NKY officials warn of whooping cough outbreak

Northern Kentucky health officials are warning that an outbreak of whooping cough, also known as pertussis, is continuing. There have now been more than 61 cases reported.

To stop the spread, the Northern Kentucky Independent Health District is offering vaccines for $4 at its four county health centers.

“Pertussis can cause serious illness, hospitalization and death — especially in infants who are too young to be fully vaccinated,” Dr. Lynne Saddler, district director of health said in a release. “Because vaccine protection fades over time, anyone who plans to be around infants should be vaccinated with the Tdap booster shot, which will provide renewed protection against whooping cough. Parents, grandparents and caregivers are strongly encouraged to get their booster shot.”

The booster is available by appointment county health centers:

• Boone County Health Center, 7505 Burlington Pike, Florence, 859-363-2060
• Campbell County Health Center, 1098 Monmouth St., Newport, 859-431-1704
• Grant County Health Center, 234 Barnes Road, Williamstown, 859-824-5074
• Kenton County Health Center, 2002 Madison Ave., Covington, 859-431-3345

Officals also urge parents of young children to make sure that their children have been vaccinated for whooping cough, typically given in a combination shot called DTaP, which includes vaccine for tetanus and diphtheria as well.

The vaccine is usually given in five doses, with the doses at two months, four months, six months, 15 to 18 months and 4 to 6 years of age.

Most doctors’ offices and many pharmacies offer the vaccine as well. Families of infants born at St. Elizabeth can also get the vaccine after delivery at the hospital.

So far this year, 61 cases of whooping cough have been reported in Northern Kentucky. From 2003 to 2009, the regiona averaged 25 cases a year. During an outbreak in 2010, 127 cases were reported.

Of the this year’s cases, eight were in children age 1 or under, who are at higher risk for serious complications from the disease.

The early symptoms include: runny nose, sneezing, low-grade fever and a mild cough. After a week or two, a persistent cough develops which occurs in explosive bursts, sometimes ending with a high-pitched whoop and vomiting.

Individuals who have a cough lasting more than two weeks and/or one that progressively gets worse are advised to contact their health care provider. Anyone with a cough should avoid contact with young children.

Health officials doctors have been reminded to consider whooping cough as a possible diagnosis. Child care centers have been asked to consider having all staff vaccinated and to encourage their parents and students to be vaccinated.

29 Bangkok schools suspend classes following HFMD outbreak

At least 29 schools in Bangkok have suspended some of their classes or shut down their whole facilities in the wake of the hand, foot, and mouth disease or HFMD outbreak.

“In Bangkok, most patients are young children aged not over four years old,” Dr Wongwat Liewlak said Tuesday as the head of Bangkok Metropolitan Administration (BMA) Communicable Diseases Control Division.

According to the Public Health Ministry, 12,581 people have come down with the HMFD in Thailand between January 1 and July 9 this year. There is no report of casualties.

West Nile outbreak at ‘epidemic level’ in Dallas

DALLAS — Dallas County health authorities announced the first death so far this year from the West Nile virus, prompting directors to warn that this season could be Dallas’ worst involving the deadly illness.

“I am very concerned,” Dallas County Health and Human Services director Zachary Thompson admitted at a Monday news conference. “When you’re in the epicenter right now of the country, it’s imperative we step up our prevention efforts.”

Thompson said Dallas is seeing more cases of the virus than any other county in the nation. So far, 16 people in Dallas County have been infected; 14 of those cases are neuro-invasive, which is considered more serious.

“It’s probably going to be the most severe season we’ve had,” said Dr. James Luby with UT Southwestern Medical Center. “This is epidemic level.”

Officials said a man in his 60s, who had underlying medical conditions, died earlier this month from West Nile — the first fatal case in Dallas County since 2009.

The man, whose name was not released, lived in the 75204 zip code, which is near downtown Dallas. The elderly and young children are especially susceptible to West Nile.

Since appearing in Texas in 2002, the disease peaked in Dallas County in 2006. That year, more than 100 people became sick and four of them died.

