New Virus Related to Ebola and Rabies

January 6, 2014 · Posted in Medicine · Comments Off on New Virus Related to Ebola and Rabies 
ebola

Frederick A. Murphy / CDC handout via EPA file

By Maggie Fox, NBC News

A virus that killed two teenagers in Congo in 2009 is a completely new type, related to rabies but causing the bleeding and rapid death that makes Ebola infection so terrifying, scientists reported on Thursday. They’re searching for the source of the virus, which may be transmitted by insects or bats.

The new virus is being named Bas-Congo virus, for the area where it was found. Researchers are finding more and more of these new viruses, in part because new tests make it possible, but also in the hope of better understanding them so they can prevent pandemics of deadly disease.

The virus infected a 15-year-old boy and a 13-year-old girl in the same village in Congo in 2009. They didn’t stand a chance, says Joseph Fair of Metabiota, a company that investigates pathogens. Fair is in the Democratic Republic of Congo now, under contract to the U.S. Agency for International Development (USAID) to help battle an ongoing Ebola outbreak.

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“They expired within three days,” Fair said in a telephone interview. “It was a very rapid killer.”

A few days later a male nurse who cared for the two teenagers developed the same symptoms and survived. Samples from the lucky nurse have been tested and it turned out a completely new virus had infected him, Fair and other researchers report in the Public Library of Science journal PLoS pathogens.

The genetic sequences went to Dr. Charles Chiu, of the University of California, San Francisco.

“We were astounded that this patient had sequences in his blood from a completely unknown and unidentified virus,” Chiu said. They weren’t expecting that.

“Congo is very much known for having Ebola and Marburg outbreaks. Yet about 20 percent of the time we have hemorrhagic fever outbreaks that are completely negative, which means unknown causes and they are not Ebola.”

The sequencing puts this new virus on its own branch of the bad virus family tree — somewhat related to Ebola and the virus that causes Lassa fever, another horrific killer, and most closely related to the rhabdoviruses. This family usually only infects animals with one notable exception — rabies.

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But rabies is not known to cause hemorrhaging. It’s plenty horrible on its own, of course, killing virtually all patients if they aren’t vaccinated soon after infection.

A nurse who took care of the first infected nurse had antibodies to the new virus. It doesn’t look like the teenagers infected one another, says Fair, but they probably infected the first nurse, who probably infected the second. Tests of other villagers have found no more evidence of the virus, however, which is good news.

“Although the source of the virus remains unclear, study findings suggest that Bas-Congo virus may be spread by human-to-human contact and is an emerging pathogen associated with acute hemorrhagic fever in Africa,” the researchers wrote.

Africa is loaded with nasty viruses. Lassa fever virus comes from a family known as arenaviruses and causes 500,000 cases of hemorrhagic fever a year. Crimean-Congo hemorrhagic fever and Rift Valley Fever viruses are in another family called bunyaviruses; Ebola and Marburg viruses are filoviruses that kill anywhere between 30 percent and 90 percent of victims. They’re also helping wipe out great apes such as gorillas in Central Africa. This adds a new one to the list.

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It worries Chiu because its closest relative is spread by biting flies in Australia. “We think that is potentially a valuable clue. This virus may have come from an insect vector,” Chiu says. “What is scary about this virus is if it does happen to be spread by insects, it has the potential to be something like West Nile.”

West Nile showed up in the United States for the first time in 1999, having never been seen here before. It causes regular outbreaks in Africa and parts of Europe, however, and some experts think a mosquito or an infected person carried it on a flight to New York. It’s killed 147 people in an especially bad U.S. outbreak this year, although more than 90 percent of people infected with West Nile never even know it.

New viruses often cause disease — there was severe acute respiratory syndrome or SARS, which killed 800 people and infected 8,000 in 2003 before it was stopped. Scientists are now watching a similar virus that has emerged in the Middle east.

Chiu says there is not enough information to know how deadly the new Bas-Congo virus is.

“It has probably been lurking out there in remote areas and causing sporadic cases of hemorrhagic fever and no one had the resources to discover it,” Chiu said. “This is probably the tip of the iceberg. I believe there are many, many more of these emerging viruses that have yet to be discovered,” he added.

“This points to the importance of being vigilant, especially these remote areas of Africa and Asia. This is the area that I believe the next generation of emerging viruses will come from.”

Fair agrees, and says his team will be looking. They’ll also be checking to see if bats or insects can spread it. “It is a frightening prospect. That is why the next step in this process is to look for the vector,” Fair said.

