Sign of the Apocalypse? Plague Is Back, With a Disturbing Twist

virus_crop380wIf you thought the film Contagion was frightening, this medical plot twist may scare you even more—because it’s real.

Back in November, the island nation of Madagascar confirmed 119 cases of plague, including 40 deaths. But the bad news recently took a disturbing turn: “The fleas that transmit this ancient disease from rats to humans have developed resistance to the first-line insecticide,” Margaret Chan, director-general of the World Health Organization, said in a new report.

You probably recognize the infectious disease as the one known as the “Black Death,” which during the 14th century became a devastating epidemic that claimed an estimated 50 million lives throughout Europe, Asia, and Africa. Caused by the bacteria Yersinia pestis, the disease spreads from rodents to humans via infected fleas. Those infected generally develop bubonic plague—exhibiting swollen lymph nodes and flu-like symptoms—or, if it spreads to the lungs, the deadlier advanced form, pneumonic plague. Caught early, antibiotics can effectively treat the disease; left untreated, however, plague kills 30 to 60 percent of those infected.

Steamboats from India carried plague to Madagascar in 1898. What makes the recent outbreak there particularly troubling is that scientists have been warning about insecticide resistance in fleas for years. Plague surveillance in Madagascar was discontinued in 2006 due to a lack of funding, but almost 17 years ago—and just six years after the first-line insecticide was initially used in Madagascar—an article published in the Journal for Emerging Infectious Diseases closed with the admonition, “the increasing resistance of fleas to insecticides have caused much concern.”

A November 2014 study conducted by the health research center Institut Pasteur in Madagascar found conclusive evidence that more than 80 percent of the fleas tested were resistant to Deltamethrin, the insecticide referenced in the WHO report. Out of the 32 flea populations examined, only two demonstrated susceptibility to the insecticide. The report’s authors conclude, “In the…re-emergence of plague…in Madagascar, Deltamethrin is ineffective against fleas. Its use in Madagascar should be stopped and the control program for plague diseases needs to change to another insecticide.”

While the study explains that many factors could contribute to the fleas’ increased resistance to insecticides—including environment, climate, geography, urbanization, and human social and cultural behaviors—the core mechanism at work is natural selection. Each time a population of fleas is treated with insecticide, fleas that by some quirk have a built-in resistance survive and breed to create the next generation of fleas, born genetically resistant to the insecticide that wiped out their parents’ peers. Over time, the insecticide becomes less effective as the flea populations are increasingly comprised of only those with the quirk of DNA that protects against it. To compensate for its lowered levels of efficacy, a higher concentration of the insecticide is often used—which breeds a generation of fleas even more resistant than the last.

For the people of Madagascar, Deltamethrin restistance is a case of déjà vu all over again. Use of the insecticide, a man-made version of a natural insecticide that chrysanthemum flowers produce, began in the 1990s after insects developed resistance to the flea-control chemical being used at the time. Some scientists have hypothesized that fleas’ resistance to Deltamethrin may be a result of the species’ exposure to the old insecticide.

What can be done? For now, Institut Pasteur researchers are testing 12 insecticides to see which will be most effective at controlling flea populations. Without plague surveillance, however, there is no way to tell how long it will take for the fleas to build resistance to the next line of insecticides. Funding shortfalls also continue to stand in the way of those trying to track and control plague in Madagascar—not to mention the growing number of other health concerns the institute must deal with: When Sébastien Boyer, head of the medical entomology unit at the institute, was contacted for comment on the status of the insecticides currently being tested, he responded by e-mail, “No time…we are currently in malaria outbreak in Farafangana…sorry.”

Ebola: A swift, effective and bloody killer

By Dr. Sanjay Gupta, CNN Chief Medical Correspondent
updated 7:01 PM EDT, Tue April 15, 2014

Conakry, Guinea (CNN) — It took only moments to feel the impact of what was happening here.

