HIV pandemic's origins located: It may have emerged in Congo in 1920s

 Scanning electron micrograph of an HIV-infected H9 T cell. Credit: NIAID

 http://medicalxpress.com/

The HIV pandemic with us today is almost certain to have begun its global spread from Kinshasa, the capital of the Democratic Republic of the Congo (DRC), according to a new study.
An international team, led by Oxford University and University of Leuven scientists, has reconstructed the genetic history of the HIV-1 group M pandemic, the event that saw HIV spread across the African continent and around the world, and concluded that it originated in Kinshasa. The team's analysis suggests that the common ancestor of group M is highly likely to have emerged in Kinshasa around 1920 (with 95% of estimated dates between 1909 and 1930).
HIV is known to have been transmitted from primates and apes to humans at least 13 times but only one of these transmission events has led to a human pandemic. It was only with the event that led to HIV-1 group M that a pandemic occurred, resulting in almost 75 million infections to date. The team's analysis suggests that, between the 1920s and 1950s, a 'perfect storm' of factors, including urban growth, strong railway links during Belgian colonial rule, and changes to the sex trade, combined to see HIV emerge from Kinshasa and spread across the globe.
A report of the research is published in this week's Science.
'Until now most studies have taken a piecemeal approach to HIV's genetic history, looking at particular HIV genomes in particular locations,' said Professor Oliver Pybus of Oxford University's Department of Zoology, a senior author of the paper. 'For the first time we have analysed all the available evidence using the latest phylogeographic techniques, which enable us to statistically estimate where a virus comes from. This means we can say with a high degree of certainty where and when the HIV pandemic originated. It seems a combination of factors in Kinshasa in the early 20th Century created a 'perfect storm' for the emergence of HIV, leading to a generalised epidemic with unstoppable momentum that unrolled across sub-Saharan Africa.'
'Our study required the development of a statistical framework for reconstructing the spread of viruses through space and time from their genome sequences,' said Professor Philippe Lemey of the University of Leuven's Rega Institute, another senior author of the paper. 'Once the pandemic's spatiotemporal origins were clear they could be compared with historical data and it became evident that the early spread of HIV-1 from Kinshasa to other population centres followed predictable patterns.'
One of the factors the team's analysis suggests was key to the HIV pandemic's origins was the DRC's transport links, in particular its railways, that made Kinshasa one of the best connected of all central African cities.
'Data from colonial archives tells us that by the end of 1940s over one million people were travelling through Kinshasa on the railways each year,' said Dr Nuno Faria of Oxford University's Department of Zoology, first author of the paper. 'Our genetic data tells us that HIV very quickly spread across the Democratic Republic of the Congo (a country the size of Western Europe), travelling with people along railways and waterways to reach Mbuji-Mayi and Lubumbashi in the extreme South and Kisangani in the far North by the end of the 1930s and early 1950s. This helped establishing early secondary foci of HIV-1 transmission in regions that were well connected to southern and eastern African countries. We think it is likely that the social changes around the independence in 1960 saw the virus 'break out' from small groups of infected people to infect the wider population and eventually the world.'
It had been suggested that demographic growth or genetic differences between HIV-1 group M and other strains might be major factors in the establishment of the HIV pandemic. However the team's evidence suggests that, alongside transport, social changes such as the changing behaviour of sex workers, and public health initiatives against other diseases that led to the unsafe use of needles may have contributed to turning HIV into a full-blown epidemic – supporting ideas originally put forward by study co-author Jacques Pepin from the Université de Sherbrooke, Canada.
Professor Oliver Pybus said: 'Our research suggests that following the original animal to human transmission of the virus (probably through the hunting or handling of bush meat) there was only a small 'window' during the Belgian colonial era for this particular strain of HIV to emerge and spread into a pandemic. By the 1960s transport systems, such as the railways, that enabled the virus to spread vast distances were less active, but by that time the seeds of the pandemic were already sown across Africa and beyond.'
The team says that more research is needed to understand the role different social factors may have played in the origins of the HIV pandemic; in particular research on archival specimens to study the origins and evolution of HIV, and research into the relationship between the spread of Hepatitis C and the use of unsafe needles as part of public health initiatives may give further insights into the conditions that helped HIV to spread so widely.
More information: The early spread and epidemic ignition of HIV-1 in human populations, Science, 2014. www.sciencemag.org/lookup/doi/… 1126/science.1256739

Ebola virus: 'Biological war' in Liberia

http://www.bbc.co.uk/news/

 

 Ebola robs death of its dignity as victims' bodies are quickly

 burnt with the plastic suits they are wrapped in

Continue reading the main story

Ebola outbreak

• How bad can Ebola get?
• How to avoid Ebola
• Doctor's report
• Why so dangerous?

With warnings from officials that the Ebola virus is "spreading like wildfire" in Liberia, Sarah Crowe, who works for the UN children's agency (Unicef), describes her week on the Ebola front line:

Flights into disaster zones are usually full of aid workers and journalists. Not this time.
The plane was one of the first in after some 10 airlines stopped flying to Liberia because of Ebola, and still it was empty.
When I was last in Liberia in 2006, it was to work on reintegration of child soldiers in a time of peace. Now the country is fighting a "biological war" from an unseen enemy without foot soldiers.
As we enter the airport, an unnerving sight - a team of health workers kitted out with masks and gloves asks us to wash our hands with a chlorine solution and takes our temperatures.

 

Health workers themselves have to be frequently sprayed with disinfectant

It was to be the start of a new routine - the hours and days since, I have had my temperature taken about 15 times and have had to wash my hands with chlorine at the entrance to every building, every office, every store, and every hotel.

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“Start Quote

It was a normal pregnancy, but she was turned away by every hospital as staff were too afraid to take her in case she had Ebola”

Even in small villages. And yet ironically, despite all this, few health facilities are properly functioning.

The next morning, the breakfast room at the hotel is buzzing - a large group of scientists from the US Centers for Disease Control and Prevention (CDC) huddle around computers animatedly talking, checking charts and data.
The world's Ebola experts are here - writing the first draft of Ebola history in real time.
The capital, Monrovia, reveals itself as a city branded by Ebola posters shouting out what people know all too well by now - Ebola is deadly, protect yourself, wash your hands.
Human booby traps The talk in the car, on the radio is only about Ebola - people calling in want to know what to do when their child gets sick, they either fear health centres and hospitals or they are not treated.

Ebola virus disease (EVD)

• Symptoms include high fever, bleeding and central nervous system damage
• Spread by body fluids, such as blood and saliva
• Fatality rate can reach 90% - but current outbreak has mortality rate of about 55%
• Incubation period is two to 21 days
• There is no proven vaccine or cure
• Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
• Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host

A colleague tells me she has just lost a family member about to give birth.
It was a normal pregnancy, but she was turned away by every hospital as staff were too afraid to take her in case she had Ebola.
She did not have the virus, but she died because of delivery complications. Her baby at least survived.
News of the US obstetrician in Liberia who contracted the deadly disease while delivering a baby has helped fuel such worries.
So far 169 Liberian health care workers have been affected by Ebola and 80 have died - a massive blow to a fragile health system.
Next I prepare to go up country to Lofa county where more warehouse space was needed - Unicef has delivered tonnes of equipment, including personal protective suits, chlorine and oral rehydration salts to Liberia - and more monitoring was required of those other now-neglected childhood killers like measles, diarrhoea and cholera.
Ebola has turned survivors into human booby traps, unexploded ordinance - touch and you die. Ebola psychosis is paralysing.

