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Posts Tagged ‘Centers for Disease Control and Prevention’

INDIA’S DENGUE FEVER EPIDEMIC RAISES ALARM

In Dengue Fever, Uncategorized on November 8, 2012 at 2:46 pm

Country has become the focal point for a mosquito-borne plague that is sweeping globe

By GARDINER HARRIS NYT NEWS SERVICE

Originally published November 7, 2012 at 12:01 a.m., updated November 6, 2012 at 6:07 p.m.

NEW DELHI — An epidemic of dengue fever in India is fostering a growing sense of alarm, even as government officials have publicly refused to acknowledge the scope of a problem experts say is threatening hundreds of millions of people, not just in India but around the world.

India has become the focal point for a mosquito-borne plague that is sweeping the globe. Reported in a handful of countries in the 1950s, dengue is now endemic in half the world’s nations.

“The global dengue problem is far worse than most people know, and it keeps getting worse,” said Raman Velayudhan, the World Health Organization’s lead dengue coordinator.

The tropical disease, though life-threatening for a tiny fraction of those infected, can be extremely painful for many who catch it. Growing numbers of Western tourists are returning from warm-weather vacations with the disease, and it’s pierced the shores of the United States and Europe. Last month, health officials in Miami announced a case of locally acquired dengue infection.

In India’s capital, hospitals are overrun and feverish patients are sharing beds and languishing in hallways. At Kalawati Saran Hospital, a pediatric facility, a large crowd of relatives lay on mats and blankets outside the hospital entrance recently.

Officials say 30,002 people in India had been sickened with dengue fever through October, a 59 percent jump from the 18,860 recorded in 2011. But the real number of Indians who get dengue fever annually is in the millions, several experts said.

“I’d conservatively estimate that there are 37 million dengue infections occurring every year in India, and maybe 227,500 hospitalizations,” said Scott Halstead, a tropical disease expert.

A senior Indian government health official, who agreed to speak about the matter only on the condition of anonymity, acknowledged that official figures represent a mere sliver of dengue’s toll. The government only counts cases of dengue that come from public hospitals and have been confirmed by laboratories, the official said. Such a census, “which was deliberated at the highest levels,” is a small subset that is nonetheless informative and comparable from one year to the next, he said.

“There is no denying that the actual number of cases would be much, much higher,” the official said. “Our interest has not been to arrive at an exact figure.”

The problem with that policy, said Manish Kakkar, a specialist at the Public Health Foundation of India, is that India’s “massive underreporting of cases” has contributed to the disease’s spread. Experts from around the world said that India’s failure to construct an adequate dengue surveillance system has impeded awareness of the illness’s vast reach, discouraged efforts to clean up the sources of the disease and slowed the search for a vaccine.

“When you look at the number of reported cases India has, it’s a joke,” said Harold Margolis, chief of the dengue branch at the Centers for Disease Control and Prevention in Atlanta.

Neighboring Sri Lanka, for instance, reported nearly three times as many dengue cases as India through August, according to WHO, even though India’s population is 60 times larger.

Part of India’s problem is that some officials view reports of dengue infections as politically damaging. A central piece of evidence for those who contend that India suffers hundreds of times more dengue cases than the government acknowledges is a recent and as yet unpublished study of dengue infections in West Bengal that found about the same presence of dengue as in Thailand, where almost every child is infected by dengue at least once before adulthood.

“I would say that anybody over the age of 20 in India has been infected with dengue,” said Timothy Endy, chief of infectious disease at Upstate Medical University in Syracuse.

For those who arrive in India as adults, “you have a reasonable expectation of getting dengue after a few months,” said Joseph Vinetz, a professor of medicine at the University of California San Diego. “If you stay for a longer period, it’s a certainty.”

Twenty years ago, 1 of every 50 tourists who returned from the tropics with fever was infected by dengue; now, it is 1 in 6.

http://www.utsandiego.com/news/2012/nov/07/tp-indias-dengue-fever-epidemic-raises-alarm/

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US West Nile outbreak second-worst at more than 4,500 cases

In Uncategorized, West Nile Virus on October 21, 2012 at 7:40 pm

By Marice Richter

DALLAS Oct 17 (Reuters) – The number of West Nile virus cases across the United States has topped 4,500, with another 282 cases reported last week, making 2012 the nation’s second-worst year on record for the mosquito-borne disease, government figures showed on Wednesday.

The Centers for Disease Control and Prevention said 4,531 cases have been reported this year, the highest number since the record outbreak of 2003, when 9,862 cases were reported.

Another 15 deaths from the disease were reported last week, bringing the total to 183, the CDC said.

Almost 70 percent of the cases have been reported in eight states: Texas, California, Louisiana, Mississippi, Illinois, South Dakota, Michigan and Oklahoma. More than one-third were in Texas, with Dallas-Fort Worth at the center of the outbreak.

Just over half of the cases reported to the CDC this year have been of the severe neuroinvasive form of the disease, which can lead to meningitis and encephalitis.

