Meningitis Epidemic in Niger Claims 75 Lives

A meningococcal meningitis (caused by Neisseria meningitidis) outbreak in Niger, which started in January this year, has kept gaining momentum. Currently, the numbers of cases in the country stands at 697, with 75 deaths attributed to this disease. A previous report stated that it had affected 345 people between January 1 to March 29 of this year, and of those, 45 people had died. The increasing numbers point to the trend that the disease is increasingly spreading through the susceptible people in the community.

According to the World Health Organization (WHO), Niger, which is one of the poorest nations in the world, is prone to frequent epidemics of meningococcal meningitis because of its position in the meningitis belt, stretching from Senegal from the west to Ethiopia in the east.
Vaccinations are the primary mode of controlling the spread of the epidemic by inducing immunity in the susceptible population. Over 13,500 doses of the vaccine has been distributed as part of a vaccination campaign that is being launched to combat the epidemic. More vaccines will be deployed once the campaign is moving.

 

First Isolation of Leishmania from Northern Thailand

A case report published in the PLoS Neglected Tropical Diseases reports the first isolation of  Leishmania from Northern Thailand. From the published abstract:

Abstract

Since 1996, there have been several case reports of autochthonous visceral leishmaniasis in Thailand. Here we report a case in a 52-year-old Thai male from northern Thailand, who presented with subacute fever, huge splenomegaly and pancytopenia. Bone marrow aspiration revealed numerous amastigotes within macrophages. Isolation of Leishmania LSCM1 into culture and DNA sequence analysis (ribosomal RNA ITS-1 and large subunit of RNA polymerase II) revealed the parasites to be members of the Leishmania enriettii complex, and apparently identical to L. martiniquensis previously reported from the Caribbean island of Martinique. This is the first report of visceral leishmaniasis caused by L. martiniquensis from the region. Moreover, the majority of parasites previously identified as “L. siamensis” also appear to be L. martiniquensis.
 
Light micrograph of Leishmania amastigotes in bone marrow aspirate.Two infected macrophages are stained (large arrows), each with a nucleus (N) and numerous amastigotes (examples with small arrows) within the cytoplasm. The specimen was stained using Wright’s stain. The bar represents 20 µm.doi:10.1371/journal.pntd.0003339.g001

Author Summary

Visceral leishmaniasis is a potentially life threatening parasitic disease that is found in many tropical and subtropical regions of the world. We report a case of visceral leishmaniasis in northern Thailand caused by a recently described new species of Leishmania parasite, Leishmania martiniquensis. By comparing DNA sequences from this parasite with those of other isolates, we show that this parasite is more widely spread than previously thought, with several other examples in Thailand, and possibly from Europe and the USA, as well as the original location in the Caribbean island of Martinique. This parasite appears to be an emerging pathogen, which, because it causes a potentially fatal disease, needs to be investigated in detail so that its transmission can be understood and control measures can be developed.

Giemsa-stained promastigote forms from culture.A–H, examples showing morphological variation of forms observed, all at the same magnification, bar in F represents 5 µm. Procyclic-like promastigotes can be observed in A (arrows);, leptomonad-like promastigotes in B and C (arrows); nectomonad-like promastigotes in D, E and F; and rosettes and aggregates in G and H.doi:10.1371/journal.pntd.0003339.g003

Reference:
Pothirat T, Tantiworawit A, Chaiwarith R, Jariyapan N, Wannasan A, et al. (2014) First Isolation of Leishmania from Northern Thailand: Case Report, Identification as Leishmania martiniquensis and Phylogenetic Position within the Leishmania enriettii Complex. PLoS Negl Trop Dis 8(12): e3339. doi:10.1371/journal.pntd.0003339 Available from: LINK.

HPAI H5N2 Strikes Two More Counties in Wisconsin

Two more counties in Wisconsin have fallen prey to the Highly Pathogenic Avian Influenza H5N2 strain which continues its exponential race across the Mississippi flyway, along which this infection has been gaining momentum. According to the report in Madison, this new outbreak, affecting the Barron and Juneau counties, have put almost 126,000 heads of poultry at risk.

