Monday, June 18, 2018

PRO/AH/EDR> Japanese encephalitis & other - India (08): (AS)

JAPANESE ENCEPHALITIS AND OTHER - INDIA (08): (ASSAM)
*****************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 19 Jun 2018
Source: The Telegraph [edited]
<https://www.telegraphindia.com/states/north-east/60-aes-cases-undetected-238656>


The etiologies for at least 60 percent of acute encephalitis syndrome
(AES) cases in Assam are still undiagnosed, according to an ongoing
research project.

According to an expert involved with the project, around 30 percent of
AES cases are likely to be those suffering from Japanese encephalitis
(JE).

Nearly 178 people, of the 2077 diagnosed with AES in Assam in 2017,
died.

Assam has reported 60 AES cases this year till 30 Apr [2018] but no
casualties so far.

The project was started in 2016 in collaboration with US-based Centers
for Disease Control and Prevention (CDC) so that AES cases can be
treated or diagnosed effectively. "We are trying to diagnose AES cases
with the help of this project at Gauhati Medical College Hospital and
Assam Medical College Hospital [AMCH]," the expert said.

The main symptoms of AES are acute onset of fever, confusion,
disorientation, inability to talk and seizures. Other clinical
symptoms may include an increase in irritability, somnolence or
abnormal behaviour.

After the 1st outbreak of encephalitis in Assam in 1978, virus
isolation from brain tissue was done at AMCH in Dibrugarh. It was only
in the early '80s that health experts learnt about JE.

A pilot project on JE diagnosis was carried out at a primary health
centre at Gogamukh in Lakhimpur in the late '80s.

"In 2008, we took up the JE/immunoglobulin (IgM) diagnostic programme
when IgM diagnosis and testing facilities became available. Under the
ongoing project, all AES cases need to be reported and studied. We
need to strengthen our AES surveillance system," the expert said.

Blood samples of some undiagnosed AES cases in 2017 were sent to
Atlanta-based CDC for 3rd generation genome testing to find the
presence of unknown virus. The genome testing is part of an ongoing
project on AES between CDC, Nimhans, Bangalore, and the Assam
government.

"These are blood samples which have not yet been diagnosed for any
disease. The samples will need further exploration," the expert said.

[Byline: Gaurav Das]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The number of AES cases are increasing, with cases in Assam from 30
Apr [2018]. As is often the case, a minority of AES cases are due to
JEV infections. The etiology of AES has been unclear but debated in
the past decade.

A recent publication of investigations conducted during the 2014 and
2015 AES outbreaks indicated that scrub typhus, caused by _Orientia
tsutsugamushi_, was the etiology in about 60 percent of those AES
cases. In the report above, there is no mention of scrub typhus.

As noted in many earlier posts, the determination of the etiology or
etiologies of AES has been confusing and elusive. Various etiological
agents have been proposed in recent years as responsible for AES
cases. AES has continued to be attributed to a variety of etiologies,
including Reye syndrome-like disease, possible enterovirus infection
from polluted water, heat stroke, lychee fruit consumption and scrub
typhus (_O. tsutsugamushi_). One hopes that the prospective studies on
collaboration with the USA CDC as the season for occurrence of
encephalitis cases in children progresses will provide additional
information about the etiology of AES. The JE and AES season is now
underway in northeastern India, and many cases of encephalitis in
children are likely to occur again this year (2018).

Maps of India can be accessed at
<http://www.mapsofindia.com/maps/india/india-political-map.htm> and
<http://healthmap.org/promed/p/299>; an Assam district map at can be
accessed at
<https://www.mapsofindia.com/maps/assam/assam-district.htm>. - Mod.TY

Maps of India can be accessed at
<http://www.mapsofindia.com/maps/india/india-political-map.htm> and
<http://healthmap.org/promed/p/309>.]

[See Also:
Japanese encephalitis & other - India (07): (MP)
http://promedmail.org/post/20180614.5855342
Japanese encephalitis & other- India (06): (HP)
Japanese encephalitis & other - India (05): (KL)
http://promedmail.org/post/20180605.5840545
Japanese encephalitis & other - India (04): (KL)
http://promedmail.org/post/20180530.5827153
Japanese encephalitis & other - India (03): (AS)
http://promedmail.org/post/20180523.5812921
Japanese encephalitis & other - India (02): (UP), typhus
http://promedmail.org/post/20180416.5749050
Japanese encephalitis & other - India: (KA, UP)
http://promedmail.org/post/20180110.5550774]
.................................................ty/msp/mpp
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Posted on 6/18/2018 07:47:00 PM | Categories:

PRO/AH/EDR> Japanese encephalitis - Taiwan (04)

JAPANESE ENCEPHALITIS - TAIWAN (04)
***********************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sun 17 Jun 2018
Source: Outbreak News Today [edited]
<http://outbreaknewstoday.com/japanese-encephalitis-cases-rise-dozen-taiwan-13519/>


In a follow-up on the Japanese encephalitis situation in Taiwan, the
Taiwan Centers for Disease Control (Taiwan CDC) announced 7 new
Japanese encephalitis cases confirmed in Taiwan last week.

The new cases include one each in Daya District, Taichung City, Xizhou
Township, Changhua County, Puzi City, Chiayi County, District, Guiren
District, Tainan City, Fengshan District, Kaohsiung City, Xiaogang
District, Kaohsiung City, and Linyuan District, Kaohsiung City.

The 7 new cases age between 17 and 70, and their onset dates vary
between 19 May [2018] - 5 Jun [2018]. During the period of
communicability [acute infection; JE virus is not communicable between
humans, nor do infected humans provide infectious blood meals for
mosquitoes because their viremias are too low. - Mod. TY], they
developed symptoms such as fever, headache, and consciousness
disturbance. As of now, 3 cases are hospitalized in the intensive care
unit for treatment, 2 cases are hospitalized in the general ward in
stable condition, and 2 cases have been discharged.

According to the epidemiological investigation, all 7 cases either
live or work near a high risk environment where there are pigpens,
pigeon farms, rice paddy fields or irrigation canals.

Thus far this year [2018], as of 12 Jun 2018, a total of 12 Japanese
encephalitis cases, including 6 in Kaohsiung City, 2 in Chiayi County,
1 in Pingtung County, 1 in Tainan City, 1 in Changhua County, and 1 in
Taichung City, have been confirmed in Taiwan. All 12 cases live in or
work near a high risk environment where there are vector breeding
sites nearby.

As the Japanese encephalitis season (May-October) has arrived, Taiwan
CDC advises people who frequent mosquito-prone areas such as pig farms
and rice paddy fields to take precautions against mosquito bites and
ensure age-appropriate children receive Japanese encephalitis
vaccination in a timely manner in order to ward off infection.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The occurrence of new Japanese encephalitis (JE) cases in Taiwan at
this time is not surprising. Japanese encephalitis virus (JEV)
transmission is now underway in Taiwan, as indicated with the 7 new
cases last week, as mentioned above. We expect cases to occur
sporadically until the transmission season ends in October 2018. The
mosquito species, _Culex tritaeniorhynchus_, is an efficient vector of
JEV and breeds in wet areas such as rice paddies. These _Culex_
mosquitoes are abundant enough there to accomplish transmission of the
virus from birds and swine to people. Vector control is difficult.

Japanese encephalitis is a vaccine-preventable disease; the affected
individuals above probably had not been vaccinated. The advice to
ensure that children are vaccinated is prudent. The only measures to
prevent infection are vaccination and avoidance of mosquito bites.

