a

question, Dr Akhtar said that the AKUH laboratory handed over the

formal serology test report to the ASH on Wednesday [15 Sep 2010] for

this patient, who is now being given all possible care and is now in

a stable condition and conscious.



The head of the infections control committee of the AKUH, Dr Bushra

Jamil, told Dawn that the AKUH lab had tested 2 samples positive in

recent days for CCHF -- one pertained to a patient admitted to the

AKUH and discharged after recovery a week ago, and the other the

sample received from the ASH.



An expert said that the doctors and paramedics [known] to have come

into contact with these patient during treatment, and relatives of

the patients, also needed to be kept under observation as a

preventive measure. It is worth noting that a few years back a doctor

handling a patient suffering from CCHF later died of the same

disease. [Nosocomial transmission of infection in hospitals in

Pakistan has been recorded previously. In 2002, a female doctor

contracted CCHF virus infection from a patient and died. 2 doctors

involved in her treatment also contracted infection; both survived

(see: ProMED-mail post - Crimean-Congo hemorrhagic fever - Pakistan

(02) 20020313.3735).]



Previously, in 1974, a physician died in Rawalpindi General Hospital

as a result of CCHFV infection contracted from patients. - Mod.CP]



[Byline: Mukhtar Alam]



--

Communicated by:

ProMED-mail





[The geographical distribution of CCHF virus, like that of its tick

vectors (_Hyalomma_ spp.), is widespread. Evidence of CCHF virus has

been found in Africa, Asia, the Middle East and Eastern Europe.

Health care workers in endemic areas should be aware of the illness

and the correct infection control procedures to protect themselves

and their patients from the risk of nosocomial (hospital-acquired)

infection.



Humans who become infected with CCHF acquire the virus from contact

with blood or other infected tissues from livestock, or they may

become infected directly from a tick bite. The majority of cases have

occurred in those involved with the livestock industry, such as

agricultural workers, slaughterhouse workers and veterinarians.

Following infection via tick bite, the incubation period is usually

one to 3 days, with a maximum of 9 days.



The incubation period following contact with infected blood or

tissues is usually 5 to 6 days. Onset of symptoms is sudden, with

fever, myalgia (aching muscles), dizziness, neck pain and stiffness,

backache, headache, sore eyes and photophobia (sensitivity to light).

There may be nausea, vomiting and sore throat early on, which may be

accompanied by diarrhoea and generalised abdominal pain. Details of

the subsequent course of the illness can be found at:

.



The mortality rate from CCHF is approximately 30 percent, with death

occurring in the 2nd week of illness. In those patients who recover,

improvement generally begins on the 9th or 10th day after the onset

of illness.



Of the 5 CCHF patients treated in the city of Karachi in recent

months, 2 (a butcher and a tannery worker) have worked with livestock

or livestock products. The case of the 23-year-old tannery worker

described in the above report is exceptional in that the patient has

tested positive for 2 unrelated hemorrhagic fever viruses -- dengue

fever virus (a flavivirus) and CCHF virus (a bunyavirus). Further

information on the course, treatment and outcome of the tannery

worker's illness are matters of general interest and would be

welcomed.



The HealthMap/ProMED-mail interactive map of Pakistan, showing the

location of the city of Karachi can be accessed at:

. - Mod.CP]



[see also:

Crimean-Congo hem. fever - Pakistan ex Afghanistan: RFI 20100629.2161

2009

----

Crimean-Congo hem. fever - Pakistan (03): differential 20091012.3527

Crimean-Congo hem. fever - Pakistan (02): ex Saudi Arabia, susp. 20091011.3516

Crimean-Congo hem. fever - Pakistan (Abottabad): RFI 20090927.3377

2008

----

Crimean-Congo hem. fever - Pakistan (03): (PB), susp. 20081121.3678

Crimean-Congo hem. fever - Pakistan (02): (PB), susp. 20081117.3630

Crimean-Congo hem. fever - Pakistan: (BA) 20081027.3392]

...................arn/lm/cp/ejp/lm

*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.