That’s not so easy. Fair’s team and hundreds of other scientists have been looking for the reservoir — the animal or insect source –of Ebola. That would be a bat or other creature that can carry it without getting sick itself. So far they have had no luck, although fruit bats are a major suspect.

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And for the new Bas-Congo virus, the trail is now three years old. “Everything we do will be as a forensic investigation,” Fair said. “We really have to go look for a needle in a sack of needles.”

And in the meantime, there’s an outbreak of Ebola to cope with. Fair says a coordinated effort is going on, although this isn’t the worst outbreak he has seen. It’s killing about 30 percent to 40 percent of patients — not nearly as bad as some strains, which killed up to 90 percent of victims.

“If you had to get Ebola, this is the strain to get,” he said.

New virus in Africa looks like rabies, acts like Ebola

Meningitis Questions

January 6, 2014 · Posted in Medicine · Comments Off on Meningitis Questions 

Need a cheat sheet to help keep it all straight? The CDC thinks you should remember 10 easy bullet points about this surprisingly complex disease. Here they are:

1. There are five “types” of meningitis.

Meningitis may develop in response to a number of causes, usually bacteria or viruses, but meningitis can also be caused by physical injury, cancer or certain drugs.

The five “types” of meningitis are:

  • Bacterial Meningitis
  • Viral Meningitis
  • Fungal Meningitis
  • Parasitic Meningitis
  • Non-infectious Meningitis

The severity of illness and the treatment for meningitis differ depending on the cause. Thus, it is important to know the specific cause of meningitis. For the ongoing outbreak of fungal meningitis and other infections linked to contaminated steroid medication, fungus was discovered as the cause. More on that below. But let’s first look at some of the other types of meningitis and facts you need to know.

2. There are vaccines that protect against three types of bacteria that can cause meningitis.

Bacterial meningitis is usually severe and can be life-threatening. While most people with meningitis recover, it can cause serious complications, such as brain damage, hearing loss or learning disabilities. In the United States, about 4,100 cases of bacterial meningitis, including 500 deaths, occurred each year between 2003-2007.

The germs that cause bacterial meningitis can be contagious. Some bacteria can spread through the exchange of respiratory and throat secretions (e.g., kissing). Fortunately, most of the bacteria that cause bacterial meningitis are not as contagious as diseases like the common cold or the flu. Also, the bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been.

Other meningitis-causing bacteria are not spread person-to-person, but can cause disease because the person has certain risk factors (such as a weak immune system or head trauma). And finally, unlike other bacterial causes of meningitis, you can get Listeria monocytogenes by eating contaminated food.

The most effective way to protect you and your child against certain types of bacterial meningitis is to complete the recommended vaccine schedule. There are vaccines for three types of bacteria that can cause meningitis: Neisseria meningitidis (meningococcus), Streptococcus pneumoniae (pneumococcus), and Haemophilus influenzae type b (Hib).

3. There are things that can increase your risk of bacterial meningitis.

Factors that can increase your risk of bacterial meningitis include:

Age: Infants are at higher risk for bacterial meningitis than people in other age groups. However, people of any age are at risk.

Community setting: Infectious diseases tend to spread more quickly where larger groups of people gather together. College students living in dormitories and military personnel are at increased risk for meningococcal meningitis.

Certain medical conditions: There are certain diseases, medications, and surgical procedures that may weaken the immune system or increase risk of meningitis in other ways.

Working with meningitis-causing pathogens: Microbiologists who are routinely exposed to meningitis-causing pathogens are at increased risk.

Travel: Travelers to the meningitis belt in sub-Saharan Africa may be at risk for meningococcal meningitis, particularly during the dry season. Also at risk for meningococcal meningitis are travelers to Mecca during the annual Hajj and Umrah pilgrimage.

Bacterial meningitis infection may show up in a person by a sudden onset of fever, headache, and stiff neck. It will often have other symptoms, such as nausea, vomiting, increased sensitivity to light, and confusion. Infants may appear to be slow or inactive (lack of alertness), irritable, vomiting or feeding poorly. The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within three to seven days after exposure. Later symptoms of bacterial meningitis can be very severe (e.g., seizures, coma). For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible.

Bacterial meningitis can be treated effectively with antibiotics. It is important that treatment be started as soon as possible. Appropriate antibiotic treatment of the most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15 percent, although the risk remains higher among young infants and the elderly.

4. Symptoms of viral meningitis in adults may differ from those in children.

Viral meningitis is generally less severe and resolves without specific treatment. However, the symptoms of viral meningitis are similar to those for bacterial meningitis, which can be fatal. Because of this, it is important to see a health care provider right away if you think you or your child might have meningitis.

