02 November, 2010

New polio outbreaks, Legionnaire’s in Madrid, and Dozens of students quarantined in China’s Guangxi Region




Polio update
In the past few weeks, polio cases have been reported in several countries. Polio is an extremely contagious viral disease. Although up to 95% of those infected show no signs, roughly 1% suffer paralytic polio. Once a worldwide scourge, polio is now endemic (continually present) in only four countries: Afghanistan, India, Nigeria and Pakistan. It is one of only two diseases with a global eradication program (the other is Guinea Worm Disease). The only diseases that have been globally eradicated are smallpox and rinderpest.
First, the good news: India has seen great progress toward its eradication goals, reporting only 39 cases in 2010 compared to 498 at this time last year. Unfortunately, flood ravaged Pakistan has seen an increase in polio cases this year. Also concerning are cases reported in non-endemic countries. Uganda reported a cluster of 5 pediatric polio cases last week. This week, a doctor in Pointe-Noire, Congo reported 8 deaths and 20 cases in a possible polio outbreak.

Legionnaire’s Disease in Madrid
Earlier this year, we discussed an outbreak of Legionnaires’ disease in Wales. A new outbreak has been identified in Spain’s capital of Madrid. The Ministry of Health reports 40 confirmed cases and 3 deaths to date due to Legionella. This disease usually appears as a pulmonary infection with symptoms of high fever and pneumonia. It is not spread from person to person, but typically spreads through contaminated water (from cooling-towers, whirlpools, aerosol sources). Officials in Madrid continue to investigate the source of the outbreak in an attempt to control it.

Paratyphoid A in Guangxi
A total of 107 people, including 84 students, have been diagnosed with Paratyphoid A fever in the Luocheng Mulao Autonomous County of Hechi City in the Guangxi Autonomous Region. Currently, 80 individuals are hospitalized, including 50 students under hospital quarantine. Most of the cases come from 2 middle schools and 1 high school in the county and although the incidence of new cases have begun to decline, investigators have not identified the source of the outbreak and the disease is not yet under complete control. The first case was identified in a 7 year old female student on September 20th but most of the cases occurred between October 17th and 24th, during which 46 cases were identified. Paratyphoid A is caused by the bacterium Salmonella paratyphi A and is most commonly transmitted via the fecal-oral route through contaminated water or food. The disease bears similar symptoms to typhoid fever, including sustained fever, abdominal pain and enlargement of the liver or spleen, but is caused by a different bacterium and is generally more benign.

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