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Confirmation of first BSE case in the United States

Source: OIE, 29 December 2003 (edited)

The World Animal Health Organisation (OIE) Reference Laboratory for bovine spongiform encephalopathy (BSE) in Weybridge, United Kingdom, confirmed the diagnostic results obtained at the National Veterinary Services Laboratories, Ames, Iowa, USA, of finding a positive case of BSE in the State of Washington.

The positive Holstein cow was traced back from the slaughter plant, where the positive brain tissue was collected, to a 4,000-animal dairy farm. The United States Department of Agriculture (USDA) continues to work with the Canadian officials to verify the origin of the index animal. Records indicate that this animal was approximately six and a half years old at the time of slaughter. The age of the animal is significant. She would have been born before feed bans were implemented in North America in August 1997. The feed bans prohibit the inclusion of ruminant protein in feed intended for other ruminants. That practice has been identified as the primary means by which BSE is spread.

The herd the affected animal came from is under a State quarantine in Washington. While USDA has not made any decisions on the dispositions of this herd, any cattle that die on the farm will be tested for BSE.

Suspected severe acute respiratory syndrome case in southern China

Source: WHO/WPRO, 28 December 2003 [edited]

On 26 December 2003, the Chinese Ministry of Health informed the World Health Organization (WHO) office in Beijing of a suspected case of severe acute respiratory syndrome (SARS) in a hospital in Guangzhou, Guangdong Province.

The patient, described as a 32-year-old television producer from Guangzhou, is in isolation in hospital. According to information supplied to WHO by the Chinese Ministry of Health, the patient developed a fever and headache on 16 December 2003. On 20 December, he sought medical assistance and was diagnosed as having pneumonia. Chest x-rays showed changes in the lower right lung. He was placed in isolation that day for observation.

The Ministry of Health also reported that all relevant human contacts of the patient have been identified, tested, and are deemed to be doing well, although some remain in isolation, under observation. The Chinese Ministry of Health said epidemiological investigations show that in the two weeks prior to the onset of symptoms, the patient had no known contact with high-risk groups such as health workers or animal handlers. The source of the suspected SARS infection is therefore unclear at this stage.

This is the first suspected SARS case found since 23 May 2003 when WHO lifted the SARS-related travel advisory against Guangdong Province.

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South Korea: Avian influenza spreading across country

Source: Reuters Health eLine, 23 December 2003 [edited]

Nearly a million chickens and ducks were slaughtered across South Korea to combat a highly contagious strain of avian influenza virus that has spread across the country and could also infect humans. So far there has been no evidence of transmission of avian influenza virus from chickens or ducks to humans during the course of this outbreak of avian influenza A(H5N1) virus in South Korea.

Avian influenza, which in rare cases can be deadly to humans, has caused poultry sales to tumble as authorities confirm outbreaks at farm after farm across the country.

UK: variant CJD suspected to have been contracted by blood donation

Source: BBC News online, 17 December 2003 [edited]

A man who received blood during an operation in 1997 has developed variant Creutzfeldt-Jakob disease (vCJD) and died. The blood was taken long before the donor was diagnosed with the vCJD. Fifteen other persons have received blood from donors who went on to develop vCJD. All have been contacted and offered counselling. However, none of these has so far gone on to develop the disease, although it may have a long incubation period.

The risks of receiving blood carrying the 'rogue' prions that cause vCJD are largely unknown, although previously thought to be tiny, as no confirmed cases could be identified. In this case, the donor involved gave blood in 1997, and fell ill with [variant] CJD in 1999, dying shortly afterwards. The disease did not develop in the recipient until this year, and the patient died earlier this month. Postmortem results appear to confirm vCJD.

Measures already exist which attempt to cut the risk of CJD transmission during blood transfusions. So far, 143 cases of vCJD have been diagnosed in the United Kingdom, although the number of new cases is falling. There is no established treatment for the illness, which causes massive brain damage and normally kills within months of being detected.

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Cluster of cases of tetanus in injecting drug users in England

Source: Eurosurveillance Vol 7, Issue 49, 4 December 2003 [edited]

Eight cases of clinical tetanus, including one death, have been reported in injecting drug users (IDUs) in England since July 2003, six of which occurred since October. The cases are in five women and three men aged between 20 and 47 years, and the latest reported onset date was 17 November 2003. Two of the cases are known to be unimmunised, and one case is known to have received a dose of tetanus toxoid nine years ago. The presentation of these cases so far has ranged from mild trismus to full-blown tetanus and respiratory arrest in the emergency department.