We had just landed in Conakry, the capital of Guinea. In the fields right outside the airport, a young woman was in tears. She started to wail and shout in Susu, one of the 40 languages spoken in this tiny country of 12 million people. The gathered crowd became silent and listened intently

We had just landed in Conakry, the capital of Guinea. In the fields right outside the airport, a young woman was in tears. She started to wail and shout in Susu, one of the 40 languages spoken in this tiny country of 12 million people. The gathered crowd became silent and listened intently.
The young man sitting next to me quietly translated, although I already had my suspicions. He told me the woman’s husband had died of Ebola, and then quickly ushered us away.

It is probably not surprising the airplane bringing us into Conakry was nearly empty, as are all the hotels here. Not many people in the United States have ever visited Guinea, or could even identify where it sits in West Africa. It is already one of the world’s poorest countries, and the panic around Ebola is only making that worse.

Some of it is justified. That’s because this time, the outbreak is different. In the past, Ebola rarely made it out of the remote forested areas of Africa.

Key to that is a grim version of good news/bad news: because Ebola tends to incapacitate its victims and kill them quickly, they rarely have a chance to travel and spread the disease beyond their small villages. Now, however, Ebola is in Conakry, the capital city, with 2 million residents. Equally concerning: it’s just a short distance from where we touched down, at an international airport.

It has gone “viral,” and now the hope is that it doesn’t go global.

When I asked doctors on the ground about that scenario, they had split opinions. Several told me the concern is real but unlikely. Most patients with Ebola come from small villages in the forest and are unlikely to be flying on international trips, they told me. Furthermore, they don’t think Ebola would spread widely in a western country; our medical expertise and our culture — not touching the dead — would prevent it.

Others aren’t so sure.

No one wants to test that theory.

With Ebola, there is an incubation period of two to 21 days. Remember these numbers. This is the range of time it takes to develop symptoms after someone has been exposed.

With an international airport close by, that means you could be on the other side of the world before you develop the headache, fever, fatigue and joint pain which make up the early symptoms of an Ebola infection. The diarrhea, rash and bleeding come later. Hiccups is a particularly grave sign with Ebola. It means your diaphragm, which allows you to breathe, is starting to get irritated.

There is a lot we know about Ebola, and it scares us almost as much as what we don’t know.

We do know Ebola, a simple virus with a small genome, is a swift, effective and bloody killer. The mortality rate is higher than 50% and in some outbreaks reaches 90%.

Ebola appears to kill in a clever way. Early on, it strategically disarms your immune system, allowing the virus to replicate unchecked until it invades organs all over your body. It convinces your blood to clot in overdrive, but only inside your blood vessels. While those blood vessels choke up, the rest of your body starts to ooze because the clotting mechanisms are all busy.

You start to hemorrhage on the outside of your body. Nose bleeds, bruising, even a simple needle stick will refuse to clot. But, it is the bleeding you don’t see — the bleeding on the inside — that causes even more catastrophic problems.

Many patients die of shock, within an average of 10 days.

 

It sounds like the stuff of horror movies. But despite the real danger, Ebola is not at all easy to “catch.” If it were, my wife would have refused to let me come in the midst of an outbreak.

 

To become infected, you generally need to spend extended time with someone who is gravely ill, and come into contact with his or her infected body fluids. That’s why family members and health care workers are the most likely to get sick.

 

Over the last three weeks, at least 112 people have died, including 14 health care workers.

 

With some infections, you can shed and spread the virus long before you get ill. That’s not the case with Ebola. It’s only after you are sick and feverish do you become contagious. However, it only takes a miniscule amount to infect and kill. A microscopic droplet of blood or saliva on your bare hand could enter through a break in your skin. And, whether you realize it or not, we all have breaks in our skin.

 

Since I was a kid, I have been fascinated with outbreaks. I learned in medical school that new pathogens generally make a jump from animals to humans, a process called zoonosis.

 

This is happening in areas where human and animals come into continuous contact. David Quammen refers to it as “Spillover,” in his book of the same name. A stew of ducks, geese, chickens, pigs and humans in southeast Asia led to the spillover of avian flu, H5N1. Contact between pigs and humans in Mexico led to swine flu, H1N1; pigs and fruit bats were the recipe for Nipah fever in Malaysia.