############################################################

############################################################

Panel to Review Fed's Investigation into Post 9/11 Anthrax Attack

http://www.newsmax.com/Newsfront/anthrax-fbi-review-gao/2010/09/16/id/370596?s=al&promo_code=AC84-1

BRUCELLOSIS, SWINE - LATVIA, OIE

Brucellosis as a biological weapon; http://www.springerlink.com/content/u4174nu585tk3842/
and here; http://www.ncbi.nlm.nih.gov/pubmed/16964579


BRUCELLOSIS, SWINE - LATVIA, OIE


********************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: 16 Sept 2010

Source: OIE WAHID (World Animal Health Information Database) Disease

Information 2010; 23(37) [edited]







Brucellosis (_Brucella suis_), Latvia

-------------------------------------

Information received on 15 Sep 2010 from Mr Vinets Veldre, Chief

Veterinary Officer and General Director, Food and Veterinary Service,

Ministry of Agriculture, Riga, Latvia



Summary

Report type: Immediate notification

Start date 31 Aug 2010

Date of 1st confirmation of the event 11 Sep 2010

Report date 15 Sep 2010

Date submitted to OIE 15 Sep 2010

Reason for notification: Reoccurrence of a listed disease

Date of previous occurrence February 1994

Manifestation of disease: Clinical disease

Causal agent: Brucella suis

Nature of diagnosis Laboratory (basic), Laboratory (advanced)

This event pertains to a defined zone within the country



New outbreaks

Outbreak 1 Avoti, Talsi, Latvia

Date of start of the outbreak 31 Aug 2010

Outbreak status: Continuing (or date resolved not provided)

Epidemiological unit: Farm

Species Cattle

Susceptible 31

Cases 0

Deaths 0

Destroyed 0

Slaughtered 0



Species Swine

Susceptible 2055

Cases 8

Deaths 0

Destroyed 3

Slaughtered 0



Epidemiology - Source of the outbreak(s) or origin of infection;

Unknown or inconclusive



Control measures: Measures applied. Quarantine; Movement control

inside the country; Screening ; Modified stamping out; Vaccination

prohibited; No treatment of affected animals

Measures to be applied - Disinfection of infected premises/establishment(s)



Laboratory name and type: National Reference Laboratory (National laboratory)

Species Swine

Test bacteriological examination

Test date 11 Sep 2010

Result Positive



Species Swine

Test complement fixation test (CFT)

Test date 11 Sep 2010

Result Positive



Future Reporting

The event is continuing. Weekly follow-up reports will be submitted.



**

Communicated by:

ProMED-mail





[Brucellosis is zoonotic disease that can have a significant negative

impact on reproductive capacity on farms. It mainly affects cattle,

sheep, goats and pigs worldwide but also dogs, mice and even murine

species. Infections in feral pigs, bison, elk and European hares also

complicate the eradication picture and pose intermittent risks for

zoonotic transmission.



The Center for Food Security and Public Health at Iowa State

University's College of Veterinary Medicine (see

)

summarizes the geographic distribution as follows: _Brucella_ species

vary in their geographic distribution. _B. abortus_ is found

worldwide in cattle-raising regions except in Japan, Canada, some

European countries, Australia, New Zealand and Israel, where it has

been eradicated. Eradication from domesticated herds is nearly

complete in the U.S. _B. abortus_ persists in wildlife hosts in some

regions, including the Greater Yellowstone Area of North America.



_B. melitensis_ is particularly common in the Mediterranean. It also

occurs in the Middle East and Central Asia, around the Arabian Gulf

and in some countries of Central America. This organism has been

reported from Africa and India, but it does not seem to be endemic in

northern Europe, North America (except Mexico), Southeast Asia,

Australia or New Zealand.



_B. ovis_ probably occurs in most sheep-raising regions of the world.

It has been reported from Australia, New Zealand, North and South

America, South Africa and many countries in Europe.



In the past, _B. suis_ was found worldwide in swine-raising regions.

This organism has been eradicated from domesticated pigs in the U.S.,

Canada, many European countries and other nations. However, it

persists in wild and/or feral swine populations in some areas,

including the U.S., Europe and Queensland, Australia. Sporadic

outbreaks are reported in domesticated herds or humans due to

transmission from this source. _B. suis_ continues to occur in

domesticated herds in some countries of South and Central America

(including Mexico) and Asia. _B. suis_ biovars 1 and 3 are found

worldwide, but other biovars have a limited geographic distribution.

Biovar 2 occurs in wild boar in much of Europe. Biovar 4 (rangiferine

brucellosis) is limited to the Arctic regions of North America and

Russia including Siberia, Canada and Alaska. Biovar 5 (murine

brucellosis) is found in the former USSR.