Common symptoms in infants:

  • Fever
  • Irritability
  • Poor eating
  • Hard to awaken

Common symptoms in adults:

  • High fever
  • Severe headache
  • Stiff neck
  • Sensitivity to bright light
  • Sleepiness or trouble waking up
  • Nausea, vomiting
  • Lack of appetite

There is no specific treatment for viral meningitis. Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. Symptoms usually last from seven to 10 days, and people with normal immune systems usually recover completely. A hospital stay may be necessary in more severe cases or for people with weak immune systems.

5. There are no vaccines for the most common causes of viral meningitis, so the best way to prevent it is to prevent viral infections.

Most viral meningitis cases in the United States, especially during the summer months, are caused by enteroviruses (small viruses made of RNA and protein); however, only a small number of people with enterovirus infections actually develop meningitis.

There are steps you can take to help lower your chances of becoming infected with viruses or of passing one on to someone else:

  • Wash your hands thoroughly and often, especially after changing diapers, using the toilet, or coughing or blowing your nose.
  • Clean contaminated surfaces, such as doorknobs or the TV remote control, with soap and water and then disinfect them with a dilute solution of chlorine-containing bleach.
  • Avoid kissing or sharing a drinking glass, eating utensil, lipstick, or other such items with sick people or with others when you are sick.
  • Make sure you and your child are vaccinated. Vaccinations included in the childhood vaccination schedule can protect children against some diseases that can lead to viral meningitis. These include vaccines against measles and mumps (MMR vaccine) and chickenpox (varicella-zoster vaccine).
  • Avoid bites from mosquitoes and other insects that carry diseases that can infect humans.
  • Control mice and rats. If you have a rodent infestation in and/or around your home, follow the cleaning and control precautions listed on CDC’s website about LCMV (Lymphocytic choriomeningitis virus). In rare cases LCMV, which is spread by rodents, can cause viral meningitis.

6. Fungal meningitis is very rare in the United States, but is more common in places such as sub-Saharan Africa.

Although anyone can get fungal meningitis, people with weak immune systems, like those with AIDS or cancer, are at higher risk. The most common cause of fungal meningitis for people with weak immune systems is Cryptococcus. This disease is one of the most common causes of adult meningitis in Africa.

CDC is currently working with countries in Africa and Asia to begin screening for Cryptococcus. We have new rapid diagnostic tests that will allow clinicians to detect fungal meningitis early among HIV positive patients, which will help them receive treatment earlier and has the potential to save hundreds of thousands of lives. There are about a million cases of fungal meningitis in sub-Saharan Africa every year, and about 600,000 deaths — even more deaths than are caused by tuberculosis, so this screening has the potential to make a huge impact in these countries.

7. Fungal meningitis is not contagious.

Fungal meningitis is not transmitted from person to person. It can develop after a fungus spreads through the bloodstream from somewhere else in the body, as a result of the fungus being introduced directly into the central nervous system, or from an infected body site infection next to the central nervous system.

You may also get fungal meningitis after taking medications that weaken your immune system. Examples of these medications include steroids (such as prednisone), medications given after organ transplantation, or anti-TNF medications, which are sometimes given for treatment of rheumatoid arthritis or other autoimmune conditions.

Symptoms are similar to symptoms of other forms of meningitis; however, they often appear more gradually and can be very mild at first.

Fungal meningitis is treated with long courses of high-dose antifungal medications, usually given through an IV line in the hospital. The length of treatment depends on the status of the immune system and the type of fungus that caused the infection. For people with immune systems that do not function well because of other conditions, like AIDS, diabetes, or cancer, treatment is often longer.

8. The United States is currently experiencing an unprecedented multi-state outbreak of fungal meningitis and other infections.

The Centers for Disease Control and Prevention (CDC), in collaboration with state and local health departments and the Food and Drug Administration (FDA), is investigating a multistate outbreak of fungal meningitis and other infections among patients who received contaminated steroid injections. The infections identified as part of this investigation include fungal meningitis, a form of meningitis that is not contagious, and infections associated with injections in a peripheral joint space, such as a knee, shoulder, or ankle.

All of the infections were associated with one of three lots of preservative-free methylprednisolone acetate, an injectable steroid medication recalled on September 26, 2012, from the New England Compounding Center (NECC).  See CDC’s website for more information about what patients need to know.

9. Primary amebic meningoencephalitis (PAM) is a very rare form of parasitic meningitis that causes a fatal brain infection.

