ZKEA

Biological Warfare : Biological Terrorism : Emerging Diseases

Archived News
Week ending January 15th, 2006

Preliminary tests showed two young brothers and an adult in Ankara have a deadly strain of bird flu, the first suspected cases confirmed outside the eastern city of Van, officials said Sunday, triggering fears the virus is spreading in Turkey.

A British laboratory also confirmed the deadly strain in a 5-year-old boy, while preliminary tests in Turkey detected H5N1 in an 8-year-old girl. Both children are in intensive care in Van, about 60 miles from the Iranian border.

The cases announced Sunday raised to seven the number of cases detected since Wednesday. A brother and sister in Van also were found to be positive for H5N1 in the preliminary tests, Health Ministry official Turan Buzgan said.

The H5N1 strain has killed at least two Turkish children in recent days ┠a 14-year-old boy and his 15-year-old sister ┠the first human fatalities from the virus outside east Asia in the current outbreak.

Tests are still being carried out to establish if a third sibling, an 11-year-old girl, also died from the virus...

Britain could see a dramatic increase in food poisoning cases and waterborne disease as the warmer, wetter weather linked to climate change takes hold. Hotter summers could lead to more salmonella cases as people opt for more barbecues but leave food out of the fridge, Professor Paul Hunter warned. Heavy rain may also lead to more cases of diarrhoea-inducing cryptosporidium.

The University of East Anglia expert said Britain may also see some malaria cases - but is likely to cope.

There's an interesting area around climate that's how is it going to impact on human behaviour - people have more barbecues when it's hot This is because unlike most areas of the world badly affected by the disease, Britain has a public health system which could tackle any outbreaks, he said.

Professor Hunter said: "It's fairly accepted that most of the changes are going to be around hotter summers and more frequency heavy rainfall. "We already know that food poisoning is related to temperature. This is because if you leave food outside the fridge at warm temperatures germs grow."

If people did not change their behaviour, and continued to leave food out at the hotter "ambient temperatures", food poisoning was likely to cases were likely to increase, he said. "There's an interesting area around climate that's how is it going to impact on human behaviour - people have more barbecues when it's hot." Poorly cooked meat on home barbecues has long been associated with food poisoning.

Professor Hunter also warned that heavy downpours could lead to an increase in outbreaks of the water-borne bug cryptosporidium which causes diarrhoea, vomiting and stomach cramps.

This was especially likely in the "periphery of water supply", such as in farms and holiday cottages, where water facilities were not supplied from the main network," he said. "There's still an unbelievably high proportion of people that drink private water supplies...

Health officials in Europe said they were on "high alert" Friday as a third child in eastern Turkey was confirmed to have bird flu and more than two dozen people suspected of having the disease were in a local hospital, an unusual cluster of human cases that raises the possibility that the H5N1 bird virus has become more contagious to human beings.

The officials have watched with concern over the last four months as the virus's path has moved steadily from East Asia to the edge of Europe, first in birds and now, in humans. An international reference lab in England confirmed for the first time Friday that at least three children in the Turkish cluster had the H5N1 virus, and further testing was under way. "I'm not sure we've seen a cluster like this in terms of numbers and certainly it's a concern," said Maria Cheng, spokeswoman in the Division of Epidemic Preparedness at the World Health Organization. "Is the virus being transmitted more easily from birds to humans, or even from humans to humans? We need to put all the pieces together before we can come to conclusions."

For the moment, international health authorities believe that the Turkish victims - the first victims outside of East Asia - most likely became ill after close contact with sick or dead chickens, infected with H5N1. Reports in the Turkish press said that two siblings who died, Mehmet Ali Kocyigit, 14, and his sister Fatma, 15, had been playing catch with the heads of dead chickens. While the H5N1 virus does not now readily infect humans or pass between them, scientists are worried that it might acquire that ability through naturally occurring processes, setting off a worldwide flu epidemic.

Still, the WHO and the European Commission were alarmed enough to dispatch teams of scientists to eastern Turkey..

Residents of the eastern Turkish town hit by a fatal outbreak of bird flu in humans have besieged a local hospital seeking treatment for symptoms. Three children from Dogubeyazit have died this week, at least two of them from the virulent H5N1 strain.

Despite no evidence that the disease has begun to spread between humans, locals have sought treatment at a poorly-equipped hospital in the town. Turkey will speed up a poultry cull this weekend to contain the virus.

The World Health Organisation has attempted to play down fears of the disease, as Turkish officials sought to defend themselves from accusations they were slow to act. A WHO spokeswoman in Geneva said the bird flu outbreak had been contained in one Turkish province and there was "no need for excessive panic". Twenty people remain in hospital in Van, a larger city in eastern Turkey, under treatment for suspected bird flu.