 

The workers often look like crop sprayers

Heavy rains lash down over the weekend - I shudder to think of Medecins Sans Frontieres and health ministry workers and patients battling under plastic sheeting in such rains.
Luckily the skies over Monrovia clear for the hour-and-a-half helicopter ride to the hot-zone border between Sierra Leone, Guinea, and Liberia.
In Voinjama, I'm out with a team of social mobilisers who interact and educate communities.
They are playing our song - Ebola Is Here - on a megaphone through the village.

Ebola in Africa: Can we dodge a global pandemic?

By Chris Kilham

Published July 10, 2014

FoxNews.com

CDC/ Cynthia Goldsmith

Right now, a fight for survival is taking place in the West African nations of Guinea, Sierra Leone and Liberia. Ebola, one of the most lethal diseases on the planet, is on a killing rampage.  In Guinea, 303 people have died. In Sierra Leone, 99 have perished, and in Guinea, 65 lives have been claimed.
Within a few days, these figures will be higher. And the disease appears to just be getting warmed up. Spread by contact with bodily fluids, Ebola is flourishing in West Africa, and could be coming soon to a place near you.
When the outbreak began in Guinea in April, the mortality rate was higher than it is now. But the virus is still an extreme hazard, and health workers must work in full bio-hazard suits in order to keep themselves from being infected by the patients they are serving. The protective suits are extremely hot in the sweltering West African climate. They are like little mobile sauna units, slowly cooking the doctors, nurses and aids working inside them.
Named after the Ebola River, the virus was first discovered in 1976 in what was then Zaire and is now the Democratic Republic of Congo. A viral disease, Ebola starts out like a bad flu, exhibiting initial symptoms of fever, weakness, headache and muscle pain – but that’s where the similarities end.
The more severe symptoms commence as early as two days after contact with the virus. Ebola is a hemorrhagic fever, meaning it causes the rupturing of blood vessels throughout the body.  Victims may bleed from the eyes, nose, mouth, ears, anus and genitals, as well as through skin ruptures. The liver, lungs, spleen and lymph nodes can be overcome by Ebola, leading to massive organ failure, and an agonizing death can follow.
There are five strains of Ebola: Zaire, Sudan, Reston, Cote d’Ivoire, and Bundibugyo. Of these, four are known to cause the disease in humans, whereas Reston does not appear to do so.  The disease is transmitted from animals to humans. Fruit bats, monkeys, and wild game may host the virus and spread it to humans, but bats in particular are on the radar of health officials. They are known as reservoir species, carrying the virus without becoming sick from the disease.
Despite urgent, high level attention from the World Health Organization and the Centers for Disease Control and Prevention, Ebola has no specific treatment, no vaccine, and no effective medicines. Bed rest and remaining hydrated appear to be as effective as any course of treatment, with a disease whose mortality rate can be as high as 90 percent. In clinics, Ebola patients are kept isolated as much as possible, and any utensils used to diagnose them must be fastidiously sterilized. Health workers take a huge risk tending to the Ebola infected, and only bio-hazard suits afford enough protection. Still, even one accidental prick from a dirty needle can lead to infection. It is very risky business.
Now, we don’t have to worry, right? Ebola is, after all, over in Africa, far removed from us. Nothing could be further from the alarming truth.
Imagine this scenario: A health worker tends to Ebola patients in Guinea, and remains healthy due to good sanitation practices. Eventually, that health worker needs to travel to the United States or Europe, and he or she boards a plane. Unknowingly, they are infected but symptom-free so far. On the long flight home, they start to feel some aches and chills, and at one point, they sneeze, sending thousands of viruses into the air through the atomized mucus expelled from the nose. Other passengers breathe that air, taking in a few viruses here and there, and they become infected.
And a global pandemic starts to roll.
This is neither a far-off scenario nor science fiction. It is a real possibility. And this is why health officials are so gravely concerned about the current Ebola outbreak. Unlike previous smaller outbreaks which have occurred in rural locations, this one is happening in hot, humid cities where crowds are dense and sanitation is sketchy; where basic hygiene is often hard to manage and many people eat wild game that might be infected. It is a perfect recipe for a massive, uncontrolled outbreak. Infecting another person is as easy as a sneeze, a kiss, cleaning up after someone, making contact with mucus, urine or feces.
The question, then, is what can you do? Except for staying away from anyone infected, you can’t do much. Right now it’s up to the health workers laboring in excessively hot bio-hazard suits, and to officials who are working hard on containment. This situation in West Africa could in fact be the start of a global disaster, or it may be another near-miss. The threat is real, and the disease is on the move. Will we dodge the Ebola bullet? Right now, all we can do is watch and wait.
Chris Kilham is a medicine hunter who researches natural remedies all over the world, from the Amazon to Siberia. He teaches ethnobotany at the University of Massachusetts Amherst, where he is Explorer In Residence. Chris advises herbal, cosmetic and pharmaceutical companies and is a regular guest on radio and TV programs worldwide. His field research is largely sponsored by Naturex of Avignon, France. Read more at MedicineHunter.com.

Doctors Without Borders: Ebola 'out of control'