 

The best guess is that fruit bats may be a natural reservoir for the Ebola virus too, but this has not been confirmed. Quammen makes the point: Ebola didn’t enter our world — we entered its world.

 

Pathogens can be predators, like lions, tigers and bears. A virus may not plan the way a big cat does, but in a sense it stalks its prey — waiting for the moment of opportunity, then attacking with fury. Because it can lie silent for years, it’s also easy to see Ebola as a killing ghost, like Jack the Ripper.

 

Presumably outbreaks begin through some human-animal contact, but since that contact is ongoing we don’t know what it is that leads Ebola to rear its ugly head. We don’t know how to treat the illness or vaccinate against it. We certainly don’t know how to cure it.

 

I thought about all of this as I left that woman in the airport, and I have thought about her a great deal since then. Her grief made an impression on all of us.

 

It also made this mysterious, exotic virus the world knows, but doesn’t fully understand, so much more real and frightening. For the next 21 days (the outer range of the incubation period) the woman we saw will be monitored for a fever or any early signs she may have contracted Ebola from her husband. If she exhibits symptoms, she will be isolated and treated with fluids, oxygen and nutrition.

 

That is all that can really be offered. Again, there is no cure for Ebola.

 

For her neighbors, in Guinea and across its border, another critical number is 42 — as in 42 days, or two incubation periods. If the health care teams here don’t see any new cases during that time then they officially say the outbreak is over. We are not there yet, not even close.

 

The clock is ticking.

 

Measles Epidemic in Wales Has Roots in Antivax Movement

The measles outbreak in Wales may have claimed its first victim.

According to the Guardian, a 25-year-old man was found dead in his apartment in Swansea Thursday. Gareth Colfer-Williams was known to have measles at the time of his death. What’s not clear is what the actual cause of death was; he was an ill man, apparently suffering from severe asthma. We’ll know what the exact cause of death was soon enough, I imagine. But his having measles at the time is very, very suspicious, and more tests will be run next week.
Either way, this tragic death has focused attention again on what’s happening in Wales. More than 800 people have been diagnosed with measles in Swansea in this recent outbreak. People are lining up to get their vaccinations, and a campaign has been started to get more people vaccinated, which is a good thing; I just hope it’s in time. But with so many people contracting the illness, serious repercussions are almost inevitable.

Wales has had low Measles/Mumps/Rubella (MMR) vaccination rates for some time … since about 1998, in fact, when Andrew Wakefield published his bogus study in the Lancet falsely linking the MMR vaccine to autism.
It’s easy to lay all this misery at Wakefield’s feet, but there’s plenty to go around. The Lancet should never have published it (many of the co-authors later withdrew their names from the paper). Tony Blair, then prime minister of Britain, declined to reveal whether his own son had gotten the MMR vaccine, prompting rumors it wasn’t safe. (Bizarrely, years later, Cherie Blair, Tony’s wife, said they had given their son the vaccine; how many people would’ve been spared misery had they simply stated the truth?) Newspapers printed ghastly articles linking vaccines and autism. And groups like the Australian Vaccination Network spread—and continue to spread—outright falsehoods about vaccines. Many of these groups actively support Wakefield.
Measles is a terrible, terrible disease. On average about 1 in 1,000 people who contract it will die. Even those who don’t die have a terrible time of it. One in 20 children with measles gets pneumonia. One in 10 gets an ear infection. One in 1,000 gets encephalitis, which can lead to brain damage.

Yet measles can be easily prevented by getting the MMR vaccine. Andrew Wakefield can point fingers all over the place, but in the end a lot of this comes back to him. Given what we’ve learned in the years since his report was published, this wasn’t the case of honest researcher being wrong. His research was unethical; it has been called fraudulent by the British Medical Journal; and it caused Wakefield to be struck off as a doctor in the United Kingdom—like being disbarred. He stood to make multiple millions of dollars from a substitute vaccine he was working on at the time, yet that huge conflict of interest is never mentioned by him or the antivaxxers who stubbornly support him despite all the evidence.