A HealthMap/ProMED-mail map of Taiwan can be accessed at
<http://healthmap.org/promed/p/3962> and of Kaohsiung City, Taiwan at
<http://healthmap.org/promed/p/50952>. - Mod.TY]

[See Also:
Japanese encephalitis - Taiwan (03)
http://promedmail.org/post/20180606.5841306
Japanese encephalitis - Taiwan (02): (KH)
http://promedmail.org/post/20180528.5823701
Japanese encephalitis - Taiwan
http://promedmail.org/post/20180522.5810345
2017
---
Japanese encephalitis - Taiwan (04): (CH)
http://promedmail.org/post/20170717.5180560
Japanese encephalitis - Taiwan (03): (NT)
http://promedmail.org/post/20170625.5129405
Japanese encephalitis - Taiwan (02): (PT)
http://promedmail.org/post/20170621.5120084
Japanese encephalitis - Taiwan
http://promedmail.org/post/20170609.5095000
2016
---
Japanese encephalitis - Taiwan: (TN)
http://promedmail.org/post/20160618.4295919
2015
---
Japanese encephalitis - Taiwan (02)
http://promedmail.org/post/20150712.3505746
Japanese encephalitis - Taiwan
http://promedmail.org/post/20150709.3495985
2014
---
Japanese encephalitis - Taiwan (03)
http://promedmail.org/post/20141108.2938576
Japanese encephalitis - Taiwan (02)
http://promedmail.org/post/20140712.2604214]
.................................................ty/msp/mpp
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and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
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or archived material.
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Posted on 6/18/2018 07:40:00 PM | Categories:

PRO/AH/EDR> Ebola virus disease: challenges for wild animal meat trade

EBOLA VIRUS DISEASE: CHALLENGES FOR WILD ANIMAL MEAT TRADE
**********************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sun 17 Jun 2018 7:02 AM EDT
Source: CTV News, Associated Press (AP) report [edited]
<https://www.ctvnews.ca/health/congo-s-ebola-outbreak-poses-challenges-for-bush-meat-1.3977007>


For 25 years, [PM] has earned a living buying and selling monkeys,
bats, and other animals popularly known as bush meat along the Congo
River. Standing on the riverbank in Mbandaka, a city affected by the
deadly new outbreak of the Ebola virus, the father of 5 said that for
the 1st time he's worried he won't be able to support his family.

"Since Ebola was declared, business has decreased by almost half. It's
really, really bad," the 47-year-old said, hanging his head.

Congo's latest Ebola outbreak declared in May [2018] has 38 confirmed
cases, including 14 deaths. The discovery of a handful of Ebola cases
among Mbandaka's more than 1 million residents also has hurt the
economy, especially among traders of meat from wild animals.

The virus, which spreads through bodily fluids of those infected, has
been known to jump from animals such as monkeys and bats to humans. In
the West Africa outbreak 4 years ago that killed more than 11 000
people, it was widely suspected that the epidemic began when a
2-year-old boy in Guinea was infected by a bat.

Usually the wild animals are highly sought-after as popular sources of
protein along with beef and pork, and cargo ships carrying the smoked
meat arrive daily in the city, the trade hub for Congo's northwestern
Equateur province. Meanwhile, bush meat markets still see locals
bartering for the animals, both dead and alive. Prospective buyers
pause at tables piled with monkey meat, picking up blackened chunks
one by one for a closer look.

"Meat is very important for people here. It's one of the biggest
industries in Mbandaka," said Matondo, a leader in the city's bush
meat association.

Dr Pierre Rollin, an Ebola expert with the US Centers for Disease
Control and Prevention, said if the meat is cooked, smoked, or dried
it kills the virus. The people at greatest risk are hunters and
butchers who process the meat, he said.

The World Health Organization has advised against trade and travel
restrictions because of the current outbreak, which is mostly in
remote areas.

Boats with bush meat continue to depart for the capital, Kinshasa, 600
kilometres (323 miles) downstream and for villages tucked deep in the
rainforest up and down the river. Disease experts warned, however,
that precautions are still necessary as monkeys and bats are sold live
throughout the region.

Traders said demand has dwindled because of Ebola, with sales for many
dropping from about 100 animals a day to about 20.

"Kinshasa and Brazzaville told us to stop sending monkeys and bats,"
said another trader in Mbandaka, [WT], who said his business has been
cut in half in recent weeks. He was referring to buyers in the capital
of the nearby Republic of Congo, which is across the river from
Kinshasa.

Congo's health minister, Dr Oly Ilunga Kalenga, said there are no
plans to ban sales of bush meat in the province since bush meat is not
the primary way the Ebola virus spreads. Instead, the government is
focusing on good hygiene practices such as hand-washing, he said.

Health officials are also tracking down anyone who had close contact
with anyone infected by the virus, offering an experimental vaccine
and promoting safe burials and other practices. Such health efforts
can be challenging in communities where many people consider Ebola to
be witchcraft. Others are skeptical that the disease exists, even
though this is the Central African country's ninth outbreak.

One Mbandaka trader, [GL], said he's still shipping 100 wild animals
to Kinshasa daily and said he won't stop eating them as they're his
main source of food. "I don't see Ebola. It isn't here," he said.

In West Africa, where there had never been an outbreak before 2014,
getting people to accept that Ebola was a real disease was key, said
WHO's Jonathan Polonsky.

For those in Kinshasa, "Ebola is very far away," said Defede Mbale,
immigration chief at the capital's port of Maluku.

Pointing to a poster of safe Ebola practices on his desk, he said the
government has provided extra resources to patrol the river and take
people's temperatures as they arrive by boats, checking for fevers.

He doesn't doubt the deadly virus exists, but Mbale said there's only
so much that he's willing to change.

"We have our customs and they won't change because of Ebola," he said.
"We'll eat all foods."

[Byline: Sam Mednick]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Wildlife trade as a potential risk for pathogen translocation has
been the focus of a large number of scientific reports and reviews.
Legal and illegal movements of wildlife and wildlife products,
including meat from wild animals ("bushmeat"), are a potential source
of zoonotic diseases.

This article unveils another negative consequence of the emergence of
an infectious disease like Ebola, which is the impact on local
livelihoods and economies. - Mod.PMB]

[One organization exploring alternatives to wild animal meat
("bushmeat") in East Africa, which does not include the DRC but is
nonetheless relevant, discusses its mission in
<http://www.bushmeatnetwork.org/alternatives.html>. "Illegal bushmeat
hunting in Africa is conducted for 2 primary purposes: food and
livelihood. As the numbers of rural households increases over time
..., pressures for limited land and food increase. These pressures are
compounded by climate change, which is predicted to reduce food and
livelihood security over the coming century. One of the impacts will
be increased reliance on natural resources, including wildlife, to
satisfy demand." ...

This report acknowledges the complexity of the problem, and in
response offers such alternatives as developing protein alternatives
to bushmeat that could also serve as a source of sustainable income,
and bringing more fish protein into the local markets to provide
increased revenue through alternative means to hunting.

Conservation experts estimate that 5-6 M tons of wild animal meat are
harvested in the Congo Basin each year. In the absence of a sizeable
domestic meat industry the creation of which would carry its own
environmental consequences -- hunting and trapping provide an
important source of protein and rural food security (National
Geographic).

Further, a report from the Centre for International Forestry Research
(CIFOR) said a blanket ban on hunting would lead to "dire
consequences" for the region's poor, 80 per cent of whom rely on wild
animal meat as their only source of fat or protein. They report that
replacing wild animal meat consumption in the Congo Basin with cattle
would require converting up to 25 million hectares of land into
pastures.

Overall, international trade in wild animal products has an estimated
value of GBP 2 billion (about USD 2.65 billion). CIFOR said European
countries are responsible in driving this demand and also in driving
demand for other resources which indirectly cause an increase in the
need for wild animal meat by relocating families to forest areas for
logging, mining, and drilling.

Robert Nasi (Deputy Director General for Research ) said the
"crackdown" advocated by some conservation organisations has led to
confusion in many communities. Instead he said rules should be
enforced to stop endangered animals being hunted and alternatives
should be provided.