The milder form of the disease causes flu-like symptoms and is rarely lethal.

http://af.reuters.com/article/commoditiesNews/idAFL1E8LHDA120121017

West Nile Virus Leaves Man Disabled Years after Bite

In Uncategorized, West Nile Virus on October 2, 2012 at 2:08 pm

BY JEFF SHANE,

PUBLISHED: OCTOBER 1

In northwest Indiana, where I have raised vegetables for 20-odd years, mosquitoes flourish when rain fills the swamp pools in the backwaters of the Kankakee River.

In August 2004, those pools spawned a particularly righteous throng. One afternoon, they found me. I had unzipped my bug-protection hood to write some notes about what I was planting. Bitten sharply on the chest, I slapped and missed. Then I was lanced on the left temple. That was her last act. The gangly bug lay flat on my palm — and so began my odyssey into the world of West Nile that even eight years later is not entirely concluded.

The Centers for Disease Control and Prevention says this year is the worst summer for West Nile virus since the disease arrived in the United States, probably in 1999. If so, my tale is a cautionary one.

A week after being bit by that mosquito, I was at a cooking conference in Vermont, working 10-hour days cutting vegetables, joking around the kitchen, making new friends. The third day, I woke with a fever and ached deeply in my bones. I figured it was a bizarrely ferocious flu.

Two days later, I had a temperature of 104, was losing the ability to walk and suddenly realized that I could not move my left arm. The friends who drove me to the hospital had to all but carry me into the emergency room. Within two hours, I had been X-rayed, CT-scanned, MRI’ed, and spinal-tapped. The tests showed extremely high white blood cell counts. There were lesions on my spinal cord, and the virus had caused my brain to swell: I had encephalitis.

As the doctors theorized about Lyme disease or a rampant herpes virus, I remembered that vicious bite of 10 days earlier and placed my bet that it was West Nile. Sure enough, there were West Nile antibodies in my spinal fluid, and the doctors put me on a serious regimen of steroids and antibiotics. Within a few days, both arms were flaccid and my legs began to fail me.

My wife and friends were at my side, but I recall little of those first days other than being stunned by this new life situation. I’d had sports injuries in the past but had never been in a hospital, rarely visited doctors and secretly applauded myself on my innate good health. Now, I could barely move. I was a spry 47 year old and could barely move. Adding to that, the medical community seemed to share the same sense of bewilderment I felt. There was no regimen of pills, no shot, no miracle cure.

The nurses became my heroes. I lived in a new world of urinals and wheelchairs, sleeplessness and a slide into more paralysis. All I had to rely on to deal with my new condition was my sense of humor and truisms that my father had cheerfully passed on to me and my siblings from his Kansas childhood during the Depresssion: “Nobody ever said life was fair” and “A little rain must fall.”

Doing me in

The virus, or my own immune system’s punch-drunk response — the doctors weren’t certain — was still killing nerve cells. Pain was rarely a big problem, but the illness was doing me in quietly and stealthily.

My physical therapy was canceled because I could no longer walk. My farm muscles were melting away. As bones settled and ligaments let go, my hospital bed became a rack where I found no comfort. Sleep came a few hours at night, medication useless.

The lowest moment came during an attempt at showering a few weeks into my illness. A sweet and tough older nurse was trying to spray me down when I slumped off the shower chair, feeling so weak that I asked to return to bed. As I passed a mirror, supported in her arms, I saw the shrunken person I was now. I remembered my father’s body ravaged by cancer: spindles for limbs, a pathetic little belly, eyes shrunken and dull. I lay there and cried off and on for the next few days.

I lost 40 pounds during that first month, though they fed me double rations. I began to feel real fear.

The anterior horn nerve cells at the top of the spinal cord that controlled my muscles — the same cells attacked in polio and Lou Gehrig’s disease — were dying. My body was so unsupported by tissue and muscle that my shoulders threatened to dislocate. My arms flopped over the side of the bed. I could barely speak. My lungs struggled in my sallow chest.

It seemed incredible: A persistent mosquito had followed nature’s prerogative and brought me to this. According to the CDC, the disease first identified in Uganda in the 1930s had traveled thousands of miles within a bug and alighted in New York 13 years ago. Birds became the vector for the virus, migrating and spreading disease throughout the country. This summer, the virus has sickened people innearly every state.

Feeling as if I had failed my caregivers, my family and myself, I focused my hopes on getting to Chicago and its world-renowned rehabilitation hospital. Chicago was home when I was not on the farm, and I had all the resources of family and friends there to count on. By mid-September, after five weeks of treatment brought no improvement, I was flown out of Vermont by air ambulance and started rehab the morning after my arrival.

A therapist strapped my hands to a sort of elevated bicycle wheel that I was supposed to crank, and she moved on to other patients. I still recall the look of surprise and muted frustration on her face when she returned a few minutes later to find my arms fallen uselessly out of the contraption, the flaccid muscles hopeless for this mode of therapy.