 http://www.breitbart.com/

DAKAR, Senegal (AP) — The Ebola outbreak ravaging West Africa is "totally out of control," according to a senior official for Doctors Without Borders, who says the medical group is stretched to the limit in its capacity to respond.
The current outbreak has caused more deaths than any other on record, said another official with the medical charity. Ebola has been linked to more than 330 deaths in Guinea, Sierra Leone and Liberia, according to the latest numbers from the World Health Organization.
International organizations and the governments involved need to send in more health experts and increase public education messages about how to stop the spread of the disease, Bart Janssens, the director of operations for the group in Brussels, told The Associated Press on Friday.
"The reality is clear that the epidemic is now in a second wave," Janssens said. "And, for me, it is totally out of control."
The outbreak, which began in Guinea either late last year or early this year, had appeared to slow before picking up pace again in recent weeks, including spreading to the Liberian capital for the first time.
"This is the highest outbreak on record and has the highest number of deaths, so this is unprecedented so far," said Armand Sprecher, a public health specialist with Doctors Without Borders.
According to a World Health Organization list, the highest previous death toll was in the first recorded Ebola outbreak in Congo in 1976, when 280 deaths were reported. Because Ebola often touches remote areas and the first cases sometimes go unrecognized, it is likely that there are deaths that go uncounted, both in this outbreak and previous ones.
The multiple locations of the current outbreak and its movement across borders make it one of the "most challenging Ebola outbreaks ever," Fadela Chaib, a spokeswoman for the World Health Organization, said earlier in the week.
The outbreak shows no sign of abating and that governments and international organizations were "far from winning this battle," Unni Krishnan, head of disaster preparedness and response for Plan International, said Friday.
But Janssens' description of the Ebola outbreak was even more alarming, and he warned that the governments affected had not recognized the gravity of the situation. He criticized the World Health Organization for not doing enough to prod leaders and said that it needs to bring in more experts to do the vital work of tracing all of the people who have been in contact with the sick.
"There needs to be a real political commitment that this is a very big emergency," he said. "Otherwise, it will continue to spread, and for sure it will spread to more countries."
The World Health Organization did not immediately respond to requests for comment.
But Tolbert Nyenswah, Liberia's deputy minister of health, said that people in the highest levels of government are working to contain the outbreak as proved by the fact that that Liberia had a long period with no new cases before this second wave.
The governments involved and international agencies are definitely struggling to keep up with the severity of the outbreak, said Krishnan of Plan, which is providing equipment to the three affected countries and spreading information about how people can protect themselves against the disease. But he noted that the disease is striking in one of the world's poorest regions, where public health systems are already fragile.
"The affected countries are at the bottom of the human development index," he said in an emailed statement. "Ebola is seriously crippling their capacities to respond effectively in containing the spread."
The situation requires a more effective response, said Janssens of Doctors Without Borders. With more than 40 international staff currently on the ground and four treatment centers, Doctors Without Borders has reached its limit to respond, he said.
"It's the first time in an Ebola epidemic where (Doctors Without Borders) teams cannot cover all the needs, at least for treatment centers," he said.
It is unclear, for instance, if the group will be able to set up a treatment center in Liberia, like the ones it is running in in Guinea and Sierra Leone, he said. For one thing, Janssens said, the group doesn't have any more experienced people in its network to call on. As it is, some of its people have already done three tours on the ground.
Janssens said this outbreak is particularly challenging because it began in an area where people are very mobile and has spread to even more densely populated areas, like the capitals of Guinea and Liberia. The disease typically strikes sparsely populated areas in central or eastern Africa, where it spreads less easily, he said.
By contrast, the epicenter of this outbreak is near a major regional transport hub, the Guinean city of Gueckedou.
He said the only way to stop the disease's spread is to persuade people to come forward when symptoms occur and to avoid touching the sick and dead.
"There is still not a real change of behavior of the people," he said. "So a lot of sick people still remain in hiding or continue to travel. And there is still news that burial practices are remaining dangerous."
___
Associated Press video journalist Bishr Eltouni in Brussels and writer Jonathan Paye-Layleh in Monrovia, Liberia, contributed to this report.

West Africa Ebola death toll hits 337: WHO

21 hours ago

Geneva (AFP) - The death toll in west Africa's three-nation Ebola outbreak has risen to 337, the World Health Organization said Wednesday, making it the deadliest ever outbreak of the haemorrhagic fever.

Related Stories

• Guinea Ebola death toll rises above 200 AFP
• West Africa's Ebola death toll rises to 337 Associated Press
• Sierra Leone doubles Ebola death toll AFP
• Death toll from West Africa Ebola hits 337: WHO update Reuters
• Death toll from West Africa Ebola hits 337 -WHO update Reuters

Fresh data from the UN health agency showed that the number of deaths in Guinea, the hardest-hit country, has reached 264, while 49 had died in Sierra Leone and 24 in Liberia.

The new toll marks a more than 60-percent hike since the WHO's last figure on June 4, when it said 208 people had succumbed to the deadly virus.

Including the deaths, 528 people across the three countries have contracted Ebola, one of the deadliest viruses known to man, the WHO said.

A majority of cases, 398 of them, have surfaced in Guinea, where west Africa's first ever Ebola outbreak began in January.

Sierra Leone has registered 97 cases in total, while Liberia has seen 33.

 

Health workers wear protective suits in an isolation center for people infected with Ebola at Donka  …

 

WHO has described the epidemic as one of the most challenging since the virus was first identified in 1976 in what is now the Democratic Republic of Congo.

That outbreak, until now the deadliest, killed 280 people, according to WHO figures.

Ebola is a tropical virus that can fell its victims within days, causing severe fever and muscle pain, weakness, vomiting and diarrhoea -- in some cases shutting down organs and causing unstoppable bleeding.

No medicine or vaccine exists for Ebola, which is named after a small river in the DRC.

Aid organisations have said the current outbreak has been especially challenging since people in many affected areas have been reluctant to cooperate with aid workers and due to the practice of moving the dead to be buried in other villages.

West African authorities have also been struggling to stop mourners from touching bodies during traditional funeral rituals.

Study: Early Human Ancestors Got Herpes From Chimpanzees

June 16, 2014 1:55 PM

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File photo of chimpanzees. (credit: SIA KAMBOU/AFP/Getty Images)

ATLANTA (CBS Atlanta) — A new study finds that early human ancestors got herpes from chimpanzees.

According to LiveScience, researchers at the University of California, San Diego found that the “herpes simplex virus 1 infected hominids before their evolutionary split from chimps 6 million years ago.” In comparison, the herpes simplex 2 virus was transferred from chimps to human ancestors nearly 1.6 million years ago.
“Before we were human, there was still cross-species transmission into our evolutionary lineage,” Joe Wertheim, study author and assistant research scientist at the university’s AntiViral Research Center, told LiveScience.
Wertheim noted in his study that herpes simplex virus 2 was caused by “cross-species transmission” from modern chimp ancestors to humans, while the herpes simplex virus 1 is a split between the chimp and human viruses.
“Understanding how and when we acquired viruses that currently infect us can give us perspective on future, potential cross-species transmission events that would lead to the introduction of new human viruses,” Wertheim told LiveScience.
According to the Centers for Disease Control and Prevention, most people infected with herpes do not know they have it and there is currently no cure for the disease.
Wertheim’s study was published in the Molecular Biology and Evolution journal.

News U.S. Officials Keep Close Eye On ‘Miserable’ Mosquito-Borne Chikungunya Virus

CDC: Cases Confirmed In 15 States, Including N.Y., With 25 In Florida Alone June 16, 2014 6:19 PM

 

NEW YORK (CBSNewYork) — First there was West Nile virus. Now health experts are warning about another virus carried by mosquitoes.
The chikungunya virus — or “chik-v” — has sickened tens of thousands of people throughout the Caribbean with high fever and severe pain. Now Americans are coming down with it, too, and there’s fear that it will spread, CBS 2′s Kristine Johnson reported.
“This is not a fatal infection; it’s just a miserable infection,” said Dr. William Schaffner, chairman of Vanderbilt University’s Department of Preventive Medicine.
Cases of the mosquito-borne virus have been confirmed in 15 states, including New York. According to the U.S. Centers for Disease Control and Prevention, 25 cases have been reported in Florida alone.
“The chikungunya fever will last for three, four, five days,” Schaffner said. “You’re miserable. Then you’ll get better. We can treat you symptomatically.”
So far, all of the infected Americans have contracted the virus in parts of the world where it is common. But researchers are worried that mosquitoes in the U.S. could pick up the disease by biting infected people.
“There’s a concern that people from the United States who go to the Caribbean might be bitten by infected mosquitoes and then bring this illness, this virus, back to the United States,” Schaffner siad. “We have the kind of mosquito that will transmit this virus here in the U.S.”
Prior outbreaks have occurred in Africa, Asia, and Europe. Late last year, the virus was found for the first time on the Caribbean islands, where more than 100,000 people have been sickened.
“So far, we have no evidence that there are U.S.-bred mosquitoes that have become infected,” Schaffner said.
There is no vaccine to prevent the virus, which is rarely fatal.

