June 30, 2006 -- The US Centers for Ache Ascendancy and Prevention (CDC) appear in the June 30 affair of the Morbidity and Bloodshed Weekly Report on animal cases of eastern equine encephalitis virus infection that accentuate the accent of its analytic application and use of careful measures adjoin mosquito exposure; cases of travel-associated dengue infection that highlight the charge for agnate measures amid travelers to ancient close areas; a Salmonella beginning that has been affiliated to acquaintance with attenuated pet treats; and a 50% access in motorcycle-related fatalities over a 5-year period.
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Cases of Mosquito-Borne EEEV in Northeast US Accentuate Charge for Careful Measures
The CDC has appear on 11 cases of animal eastern equine encephalitis virus (EEEV) ache in New Hampshire (7) and Massachusetts (4) from August to September 2005. According to the CDC, these are the aboriginal cases to action in New Hampshire in 41 years, and they represent a 5-fold access over anniversary Massachusetts EEEV ante for the aftermost 10 years.
Findings from the afterwards assay accentuate the accent of analytic application of arboviral encephalitis in the United States and use of antitoxin measures such as bounded mosquito ascendancy and use of insect repellant.
The CDC begin that in all cases, the afflicted individuals lived and additionally formed or socialized in areas abreast swamps, cranberry bogs, or added wetlands able of acknowledging assembly of arch mosquito populations and both communicable and enzootic transmission. Although the abeyant for acknowledgment at aurora or dark was present for 2 weeks above-mentioned evidence onset, the majority of patients appear casual or never use of insect repellant.
Prior to assay for encephalitis or meningitis, best patients (73%) had accomplished affection for a aeon of 2 to 15 canicule and 3 appear affection abiding beneath than a day. Five patients, including the 4 (36%) who died, had been ahead evaluated by healthcare providers for all-embracing symptoms.
Encephalitis apparent by adapted brainy cachet was diagnosed in the majority of cases (9 [82%]); meningitis afterwards adapted brainy cachet occurred beneath frequently (2 [18%]). Three patients with encephalitis had astute neurologic affection astute actual hospitalization, and 6 had neurologic affection afterwards all-embracing prodromal systemic symptoms.
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The CDC advises healthcare professionals to assay for EEEV in patients presenting with antibacterial meningitis or encephalitis and who abide in areas that abutment ache transmission.
Recommendations to abate the accident for acknowledgment to this and added mosquito-borne diseases accommodate approved use of insect repellents absolute DEET, picaridin, or oil of auto eucalyptus; acid long-sleeved shirts and pants back outdoors; and abstention of alfresco acknowledgment during periods of aerial mosquito action (dusk to dawn).
Travel-Associated Dengue Cases Highlight Charge for Mosquito Abstention in Close Areas
The CDC has appear on 96 cases of travel-associated dengue virus infection in US association during 2005 that accentuate the accent of application repellants and alienated acknowledgment to mosquitos while traveling to close areas area the ache is endemic.
Of the 73 patients for whom biking destinations were identified, 44% appear biking to Mexico during the 2 weeks above-mentioned to evidence onset; visits to Central America, the Caribbean, and Asia were appear by 26%, 22%, and 8% of patients, respectively.
Clinical affection were appear for 24 patients (25%), of whom 6 had at atomic 1 hemorrhagic evidence such as epistaxis, hematemesis, hematuria, hemoptysis, petechia, or purpura. Alone 17 (18%) of 96 patients were appear accepting been hospitalized, including 1 woman age-old 28 years for whom the infection was fatal.
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Because no vaccine is currently accessible to anticipate infection, individuals traveling to dengue-endemic areas should abstain acknowledgment to mosquitos by application repellants, acid careful clothing, and actual in well-screened or air-conditioned areas. The CDC addendum that these measures are important not alone for the traveler, but additionally to anticipate the addition of dengue virus into the United States with the abeyant for aboriginal manual (eg, the southeastern states).
The CDC advises that healthcare providers accede dengue in the cogwheel assay of patients who accept agitation and a history of biking to close areas any time during the 2 weeks afore evidence onset.
To assay for dengue, serum samples should be acquired during the astute appearance of the affliction (0 to 5 canicule afterwards evidence onset) and afresh during the ambulatory appearance (1 to 2 weeks later) for viral apprehension and serologic diagnosis, respectively.
Specimens should be beatific through accompaniment or territorial bloom departments to the CDC's Dengue Branch, Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, 1324 Calle Cañada, San Juan, Puerto Rico 00920-3860 (telephone, 787-706-2399; fax, 787-706-2496).
The CDC addendum that samples should be accompanied by a arbitrary of analytic and epidemiologic information, including date of ache onset, date of sample collection, and abundant contempo biking history. Additional advice apropos dengue case advertisement and instructions for case aircraft are accessible at http://www.cdc.gov/ncidod/dvbid/dengue/dengue-hcp.htm.
Salmonella Beginning Affiliated to Acquaintance With Attenuated Pet Treats
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The CDC has appear on an beginning of animal Salmonella Thompson cases attributed to acquaintance with attenuated pet treats of beef and seafood origin. The 9 cases were traced to 2 manufacturers that candy arctic raw beef and apricot into pet treats for bodies and dogs by thawing the materials, acid them into adapted shapes and sizes, and again dehydrating them for packaging and distribution.
According to CDC, aridity temperatures may not accept been aerial abundant to annihilate bacteria, and no added processing accomplish (eg, irradiation) were used. Subsequent cultures of the apricot treats appear the attendance of up to 80,000 colony-forming units of Salmonella Thompson per gram.
To abate the accident for bacterial transmission, consumers are brash to consistently ablution their easily thoroughly with soap and baptize afterwards administration animal-derived pet treats. The CDC advises that acquaintance with treats be abhorred altogether by individuals at added accident for infection or austere complications from salmonellosis (eg, accouchement age-old < 5 years, earlier adults, and those with compromised allowed systems).
Motorcycle-Associated Fatalities Double During 5-Year Period
An assay of 1999 to 2003 abstracts from the National Vital Statistics System has appear a 5.4% access in the all-embracing bloodshed amount due to accidental injury.
Although bloodshed ante associated with suffocation/choking, fire/burn, and drowning decreased, those associated with poisoning, falls, and motor agent accidents (MVA) added by 52.3%, 20.8%, and 0.7%, respectively, with 50% of the access in MVA fatalities attributed to motorcycle accidents.
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MMWR . 2006;55:697-719
Reviewed by Gary D. Vogin, MD
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