"Only if the local hunter is bestowed with some right to decide what,
where and how he may hunt -- as well as the knowledge to understand
the consequences of his decisions -- will he embrace his
responsibility to hunt sustainably," he said.

(excerpted from
<https://www.telegraph.co.uk/news/worldnews/2963966/Bushmeat-trade-in-Africa-threatens-animal-species.html>)

What is not mentioned in the articles discussed here is risk of
transmission of zoonotic pathogens to hunters of wildlife, which is
really the issue at hand in the origin of recent Ebola outbreaks. The
hunting and butchering of wildlife, as well as transporting of live
animals that may be shedding pathogens is the problem. As Pierre
Rollin of the US CDC stated, it is not the actual eating of cooked
wild animal meat. Public health interventions need to target the
drivers that lead to hunting behavior in order to effect a change in
behavior. That being said, the origin of the current DRC outbreak has
not been confirmed to be due to hunting of wild animal meat, although
that seems highly likely. - Mod.LK

HealthMap/ProMED-mail map of Democratic Republic of the Congo:
<http://healthmap.org/promed/p/44490>]

[See Also:
2012
----
Bushmeat trade - Cameroon (02): comment
http://promedmail.org/post/20120531.1152075
Bushmeat trade - Cameroon: disease transmission risk
http://promedmail.org/post/20120528.1148068
Illegal trade, wildlife - Argentina: reptiles
http://promedmail.org/post/20120104.0023
2010
----
Bluetongue, ruminants: intercontinental trade
http://promedmail.org/post/20100217.0556
2004
----
Illegal trade, beef - Indonesia
http://promedmail.org/post/20040819.229
Bush-meat
trade and risk of disease transmission
http://promedmail.org/post/20040808.2192]
.................................................sb/pmb/mj/mpp
*##########################################################*
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ProMED-mail makes every effort to verify the reports that
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information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
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Posted on 6/18/2018 04:35:00 PM | Categories:

PRO/AH/EDR> Neospora caninum, canine - USA: (NC) parasite

NEOSPORA CANINUM, CANINE - USA: (NORTH CAROLINA) PARASITE
*********************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: 18 Jun 2018
Source: Jacksonville Daily News [edited]
<http://www.jdnews.com/news/20180618/vet-warns-about-fatal-parasite-urges-precaution-for-dog-owners>


A lethal parasite has been discovered in area canines by a local
veterinarian, and its presence is troubling for animal doctors and pet
owners.

Dr. Michelle Cox, veterinarian and founder of Island Pet Veterinarian
Hospital located in Cape Carteret, 1st examined [D] in November 2017,
when the young canine had just celebrated its 2nd birthday. "[D's]
owner came to see me with her 2-year-old dog," Cox recalls. "She was
extremely distraught. Her dog had started to have grand-mal seizures 7
months prior, and they were escalating in duration and frequency."

Though [the] tan, short-haired, lab mix, had been to several other
vets in hopes of finding the cause of the seizures and path to
recovery, nothing seemed to work. "She was a rescue dog we brought
into our family from the local animal shelter," said [the owner] "She
was a loving dog."

In 24 years of practicing veterinary medicine, Cox said seizures in
dogs were pretty straight forward and were usually attributed to
epilepsy, toxins, hypoglycemia, and brain tumors. Recently, though,
Cox has had to tack a different course when confronted with seizure
cases.

"When I saw [D] for the 1st time she seemed like a normal dog. I
reviewed the blood work the other veterinarian had performed, and
there were no abnormal findings," Cox said. "At [her] 1st visit I
changed her seizure medication along with adding a medication to
administer during a seizure to help shorten the length of the seizure
and post-ictal period, the hours following a seizure. After several
days on this medication, [her] condition had deteriorated. [She] had
become disoriented and aggressive, acting completely different than
she ever had before. [She] had always been a loving lap dog who was
now constantly pacing, whimpering, and refusing to acknowledge her
family like she once did."

It was after trying a 3rd type of anticonvulsant medication -- and
seeing no improvement -- that Cox realized [D] was dealing with
something completely different. Cox said she knew she was tracking a
"silent killer" rarely seen or diagnosed in eastern North Carolina.

According to Cox, _Neospora caninum_ is a deadly parasite that lives
in infected cattle, deer, and other deer relatives such as elk and
moose. Dogs, coyotes, gray wolves, and dingoes are definitive hosts.
These animals are capable of shedding oocysts in feces after eating
tissue of infected hosts. _Neospora_ oocysts have an impervious shell
that enables them to survive in soil and water for prolonged periods
after the feces have decomposed. Intermediate hosts, such as cattle,
become infected by ingesting oocysts. Once the dog eats the infected
raw meat, the oocytes burst, and the life cycle of the parasite starts
all over again.

Cox consulted with an internist who agreed and advised her to start
[the dog] on Prednisone and 2 antibiotics and test [her] for
_Neospora_. [She] immediately improved. "She went from seizing
multiple times a week to not having any seizures at all. Her
aggression subsided, and Kori said the pacing and whining stopped,"
Cox said.

Cox was pleased to learn that the medications seemed to be working but
was "very surprised" when [the] _Neospora_ reading came back more than
200, a very strong positive. Cox wondered how [the dog] had contracted
this disease.

Recently in Eastern North Carolina, coyotes have become very
prevalent, and they are hosts for _Neospora_. Cox recalls a
conversation with [the dog's owner] who said she had seen coyotes near
her home in Cape Carteret and had caught [the dog] eating a deer
carcass 2 months prior to the onset of her seizures.

Jodie Owen, public information officer with the N.C. Wildlife
Organization, said coyotes are not only native to North America but
are "found in all 100 counties of North Carolina."

Cox said after [D's] diagnosis of _Neospora caninum_ on 6 Dec 2017,
she lived seizure free for nearly 6 weeks while continuing to take the
medication just long enough to spend Christmas with her family and
play in the snow for the 1st time. On 15 Jan 2018, [the dog]
experienced 8 grand-mal seizures within 2 hours, according to Cox.
[D] never regained full consciousness and she was euthanized. Cox
feels because [the dog] went undiagnosed for 7 months, the parasite
eventually encysted in her brain.

There is no canine vaccine preventing this disease at this time, Cox
said, and the best prevention for your pet is prohibiting them from
eating raw meat. Cox believes hunters should be aware and not leave
carcass in the field if possible, and cattle ranchers and dairy
farmers should take measures to remove deceased cattle and aborted
fetuses from their farms.

Cox is currently treating a 2nd dog who came to her clinic a few weeks
ago presenting different signs than [D].

[R] a 5-year-old pit mix who came in on 21 May 2018, was weak and had
weight loss, according to Cox. [R's] initial test for_ Neospora_ came
back "suspect" and will undergo a 2nd test in 2 weeks to get an actual
reading.

"Dogs that are clinically affected and symptomatic usually do not shed
oocysts in their feces. It is very rare to find this parasite in
routine fecal exams. A blood test performed by your veterinarian is
the best way to diagnose this disease. Early detection is paramount
for full recovery," Cox said.

[Byline: Mike McHugh]

--
Communicated by:
Kathryn Smith
<landsharkinnc@suddenlink.net>

[What a very sad case. The outcome of such cases is not always what we
wish it would be.

_Neospora_ infections in cattle may be more well known than those
affecting our canine companions.

_Neospora caninum_ is a microscopic protozoan parasite with worldwide
distribution. Many domestic (e.g. dogs, cattle, sheep, goats, water
buffalo, horses, chickens) and wild and captive animals (e.g. deer,
rhinoceros, rodents, rabbits, coyotes, wolves, foxes) can be infected.
Neosporosis is one of the most common causes of bovine abortion,
especially in intensively farmed cows. Neosporosis abortion also
occurs in sheep, goats, water buffalo, and camelids, although they may
be less susceptible than cattle.