Whooping Cough Epidemic in California as Cases Surge

  http://www.bloomberg.com/

By Marie French Jun 13, 2014 11:01 PM CT

20 Comments E

California’s whooping cough outbreak has reached epidemic levels, with 800 new cases in the last two weeks, according to the state’s public health agency.
There have been 3,458 cases of the respiratory infection, formally known as pertussis, in California as of June 10, the state’s Department of Public Health reported. That’s more than were reported in all of 2013. Most at risk are newborns, and two have died in California so far this year.
“Our biggest concern is always infants,” Stacey Martin, an epidemiologist with the U.S. Centers for Disease Control and Prevention’s division of bacterial diseases, said in a telephone interview. “There’s a gap in coverage between birth and the first vaccine.”
Whooping cough carries different symptoms at different ages. For children, a case can begin with a cough and runny nose before the cough worsens, characterized by a whooping sound that gives the disease its nickname. Infants don’t always have a cough but their faces may turn red or purple.
More than 900 of California’s cases occurred in April and May, a fivefold increase on the typical number seen in non-peak years, said Corey Egel, a spokesman for state health department.
The high number of cases isn’t unexpected because of the cyclical nature of the disease. California last had a widespread outbreak, or “peak,” in 2010. Martin said the priority is to encourage pregnant women to get the vaccine for pertussis, which the CDC has recommended since 2013.
Vaccinating pregnant women and infants helps prevent the spread of the disease, Ron Chapman, the state’s health department director, said yesterday in a statement.
The CDC recommends infants be vaccinated as early as six weeks after birth, because the effect of a vaccination given to their mother during pregnancy soon wears off, Martin said. The CDC also suggests shots for those spending time with newborns.
Nationwide, there have been three other deaths reported from whooping cough this year, Martin said. In total, 9,964 cases of whooping cough were reported in the U.S. through June 8, compared with 7,573 at the same time last year, the CDC said.

Sierra Leone shuts borders, closes schools to fight Ebola

12 hours ago

FREETOWN (Reuters) - Sierra Leone shut its borders to trade with Guinea and Liberia on Wednesday and closed schools, cinemas and nightclubs in a frontier region in a bid to halt the spread of the Ebola virus.

Sixteen people have died of Ebola in Sierra Leone, a figure that has doubled in the last week, Ministry of Health figures showed.

Authorities will also mount health checkpoints in the eastern Kailahun district and mandated that all deaths there be reported before burial. Anyone who dies of the virus must be buried under the supervision of health personnel, the Information Ministry said.

The decision to close district schools came after a nine-year-old whose parents died of Ebola tested positive for the virus, Deputy Minister of Information Theo Nicol told Reuters.

"There is more contacts between school-going kids than adults hence the closure of schools in the most affected district," he said. The ban exempted churches and mosques but religious leaders should urge anyone with a fever to go to a clinic, he said.
Local groups welcomed the measures given public concern over the virus, which can be transmitted by touching victims or their body fluids.
The virus initially causes a raging fever, headaches, muscle pain and conjunctivitis, before moving to severe phases that bring on vomiting, diarrhoea and internal and external bleeding.
Some 328 cases and 208 deaths are linked to Ebola in Guinea, according to the World Health Organization, making the outbreak one of the deadliest for years.

More than half of new deaths in Guinea were in the southern region of Gueckedou, epicenter of the outbreak which began in February, near the Sierra Leone and Liberian borders. The town is known for its weekly market which attracts traders from neighboring countries.

(Reporting by Umaru Fofana; Editing by Matthew Mpoke Bigg and Janet Lawrence)

CDC: Texas patient died of mad cow-related disease

June 6, 2014 4:11 AM

DALLAS (AP) — Health officials say a Texas patient is the fourth person in the United States to die of a rare brain disorder that is believed to be caused by consumption of beef products contaminated with mad cow disease.

The Centers for Disease Control and Prevention says in a statement that recent laboratory tests confirmed a diagnosis of variant Creutzfeldt-Jakob disease in the patient.
The CDC says that in each of the three previous U.S. cases, infection likely occurred outside the U.S. And the center says the Texas patient's history included extensive travel to Europe and the Middle East and suggests the infection occurred outside the country.
The CDC says that worldwide more than 229 variant CJD patients have been reported, with a majority of them in the United Kingdom and France.

The Texas Department of State Health Services says there are no state public health concerns or threats associated with the case. The CDC and DSHS are investigating.

The CDC says there is no known treatment for the disease and it is invariably fatal.

Florida facing threat from two mosquito-borne diseases

By Barbara Liston

ORLANDO Fla. Wed Jun 4, 2014 6:05pm EDT

(Reuters) - Two mosquito-borne diseases - dengue fever and chikungunya - are posing a serious threat to Florida and residents should take steps to control mosquito populations to try to limit the danger, a leading health expert said on Wednesday.
The Florida Department of Health, in its latest weekly report, said that through last week dengue fever had been confirmed in 24 people in Florida and chikungunya confirmed in 18 people. Both are viral diseases spread by mosquito bites.
All of the infected people in Florida have traveled to the Caribbean or South America and could have become infected there, according to Walter Tabachnick, director of the Florida Medical Entomological Laboratory in Vero Beach, which is part of the University of Florida.
Epidemiologists are worried that mosquitoes in Florida may have picked up the diseases by biting infected people, which could kick off an epidemic in the state, Tabachnick said.
"The threat is greater than I've seen in my lifetime," said Tabachnick, who has worked in the field for 30 years.
"Sooner or later, our mosquitoes will pick it up and transmit it to us. That is the imminent threat," he added.
Tabachnick urged the public to eliminate standing water including in buckets and rain barrels where mosquitoes can breed. "If there is public apathy and people don't clean up the yards, we're going to have a problem," Tabachnick said.
Dengue is potentially fatal, and both diseases cause serious and lingering symptoms. The most common symptoms of chikungunya infection are fever and joint pain, according to the U.S. Centers for Disease Control and Prevention.
Tabachnick said the last statewide epidemics in Florida of dengue occurred in the 1930s. Localized epidemics of dengue occurred in 2013 in a small neighborhood in Jensen Beach where 24 people were infected, and in 2009 and 2010 in Key West where 28 people were infected, according to state and federal reports.
The Caribbean Public Health Agency said this week that authorities in 18 Caribbean countries or territories had reported more than 100,000 confirmed or suspected cases of chikungunya.
In the Dominican Republic, where health officials reported more than 53,000 suspected cases, hospitals in hard-hit areas are treating hundreds of new patients per day.
(Additional reporting by Ezra Fieser in Santo Domingo; Editing by David Adams and Will Dunham)

Five dead as Sierra Leone records first Ebola outbreak

16 hours ago

ABID (Reuters) - Five people have died in Sierra Leone's first confirmed outbreak of Ebola virus, the World Health Organisation (WHO) said on Monday, signalling a new expansion of the disease which regional officials said had been brought under control.

