10 June, 2011

Source of e. coli Outbreak Discovered; Meningitis Vaccine Reduces Cases; Fungal Infection Strikes Joplin, MO

Germany: It’s the sprouts. We mean it this time.
First it was cucumbers (Spanish), then it was sprouts. Then it was cucumbers (German) and now officials say it truly was the sprouts. Although lab tests failed to find the E. coli on plants at the farm which produced the sprouts, the strain was isolated on leftover sprouts from a family which became ill. At the moment, the European Centre for Disease Prevention and Control reports that 3086 people became ill. Media reports state 33 have died (all German except for 1 Swede). The United States and Canada also reported cases suspected to be associated with the outbreak. Over a quarter of cases experienced the severe form of the infection,  Hemolytic Uremic Syndrome. This strain has been unusually severe, with doctors noting neurologic damage in many patients.

In the end, traditional epidemiological studies examining foods consumed and events attended by both sick and healthy individuals showed many of the infected ate at restaurants and cafeterias supplied by one organic sprout farm. From there, investigators were eventually able to track down sprouts that test positive for the strain. Those interested in reading about the methods and challenges of investigating an outbreak of foodborne illness may enjoy this post.

The outbreak has been devastating to farmers. While Spanish cucumber farmers were the first to feel the impact, consumers soon began to avoid all produce as no single source was quickly identified.

The German E. coli outbreak has sparked increased news reporting of E. coli cases, even those not linked to the outbreak. The Netherlands, Thailand and Finland all reported finding E. coli. In Tennessee, a two year old girl has died and 8 are believed to be ill from E. coli.

Meningitis Vaccine Project (MVP) Reduces Cases
World Health Organization (WHO) data on the MenAfriVac vaccine distributed in Meningitis Belt countries show a massive decrease in cases in Burkina Faso, Mali and Niger.  The Serum Institute, based in India, developed MenAfriVac against meningitis A, which has been very common throughout the infamous Meningitis Belt.  They began distribution for 50 U.S. cents a dose six months ago.  In the 2011 meningitis season, Burkina Faso confirmed 4 cases (compared to 66 this time in 2010), Niger also reported 4 cases (compared to 219 last year) and Mali had no reported cases (10 cases the previous year). These dramatic decreases are promising for the fight against meningitis. The MVP hopes to immunize 250 million people in Africa between 2010 and 2015.

Rare Fungal Infection Strikes Joplin Tornado Survivors
On May 22, 2011 much of Joplin, Missouri was destroyed when an EF-5 tornado ripped through the small town killing 151 in its path. (The EF-5 rating is the highest rating on the Enhanced Fujita tornado scale.) The storm ravaged a one-mile wide, thirteen-mile long path through Joplin, destroying 8000 homes and apartment complexes, and leaving thousands homeless.  The tornado that hit Joplin, MO is the deadliest twister to strike in the United States since modern record keeping began in 1950.

As if the people of Joplin haven’t suffered enough, a new threat has emerged, as a potentially lethal fungal infection has been contracted by at least 9 tornado survivors, killing 3. (The Jasper county coroner has so far stated that 1 was killed as a direct result of the fungal infection while the other two victims had other medical conditions that could have contributed to their deaths.)

Zygomycosis (also known as mucormycosis) is caused when commonly present fungi, found in soil and decaying vegetation, becomes embedded under the skin. These secondary skin-fungal infections are sometimes seen in survivors of mass trauma where multiple injuries and skin lacerations are treated as quickly as possible in makeshift emergency shelters (such as the 2004 Indonesian tsunami).  Doctors began seeing patients in Joplin with fungal infections a week after the tornado. Patients have visible mold growing in their wounds, and surgery is typically required to remove the dead tissue. Zygomycosis can also invade the brain, lungs, or sinuses, and generally kills half of its victims. Despite the severity of zygomycosis, it should be stressed that people should not panic. The infection does not spread from person to person and does not invade normal, intact skin.

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