Tuesday, May 11, 2010

Travel-related Schistosomiasis Acquired in Laos

Schistosoma Mansoni is one of the microbial species that causes similar symptoms found with S. mekongi, one of 3 species in Asia that are known to cause infection in humans. The other two are known as S. japonicum and S. Malayensis. Human infection is known as Acute Schistosomiasis, caused by helminth parasites of the genus Schistosoma and is characterized by, most commonly fever and cough, but also by myalgia, gastrointestinal complaints, fatigue and urticaria. The region of Asia where these infections have been reported was Laos, after 7 travelers from Israel had been diagnosed from serology. It has been reported that over 200 million humans are infected, but about 85% of those infected are in Africa. What is interesting to note is that anyone can be at risk who travels to endemic areas such as Laos or Africa and are exposed to fresh water. Freshwater snails are generally the host.


http://www.cdc.gov/eid/content/15/11/1823.htm

http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-5/schistosomiasis.aspx
Clostridium difficile is an acute, severe disease of the colon, developing as a complication of antibiotic therapy. People in good health usually don't get C. difficile disease. Doctors quite often faced with diarrhea in patients after antibiotic use. Only infected people can spread the disease to others. However, only people that are hospitalized or on antibiotics are likely to become ill. Clostridium difficile is the causative agent of the most severe complications, up to the development of fulminant colitis and toxic dilatation of the colon. The key to the pathogenesis S.diffichili associated colitis is a violation of microbial ecology in the colon, the oppression of the resident anaerobic microflora, the occurrence of metabolic niches for reproduction S.difficile and its conversion into toxinoforming form.
Clostridium difficile infections (CDIs) have increased in incidence and severity within the past decade in North America and Europe (1), in large part because of the emergence of the hypervirulent North American pulsed-field type 1 (NAP1/027/III) strains (2-5). Recently, interest has increased in the ribotype 078 strain. An infection was considered healthcare-associated CDI of the patient's symptoms occurring. An infection was considered community-onset CDI if the healthcare-associated definition was not met. Outcomes 30 days postinfection were recorded to capture severe cases, which were defined as infections in patients admitted to an intensive care unit, in patients who had undergone colectomy, or in patients who had died (12). Deaths were assessed by the Canadian Hospital Epidemiology Committee member and categorized into three groups: 1) death directly attributable to CDI, 2) death indirectly related to CDI by exacerbation of an existing disease condition, or 3) death not a result of CDI. The assessment was made from information obtained from medical charts, nurse logs, laboratory reports, and consultation with nursing and medical staff. It is harmful, so it would be great to use safety percussion to reduce the chance of a spread.

“General Information about Clostridium difficile Infections ” August 2004, Jul 22, 2005 .

“Hypervirulent Clostridium difficile Strains in Hospitalized Patients, Canada”Dispatch,Vol. 16, #4, April 2010 .

Human Plasmodium Knowlesi Infection Detected by Rapid Diagnostic Tests for Malaria

P. Knowlesi is a Malaria parasite that was regarded as a rare disease, mainly occuring in long-tailed and pig tailed macaques(monkey) but has occured sporadically in humans. There have been a large number of infected patients in Malaysian Borneo and other reports of human cases in Thailand, Myanmar, Philippines and Singapore.
"Human Plasmodium Knowlesi infection detected by rapid diagnostic tests for malaria". Dispatch, volume 15 number 9 September 2009 http://www.cdc.gov/eid/content/15/9/478.htm

P. Knowlesi is transmitted from monkeys to humans by mosquitos. Sx's of malaria include fever and flu like sx's, headach, muscle aches and tiredness, nausea, vomitting and diarrhea. May also cause juandice(yellow coloring of the skin and eyes). If not treated the infection can cause kidney failure, seizures, mental confusion, coma and death.
http://www.cdc.gov/malaria/about/faqs.htm

Lymphocytic Choriomeningitis Virus Meningitis, New York, NY, USA, 2009

Lymphocytic choriomeningitis virus (LCMV)belongs to the family of the arenaviruses, which are associated with rodent-transmitted disease in humans and are zootonic. Humans can come into contact with arenaviruses by ingesting contaminated food and having direct contact with rodent excrement. Such arenavirus infections can cause severe illnesses and are more common in humans.The rodent hosts of arenaviruses have been known to be chronically infected with viruses, which do not show obvious symptoms inside the hosts. Some arenaviruses are also associated with nosocomial transmission and secondary person to person. Nosocomial transmission occurs when a person is exposed and then infected with the arenavirus from the rodent host. Once the person is infected the virus, he or she can spread it to other humans. However, person to person transmission is associated with having direct contact with one another's blood and other excretions that contain virus particles of infected individuals.
Since LCMV belongs to the family of the arenavirus, it has been discovered in the common house mouse (MUS musculus and M. domesticus), pets, and research rodents, such as hamsters and guinea pigs. LCMV is transmitted through inhalation, fomites, and direct contact with blood from infected rodents. Such a virus has also been transmitted by infected mothers during pregnancy to the fetus and through solid organ transplantation. The incubation period for LCMV is from one to two weeks and infected individual usually experience symptoms, such as fever chills, myalgia, pharyngitis, testicular pain, and photophobia.
In the article, "Lymphorcytic Choriomeningitis Virus Meningitis, New York, NY, USA, 2009," it mentioned about how a forty-nine year old man (taxi driver) received treatment for LCMV. The patient also had all the symptoms for the virus, such as chills, headache, vomiting, generalized weakness, nausea, and a seven day history of fever. The article also stated that he received a corneal transplant the previous year that may have caused LCMV. After the patient received supportive care, he fully recovered and was discharged on day twelve.
Although the patient received a corneal transplant the previous year, it was not actually the source of infection. The Centers for Disease Control and Prevention concluded that the patient experienced meningitis during the fall-winter season. Then,a febrile illness followed by brief remission before an onset of neurological illness, and CSF with a hypoglycorrachia and lymphocytosis. After the case, the Center for Disease Control and Prevention implemented new rules and regulations for diagnosing LCMV. Within the preceding three months, patients with a history of organ transplantation should be evaluated to determine whether infected organs were the primary souce of LCMV. Patients with LCMV should also be questioned about potential rodent exposure. By having a better understanding of the true incidence of LCMV, authorities will be able to prevent and control the virus.

Asnis, Deborah, "Lymphorcytic Choriomeningitis Virus Meningitis" Center for Disease Control and Prevention, February 2010, http://www.cdc.gov/eid/content/16/2/328.htm.

"Arenaviruses," Special Pathogens Branch, August 2005, http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/arena.htm.

Q Fever in Greenland

Coxiella burnetii is the microbial agent responsible for causing Q fever in Greenland. This is zoonosis disease. Cattle, goats and sheep are reservoirs for the small bacterium yet many other animals are capable for housing it at well. The latent attribute or c. burnetti causes it so be shed during birth in animals, but in humans the symptoms are asymptomatic or just causing fever like symptoms but do not be fooled, this bacterium can also cause pneumonia or hepatitis.

A native of Greenland went to the hospital in December 2007 after having a fever for two months. As a child he had rheumatic fever and six years prior to this hospital visit, he had biological aortic and mitral valves implanted which put him at risk for Q fever endocarditis. January 2008 he was transferred to a different hospital. But he was enduring a low-grade fever, cardiac insufficiency with peripheral edema, hepatosplenomegaly, and 20% half-moon nephritis. His heart seemed fine though and his blood tests were negative for the bacterium. In may 2008, a surgery found massive endocarditis - and his biological valves were replaced with mechanical valves and his symptoms subsided.

After 30 days of incubation, the mans culture was positive after indirect immunofluorescent assay with C. burnetii phase II–specific antibodies..


Google Heath, "Q Fever"retrieved May 11, 2010 from https://health.google.com/health/ref/Q+fever

Koch A, Svendsen CB, Christensen JJ, Bundgaard H, Vindfeld L, Christiansen CB, et al. Q fever in Greenland. Emerg Infect Dis. 2010 Mar [May 11, 2010]. http://www.cdc.gov/EID/content/16/3/511.htm

Merkel Cell Polyomavirus in Cutaneous Swabs

Merkel cell polyomavirus (MCPyV) was recently discovered in Merkel cell carcinomas, rare but aggressive skin cancers. Merkel cell polyomavirus DNA has been detected in the majority of merkel cell carcinoma (MCC) and less commonly in other skin tumors and healthy skin. To determine if MCPyV might be a widespread in the general population, a retrospective study and tested MCC as well as healthy and skin lesion and mucosa samples of immuno competent and immunosuppressed persons without MCC for MCPyV DNA are conducted. The majority of patients with Merkel cell carcinoma carry MCPyV, but little is known about polyomavirus prevalence in the general population and the association between circulating antibodies against MCPyV and the rare skin cancer.

MCPyV DNA can be efficiently detected by cutaneous swabbing. This method could be useful tool for future epidemiologic studies targeting MCPyV. Indeed, this noninvasive procedure may be easily performed without the potential risk for side effects related to biopsy collection and is more acceptable than a biopsy for patients who not have a cutaneous disease. The high prevalence of MCPyV DNA at the skin surface, contrasted with its low prevalence in buccal mucosa and its absence in skin ulcers, strongly suggests that MCPyV is localized in the epidermis.

Work cited: Toland AE. Merkel cell polyomavirus in cutaneous squamous immunocompetent individuals. J Invest Dermatol. 2009

Journal of the National Cancer Institute published September 23

Monday, May 10, 2010

Influenza Virus A (H1N1) in Giant Anteaters (Myrmecophaga tridactyla)

Influenza (H1N1) is a subtype of influenza virus which is the most common cause of Human influenza. This virus was originally called swine flu because of the genes that are similar to flu viruses in pigs. Like other flu strains, the H1N1 flu virus is passed from person to person. H1N1 causes flu-like symptoms including, sore throat, fever, fatigue, and body aches.

Influenza is known to cross species line into mammalian species. Influenza virus is a pathogen that not only affects its avian reservoir but also mammalian species such as swine, horses, cats, dogs, and humans. In 2007, researchers documented a respiratory disease occurrence in a group of giant anteaters- the new host- at the Nashville zoo. Isolates from two affected animals were identified as a type A influenza virus related to human influenza subtype H1N1. This host could potentially impact human population as possible sources of zoonotic spread of influenza. Emergence of viruses in new host increases people’s concern. However, the good news is that the H1N1 vaccine has been developed now and is available for everyone. CDC recommends influenza vaccination as the most important step in protection the flu.

Sally Nofs, Mohamed Abd-Eldaim, Kathy V. Thomas, David Toplon, Dawn Rouse, and Melissa Kennedy “ Influenza Virus A (H1N1) in the Giant Anteaters ( Myrmecophaga tridactyla).” Emerging Infectious Disease. Volume 15, Number 7- July 2009


“2009 H1N1 Flu” Centers for Disease Control and Prevention. May 7, 2010