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Emerging Infections/CJD

Published on:
8 August 2008

Next update: 12 November 2008
Last updated: 8 August 2008, Volume 2 No 32 (PDF file, xxx KB)

Topic Archives: 2007 | 2006 | 2005 |

Emerging Infections Update: January to June 2008

Monthly summaries of notable events and developments of potential public health importance are produced by the Emerging Infections and Zoonoses Department, for circulation to recipients including the Chair and members of the National Expert Panel on New and Emerging Infections (http://www.advisorybodies.doh.gov.uk/nationalexpertpanel/index.htm). Incidents reported over recent months are shown in the table below. Events are identified through horizon scanning activities and then logged and systematically followed up. Multiple sources are scanned including: ProMED online (http://www.promedmail.org); World Health Organization sources (Disease Outbreak News,http://www.who.int/csr/don/en/); Weekly Epidemiological Record (Outbreak Verification List, http://www.who.int/wer/en/); Eurosurveillance (http://www.eurosurveillance.org/index-02.asp); the Global Public Health Intelligence Network (GPHIN) early warning system; CIDRAP online (http://www.cidrap.umn.edu/index.html); CDC Morbidity and Mortality Weekly Report (http://www.cdc.gov/ncidod/EID/index.htm) and the wider scientific literature.

Table 1 notable events/incidents of potential public health significance: January to June 2008

Month reported

Incident

Location / Description

January

Chikungunya

Singapore: First local transmission of the virus.
Taiwan : Screening at airport finds two travel related cases.

Community-acquired MRSA USA300 USA: Link with men who have sex with men.
Ebola Haemorrhagic Fever Uganda: Report on the containment of the outbreak in Bundibugyo; Modification of ebola virus to make it safer to handle in labs.
Extensively-drug resistant TB (XDR-TB) Botswana: First two cases identified
Influenza Indonesia, Vietnam, Egypt: H5N1 (human).
UK: H5N1 in mute swans.
Europe: Oseltamivir resistance in H1N1
Human malaria caused by P. knowlesi Malaysia: Monkey parasite shown to infect and cause disease in humans
Merkel Cell Carcinoma (MCC) Novel polyomavirus discovered as possible cause of MCC.
Poliomyelitis Worldwide: Global case count 2007
Rabies Netherlands ex Kenya: Fatal case of Duvenhage virus.
Scotland : Results of EBLV survey in bats

Rift Valley Fever

Sudan: Report of decline in case numbers of large outbreak.

Undiagnosed neurological illness USA: Cases associated with working with a compressed air device to process pig brains.

February

Chlamydiaciae species in trachoma

Evidence for involvement of C. psittaci and C. pneumoniae in cases of trachoma

Drug-resistant tuberculosis
Worldwide: WHO report detailing MDR and XDR-TB cases.
Ebola haemorrhagic fever
Uganda: Outbreak declared over.
Global trends on new and emerging infections.
New research published
Health effects of climate change
New research published
Influenza
China , Egypt , Indonesia , Vietnam: Human cases of H5N1
New arenavirus
Australia: New virus related to lymphocytic choriomeningitis viruses identified in organ recipients
Progressive Inflammatory Neuropathy USA: Reports of a 13 th case amongst pork processing plant workers
Rabies
France: Three cases of rabies in dogs in France
Ricin USA: Suspected case of ricin poisoning
Yellow Fever
Paraguay: First autochthonous case in 34 years.

March

Bluetongue

UK: Possible foetal viraemia reported in ruminants

Dengue fever
Brazil: Increase in cases reported (total 43,528 cases in the state of Rio de Janeiro)
Hepatitis E
UK: Four confirmed cases of Hepatitis E in passengers returning from a World cruise
Influenza
Indonesia, Vietnam and Egypt: H5N1 human cases.
Indonesia: Simultaneous human infection with human H3N2 and avian H5N1
Myxozoa anatidum
Novel species of fish parasite detected in wildfowl (USA) and shrews (Europe)
Poliomyelitis
Somalia: Country declared free of polio

Progressive Inflammatory Neuropathy

USA: 14th case identified

Rabies

France: Loss of rabies free status
USA: Rabid mountain lion attacks boy

TB
Scotland: Imported XDR-TB case ex Somalia. The UK has confirmed 8 cases of XDR-TB between 1993-2008.
USA: TB transmission via organ transplantation.
Undiagnosed deaths in children
India
White nosed syndrome, bats USA: Die-off of bats in caves in Vermont and New York
Yellow Fever
Argentina and Paraguay

April

Avian influenza

Indonesia and Egypt : H5N1 human cases.
China and Pakistan : Possible human-to-human transmission in family clusters.