A 2nd _Neospora_ species, _N. hughesi_, is a cause of myelitis in
horses and shares clinical features with equine protozoal myelitis,
which in North and South America is usually caused by _Sarcocystis
neurona_. The life cycle of _N. hughesi_ is unknown. Discussion in
this chapter deals only with _N. caninum_ infection.

In cattle, _N. caninum_ can be transmitted transplacentally from an
infected cow to the developing fetus, an event that may occur in
multiple pregnancies of the same cow. Because most congenital
infections are subclinical, congenitally infected heifer calves may be
retained and added to the breeding herd and, in turn, may pass
infections transplacentally to their own offspring. This endogenous
transplacental transmission may enable transgenerational maintenance
of the parasite even if the herd does not have frequent transmission
from dogs. Exogenous transplacental transmission may occur when a
previously uninfected cow ingests _Neospora_ oocysts during pregnancy
and the fetus becomes infected.

Dogs have been shown to become infected by eating infected cattle
(including placentas) and deer and are presumed to become infected by
consuming raw meat diets, barnyard chickens, and a variety of wild
animals.

Most neosporosis abortions occur in mid to late gestation.
Congenitally infected calves may be born weak or with neurologic
deficits. However, most congenital infections are subclinical.

In dogs, subclinical infection is the rule, although there are a
greater variety of exceptions. Litters or individual puppies may
develop progressive hindlimb paresis associated with
polyradiculoneuritis, myositis, and muscle atrophy. Adult dogs may
have encephalomyelitis, focal cutaneous nodules or ulcers, pneumonia,
peritonitis, hepatitis, or myocarditis with use of immunosuppressive
drugs.

Clinically affected dogs often have _Neospora_ antibody levels much
higher than levels seen in subclinically infected individuals. Biopsy
of clinically affected tissues demonstrates nonsuppurative
inflammation and may reveal the presence of protozoal organisms, but
immunohistochemistry or PCR [polymerase chain reaction] may be
required to detect the organisms or to differentiate them from other
protozoa.

Dogs with symptomatic neosporosis usually do not shed oocysts in
feces. The finding of _Neospora_ in routine fecal floats is
serendipitous, because dogs typically shed oocysts for only a period
of days or weeks after ingesting tissue of an infected animal. The
tiny oocysts are round to slightly oval and 10-11 microns in diameter;
in comparison, _Giardia_ cysts are oblong and approximately 9-13
microns, and coccidia are 2-4 times the diameter of Neospora. A smooth
outer contour helps to differentiate _Neospora_ oocysts from pitted
pollen grains of similar size. The oocysts are nearly identical to
those of _Hammondia heydorni_, a closely related parasite that has not
been associated with systemic disease in dogs or with abortion in
ruminants. PCR may be necessary to distinguish between oocysts of _N
caninum_ and _H heydorni_.

There is no approved treatment for neosporosis in cattle. Clinical
neosporosis in dogs is treated with prolonged administration of
clindamycin or potentiated sulfa drugs. The prognosis is negatively
associated with the severity of presenting clinical signs and with
delayed treatment. The prognosis is poor in puppies if disease has
progressed to hindlimb paresis with atrophied, rigid limbs.

Currently, there are no available _Neospora_ vaccines for cattle or
dogs.

In cattle it is impractical to test for this agent, but knowledge is
power and therefore, knowing how to prevent the disease is critical.
Knowing what to watch for and inform your veterinarian about may also
provide valuable clues to the detective work the veterinarian must
do.

Certainly, a take-away-message is to not feed your dog raw meat and
prevent your animal from consuming placenta of other animals. To
reiterate: Dogs have been shown to become infected by eating infected
cattle (including placentas) and deer and are presumed to become
infected by consuming raw meat diets, barnyard chickens, and a variety
of wild animals.

Portions of this comment were extracted from:
<https://www.merckvetmanual.com/generalized-conditions/neosporosis/overview-of-neosporosis>.
- Mod.TG

HealthMap/ProMED-mail map:
North Carolina, United States: <http://healthmap.org/promed/p/235>]

[See Also:
2015
----
Neospora caninum, canine: progressive neuron disease, comment
http://promedmail.org/post/20150405.3278517
Neospora caninum, bovine - UK: prevention, control
http://promedmail.org/post/20150402.3268975
2012
----
Neospora caninum, bovine - UK: (England)
http://promedmail.org/post/20120830.1273827
2001
----
Neospora, cattle: significance
http://promedmail.org/post/20010302.0419
Neospora, cattle - USA (Texas) (02)
http://promedmail.org/post/20010227.0384
Neospora, cattle - USA (Texas)
http://promedmail.org/post/20010225.0369
1998
----
Neospora caninum, dogs are definitive hosts
http://promedmail.org/post/19981104.2149]
.................................................tg/msp/mpp
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Posted on 6/18/2018 04:34:00 PM | Categories:

PRO/AH/EDR> Ebola Update (38): DR Congo, cases, WHO, Oxfam

EBOLA UPDATE (38): DEMOCRATIC REPUBLIC OF CONGO, CASES, WHO, OXFAM
******************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update
[1] Case update
- Epidemiological situation 16 Jun 2018, DRC Ministry of Health
- Weekly bulletin on outbreaks and other emergencies week 24 [9 - 15
Jun], WHO Africa
[2] Oxfam - distribution of food

******
[1] Case update
- 17 Jun 2018. Epidemiological situation. Democratic Republic of
Congo, Ministry of Health
<https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=febbe78b5f>
[in French, machine trans., edited]

The epidemiological situation of the Ebola virus disease dated 16 Jun
2018

- A total of 64 cases of haemorrhagic fever were reported in the
region, including 38 confirmed, 14 probable and 12 suspected.
- 6 new suspected cases, including 2 in Bikoro and 4 in Iboko.
- Postponement of 6 former cases of 15 Jun 2018 that were reported
late and could not be included in our bulletin of 16 Jun 2018.
- 5 samples were negative.
- 24 people have been cured of Ebola Virus Disease since the beginning
of the epidemic.
- No deaths reported so far 16 Jun 2018 [28 deaths to date]
- No new cases confirmed [28 reported to date]

Epidemiological analyzes have identified contacts living in nearby
health areas in Bikoro and Iboko. These contacts are followed and
advised to limit their movements during the entire follow-up period of
21 days.

Remarks
Negative tests are systematically removed from the summary table.
The category of probable cases includes all reported deaths for which
it was not possible to obtain biological samples for laboratory
confirmation.

News from the Ebola response
Vaccination
- Since the launch of the vaccination on 21 May 2018, 3017 people have
been vaccinated, including 829 in Mbandaka, 726 in Bikoro, 1,374 in
Iboko, 77 in Ingende and 11 in Kinshasa.

Minister's trip
- During his stay in Itipo, the Minister of Health, Dr. Oly Ilunga
Kalenga, participated in the training of community development cells
(CAC) on generalities, prevention, active case research and awareness
on the Ebola virus disease.
- In Mbandaka, the Minister of Health held a meeting with the security
committee of the Province of Equateur, including the provincial
ministers of justice and the interior, in the presence of the deputies
and notables from the territory of Bikoro.

Generosity
-The NGO Amani Global Networks donated 5000 USD and 50 bicycles to the
Ministry of Health to support the Ministry's efforts in the Ebola
response. The financial contribution was paid in full to the
Association of Winners of the Ebola Virus Disease (ANVE) gathering all
the cured and relatives of the victims to ensure better biological,
psychological and social monitoring. And the 50 bicycles will be sent
to the various health zones affected to facilitate the movement of
surveillance teams in the field.

World Day of the African Child
- On the occasion of the World Day of the African Child on 16 Jun
2018, UNICEF invited 32 children reporters of Bikoro to animate radio
programs on the dignified and safe burial. The Minister of Health, who
was in Bikoro that day, praised the initiative that allowed children
to fully participate in the Ebola response.