According to the OIE WAHID database, _Brucella suis_ has sporadically

caused outbreaks in Europe over the last 5 years. It has occurred

both in commercial and feral swine populations. Armenia had an

outbreak in 2008; Croatia has reported outbreaks yearly since 2006 as

has been the case for the Czech Republic. France reported outbreaks

of _B. suis_ in 2006, 2008, 2009; Germany reported outbreaks in 2008

and 2009 as well as this year. Hungary report outbreaks in 2008 and

2009. Italy reported outbreaks every year including 2010 since 2006.

Romania reported outbreak in 2006 and 2008; while the former Serbia

and Montenegro reported an outbreak in 2006. Finally, both Spain and

Switzerland reported outbreaks in 2009. - Mod.PC]



[see also:

Brucellosis, swine - Germany: (BB), OIE 20100213.0508

Brucellosis, swine hunters - USA (02): (TX) hunters 20090920.3303

2008

----

Brucellosis, porcine - Germany: (MV), serovar 2 20080923.2995

Brucellosis, porcine - Germany: (MV) 20080918.2927

Brucellosis, porcine - Romania: OIE 20081011.3220]

...................pc/ejp/lm

*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.

############################################################

############################################################

Wednesday, September 15, 2010

DENGUE/DHF UPDATE 2010 (48)

***************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases

http://www.isid.org/

In this update:

Europe

[1] France (Alpes-Maritimes)

Americas

[2] USA (Florida): correction

[3] Brazil (Roraima)

Asia

[4] Philippines (Cebu)

[5] India (Delhi)



******

[1] France (Alpes-Maritimes)

Date: Mon 13 Sep 2010

Source: French Ministry of Health and Sport [in French, trans. Mod.SC

& CopyEd. Laurence Mialot, edited]

http://www.sante-sports.gouv.fr/premier-cas-autochtone-isole-de-dengue-en-france-metropolitaine.html


The Ministry of Health and Sports confirmed the presence of the 1st

indigenous case of dengue fever in France, Nice (Alpes-Maritimes).

This is an isolated case and no further cases have been reported to

date. The patient is cured and healthy.

This is level 2 of the national anti-dengue dissemination plan in

France, which is coordinated by the Directorate General of Health and

whose implementation is local, in this case, the Regional Agency for

Health PACA, the Prefecture of Alpes-Maritimes, and local communities.


To prevent any further spread of the virus, the epidemiological

surveillance measures and entomological (that is to say mosquito)

will be strengthened. Mosquito control actions have been implemented

around the area of the residence of the person who was affected.


The risk of development of an epidemic is considered limited, but can

not be excluded, due to the significant presence of the tiger

mosquito [_Aedes albopictus_] locally. The Ministry of Health

therefore calls upon the individual and community mobilization and

calls for people residing in and around Nice to adopt a number of

measures to prevent any further spread of the virus:

- destroy the larvae and potential mosquito breeding habitat in and

around (removing saucers under flowerpots and empty at least once a

week all the containers of still water: garbage, gutters ...);

- protect yourself from mosquito bites by wearing long sleeve shirts

and long pants, using insect repellents (following the proper dosage,

especially for children and pregnant women) as well as mosquito nets

crib for newborns and infants.

- protect habitat (mosquito nets, electric diffusers. ...).



Dengue is transmitted from person to person, only through a bite of

the _Aedes_ mosquito. In the south of France the _Aedes albopictus_

(tiger mosquito) is present. During a bite, the mosquito takes the

virus on an infected person. After an incubation period in the

mosquito of up to a few days and [then] it can transmit the virus to

a healthy person after another bite. Individual measures of

protection against mosquito bites are essential to fight against the

development of an epidemic.
--

Communicated by:

HealthMap Alerts via ProMED-FRA

promed-fra@promedmail.com


[The occurrence of a locally-acquired dengue virus infection is not

surprising. _Aedes albopictus_ has become established in various

parts of the Mediterranean Basin, including Nice (see ProMED-mail

archive no. 20100731.2564). Many individuals have become infected

with dengue viruses acquired in endemic areas and become ill after

their return to France (see ProMED-mail archive no. 20100616.2008).

When a viremic individual is located in an area with _Aedes

albopictus_, there is a risk of ongoing infection similar to the

chikungunya outbreak that occurred in Italy in 2007 (see ProMED-mail

archive no. 20071210.3980).


A HealthMap/ProMED-mail interactive map of France showing the

location of Nice can be accessed at

. - Mod.TY]



******

[2] USA (Florida): correction

Date: Tue 14 Sep 2010

From: Danielle Stanek [edited]


We would like to provide a correction to the PAHO dengue alert

recently published in ProMED-mail that erroneously reported both

dengue 1 and dengue 3 virus circulation in Monroe County, Florida.

This is not the case; dengue 1 [virus] has been the only dengue

serovar detected in multiple samples collected in Monroe both in the

fall of 2009 and since re-emergence or re-introduction in March of

2010.

