News Archives |
Volume 4 No 35; 3 September 2010
- West Nile Virus in Europe
- Anthrax cases in IDUs in the UK - an update (3)
- New publication: Environmental Medicine
West Nile Virus in Europe
On 7 August 2010, the public health authorities in Greece confirmed an outbreak of West Nile virus (WNV) on the Greek mainland. Although WNV had been previously identified in animals, these were the first reports of human cases from Greece [1, 2]. Since then, case numbers have increased significantly: as of 2 September, 173 cases and 15 deaths had been reported [3]. Cases have been confirmed in the region of Central Macedonia (Northern Greece) and its capital, Thessaloniki.
Further to this, 13 confirmed and two probable cases (including two deaths) have recently been reported in Romania – from districts throughout the country including: Alba, Bucharest, Cluj, Constanta, Dolj, Galati, Mures, Sibiu, and Teleorman; and three confirmed cases have been reported from Hungary – from Budapest and the counties of Pest and Bekes [4]. Both these countries have had a previous history of West Nile virus.
The National Travel Health Network and Centre has produced a clinical update that advises travellers to risk areas to ensure they practise mosquito bite avoidance measures [5]; it also advises physicians who may see travellers with a characteristic febrile illness, who have returned from WNV endemic areas, to be alert to the possibility of WNV infection.
Advice for health professionals seeing returning travellers from Greece has also been produced by the Health Protection Agency. Relevant samples for testing together with a full clinical and travel history should be submitted to the Health Protection Agency Special Pathogens Reference Unit.
References
1. ECDC. West Nile virus outbreak in Greece [online]. [Accessed 2 September 2010]. ECDC website: ECDC Portal > English > Activities > Scientific Advice.
2. HPA. West Nile virus in Greece. Health Protection Report 2010; 4(13): travel health. Available at: http://www.hpa.org.uk/hpr/archives/2010/hpr3210.pdf.
3. Centre of Control and Prevention of Disease. Athens, Greece. Daily Report of Epidemiological Surveillance of West Nile Virus Infection in Greece. 3 September 2010 [Accessed 3 September 2010] Available at: http://www.keelpno.gr/keelpno/2010/id990/daily_report_20100903_en.pdf.
4. ECDC. West Nile virus transmission in Europe [online]. [Accessed 3 September 2010]. ECDC website: ECDC Portal > English > Activities > Scientific Advice.
5. National Travel Health Network and Centre. West Nile virus (humans): Greece, Romania, Hungary and the Russian Federation – Clinical Update, 3 September 2010. Available at: http://www.nathnac.org/pro/clinical_updates/westnile_eu_030910.htm.
Anthrax cases in IDUs in the UK – an update (3)
The third fatal case of anthrax in an injecting drug user (IDU) in England was confirmed on 31 August [1], following more than a dozen similar IDU fatalities reported in the UK since the start of the current outbreak.
The latest fatal case, in Leicestershire, was the fourth case of anthrax seen in an IDU in England, the first being announced in London on 5 February 2010 [2]. Forty seven such cases have been confirmed in Scotland since December 2009, and one in Germany, but no new cases have been reported in Scotland since 9 July.
It seems likely that the heroin, or a contaminated cutting agent mixed with the heroin, is the source of infection. The HPA said that, while public health investigations are ongoing, it must be assumed that all heroin in Leicestershire carries the risk of anthrax contamination. All heroin users are therefore urged to be extremely alert to the risks and to seek urgent medical advice if they experience signs of infection such as redness or excessive swelling at or near an injection site, or other symptoms of general illness (high temperature, chills or a severe headache or breathing difficulties), as early antibiotic treatment can be lifesaving.
References
1. Death of injecting drug user in Leicestershire, HPA press release, 31 August 2010. HPA website: Home > News Centre > National Press Releases > 2010 Press Releases > Death of Injecting Drug User in Leicestershire.
2. HPA website. Topics > Infectious Diseases > Infections A-Z > Anthrax > Anthrax: Information on 2010 outbreak, http://www.hpa.org.uk/HPA/Topics/InfectiousDiseases/InfectionsAZ/126563716348.
New publication: Environmental Medicine
An important new, multi-author publication reviewing the current state of knowledge on the health effects of environmental exposures has been published by Hodder Arnold. Modelled on the classic occupational medicine textbook, Hunter's Diseases of Occupations, Environmental Medicine comprises 63 chapters, 50 of which make up the core, 500-page third section of the book entitled Health Effects*. This covers a broad variety of environmental exposures, both natural and man-made, including chemical, microbiological, physical, radiation and radiological exposures; it also examines human health effects related to volcanos, air travel, air quality, contaminated land, vector borne diseases, animal disposal and accidental or deliberate environmental contamination. The 97 contributors are a mixture of national and international experts in their fields, including more than a dozen from the Health Protection Agency.
Although methods for determining the health impacts are different for chronic exposures to chemicals and more acute infectious diseases, having these brought together in a single book provides some perspective on the range of factors influencing health and where changes in climate, population size, technology, food supply, development and a variety of interventions may take human health in the future.
The target audience for the book is physicians, scientists, and environmental health professionals involved in health protection. It should also be of value to undergraduates in courses addressing aspects of environmental science, in particular departments of public health, environmental health and occupational health. The book is written from a developed world perspective but with the problems of the developing world well represented.
Environmental Medicine, edited by Jon Ayres, Roy Harrison, Gordon Nichols and Robert Maynard (700 pages, ISBN-13 978-0-340-94656-5, RRP £135), is published by Hodder Arnold, 338 Euston Road, London NW1 3BH.
The publication is being offered to Health Protection Report subscribers for £100 (ie a £35 discount) until 30 September 2010. Online purchasers should use the promotional code WL0003724 when ordering online at www.hodderarnold.com.