Although this disease seems to be highly infectious and has a very high case fatality rate, it has not yet made the species jump at similar proportions and is believed to be of little infectivity and virulence to man.

Salmonella enteritidis Outbreak in Liverpool

An outbreak of Salmonella enteritidis has reportedly taken place in Liverpool, at the Kirkby takeaway, Woks Cooking. According to the report published in the Liverpool Echo, the outbreak has been linked with infected german eggs and improper maintenance of hygiene in the kitchen. This food outlet has had a history of run ins with the health authorities as it was shut down in July last year, only to be re-opened under new management the very next month.

The current outbreak has been associated with the use of German eggs, which have also been implicated in other outbreaks elsewhere. Salmonellosis is usually spread from fecal contamination of eggs, but this current crop of cases attributed to this single source has also been seen in consumers Grade A eggs, which are clean and do not have any cracks or other ways of getting contaminated. It is believed that the infection had occurred during ovulation and may have been cloistered within as the eggshell formed.

Swine Brucella Risk While Hunting Feral Hogs

The Alabama feral hog hunting trend has increased over the past year, and with larger number of people getting involved in handling the wild hog once it has been killed, the risks of contracting Swine Brucella is on the rise. Swine Brucella is caused by the bacterium Brucella suis and is usually contracted while handling an infected hog without proper precautions.

The CDC has recommended the following pointers to be kept in mind to prevent contracting this disease:

  • Use clean, sharp knives for field dressing and butchering.
  • Wear eye protection and rubber or latex gloves when handling carcasses.
  • Avoid direct contact of bare skin with fluid or organs from the animal.
  • After butchering, burn or bury disposable gloves and parts of the carcass that will not be eaten.
  • Avoid feeding raw meat or other parts of the carcass to dogs.
  • Wash hands as soon as possible with soap and warm water for 20 seconds or more.
  • Dry hands with a clean cloth.
  • Clean all tools and reusable gloves with a disinfectant, such as diluted bleach.
  • Thoroughly cook the meat.
  • Be aware that freezing, smoking, drying and pickling do not kill the bacteria that cause brucellosis.

Soft Tissue Infection Outbreak in Scotland Amongst Users of Intravenous "Legal Highs"

“Legal Highs” are produced by new psychoactive substances which have properties similar to  illicit psychoactive substances but have not yet been classified as illegal, and are available over anonymous internet stores. One of the most commonly abused legal highs is a stimulant called Ethylphenidate, which is also sold under the trade name “Burst”, and has been linked to a number of soft tissue infections in users who take it by the intravenous route.

Ethylphenidate is available in a drug form and maybe either snorted or dissolved in liquids and then injected IV. However, it has a very short duration of action, around 1.5 hours, which makes the user dose on it multiple times. According to the news report in The Herald Scotland, in extreme cases, the users may shoot up as many as thirty times in a day.

These soft tissue infections are usually the result of contaminated diluent liquid, contaminated needles, shared needles or syringes or even contaminated drug. The common infections associated with Burst injection includes life threatening ones such as gas gangrene, necrotising fasciitis, anthrax, botulism or tetanus.

 

Leishmaniasis Outbreak in ISIS Held Raqqa, Syria

Leishamaniasis, a disease caused by Leishmania donovani, and spread by the sand fly, is reportedly raging through the capital of the Caliphate held by ISIS, Raqqa, Syria. Newspaper reports contend that there may be as many as 2,500 cases of Leishmaniasis in the city, which has become the focus of military strikes by multiple nations that has targeted it as the stronghold of the ISIS.

The city of Raqqa reportedly lies in ruins and amidst massive shortage of medical personnel and drugs, the outbreak is likely to get worse. This further goes to highlight the impact that social, political and civil unrest has on health, and takes the discourse of infectious disease outbreaks and controls to domains beyond medical issues. Social, economic and political determinants are equally important in deciding the outcome of infectious diseases in today’s world.