Ebola, a haemorrhagic fever with a fatality rate of up to 90 percent, is believed to have killed some 185 people in neighbouring Guinea and Liberia since March in the first deadly appearance of the disease in West Africa.

Previously, several suspected cases of Ebola were recorded in Sierra Leone early on in the West African outbreak, but they later tested negative for the disease.

In a statement posted on its website, the WHO said the outbreak in Sierra Leone was located in an area along the country's border with Guinea's Guéckédou prefecture, where some of the earliest cases of the disease were recorded.

"Preliminary information received from the field indicates that one laboratory-confirmed case and five community deaths have been reported from Koindu chiefdom," it said.

The WHO said it was deploying six experts to the area along with essential supplies.
The West African outbreak spread from a remote corner of Guinea to the capital, Conakry, and into Liberia, causing panic across a region struggling with weak healthcare systems and porous borders.
A total of 258 clinical cases have been recorded in Guinea since the outbreak was first identified as Ebola, including 174 deaths - 95 confirmed, 57 probable and 57 suspected - according to the WHO.
No new cases of Ebola have been detected since April 26 in Conakry, where an outbreak could pose the biggest threat of an epidemic due to the city's role as an international travel hub.
However Guinean health officials announced two new confirmed cases on Friday in an area previously untouched by the virus. [ID:nL6N0O94X8]
The disease is thought to have killed 11 people in Liberia.
Ebola is endemic to Democratic Republic of Congo, Gabon, Uganda and South Sudan, and scientists initially believed that Central Africa's Zaire strain of the disease was responsible for the infections in Guinea and Liberia.

However researchers later published a study saying the West African outbreak was caused by a new strain of Ebola. [ID:nL6N0N94AE]

(Reporting by Joe Bavier; Additional reporting by Tom Miles in Geneva; Editing by Alison Williams)

Burger worker may have exposed thousands to hepatitis

As many as 5,000 people might have been exposed to hepatitis A at a Red Robin restaurant in Springfield, Missouri. The health threat is linked to an employee. VPC

Sarah Okeson, Springfield (Mo.) News-Leader 8:20 a.m. EDT May 22, 2014

 

(Photo: Valerie Mosley, Springfield (Mo.) News-Leader)

SPRINGFIELD, Mo. — Health officials worry that as many as 5,000 people could have been exposed to hepatitis A at a Red Robin restaurant here after a worker was diagnosed with the virus.
Springfield-Greene County Health Department officials received a report Tuesday about the illness, which can affect the liver, and worked with state and federal officials to get enough vaccine shipped so people who went to the restaurant May 8 to 16 can be immunized.
The goal is to get as many customers vaccinated within 14 days of their possible exposure, officials said Wednesday. Otherwise, the shot won't work, so they've set up clinics through the Memorial Day holiday weekend.
"Upon being informed of the incident, the Springfield Red Robin took all safety measures to ensure the well being of our guests and team members including arranging the inoculation of all Springfield team members with the immune globulin prophylaxis shot," Red Robin Gourmet Burgers (RRGB) officials said in a statement.
The restaurant now is considered safe, health department officials said. The city of Springfield, in southwest Missouri, has about 160,000 residents.
STORY: Teavana worker may have exposed shoppers to hepatitis
STORY: 118 sickened in hepatitis A outbreak linked to berries
Typically, hepatitis A is spread from the feces of an infected person to some food or drink that another person consumes. That's why proper hand washing after using the bathroom offers the first line of defense.
Hepatitis A does not always produce symptoms, and adults are more likely to have symptoms than children. Symptoms include nausea, vomiting, fever and yellowing of the skin or eyes.
Most cases of hepatitis A infection resolve themselves in a few weeks and do not cause permanent liver damage. About 10% to 15% of those who have the virus have a relapse of symptoms at some point in the six months following its onset, according to the federal Centers for Disease Control and Prevention.
Since the early 1990s the number of acute hepatitis A cases nationwide has fallen dramatically from more than 30,000 in the early 1990s to fewer than 1,700, attributed in great part to the introduction of the hepatitis A vaccine.
Nationwide, the CDC estimates that about 2,700 people came down with acute cases of the disease in 2011; about 1,400 cases were reported, an average of 28 cases per state.
Also recently:
• A Red Robin employee in Stroudsburg, Pa., also was diagnosed May 5 with hepatitis A. The Pennsylvania Department of Health did not consider the diagnosis a risk to the public though officials did say customers who dined there April 16 to May 5 should contact the department with concerns.
• A Teavana worker in Indianapolis may have exposed shoppers to the virus on three occasions in April while preparing tea samples, said Marion County Public Health Department officials, who told customers to watch for symptoms and offered vaccines for those who had been more recently exposed. Teavana is owned by Starbucks (SBUX).
• A Papa John's (PZZA) employee in Charlotte, N.C., may have infected customers of the pizza shop March 27 to April 7, according to the Mecklenburg County Health Department, which had more than 700 people come to vaccination clinics not far from the restaurant.
Contributing: Sony Hocklander, Jon Shorman and Stephen Herzog, Springfield (Mo.) News-Leader

MERS in the U.S.: Why You'll See More of It

By Maggie Fox

Health officials reported the second U.S. case of the mysterious new Middle East respiratory syndrome virus, or MERS, on Monday. Like the first case, it’s in a health care worker who traveled from Saudi Arabia.

Second US Case of MERS Found in US

Here are six things you need to know about MERS:

It’s new.

MERS was first seen in Saudi Arabia in 2012. Since then it has spread to 16 countries, most in the Middle East but also in Europe and Asia and now including the United States. It’s a coronavirus, a distant relative of the SARS — severe acute respiratory syndrome virus — that infected more than 8,000 people around the world and killed 774 before it was stopped in 2004.

You can expect more US cases.

"This is unwelcome, but not unexpected," Centers for Disease Control and Prevention Director Dr. Tom Frieden says. Health officials note that just about any disease is just a plane ride away. But most Americans are at very low risk of ever becoming infected. In 2003, eight SARS cases were confirmed in the U.S., all of them in travelers who were infected overseas and who did not infect anyone else.

It can be deadly.

WHO reports more than 530 confirmed cases and 174 deaths since the virus was identified in 2012. It’s killed between a quarter and a third of victims, which is a very high death rate for an infectious disease. But health experts say as officials look more closely for people infected with MERS they are finding milder cases, which takes the mortality rate down. Most who die have been either elderly or had another illness, such as diabetes or kidney failure. MERS

It doesn’t spread easily.