Dengue 3 serovar was identified by the Florida Department of Health

Bureau of Laboratories in a single patient from Broward County,

Florida several weeks ago (patient onset date was 1 Aug [2010]).

Since that time no further locally acquired cases have been

identified in Broward even following initiation of active

surveillance conducted by the Broward County Health Department.

Broward County does not directly border Monroe County.


We thank PAHO for quickly correcting their report and webpage once we

alerted them to the error. The Florida Department of Health Bureau of

Environmental Public Health Medicine weekly arbovirus surveillance

reports include all confirmed human and veterinary arbovirus cases as

well as positive results from sentinel chickens and may be viewed at

http://myfloridaeh.com/medicine/arboviral/Weekly-Summary.html
--

Communicated by:

Danielle Stanek, DVM

Medical Epidemiologist

Florida Department of Health

Bureau of Environmental Public Health Medicine

Zoonotic and Vector-borne Disease Program

4052 Bald Cypress Way, BIN A08

Tallahassee, FL 32399-1712



[ProMED-mail thanks Dr Stanek for bringing this correction to our

attention. The failure to detect ongoing dengue virus transmission of

dengue virus 3 in Broward County is good news, indeed.



A HealthMap/ProMED-mail interactive map showing Florida in the

southeast USA can be accessed at

.

Broward and Monroe counties in South Florida can be located on the map at

. - Mod.TY]



******

[3] Brazil (Roraima)

Date: Mon 13 Sep 2010

Source: O Globo [in Portuguese, trans. & summ. Mod.TY, edited]







Researchers in the Roraima Central Laboratory, the Roraima Federal

University, and the Oswaldo Cruz Foundation (FIOCRUZ) confirmed that

the dengue virus serotype 4 circulating in the state came from

Venezuela and is the same one that circulated in the country 28 years

ago, according to the state Secretariat of Health. They compared

current [virus] samples with information from a world bank of

genomes. From that point the virus was identified as having come from

Venezuela, where the disease is common, and has not mutated since

1982.



The discovery of the origin of the virus will help Epidemiological

Surveillance in fighting dengue in the state. In Roraima, 3 cases of

dengue [virus] type 4 were confirmed with 4 new suspected [cases].



After 28 years, this virus has returned to Brazil. The majority of

Brazilians do not have immunity to [dengue] virus type 4, which

increases the chances of an epidemic. At the beginning of the month

[September 2010], the Minister of Health, Jose Gomes Temporao, stated

that the disease is contained in the state and that there is no

evidence that it will spread to other parts of the country.



--

Communicated by:

ProMED-PORT





[This is informative but not surprising. - Mod.LJS]



[A map showing the states in Brazil, with Roraima in the north, can be seen at

.

A HealthMap/ProMED-mail interactive map of Brazil can be accessed at

. - Mod.TY]



******

[4] Philippines (Cebu)

Date: Sun 12 Sep 2010

Source: Manila Bulletin Publishing Corporation [edited]







The mosquito-borne disease [virus] continues to wreak havoc in the

province, claiming at least 8 lives of children just this month

[September 2010], the Regional Epidemiology Surveillance Unit (RESU)

7 revealed late last week.



The latest fatalities expired midweek last week inside the Vicente

Sotto Memorial Medical Center (VSMMC), a RESU 7 personnel said. There

were at least 270 patients brought to the VSMMC during a one-week

period from 1 Sep [2010]; 5 of them died. These patients, whose ages

range from 9 months old to 35 years old are from the different parts

of Cebu, including Cebu City.



DoH 7 director Susana Madarieta said from January to September of

this year [2010], the region has recorded 5571 dengue cases or 1229

cases more compared to the same period of last year [2009].



With the number of dengue cases in Cebu and the rest of Central

Visayas rapidly increasing, local government officials and the DoH 7

are stepping up its measures against the mosquito-borne dengue

disease here.



Cebu City Medical Center (CCMC) has been jam packed with dengue

patients being brought in almost daily, prompting Cebu City mayor

Michael Rama to ask those from outside the city to go to other

hospitals so as not to drain the city's resources.



[Byline: Mars W Mosqueda Jr]



--

Communicated by:

HealthMap Alerts via ProMED-mail





[A map showing the provinces in the Philippines can be accessed at

.