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[It is a terrific idea to involve the children so they become vested
in proper preventative measures, and bring that knowledge to their
families. - Mod.LK]

A map showing the location of Ebola outbreaks in DRC and a table of
this outbreak's cases in Bikoro, Iboko, and Wangata (Equateur
province) are available at the source URL above.

-9--15 Jun. WHO Africa
<http://apps.who.int/iris/bitstream/handle/10665/272848/OEW24-815062018.pdf>

Weekly bulletin on outbreaks and other emergencies week 24 [9-15 Jun
2018]
Data as reported by 17:00; 15 Jun 2018

Ebola virus disease in DRC [57 cases, 28 deaths, 49.1 percent CFR]
------------------------------------------------------------------

Event Description
-----------------
The Ministry of Health and WHO continue to closely monitor the
outbreak of Ebola virus disease (EVD) in the Democratic Republic of
the Congo with cautious optimism. On 15 Jun 2018, 5 new suspected EVD
cases were reported in Bikoro Health Zone. A total of 6 laboratory
specimens (from suspected cases reported previously) tested negative.
No new confirmed EVD cases and no new deaths were reported on the
reporting date. Since 17 May 2018, no new confirmed EVD cases have
been reported in Bikoro and Wangata health zones, while the last
confirmed case-patient in Iboko Health Zone developed illness on 2 Jun
2018 and was confirmed 6 Jun 2018. To date, a total 24 case-patients
with confirmed EVD have been cured since the onset of the outbreak.

Since the beginning of the outbreak (on 4 April 2018), a total of 57
EVD cases and 28 deaths (case fatality rate 49.1 percent) have been
reported, as of 15 Jun 2018. Of the 57 cases, 38 have been laboratory
confirmed, 14 are probable (deaths for which it was not possible to
collect laboratory specimens for testing) and five are suspected. Of
the confirmed and probable cases, 27 (52 percent) are from Iboko,
followed by 21 (40 percent) from Bikoro and 4 (8 percent) from Wangata
health zones. A total of 5 healthcare workers have been affected, with
4 confirmed cases and 2 deaths.

The outbreak has remained localized to the 3 health zones initially
affected: Iboko (24 confirmed cases, 3 probable, 7 deaths), Bikoro (10
confirmed cases, 11 probable, 5 suspected, 18 deaths) and Wangata (4
confirmed cases, 3 deaths).

The number of contacts requiring follow-up is progressively
decreasing, with a total 1319 completing the mandatory 21-day
follow-up period. As of 14 Jun 2018, a total of 387 contacts were
under follow up, of which 360 (93 percent) were reached on the
reporting date.

Public Health Actions
----------------------
-On 11 Jun 2018, the WHO Director General (DG) and the Minister of
Health visited the affected areas, including Itipo health area (the
remaining hotspot with active transmission) in Iboko Health Zone to
conduct on-the-spot assessment and support response operations. The DG
and the Minister of Health met the local coordination commission, the
National Association of Ebola Winners (people who were cured) and
field responders. The mission also visited the newly established Ebola
Treatment Centre (ETC) in Itipo. The DG thanked the government for the
strong leadership and commitment to the EVD response.

-As of 12 Jun 2018, WHO has deployed a total of 271 technical experts
in various critical functions of the Incident Management System (IMS)
to support response to the EVD outbreak.

- Since the launch of the vaccination exercise on 21 May 2018, a total
of 2920 people have been vaccinated in Iboko (1290), Wangata (822),
and Bikoro (726), Ingende (77), and Kinshasa (5), as of 15 June 2018.
The targets for vaccination are front-line health professionals,
people who have been exposed to confirmed EVD cases and contacts of
these contacts.

- WHO continues to support neighbouring countries to enhance their
preparedness and readiness to detect and contain EVD should it be
introduced. The countries have developed national contingency response
plans, which were incorporated into the regional readiness and
preparedness plan that was published. The regional readiness and
preparedness plan requires 15.5 million USD. A total of 1.55 million
USD has been mobilized through Contingency Funds for Emergency (CFE)
to support the preparedness and readiness contingency plans in the 9
countries.

-A community dialogue about signs, mode of transmission, prevention
measures and community involvement in EVD response was conducted with
37 local leaders (including 3 sector leaders, 17 group leaders and 17
village chiefs) in Bikoro territory.

Situation Interpretation
------------------------
Slightly over a month into the EVD response, tremendous progress has
been made in containing further spread of the disease. Currently,
active transmission is mainly limited to the remote and hard-to-reach
communities in Itipo health area in Iboko Health Zone. The situation
in Bikoro and Wangata (Mbandaka city) health zones is stable and is
being cautiously monitored, with the last confirmed cases reported in
mid-May 2018. The 2nd phase of EVD response has now shifted to rapid
investigations of suspected cases and alerts, thorough contact tracing
in the remote area sand engagement of communities, including the
indigenous population in and around the villages. This will imply
redeployment of field responders and response logistics.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The coordinated response has been very effective in containing the
outbreak. See map of geographic distribution of Ebola virus disease
cases to 13 Jun and epidemic curve to 12 Jun 2018 at URL above. -
Mod.LK]

******
[2] Oxfam
- 17 Jun 2018. Oxfam distribution of food
Actualite [in French, machine trans., edited]
<https://actualite.cd/2018/06/17/rdc-plus-de-4000-personnes-victimes-de-lepidemie-debola-recoivent-laide-alimentaire-doxfam/>

Oxfam distributes rice, beans and flour to approximately 4525 people
affected by the Ebola outbreak in Equateur Province. The 1st
distributions took place in Mbandaka - the provincial capital - and
will extend into rural communities.

It is vital to feed families who have been in contact with sick people
so they can eat while protecting others from the disease. Not
providing food means that they have to go out into the market,
potentially infecting other people. In recent weeks, the spread of
Ebola has slowed as a result of joint efforts of government,
humanitarian agencies and local partners. However, "more than 50 cases
of Ebola are way too much," said Jose Barahona, Oxfam Country Director
in the Democratic Republic of Congo.

A total of 57 cases of haemorrhagic fever were reported in the region,
including 38 confirmed, 14 probable and 5 suspected. This Sat [16 Jun
2018], 5 new suspected cases were reported in Bikoro and 6 samples
were negative.

"We have all the lessons learned from the Ebola outbreak in West
Africa to fight Ebola in the DRC. We work with communities to listen
to their fears, concerns and beliefs because it is crucial to
understand them in order to overcome them. In West Africa, because of
movement restrictions, many people no longer cultivated their fields
and prices of food increased considerably (...). We need to prepare a
post-Ebola response, including helping people earn a living and
providing safe drinking water and sustainable sanitation. Oxfam's work
should not stop when the epidemic is over," added Barahona.

Oxfam's response to the Ebola outbreak aims to reach 40 000 people in
the 1st 3 months of the response. The NGO provides door-to-door
information to the most vulnerable people, works with communities and
conducting mass outreach activities, including film screenings. Oxfam
also installs chlorinated water points in hospitals, health centers,
schools and ports, and helps to disinfect homes in which cases of
Ebola have been detected. Oxfam also provides disinfection kits and
hygiene kits to communities.