His misdeeds still echo in the hallways of medical centers in Wales.

 

Liberia confirms spread of ‘unprecedented’ Ebola epidemic

Conakry (AFP) – Aid organisation Doctors Without Borders said Monday an Ebola outbreak suspected of killing dozens in Guinea was an “unprecedented epidemic” as Liberia confirmed its first cases of the deadly contagion.

Guinea’s health ministry this year has reported 122 “suspicious cases” of viral haemorrhagic fever, including 78 deaths, with 22 of the samples taken from patients testing positive for the highly contagious tropical pathogen.

“We are facing an epidemic of a magnitude never before seen in terms of the distribution of cases in the country: Gueckedou, Macenta, Kissidougou, Nzerekore, and now Conakry,” Mariano Lugli, the organisation’s coordinator in the Guinean capital, said in a statement.

The group, known by its French initials MSF, said that by the end of the week it would have around 60 international field workers with experience in working on haemorrhagic fever divided between Conakry and the south-east of the country.

“MSF has intervened in almost all reported Ebola outbreaks in recent years, but they were much more geographically contained and involved more remote locations,” Lugli said.

“This geographical spread is worrisome because it will greatly complicate the tasks of the organisations working to control the epidemic.”

The World Health Organization (WHO) and local health authorities have announced two Ebola cases among seven samples tested from Liberia’s northern Foya district, confirming for the first time the spread of the virus across international borders.

Liberian Health Minister Walter Gwenigale told reporters the patients were sisters, one of whom had died.

The surviving sister returned to Monrovia in a taxi before she could be isolated and the authorities fear she may have spread the virus to her taxi driver and four members of her family.

The woman and those with whom she has come into contact are in quarantine in a hospital 48 kilometres (30 miles) south-east of Monrovia, Gwenigale said.

 

— Unstoppable bleeding —

 

Ebola has killed almost 1,600 people since it was first observed in 1976 in what is now the Democratic Republic of Congo but this is the first fatal outbreak in west Africa.

The tropical virus leads to haemorrhagic fever, causing muscle pain, weakness, vomiting, diarrhoea and, in severe cases, organ failure and unstoppable bleeding.

The WHO said Sierra Leone has also identified two suspected cases, both of whom died, but neither has been confirmed to be Ebola.

No treatment or vaccine is available for the bug, and the Zaire strain detected in Guinea has a historic death rate of up to 90 percent.

It can be transmitted to humans from wild animals, and between humans through direct contact with another’s blood, faeces or sweat, as well as sexual contact or the unprotected handling of contaminated corpses.

MSF said it had stepped up support for the isolation of patients in Conakry, in collaboration with the Guinean health authorities and the WHO.

“Other patients in other health structures are still hospitalised in non-optimal conditions and isolation must be reinforced in the coming days,” it added.

The WHO said it was not recommending travel or trade restrictions to Liberia, Guinea or Sierra Leone based on the current information available about the outbreak.

But Senegal has closed border crossings to Guinea “until further notice”.

103 Ebola cases registered in Guinea as deadly virus hits capital, neighboring states.

Guinea's capital Conakry was on high alert on Friday after a deadly Ebola epidemic which has killed dozens in the southern forests was confirmed to have spread to the sprawling port city of two million people.

Guinea’s capital Conakry was on high alert on Friday after a deadly Ebola epidemic which has killed dozens in the southern forests was confirmed to have spread to the sprawling port city of two million people.

Guinea’s capital Conakry was on high alert on Friday after a deadly Ebola epidemic which has killed dozens in the southern forests was confirmed to have spread to the sprawling port city of two million people. Four people believed to have been infected after attending the funeral of a brother in central Guinea have been put into isolation centres to avoid the highly contagious virus getting into the population.

