Several states reporting high tularemia cases
US health officials are grappling with a surge in human cases of tularemia in several states this year, Reuters reported today.
Colorado has had 41 confirmed cases so far this year, Wyoming 14—including 1 death—and South Dakota at least 19, the story said, and a Nebraska official today told CIDRAP News that that state has had 18, for a total of 92 in the four states.
The previous high in Colorado was 20 cases, in 1983, according to the Colorado Department of Public Health & the Environment Web site. Jennifer House, DVM, MPH, Colorado's state public health veterinarian, told CIDRAP News today, "Climatic conditions are very similar this year to what they were in 1983."
Wyoming's 14 cases also represent a record in the 25 years that statistics have been compiled, the story said. South Dakota recorded 34 cases in 1984, Reuters reported.
Leah Bucco-White, public information officer with the Nebraska Department of Health and Human Services, said the state has had 18 tularemia cases so far in 2015. In the previous 8 years, the state reached double figures only twice, with 10 cases in 2007 and 17 in 2013, she added.
At least 11 of the 18 cases have required hospitalization, but no deaths have been reported, Bucco-White said. Many cases are concentrated in Nebraska's panhandle area. "Working in conjunction with our local health departments, we're in the process of interviewing people to determine how they may have contracted the disease," she said.
The disease can be transmitted via wild animals, especially rabbits and ticks, via infected pets, and by environmental exposure such as while lawn mowing, which can aerosolize Francisella tularensis bacteria.
US Centers for Disease Control and Prevention (CDC) data from 2004 through 2013 reveal a range in annual tularemia cases for all states from a low of 93 in 2009 to a high of 203 in 2013. Of those 203 cases, however, only 25 were in Colorado, Wyoming, South Dakota, and Nebraska, with Colorado having only 1 case that year and Wyoming none.
"This is quite unusual," South Dakota epidemiologist Lon Kightlinger, PhD, MPH, said about this year's numbers, according to Reuters. The CDC is studying cases in the four states to identify common factors, Wyoming state epidemiologist Tracy Murphy, MD, said.
Sep 11 Reuters report
CDC tularemia cases, 2004-2013
WHO: Cholera cases reach 971 across Tanzania
A cholera outbreak in Tanzania that has reached almost 1,000 cases has expanded into new areas, including the region that includes the nation's largest city, Dar es Salaam, the World Health Organization (WHO) said in an update today.
The number of suspected and confirmed cases as of Sep 6 is 971, including 13 deaths, the agency said.
The outbreak was first reported in Mara region in the north and by late July Kigoma region in the northwest was also affected. By Aug 25, Dar es Salaam, Pwani, Iringa, and Morogoro regions also reported cases, signaling a widespread outbreak. All four regions adjoin, with Iringa in the central part of Tanzania and the others in the east.
Rapid assessment has been conducted to identify gaps and urgent needs, the WHO said. The agency and local and regional partners are holding bi-weekly meetings to coordinate response efforts.
Sep 11 WHO update