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[This seems to be exactly the right approach. Oxfam's programmes
address the structural causes of poverty and related injustice and
work primarily through local accountable organizations, seeking to
enhance their effectiveness. Oxfam's stated goal is to help people
directly when local capacity is insufficient or inappropriate for
Oxfam's purposes, and to assist in the development of structures which
directly benefit people facing the realities of poverty and injustice.
Oxfam recognizes the universality and indivisibility of human rights
and has adopted these overarching aims to express these rights in
practical terms: the right to a sustainable livelihood, the right to
basic social services, the right to life and security, the right to be
heard, and the right to an identity.
See <https://www.oxfam.org> - Mod.LK]

[HealthMap/ProMED-mail map
DR Congo: <http://healthmap.org/promed/p/194>]

[See Also:
Ebola update (37): DR Congo, cases, response
http://promedmail.org/post/http://promedmail.org/post/20180617.5859839
Ebola update (36): Congo DR, cases, threat, assistance
http://promedmail.org/post/http://promedmail.org/post/20180615.5858111
Ebola update (35): Congo DR, cases, response, WHO
http://promedmail.org/post/http://promedmail.org/post/20180614.5855415
Ebola update (34): Congo DR, cases, response, WHO
http://promedmail.org/post/http://promedmail.org/post/20180613.5853602
Ebola update (33): Congo DR, cases, response, WHO, diagnosis
http://promedmail.org/post/http://promedmail.org/post/20180612.5850968
Ebola update (32): Congo DR, cases, preparation, research
http://promedmail.org/post/http://promedmail.org/post/20180611.5849759
Ebola update (31): Congo DR, cases, response, WHO
http://promedmail.org/post/http://promedmail.org/post/20180610.5848785
Ebola update (30): Congo DR, cases, WHO, action
http://promedmail.org/post/http://promedmail.org/post/20180609.5847441
Ebola update (29): Congo DR, cases, MSF, antivirals
http://promedmail.org/post/http://promedmail.org/post/20180608.5845483
Ebola update (28): Congo DR, cases, WHO, response, treatment, funding
http://promedmail.org/post/http://promedmail.org/post/20180607.5843872
Ebola update (27): Congo DR, cases, travel screening, children
http://promedmail.org/post/http://promedmail.org/post/20180606.5841051
Ebola update (26): Congo DR, border controls, bat reservoir
http://promedmail.org/post/http://promedmail.org/post/20180604.5838529
Ebola update (25): Congo DR, case update, intl. travel screening
http://promedmail.org/post/http://promedmail.org/post/20180603.5836552
Ebola update (24): Congo DR, case update, African aid response
http://promedmail.org/post/http://promedmail.org/post/20180602.5835414
Ebola update (23): Congo DR, cases, vacc. campaign targets, vaccine
development
http://promedmail.org/post/http://promedmail.org/post/20180601.5834040
Ebola update (22): Congo DR, cases, cures, domestic and international
travel
http://promedmail.org/post/http://promedmail.org/post/20180531.5831747
Ebola update (21): Congo DR, update, WHO, vaccination, therapeutics
http://promedmail.org/post/http://promedmail.org/post/20180530.5829192
Ebola update (20): Congo DR, case update, lessons, logistics,
financing, flights
http://promedmail.org/post/http://promedmail.org/post/20180529.5824985
Ebola update (19): Congo DR, case update
http://promedmail.org/post/http://promedmail.org/post/20180528.5822466
Ebola update (18): cases, Uganda NOT, Congo DR vaccination campaign
http://promedmail.org/post/http://promedmail.org/post/20180527.5821927
Ebola update (17): case update, public fears, government responses
http://promedmail.org/post/http://promedmail.org/post/20180526.5820606
Ebola update (16): cases, Congo DR cultural factors, vaccine impl.,
case terminology
http://promedmail.org/post/http://promedmail.org/post/20180525.5817907
Ebola update (15): case update, quarantine breaches, border controls,
vaccine
http://promedmail.org/post/http://promedmail.org/post/20180524.5816349
Ebola update (14): case update, response, prediction, maps
http://promedmail.org/post/http://promedmail.org/post/20180523.5812835
Ebola update (13): case update, prevention
http://promedmail.org/post/http://promedmail.org/post/20180521.5809540
Ebola update (12): update, USA, response
http://promedmail.org/post/http://promedmail.org/post/20180520.5806396
Ebola update (11): WHO, vaccination, response
http://promedmail.org/post/http://promedmail.org/post/20180519.5805133
Ebola update (10): urban case Congo DR, response, support
http://promedmail.org/post/http://promedmail.org/post/20180517.5801917
Ebola update (09): update, alerts, prevention
http://promedmail.org/post/http://promedmail.org/post/20180516.5799567
Ebola update (08): summary, emergency plan, vaccine, roads
http://promedmail.org/post/http://promedmail.org/post/20180515.5797415
Ebola update (07): Congo DR, nurse, Uganda susp, WHO, border, vaccine
http://promedmail.org/post/http://promedmail.org/post/20180513.5795881
Ebola update (06): Congo DR, susp, RFI, vulnerability, response,
control
http://promedmail.org/post/http://promedmail.org/post/20180512.5794300
Ebola update (05): Congo DR, outbreak update, vaccine, preparedness,
research
http://promedmail.org/post/http://promedmail.org/post/20180511.5792856
Ebola update (04): Nigeria, Kenya, Congo DR (ET), WHO
http://promedmail.org/post/http://promedmail.org/post/20180510.5791247
Ebola update (03): Congo DR (ET), WHO
http://promedmail.org/post/http://promedmail.org/post/20180509.5790577
Ebola update (02): Congo DR (ET)
http://promedmail.org/post/http://promedmail.org/post/20180508.5789723]]
.................................................mhj/lk/ao/mpp
*##########################################################*
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information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
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Posted on 6/18/2018 03:20:00 PM | Categories:

PRO/AH/EDR> Cowpox - UK: (Wales), human, bovine source suspected, RFI

COWPOX - UK: (WALES), HUMAN, BOVINE SOURCE SUSPECTED, REQUEST FOR
INFORMATION
*****************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sat 16 Jun 2018
Source: BBC News [edited]
<https://www.bbc.com/news/uk-wales-44484599>


A 15-year-old boy has surprised doctors by contracting cowpox, a
historical disease now so rare it has not been seen in Wales for more
than a decade.

The teenager, who lives on the Wrexham-Cheshire border, developed
lesions on his hands after feeding calves.

Public Health Wales said the last reported human case in Wales was
some 10 to 15 years ago. Cowpox was more common in the 18th century
when milking maids often caught it. The virus, which is not contagious
from person to person, has all but disappeared because industrial
farming methods mean fewer people milk cows by hand. Now it is very
rare in both humans and animals, according to Public Health Wales,
with feral cats most likely to catch it from rodents.

The boy's mother, who does not want to be identified, said the calves
he had been feeding had nibbled on his hands, causing them to become
grazed. He then developed pus-filled lesions on his hands, arms and
feet. "We were really unsure what it was," she said. "The one on his
ankle was worrying - it was weeping a clear liquid down his ankle."

After seeing their GP, they got sent straight to the Countess of
Chester Hospital, where he was diagnosed with cowpox.

"I didn't really know what it was, so I was quite concerned. The 1st
thing you do is look on the internet and that's when I found out it
was quite rare," she said.

"It took weeks and weeks to go, a long time. He still has some marks
on his hands."

Dr. Aysha Javed, who diagnosed the teenager after seeing the
distinctive pus-filled lesions on his hands, arms and feet, said it
was the 1st case of cowpox she had seen. "I think the boy and his
family were quite bemused when we told them - I don't think they
expected that to be the diagnosis," she said. "I think it was very
itchy for him but it wasn't particularly painful."

Dr. Robert Smith, clinical scientist lead for zoonoses at Public
Health Wales, said cowpox had not been reported in Wales for some 10
to 15 years. "A total of 29 laboratory reports of cowpox were received
by the public health laboratories (PHLS) communicable disease
surveillance centre between 1975 and 1992 (with a range of 0 to 4
reports annually)," he added.

The boy was diagnosed about 3 months ago, but his case came to light
when Dr. Javed and her colleagues alerted other medics to it during a
recent European Society for Pediatric Dermatology annual meeting. "We
have to inform other colleagues about rare cases and, if it's
something that's going to be re-emerging, public health professionals
need to be alerted," she added. "We don't really see cowpox anymore -
it's one of those diseases that went away."