Aid organisations have sent dozens of workers to help the poor west African country combat a haemorrhagic fever outbreak which has killed at least 66 people, many of whom have been confirmed to have been infected by Ebola.

“Intensive case investigations are underway to identify the source and route of these patients’ infection, record their travel histories before arrival in Conakry and determine their period of infectivity for the purposes of contact tracing,” the World Health Organisation (WHO) said in a statement.

Guinea is one of the world’s poorest nations despite vast untapped mineral wealth, with a stagnating economy, youth unemployment at 60 percent and a rank of 178th out of 187 countries on the UN’s Human Development Index.

Residents of Conakry’s suburbs said they feared venturing into the city centre to shop and were keeping their children home from school.

“I wonder what Guinea has done to God to make him send us this untreatable disease… I’m wary of anything that moves that could be a carrier of the disease,” said unemployed graduate Abdoulaye Soumah.

The 15-member Economic Community of West African States said the outbreak was now “a serious threat to regional security” and appealed for help from the international community. Fifteen new confirmed or suspected cases, including in the Conakry outbreak, were reported on Thursday, the health ministry said, bringing the total in Guinea to 103. The tropical virus – described in some health publications as a “molecular shark” – causes severe fever and muscle pain, weakness, vomiting, diarrhoea and, in severe cases, organ failure and unstoppable bleeding.Ebola had never spread among humans in west Africa before the current outbreak, but further suspected cases being investigated in Liberia and Sierra Leone could bring the total death toll to at least 77.
Scientists have examined 41 samples from victims, Guinea’s health ministry said, with 15 testing positive for the Zaire strain of Ebola, the most virulent.

The WHO said Liberia had reported eight suspected cases of Ebola fever, including six deaths, while Sierra Leone had reported six suspected cases, five of them fatal. Transmission of Ebola to humans can come from wild animals, direct contact from another human’s blood, faeces or sweat, as well as sexual contact or the unprotected handling of contaminated corpses.

The health charity Doctors Without Borders, known by its French initials MSF, said the spread of the disease was being exacerbated by people travelling to funerals in which mourners touch the bodies of the dead.

Guinea has banned the consumption of bat soup, a popular delicacy in the country, as the fruit bat is believed to be the host species. No treatment or vaccine is available, and the Zaire strain detected in Guinea – first observed 38 years ago in what is today called the Democratic Republic of Congo – has a 90 percent death rate.Customers in a suburban cafe in Conakry described the epidemic as “divine retribution” and “a curse that has befallen us and will allow us to reflect on our daily behaviour”.

“There is total panic among the population,” said Fanta Traore. But the WHO played down fears of a massive spread, pointing out that the disease typically caused much less death and sickness than influenza, and adding that it was not recommending travel restrictions.

“Outbreaks tend to be limited. But certainly we need to watch this extremely carefully because there is no treatment, there is no cure and the course of the disease is more often than not fatal,” WHO spokesman Gregory Hartl told reporters in Geneva.

Giant Virus Resurrected from Permafrost After 30,000 Years

Giant Virus Resurrected A mysterious giant virus buried for 30,000 years in Siberian permafrost has been resurrected.

The virus only infects single-celled organisms and doesn’t closely resemble any known pathogens that harm humans.

Even so, the new discovery raises the possibility that as the climate warms and exploration expands in long-untouched regions of Siberia, humans could release ancient or eradicated viruses. These could include Neanderthal viruses or even smallpox that have lain dormant in the ice for thousands of years.

“There is now a non-zero probability that the pathogenic microbes that bothered [ancient human populations] could be revived, and most likely infect us as well,” study co-author Jean-Michel Claverie, a bioinformatics researcher at Aix-Marseille University in France, wrote in an email. “Those pathogens could be banal bacteria (curable with antibiotics) or resistant bacteria or nasty viruses. If they have been extinct for a long time, then our immune system is no longer prepared to respond to them.”

(A “non-zero” probability just means the chances of the event happening are not “impossible.”)