Potential sources for tetanus infection in IDUs are contaminated drugs, paraphernalia, and contaminated skin. The source of infection in this incident is not known. The close clustering of recent cases suggests contamination of drugs, either the drug itself or an adulterant.

China: Human rabies death toll continues to rise

Source: Reuters Health online, 25 November 2003 [edited]

Rabies cases leapt nearly 63 per cent in China in the first nine months of 2003 as the people's affair with pet dogs deepened, the China Daily reported on 25 November 2003. Rabies, 'mad dog disease' in Chinese, killed 1,297 people up to the end of September 2003, far exceeding the 1,003 deaths the Health Ministry reported for all of 2002. This is the fifth straight year that China has seen a big jump in rabies infections. Experts from the China Center for Disease Control and Prevention are blaming the trend on pet ownership, the poor quality of rabies vaccines, low public awareness and low vaccination rates among dogs as the major causes of the rapid rise in cases. Another factor was stray dogs running wild on the outskirts of cities and in rural areas. The Ministry said earlier this year that rabies was the most deadly infectious killer in China, well surpassing SARS and AIDS.

UK (England & Wales): Mumps cases at highest level for a decade

Source: The Independent online, 23 November 2003 [edited]

Cases of mumps are at the highest levels for almost a decade. So far this year, there have been more than 2,000 formal notifications of the disease in England, at least half of them thought to be positive. In Wales there have been 323 confirmed cases, compared with just two in 1999.

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Public health doctors have warned that in some areas, one child in five starting primary school this year was not protected against the disease. The massive rise in mumps cases is a cause of huge concern for health officials, who have seen the take-up of the triple measles, mumps and rubella (MMR) vaccination drop alarmingly because of health scares.

Mumps can cause fever, headache and inflammation of the salivary glands, and occasionally infection of the membrane covering the brain. The disease can also cause permanent deafness. About one in five adolescent or adult males who contracts mumps develops a painful inflammation and swelling of the testicles, which can in a small number of cases result in infertility. Central nervous system complications are not uncommon. Teenagers are the group most at risk because they may have missed out on the MMR, which was introduced in 1988. Some universities are now offering MMR vaccinations to students.

There have been warnings that the fall in the take-up of the MMR, blamed on controversial and hotly disputed links that have been made between the vaccine and autism, will result in more outbreaks of measles and rubella. Less attention has been paid to mumps, which is often considered a benign illness with low mortality rates. However, doctors warn that it should not be underestimated.

New TB strain in South Africa

Source: Ninemsn.com, 18 November 2003 [edited]

A new 'super' strain of tuberculosis (TB) that is costly and time-consuming to treat has been identified in South Africa's Western Cape Province. The team found that the strain (DRF150) was resistant to almost all antimicrobial agents, used to treat tuberculosis. Usually five drugs are used to combat TB. The DRF150 strain is resistant to four of these.

The new strain had its epicenter in the town of George, about 400 kilometres (250 miles) east of Cape Town, where about 60 cases had been identified. About 20 other cases have been identified in other parts of the Western Cape, but isolates of the new strain have also been found in the South Africa's Northern Province, the Pumalanga Province and in Nairobi, Kenya. Last year 224,420 cases of tuberculosis were reported in South Africa.

Republic of the Congo: Officials confirm Ebola haemorrhagic fever outbreak

Source: Newsday.com, 14 November 2003 [edited]

Health officials, on 14 November 2003, confirmed Ebola haemorrhagic fever as the cause of 11 deaths in the northern forests, signalling the Republic of Congo's second outbreak of Ebola haemorrhagic fever this year. Blood specimens from corpses suspected to be infected with Ebola virus have tested positive.

First reports from the remote northern region emerged on 31 October 2003. Ebola haemorrhagic fever, one of the world's deadliest viral diseases, causes rapid death through massive blood loss in up to 90 per cent of those infected. In June 2003, Republic of Congo health authorities announced the end of an Ebola epidemic that killed over 120 people in the same region. That epidemic was believed to have been started by contact with infected gorilla flesh, which is eaten in parts of sub-Saharan Africa. The WHO says Ebola haemorrhagic fever has killed more than 1,000 people since the virus was first identified in 1976 in western Sudan and in the Democratic Republic of the Congo.

This article was published in Communicable Diseases Intelligence, Volume 28 No 1, March 2004.