epidemiology
revere | July 22, 2008The tomatoes-peppers-cilantro-? Salmonella story is starting to break, although which way is hard to say at this moment. Beginning about 3 pm yesterday afternoon newswire stories began to report that the FDA had found a single jalapeno pepper in a small distribution center in McAllen, Texas, contaminated with the same uncommon Salmonella serovar (S. stpaul) implicated in a large outbreak that has infected over 1200 people in 43 states. This is the first time any food item has turned up positive for this Salmonella strain in the 14 weeks federal and state authorities have been trying to nail…
revere | July 21, 2008Lots of bloggers follow HIV/AIDS, although we haven't. Maybe because it's no longer an automatic death sentence, it has fallen off the public radar screen, but not because it isn't a huge public health problem. Just how big a problem seems to be a matter of some sensitivity for the Bush administration:
Since the fall of last year, rumors have been circulating that the Centers for Disease Control and Prevention (CDC) will release revised statistics indicating that the number of people with new HIV infections living with HIV in the United States is actually higher than previously reported. Some…
revere | July 9, 2008While CDC and FDA struggle to figure out where the Salmonella saintpaul in a large multistate outbreak is coming from they are not being forthcoming about where it has gone. We know the case total but not much about who is getting sick, where and when. There is no good scientific or privacy reason not to release more information. It's just the usual tendency to keep control. But some of the information is "out there" anyway, in news reports and other sources of information. People interested in disease outbreaks discovered years ago that this information could be harvested and disseminated to…
revere | July 8, 2008The FDA and CDC still don't know the origin of the massive Salmonella outbreak, now extending to 40 states. They have lots of reasons, and under current conditions it's not an easy problem since the production channels for things like tomatoes are labyrinthine. There's lots of mixing, matching, diverting, and who knows what else going on as a tomato goes from a farm or hothouse to your table or local salad bar. We know this because FDA and CDC have been telling us so as explanation for why they still don't know where a single clone of Salmnella saintpaul has managed to infect almost 1000…
revere | July 1, 2008As the tomato Salmonella outbreak heads past the 800 case level, it's time to ask some questions about why we don't know the source of what is the largest produce associated disease outbreak on record. CDC has its own explanation, namely, that figuring out where tomatoes come from and where they go is much harder than they thought. Said another way, the experts in foodborne disease outbreaks at CDC and FDA didn't know much about the industry. Since tomatoes have been a frequent cause of Salmonella outbreaks, that seems odd, except that my experience with CDC in recent years is that it is full…
revere | June 30, 2008We started blogging on public health at the beginning of the 2004 - 2005 flu season, although we didn't concentrate on flu immediately. We intended to use the public health problem of influenza, a disease that contributes to the death of almost 40,000 US citizens a year, as a lens through which to look at public health. The interest in bird flu and pandemic flu followed naturally. The intervening years saw seasonal influenza outbreaks that were milder than previous years, but this resourceful virus made a comeback in the flu season just concluded. CDC has just summarized the 2007 - 2008 flu…
revere | June 7, 2008Like most public health scientists I am fascinated by the complicated relationship between the environment and disease. You build a military base somewhere and sexually transmitted diseases follow. You build a dam in Egypt and urinary schistosomiasis, a chronic debilitating disease that also predisposes to bladder cancer, entrenches itself in an area because infected workers are attracted from far away endemic areas. They work and often urinate in the water, seeding the shallows of rivers and lakes with schistosome eggs. When the eggs get into the snails, they germinate, the schistosome…
revere | June 4, 2008What do the US states of Texas, New Mexico, Arizona, Utah, Colorado, Kansas, Idaho, Illinois and Indiana have in common? They are locations of reported illnesses from Salmonella Saintpaul infections, forty in Texas and New Mexico alone, with 17 hospitalizations. Thirty more cases have been reported in the other seven states. The cases are connected by being genetically identical. S. saintpaul is a less common cause of human infection than other non typhoid Salmonella strains and the bugs isolated from these cases are said to be identical. This makes a common source the only reasonable…
revere | May 19, 2008It seems with every terrible natural disaster we have to say the same thing. Dead bodies aren't a public health risk:
Contrary to popular belief, dead bodies left from natural disasters such as the China earthquake and Myanmar cyclone are not a source of disease or a health threat to survivors, the World Health Organization said Friday.
[snip]
"There is a widespread and erroneous belief that dead bodies are a source of disease and therefore a threat to public health. This is untrue," [Arturo Pesigan, WHO's Western Pacific Region's headquarters in Manila] said.
"There has never been a…
revere | May 18, 2008Almost all stories in the news about H5N1 (bird flu) have some obligatory line in them, "It is believed that all or almost all human cases come from contact with infected poultry." This is like a mantra of many public health officials and I suspect some reporters have the requisite disclaimer as a cut and paste text they mechanically insert into their stories. But it isn't true. There are an awful lot of human cases for which no poultry source has ever been located and we have yet another example in the latest Indonesia cases:
The city's husbandry, fishery and maritime agency said Friday it…
grrlscientist | April 13, 2008tags: hamster, PetSmart, lawsuit, lymphocytic choriomeningitis virus, LCMV, zoonosis
Portrait of a murderer:
A Siberian dwarf hamster, Phodopus sungorus.
