NEWS SCAN: Cholera in Cuba, TB in Florida, BSE pathogenesis

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Jul 9, 2012

Cholera outbreak in Cuba confirmed, but its size unclear
The Cuban government recently confirmed Cuba's first cholera outbreak in decades, with three deaths and about 50 more cases, but others put the numbers higher, according to media reports. The government reported the cases on Jul 3 and attributed them to contaminated wells, according to a Reuters report of that date. The Public Health Ministry said Manzanillo in the southeastern province of Granma had the most cholera cases and asserted that the outbreak was slowing, Reuters reported. But a report carried by the Miami Herald on Jul 6 said the disease had killed 15 people and sent hundreds to hospitals, which were being patrolled by security officers trying to suppress news of the cases. Yoandris Montoya, a resident of Bayamo, the provincial capital, told the newspaper there were "1,000-plus cases" in the province. And Santiago Marquez, a physician in Manzanillo, reported "a lot of panic" in the region because of a lack of official information about the disease. The report of 15 deaths came from Calixto R. Martinez, a Havana independent journalist writing in the Miami-based blog Café Fuerte, or Strong Coffee, according to the Herald. On Jul 7, BBC News reported a cholera case in a 60-year-old woman in Havana, 470 miles from Granma province. Reports noted that scores of Cuban medical personnel work in Haiti, where a cholera epidemic that began in late 2010 has caused more than 7,400 deaths. The Health Ministry said the last reported cholera outbreak in Cuba was soon after the 1959 revolution, according to the BBC story.
Jul 3 Reuters story
Jul 6 Miami Herald story
Jul 7 BBC News story

Newspaper says Florida health officials kept mum about TB outbreak
Florida health officials withheld from key state decision makers a Centers for Disease Control and Prevention (CDC) report of a serious tuberculosis (TB) outbreak in Jacksonville, even as the state took steps to close a TB hospital, the Palm Beach Post reported yesterday. In the CDC report, Robert Luo, MD, MPH, warned Florida officials that the Jacksonville outbreak, with 13 deaths and 99 cases, was one of the worst his group had investigated in 20 years, the story said. Luo issued his report in April, shortly after Gov. Rick Scott signed a bill that trimmed the Department of Health and required closure of the A.G. Holley State Hospital in Lantana, where patients with difficult TB cases have been treated for 60 years, the newspaper said. Luo's report said that 3,000 people might have had close contact with contagious people at Jacksonville homeless shelters over the past 2 years, but only 253 people had been found and tested, according to the story. The CDC report still had not been widely circulated as of yesterday, it said. Rep. Matt Hudson, R-Naples, who pushed for the "health agency consolidation," told the Post he had not been told of the Jacksonville outbreak as of Jul 6. When he was told the details, he promised there would be money for TB treatment, the story said.
Jul 8 Palm Beach Post story

Early involvement of autonomic nervous system in BSE reported
The autonomic nervous system (ANS), like the central nervous system (CNS), is affected during the early pathogenesis of bovine spongiform encephalotis (BSE) and may even precede CNS involvement, says a study published online Jul 8 in the American Journal of Pathology. Previous research had shown ANS involvement only after CNS involvement. The researchers orally infected 56 4- to 6-month-old calves with material from BSE-infected cattle and tested tissue samples from the gut, CNS, and ANS every 4 months from 16 to 44 months after infection. Almost all the gut samples showed the pathological prion protein. BSE prions were found in the ANS system beginning 16 months after infection and in the sympathetic ANS beginning at 20 months post infection. Little or no sign of CNS infection was found in those samples. BSE prions were first noted in the brainstem at 24 months after infection. Martin H. Groschup, lead author, said in a news release, "Our study sheds light on the pathogenesis of BSE in cattle during the early incubation period, with implications for diagnostic strategies and food-safety measures."
Jul 8 Am J Pathol abstract
Jul 9 EurekAlert press release

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