Q Fever in the US; H1N1 in Argentina; Scarlet Fever Spreads Throughout Asia

Two Q Fever Outbreaks in the US
Q fever is caused by a bacteria (Coxiella burnetii) primarily found in sheep, goats, and cattle. Infected animals secrete the bacteria in milk, urine, feces, and amniotic fluids when giving birth. Humans typically become infected by inhalation of the bacteria present in barnyard dust, dried birth fluids, or feces. Other routes of transmission include tick bites and ingestion of unpasteurized dairy products. Human-to-human transmission is rare.

Currently, two Q fever outbreaks are ongoing in the United States. In Livingston County, Michigan three cases have been reported, and are associated with the consumption of raw milk products. Local public health officials are reminding consumers of the importance of only consuming pasteurized dairy products.

In the states of Washington and Montana, eleven people have been diagnosed with Q fever after having contact with infected goats. (Six cases in Washington and 5 in Montana) The goats were part of a now quarantined herd in central Washington that was later sold to a livestock operator in Montana. The investigation into this multi-state outbreak is ongoing.


Swine Flu Hits Mendoza, Argentina
As the weather becomes colder, Mendoza, well known for it’s delicious wines, is experiencing a Swine Flu outbreak. On June 22, the Mendoza government finally confirmed that there is indeed an outbreak in the city with 54 confirmed cases and 1 death. Health officials are urging people in the province to become vaccinated against H1N1 as only 41% are currently registered as being vaccinated. The government hopes to contain this outbreak before it spreads to other cities like Santa Fe and Corrientes.


Scarlet Fever Continues to Spread Throughout Asia
Earlier this week, we reported that a mutated strain of the bacteria that causes scarlet fever resulted in 2 deaths and a record number of cases in Hong Kong for this year. On Tuesday, authorities closed a kindergarten after early testing suggested another suspect death in a 5 year old boy. As of June 22nd, Hong Kong has reported 494 cases. Although scarlet fever occurs every year and is endemic to most of Southeast Asia, this year’s epidemic has been particularly severe. Shanghai reported 771 cases in the last month alone - a 13-fold increase compared to the same period last year, although the mutated strain has not been found to be the cause. The epidemic in Hong Kong has also caused growing concern in Macau, where 49 cases have already been reported, and also in nearby Thailand, where authorities are making all effort to assuage public fear in spite of the 524 cases that have already been reported for this year. Experts believe that with the onset of school breaking for the summer, the rate of infection could taper off as a result of reduced contact among children.

Scarlet Fever Kills 2 in Hong Kong, Undiagnosed Disease Strikes Bihar, and More Breaking News

Scarlet Fever Kills Two Children in Hong Kong
A new strain of Scarlet Fever is spreading through Hong Kong. In the past three weeks, two children, a 15-year-old boy and a 7-year-old-girl, became the city’s first fatal victims in the last 10 years. Since January, 419 cases have been confirmed in Hong Kong with 142 cases in the first weeks of June.

Scarlet Fever is caused by the Streptococcus pyogenes bacteria and mostly affects children ages 2-8. The disease causes a fever, sore throat and a rash on the neck, face and tongue, and eventually spreads across the entire body.  Scarlet Fever is typically treated with antibiotics that are very effective, but this new strain is actually a mutation of the Streptococcus bacteria and is resistant to several antibiotics. A physician from the Hong Kong Medical Association encourage doctors who are treating children infected with the disease to try alternative antibiotics before the disease spreads even more.

Japanese Encephalitis Suspected as Unknown Disease in Bihar
A team of experts from the Union Health Ministry and Regional Malaria Research Institute (RMRI) team is investigating an “unknown disease” killing children in the Muzaffarpur region of Bihar, a state in India. The disease has caused the death of 26 children in the last seven days and affected over 35 others. It is believed to be Japanese Encephalitis. Some of the symptoms include high fever, memory loss, convulsions, falling in and out of consciousness, and eventually coma. Hopefully once the disease can be confirmed, health officials will be able to take the necessary precautions to prevent more children from becoming victims.

Rabies PEP Failure
A patient in Mumbai, India is now in a coma after becoming infected with rabies despite completing the recommended postexposure prophylaxis (PEP) regimen following a dog bite. A 2nd patient is also in a coma with the deadly virus after failing to complete the PEP series of vaccinations. (PEP typically consists of one dose of immune globulin and four doses of rabies vaccine over a 14-day period.) PEP is usually highly effective, however in a small percentage of patients the vaccine series may not build up enough of an immune response. It is also important that PEP be administered promptly after a rabies exposure and that the schedule of doses is followed. According to the WHO, India sees 25,000-30,000 deaths due to rabies each year.

Mumps Outbreaks in Vancouver
The British Columbia Centre for Disease Control has issued a health alert for mumps in Vancouver.  Although the number of cases has not been released, it is reportedly the largest outbreak since 2008 when almost 200 people were diagnosed.  Earlier this year, Whistler saw a mumps outbreak as well.  HealthMap will update this story as more details become available.