The British Association of Dermatologists said it was very useful for
doctors and members of the public to be aware of "what we might
consider historical diseases making resurgence".

"Cowpox is quite unusual and, as the doctors note, when you look at a
pox-like rash on a child these days the 1st thing that tends to spring
to mind is chicken pox," a spokesman said. "Although this resurgence
is interesting, it's not something that is particularly worrying as
cowpox tends to be benign in nature to otherwise healthy people."

[Byline: Gemma Ryall]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The BBC report presents pictures of the boy's rash.
Subscribers are referred to Mod.CP's commentary in
http://promedmail.org/post/20110629.1982:

"As previously commented, cowpox virus is a misnomer. Cowpox virus is
not normally present in cows. The natural hosts are probably rodents,
but it has been isolated from a variety of animals, including domestic
and wild felines and canines, elephants and humans. Human infections
have usually been traced to handling of cowpox-infected animals. Human
cowpox is a rare zoonotic infection, evoking a self-limiting disease,
except in the case of immunocompromised and eczematous patients
(particularly children), where it can become severe.

Cowpox virus is distributed widely in Europe, western parts of the
former Soviet Union, and adjacent areas of Northern and Central Asia,
with an increasing number of reports originating from Europe. Genome
sequence analyses have revealed considerable diversity among isolates
of cowpox virus. There is a considerable literature on cowpox virus
and human infection that can be accessed via the ProMED-mail archived
material listed below".

A recent (2017) paper (Ref 1) included the following
literature-derived comments (for the references, please go to the
paper's URL):

"Cowpox virus is an orthopox virus causing rare zoonotic infections in
humans. The genus _Orthopoxvirus_ is a group of large, double-stranded
DNA viruses which replicate in hosts cytoplasm. Other members of the
genus which infect humans are variola (causative agent of smallpox),
vaccinia and monkeypox viruses. Research on cowpox virus played
important part in the history of medicine. Edward Jenner's
observations that infection with cowpox virus induces immunity against
smallpox led to the development of the 1st vaccine.

"Humans are accidental hosts and acquire cowpox virus by close contact
with infected animals. Despite its name, cowpox virus sporadically
infects cattle. Most cases of human cowpox result from transmission
from cats, however there have been reports of passage from rats and
zoo animals. Based on geographical distribution and serological
studies small rodents are currently believed to be the reservoir hosts
of cowpox. Cats and other animals".

The bovine source of the reported, recent case in Wales is in need of
verification.

References
1. Wiacek K, Cwynar J, Bursa D, Horban A, Telega G and Mazur A. A case
of cowpox virus infection in a 15-year-old boy and literature
overview. Pediatria Polska 92 (2017) 778-780.
<http://dx.doi.org/10.1016/j.pepo.2017.07.004>
- Mod.AS

HealthMap/ProMED-mail map
Wales, United Kingdom: <http://healthmap.org/promed/p/281>

Perhaps this human cowpox case is related to environmental exposure to
the virus. Cowpox virus is endemic in voles (_Microtus agerestis_) in
the UK that have population flections. There is evidence that as vole
populations build up, there is increased prevalence of cowpox virus
with a delay. Prevalence peaks as the vole population declines and
cowpox infection may be a factor in determining vole population
dynamics. When populations of infected voles are abundant, that may
provide a source of human infection in those extremely rare cases-
Mod. TY

Some historical information excerpted from CDCs history of smallpox:
"One of the first methods for controlling the spread of smallpox was
the use of variolation. Named after the virus that causes smallpox
(variola virus), variolation is the process by which material from
smallpox sores (pustules) was given to people who had never had
smallpox. This was done either by scratching the material into the arm
or inhaling it through the nose. With both types of variolation,
people usually went on to develop the symptoms associated with
smallpox, such as fever and a rash. However, fewer people died from
variolation than if they had acquired smallpox naturally.

"The basis for vaccination began in 1796 when an English doctor named
Edward Jenner observed that milkmaids who had gotten cowpox did not
show any symptoms of smallpox after variolation. The first experiment
to test this theory involved milkmaid Sarah Nelmes and James Phipps,
the 9 year-old son of Jenner's gardener. Dr. Jenner took material from
a cowpox sore on Nelmes' hand and inoculated it into Phipps' arm.
Months later, Jenner exposed Phipps a number of times to variola
virus, but Phipps never developed smallpox. More experiments followed,
and, in 1801, Jenner published his treatise "On the Origin of the
Vaccine Inoculation," in which he summarized his discoveries and
expressed hope that "the annihilation of the smallpox, the most
dreadful scourge of the human species, must be the final result of
this practice."

"Vaccination became widely accepted and gradually replaced the
practice of variolation. At some point in the 1800s (the precise time
remains unclear), the virus used to make the smallpox vaccine changed
from cowpox to vaccinia virus." (see
<https://www.cdc.gov/smallpox/history/history.html>). - Mod.MPP]

[See Also:
Cowpox - Europe: France, rodent, human infection
http://promedmail.org/post/20110629.1982
Cowpox, human - USA: (GA) lab infection
http://promedmail.org/post/20110209.0444
2009
----
Cowpox, rodents, human (06): Europe, background
http://promedmail.org/post/20090306.0938
Cowpox, rodents, human (05): Europe, monkeypox?
http://promedmail.org/post/20090305.0912
Cowpox, rodents, human (04): Europe
http://promedmail.org/post/20090304.0890
Cowpox, rodents, human (03): Czech Republic, NOT
http://promedmail.org/post/20090303.0870
Cowpox, rodents, human (02): France
http://promedmail.org/post/20090226.0809
Cowpox, rodents, human - Germany, France ex Czech Rep.
http://promedmail.org/post/20090225.0786
2007
----
Cowpox, human - Germany (02): comment
http://promedmail.org/post/20070420.1299
Cowpox, human - Germany http://promedmail.org/post/20070419.1286
2003
----
Cowpox, bovine, human - Brazil (Sao Paulo) (02)
http://promedmail.org/post/20030114.0115
Cowpox, bovine, human - Brazil (Sao Paulo)
http://promedmail.org/post/20030111.0095
2001
----
Cowpox, cattle & human - Ukraine (02)
http://promedmail.org/post/20010509.0895
Cowpox, cattle & human - Ukraine
http://promedmail.org/post/20010508.0888
1999
----
Cowpox, cattle & humans - Brazil (Rio de Janeiro) (04)
http://promedmail.org/post/19990913.1633
Cowpox, cattle & humans - Brazil (Rio de Janeiro) (03)
http://promedmail.org/post/19990906.1558
Cowpox, cattle & humans - Brazil (Rio de Janeiro) (02)
http://promedmail.org/post/19990901.1529
Cowpox, cattle & humans - Brazil (Rio de Janeiro)
http://promedmail.org/post/19990830.1516]
.................................................sb/mpp/arn/ao/ty/mpp
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and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
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or archived material.
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Posted on 6/18/2018 02:53:00 PM | Categories:

PRO/EDR> Typhoid fever - El Salvador

TYPHOID FEVER - EL SALVADOR
***************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Fri 15 Jun 2018 12:02 AM CST
Date: El Mundo, El Salvador [in Spanish, trans., edited]
<http://elmundo.sv/ministerio-de-salud-dice-hay-un-brote-epidemico-de-fiebre-tifoidea/>


The Minister of Public Health, Violeta Menjívar, said that there is
an epidemic outbreak of typhoid fever in some 26 municipalities, not
in the entire country. "We have salmonellosis and within it some
typhoid cases, an increase of cases in 26 municipalities, which have a
mild to moderate affectation ... What does that mean? We are talking
about an epidemic outbreak because it is localized; it is not a
national epidemic, "Menjívar said on [14 Jun 2018].

