Minnesota Department of Health (MDH) Bug Bytes

September 28, 2006
Vol. 7: No.1


Topics in this Issue:

1. Antibiotic resistance education at the Science Museum of Minnesota (AKA Bacteria Blaster)!
2. Evaluation of Death Certificate Identification of Creutzfeldt-Jakob Disease (CJD) in MN, 1996-2005
3. Emerging Infections Annual Conference


1. Antibiotic resistance education at the Science Museum of Minnesota (AKA Bacteria Blaster)!
Take a trip to the Science Museum of Minnesota and check out a new exhibit sponsored by the Minnesota Antibiotic Resistance Collaborative (MARC). Bacteria Blaster, a permanent exhibit in the Infectious Diseases Section of the Human Body Gallery, is designed for middle-school students.  The game uses action-packed adventure to educate students (and adults!) about antibiotic resistance and preventing disease transmission.

The game has three educational levels to explore these key messages:

  • Antibiotics are not effective against viral infections
  • Inappropriate antibiotic use can lead to antibiotic resistance in individuals and the community        
  • Hand washing prevents disease transmission 

MARC is a broad-based collaborative of healthcare organizations committed to promoting judicious antibiotic use and decreasing antibiotic resistance in Minnesota.  MARC members are: BlueCross BlueShield of Minnesota, HealthPartners, Medica, Minnesota Council of Health Plans, Minnesota Department of Health, Minnesota Medical Association, Minnesota Pharmacists Association, Stratis Health, and UCare Minnesota. 

Learn more about: The Minnesota Antibiotic Resistance Collaborative >>

2. Evaluation of Death Certificate Identification of Creutzfeldt-Jakob Disease (CJD) in MN, 1996-2005
The World Health Organization (WHO) has developed criteria for classifying potential case-patients with CJD as definite, probable, and possible. For definite case-patients, the diagnosis is established through neuropathological examination of brain tissue and/or by confirmation of protease-resistant prion protein in the brain. Probable case-patients must have clinical and laboratory features consistent with CJD in the absence of neuropathological, immunohistochemistry, or Western blot analysis. Possible case-patients have clinical features consistent with CJD in the absence of neuropathological, immunohistochemistry, or Western blot analysis and the absence of electroencephalogram results and cerebral spinal fluid evaluation (14-3-3 assay).

In conjunction with the CDC, MDH have been involved in national surveillance for CJD since 1996. Cases are identified through a word search for CJD on death certificates or in rare instances, reports from clinicians. In order to determine the true epidemiology of CJD, MDH requested medical records from death certificate-identified CJD cases from 1996-2005. Information on clinical signs and symptoms, electroencephalography (EEG), magnetic resonance imaging (MRI), 14-3-3 protein in CSF, neuron-specific enolase (NSE) protein in CSF, histology, immunohistochemistry (IHC), and Western blot (WB) for PrPSc results were collected.  WHO case definitions for definite, probable, possible, iatrogenic, and familial CJD was used to classify cases.

Seventy-three death certificate-associated CJD cases were identified and medical records were available for 66 (90%) of these cases. Of these, 55 (83%) met the WHO case definition for CJD, 11 (17%) did not. Of the 55 WHO-recognized cases, 24 (44%) were definite CJD, 30 (55%) probable CJD, and 1 (2%) familial CJD.  WHO-recognized cases had a shorter duration of illness (6.4 month vs. 28.2 months) and were more likely to have myoclonus (75% vs. 27%) and ataxia (73% vs. 27%) than non-cases. Diagnostic evaluation including EEG (83% vs. 46%), 14-3-3 immunoassay (49% vs. 18%), and NSE (36% vs. 0%) occurred more often among WHO-recognized cases than non-cases. Sensitivity of diagnostic evaluation was highest for NSE (80%), followed by EEG (63%), 14-3-3 (48%), and MRI (40%). Specificity was highest for EEG (100%), followed by MRI (75%), and 14-3-3 (50%). Clear differences were found when comparing WHO-recognized cases and non-cases. Review of medical records provides a more accurate accounting of the epidemiology of CJD by excluding cases that do not meet the WHO case definition.    

Learn more about: Creutzfeldt-Jakob Disease >>

3. Emerging Infections Annual Conference
Our 12h Annual Emerging Infections in Clinical Practice and Public Health Conference will be held November 2 (all day) and November 3 (half day) in downtown Minneapolis.  We will have another great conference this year with outstanding speakers. Topics will include travel medicine, immigrant health issues, zoonotic diseases, tuberculosis, pandemic influenza, and various hot topics. For the agenda and registration go to www.cme.umn.edu and click on “Course Calendar.”

 

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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Updated Friday, November 19, 2010 at 02:16PM