The new strain of E. coli O104 in Germany!

The strain of verotoxin producing Escherichia coli (VTEC) O104 that is currently being seen is a really very unusual serogroup. Currently it is clear that actual source of the outbreak is the cause of considerable debate, it certainly requires more work to establish where the organism came from. There have been suggestions that this particular strain of VTEC O104 is an entirely new strain, this has not yet been formally proven. However it is clear that the organism associated with this outbreak is a VTEC O104 and does have an unusual set of virulence factors.

It would appear at present that salad vegetables, particularly lettuce and cucumbers appear to be closely involved with the outbreak of the infection in Germany. At the present time there are no food associated links with the infection in the UK. There have been cases reported in the UK and to my knowledge these have all been linked with recent travel to Germany, although this situation may change over time.

The spread of the infection can essentially be slowed by the use of good hygiene practices in limiting person to person spread. Food hygiene is of equal importance and cleaning of foodstuffs and good hand washing practices are required. This is equally true for salad vegetables and fruit; these items should be washed and cleaned to help remove surface organisms. The peeling and cooking of fruit and vegetables will also help in the removal of potentially pathogenic organisms. An important feature to remember is that good hygiene is of great importance and something as simple as hand washing can break the cycle of infection and so help stop the spread of the organism.

Scientists talking to the media!

Look at this fantastic blog entry on the Birmingham Skeptics by SfAMs Dr Lucy Harper (http://brumskeptics.blogspot.com/2011/02/scientists-need-to-talk.html or http://bit.ly/ereg1z), its fantastic have a look see!

Communicating microbiology to non specialist audiences

Got this from a Tweet by Cesar Sanchez (@TwistedBacteria), really good article by the excellent Bernard Dixon, perhaps we should all take note!

http://www.microbemagazine.org/index.php/11-2010-animalcules-and-forum

Hmm this link seems to be broken, works if you type it into the URL bar - strange!!

Try the magazine home page and navigate from there - sorry....

Anthrax Heroin – it is still here.

Following reports from Scotland in January and May 2010 about the presence of Bacillus anthracis, the causative agent of anthrax in Heroin, the BBC website reports the death of a drug user in Kent. According to the Health Protection Agency this represents the fifth case of a person becoming ill via this route. The case was described as ‘sad’ by Dr Mathi Chandrakumar from the Kent Health Protection Unit, who added that the risk of person to person spread of this disease, in this particular circumstance was extremely unlikely. Infection with Anthrax is now recognised as one of a number of risks facing intravenous drug users.

Importantly those at risk are advised that people should be vigilant for the symptoms of Anthrax infection. These include swelling and redness around the injection site, general feeling of being unwell such as a raised temperature, chills or a severe headache and breathing difficulties. On a positive note if identified early the infection can often be treated successfully with antibiotics, this can be life saving – but early recognition is the key.

I would completely agree with this assessment. The route of infection in these cases is clear and based around a very specific action. It is completely different to the situation experienced by people who are involved with the processing of hides. In the case of an intravenous drug user, where the heroin appears to be contaminated, the organism is likely to be introduced directly into the bloodstream where vegetative organisms can grow and spores germinate.

More can be read on the BBC Website (http://www.bbc.co.uk/news/uk-england-kent-11685984) and the health protection agency website (http://www.hpa.org.uk/ProductsServices/LocalServices/SouthEast/SouthEastPressReleases/Kent/seast101103anthraxupdate/)

Cholera is not respecting national boundaries!

According to the ProMed Mail site, first reports of suspected cases of cholera are appearing in the Dominican Republic. Reports indicate that a 43 year old man in the Dominican Republic is being treated in Barahona University hospital. The patient is thought to be a business man who has recently returned from Haiti and he represents the third suspected case, if confirmed, in the Dominican Republic.

The situation continues to develop.

(http://www.promedmail.org/pls/apex/f?p=2400:1001:2214615575705944::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,85752)

Has Cholera reached Port au Prince?

It would appear that cholera has reached the Haitian capital of Port au Prince. It has been reported on the Sky News website and via Reuters that the first isolated cases have been seen in the city. It is reported that a young child of 3 years has the disease and that he had not left the city for the past year. It is reported that he is currently being treated in hospital for dehydration, vomiting and diarrhoea.

Suggestions are currently that Hurricane Tomas may have contributed to the appearance o0f the disease in the capital due to the increased flow of the Artibonite river which burst its banks at the weekend. This is one of the suspected sources of the infection. The fear voiced by Health Authorities is that the disease could now infiltrate the various camps inside the capital. A further 100 suspected cases of cholera in city residents are currently being investigated.

Latest Shooting Up report has an HIV focus and is published on the HPA Website.

The latest instalment of the annual Shooting up report has been published by the Health protection agency (HPA) and is focussed on HIV infection

The report starts with a timely reminder of the list of bacteria and viruses that are particularly important when considering intravenous drug abusers (IVDA), these include, Clostridium botulinum, Grp A streptococci and potentially community acquired MRSA as well as viral agents such as HIV and Hepatitis C.

The report states that the prevalence of HIV amongst IVDU is quite low with rates of 4.1% in London and 0.6% in Scotland and are at a level 1.5% across the UK. It was also noted HIV prevalence in IVDU has increase from 0.7 to 1.5% in the last decade returning to levels seen in the early 1990s. On a personal note I wonder if we have lost the momentum in getting the message across to the public at large?

Returning to the report there has been an increase in the uptake of HIV testing with up to three quarters of IVDUs report having had a test and about a third of IVDU patients still not aware of their status.  A large proportion of HIV positive IVDU patients are involved with specialist treatment services.

A number of IVDU patients report being infected with Hepatitis C (numbers equated to about a half of patients), whereas around a sixth presented with Hepatitis B infection. Bacterial infections such as sores or abscess were reported in approximately one patient in three. On a more positive note needle and syringe sharing appears to have generally fallen but still almost one in five patients reported the sharing of either syringes or needles.

  

One thing the report highlights is a continued need for education and investigation into sharing of needles and paraphernalia that increases the risk of the patient to potentially serious infections that may well be life threatening. We need to maintain and develop surveillance to inform decisions that feed into UK policy making.

More detail can be seen on the HPA Website (http://www.hpa.org.uk/hpr/archives/2010/news4410.htm#idus09)