Giant viruses

In recent years, Claverie and his colleagues have discovered a host of giant viruses, which are as big as bacteria but lack characteristic cellular machinery and metabolism of those microorganisms. At least one family of these viruses likely evolved from single-celled parasites after losing essential genes, although the origins of other giant viruses remain a mystery, Claverie said.

In the researchers’ hunt for more unknown pathogens, they took a second look at permafrost samples collected from Kolyma in the Russian Far East in 2000. Because the permafrost was layered along steep cliffs, drillers could extract samples from 30,000 years ago by drilling horizontally into the ice, thereby avoiding contamination from newer samples.

An ultrathin section of a Pithovirus particle in an infected Acanthamoeba castellanii cell observed  …

The team then took samples of this permafrost and put them in contact with amoebas (blob-like single-celled organisms) in Petri dishes. The researchers then waited to see what happened.

Some of the amoebas burst open and died. When the scientists investigated further, they found a virus had killed the amoebas.

The ancient virus infects only amoebas, not humans or other animals. This pathogen belongs to a previously unknown family of viruses, now dubbed Pithovirus, which shares only a third of its genes with any known organisms and only 11 percent of its genes with other viruses. Though the new virus resembles the largest viruses ever found, Pandoraviruses, in shape, it is more closely related to classical viruses, which have an isocahedral shape (with 20 triangular-shaped faces), Claverie said.

Pathogens reawakened?

The findings raise the possibility that other long-dormant or eradicated viruses could be resurrected from the Arctic. As the climate warms and sea ice and permafrost melt, oil and mining companies are drilling many formerly off-limit areas in Russia, raising the possibility that ancient human viruses could be released.

For instance, Neanderthals and humans both lived in Siberia as recently as 28,000 years ago, and some of the diseases that plagued both species may still be around.

“If viable virions are still there, this is a good recipe for disaster,” Claverie said. “Virions” is the term used for the virus particles when they are in their inert or dormant form.

But not everyone thinks these viruses spell potential doom.

“We are inundated by millions of viruses as we move through our everyday life,” said Curtis Suttle, a marine virologist at the University of British Columbia in Canada, who was not involved in the study. “Every time we swim in the sea, we swallow about a billion viruses and inhale many thousands every day. It is true that viruses will be archived in permafrost and glacial ice, but the probability that viral pathogens of humans are abundant enough, and would circulate extensively enough to affect human health, stretches scientific rationality to the breaking point.”

“I would be much more concerned about the hundreds of millions of people that will be displaced by rising sea levels than the risk of being exposed to pathogens from melting permafrost.”

The findings were published today (March 3) in the journal Proceedings of the National Academy of Sciences.

Thanks to Climate Change, West Nile Virus Could Be Your New Neighbor

Asian Tiger Mosquitos - West Nile Virus

Asian tiger mosquitoes are a major vector for West Nile virus.

A new study shows how climate change will contribute to the spread of the mosquito-borne West Nile virus

Invasive species aren’t just species—they can also be pathogens. Such is the case with the West Nile virus. A mosquito-borne virus identified in the West Nile subregion in Uganda in 1937—hence the name—West Nile wasn’t much of a concern to people elsewhere until it broke out of Africa in 1999. The first U.S. cases were confirmed in New York City in 1999, and it has now spread throughout much of the world. Though 80% of infections are subclinical—meaning they yield no symptoms—those who do get sick can get very sick.The virus can led to encephalitis—inflammation of the brain and nervous system—and even death, with 286 people dying from West Nile in the U.S. in 2012. There were more than 5,500 cases reported that year, and the scary thing is that as the climate warms, West Nile will continue to spread.

That’s the conclusion of a new study from a team of researchers in the U.S., Britain and Germany, including those at the Center for Tropical Research at UCLA’s Institute of the Environment and Sustainability. In a study published in the journal Global Change Biology, the researchers took climate and species distribution data, and created models that try to project the spread of the virus as the globe warms. West Nile virus is carried by mosquitoes, and infected insects transmit the virus to human beings with a bite. But birds play a role too—if bitten by an infected mosquito, birds can generate high levels of the virus in their bloodstream, and can then transmit it to uninfected mosquitoes, which in turn can infect people. The biggest indicator of whether West Nile virus will occur is the maximum temperature of the warmest month of the year, which is why the virus has caused the most damage in hot southern states like Texas.

