Minnesota Department of Health (MDH) Bug Bytes
October 02, 2002
Vol. 3: No. 12
Topics in this Issue:
1. West Nile Virus - Gone but Not Forgotten
2. Syphilis Increase
3. E. coli O157:H7 Outbreak
4. Conference Reminder
1. West Nile Virus - Gone but Not Forgotten
No one's happier to see the arrival of fall and frost then
us. Mosquito populations are rapidly declining as they are
preparing for their winter life stage. Thus, the risk of West
Nile Virus (WNV) infection is rapidly declining.
To date, 26 human cases of WNV infection have been reported
in Minnesota. The median age of cases is 48 years, with an
age range of 29-85. Sixteen persons were hospitalized; there
were no deaths. The 26 cases included 6 cases of encephalitis,
6 with aseptic meningitis; 1 with acute flaccid paralysis
(AFP), 1 with both encephalitis and AFP, and the rest were
classified as WNV fever. AFP was described in detail in a
recent MMWR (at http://www.cdc.gov/mmwr/preview/
mmwrhtml/mm5137a1.htm) with patients developing a polio-like
syndrome with involvement of the anterior horn cells of the
spinal cord and motor axons. Patients developed asymmetrical
weakness without pain or sensory loss. We may become aware
of additional human cases in Minnesota as laboratory test
results make their way through the pipeline to us. In 2002
to date, in the U.S., 2,427 human cases including 124 deaths
have been reported.
Over 725 horses (among the highest number of any state) and
292 birds have tested positive for WNV in Minnesota in 2002
to date. Updated maps depicting the distribution of birds,
horses, and humans are at http://www.health.state.mn.us/divs/
idepc/diseases/westnile/.
In the next few months we will be testing previously collected birds and mosquitoes, reviewing data, and strategizing for next year's WNV season.
2. Syphilis Increase
After declining for the last 10 years, syphilis is on the
increase. Fifty cases of early syphilis infections have been
reported in Minnesota for the first 9 months of 2002 compared
to 49 cases for the entire year of 2001. Of the 50 syphilis
cases this year, 44 are male and 6 are female. Thirty-four
of the male cases are among men who have sex with men (MSM)
compared to just 5 cases in this group last year. Nineteen
are also HIV-infected. This trend follows increases in syphilis
being seen among MSM on the east and west coasts the last
few years as described in last week's MMWR (at http://www.cdc.gov/mmwr/preview/
mmwrhtml/mm5138a1.htm).
"Know syphilis in all its manifestations and relations, and all other things clinical will be added unto you." (Sir William Osler, 1897) We are recommending that physicians step up their screenings for syphilis among male clients along with encouraging people who may be at risk to get checked for syphilis. The CDC treatment guidelines for STDs are available online at www.cdc.gov/std/treatment/default.htm.
3. E. coli O157:H7
Outbreak
The Wisconsin Division of Public Health is currently investigating
two outbreaks of E. coli O157:H7 infections that have
occurred in multiple Wisconsin counties. The suspected vehicle
for transmission of E. coli O157:H7 in both of these
outbreaks is ground beef. To date, a total of 53 laboratory-linked
cases among Wisconsin residents have been identified with
the outbreaks. We have had 6 cases that match to one of their
two outbreak strains by pulsed-field gel electrophoresis.
A ground beef sample obtained from one of our cases tested
positive for one of the outbreak strains of E. coli
O157:H7. Based on this and additional isolation of the organism
from ground beef samples in Wisconsin, the U.S. Department
of Agriculture has announced a recall of approximately 416,000
pounds of ground beef produced in Milwaukee and distributed
in Minnesota, Wisconsin, Michigan, and Illinois. Specific
recall details (product type, dates, etc.) are at http://www.fsis.usda.gov/oa/recalls/
rnrfiles/rnr086-2002.htm.
4. Conference Reminder
There's still time to register for our "8th Annual Emerging
Infections in Clinical Practice and Emerging Health Threats
Conference." With such great speakers and timely topics
such as E. coli O157:H7, pneumococcal disease, vancomycin-resistant
S. aureus, judicious antibiotic use, and bioterrorism,
you don't want to miss out! Registration is available now
through University of Minnesota Continuing Medical Education.
Call 612 626-7600 or 1-800-776-8636 or access the conference
brochure and registrations materials at http://www.med.umn.edu/cme/brochures2002/
emerginginf2002/emergiginf2002.html.
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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