A HealthMap/ProMED mail interactive map of the Philippines can be accessed at

. - Mod.TY]



******

[5] India (Delhi)

Date: Tue 14 Sep 2010

Source: India Talkies, Indo Asian News Service (IANS) report [summ., edited]







With 4 deaths and over 1800 infected by the mosquito-borne disease

[virus] here [in New Delhi], medical institutions have their hands

full. While the bigger hospitals are trying to cope by joining beds,

there are some where patients have little option other than the

floor. At Safdarjung Hospital, run by the government and one of the

biggest here, the rush of dengue patients has become difficult to

manage. Prathap Dutta, joint secretary of resident doctors

association, told IANS. As many as 150 patients, Dutta said, land up

at Safdarjung Hospital in a day. "We are running out of medicines,

intravenous fluids and saline drips," Dutta said.



The incessant rains lashing the city and the debris created by

construction for the upcoming Commonwealth Games are the main reasons

cited for the dengue outbreak in the capital. The Municipal

Corporation of Delhi (MCD) has confirmed 4 deaths from the disease.

Over 1836 dengue cases have been recorded so far in Delhi.



According to MCD, the number of dengue cases this year [2010] will

cross the 2006 figure of 3366 cases.



The corporation has found a high density of mosquito breeding in the

south and central areas of the city. So far, they have issued 45 532

notices to errant residents and housing societies.



[Byline: Prathiba Raju]



--

Communicated by:

HealthMap Alerts via ProMED-mail





[A HealthMap/ProMED-mail interactive map of India showing the

location of Delhi can be accessed at

. - Mod.TY]



[see also:

Dengue/DHF update 2010 (47) 20100913.3308

Dengue/DHF update 2010 (46) 20100906.3198

Dengue/DHF update 2010 (45) 20100830.3085

Dengue/DHF update 2010 (44) 20100826.3010

Dengue/DHF update 2010 (43) 20100819.2891

Dengue/DHF update 2010 (42) 20100817.2847

Dengue/DHF update 2010 (41) 20100810.2726

Dengue/DHF update 2010 (40) 20100805.2651

Dengue/DHF update 2010 (39) 20100804.2636

Chikungunya and dengue - France (02): risk 20100731.2564

Dengue/DHF update 2010 (38) 20100727.2520

Dengue/DHF update 2010 (37) 20100720.2435

Dengue/DHF update 2010 (36) 20100719.2429

Dengue/DHF update 2010 (35) 20100715.2372

Dengue/DHF update 2010 (34) 20100715.2368

Dengue/DHF update 2010 (33) 20100713.2342

Dengue/DHF update 2010 (32) 20100705.2240

Dengue/DHF update 2010 (31) 20100701.2196

Dengue/DHF update 2010 (30) 20100627.2152

Dengue/DHF update 2010 (29) 20100622.2085

Dengue/DHF update 2010 (28) 20100618.2043

Dengue/DHF update 2010 (27) 20100616.2009

Chikungunya and dengue - France ex overseas 20100616.2008

Dengue/DHF update 2010 (26) 20100607.1903

Dengue/DHF update 2010 (25) 20100601.1821

Dengue/DHF update 2010 (24) 20100524.1722

Dengue/DHF update 2010 (23) 20100517.1620

Dengue/DHF update 2010 (22) 20100510.1528

Dengue update 2010 (21) 20100503.1439

Dengue/DHF update 2010 (20) 20100426.1347

Dengue/DHF update 2010 (19) 20100420.1279

Dengue/DHF update 2010 (18) 20100412.1190

Dengue/DHF update 2010 (17) 20100405.1094

Dengue/DHF update 2010 (16) 20100329.0982

Dengue/DHF update 2010 (15) 20100323.0922

Dengue/DHF update 2010 (14) 20100322.0910

Dengue/DHF update 2010 (13) 20100316.0840

Dengue/DHF update 2010 (12) 20100315.0835

Dengue/DHF update 2010 (11) 20100308.0753

Dengue/DHF update 2010 (10) 20100304.0707

Dengue/DHF update 2010 (09) 20100302.0685

Dengue/DHF update 2010 (08) 20100222.0597

Dengue/DHF update 2010 (07) 20100216.0537

Dengue/DHF update 2010 (06) 20100208.0426

Dengue/DHF update 2010 (05) 20100201.0346

Dengue/DHF update 2010 (04) 20100125.0277

Dengue/DHF update 2010 (03) 20100119.0211

Dengue/DHF update 2010 (02) 20100111.0131

Dengue/DHF update 2010 (01) 20100104.0038]

...................................lm/ty/mj/lm



*##########################################################*

************************************************************

ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

Donate to ProMED-mail. Details available at:



************************************************************

Visit ProMED-mail's web site at .

Send all items for posting to: promed@promedmail.org (NOT to

an individual moderator). If you do not give your full name

name and affiliation, it may not be posted. You may unsub-

scribe at .

For assistance from a human being, send mail to:

.