I was in the post-polio division, tended to by neurologists as famous as world-class athletes and by nurse’s aides who fed me, cleaned me from stem to stern and taught me not to buzz too often, especially at night. My siblings flew in to visit, sit by my bedside, read to me and roll my wheelchair to the park down the street. My son, 11 at the time, and my wife bravely endured, willing me to keep my spirits up, feeding me on little doses of love, salted with humor.

I fended off the psychiatrist obsessed with putting me on antidepressants and overruled proposed 3 a.m. shots of blood thinner that was supposed to keep me from dying from a blood clot. There was no real therapy, just visits from young and shiny residents intrigued by my strange, slowly deteriorating condition. My doctors were stymied and began planning to discharge me — in theory, to somehow gain the strength at home to return for therapy.

Then my older sister, a scientist and Internet bloodhound, found a new source for information and guidance: a doctor in Jackson, Miss. Neurologist Arturo Leis of the Methodist Rehabilitation Centerhad treated as many cases of West Nile as anyone in the country. She persuaded my reluctant doctors to consult him.

And then I heard Leis’s voice on the speakerphone explaining that I should no longer be getting weaker as a result of the virus alone and that my symptoms suggested that some secondary, dangerous process was killing more nerve cells. He advised massive doses of IV steroids. My doctors quickly agreed, wordlessly forgetting their plan to send me home.

Going home in a wheelchair

It was autumn when I finally left rehab and saw Lake Shore Drive again, sitting in my wheelchair aboard the ambulance taking me home. The lake was bluer than I remembered amid the sere of late summer, with yellowed grass and tumbling leaves. My wife and son were waiting, soon joined by Bouma, a towering man from Mongolia who for months would be my caretaker.

The steroids brought the first, timid signs of recovery. Faint nerve signals moved muscles even as I called myself “baloney on a slab” and knighted my useless left hand “the claw.” I still could not sleep, overspilled my urinal nightly and came to understand more plainly the value of an enema.

My son said a soft goodbye each day on his way out to school. I would cry sometimes when he left, trying instead to think about my father’s homespun admonitions, my wife’s constant efforts to help me heal and the underpaid heroes who had tended to me in Vermont and Chicago.

I started outpatient therapy and saw an acupuncturist whose needles and herbs rallied my hope. And then one December night at home, in a foul mood, I demanded that someone help me out of my wheelchair — and jerked myself up and tottered a few feet to the table. I started to be able to walk again.

As uncalled and silent as the virus when it crept in, so my recovery began.

West Nile’s aftereffects

The mosquitoes are still multiplying in the heat out in the country. Hurricane Isaac’s remnants provided them with one final birthing bonanza before their demise in the season’s first hard frost.

The CDC, meanwhile, advises that immunity to West Nile for those who have been exposed to the virus should, in most cases, be lifelong.

Although I have regained fairly robust health and returned to farming, my left arm has little strength and my shoulders and upper back have only half the muscle they had before 2004.

I visited Art Leis in Mississippi about five years ago. He tested my nerves and muscles, evaluated my whole history, and stated that my case of West Nile was one out of 30,000: I had been too healthy to get so sick, I had been too sick to recover so well. There was still no certainty as to whether the virus alone ravaged me or whether my own immune system had joined the attack.

Of the more than 3,500 cases of West Nile reported to CDC in this record-setting year, a little more than half developed into encephalitis, meningitis or another disease classified as “neuroinvasive” such as mine. All these years later, I continue to recover, feeling my shoulder blade reattach and surprising myself by sprouting a miniature triceps on my left arm.

Strange as it might seem, because of all that I have learned about myself and my place in the world — where I have been carried by strangers who became heroes and by family and friends — I would not trade these lessons even to be made whole again.

When he’s not working on his organic farm, Shane is a chef in Chicago

http://www.washingtonpost.com/national/health-science/west-nile-virus-leaves-man-disabled-years-after-the-bite-of-an-infected-mosquito/2012/10/01/b552c768-0408-11e2-91e7-2962c74e7738_story.html?hpid=z5

Dengue Fever in Texas?

In Dengue Fever, Uncategorized, West Nile Virus on September 10, 2012 at 8:51 am
September 4, 2012 

By 

drjane65@gmail.com

Recently, there is a lot of buzz in the news and on-line about Dengue Fever.  I had to really dig in my heels and sort through the published literature on this latest in “medical gossip”.

Normally found in more tropical climates such as the Philippines, Puerto Rico and Mexico, a few cases in recent years have been found in southern Florida according to the Center for Disease Control (CDC).    There is increasing concern that areas on the border such as Juarez, which have experienced an upsurge of Dengue Fever, could put the South Texas region on alert.

According to the most recent CDC map, recent cases in Texas seem to be travelers arriving from places outside the U.S. The concern however, is that increased international commerce from areas with infected mosquitoes and warmer environmental climates could be allowing more mosquitoes to survive thru the winter months.  Remember: it was an unseasonably warm winter this past year.

Approximately 3-8% of travelers returning from the tropics may become infected.  Next to malaria, Dengue is the second most common tropical disease infection resulting in hospitalizations.

