Health Risks of Black Henna Tattoos

The Florida Health Department is issuing advisory against the use of Black Henna tattoos, with the onset of spring break season, according to the Outbreak News blog. Henna is not naturally black in color, and is usually a reddish powder that turns brown when water is added and it is allowed to stand for a while. To induce the black color, a pigment, called para-phynelenediamine is added to it.

Short term exposure to PPD may precipitate dermatitis, asthma, gastritis, renal failure, vertigo, tremors, convulsions and even coma in human beings. The effect of chronic exposure to it are not known in man, though in experimental rats it has been shown to only cause a failure to gain weight, and nothing else.

“About two years ago I had a reaction to a “henna” design of a dragon. The colour faded quickly which surprised me, and about two weeks afterwards my skin welted up about a quarter of an inch in the exact pattern of the dragon. The itching was bad enough to keep me awake at night for several days. The swelling went away, but the pattern stayed for almost a year.

The carcinogenicity of PPD is unknown and its effect on the reproductive or developmental processes are also not clearly known. PPD is basically an allergen that evokes histamine release and a cell-mediated immune response, leading to a cascade which may precipitate the above mentioned conditions.

The primary method of prevention is to ban or restrict the use of PPD in tattooing chemicals, and increasing user awareness so that they may demand to know the composition of the dye being used for tattoo.

“This is how my daughter’s PPD black henna tattoo turned after returning from Bali The worst of it though is she has been feeling ill for the whole week that we have been home. Muscle weakness, headaches, sore throat, stomach ache and light headedness. We are off to the doctors today to show them this information on PPD to see if her symptoms are related.”
This tattoo was applied on the 20th April 2001. This photograph was taken 10 days later “Thought you might like to see how they (the black henna tattoos) look today. The one on her arm is now 1 week and 3 days old.

Images from: East on West, Black Henna Warning

Anthony Fauci: Ebola Virus Not Showing Accelerated Evolution

One of my modern day medical idols is Dr. Anthony Fauci, one of the lead editors of the two-volume Bible of Internal Medicine, “Harrison’s Internal Medicine”, and also the Director of the National Institute of Allergy and Infectious Diseases. In an NIH News piece he has commented:

“The Ebola virus in the ongoing West African outbreak appears to be stable—that is, it does not appear to be mutating more rapidly than viruses in previous Ebola outbreaks, and that is reassuring,”…. “We look forward to additional information to validate this finding, because understanding and tracking Ebola virus evolution are critical to ensuring that our scientific and public health response keeps pace.”

This news article presents good news in context of the proportions that the Ebola outbreak has assumed in the Western African countries, accounting for 25,000 odd cases and about 10,000 deaths.

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.

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.

Plague Bacteria Detected in Arizona Fleas

The causative bacterium of plague, Yersinia pestis, has been detected in fleas in Picture Canyon, Arizona. Deaths of prairie dogs in this region alerted officials to the possibility of the disease.

Prairie dogs are especially vulnerable to this bacterium as they live in social burrows which may be infested with rodents that carry the fleas bearing the disease causing bacteria. Once the host rodent dies, the fleas seek out new hosts to feed off as they are sanguinivorous. It has been noted that even a single infected member of a prairie dog colony may lead to the death of as many as 90% of the members of the colony.

Human cases have been known to develop from close contact with cats that have preyed on infected rodents, and adequate advisory is being issued, especially to campers and hikers in the region, about the risks of plague. In addition, the prairie dog burrows at the affected place, Picture Canyon, are being sprayed with insecticide to kill the fleas that may host the plague bacillus.

Pertussis Cases on the Rise in Washington

Compared to the first 14 weeks of 2014, in the same period in 2015, Washington has experienced a major spike in the number of pertussis cases. There were 49 cases in the corresponding period of 2014, compared to which, in 2015, there have been 319 cases.

Pertussis shows cyclical trends of increasing numbers every three to five years as there is an increase in the number of susceptible people due to waning of immunity from vaccines and previous disease incidence. Washington last experienced epidemic proportions of pertussis in 2012, when more than 5000 cases were registered.

The overall incidence of pertussis appears to be 4.7 per 100,000 population, while that for infants is massively higher at 26 per 100,000 population. Unfortunately, the disease also follows a more severe course in infants, who happen to be more susceptible to it.

It is a vaccine preventable disease and may be warded off by using the DTaP vaccine.

