The Observatory
Chicks and ducklings linked to Salmonella outbreak. Health officials are investigating a multistate Salmonella outbreak linked to contact with live chicks and ducklings, which has sickened at least 25 people, CIDRAP News reports. A May 27 statement by the Centers for Disease Control and Prevention (CDC) reveals that the Salmonella enterica serotype Altona infections matching the outbreak strain have been reported in 11 states. Investigators found that 16 of 21 patients had contact with chicks, ducklings, or both before becoming ill. Trace-back investigations revealed that a single hatchery is the source of the chicks and ducklings linked to the outbreak.
CDC offers tips to prepare for zombie apocalypse. The CDC released a disaster preparedness memo in its Public Health Matters Blog May 16 on the topic of preparing for a zombie apocalypse. The post, written by Assistant Surgeon General Ali Khan, instructs readers how to prepare for flesh-eating zombies — from having an emergency kit to planning an evacuation route. Coincidently, the same steps people should take in preparation for an invasion of the undead are similar to those suggested in advance of a hurricane or pandemic. A CDC spokesperson told The Wall Street Journal the idea came about when a staff member noticed that the word “zombie” on Twitter increased traffic. The purpose of the post is to get people engaged and then convey important facts about emergency preparedness, the spokesperson explained. Read the CDC's zombie apocalypse preparation recommendations at http://tiny.cc/02e7a.
Human Jamestown Canyon virus infection in Montana. Federal health officials have confirmed the first human illness from the Jamestown Canyon virus (JCV) — a mosquito-borne arbovirus — in Montana. Scientists from the CDC say a man who had not traveled outside of Montana complained of fever, severe frontal headache, dizziness, left-sided numbness, hypertension, tingling, and muscle pain and weakness. After ruling out other illnesses, tests at the Montana Public Health Laboratory detected West Nile virus antibodies, but further testing confirmed JCV infection. This case is the 15th JCV infection in the United States since 2004, according to the report published in the May 27 issue of Morbidity and Mortality Weekly Report.
Bacterial meningitis cases on the decline. The incidence of bacterial meningitis dropped by 31% between 1998 and 2007, government research shows. Published in the May 26 issue of The New England Journal of Medicine, the study finds that the drop was led by reductions in infections by two germs — Neisseria meningitidis and Streptococcus pneumoniae — that are covered by available immunizations. During the surveillance period, the incidence of bacterial meningitis dropped from two cases per 100,000 people to 1.38 cases per 100,000 people, based on information from the CDC's Emerging Infections Programs Network. There are still at least 4,000 cases of bacterial meningitis diagnosed each year, including about 500 cases that are fatal, according to the CDC.
Infectious diseases
MRSA outbreak in one hospital affects other facilities. Since many healthcare facilities in a region often share patients, a methicillin-resistant Staphylococcus aureus (MRSA) infection outbreak at one hospital could lead to infection outbreaks at other hospitals in the same region, according to research published in the June issue of Infection Control and Hospital Epidemiology. Researchers conducted simulated MRSA outbreaks in various healthcare settings. Results showed that every simulated outbreak eventually affected all hospitals in the network, with effects depending on the outbreak size and location. Increasing MRSA prevalence at a single hospital (from 5% to 15%) resulted in a 2.9% average increase in relative prevalence at all other hospitals.
Lessons learned from healthcare-associated measles outbreak. In a report published online April 28 in The Journal of Infectious Diseases, researchers describe a healthcare-associated measles outbreak in Arizona in 2008 to show the high costs hospitals can incur when responding to measles outbreaks. To minimize costs and prevent the healthcare-associated spread of measles, researchers stress that healthcare facilities must 1) have rapidly retrievable measles-immunity/immunization records for healthcare personnel; 2) consider measles as a diagnosis, especially among patients presenting with fever, rash, and a recent history of international travel or contact with a person with a clinically consistent rash illness; and 3) immediately isolate of patients with suspected and confirmed measles. Read more at http://tiny.cc/dmyi2.
Ontario study reveals HIV rates among women. An estimated 25% of new HIV infections in Ontario, Canada, from 2006 to 2008 were among women, according to a study by researchers from the Institute for Clinical Evaluative Sciences and St. Michael's Hospital. The researchers say 93% of new infections among women are acquired through sexual transmission and 7% through injection drug use. About 60% of newly infected women are immigrants. The findings from the Project for an Ontario Women's Health Evidence-Based Report, or POWER, study also reveal that more than 90% of HIV-positive pregnant women who knew their HIV status received antiretrovirals during pregnancy to prevent HIV transmission to their babies.