Chapare virus
Bolivia: New arenavirus discovered

Crimean-Congo haemorrhagic fever (CCHF)

Russia and Bulgaria

Hepatitis E

UK: Update on cruise ship investigation

Leptospirosis

Peru: Unique species of leptospira identified

Progressive inflammatory neuropathy

USA: Update on investigation

Rabies

UK: Rabies in a quarantined dog imported from Sri Lanka.
France and Belgium: Rabid dog imported from Gambia

Rift Valley Fever

Madagascar

Scrapie

Paper reports possible transmission via milk (ewe to lamb)

May

Avian influenza

Bangladesh: 1 st human case of H5N1.
USA: Avian influenza H7 mutation

CCHF

Russia and Turkey: Increase in cases

EBLV-2

UK: EBLV-2 in a Daubentons bat

Global Health Strategy

UK publication

Global wildlife disease news maps

Launch of new facility

Hand, Foot and Mouth Disease China and Mongolia: A large outbreak reported with 61,549 in China and 583 cases in Mongolia.
Human lymphocytic choriomeningitis virus
USA: Transmission via organ transplantation
Poliomyelitis
Benin: First case in four years
Poxviruses
DRC: Monkeypox outbreak, 220 cases.
Uganda: Possible novel poxvirus identified
Psittacosis
UK: Five confirmed and three suspected cases in poultry workers.
Trichinellosis
Italy ex Romania: Associated with eating raw meat

June

Avian influenza H7N7

UK: Publication of report on June 2008 outbreak

CCHF
Turkey and Russia: Update on ongoing outbreak.
Greece: First fatal case of CCHF recorded in the country
Hepatitis E
Transmission via organ transplantation and development of chronic infection
Measles
UK: Measles once again endemic

MRSA ST398

Scotland: 3 human cases of the community acquired MRSA ST398, normally associated with pigs

Poliomyelitis

Nigeria: A large outbreak (287 cases) of WPV1 with international spread to Benin and West Niger

Secure diagnostics for high containment level pathogens

UK: House of Commons report

Toxoplasmosis

Paper on toxoplasmosis in marine mammals

Tuberculosis

Namibia: First XDR-TB cases; WHO guidelines for air travel

Tularemia

USA: Human case reported in Brooklyn , New York

Undiagnosed fatal illness in children

North Korea

Vector borne diseases

Europe: Report on epidemiology of tick-borne encephalitis

Suspected viral haemorrhagic fever

DR Congo: Four fatal cases

Progressive Inflammatory Neuropathy (PIN)
Investigations have continued into the cluster of cases of neurological illness reported in workers at a pork processing plant in Minnesota in early January 2008. A survey of swine slaughterhouses in the US found that only three use the compressed air technique to harvest brain tissue, and following intense investigations cases of PIN have now been identified at all three plants. A total of 24 cases of PIN have now been confirmed, including 18 among workers at the plant in Minnesota, five in Indiana, and one at a plant in Nebraska . The working hypothesis remains that the workers were exposed to a fine mist of brain tissue, leading to the development of an autoimmune response which caused nerve damage.

The compressed air technique is not used for removal of livestock brains at meat processing plants in the UK and no similar cases have been identified here to date.
See: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e131a1.htm

Rabies
Imported rabid dog from Gambia to Belgium and France
Rabies was identified in a dog imported from the Gambia into France and Belgium. The dog was found injured in the Gambia by a Belgian woman, where it was treated by a vet and given a first dose of rabies vaccine. The woman adopted the dog and brought it back to Belgium on 7 April, and then to Var region in SE France on 13 April. The dog developed rabies symptoms on 16 April and died on 21 April.
See: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18856

Chapare virus
A recent paper describes a newly identified arenavirus, named Chapare virus, which was isolated from the serum of a 22 year old man who died of haemorrhagic fever in Bolivia in January 2004. The patient was part of a small cluster of haemorrhagic fever cases which occurred near Cochabamba, Bolivia, between December 2003 and January 2004. Details of the cluster were sparse and samples were only available from one of the cases, who worked as a tailor and a farmer. The man reported no history of travel and no contact with any case with compatible illness for at least four weeks prior to his disease onset. Clinical signs included fever, headache, arthralgia, myalgia and vomiting with subsequent deterioration and multiple haemorrhagic signs. Sequence analysis of the virus indicated that it was a unique member of the Clade B New World arenaviruses, most closely related to Sabia virus.
See: Delgado et al (2008) PLOS Pathogens, vol 4, issue 4, e1000047