19 October, 2010

Leptospirosis Outbreaks, Toxic Sludge and a Historic Victory!

Spotlight News of the Week:
Leptospirosis Outbreaks around the World

Leptospirosis outbreak leads to state of emergency in Nicaragua

Nicaragua has declared a national state of emergency due to a spike in cases and deaths from leptospirosis. Leptospirosis is typically spread through contact with water or plants that have been contaminated by the urine of infected animals (most often rodents). Recent heavy rains and flooding have created ideal condition for its spread. So far, 146 cases and 16 deaths have been confirmed with more cases and deaths suspected. Untreated, it can lead to kidney damage, meningitis, liver failure, respiratory distress, and death. Leptospirosis is rare in the United States with half of the 100-200 cases each year occurring in Hawaii. In the US and Canada, leptospirosis is more often a veterinary disease; diagnoses have increased substantially in dogs during the last decade.

Leptospirosis in El Eulma, Algeria *Picture Source: Sawt El Ahrar
Another leptospirosis outbreak has been reported in city of El Eulma, Algeria. To date, 4 deaths and 75 cases have been confirmed with up to 100 total cases suspected. Investigators report that rat urine was found in mixed with the groundwater in wells, including that of a mosque in the region. The epidemic has increased concern, reaching the front page of the official website of El Eulma in the form of the political cartoon at the top of our blog. The heading above repeats the finding that rat urine has been discovered in well water. The man says “well water” while the rat, which is leaving a door marked “WC,” says “house water.”

Additional News Highlights:

Toxic Sludge Disaster in Hungary
On Monday, October 4th, 2010 the villages of Kolontar and Devecser in Western Hungary were devastated by a flood of a toxic red sludge from a reservoir at the Ajkai Timfoldgyar alumina plant in Ajka. A state of emergency was declared the following day as the death count from the sludge, a waste product in aluminum production containing heavy metals, rose to three and ecological concerns increased for the Marcal, Raba, and Danube rivers. Since then, 9 people have been confirmed dead and more than 150 injured due to the toxic deluge. A team of environmental scientists and toxicologists have been deployed to aid in the clean-up efforts of over 15 sq. miles of land. While residents were allowed to return to what was left of their homes on October 15th, the alumina plant at the source of the spill reopened. The state of emergency has been extended until December 31st for the affected towns, which have been declared “ecological disaster zones.”

Rinderpest joins smallpox in history books
For only the second time in human history, a viral disease has been eradicated worldwide. The UN’s Food Animal Organization (FAO) announced last week that it would suspend tracking efforts for Rinderpest because the disease has been eradicated. Rinderpest is possibly the most important veterinary disease in history. This viral disease kills the vast majority of infected cattle. Devastating losses in the 1700s motivated France’s establishment of the world’s first school of veterinary medicine to teach control methods; most European countries quickly followed suit. When Rinderpest entered sub-Saharan Africa in the late 1800s, 80-90% of all cattle died leading to famine and destabilization that left the region “weak in the face of European colonization.” FAO launched the Global Rinderpest Eradication Programme in 1994, and the virus was last detected in 2001 in wild buffaloes in Kenya’s Meru National Park. The official declaration of eradication will come from the OIE in 2011.

Leishmaniasis in Afghanistan
On Friday, WHO officials highlighted an ongoing outbreak of Leishmaniasis in their first global report on neglected diseases. An ongoing outbreak in Herat as well as the dramatic increase of cases in Kabul has alarmed health officials. Leishmaniasis causes severe skin sores that often leave substantial scarring. The visceral form of Leishmaniasis is less common but is often fatal. It is transmitted through bites from sand flies. Leishmaniasis is extremely rare in the United States, but military personnel deployed to the Persian Gulf and to Southwest/Central Asia have been diagnosed with it after returning to the US.

Typhoon-related Melioidosis Outbreak in Taiwan results in 1 death
On October 15th, Kaohsiung City health officials reported 7 confirmed cases of melioidosis, including 1 death, in the aftermath of the Abigail van typhoon that swept through Taiwan in mid-September. The death occurred in a 82 year old with underlying conditions of hypertension and diabetes. Melioidosis is caused by the bacterium Burkholderia pseudomallei and is endemic in tropical countries in Southeast Asia. Its incidence increases during the rainy season and melioidosis often affects adults who have chronic underlying diseases, especially diabetes mellitus. Interestingly, the disease burden for Taiwan this year was relatively light compared to previous years, when between July and September 2005, 40 cases of melioidosis were identified after Typhoon Haitang swept through the region.

Update on KPC in Brazil’s Federal District
In the capital city of Brazil, the Department of Health has acknowledged an increase (English translation) of hospital related bacterial infections, triggering warnings and widespread concern amongst patients and clinics alike. The bacteria has been identified as Klebsiella Pneumoniae Carbapenemase (KPC). The Secretary of Health for the Federal District announced on October 16th that the number of suspected cases of KPC has ballooned to 135 in the Federal District alone, and now a total of 16 hospitals (9 public hospitals and 7 private hospitals) within the Federal District have been identified as hosts of KPC.

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