California Sees Record West Nile Virus Cases in 2014

The recent report by the California Department of Public Health clearly indicates that the West Nile Virus is reaching greater proportion with every passing year. The Press Release of the CDPH on this issue states:

California had the second-highest number of human cases of West Nile virus (WNV) in 2014 since the virus first invaded California in 2003. In 2014, California recorded 801 cases of the potentially fatal disease. In 2005, CDPH detected 880 cases of WNV.The highest number of cases was in Orange County (263 cases) and the highest incidence occurred in Glenn County (35.3 cases per 100,000 population).

The level of WNV activity last year broke several records including:

  • Five-hundred-sixty-one cases of West Nile neuroinvasive disease (WNND), the more serious neurological form of the disease often resulting in encephalitis or meningitis, were detected.
  • The number of fatal WNV cases, 31, exceeded all previous years.
  • The proportion of mosquitoes infected with WNV was the highest level ever detected in California (mosquito infection rate = 6.0; epidemic conditions equate with 5.0).
  • The prevalence of WNV infection in tested dead birds, 60 percent, was the highest ever detected in California.

CDPH recommends that individuals prevent exposure to mosquito bites and West Nile virus by practicing the “Three Ds:” 

  1. DEET- Apply insect repellent containing DEET, picaradin, oil of lemon eucalyptus, or IR3535 according to label instructions. Repellents keep the mosquitoes from biting you. DEET can be used safely on infants and children 2 months of age and older.
  2. DAWN AND DUSK – Mosquitoes bite in the early morning and evening so it is important to wear protective clothing and repellent if you are outside during these times. Make sure that your doors and windows have tight-fitting screens to keep out mosquitoes. Repair or replace screens with tears or holes.
  3. DRAIN – Mosquitoes lay their eggs on standing water. Eliminate all sources of standing water on your property, including in flower pots, old car tires and buckets. If you know of a swimming pool that is not being properly maintained, please contact your local mosquito and vector control agency.

A brief summary of the outbreak statistics from 2003:

Texas Listeria Cluster Linked to Ice Cream

The Outbreak News Today blog has reported an outbreak of Listeriosis associated with Blue Bell ice cream in Texas, with the following message:

Retailers are urged not to sell or serve products from the Oklahoma plant. They can be identified by checking for letters “O,” “P,” “Q,” “R,” “S” and “T” following the code date printed on the bottom of the product package. Consumers should discard or return Blue Bell products with those letters.

Rare, Fatal Complications of Yellow Fever Vaccination

Yellow fever vaccine is recommended to all travelers who are planning a trip to countries endemic for the disease. The vaccine is relatively safe and effective and recently, there have been two isolated reports of a fatal and extremely rare complication arising from the YF vaccine, the Yellow Fever Vaccine associated Viscerotropic Disease (YEL-AVD). The CDC MMWR reported a case in Oregon, USA, and the Outbreak News Blog reported a case from Hong Kong.

YEL-AVD results from the uncontrolled replication of the vaccine virus, finally leading to multi-organ failure and has a reported mortality to the tune of 60%.

FIGURE from CDC Report: Yellow fever virus antigens (red) detected after immunohistochemical staining in tissue samples from various organs* of a patient who died from yellow fever vaccine–associated viscerotropic disease — Oregon, September 2014
* Sample A: myocytes in heart; sample B: fibroblasts in vascular wall in lung; sample C: kupffer cell in liver; sample D: fibroblasts and histiocytes in skin. (Immunoalkaline phosphatase with naphthol fast-red substrate and hematoxylin counterstain. Original magnifications: A = x400; B = x100; C = x400; D = x100.)
The CDC report further states that the risk of YEL-AVD is 0.4 per 100,000 doses of YF vaccine administered. The risk is increases with age: in patients older than 60 years it has a risk of 1/100,000 doses while those that, those who are older than 70 years have a risk of 2.3/100,000 doses administered. Almost a quarter of the first few cases of YEL-AVD that have been reported had a history of thymoma and it is estimated that the increased risk attributable to thyme disease persists even after thyme resection.

Syphilis on the Rise in Alaska: LGBT Community Worst Hit

A recent post on Outbreak News Today seems to suggest that the number of cases of Syphilis is on the rise in Alaska, which reported and 8-fold increase in the number of cases in 2014, in comparison to 2009. From 5 reported cases in 2009, the number of cases has risen to 40 in 2014, in what is being perceived as mostly being driven by adverse sexual behavior.

The problem of Sero-sorting has been seen in this issue for a long time, which is believed to be one of the important reasons driving up the number of cases. Sero-Sorting is the phenomenon when a previously HIV-status-known person chooses to have sex with another person of similar sero-status so that they do not have to use condoms.

The reduction of the fear of HIV transmission, and the rising incidence of drug use are also seen as potent drivers of this rise in the number of cases.