Primary amebic meningoencephalitis (PAM) is a very rare form of parasitic meningitis that is caused by the microscopic ameba (a single-celled living organism) Naegleria fowleri.

Naegleria fowleri infects people by entering the body through the nose. This typically occurs when people go swimming or diving in warm freshwater places, like lakes and rivers. The Naegleria fowleri ameba travels up the nose to the brain where it destroys the brain tissue.

No data exist to accurately estimate the true risk of PAM. The hundreds of millions of visits to swimming venues that occur each year in the U.S. result in 0-8 infections per year.

Naegleria fowleri is found around the world. In the United States, the majority of infections have been caused by Naegleria fowleri from warm freshwater located in southern-tier states. The ameba can be found in:

  • Bodies of warm freshwater, such as lakes and rivers
  • Geothermal (naturally hot) water, such as hot springs
  • Warm water discharge from industrial plants
  • Geothermal (naturally hot) drinking water sources
  • Soil
  • Swimming pools that are poorly maintained, minimally-chlorinated, and/or un-chlorinated
  • Water heaters with temperatures less than 116.6 degrees Fahrenheit (47 degrees Celsius).

Naegleria fowleri is not found in salt water, like the ocean.

Several drugs are effective against Naegleria fowleri in the laboratory. However, their effectiveness is unclear since almost all infections have been fatal, even when people were treated. The fatality rate for an infected person who begins to show signs and symptoms is over 99 percent. Only 1 person out of 123 known infected individuals in the United States from 1962 to 2011 has survived.

10. There are several things that can cause non-infectious meningitis.

Non-infectious meningitis causes include:

  • Cancers
  • Systemic lupus erythematosus (lupus)
  • Certain drugs
  • Head injury
  • Brain surgery

Treatment depends on the underlying cause (cancer, head injury, brain surgery, etc.).

This type of meningitis is not spread from person to person.  Like other types of meningitis, symptoms of non-infectious meningitis include a sudden onset of fever, headache and stiff neck. It is often accompanied by other symptoms, such as nausea, vomiting, photophobia (sensitivity to light), and altered mental status.

Source: Centers for Disease Control and Prevention

If you still have questions about meningitis, join the NewsHour’s live chat with the CDC’s Dr. Amanda Cohn and Dr. Benjamin Park on Thursday, Nov. 15, at 1 p.m. ET. Submit your question in the comments section below or participate in the conversation live on Thursday.

Beware in Denver Salads sold at Safeway recalled due to Salmonella risk

May 3, 2011 · Posted in Medicine · Comment 

DENVER – The department of Public Health and Environment is recalling grape tomatoes sold in Colorado due to Salmonella risk. The recalled tomatoes were used in pre-packaged salads made by Taylor Farms Pacific for several stores. However, in Colorado, only products sold at Safeway stores are included in the recall.

According to a Safeway representative, the recalled products were pulled from store shelves on Sat. April 30. No illnesses have been reported.

The following Signature Café products sold at Safeway stores in Colorado are included in the recall:

– Chef salad in 11-oz. plastic trays with use by dates of 4/30/2011-5/5/2011 and UPC code 21130-06252

– Cobb salad in12-oz. plastic trays with use by dates of 4/30/2011-5/3/2011 and UPC code 21130-06251

– Greek salad in 13.5 oz. plastic tray with use by dates of 4/30/2011-5/3/2011 and 4/30/2011-5/5/2011, and UPC code 21130-06257

– Tomato mozzarella salad (sold at the deli counter) in varying sizes with use by dates of 4/30/2011-5/6/2011, 4/30/2011-5/7/2011, and 4/30/2011-5/8/2011, and UPC code 21256300000

Anyone who purchased any of the recalled products is advised to discard it or return it to the place of purchase for a refund.

Salmonella is a food-borne bacteria which cause serious and sometimes fatal infections in children, elderly and others with weakened immune systems. Healthy people infected with Salmonella often experience fever, diarrhea, nausea, vomiting and abdominal pain.

Ebola Virus Outbreaks Table

May 1, 2011 · Posted in Medicine · Comments Off on Ebola Virus Outbreaks Table 

 

 Known Cases and Outbreaks of Ebola Hemorrhagic Fever, in Chronological Order Source: http://www.cdc.gov/

Year(s)

Country

Ebola subtype

Reported no.
of human cases

Reported no. (%) of deaths among cases

Situation

 
 
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Ebola Hemorrhagic Fever

May 1, 2011 · Posted in Medicine · Comments Off on Ebola Hemorrhagic Fever 

Table of Ebola Outbreaks

What is Ebola Virus?
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