NEWS SCAN: Alleged anthrax attacker's instability, stopping MDR TB, online TB atlas, Salmonella declines in EU, norovirus on cruise ships

Mar 23, 2011

Report: Army missed alleged anthrax attacker's mental problems
A panel of behavioral experts found that Bruce E. Ivins, the scientist believed to have perpetrated the anthrax letter attacks of 2001, had "alarming mental problems that military officials should have noticed and acted on long before he had a chance to strike," the Los Angeles Times reported today. The panel said the attacks, which sickened 22 people and killed 5, "could have been anticipated—and prevented." According to the Times, the panel said the Army made no effort to interview any of the psychologists or counselors who met with Ivins before or after the attacks, nor did the Army pursue questions raised by Ivins' annual disclosures of aspects of his medical treatment. If the military had done so, Ivins would have lost his security clearance and been unable to work with anthrax in his job at the US Army Medical Research Institute of Infectious Diseases (USAMRIID). In its 285-page report, the panel also concluded that Ivins' psychiatric records contained "considerable additional circumstantial evidence" that he was the attacker, the Times said. A USAMRIID spokeswoman declined to comment on the report, citing privacy law, the story said. The nine-member panel was formed in 2009 at the suggestion of, and was chaired by, Dr. Gregory Saathoff, a University of Virginia psychiatrist. It was funded by the US Justice Department. The report was filed with US District Court Judge Royce Lamberth in Washington, DC, last August but was sealed until this month, when the Justice Department got the judge's permission to release a version of it. Lamberth had issued an order for the release of Ivins' psychiatric records to the panel, the Times said.
Mar 23 LA Times story
Feb 16 CIDRAP News story on the National Research Council's report on the FBI anthrax investigation

WHO and partners call for bigger effort to stop MDR TB
On the eve of World TB Day, the World Health Organization and two partner groups today urged world leaders to step up efforts to stop multidrug-resistant tuberculosis (MDR TB), which killed 150,000 people in 2008. The WHO, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Stop TB Partnership called for an increased effort to meet the goal of diagnosing and treating 1 million people with MDR TB between now and 2015, the WHO said in a press release. The agency today released a report on progress in the MDR TB response in the countries that have the greatest burden. "Many countries have made progress, but despite the recent scale up in efforts, the world needs to do much more to get care to all MDR-TB patients who need it," said WHO Director-General Dr. Margaret Chan. The WHO said programs financed by the Global Fund and following WHO treatment standards are expected to help diagnose and treat about 200,000 people for MDR TB by 2015, but the WHO estimates there will be more than 2 million new cases by then. The agency said there were 440,000 cases in 2008, the latest year for which estimates are available.
Mar 23 WHO press release

McGill groups launch global TB atlas
Research groups at Canada's McGill University yesterday launched the world's first online atlas of tuberculosis (TB) vaccination policies throughout the world. It provides detailed information on current and past vaccination policies for more than 180 countries, according to a McGill press release. TB is a major global health threat, and varying TB vaccination practices often complicate testing and treatment. The group published a description of the atlas in Public Library of Science (PLoS) Medicine. The atlas is designed not only for researchers and vaccine developers, but also as tool for clinicians who are treating foreign-born adults who were vaccinated as children and don't likely have their childhood vaccination records. Alice Zwerling, a project leader, said in the press release that Bacille Calmette-Guerin (BCG) vaccine used to prevent TB can cause false-positives to the most common test used to diagnose the disease. She said the atlas can help doctors interpret test results, because they can find out when and how often vaccine was given. Consulting the atlas can also help doctors decide when to use a new blood test for TB that isn't affected by previous vaccination, Zwerling said.
Mar 22 PLoS Med abstract

EU says Salmonella cases dropped 17% in 2009
Salmonella infections in the European Union dropped by 17% in 2009, while Campylobacter cases increased about 4%, according to the annual report on EU foodborne outbreaks and zoonoses from the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control. Salmonella cases dropped from 131,468 in 2008 to 108,614 in 2009, marking the fifth straight year of declines, the EFSA said in a press release. In addition, the number of laying-hen flocks infected with Salmonella was 3.2%, down from 3.5% in 2008. EFSA officials said the declines show that Salmonella control measures are working. Campylobacteriosis remained the most common zoonotic disease in humans, with 198,252 cases in 2009, compared with 190,566 the year before. The pathogen was found mostly in raw poultry meat. In other findings, the report said the EU recorded 1,645 Listeria infections in 2009, a 19% increase, and 3,573 cases of verotoxigenic Escherichia coli, a slight increase. The EU in 2009 had 5,550 foodborne disease outbreaks, which affected 48,964 people and caused 46 deaths, the EFSA said. Salmonella was the leading outbreak cause at 31%, followed by viruses (19%) and bacterial toxins (10%).
Mar 22 EFSA press release

Study looks at norovirus transmission factors in cruise-ship outbreak
A study of a large norovirus outbreak on a cruise ship in 2009 showed that a sizable minority of the sick passengers didn't seek medical care on board, which may have hampered efforts to control the outbreak, according to a report in Clinical Infectious Diseases. After the outbreak began, personnel from the Centers for Disease Control and Prevention (CDC) placed questionnaires in every cabin. Eighty-three percent of the 1,842 passengers returned the questionnaires, and 15.4% (236) of them met the case definition. Of these, 40% did not seek medical care on the ship. Compared with well passengers, infected passengers were three times as likely to have a sick cabinmate and 2.8 times as likely to have witnessed a vomiting incident during boarding. Thirty-eight percent of sick passengers and 11% of well passengers said they decreased their participation in public activities. Less than 1% of the crew members reported being sick, a finding probably related to the lack of direct contact between most crew members and passengers, the Infectious Diseases Society of America (IDSA) said in a news release about the study. First author Mary Wikso, MPH, of the CDC said ship personnel should discourage sick passengers from boarding, and passengers and crew who get sick on board should report to the ship's medical center as soon as possible.
Mar 22 Clin Infect Dis abstract
Mar 23 IDSA press release

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