Health officials have closely studied the known patients, and the people who become infected usually have been in close and prolonged contact. One-fifth of the cases have been among health care workers who were treating patients intensively. There’s been no documented spread on an airplane, for instance. A patient in France who died infected a person who shared his hospital room, and family clusters have been reported from Saudi Arabia.

"We believe that if good infection control precautions are used during healthcare the risk to healthcare workers is also exceedingly low," says Dr. William Schaffner of Vanderbilt University, an infectious diseases expert. That includes wearing masks, gowns and gloves when treating patients.

There’s no treatment.

There’s no vaccine against MERS, although some groups are working on one, and antiviral drugs don’t appear to be of much use against it, either. The CDC has told U.S. hospitals to take strict precautions if someone shows up with symptoms. Patient care is mostly support, such as providing oxygen or breathing care.

No one knows where it came from.

The latest research suggests camels, but many patients have had no known contact with camels. Camel meat or milk might be a source, and the virus can live on surfaces and potentially could spread when people touch an infected surface. SARS was eventually traced to an animal called a civet, often sold in Asian markets as food.

Some health officials say it's possible MERS has been circulating but no one knew what it was because there wasn't a test for it. Many respiratory diseases are never diagnosed.

“While experts do not yet know exactly how this virus is spread, CDC advises Americans to help protect themselves from respiratory illnesses by washing hands often, avoiding close contact with people who are sick, avoiding touching their eyes, nose and/or mouth with unwashed hands, and disinfecting frequently touched surfaces,” the agency advises.

First published May 12th 2014, 2:59 pm

Ohio measles outbreak largest in USA since 1996

Kim Painter, Special for USA TODAY 1:41 p.m. EDT May 13, 2014

(Photo: CDC handout)

A measles outbreak in Ohio has reached 68 cases, giving the state the dubious distinction of having the most cases reported in any state since 1996, health officials say.
The Ohio outbreak is part of a larger worrisome picture: As of Friday, the federal Centers for Disease Control and Prevention had logged 187 cases nationwide in 2014, closing in on last year's total of 189. CDC warned several weeks ago that the country could end up having the worst year for measles since home-grown outbreaks were eradicated in 2000.
The last time a state had more measles cases than Ohio has now was 1996, when Utah had 119, according to CDC.
The Ohio outbreak, like ongoing outbreaks in California and elsewhere, has been linked to unvaccinated travelers bringing the measles virus back from countries where the disease remains common. In Ohio, all of the cases have been among the Amish, health officials say. The outbreak began after Amish missionaries returned from the Philippines. The Philippines is experiencing a large, ongoing measles outbreak with more than 26,000 cases reported, according to CDC.
The California outbreak, also linked to the Philippines, had reached 59 cases as of Friday, according to the California Department of Public Health.
The center of the Ohio outbreak is Knox County, where 40 cases have been reported. Thousands of Amish in Knox and surrounding areas have lined up to be vaccinated, says Pam Palm, spokeswoman for the county health department. Though the Amish traditionally have low vaccination rates, "they have been very receptive to coming in and getting immunized," to stem the outbreak, Palm says.
Some of the unvaccinated missionaries told local health officials they would have been vaccinated for measles before going to the Philippines if they had been told there was an outbreak there, Palm says: "One guy we spoke to feels just terrible that he brought the measles back and exposed his family."
Ohio also is in the midst of a mumps outbreak of more than 300 cases. Given the outbreaks, state health officials are urging families to check vaccination records and get up to date before summer camps and gatherings begin. "Activities that bring large groups of people together can accelerate the spread of these diseases," state epidemiologist Mary DiOrio said in a news release.
Before the measles vaccine became available in 1963, the virus infected about 500,000 Americans a year, causing 500 deaths and 48,000 hospitalizations. Case counts since 2000 have ranged from 37 in 2004 to a high of 220 in 2011, CDC says.
While most people recover from the fever, rash and other symptoms associated with measles after a few days, complications can occur, especially in children. Those complications can include ear infections and pneumonia or, more rarely, brain infection. One or two out of 1,000 children with measles will die, says CDC

Chikungunya Virus Outbreak Likely in the U.S., Say Experts

Yahoo Health

By Dana K. Cassell
Thu, May 08, 2014

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Chikungunya (pronounced chik-en-gun-ye) is a viral disease transmitted to humans by the bites of infected Aedes aegypti and Aedes albopictus mosquitoes, which are found across the globe. First described during an outbreak in southern Tanzania in 1952, the virus then spread to Africa, Asia, and the Indian subcontinent.
Originally believed to be a “tropical” disease, experts were surprised when an outbreak occurred in northeastern Italy in 2007. Now it has spread farther—to 14 Caribbean island countries since it was first detected on the island of St. Martin in December 2013. On May 1, 2014, the Caribbean Public Health Authority declared it an epidemic, with 4,108 probable cases across the region.
Get the Facts: Chikungunya Symptoms and Treatments

Symptoms, Diagnosis, and Treatment of Chikungunya

The most common symptoms of chikungunya are acute, high fever and intense joint pain. The infected person may also experience headaches, muscle pain, swollen joints, and/or a rash.
According to the U.S. Centers for Disease Control and Prevention (CDC), chikungunya infection should be considered as a possibility in anyone who develops a high fever and joint pain, and who has traveled to the location of an active outbreak within the previous three to seven days.
A blood test is used to diagnose chikungunya and to differentiate it from dengue, a more serious viral infection, which is also transmitted by Aedes mosquitos. Outbreaks of dengue usually occur in tropical urban areas, according to the CDC.
Even though chikungunya symptoms can be severe, the disease is rarely fatal, unlike dengue, which can be lethal if not treated in a timely manner. Most patients with chikungunya begin feeling better within a week; a few may experience joint pain for several months. Some cases result in persistent arthritis symptoms. People at risk for more severe cases of the disease include newborns, adults over the age of 65, and patients with underlying medical conditions.
There is no cure for chikungunya, and no vaccine to prevent it, so treatment is focused on relieving the symptoms. An infected person needs to rest, drink lots of fluids, and take medicines like ibuprofen, naproxen, or acetaminophen to relieve fever and pain until the symptoms fade.
Learn More: The Big Dangers of Small Bug Bites

Mosquitoes May Spread the Virus to the Southeastern U.S.