Health experts said it appears the number of infections and deaths this year will surpass those of 2006.

“We have to expect more deaths,” Dr. Luby warned. “This promises to be at least as severe as 2006.”

Since the illness is spread through mosquitoes, county leaders are urging homeowners to dump standing water and to apply insect repellent when spending time outside.

Officials blame the weather for the spike. A serious drought for the past two summers kept the disease largely at bay. County officials reported only two illnesses those years.

But frequent storms this spring and early summer have refilled ponds and creeks, helping mosquitoes thrive.

“Increase in moisture has allowed an increase in mosquito activity,” said Christopher Perkins, Dallas County’s Medical Director and Health Authority.

In response, the City of Dallas has started spraying neighborhoods with insecticide. It’s the first time the city has deployed its sprayers since 2010. Crews are now spraying neighborhoods three nights a week.

The city, however, is only spraying neighborhoods where tests have confirmed the existence of the West Nile virus. The city considered and dismissed more widespread spraying in all neighborhoods — not just where the disease has been found.

“If you over-spray, there is a possibility and a risk for what we call ‘resistance’ from the mosquitoes,” said Micheal Wheeler with the city’s code department.

Tracking the disease is also proving difficult. Currently, workers trap mosquitoes at 90 sites across the city and then later examine the mosquitoes for the virus.

Officials gave up testing dead birds a couple of years ago, because it proved too unreliable in determining where the virus was concentrated. Birds can migrate for miles, but mosquitoes can only fly over a half-mile area.

“The enemy is treacherous and it is a powerful enemy,” Dr. Luby said. “We don’t have the means to control the virus, and that’s why it’s a problem.”

Outbreak claims 112 in China

A Chinese province urged parents on Sunday to seek immediate treatment for children showing symptoms of hand, foot and mouth disease after official figures showed 112 people died from the illness last month.


File photo – A Chinese mother comforts her son undergoing treatment for hand, foot and mouth disease, at a hospital in Hefei, eastern China’s Anhui province on April 3, 2009.


The disease, which children are especially vulnerable to, also infected more than 381 000 people, the Ministry of Health reported last week.


“The disease incidence rate in June was much higher than that of last June, which has much to do with the high temperatures this summer,” said Liu Fuqiang with the provincial Centre for Disease Control and Prevention (CDC).


The province urged parents and teachers to send children to hospital as soon as they showed symptoms of the disease, including mouth sores, skin rashes or fever.


In June, 34 768 cases were reported and 17 people died from the disease in Hunan, the statement said.


According to the Ministry of Health, over 460 000 people were infected by the disease in May, leading to 132 deaths.


In recent days, health departments in numerous Chinese provinces and regions, including Gansu, Fujian, Jiangsu and Xinjiang have issued warnings over the outbreak of the disease, state press reports said. – AFP

CHP investigates outbreak of fifth disease

Hong Kong (HKSAR) – The Centre for Health Protection (CHP) of the Department of Health today (July 16) alerted members of the public and management of institutions to maintain good environmental and personal hygiene to prevent fifth disease, an infection caused by parvovirus B19.

The appeal followed the CHP’s investigation into an outbreak of fifth disease at a kindergarten-cum-child care centre in Yuen Long, affecting 25 persons.

The affected students comprised 11 males and 10 females, aged between 3 and 6. Together with four staff members, they presented with symptoms of fifth disease, including fever and rash over their face, limbs or trunk, since May 27.

None of the affected students or staff required hospitalisation.

All of them remained in stable condition.

The blood sample of one affected student tested positive for antibodies against parvovirus.

CHP staff have visited the institution and provided health advice to the management.

Fifth disease is a mild illness that occurs mostly in children. A typical rash occurs on the face, giving a characteristic “slapped-cheek” appearance. The rash appears less often on the limbs and trunk and sometimes it is slightly itchy.

It is preceded by a few days of low-grade fever and tiredness. The rash usually disappears in seven to 10 days.

Parvovirus B19 is transmitted primarily through direct contact with infected respiratory secretions. It can also be transmitted from mother to foetus during pregnancy.

As fifth disease is usually a mild illness, no definite treatment is needed. Anti-fever drugs may relieve the symptoms. Patients should rest at home until they fully recover.

Pregnant women and persons with low immunity who have been exposed to someone with fifth disease should consult their doctor for further management.

To prevent fifth disease, members of the public are advised to adopt the following measures:

* Maintain good personal hygiene;
* Keep hands clean and wash hands properly;
* Wash hands when they are dirtied by respiratory secretions, e.g. after sneezing;
* Cover the nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly;
* Maintain good ventilation; and
* Avoid close contact with patients with fifth disease.

Chicken vaccines form new virus

The second live attenuated vaccine (a vaccine where part of the virus is still living) was used when the Australian vaccine strain ran out, but the two vaccines combined to form new virus strains, which could now kill thousands of chicken. The viruses don’t pose a threat to humans, food or other animals, but suggest the risk of live attenuated vaccines needs to be considered. 

Image: fotostok_pdv/iStockphoto

Research from the University of Melbourne has shown that two different vaccine viruses – used simultaneously to control the same condition in chickens – have combined to produce new infectious viruses, prompting early response from Australia’s veterinary medicines regulator.


The vaccines were used to control infectious laryngotracheitis (ILT), an acute respiratory disease occurring in chickens worldwide. ILT can have up to 20% mortality rate in some flocks and has a significant economic and welfare impact in the poultry industry.
 
The research found that when two different ILT vaccine strains were used in the same populations, they combined into two new strains (a process known as recombination), resulting in disease outbreaks.
 
Neither the ILT virus or the new strains can be transmitted to humans or other animals, and do not pose a food safety risk.
 
The study was led by Dr Joanne Devlin, Professor Glenn Browning and Dr Sang-Won Lee and colleagues at the Asia-Pacific Centre for Animal Health at the University of Melbourne and NICTA’s Victoria Research Laboratory and is published on 13 July 2012 in the international journal Science.
 
Dr Devlin said the combining of live vaccine virus strains outside of the laboratory was previously thought to be highly unlikely, but this study shows that it is possible and has led to disease outbreaks in poultry flocks.
 
“We alerted the Australian Pesticide and Veterinary Medicines Authority (APVMA) to our findings and they are now working closely with our research team, vaccine registrants and the poultry industry to determine both short and long term regulatory actions,” she said.
 
“Short-term measures include risk assessment of all live virus vaccines currently registered by the APVMA in regard to the risk of recombination and could include changes to product labels, which may result in restrictions on the use of two vaccines of different origins in the one animal population.”
 
The ILT vaccines are ‘live attenuated vaccines’, which means that the virus has some disease-causing factors removed but the immune system still recognises the virus to defend against a real infection.
 
“Live vaccines are used throughout the world to control ILT in poultry. For over 40 years the vaccines used in Australia were derived from an Australian virus strain. But following a vaccine shortage another vaccine originating from Europe was registered in 2006 and rapidly became widely used,” Dr Devlin said.
 
“Shortly after the introduction of the European strain of vaccine, two new strains of ILT virus were found to be responsible for most of the outbreaks of disease in New South Wales and Victoria. So we sought to examine the origin of these two new strains.”
 
The team sequenced all of the genes (the genome) of the two vaccines used in Australia, and the two new outbreak strains of the virus. Following bioinformatic analysis on the resulting DNA sequence, in conjunction with Dr John Markham at NICTA’s Victoria Research Laboratory, they found that the new disease-causing strains were combinations of the Australian and European origin vaccine strains.
 
“Comparisons of the vaccine strains and the new recombinant strains have shown that both the recombinant strains cause more severe disease, or replicate to a higher level than the parent vaccine strains that gave rise to them,” Dr Lee said.
 
Professor Glenn Browning said recombination was a natural process that can occur when two viruses infect the same cell at the same time.
 
“While recombination has been recognised as a potential risk associated with live virus vaccines for many years, the likelihood of it happening in viruses like this in the field has been thought to be so low that it was considered to be very unlikely to lead to significant problems,” he said.
 
“Our studies have shown that the risk of recombination between different vaccine strains in the field is significant as two different recombinant viruses arose within a year. We also demonstrated that the consequences of such recombination can be very severe, as the new viruses have been responsible for the deaths of thousands of Australian poultry.”
 
“The study suggests that regulation of live attenuated vaccines for all species needs to take into account the real potential for vaccine viruses to combine. Measures such as those now being taken for the ILT vaccines will need to be implemented.”

TB strain found in 18 counties outside Duval

The tuberculosis strain that has rocked Florida politics and raised questions of undue government secrecy is referred to as FL 046 by epidemiologists, the professionals who track disease outbreaks.

Last year, in the shelters and halfway houses where Jacksonville’s homeless congregate, it bloomed into the nation’s most extensive, fastest-growing TB outbreak, one described by a visiting official from the U.S. Centers for Disease Control and Prevention as among the worst his group had seen in 20 years.

Although state health officials maintain the outbreak is now mostly contained within the Jacksonville homeless, a state database obtained by The Palm Beach Post on Friday showed sick people with FL 046 have also popped up in 17 other Florida counties. About 23 percent of all FL 046 cases have occurred outside Duval County, analysis suggests, and most of those have been identified in the past two years.

North Florida has logged the most cases, while Miami-Dade, Pinellas and St. Lucie counties have confirmed two cases each. In response to questions about whether the outbreak is truly contained, the health agency issued a statement saying relocation of a sick individual does not equate to a spread of the disease.

“There is no other epidemiological evidence indicating transmission outside of the Duval cluster,” the agency wrote.

Dr. Steven Harris, deputy secretary of the Florida Department of Health, said last week in an video interview with the News Service of Florida that his agency had the resources needed to manage the outbreak.

“The CDC has assigned a public health specialist to the Duval County Health Department to assist us locally, and we have, from our own Bureau of Tuberculosis and Refugee Health, sent staff members to Duval County,” Harris said. “We have been doing that since April to assist their local coalition and partners on the ground. We have also identified health department employees from surrounding health departments around Duval County to assist in testing for this strain.”

The Post also has learned the state has also asked the CDC for a $250,000 supplemental grant, with an additional request contemplated for 2013, to help it find and treat people exposed to TB. The grant proposal, compiled with the help of the state’s CDC specialist, would add an additional surveillance team of a doctor, nurse, epidemiologist and support staff. They would be charged with seeking out the close contacts of people who develop active tuberculosis, so they can be questioned about symptoms, and tested if necessary.

Other recommended items included fast-food gift cards and free Boost dietary supplement drinks, intended to reward the homeless for staying on their medications. The City Rescue Mission in Duval County should get 23 UV-light air cleaners, and the team should have a van outfitted with an air filtration system, the expert recommended.

A CDC spokesperson confirmed the agency is considering a state request for money “to address programmatic gaps and for strengthening Duval’s local infrastructure and capacity to address this TB outbreak.”

Tuberculosis has been a disease in decline in most of the United States, and Florida. In 2011, 10,521 cases of active TB were recorded in the United States. Florida had 753 cases of TB, down from 835 in 2010.

But across the nation, areas that serve the homeless have had a more difficult time controlling the disease. Treatment for an uncomplicated case can require six months on a cocktail of multiple antibiotics, while drug-resistant strains can take two years to treat, often with drugs that are much more expensive and difficult to find. People without a fixed address and those with substance abuse and mental health problems pose significant problems for public health authorities trying to contain an outbreak. Complicating matters, infected people can have a latent form that can lurk for years before surfacing.

In Jacksonville, health officials are treating 234 people with latent disease with preventive antibiotics. They are also making progress at reaching contacts of people with active TB to test them. Since January, Duval County Health Department officials have screened nearly 2,100 people who may have come in contact with people with active tuberculosis, an agency spokeswoman said.

In April, the CDC’s team’s assessment that called Florida’s outbreak the worst in 20 years also projected that more than 3,000 people had been in close contact with the sick, but only a few hundred had been evaluated at that time.

The report had not been widely circulated until The Post published it July 8. Key legislators who had pushed for the downsizing of the Department of Health and the closure of the state’s only tuberculosis hospital in March said they hadn’t been briefed.

Rep. Mark Pafford, D-West Palm Beach, said Saturday he’s been on the phone with Health Department leadership several times asking about who knew of the outbreak and when. He said that

Read more: http://www.wptv.com/dpp/news/state/tb-strain-found-in-18-counties-outside-duval#ixzz20iwNFhdm

Local hospitals react to Exeter’s Hepatitis C outbreak

New Hampshire health officials suspect an outbreak of Hepatitis C at Exeter Hospital was caused by an employee who stole and injected hospital drugs and used contaminated needles on patients in the hospital’s Cardiac Catheterization Lab and recovery room.

So far 30 patients have tested positive for the same strain Hepatitis C — a blood-borne viral infection that causes liver damage and potentially chronic health problems.

Many local hospital said the outbreak at Exeter unfairly casts their profession in a negative light, said Cristina Galli, spokeswoman for Parkland Medical Center in Derry, N.H.

“This is a really isolated and rare incident,” said Galli. “We’re extremely cautious when it comes to patient safety.”

But several officials interviewed last week admit what occurred at Exeter Hospital could happen anywhere, given that it appears the outbreak was caused by an individual employee.

“I do think this is something that could happen in most hospitals,” said Delia O’Connor, president and chief executive officer of Anna Jaques Hospital in Newburyport. “Unfortunately, there are stories like this around the country. … Nothing is a sure thing when it comes – apparently — to addiction and the behaviors it stimulates.”

The Exeter outbreak is reportedly being investigated by the New Hampshire Attorney General’s office and U.S. Attorney’s office.

First reported in June, the hospital had found four patients with the virus. The number climbed to 30 last week with 45 more patients to be tested.

With strict protocols in place for storing and administering medicine and sanitizing medical instruments and equipment, area hospital officials said their patients’ safety is already a priority.

“There are intensive procedures for infection control,” said Galli at Parkland. “We haven’t made any changes because we feel what we have in place is adequate.”

All 1,000 employees at Anna Jaques Hospital must pass a drug test before they are hired. But after the Exeter outbreak, O’Connor said the hospital board is considering continued employee drug testing.

O’Connor said the hospital also counts on employees to report potential problems with their coworkers.

“We have very vigilant employees,” said O’Connor. “They are very attuned to picking up if their coworkers have issues … Employees are empowered to protect patients and go out of the chain of command.”

In Massachusetts, the state Department of Public Heath requires that communicable diseases be reported to the department within 24 hours of diagnosis.

To prevent the transmission of blood-borne pathogens, health care workers must adhere to standard precautions and fundamental infection-control principles � including safe injection practices and appropriate aseptic techniques — according to information provided by the department.

At Lawrence General Hospital, Vice President Theresa Sievers said employees follow all “safe injection practices” put forth by the Centers for Disease Control and Prevention (CDC). That includes using needles and syringes one time only and using single-dose vials. CDC guidelines are also followed for cleaning, disinfecting and sterilizing medical instruments, patient care equipment and employees’ personal protective equipment, Sievers said.

Mary O’Neil, regional spokeswoman for Steward Health Care System — which operates Holy Family Hospital in Methuen and Merrimack Valley Hospital in Haverhill — said “all of our infection control policies follow CDC guidelines. We do this for the safety of our patients and our staff.”

At Parkland Medical Center, Galli said workers follow the same safety guidelines established by hospitals across the country. She said protocols and procedures are monitored regularly to ensure patient safety.

Among the checks in place are regular audits by the New Hampshire Board of Pharmacy and The Joint Commission, an independent nonprofit organization that accredits and certifies health care organizations, she said.Galli said Parkland also regularly conducts “rigorous” internal audits.

