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

Chickenpox in Guangxi, Legionella in Scotland, and "Apollo" Strikes Ghana

Hundreds of cases of chickenpox in Guangxi, China
Multiple elementary schools and daycare centers in Beihai City of Guangxi Province have seen an explosion of chickenpox among students since the end of last year. The 251 cases reported to date is a staggering 27 times greater than the case count during the same time period last year. Although the winter to spring season is the high-incidence period for chickenpox, this year’s spring has been especially cold and rainy, creating an environment especially conducive to the propagation of varicella-zoster virus. Furthermore, children have relatively weaker immune, and when they congregate in school, the chance of the virus spreading through direct contact or aerosolized spray greatly increases. Since mid-March, two schools have seen 14 and 15 cases, respectively, while the remaining cases have dispersed throughout the city.

Legionella outbreak in Scotland
One individual has been hospitalized with Legionnaire's disease and over 100 guests and staff of a four-star hotel in Dundee, Scotland have reported flu-like symptoms. Pontiac fever and Legionnaire’s disease are both caused by Legionella bacteria, but Pontiac fever is milder while Legionnaire’s can be deadly.  Many of those reporting flu-like symptoms may have Pontiac fever.  Outbreak investigators found Legionella in the hotel’s club.  In February, an outbreak of Legionella reportedly originated at the Playboy mansion.  

“Apollo” strikes Ghana
Over 400 cases of acute hemmorrhagic conjunctivitis have been reported in clinics throughout Ghana.  This viral infection is highly contagious and typically resolves after two weeks.  The disease is known as Apollo in West Africa because the first epidemic occurred during the Apollo 11 lunar landing.

Hand, Foot, and Mouth: Outbreak Spreading in China

Over 125,000 cases, and 57 fatalities of hand, foot, and mouth disease (HFMD) have been reported by China's Ministry of Health so far this year. It is estimated that 95% of cases of HFMD have been in children less than 5 years old living in the most rural parts of the country. Regions reporting the greatest number of cases include Henan, Shandong, Jiangsu, Guangxi, Anhui, Guangdong, Hebei, Hubei, Hunan, and Zhejiang, all within China’s agricultural belt where healthcare is minimal.

Continuing problems, such as the lack of HFMD prevention training for rural doctors, and the existing fear that government officials are hiding the problem and number of deaths, plague the provinces most severely affected. In addition, with the outbreak not expected to peak until May-July, it is likely that the number of cases and fatalities will rise.

HFMD is a common enterovirus most often seen in infants and children. Symptoms of the disease include fever, sore throat, non-itchy skin rash, and painful sores on the palms of the hands and soles of the feet. While not usually fatal, serious complications can result from infection such as meningitis, and encephalitis that can lead to death. Infection is spread person-to-person via direct contact with infectious virus contained in the nose, throat, saliva, blisters, and stool of infected persons. HFMD is often confused with foot-and-mouth (hoof-and-mouth), which is a disease that occurs in cattle, sheep and pigs. The diseases are not related, as a different virus causes hoof-and-mouth, and humans cannot get the animal disease and animals cannot get the human disease.

No specific treatment exists for HFMD, however symptoms can be treated to provide relief from painful sores. Currently, there is no vaccine to protect against the enteroviruses that are able to cause HFMD. The use of good hygiene practice, including frequent hand washing and avoiding close contact with infected persons, is the best means to lower the risk of becoming infected.

Related Articles (More available at www.HealthMap.org):

Hand-foot-mouth outbreak spreads in China
http://www.upi.com/Health_News/2009/04/12/Hand-foot-mouth-outbreak-spreads-in-China/UPI-52091239582260/

PRO/MBDS> Hand, foot & mouth disease - China (07)
http://apex.oracle.com/pls/otn/f?p=2400:1001:2754572062065237::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1045,77034

Toll in China disease outbreak rises to 50
http://www.google.com/hostednews/afp/article/ALeqM5iUpvt3vOt_ccnmpEBww545p8gnPA

Human Infections of Avian Influenza (H5N1) on the Rise in Central China

Since the beginning of 2009, eight cases of highly pathogenic human avian influenza have been reported in China. Three of the cases have been confirmed to be from central China’s Hunan province. However, individual cases have also been reported from nearby Shanxi, Shandong, and Guizhou provinces among others. It is suspected that China’s winter weather is aiding in the spread of the virus.

While exposure to sick or deceased poultry continues to be the main route that humans become infected, experts warn that H5N1 may evolve into a form that can be easily transmitted from person-to-person. Since the beginning of a pandemic cannot be predicted, all contacts of avian influenza cases are closely monitored to ensure that the disease does not spread. In addition, epidemiologic investigations are carried out in each case to determine the most likely source of infection so that the appropriate actions can be taken such as the culling of poultry.

Why such concern about the spread of one type of influenza? Of the 37 cases to date in China, 25 of them have been fatal. With a case fatality rate over 65% a pandemic of H5N1 would surely have a devastating impact around the globe.

Related Articles (additional articles available at www.HealthMap.org):

http://apex.oracle.com/pls/otn/f?p=2400:1001:5724127436830768::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1010,75901

http://www.who.int/csr/don/2009_01_27/en/index.html

http://en.epochtimes.com/n2/content/view/10648

http://www.straitstimes.com/Breaking%2BNews/Asia/Story/STIStory_332738.html