Orphaned image.
I just learned that a lawsuit was recently filed in Massachusetts Superior Court on behalf of a man who died one month after receiving a transplanted liver that was later determined to be infected with lymphocytic choriomeningitis virus (LCMV). Apparently, the organ donor purchased a pet hamster from a PetSmart in Warwick, Rhode Island, and this hamster was later shown to be infected with this deadly virus.
LCMV is…
revere | March 9, 2008
(Source unknown)
It's a lousy disease, but Radio New Zealand's headline has to be one of the more amusing headlines I've seen in ages: "Listeria sandwiches on sale at hospital cafe":
Listeria has been found in packaged sandwiches sold by a cafe at Middlemore Hospital, Auckland.
Food contractors to Counties Manukau District Health Board, Spotless Services, informed the DHB of the situation on Friday.
The contamination was found in Naturezone Thai chicken sandwiches, sold by the Aviary Cafe on Monday, 3 March. (Radio New Zealand)
So what's this Listeria stuff about, anyway? This material is…
revere | March 3, 2008Highly pathogenic variant of avian influenza A of the subtype H5N1 is here to stay, at least in the world's poultry population. While it's around it continues to cause sporadic but deadly human infections, some 369 of them of whom 234 have died (official WHO figures as of 28 February 2008). So this virus can infect humans and make them seriously or fatally ill. There is truly massive exposure because people live in close contact with infected domestic poultry in many countries. And the human population has not seen this subtype of virus before so there is little natural immunity. All that's…
revere | February 27, 2008Chromium is OK when it's on your car bumper but not so OK when it's in your workplace air or your drinking water. That's because chromium, in some of its forms, causes cancer. In fact it is a remarkably good carcinogen. A few years, ago both epidemiological studies and risk estimates done by the US Environmental Protection Agency (EPA) suggested the lifetime risk of dying of lung cancer for workers exposed at the then workplace limits as about 25%. This is higher than for heavy cigarette smokers. The US Occupational Safety and Health Administration (OSHA) lowered the workplace standard by a…
revere | February 26, 2008As I write this I am at 30,000 feet winging my way to Montreal, Canada, where the temperature is below freezing. So what more appropriate topic than microbial hazards of bathing beaches? Maybe it was my foray into the wonderful world of fecal accidents that prompted me to look further into the subject but I found a couple of papers from last year by a groups at Johns Hopkins about the effect of bather density on levels of parasites pathogenic for humans at one particular beach in Maryland, the Hammerman area of Gunpowder Falls State Park in Chase, Maryland in mid to late summer of 2006 (here…
revere | February 21, 2008A notice from ProMed yesterday alerted many of us to a new published report [subscription firewall] about H5N1 influenza detection in an arthropod species in the vicinity of an infected poultry farm. The arthropods were mosquitoes (Culex tritaeniorhynchus) in Thailand. Two years ago a similar report implicated blowflies (Calliphora nigribarbis and Aldrichina grahami) near some infected farms in Kyoto, Japan. Both papers suggested using arthropods near infected farms as surveillance tools. But both, especially the Japanese paper, raised the open question whether arthropods might play a part in…
revere | February 19, 2008There's bird flu in poultry all over Bangladesh and new human cases reported in China, Vietnam and Indonesia. Is this the sound of the other shoe dropping? Or is it just this:
This barchart is from February 5 so it doesn't include all the new cases. But it clearly shows that when we get to flu season we also get to bird flu season. How will we know if something different is happening? It's a good question and I don't have an easy answer. Here are four signals and what I would make of them.
Sudden increase in number of cases that are not connected or are connected by a common source (as…
revere | February 17, 2008When my colleagues announced early afternoon on Friday he was headed home because he was sick, I knew the flu had finally arrived on my doorstep. It was already here, of course. The emergency rooms are jammed, clinics have long waits and hospital admissions for flu are up -- way up. The flu situation was the page one column eight story in Saturday's Boston Globe:
The flu virus is rampaging across New England, spawning waves of coughs and fevers, causing patients to flood doctors' offices, and raising questions about the effectiveness of flu shots given to tens of millions of Americans.
During…
revere | February 1, 2008I'm an environmental epidemiologist with a special interest in surveillance. So it would be nice to say that epidemiological investigations and surveillance systems were responsible for discovering most of the workplace diseases we see nowadays. But the simple truth seems to be that most environmental and occupational diseases are still discovered the old fashioned way: by astute clinicians, workers or family members. Such was the case for the recent cluster of cases of a progressive neurologic syndrome among slaughterhouse workers we posted on a while back. The Minnesota Department of Health…
grrlscientist | January 31, 2008tags: bats, little brown bats, Indiana bats, white nose syndrome, cavers, Alan Hicks
Hibernating bats suffering from the mysterious "White Nose Syndrome" (arrows).
Image: Alan Hicks, NYS Department of Environmental Conservation [larger view]
If you live in New York or Vermont, then you might have heard about the mystery disease that is killing tens of thousands of bats hibernating in caves and mines throughout these two states. The disease has been given the descriptive appellation, "white nose syndrome" because its most obvious symptom (besides death), is the peculiar ring of white fungus…