Minnesota Department of Health (MDH) Bug Bytes
April 16, 2003
Vol. 4: No. 5
1. SARS Update
We continue to receive reports of possible SARS cases in Minnesota. If you are a clinician and are seeing a potential patient, please call us at (612) 676-5414 for consultatation including lab testing and infection control information. To date, seven suspect SARS cases have been reported. Due to the rapidly changing epidemic and recommendations, we have been directing persons to the CDC SARS website at http://www.cdc.gov/ncidod/sars/.
2. 75th Anniversary and the 2002 Antibiogram
Seventy-five years ago, in 1928, Alexander Fleming noticed that a culture plate contaminated with the mold Penicillium notatum caused staphylococci growing near the mold to lyse. Further work by him and others identified and purified a substance that he called penicillin. In his Nobel Prize acceptance lecture on December 11, 1945 for the discovery of penicillin, Sir Fleming (he was knighted in 1944) warned of the dangers of development of antibiotic resistant bacteria, through underdosage of penicillin.
Sir Fleming's concerns have become reality and we continue to be concerned about antibiotic resistance. The MDH antibiogram is a compilation of antimicrobial susceptibilities of selected pathogens submitted to the Public Health Laboratory during the year 2002. Check it out at http://www.health.state.mn.us/divs/
dpc/ades/pub.htm. Laminated pocket-sized copies will be available and distributed soon. Thanks again microbiologists and ICPs for your efforts that have resulted in this tangible useful tool for clinicians.
We continue our collaborative efforts to combat antibiotic resistance in Minnesota through the Minnesota Antibiotic Resistance Collaborative. For information about its activities, see http://www.minnesotaarc.org/.
3. Meningococcal Disease
On March 25, a case of meningococcemia in a 20-year old University of Minnesota student was reported to us. The case-patient expired on March 27. Neisseria meningitidis was isolated in cerebrospinal fluid and blood and identified as serogroup C. Close contacts of the case were given antibiotic prophylaxis.
On April 6, a 29-year old UM graduate student was admitted to a hospital with fever, chest pain, and arthritis. Pericarditis and septic arthritis were diagnosed and N. meningitidis serogroup C was isolated from synovial fluid. We performed PFGE subtyping and found the strains from the two case-patients to be identical. Close contacts of the case were given antibiotic prophylaxis.
Current Advisory Committee on Immunization Practices guidelines
suggest that vaccine may be considered for use in control
of serogroup C meningococcal outbreaks (at http://www.cdc.gov/mmwr/
preview/mmwrhtml/rr4907a1.htm). An outbreak is defined by the occurrence of three or more confirmed or probable cases of serogroup C meningococcal disease during a period of <3 months, with a resulting primary attack rate of at least 10 cases per 100,000 population. Since this threshold had not been reached, we opted not to begin a vaccination program on campus, but opted for aggressive contact tracing and chemoprophylaxis of those contacts.
4. 2002 HIV/AIDS Surveillance Data
HIV/AIDS surveillance reports are produced annually each April. The annual HIV/AIDS surveillance report serves a vital role as a resource for education, funding allocation, and policy decisions related to the HIV/AIDS epidemic in Minnesota. The 2002 annual report (slides, tables, text) is currently available at http://www.health.state.mn.us/divs/dpc/
Between 2001 and 2002 the annual number of HIV infections diagnosed in Minnesota increased 6% (from 288 to 305 cases) that is attributable in whole to the continued increase in the number of cases diagnosed among African-born persons. The number of HIV diagnoses in this group increased by 41% from 46 cases in 2001 to 65 cases in 2002. The relatively equal impact of HIV/AIDS on men and women is an additional characteristic unique to this group.
Many cultural, social, and personal barriers exist that make HIV/AIDS prevention and service utilization challenging for this diverse group of Minnesotans. There are a growing number of resources to help address these barriers - please contact Elizabeth Namarra at 612-676-5914 for more information.
Thank you for your contributions to the completeness and accuracy of the Minnesota HIV/AIDS Surveillance System. If you have any questions or comments contact Tracy Sides (firstname.lastname@example.org) at 612-676-5461.
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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