The investigation at Exeter Hospital went public in late May when it was announced that four patients had been diagnosed with Hepatitis C. Now, in addition to the 30 patients and one hospital employee found to be infected, 12 people have been diagnosed with a strain of Hepatitis C that does not match the outbreak strain.

Exeter Hospital “is a 100-bed tax exempt, community-based hospital and one of five affiliates of Exeter Health Reso

urces,” according to the hospital’s website. The hospital employs approximately 1,500 people and accepts around 35,000 emergency room visits and more than 5,000 admissions each year, according to the site.

So far, state health officials have tested more than 1,000 blood samples from patients treated at Exeter Hospital’s Cardiac Catheterization Lab and recovery room between Oct. 1, 2010, and May 25, 2012.

Exeter Health Resources Spokesman Ryan Lawrence said the testing is nearing completion, though approximately 45 patients who received treatment within that time frame have yet to come forward.

“We remain focused on supporting identified patients and their families, along with all patients who have required testing,” said Lawrence. “Exeter Hospital is continuing to do everything it can to help support the identified patients and a few weeks ago established a dedicated clinical response team to care for these patients.”

On Friday, the Associated Press reported a number of lawsuits have been filed against Exeter Hospital. At the start of July, almost 60 former patients of the hospital had filed suit. Of those, at least 47 patients have signed on to a class-action lawsuit, as well as 12 others who have each filed individual lawsuits.

Lawrence declined to comment on pending litigation.

When asked whether a worker’s misuse of drugs led to the outbreak, Lawrence said the employee has been let go.

“The investigation into the potential cause is still ongoing,” said Lawrence. “The individual is no longer employed at Exeter Hospital. The individual had been previously placed on an administrative suspension since the middle of May. We cannot provide any further comment due to the ongoing investigation.”

Officials investigating salmonella outbreak at Denny’s in Rochester

By Jill Jensen
The Post-Bulletin, Rochester MN

	More information  Officials say if you believe you contracted salmonella, you should contact your health care provider.

The first salmonella outbreak in years is linked to Denny’s Restaurant in Rochester.

Three confirmed cases and one suspected case of salmonella montevideo are being investigated by Olmsted County Public Health Services and the Minnesota Department of Health, according to a news release.

As of Friday, they had not found a specific food source, said Shaylene Baumbach, a public health educator for Olmsted County. They are investigating the possibility that a Denny’s Restaurant patron or employee brought in the food-borne illness.

The confirmed cases all dined at Denny’s Restaurant between June 27 and July 5 and were hospitalized for salmonella montevideo, which began between July 2 and 7.

However, Baumbach said, it is still safe to eat at Denny’s Restaurant.

Baumbach said the restaurant has cooperated fully with the investigation. The county and state health departments have discarded potentially contaminated foods, cleaned and sanitized food surfaces, implemented strict glove use, and excluded ill or recently ill employees, according to the release.

“We did not close down Denny’s specifically because we were able to get into the restaurant early enough to start the intervention right away,” she said.

Baumbach said the number of cases and other details will change as more information is gathered.

Salmonella symptoms include diarrhea, abdominal pain, cramps and fever and usually develop 12 to 72 hours after exposure, according to the release. Infections usually last five to seven days, but about 20 percent require hospitalization.

Baumbach said it’s been years since a salmonella outbreak has occurred, meaning the cases can be traced back to a particular source, but there are still cases throughout the year.

“A lot of people don’t know they have it,” she said.

More E. coli cases reported in outbreak

GERMANTOWN — Health officials investigating an E. coli outbreak among people who ate at a southwest Ohio picnic have announced six additional cases, bringing the total to 61.

The illnesses were reported in Germantown, southwest of Dayton. The Montgomery County’s health department said 11 people have been hospitalized at some point. Updates on their conditions weren’t available.

People who became ill were among attendees at a July 3 customer appreciation picnic for a lawn care business.

Health department spokesman Bill Wharton told the Dayton Daily News officials are interviewing them about what they ate at the picnic to determine how the outbreak started.

The bacteria can cause diarrhea, dehydration and, in severe cases, kidney failure.