The UCLA model indicates that higher temperatures and lower precipitation will generally lead to more cases of West Nile, as well as the spread of the virus to northern territories that haven’t yet been affected by it. In California alone, for example, more than half of the state will see an increased probability of West Nile in the decades to come, and by 2080 the virus may well be prevalent in parts of southern Canada, and as far north as northern British Columbia, as you can see in this map:

The UCLA model looks only at climate data, and doesn’t take into account the kind of control methods that can be used to combat West Nile on the ground, including pesticide spraying and land-use changes that deny mosquitoes the pools of stagnant water they use as breeding sites. That’s important to remember: while climate change can raise the risk of typically tropical diseases like West Nile or malaria, smart control efforts can offset at least some of that dnger. (Malaria used to be common throughout much of the South—which is easily warm enough in the summer for the disease—before steps were taken to eliminate it, a process that led to the creation of the Centers for Disease Control.) But the UCLA study underscores the fact that climate change operates as a threat multiplier for tropical diseases, one that that will allow pathogens to invade new territory—and ultimately, us.

Influenza Claims Hundreds in California

Flu Vaccine as Hundreds die in CaliforniaThe current flu season has taken a heavy toll on those in California.  The number of patients under the age of 65 that have succumbed has been confirmed at 302.  Comparatively, at this time last year only 34 flu deaths had been reported.  The hundreds of lives that influenza has claimed this season in California is almost ten times the number of victims from last year.

The particular flu strain, H1N1, is not just causing deaths in California.  The strain is seen nationwide.  The influenza strain involved in these deaths is more widespread and severe in people between 25 and 64 years old.  Physicians believe that many older people have a greater immunity to this strain because there were similar outbreaks decades ago.

This continues to be a severe flu season and the death toll continues to rise.  The H1N1 strain first surfaced in the United States in 2009 and California had hundreds more victims claimed by that influenza outbreak.  The year 2009 has been recorded as the first global pandemic in over four decades, causing 539 deaths in California alone.  The CDC had no vaccine for this particular flu.

It has not yet been determined whether these cases are indicative of other state counts around the United States or if California simply has a higher than average mortality rate.  The data is collected according to state-by-state regulations.  States are not required to report influenza deaths to the Center for Disease Control.  While the CDC does not have hard figures to determine whether the percentages in California are similar to other states, the agency does receive information on the general causes for visits to the doctor and whether a patient is hospitalized with the flu.  Those numbers appear to indicate that the 2013-2014 flu season will continue to be hard hitting.

A release issued by the California Department of Public Health indicates that the flu season is continuing.  They are maintaining a stance that it is still not too late to get a vaccination.  The influenza vaccine continues to be available.  Typically the flu season lasts until the end of April.

Physicians state that people with the highest risk factors, such as pregnant women, people with health conditions, the elderly and infants should seek immediate medical attention when they exhibit signs of the flu.  The earlier medical attention is sought, the more effective the treatment may be.  Influenza symptoms include body aches, fatigue, headache, cough, fever, and sore throat.

The highest number of deaths has been in Los Angeles where they have a current total of 44 confirmed fatalities.  San Diego has reported 25 fatalities and has the second highest flu related death count in the state.  To compare, at this time last year there had been a total of only 34 influenza fatalities.  By the end of the 2012-2013 season, the state had a total of 106 deaths, approximately one third of the state’s current count.  Influenza has already claimed hundreds in the state of California this year and the flu season is expected to continue for about two more months.  The end result may rival the totals from the 2009 year of the pandemic.

By Dee Mueller

Polio-like disease appears in California children

STANFORD, Calif. (AP) — An extremely rare, polio-like disease has appeared in more than a dozen California children within the past year, and each of them suffered paralysis to one or more arms or legs, Stanford University researchers say. But public health officials haven’t identified any common causes connecting the cases.

