NEWS SCAN: Dengue in Hawaii, superbug in LA, TB success, Pakistan polio obstacles, North Korea FMD aid

Mar 25, 2011

Hawaii reports four dengue cases
The Hawaii Department of Health (HDH) said yesterday that it is investigating two confirmed dengue fever cases and two more suspected infections among Oahu residents and are warning those on the island to take precautions, according to an HDH press release. An investigation into the cases suggests the patients were infected near their homes by mosquitoes, the HDH said. Earlier this week officials sent an alert to physicians, advising them to consider dengue infection in those with similar symptoms and test and report suspected cases. Health director Loretta Fuddy said in the statement that authorities are conducting more tests and surveying, along with developing a mosquito control plan for the areas where the four patients were likely infected. In 2001 Hawaii identified its first locally acquired dengue case in 56 years. The reemergence of the virus led to an outbreak with 122 confirmed cases on three if the state's islands, according to a 2005 report by HDH researchers in Emerging Infectious Diseases. In background information on its Web site, the HDH said that incoming travelers with dengue fever can infect local mosquitoes, which played a role in the 2001 outbreak.
Mar 24 HDH press release
May 2005 Emerg Infect Dis report
HDH dengue background information

Highly resistant bug turning up in Los Angeles hospitals
A highly antibiotic-resistant bacterium that was thought to be confined mainly to the East Coast is invading hospitals and other health facilities in the Los Angeles area, according to a report from the Society for Healthcare Epidemiology of America (SHEA). The pathogen, called carbapenem-resistant Klebsiella pneumonaie (CRKP), is resistant to nearly all antibiotic options and has been linked to higher mortality, longer hospital stays, and higher healthcare costs, SHEA reported in a news release. At a SHEA news briefing this week, Dr. Dawn Tereshita of the Los Angeles County Department of Public Health said CRKP previously was believed to be rare in the region. After the health department declared CRKP a lab-reportable disease, 350 cases were reported from June through December of 2010. Tereshita said 42% of the cases were from long-term acute care hospitals and 6% from skilled nursing facilities. The study did not address why CRKP is growing more common in the area. Tereshita commented that patients in long-term acute care hospitals tend to be elderly people with many health problems and "are often placed on antibiotics which may or may not be appropriate," all of which tend to increase their risk for healthcare-acquired infections. Tereshita's study is scheduled to be reported in more detail at SHEA's annual meeting on Apr 3.
Mar 24 SHEA news release
Aug 20, 2010, CIDRAP News story discussing carbapenem-resistant K pneumoniae

TB rates down in Europe
The number of cases of tuberculosis (TB) in Europe declined 4.5% in 2009 and 27% since 1995, but treatment success seems to have leveled off, according to a Eurosurveillance report yesterday. In 2009, the last year for which data were available, 79,665 TB cases were reported by the 27 EU countries, Iceland and Norway, down 3,635 cases (4.5%) since 2008. The decrease between 2007 and 2008 was 1.4%. The number of cases dropped 29,992 since 1995, from 109,657 to 79,665, for a 27.4% drop. Cases per 100,000 population dropped from 22.7 in 1995 to 15.8 in 2009, a 30.4% decline. Countries reporting the highest rates per 100,000 were Romania (108.2), Lithuania (62.1), Latvia (43.2), Estonia (30.7), Bulgaria (38.3), Portugal (27.0), and Poland (21.6). Those at the lower end were Iceland (2.8), Greece (5.2), Germany (5.4), Luxembourg (5.5), Denmark (6.0), and Italy (6.5). By comparison, figures released yesterday by the US Centers for Disease Control and Prevention (CDC) showed 3.6 TB cases per 100,000 US residents in 2010. The European report also said that, while the number of countries achieving the target of 85% TB treatment success has doubled since 2008, overall European treatment success has not improved and even declined a bit from 2007 to 2008.
Mar 24 Eurosurveill report
Mar 24 CDC TB data

Pakistan faces tough polio battle
The battle against polio in Pakistan faces many complexities, including opposition to immunization from religious groups who have armed militia members on their side, floods in 2010 that seemed to exacerbate the spread of the virus, and possible vaccine campaign mismanagement, Integrated Regional Information Networks (IRIN), the humanitarian news organization of the United Nations, reported today. After leading the world in polio cases last year, the country has already reported 15 this year, with President Asif Ali Zardari declaring a national emergency over the epidemic and saying that failure to eradicate the disease amounted to "criminal negligence." Late last year a polio vaccine worker in one of the tribal areas was reportedly kidnapped and killed, and in February the virus was detected in water samples from five cities. A polio vaccine campaign official told IRIN that more supervisors have been sent to oversee vaccination activities. Also, a nongovernmental organization called National Research and Development Foundation is enlisting religious leaders to build the public's support for polio vaccination, according to the report.
Mar 25 IRIN story

FAO: North Korea needs $1 million to control FMD outbreak
North Korea needs $1 million worth of equipment and vaccine to stop foot-and-mouth disease (FMD) outbreaks, the United Nations Food and Agriculture Organization (FAO) said yesterday. It based the estimate on reports from international veterinary experts who were invited by North Korea to assess and help manage the outbreak between Feb 27 and Mar 8. Outbreaks of type O FMD have been reported in a variety of locations in 8 of North Korea's 13 provinces. The team found that the country's capacity to detect and contain outbreaks needs to be strengthened significantly, especially biosecurity practices and laboratory infrastructure. They recommended several steps to their North Korean colleagues, including conducting surveillance, mapping disease clusters, conducting adequate sampling, and strategizing the use of appropriate vaccines to contain disease outbreaks. The FAO said farm animals are vital to North Korea's food security and that cows and oxen are also a key source of draft power for agricultural production.
Mar 24 FAO press release

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