Dengue fever is characterized by high fever, vomiting, rash and dehydration and may occur from 3-15 days after an infected mosquito bites its victim.  Headache, chills and swollen lymph nodes may be the first signs of infection.   Symptoms may last 1-2 weeks with complete recovery.  Infected individuals with more severe viral forms of Dengue may develop life-threatening symptoms such as bleeding of the skin, gums and gastrointestinal tract (referred to as Dengue Hemorrhagic Fever).

Not limited to blood work, sometimes a spinal tap is necessary for diagnosis.  Treatment is limited and usually just an increase in fluid intake is needed.  Occasionally IV fluids, and rarely hospitalization is necessary for Dengue Fever.  For Dengue Hemorrhagic Fever, blood transfusions and more intensive care is necessary.

Tylenol is the medication of choice and drugs such as aspirin and NSAIDS (ibuprofen, naproxen, etc) are not recommended as they could increase the risk of bleeding.

The prognosis (outcome) is most always excellent for Dengue Fever. As with West Nile, people with altered immune systems such as the elderly and those on chemotherapy are more likely to experience complications. Overall fatality rate is about 1%.  Although that seems low, world wide about 500,000 to 1 million people die each year from the disease (which is significant).

No vaccines are available at this time and the CDC recommends insect repellent with up to 50% DEET for adults and children over 2 months of age.

So, is the hype real?  I suspect we must all be on alert.  It was a warm winter.  For now, I am going to invest in  DEET insect repellent and pray fo a really good winters freeze.  I suggest you do the same.

Disease-Spreading Ticks on the Move as Climate Changes

In Lyme Disease, Uncategorized on September 9, 2012 at 11:15 am
Posted by David Braun of National Geographic in Tales of the Weird on September 7, 2012
A female blacklegged tick converting its blood-meal into thousands of eggs. Credit: NSF/Graham Hickling, University of Tennessee

A female blacklegged tick converting its blood-meal into thousands of eggs. Credit: NSF/Graham Hickling, University of Tennessee

One more reason to be nervous about climate change: Tick species are on the march.

The blood-sucking, disease-spreading parasites are expanding into new territories as wildlife populations, forest habitats and weather patterns change across North America, biologists have found.

“This year’s mild winter and early spring were a bonanza for tick populations in the eastern United States,” the National Science Foundation said today. “Reports of tick-borne disease rose fast.”

While Lyme disease is the most common tick-borne disease in the Northeast and Upper Midwest, new research finds that it is not the greatest cause for concern in most Southeastern states, the NSF said in a news statement about a research paper in the journal Zoonoses and Public Health.

“The majority of human-biting ticks in the North–members of the blacklegged tick species–cause Lyme disease, but these same ticks do not commonly bite humans south of mid-Virginia,” the NSF explained.

Biologist Graham Hickling of the University of Tennessee, co-author of the Zoonoses and Public Health paper, says many patients in Southeastern states, who become sick from a tick-bite, assume they have Lyme disease, but the odds of that being the case are low.

“Ticks in the eastern U.S. collectively carry more than a dozen agents that can cause human disease,” says Hickling.

“Here in Tennessee we regularly collect lone star ticks that test positive for Ehrlichia, [a tick-borne bacterial infection]. Lone stars are an aggressive species that account for most of the human bites that we see in this region. So ehrlichiosis has to be a big concern, yet most people have never heard of it.”

In contrast, explains Hickling, there have been no confirmed reports to date of the Lyme disease pathogen among the sparse populations of blacklegged ticks found in Tennessee.

Spotted Fever Rickettsiosis and Ehrlichiosis

“The Southeast is dominated by different tick species than the ones that attack humans in the North,” says Ellen Stromdahl, an entomologist at the U.S. Army Public Health Command and lead author of the paper.

“The lone star tick is by far the most abundant tick in the Southeast, and which species of tick bites you is critical because different ticks carry different diseases. In the Southeast you are unlikely to be bitten by the blacklegged ticks that spread Lyme disease,” Stromdahl says.

Most bites in the Southeast are from the tick species that spread spotted fever rickettsiosis and ehrlichiosis, but not Lyme disease, the NSF said. “A complicating factor for public health officials is that tick species are on the move, as wildlife populations, forest habitats and weather patterns change across the continent. This spring the Tennessee Department of Health, for example, reported a 500 percent increase in tick-borne rickettsiosis.”

“Identifying health risks in the face of changing climates will be critical in coming years.”

“Identifying health risks in the face of changing climates will be critical in coming years,” says Sam Scheiner, National Science Foundation program director for the joint NSF-National Institutes of Health Ecology and Evolution of Infectious Diseases (EEID) program, which funds Hickling’s research. This study will inform public health officials about what diseases are found in which areas, so they can minimize human health problems.”

Hickling’s work is also in collaboration with scientist Jean Tsao of Michigan State University and is part of an EEID project to identify the ecological factors leading to distributions of tick species and pathogens–in particular, where the Lyme disease tick and pathogen are found.

Lyme-infected blacklegged ticks are expanding south through Virginia, and lone star ticks are moving north, the NSF said in its statement. “The bite of the lone star tick can create a bulls-eye rash that appears like that of Lyme disease, but the rash isn’t caused by the Lyme bacteria. The scientists say that this almost certainly leads to misdiagnosis of some patients in mid-Atlantic states, where both tick species are common.”

The best way to distinguish Lyme from other tick-borne diseases is to be vigilant for tick bites, and whenever possible save any tick that manages to bite you. “Store the tick in your freezer or in a vial of alcohol so it can be identified if you become ill,” the NSF recommends.

Nymphal Blacklegged Ticks of the Northeast

In the Northeast, the NSF release explained, Lyme disease awareness campaigns have focused public attention on the nymphal blacklegged tick–which is responsible for most disease transmission and which is tinier than the adult form. “While nymphal blacklegged ticks and nymphal lone star ticks–which also bite humans–can be distinguished, the two are often confused by the public. In one study, 13 of 20 patients reporting tick bites to physicians were given antibiotics on the assumption that they were at risk for Lyme disease, yet 53 of the 54 ticks removed from those same patients were lone star ticks, which do not spread Lyme disease.”

“Where you live determines which tick species is likely to bite you.”

“Where you live determines which tick species is likely to bite you,” says Tsao, “and therefore which diseases you’re most likely to contract.”

The NSF says biologists are happy that recent treatment recommendations have begun to emphasize the importance of considering the tick species and its infection status as part of the diagnostic process. “Their advice: Stay open-minded about which tick-borne diseases are most common in your area–and save the tick that bites you.”

This blog post was based on publicity material provided by the National Science Foundation, an independent federal agency that supports fundamental research and education across all fields of science and engineering.

Lyme Disease

(From the Centers for Disease Control and Prevention)

The Lyme disease bacterium, Borrelia burgdorferi, is spread through the bite of infected ticks. The blacklegged tick (or deer tick, Ixodes scapularis) spreads the disease in the northeastern, mid-Atlantic, and north-central United States, and the western blacklegged tick (Ixodes pacificus) spreads the disease on the Pacific Coast.

Ticks can attach to any part of the human body but are often found in hard-to-see areas such as the groin, armpits, and scalp. In most cases, the tick must be attached for 36-48 hours or more before the Lyme disease bacterium can be transmitted.

Most humans are infected through the bites of immature ticks called nymphs. Nymphs are tiny (less than 2 mm) and difficult to see; they feed during the spring and summer months. Adult ticks can also transmit Lyme disease bacteria, but they are much larger and may be more likely to be discovered and removed before they have had time to transmit the bacteria. Adult Ixodes ticks are most active during the cooler months of the year.

Which Bug Repellent Is Best?

In DEET, Lyme Disease, Uncategorized, West Nile Virus on September 2, 2012 at 11:05 am

Bucks - Making the Most of Your Money

August 30, 2012, 4:17 PM
By ANN CARRNS

If your family is like ours, you’ll be spending time outdoors this Labor Day weekend.

And if you’re a mother like me (read: a worrier), you’re well aware of news reports

about the abundance of ticks this year,

and about an increase in cases of West Nile virus in some parts of the country.

That means we’ll be spraying ourselves and our children with bug repellent, to ward off both ticks

and the pesky mosquitoes that carry West Nile.

(Generally we avoid slathering our offspring with chemicals.

But we make an exception in this case,

if they’re going to be out in nature for extended periods of time). But which repellent is best?

Consumer Reports has updated a test of widely available repellents that work on both deer ticks and mosquitoes that carry West Nile,

along with cost information on a per-ounce basis. The six top-rated products are $2 an ounce or less.

The data on costs is from 2010, according to Consumer Reports, but all the products are currently available.

(And a quick check online suggests prices are about the same, or in some cases, lower.)

Just how much chemical you are comfortable exposing yourself

and your children to is up to you. The four top-ranked brands

— Off Deep Woods Sportsmen II, Cutter Backwoods Unscented, Off Family Care Smooth & Dry,

and 3M Ultrathon Insect Repellent — all contain DEET in varying concentrations from 15 percent to 30 percent,

and were able to repel mosquitoes for at least eight hours.

DEET is effective, and the Environmental Protection Agency says it is safe when used as directed,

but you shouldn’t use it on babies under 2 months old. The American Academy of Pediatrics advises

against using products with more than 30 percent DEET on children.

The fifth- and sixth-ranked products — Repel Plant Based Lemon Eucalyptus and Natrapel 8-hour with Picaridin —

don’t contain DEET, but provided long-lasting protection as well.

The lower-ranked products also repelled mosquitoes effectively, but generally for shorter periods of time,

and some had other drawbacks, like a tendency to stain clothing.

The upshot, Consumer Report says, is that “most of the tested products will do the job if you’re

going to be outside for only a couple of hours, but look for a highly rated product to protect you on longer excursions.”