The illness is still being investigated and appears to be very unusual, but Dr. Keith Van Haren at Lucile Packard Children’s Hospital at Stanford University warned Monday that any child showing a sudden onset of weakness in their limbs or symptoms of paralysis should be immediately seen by a doctor.

“The disease resembles but is not the same as polio,” he said. “But this is serious. Most of the children we’ve seen so far have not recovered use of their arm or their leg.”

But doctors are not sure if it’s a virus or something else, he said. Van Haren said he has studied five cases from Monterey up through the San Francisco Bay Area, including two that were identified as the disease enterovirus-68, which is from the same family as the polio viruses. He said there have been about 20 cases statewide.

“We want to temper the concern, because at the moment, it does not appear to represent a major epidemic but only a very rare phenomenon,” he said, noting similar outbreaks in Asia and Australia.

But for some children, like Sofia Jarvis, 4, of Berkeley, rare doesn’t mean safe.

In this photo taken with a mobile phone, Jeff Jarvis …

In this photo taken with a mobile phone, Jeff Jarvis of Berkeley, Calif., holds his 4-year-old daugh …

She first developed what looked like asthma two years ago, but then her left arm stopped moving, and it has remained paralyzed ever since.

“You can imagine. We had two boys that are very healthy, and Sofia was healthy until that point,” said her mother, Jessica Tomei. “We did not realize what we were in store for. We did not realize her arm would be permanently paralyzed.”

Van Haren, who diagnosed Sofia, said polio vaccines do not protect children from the disease, but he stressed that it is still important for children to receive that vaccine.

Dr. Jane Seward of the Centers for Disease Control and Prevention in Atlanta said Monday that the research is still underway in California, and there are a variety of infectious diseases that can cause childhood paralysis.

Any of a number of illnesses could be at work, and it’s possible some of the cases had one infection and some had another. Regarding the presence of EV-68 in at least two cases, “it could be an incidental finding,” Seward said.

In this photo taken with a mobile phone, Jessica Tomei …
In this photo taken with a mobile phone, Jessica Tomei holds her 4-year-old daughter, Sofia Jarvis,  …

Until officials get more information, Seward said they are not looking around the country for similar cases of EV-68.

The California Department of Public Health has not identified any common causes that suggest that the cases are linked, said Dr. Gil Chavez, the deputy director of the Center for Infectious Disease and state epidemiologist.

“Physicians and public health officials who have encountered similar illnesses have submitted 20 reports to CDPH, and CDPH has conducted preliminary tests on 15 of these specimens,” he said. “Thus far, the department has not identified any common causes that suggest that the cases are linked.”

University of California, San Francisco, neurology professor Emmanuelle Waubant said doctors believe, but don’t have proof, that it’s a virus that for most children shows up only as a benign cold. She said a few children, due to their biological makeup, are having much more serious symptoms and she hoped doctors would look for them.

“For a lot of the neurologists who have trained in the last 30 years, it’s extremely rare to see polio or polio-like syndrome,” she said.

Confirmed case of typhus in Manhattan Beach – Los Angeles

Typhus Fever Los Angeles

Santa Ana police animal services supervisor Sondra Berg, center, and other officers carry traps to be placed around Willard Intermediate School to capture feral cats that might have fleas infected with typhus.

Los Angeles County public health officials say they have confirmed a case of endemic typhus fever in Manhattan  Beach, in the neighborhood around Polliwog Park, officials said in a statement Thursday.

Officials did not release any information about the patient’s identity or condition. It was also unclear whether this was a new case of typhus. In December, Manhattan Beach officials said county public health officials had contacted residents in the same neighborhood regarding a case of typhus and handed out brochures about how to take precautions against the disease.

Typhus is spread by bacteria-infected fleas, found on cats, opossums and rats. Infected people suffer from fever, headaches, chills and body aches. Though typhus often requires hospitalization, it is usually treatable with antibiotics.