Genetic test predicts clinical outcomes in glioblastoma patients. A change in a particular gene can identify which patients with a specific kind of brain cancer will respond better to treatment, according to research presented at the 2011 American Society of Clinical Oncology annual meeting in Chicago. Testing for the gene can distinguish patients with a more- or less-aggressive form of glioblastoma, researchers say. The prospective study looked at a gene called MGMT in tumors removed from 833 glioblastoma patients. It showed that when the gene promoter is altered by a chemical change called methylation, patients respond better to treatment. Patients with tumors carrying the methylated gene had an overall survival of 21 months vs. 14 months for those with the unmethylated gene.
New studies
Researchers develop non-invasive test for gastric cancer. Certain proteins excreted in urine can indicate the presence of gastric cancer, reveals a study published Feb. 18, 2011, in PloS ONE. University of Georgia researchers identified a protein called endothelial lipase that differed significantly in its abundance in urine samples of stomach-cancer patients vs. healthy people. Researchers say the computational capability presented in the study for predicting which of the abnormally abundant proteins in diseased tissues can be excreted into urine is a key breakthrough in cancer detection. Using samples from known excretory and non-excretory proteins, the study found that the classification system was more than 80% accurate. The researchers say they eventually hope to develop a method where urine can change the color of a piece of paper to indicate the presence or absence of the protein.
Researchers ID pancreatic-cancer-screening marker. Researchers at the University of Michigan Comprehensive Cancer Center have identified a protein that shows distinct changes in structure between pancreatic cancer, non-cancerous diseases, and normal blood serum. The protein, haptoglobin, is a type of glycoprotein, which also changes from early-stage pancreatic cancer to advanced disease. The study, published online in the Journal of Proteome Research, suggests that a blood test could serve as a potential screening tool to detect pancreatic cancer. Researchers continue to refine the assay, and believe that a similar test could be used for colon and liver cancer, although more work is needed to identify the best markers in those diseases.
Low vitamin D levels linked to more aggressive breast cancers. Breast cancer patients with low levels of vitamin D have more aggressive tumors and poorer outcomes, a new study finds. A team from the University of Rochester Medical Center tracked 155 women who had surgery for breast cancer between January 2009 and September 2010. The team examined blood tests that provided vitamin D levels for all the patients in the one-year period before and after surgery. They also analyzed relevant breast-cancer patient data, such as age, race, cancer stage at diagnosis, menopause status, gene expression, and estrogen and progesterone status. The researchers found an association between low vitamin D levels (less than 32 milligrams per milliliter of blood) and poor scores on every major biological marker used to predict a breast-cancer patient's outcome.
Experimental prostate-cancer test more sensitive and specific than PSA test. A new test for prostate cancer that measures levels of prostate-specific antigen (PSA) as well as six specific antibodies found in the blood of men with the disease is more sensitive and more specific than the conventional PSA test used today, according to a study by researchers at UCLA's Jonsson Comprehensive Cancer Center. With the new test, called the A+PSA assay, the percentage of men with prostate cancer who were correctly identified as having a malignancy was 79%, compared with the 52% found in PSA testing. The percentage of healthy men correctly identified as not having prostate cancer was 84% with the A+PSA assay, compared with the 79% found when testing for PSA alone. The new test also reduced the rate of false positives, according to researchers. The study appears in the May issue of the Journal of Translational Medicine.
PCR saliva test useful for congenital CMV screening. Congenital cytomegalovirus (CMV) infection in newborns can be detected accurately by real-time polymerase-chain-reaction (PCR) assays with liquid or dried saliva samples, according to researchers. In a study published in the June 2 issue of The New England Journal of Medicine, researchers at the University of Alabama-Birmingham examined saliva samples taken from 34,989 infants from seven U.S. hospitals. Assays using both liquid and dried saliva had high sensitivity and specificity for identifying the infection, with positive predictive values over 90% and negative predictive values at or near 100%. CMV is the most common infection passed from a mother to her unborn child. Of the 20,000 to 30,000 infants born infected with CMV each year, 10% to 15% are at risk for developing hearing loss. Most infants with congenital CMV infection are not identified because the infection is asymptomatic, and testing is not routine. The current rapid culture testing method involves a lengthy incubation and testing procedure, so it is not conducive to a widespread screening program.
Blood test finds markers of bladder-cancer risk. A blood test can accurately detect biomolecular markers of bladder cancer resulting from environmental carcinogens. Researchers at Brown University in Providence, RI, reported online Feb. 22, 2011, in the Journal of Clinical Oncology that the blood test measures a pattern of methylation — a chemical alteration to DNA that is affected by exposure to such carcinogens as cigarette smoke and industrial pollutants. In a study of 112 bladder-cancer patients and 118 controls, those exhibiting the methylation pattern were 5.2 times more likely than those without the pattern to have bladder cancer.