Because the Caribbean islands are close to the U.S., there is some concern that chikungunya will spread to the U.S., perhaps via Florida.
The disease has been diagnosed in the U.S. before, but only in travelers returning from areas where there are outbreaks, according to the Center for Infectious Disease Research and Policy. So far, no U.S.-based infections have occurred. But Dr. Gio J. Baracco, an associate professor of clinical medicine at the University of Miami Miller School of Medicine, told Healthline that the mosquitoes spreading the virus are already in the southeastern part of the U.S. “This fact, and the large amount of travelers passing through South Florida en route to and from the Caribbean islands, makes it very likely that chikungunya will be introduced into the U.S.,” he said.
Another infectious disease expert, Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University, explained how this “spreading” might occur. “Patients can acquire the infection while in the Caribbean through mosquito bites, and be incubating the infection. They’re feeling well as they come to the U.S. and then when they get sick, the virus is circulating in their blood streams.”
Then, an Aedes mosquito could bite that person and become infected itself, said Schaffner. “The mosquito thus infected in the U.S. infects another U.S. person, and that person in turn infects further mosquitoes. That’s how the virus appeared for the first time in a temperate zone, in Italy in 2007."
The virus could be carried beyond Florida, Schaffner said, but he added, “It might be established more readily in Florida, partly due to the volume of travel.”
Dr. Aileen M. Marty, a professor of infectious diseases at the Herbert Wertheim College of Medicine in Miami, agreed. “It can spread to any part of the U.S. where the mosquitoes live and breed,” she said.
Although an outbreak may occur at any time, Baracco said that summer is a vulnerable time. “The likelihood of an outbreak is related to the amount of vectors [infected mosquitoes] present. Aedes mosquitoes breed in stagnant water, and therefore are more common during the rainy season.”
The CDC's Dr. Erin Staples told Healthline that although it’s not possible to say at this point when local cases may occur here, it becomes more likely as more travelers return from areas where there are currently outbreaks, as mosquito populations grow, and as the weather gets warmer.

How Can I Protect Myself from Chikungunya?

To avoid becoming infected, Baracco said, “People should prevent mosquito bites by using adequate clothing, applying repellent, and getting rid of potential mosquito breeding sites."
Business travelers and vacationers in the Caribbean should exercise extra caution, Schaffner added. “Cruise travelers and people who stay in the islands for a period of time will need much more awareness about the prevention of mosquito bites. Use repellant—especially if you go out in the evening or in the early morning, when most of these mosquitoes like to bite. Wear longer trousers and long sleeves.”
Schaffner also envisions a wider use of bed netting. “People like to go to the islands, open the windows, and let the Caribbean breezes come through—they’re not always in hermetically sealed, air conditioned rooms. If you do that now, you might have to sleep under a bed net.”
The CDC is taking several steps to educate travelers to the Caribbean about the risks of chikungunya and how to protect themselves. Staples explained, "We are continually updating our travel notice with the latest on the spread of the virus and recommendations to prevent infection. In addition, the CDC has been working with its partners at airports with flights to the Caribbean to educate outgoing travelers about how to stay safe from chikungunya while in the Caribbean, and returning travelers about what symptoms to watch for and when to seek care. We’re also working to post them at additional airports and to translate them into Spanish."
Read this article at Healthline.com

Exclusive: Specter of SARS weighs on CDC as MERS virus lands in U.S.

http://www.reuters.com/

By Julie Steenhuysen

CHICAGO Sun May 4, 2014 10:04pm EDT

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(Reuters) - When the SARS outbreak arrived in Toronto on Feb. 23, 2003, carried by a woman traveling from Hong Kong, the disease quickly spread to hospital workers and patients in area hospitals, ultimately infecting 257 individuals and killing 33 people.
It's a memory that hangs fresh in the mind of Dr Michael Bell, deputy director of the division of healthcare quality promotion at the Centers for Disease Control and Prevention. The Atlanta-based federal agency last week sent a team of infectious disease experts to Community Hospital in Munster, Indiana, to attend to the first confirmed U.S. case of Middle East Respiratory Syndrome or MERS.
"We take this very seriously," Bell told Reuters in an exclusive interview. "In a worst-case scenario, this could spread rapidly."
MERS is caused by a coronavirus, a family of viruses that includes Severe Acute Respiratory Syndrome or SARS, which emerged in China in 2002-2003 and killed some 800 people.
"If you recall the SARS experience in Toronto, that was something that managed to be transmitted into the healthcare facility, leading to severe illness and death," he said.
"This is not something that we want to take lightly."
State health officials in Indiana report the man is in good condition and improving daily. Hospital personnel who may have been exposed to the virus are being kept in home isolation and watched daily for the emergence of pneumonia-like symptoms. Generally the incubation period of MERS is 14 days.
The patient is a healthcare worker who on April 28 was admitted to the hospital just 30 minutes south of Chicago after having worked in healthcare in Saudi Arabia, the center of the MERS outbreak that began in 2012. So far, 262 people in 12 countries have had confirmed infections that have been reported by the World Health Organization, and another 100 MERS patients have been confirmed by other ministries of health. So far, 93 people have died.
U.S. health officials are now checking airline manifests and contacting patients who may have been seated near the man who took a plane from Riyadh, Saudi Arabia, to London and then to Chicago, where he then took a bus to an undisclosed city in Indiana.
'ABSOLUTELY METICULOUS'
To keep the infection from spreading within the hospital, the man is being treated in an isolation room from which air is expelled through a filter, preventing it from being shared in the hallway.
"It's not because we have proof that this virus spreads easily through the air, but we don't want to take any chances," Bell said.
People who enter the room wear a respirator, a type of filtering mask that keeps them from breathing in any airborne particles in the room.
And because MERS is in a family of viruses called coronaviruses that can also be spread through contact with the patient's stool, the team is taking measures to keep all possibly infectious materials from leaving the room.
"You put on gowns and gloves before you go in the room. You take them off before you leave. You pay a lot of attention to washing your hands afterwards with alcohol gel or soap and water," Bell said.
Finally, because tear ducts in the eyes are connected to the throat, healthcare workers wear goggles or face shields to prevent any droplets from entering the eyes.
All of these measures are part of standard hospital protocols for treating various infectious diseases. People with tuberculosis are placed in airborne isolation rooms. With diarrheal diseases, healthcare workers use contact prevention measures.
"None of this is different from what the hospital is already accustomed to doing. We're just making sure the implementation in this case is absolutely meticulous," Bell said.
Bell said current hospital control measures became common practice during the HIV epidemic, when hospital workers had to assume anyone coming in the doors could be infected with the virus that causes AIDS.
"I think it's safe to say every healthcare worker, even in an outpatient setting, understands that whatever comes in the doors, they could be exposed to something infectious," Bell said.
"That ranges from something as common as seasonal influenza, or, if you work in a pediatric facility, there any number of diarrheal diseases," he said.
Despite the best efforts, however, hospitals remain a major source of infection. In March, the CDC reported that roughly one of every 25 U.S. hospital patients contracts an infection during their stay.
DISEASE POORLY UNDERSTOOD
Standard procedures for patients walking into the emergency department with a fever and respiratory complaints, as the MERS patient did in Indiana, are to put a mask on the patient and place them in room with a closed door.
"My understanding is the patient was placed in a private room very quickly," Bell said of the Indiana patient.
As for treatments, there are no specific drugs that can treat MERS, but there are basic treatments that can help the patient fight off the infection, including oxygen, which can reduce the burden on the lungs.
In addition to disease prevention experts, the CDC has sent a team of virologists to the hospital to study the MERS virus, which is still poorly understood. Although the virus first surfaced in 2012, its presence in the United States will give U.S. scientists the opportunity to study it up close.
Currently, it is not clear how the virus is transmitted, but it is clear that it can pass among individuals who have close contact with infected patients.
"The good news is that it's a group of viruses that have a very delicate envelope or membrane on the outside. Because of that, the virus tends to be rapidly inactivated by disinfectants," Bell said.
Since March of 2014, there has been a spike in the number of cases reported in Saudi Arabia. Bell said it is not clear whether that represents a change in the virus that makes it easier to spread, or an increase in the number of cases being reported to health officials.
"That is completely unknown at the moment. It's still rather early in terms of the viral characterization. Since this has all been happening outside the U.S., it's not something we've had a lot of time to work on."
At this point, the CDC has not issued any restrictions on air travel, but Bell said the case makes clear just how easily infections can spread. He recommends that people traveling through airports try to limit what they touch, and wash their hands frequently.