The head of the health surveillance unit, Hector Ramos, said that they
had 644 cases suspected of typhoid but that it is too early to speak
of a decrease. "We have to wait but it seems that it is starting to
level off and we hope that it will continue to decrease," said
Minister Menjívar.

The minister explained that the increase was a surprise because the
winter was early as a result of the La Niña phenomenon.

The municipalities moderately affected are: San Antonio Pajonal in the
department of Santa Ana; Santa Tecla in La Libertad; and Apopa,
Cuscatancingo, San Salvador, Mejicanos, Panchimalco, Ilopango, and
Soyapango in the department of San Salvador.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
via
ProMED-ESP
<promed-esp@promedmail.org>

******
[2]
Date: Tue 12 Jun 2018 12:00 AM CST
Source: El Mundo, El Salvador [in Spanish, trans. Sr.Tech.Ed.MJ,
summ., edited]
<http://elmundo.sv/tifoidea-ha-afectado-nueve-municipios-moderadamente/>


The epidemiological bulletin of the Salvador Ministry of Public Health
and Social Assistance (MINSAL) reported moderate activity of typhoid
fever in 9 of the country's 262 municipalities.

From January 2018 to date, 469 suspected cases of typhoid fever have
been hospitalized, of which 346 have been confirmed by blood culture.
In addition to the 9 municipalities moderately affected, there are 19
municipalities mildly affected and none severely affected.

During the week of 4 Jun 2018, the epidemiological bulletin reported
644 suspected cases between January and May 2018. 376 cases were
reported during the same period in 2017. One person has died in 2018
and one person died in 2017.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Typhoid fever, so-called enteric fever caused by _Salmonella
enterica_ serotype Typhi, has a totally different presentation from
that of the commoner kinds of salmonellosis. Epidemiologically,
usually spread by contaminated food or water, typhoid is not a
zoonosis like the more commonly seen types of salmonellosis.
Clinically, vomiting and diarrhea are typically absent; indeed,
constipation is frequently reported. As it is a systemic illness,
blood cultures are at least as likely to be positive as stool in
enteric fever, particularly early in the course of the infection, and
bone marrow cultures may be the most sensitive.

The symptoms of classical typhoid fever typically include fever,
anorexia, lethargy, malaise, dull continuous headache, non-productive
cough, vague abdominal pain, and constipation. Despite the often high
fever, the pulse is often only slightly elevated. During the 2nd week
of the illness, there is protracted fever and mental dullness,
classically called coma vigil. Diarrhea may develop but usually does
not. Many patients develop hepatosplenomegaly (both liver and spleen
enlarged). After the 1st week or so, many cases develop a
maculopapular rash on the upper abdomen. These lesions ("rose spots")
are about 2 cm (0.78 in) in diameter and blanch on pressure. They
persist for 2-4 days and may come and go. Mild and atypical infections
are common.

The word typhoid (as in typhus-like) reflects the similarity of the
louse-borne rickettsial disease epidemic typhus and that of typhoid
fever; in fact, in some areas, typhoid fever is still referred to as
abdominal typhus. - Mod.LL

Maps of El Salvador:
<http://www.lib.utexas.edu/maps/americas/elsalvador.jpg> and
<http://healthmap.org/promed/p/21>.]

[See Also:
Typhoid fever - USA: (MA) daycare center, imported
http://promedmail.org/post/20180510.5792030
Typhoid fever - Pakistan (04): multidrug resistance
http://promedmail.org/post/20180415.5747027
Typhoid fever - Syria: (HA) refugee & IDP camp
http://promedmail.org/post/20180323.5706324
Typhoid fever - Pakistan (03): multidrug resistance, fatal
http://promedmail.org/post/20180223.5646599
Typhoid fever - Pakistan (02): (SD) multidrug resistance, fatal
http://promedmail.org/post/20180127.5586255
Typhoid fever - Pakistan: (SD) multidrug resistance, fatal, RFI
http://promedmail.org/post/20180124.5582615
Typhoid fever - Zimbabwe: (HA)
http://promedmail.org/post/20180118.5569032
2017
----
Typhoid fever - South Africa: (LP)
http://promedmail.org/post/20171203.5479456
Typhoid fever - Zambia (02): (SO)
http://promedmail.org/post/20171102.5420643
Typhoid fever - North Korea (02): (RG)
http://promedmail.org/post/20171026.5405816
Typhoid fever - North Korea: (RG) RFI
http://promedmail.org/post/20171026.5402675
Typhoid fever - India (02): (AP)
http://promedmail.org/post/20171024.5400854
Typhoid fever - Zimbabwe (03): (Harare)
http://promedmail.org/post/20171024.5400690
Typhoid fever - Fiji: (LO)
http://promedmail.org/post/20171011.5374145
Typhoid fever - USA: (OH) cluster
http://promedmail.org/post/20171006.5364847
Typhoid fever - Europe (02): alert
http://promedmail.org/post/20170929.5349459
Typhoid fever - Europe: MSM, alert, RFI
http://promedmail.org/post/20170927.5345228
Typhoid fever - Guyana: (PM) susp
http://promedmail.org/post/20170914.5316793
Typhoid fever - South Korea: (HN) ex India, student
http://promedmail.org/post/20170823.5269596
Typhoid fever - Guatemala: (PE)
http://promedmail.org/post/20170809.5238178
Typhoid fever - India: (AP)
http://promedmail.org/post/20170808.5235812
Typhoid fever - Pakistan: (SD) multidrug resistance, RFI
http://promedmail.org/post/20170716.5178355
Typhoid fever - Zambia: (LS)
http://promedmail.org/post/20170524.5059531
Typhoid fever - New Zealand (04): (MW)
http://promedmail.org/post/20170524.5058851
Typhoid fever - Syria: (HL)
http://promedmail.org/post/20170523.5057372
Typhoid fever - Kenya: H58 haplotype, antimicrobial resistance
http://promedmail.org/post/20170430.5005152
Typhoid fever - Tonga http://promedmail.org/post/20170414.4971570
Typhoid fever - New Zealand (03): (AU) church community
http://promedmail.org/post/20170413.4969569
Typhoid fever - New Zealand (02): (AU) church community
http://promedmail.org/post/20170405.4947714
Typhoid fever - New Zealand: (AU) RFI
http://promedmail.org/post/20170403.4943251
Typhoid fever - Zimbabwe (02): (HA)
http://promedmail.org/post/20170402.4942851
Typhoid fever - Zimbabwe: (Harare)
http://promedmail.org/post/20170107.4749025
2016
----
Typhoid fever - USA: (CO) restaurant cluster, 2015
http://promedmail.org/post/20160624.4307017
Typhoid fever - Zimbabwe: (Harare)
http://promedmail.org/post/20160318.4103720
2015
----
Typhoid fever - USA: (CO) restaurant cluster
http://promedmail.org/post/20151107.3774978
Typhoid fever - Syria (03): (DI) refugee camp
http://promedmail.org/post/20150928.3670433
Typhoid fever - Syria (02): (DI) susp., refugee camp
http://promedmail.org/post/20150903.3622700
Typhoid - Syria: (DI) refugee camp
http://promedmail.org/post/20150821.3591694
Typhoid fever - Nepal: (SP) post-earthquake
http://promedmail.org/post/20150726.3528925
Typhoid fever - Africa, Asia: multidrug resistant
http://promedmail.org/post/20150512.3357675
Typhoid fever - Fiji (02): (NO) commentary
http://promedmail.org/post/20150123.3114013
Typhoid fever - Fiji: (NO)
http://promedmail.org/post/20150122.3111081]
.................................................jt/ll/mj/mpp
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are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Donate to ProMED-mail. Details available at:
<http://www.isid.org/donate/>
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Visit ProMED-mail's web site at <http://www.promedmail.org>.
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Posted on 6/18/2018 01:27:00 PM | Categories: