The HealthMap Blog is MOVING - Join Us at The Disease Daily!!

The HealthMap Blog is moving up in the world! HealthMap has always worked to provide you with the infectious disease outbreak news you need to know along with the geographic and timeline context for you to understand it. In January 2009, we started this blog to provide broader information on outbreaks occurring worldwide. Today we are excited to start The Disease Daily and HealthMap Local.

At The Disease Daily, we're expanding the coverage you've come to expect at the HealthMap blog.  We'll still provide you with the context you need to understand current outbreaks: "Does the report of a new tattoo infection mean there's a scary new disease?,” "Why is there an anthrax outbreak in China?," or "What's going on in the Somali refugee camps?"

In the upcoming weeks, we'll be greatly expanding our reporting beyond what you've seen here: more updates, deeper explanations of outbreaks, and even more extensive coverage. We've created a news section called Outbreaks 101 where we plan to breakdown basic but important questions like "How do you eradicate a disease forever?" or "Why do people need to be vaccinated for measles in a 'measles-free' country?" Have a question you want us to answer? E-mail us at DiseaseDaily@gmail.com and we'll put in on the list for future columns.

While you're checking out The Daily Disease on the new website, don't forget to click over to HealthMap Local to see what illnesses have been reported in your area.  With HealthMap Local, you can set your location and see what's happening near you, just like checking your local weather forecast online. 

Thank you to all of our blog followers! Your readership and support inspired The Daily Disease.  We hope you’ll continue to follow us. Please consider “liking” us on Facebook and “following” us on Twitter too!  

CDC Links Rare Bacterial Infection to Tattoos

September’s Emerging Infectious Diseases journal reports that two individuals’ tattoos were infected by a bacteria normally seen only in people with poor immune systems. In August 2009, an otherwise healthy adult sought medical care for pustules at the site of his new tattoo. When the infection did not respond well to antibiotics, the case was referred to the local public health department and an investigation by CDC and Washington State public health officials was launched.

Medical tests isolated Mycobacterium haemophilum,which can be difficult to treat, just like its Tuberculosis-causing relative. The lesions did not fully heal until March 2010. M. haemophilum does not normally cause the pustules seen in this case. They may have been due to the mode of infection, via tattooing needle. The authors report a second individual had identical symptoms and had been tattooed at the same shop, but tests failed to identify the organism.

An outbreak of M. haemophilum was earlier reported among 12 Swiss women who had their eyebrows tattooed as permanent makeup.  In addition to lengthy antibiotic treatment, 10 of them needed surgery.

Tattoo regulations vary widely in the United States. The tattoo establishment was operating within state safety and sanitation standards. Investigators believe the use of tap water to dilute the tattoo ink may have contributed to the infections. While this practice is permitted, the authors recommended the tattoo establishment use sterile water in the future. M. haemophilum was not found in samples of tap water or on any surfaces in the business, but previous studies have suggested water can be a vehicle for it. It is important to note that this study does not suggest the tap water was dangerous, simply that at some point the water used to dilute the ink could have picked up M. haemophilum which was then injected into the skin to cause the infection. Since M. haemophilum does not normally cause disease in healthy people, injecting it may be a necessary step in causing illness in people with health immune systems.

Traditionally, health officials have been concerned about the risk of blood-borne diseases during tattooing.  The widespread adoption of single-use needles has helped reduce this risk.  The difference in the story reported here is that M. haemophilum is common in the environment.  These infections were not due to transmission between clients.

For more information on tattoos and health, you can visit the CDC’s webpage on the topic.

Outbreak of Cutaneous Anthrax in Liaoning, China

As of yesterday, 30 patients, 3 of which have been confirmed,  in Haicheng City and Xiuyan County of Liaoning Province, were admitted to local hospitals with symptoms of cutaneous anthrax. All sick residents became infected after having recently slaughtered anthrax-infected cows. All sick animals were traced back to one village in Haicheng City where there had previously been an anthrax outbreak among animals. In the preliminary investigation, 4 sick animals were found, 2 of which died. Currently, no deaths have occurred and all patients are being treated at their local hospitals.

Anthrax is a common bacterial infection among hoofed-animals, but humans can become infected after close contact with sick animals or upon being exposed through 3 main routes - open wound, inhalation, or consumption of tainted meat. Cutaneous anthrax is relatively mild and individuals infected usually develop a sore or blister. Inhalation anthrax and gastrointestinal anthrax may lead to internal bleeding, shock, and tissue death.

Photo courtesy of: http://commons.wikimedia.org/wiki/File:Anthrax_01.jpg

Drought Brings Famine and Disease to Horn of Africa

As the Horn of Africa – including Ethiopia, Somalia, Kenya, and Djibouti - faces its worst drought in over 50 years, thousands of Somali refugees seek shelter in the capital city of Mogadishu and in refugee camps in northeastern Kenya and southeastern Ethiopia. The Dadaab refugee camps in Kenya have swelled to a population of over 400,000, as Somalis walk for 15 to 20 days prior to arrival in search of food and water. The Dolo Ado camp in Ethiopia continues to see an average of 200-300 Somalis arrive each day.  In just the past 2 months, facing imminent starvation and death, an estimated 220,000 have fled their drought-stricken farms.

The situation in the Horn of Africa continues to worsen with confirmed cases of cholera and dengue in Somalia (including Mogadishu) and measles outbreaks in refugee camps (with the hardest hit being the Dolo Ado camp in Ethiopia). The United Nations (UN) has warned that the situation could become “unbearable,” as the famine is expected to spread throughout southern Somalia in the next 4-6 weeks.

In such an unstable region of the world, delivering aid is challenging, however international organizations are responding. For the first time in five years the UN airlifted emergency aid into Mogadishu, and an additional 800 metric tons of food is on its way to East Africa. Furthermore, the World Health Organization (WHO) has launched a vaccination campaign along the Kenya-Somalia border to protect over 200,000 malnourished children from diseases such as measles and polio. 

Visit the World Food Program’s Website at www.wfp.org to learn more about the ongoing humanitarian crisis in the Horn of Africa or to make a donation.

New England Journal of Medicine Reports on New Tick-borne Bacteria

Ticks are known for carrying Lyme disease, Rocky Mountain Spotted Fever, Babesia, among other diseases. Now, there’s a new bacteria on the list. Researchers at the Mayo Clinic in Minnesota and from public health departments in Minnesota and Wisconsin, have identified a new type of Ehrlichia which sickened at least four people in those states.

There are several Ehrlichia species, but the two common which sicken humans (Ehrlichia chaffeensis and Ehrlichia ewingii) are not found in the MidWest. The researchers isolated this new species through molecular, culture, and serologic methods on patient blood samples and harvested ticks.  They have named their discovery ehrlichia species Wisconsin. Patients reported symptoms similar to the previously known Ehrlichia spp.: fever, fatigue, and headache.

This discovery is particularly important since ehrlichiosis had not been previously identified in this part of the United States.  Now that physicians know to test for it, the number of cases identified will likely increase rapidly.  

Ticks typically feed on rodents and deer, so other mammals are likely part of the life cycle of this bacteria. Among the many emerging human disease threats, 75% have a link to animals. As animal populations move due to changes in their environments (be it construction on their habitat, climate changes, or anything else) diseases that have not previously been seen in humans may have the opportunity to make that leap.  Given the relatively mild symptoms of the new Ehrlichia species, it is difficult to know if the organism has simply been present but undiagnosed in humans for decades. Additional studies will help describe its epidemiology and give more context to a very interesting discovery.

Salmonella from Ground Turkey Leads to Widespread Recall in US

Salmonellosis has swept the nation, with 76 illnesses and 1 death identified across 26 states. Beginning March 9 and continuing into August, the U.S. Department of Agriculture and the Center for Disease Control have followed reports of foodborne illness caused by Salmonella Heidelberg across the country. Cases have sprung up from Massachusetts to Arizona, with the lone death occurring in Sacramento, California.

On July 29, the Food Safety and Inspection Service of the USDA issued an alert about possible contamination of ground turkey, but had not yet determined specific brands under investigation. Just days later, meat producer Cargill announced a voluntary recall of fresh and frozen ground turkey from its Arkansas plant, believed to be the source of the outbreak. Cargill has halted production while they investigate the cause of contamination and also issued an apology to those who fell ill. With 36 million pounds of ground turkey recalled, this is one of the largest food recalls ever.

The Salmonella Heidelberg strain at the center of the outbreak is resistant to many antibiotics, creating significant problems in treatment. Signs of infection with salmonella include abdominal cramps, vomiting, and diarrhea. Symptoms usually begin 12-72 hours after exposure and can last 4-7 days. As a precaution, the CDC reminds that ground turkey must be cooked to an internal temperature of 165 degrees Fahrenheit. Contaminated turkey, if properly cooked, will not cause illness.

Photo courtesy of: http://www.flickr.com/photos/voght/2441818832/

Cerebrospinal Meningitis Outbreak in Ghana Leaves 5 Dead

An outbreak of CSM, commonly known as cerebrospinal meningitis, in the New Nsuta community of Obuasi Municipality in Ghana, has killed 5 and infected 17 individuals. It has not yet been established how the disease broke out in the area. Fearful residents are urging local health officials to immediately immunize them, and the Ministry of Health is working to dispatch vaccines to the area, although the strain has yet to be identified. Meningitis is an infection that causes inflammation of the brain and spinal membrane and can be caused by a variety of viruses and bacteria. The outbreak has reportedly taken a toll on businesses in the area, as patrons are pulling out. Last year’s meningitis outbreak in northern Ghana resulted in 54 cases and 27 deaths.

“Unusual Cluster” of Deadly Meningitis in New Zealand

Health care professionals on New Zealand’s South Island have been told to be extra vigilant after 4 cases of a rare and aggressive type of meningitis (Neisseria meningitidis type C) were confirmed.  One patient has died (a well-known construction company CEO and father of three), and three others remain hospitalized. The individuals hospitalized include a colleague of the deceased CEO, a Christchurch woman in her 40s, and a toddler in a Dunedin Hospital. All are expected to make a full recovery. What has made this outbreak particularly unusual is the confirmation by public health officials that there is nothing linking the two men with the woman or toddler.

Anyone with suspected infection with meningococcal disease should seek immediate medical attention. Symptoms can develop quickly and include nausea, fever, headache, stiff neck, vomiting, and sensitivity to light.