Minnesota Department of Health (MDH) Bug Bytes
December 1, 2000
Vol. 1: No. 9
1. World AIDS Day
2. No Culture-Confirmed Influenza So Far in Minnesota
3. Mad Cows and Creutzfeldt-Jacob Disease
4. Breaking News - E. coli O157:H7 Outbreak
1. World AIDS Day
December 1, 2000 will mark the 13th annual World AIDS Day. As of January
1, 2000, over 33.4 million people world-wide were estimated to be living
with HIV/AIDS. In Minnesota from 1990 through 1999, approximately 1 person
per day was reported with an HIV diagnosis; over 1,600 persons died with
a HIV diagnosis. Currently over 3,900 persons reported to MDH are living
with HIV/AIDS. More information on World AIDS Day and the HIV/AIDS pandemic
can be accessed at website: http://www.avert.org/worldaid.htm.
Attention: Non-MDH link
2. No Culture-Confirmed Influenza So Far in Minnesota
So far this season, we have not had any culture-confirmed influenza cases
in Minnesota. Laboratory confirmed influenza (diagnosed by culture, rapid
antigen test or serology) is a reportable condition in Minnesota. In addition
to mandatory reporting, 13 sentinel clinics in the state voluntarily submit
isolates from patients with influenza-like illness and report the number
of patients seen weekly with influenza-like illness. The CDC provides
weekly updates on influenza activity throughout the nation which can be
found on this website: http://www.cdc.gov/ncidod/diseases/flu/weekly.htm.
Attention: Non-MDH link
3. Mad Cows and Creutzfeldt-Jacob Disease
Last week we received a telephone call similar to one we receive at least
a half dozen times a year: "Isn't it true that Minnesota has just had
its first case of ‘mad cow disease in humans'?"
Untrue. Creutzfeldt-Jakob disease (CJD), a rapidly progressive neurodegenerative
disease, was first described in 1920 and 1921 by H.J. Creutzfeldt and
A. Jakob. CJD occurs sporadically and famially and produces spongioform
changes in the brain. It occurs at a rate of 0.5-1.5 per million per year;
thus, we see about 4 cases/year in Minnesota. It tends to occur in those
50-70 years of age and since mean survival is 5 months, monitoring of
death certificates is a reliable method of monitoring for CJD. CJD and
other transmissible encephalopathies are thought to be due to prions (inexplicably
derived from the term, proteinaceous infectious particles). In 1985 in
the United Kingdom, several cows were observed to have symptoms of uncoordination
and apprehension. This lead to the discovery of bovine spongioform encephalopathy
(BSE) or mad cow disease. Over 170,000 cows have since been diagnosed
with BSE in the UK. Recent headlines have documented BSE spread to France
and Germany. BSE is thought to have originated when cows were fed bone
and meat supplements inadequately rendered to have destroyed the prion
agent (from sheep or cows). In 1996, a variant form of CJD (vCJD) was
described in the UK; case-patients were younger, lived longer, and had
differing clinical presentations than CJD. As of November 6, 85 cases
have been reported in the UK. It has been shown by a variety of means
that the causative agent of vCJD is the same as BSE. How humans have acquired
this disease from cows is unknown. No cases of vCJD or BSE have been documented
anywhere in the U.S. to date. We remain vigilant. Neuropathologists are
primed to report suspicious vCJD cases; in particular cases of CJD in
persons less than 55 years of age are closely scrutinized. If you have
questions about spongioform encephalopathies, please call us. A good website
documenting BSE and vCJD is http://www.cjd.ed.ac.uk.
Attention: Non-MDH link
4. Breaking News - E. coli
O157:H7 Outbreak
Since Monday our lab has confirmed 17 cases of E. coli O157:H7
with an identical PFGE subtype. Six of these cases have been hospitalized.
We have been interviewing cases and age-matched controls, and initial
analysis seems to implicate retail ground beef (hopefully not from mad
cows).
Bug Bytes is a combined effort of the Infectious Disease Epidemiology, Prevention and Control Division and the Public Health Laboratory Division of MDH. We provide Bug Bytes as a way to say THANK YOU to the infection control professionals, laboratorians, local public health professionals, and health care providers who assist us.
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