The E.P.A. has information on its Web site to help you choose a repellentbased on your specific needs,

although it doesn’t include cost data. General information about West Nile is available

from the Centers for Disease Control and Prevention.

Are you stepping up your use of bug repellent due to West Nile?

http://bucks.blogs.nytimes.com/2012/08/30/which-bug-repellent-is-best/?src=rechp

NYT: West Nile Hits Hard Around Dallas, With Fear of Its Spread

In West Nile Virus on August 18, 2012 at 12:45 pm

By  and 

DALLAS — An outbreak of West Nile virus has engulfed Dallas County, with nearly 200 cases of human infection and 10 deaths, leading the mayor of Dallas to declare a state of emergency and to authorize the first aerial spraying of a pesticide in the city since 1966.

The high number of infections and deaths from the mosquito-borne disease marks the nation’s worst outbreak of West Nile in a year that has already logged a record number of cases across the country. The virus has become endemic in the United States since the first outbreak in 1999.

An official with the federal Centers for Disease Control and Prevention said the Dallas-area outbreak was probably a harbinger of a larger spread of the virus into other parts of the country. In Cook County, Ill., which includes Chicago, human cases of infection rose steadily this week, from 5 on Monday to 8 on Wednesday to 10 on Thursday, though no deaths had been reported, the authorities said.

Texas officials say the statewide death toll so far is 17, the most West Nile-related fatalities of any state.

In a report, the C.D.C. said that as of Tuesday, 693 cases of infection had been reported nationwide. Louisiana had six deaths, according to the report, and no other state had more than one.

“With this huge outbreak in Texas, the jury is still out on what’s going to happen with the rest of the country,” said the official, Dr. Lyle R. Petersen, director of the C.D.C.’s Division of Vector-borne Infectious Diseases. “But in Chicago, we’ve already observed high numbers of West Nile virus-infected mosquitoes. This is looking like a large regional event. We don’t know if the number of cases is going to drastically increase, but we do expect more cases.”

And yet, as local and state officials have stepped up their efforts to fight West Nile in the Dallas area, there has been a kind of backlash, with many residents growing more concerned about the aerial spraying than the virus itself.

More than 1,700 people signed an online petition on Change.org calling on Dallas officials to stop the spraying, describing it as ineffective, unsafe and harmful to insects like honeybees and ladybugs. A number of other cities in Texas and around the country do aerial spraying to reduce their mosquito populations — including New York, which recently sprayed over uninhabited wetlands on Staten Island — but this is the first time Dallas is doing so in more than 45 years.

Though officials in Dallas describe the procedure as safe and effective, they have added to some residents’ worries by advising those concerned about exposure to avoid being outside, close their windows and keep their pets inside while spraying occurs. “I think residents need to take the precautions that they’re comfortable with,” said Frank Librio, a city spokesman.

The aerial spraying was to begin Thursday at 10 p.m. in a 106,000-acre section of the city and county, including the wealthy areas of University Park and Highland Park. Twin-engine planes flying about 300 feet above the ground will spread a pesticide called Duet to kill the adult mosquito population.

Duet has been approved by the federal Environmental Protection Agency for ground and aerial use in outdoor residential and recreational areas, and it is similar to the pesticide the city has been using as part of a truck-mounted spraying operation it began in June. The last time Dallas conducted aerial spraying was in the summer of 1966, to combat an outbreak of St. Louis encephalitis, a mosquito-borne infection. That outbreak killed 14 people in the county.

The spraying operation this time is being led — and paid for — by the state. More than half of the human cases of infection in the United States this year are in Texas, which has confirmed more than 400 cases statewide.

More planes are scheduled to spray Friday night and possibly over the weekend. “The disease poses an immediate public health threat to Dallas County,” Dr. David Lakey, the commissioner of the Texas Department of State Health Services, said in a statement. “We need to use all possible tools, including aerial spraying, to fight this outbreak.”

Five of the 10 deaths in the county occurred in Dallas, the third-largest city in Texas, with a population of 1.2 million. Mayor Michael S. Rawlings declared the state of emergency on Wednesday, one week after officials issued a similar declaration for Dallas County. Dallas officials have asked the state to spray the entire city.

Dr. Petersen with the C.D.C. said it was difficult to say why the Dallas area has had such a severe outbreak, but he said that the early spring and the hot summer were likely culprits, because heat affects factors like mosquito abundance. Hot weather both increases the mosquito population and causes more of the virus to build up in their salivary glands.

“That summer in New York City when it was discovered in this country — 1999 — was a very hot summer,” Dr. Petersen said. “In 2002, 2003, when it was all over the U.S., it was abnormally hot. We had an early spring and abnormally hot weather this year, so that could be a factor.”

A spokeswoman for the New York City health department, Alexandra Waldhorn, said the city had only 3 cases so far, with only 11 in all of last season.

At 10:16 p.m. in University Park, a low-flying plane with two misty trails streaming behind it flew over James Smith, 41, who stood with his girlfriend on a shop-lined street near Southern Methodist University. He had no reservations about being outside.