Newly arrived virus gains foothold in Caribbean

By DAVID McFADDEN 19 hours ago

FILE- In this undated file photo provided byt he USDA, an aedes aegypti mosquito is shown on human skin. Health officials in the Dominican Republic said this Tuesday April 29, 1014, that the mosquito-borne chikungunya virus has spread widely since making its first appearance in the country. According to the Centers for Disease Control the chikungunya virus is most often spread to people by Aedes aegypti and Aedes albopictus mosquitoes. These are the same mosquitoes that transmit dengue virus. They bite mostly during the daytime. (AP Photo/USDA, File)

KINGSTON, Jamaica (AP) — A recently arrived mosquito-borne virus that causes an abrupt onset of high fever and intense joint pain is rapidly gaining a foothold in many spots of the Caribbean, health experts said Thursday.

There are currently more than 4,000 confirmed cases of the fast-spreading chikungunya virus in the Caribbean, most of them in the French Caribbean islands of Martinique, Guadeloupe and St. Martin. Another 31,000 suspected cases have been reported across the region of scattered islands.
The often painful illness most commonly found in Asia and Africa was first detected in December in tiny St. Martin. It was the first time that local transmission of chikungunya had been reported in the Americas. Since then, it has spread to nearly a dozen other islands and French Guiana, an overseas department of France on the north shoulder of South America.
It is rarely fatal and most chikungunya patients rebound within a week, but some people experience joint pain for months to years. There is no vaccine and it is spread by the pervasive Aedes aegypti mosquito that transmits dengue fever, a similar but often more serious illness with a deadly hemorrhagic form.
The U.S. Centers for Disease Control and Prevention is closely monitoring the uncontrolled spread of the new vector-borne virus in the Caribbean and has been advising travelers about how best to protect themselves, such as applying mosquito repellant and sleeping in screened rooms. It is also closely watching for any signs of chikungunya in the U.S.
"To help prepare the United States for possible introduction of the virus, CDC has been working with state health departments to increase awareness about chikungunya and to facilitate diagnostic testing and early detection of any U.S. cases," said Dr. Erin Staples, a medical epidemiologist with the CDC.
In the Caribbean, concern about chikungunya is growing as many countries enter their wettest months. The only way to stop the virus is to contain the population of mosquitoes — a task that commonly relies on individual efforts such as installing screened windows and making sure mosquitoes are not breeding in stagnant water.
Experts say eradicating vector-borne diseases like chikungunya once they become entrenched is an extremely difficult task. Dr. James Hospedales, executive director of the Trinidad-based Caribbean Public Health Agency, recently described the virus as the "new kid on the block."

In late April, St. Vincent & the Grenadines and Antigua & Barbuda became the latest Caribbean countries to report confirmed cases. In the Dominican Republic, there are now 17 confirmed cases and over 3,000 suspected ones. This week, the virus was discussed by health authorities at a two-day conference in the Dominican Republic attended by representatives of Central American countries.

Marie Guirlaine Raymond Charite, general director of Haiti's health ministry, said there are several suspected cases of chikungunya but nothing has been confirmed yet.

___

AP writer Trenton Daniel contributed to this story from Port-au-Prince, Haiti.

David McFadden on Twitter: http://twitter.com/dmcfadd

The African Ebola outbreak that shows no sign of slowing

By Terrence McCoy 

April 23 at 5:56 am

 http://www.washingtonpost.com/

 

Last week, officials in Guinea expressed optimism. The outbreak of Ebola that had spread into Liberia and beyond appeared to be waning. The number of deaths, which had then numbered 106, had slowed. Travel restrictions had been bolstered. The outbreak, which had sent waves of panic across West Africa, finally seemed under control.
“The number of new cases have fallen rapidly,” Rafi Diallo, a spokesman for Guinea’s health ministry, told Reuters. On the day of the interview, April 15, there were 159 confirmed or suspected cases of the disease. “Once we no longer have any new cases … we can say that this is totally under control.”
It’s eight days later. And the number of those killed by the Ebola killed in Guinea is now 136. Nearly 210 cases have been confirmed. In all, across Liberia and Guinea, 142 people have been killed — and 242 infected — in an outbreak that began months ago in the forested villages of southeast Guinea and shot to the capital city.
It has dominated headlines in Africa since. The World Health Organization, which says it may spread for months, cautions that more deaths could be on the way. “As the incubation period for [Ebola] can be up to three weeks, it is likely that the Guinean health authorities will report new cases in the coming weeks and additional suspected cases may also be identified in neighboring countries,” the WHO reported on Tuesday.
The disease, for which there is no cure, is terrifying in part because of the gruesome way it kills. It predominantly spreads through blood, secretions and other bodily fluids. At first, the WHO says, symptoms include intense weakness and fever, but then the sickness deepens with bouts of diarrhea, vomiting, and internal and external bleeding.
There are several theories explaining the outbreak, Africa’s worst in seven years and the first to kill in the continent’s west. One was published last week in the New England Journal that established “the emergence of a new EBOV strain in Guinea,” which had “evolved in parallel” to other disease veins.
It said the sickness first appeared in December — substantially earlier than other estimates. “The [virus] introduction seems to have happened in early December 2013 or even before,” the researchers said. “It is suspected that the virus was transmitted for months before the outbreak became apparent because of clusters of cases in the [Guinea] hospitals of Guéckédou and Macenta. This length of exposure appears to have allowed many transmission chains and thus increased the number of cases of Ebola virus disease.”
The scientists said data suggests “a single introduction of the virus into the human population. … Further investigation is ongoing to identify the presumed animal source of the outbreak.” The animal that’s most likely behind the outbreak is the fruit bat, which pervades large swaths of west Africa. Officials suspect someone handled the meat of a contaminated bat, fell ill, and then spread the infection.
The fatality rate, the study concluded, was 86 percent “among the early confirmed and 71 percent among the clinically suspected cases,” a rate consistent with previous Ebola outbreaks. ”The emergence of the virus in Guinea highlights the risk of [Ebola] outbreaks in the whole West African sub-region.”