“I think whatever the risk may be, if there’s any, it’s outweighed by the risk of the mosquitoes that are infecting people,” he said. “There’s a lot of things out there that can kill you. I don’t think this is one of them.”

Manny Fernandez reported from Dallas, and Donald G. McNeil Jr. from New York.

This article has been revised to reflect the following correction:

Correction: August 17, 2012

An earlier version of this story referred imprecisely to mosquito-control efforts on Staten Island. The city sprayed in some uninhabited wetlands, not in residential areas

http://www.nytimes.com/2012/08/17/us/west-nile-virus-hits-hard-in-dallas-area-and-is-seen-spreading.html?_r=1&pagewanted=print

Rhode Island Lawmakers Push Lyme Disease Strategy

In Lyme Disease, Uncategorized on July 21, 2012 at 5:08 pm

July 15, 2012

PROVIDENCE, R.I. (AP) —

A group of lawmakers is pushing for a national strategy to combat

Lyme disease aimed at speeding advances in diagnosis, treatment and prevention of the sometimes serious illness that infects tens of thousands of people every year.

“The tick problem is growing. The Lyme disease problem is growing,” said Sen. Jack Reed, D-R.I., a cosponsor of the bill in the U.S. Senate. “This requires resources.”

The legislation provides for the establishment of an advisory committee made up of researchers, patient advocates and agencies, as well as the coordination of support for developing better diagnostic tests, surveillance, research and other efforts.

“The key with the bill is to get everyone in the room, get all of the best available science and then aggressively attack this hideous disease that has ruined so many lives,” said Rep. Chris Smith, R-N.J., the sponsor in the House who has pushed similar legislation in the past.

Reed and Sen. Richard Blumenthal, D-Conn., who introduced the Senate bill, said they hope to pass a bill this year.

“It is essentially designed to create awareness and understanding in public healt

h agencies about the urgent and immediate need to act more effectively against a disease that truly has reached epidemic proportions,” Blumenthal said.

Lyme disease is the sixth most common reportable disease in the United States, and the second highest (behind chlamydia) in the Northeast, said Dr. Ben Beard, director of vector-borne diseases at the federal Centers for Disease Control and Prevention.

In recent years, Lyme disease cases have increased around the country. Some of that may reflect improved testing and reporting, Beard said. But he said researchers also believe there has been a real growth in cases, possibly because of more deer and the spread of suburbia into previously uninhabited places.

This year, 8,400 cases have already been reported, the CDC said. Lyme experts believe the number of actual cases is likely larger, in part because tests for the disease are unreliable.

Lyme disease is named after Lyme, Conn., where the illness was first discovered in 1975. It’s transmitted through t

he bites of infected deer ticks, which are about the size of a poppy seed. Those infected often develop a fever, headache and fatigue, and sometimes a tell-tale rash that looks like a bull’s eye centered on the tick bite. Most people recover with antibiotics, although some symptoms can persist. If left untreated, the infection can cause arthritis or spread to the heart and nervous system.

Treatment can be tricky, especially in cases that aren’t caught early.

Reed said the bill would ultimately result in more federal money aimed at Lyme disease, welcomed news to Thomas Mather, a professor and director of the University of Rhode Island’s Center for Vector-Borne Disease, which runs the TickEncounter Resource Center.

A grant from the U.S. Department of Agriculture in 2006 helped start his program, which works to reduce tick-borne illnesses including

Lyme disease. Mather said it’s difficult to get the money he needs to keep the work going, and he hopes enacting a federal strategy will make that easier.

“We’re really looking for ways to sustain these activities,” he said. “Mostly what’s needed are more resources.”

The Infectious Diseases Society of America, an influential doctor’s group that sets guidelines for treatment of Lyme disease, has opposed similar legislation in the past. In 2009, it raised concerns about whether such a panel might be slanted and not adequately represent the views of the scientific community.

It has not yet taken a position on the pending legislation.

If the legislation passes, Lyme disease would be the latest in a string of diseases to be targeted with a national strategy, the most recent being Alzheimer’s disease.

Smith has scheduled a Congressional subcommittee hearing on Tuesday about challenges in diagnosing and managing Lyme disease.

http://www.eagletribune.com/local/x1301512142/Rhode-Island-lawmakers-push-national-lyme-disease-strategy

Diagnostic Test Approved for Dengue

In Dengue Fever, Malaria, Uncategorized on June 25, 2012 at 3:06 pm
June 21 2012

The Centers for Disease Control and Prevention (CDC) has received approval from the FDA for a new diagnostic test to detect the presence of dengue virus in people with symptoms of dengue fever or dengue hemorrhagic fever. The test, called the CDC DENV-1-4 Real Time RT PCR Assay, can be performed using equipment and supplies many public health laboratories already use to run  influenza Real-Time PCR assays.

The new test will help diagnose dengue within the first seven days after symptoms of the illness appear, which is when most people are likely to see a health care professional and the dengue virus is likely to be present in their blood. The test can identify all four dengue virus types. It is the first FDA-approved molecular test for dengue that detects evidence of the virus itself.

Dengue is caused by any of the four virus types, which are transmitted by Aedes mosquitoes. Travelers returning from Asia, Latin America, and the Caribbean are most at risk for contracting dengue. Symptoms of dengue include high fever, severe headache, severe pain behind the eyes, joint pain, muscle and bone pain, rash, mild bleeding involving mucous membranes, and easy bruising. There are no FDA-licensed vaccines available for this illness.

Diagnostic kits will be available for distribution beginning July 2, 2012.

For more information call (800) 232-4636 or visit www.cdc.gov/Dengue.

 

http://www.empr.com/diagnostic-test-approved-for-dengue/article/246795/

Long Tick Season in Affected Areas

In Lyme Disease on May 7, 2012 at 8:01 am

 

It could be a long tick season in affected areas; tips for staying safe

May 1, 2012

Shortly after her first child was born, Colleen Safford left Manhattan for a 10-acre spread north of the urban jungle to create a new life for her growing family — a life immersed in the outdoors.

But along with the woods and grassy fields came a drawback of country life in the Northeast: the black-legged tick, which can carry the Lyme disease bacteria.

“I wanted grass stains for my kids instead of cement scrapes,” said Safford, who owns a dog boarding business on her property in Chatham, N.Y., about two hours north of New York City. “I wanted them to have an intense outdoor experience, and Lyme disease came with it. But it’s worth it.”

There were 30,158 cases of confirmed and probable Lyme cases reported in 2010, according to the federal Centers for Disease Control and Prevention, with 94 percent of those cases being reported from 12 states in the Northeast and upper Midwest.

The disease may be spreading, according to a study released in February in the American Journal of Tropical Medicine and Hygiene. It showed a clear risk across much of the Northeast, from Maine to northern Virginia; a high-risk region in the upper Midwest, including parts of Wisconsin, Minnesota and Illinois; and “emerging risk” regions including the Illinois-Indiana border, southwestern Michigan and eastern North Dakota.

The mild winter this year could increase the number of Lyme cases. Adult ticks have been active earlier than usual and people have been getting outside sooner than they typically do, increasing the exposure season, said Paul Curtis, a natural resources professor and tick expert at Cornell University.

Nobody suggests staying indoors this summer. But nature enthusiasts, hikers, gardeners and people who work outside in high-risk areas need to guard against ticks.

“If you’re engaged in outdoor activities and you do regular tick checks, you’ll be able to find them,” said Phillip Baker, executive director of the American Lyme Disease Foundation. “Once they take a meal, they get bigger. If they’re still there the next day and it’s still less than 48 hours, you can pick them off. That gives you a bit of a safety measure.”

Only an infected tick attached to your body for about 36 to 48 hours can make you sick, he said.

Lyme disease causes flu-like symptoms including fever, chills and achy joints, and often a distinctive bull’s-eye rash. Most people recover quickly when treated early with antibiotics, but untreated infections can cause more serious conditions like Bell’s palsy, arthritis and neurological problems.

Besides tick checks, the American Lyme Disease Foundation recommends wearing light-colored, tightly woven clothing to make it easier to see crawling ticks; avoiding sitting directly on the ground or on stone walls; walking in the middle of established trails rather than at the edges; tucking pants into socks, and shirts into pants; and wearing covered shoes.

For sun lovers and others who don’t want to cover up, there are spray repellents that Baker said work “pretty well.”

There also is clothing made with the insect repellent permethrin bonded to the fibers.

Other ways to help prevent Lyme disease, according to the CDC, include bathing after being outside, to help spot ticks or wash of ones that haven’t attached yet; checking outdoor gear and pets for ticks; and running clothing through a hot dryer for an hour to kill any ticks.

In New York’s Columbia County, where Safford lives, Lyme is a part of everyday life.

“People talk about it like you would talk about a common cold up here,” Safford says.

“You just need to be aware that it’s in your environment and err on the side of caution in terms of your checking, but not allow it to hinder or affect your lifestyle.”

Her two older children — Sayer, 5, and Orla, 3 — attend a school where they spend most of the day outside tending to gardens and animals, and the family of five often hikes on weekends. Only Sayer has been treated for Lyme, twice when he was 4.

Boys ages 5 to 10 have the highest number of reported Lyme disease cases, according to federal figures.

Safford says she uses natural repellents against Lyme and checks her children’s bodies nightly at bath time, removing any ticks that are found. Ticks are especially fond of bodily creases such as armpits, the back of the knee, the groin and the nape of the neck.

“We just say, ‘tick check,’ and they lift up their arms and I look through their scalp and hair,” Safford says. And she and her husband scan each other. “It’s very romantic,” she joked.

___

Online:

CDC Lyme site: http://www.cdc.gov/lyme/

American Lyme Disease Founndation: http://www.aldf.com/

http://wapo.st/ticks2012

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