Tests carried out in a UK laboratory confirmed that Mehmet Ali and Fatma died from the H5N1 strain, which has killed more than 70 in south-east Asia and China.

The children's family kept poultry at their home in Dogubeyazit, close to the Iranian border in Van province.

All four children developed symptoms including a high fever, coughing and bleeding in the throat. Doctors said they had been playing with the heads of chickens who had died of bird flu...

A 14-year-old farm boy who died after developing pneumonia-like symptoms had tested positive for bird flu, Turkey's health minister said Wednesday.

If the test is confirmed by the World Health Organization, it would be the first bird flu-related death outside Asia.

Three other members of his family also tested positive and are hospitalized, Health Minister Recep Akdag said.

Akdag's statement contradicted a ministry statement earlier this week, which said the boy's death was not caused by bird flu.

The tests have not been confirmed but a senior World Health Organization official said the boy probably had died of the H5N1 bird flu virus, Reuters news agency reported.

The 14-year-old boy, Mehmet Ali Kocyigit, died on Sunday.

He was among two brothers and two sisters between 6 and 15 years old who were admitted to hospital in the country's southeastern Van province last Saturday after developing high fevers, coughing, and bleeding in their throats. The children helped to raise poultry on a farm and were in close contact with sick birds. They became sick after reportedly eating one of them.

Two other patients, aged 35 and 5, were sent to the same hospital on Sunday, the Anatolia news agency reported...

A teenage girl has become the first known person to survive rabies without a vaccination, say doctors. A team at the Children's Hospital of Wisconsin used an experimental treatment on 15-year-old Jeanna Giese.

She was admitted to hospital last month with advanced symptoms of the disease after being bitten by an infected bat at a church in September.

Doctors used a cocktail of drugs to protect the brain and nervous system from the effects of the disease. They were able to diagnose the condition quickly because Jeanna was exhibiting classic signs of the disease, such as periods of unconsciousness, double vision and slurred speech.

The disease had progressed to a point where immunisation was not an option. So a team of eight specialists used coma inducing drugs to protect the teenager's brain and a cocktail of drugs to protect her nervous system and boost her immune system.

Dr Rodney Willoughby, an expert in child infectious disease who led the team, said the aim was to protect the brain while the disease ran its course through the rest of the teenager's body. Previous research has indicated that the virus tends to kill by damaging the brain tissues.

Jeanna lapsed into a coma within an hour of starting treatment. After a week of treatment tests showed that Jeanna's immune system was creating antibodies to fight the virus.

The drug treatment was gradually eased off as the virus began to subside, allowing the teenager to regain consciousness. Subsequent laboratory tests carried out by the US Centers for Disease Control and Prevention in Atlanta showed that the teenager had cleared the virus.

Dr Willoughby said Jeanna was now physically weak but regaining her strength and voice after weeks of mechanical ventilation...

First came stomach cramps, which left Christina Shultz doubled over and weeping in pain. Then came nausea and fatigue -- so overwhelming she could not get out of bed for days.

Just when she thought things couldn't get worse, the nastiest diarrhea of her life hit -- repeatedly forcing her into the hospital.

Doctors finally discovered that the 35-year-old woman from Hilliard, Ohio, had an intestinal bug that used to be found almost exclusively among older, sicker patients in hospitals and, usually, was easily cured with a dose of antibiotics. But after months of treatment, Shultz is still incapacitated.

"It's been a nightmare," said Shultz, a mother of two young children. "I just want my life back."

Shultz is one of a growing number of young, otherwise healthy Americans who are being stricken by the bacterial infection known as Clostridium difficile -- or C. diff -- which appears to be spreading rapidly around the country and causing unusually severe, sometimes fatal illness.

That is raising alarm among health officials, who are concerned that many cases may be misdiagnosed and are puzzled as to what is causing the microbe to become so much more common and dangerous.

"It's a new phenomenon. It's just emerging," said Clifford McDonald, of the federal Centers for Disease Control and Prevention in Atlanta. "We're very concerned. We know it's happening, but we're really not sure why it's happening or where this is going."

It may, however, be the latest example of a common, relatively benign bug that has mutated because of the overuse of antibiotics.

In addition, new evidence released last week suggests that the enormous popularity of powerful new heartburn drugs may also be playing a role. The antibiotics Flagyl (metronidazole) and vancomycin still cure many patients, but others develop stubborn infections like Shultz's that take over their lives. A small number have died, including an otherwise healthy pregnant woman who succumbed earlier this year in Pennsylvania after miscarrying twins.

The infection usually hits people who are taking antibiotics for other reasons, but a few cases have been reported among people who were taking nothing, another unexpected and troubling turn in the germ's behavior...

Scientists have cracked the genetic code of a fungus responsible for deadly infections and allergic reactions. Aspergillus fumigatus, which causes more infections than any other mould, is particularly dangerous to people with weakened immune systems.

Researchers at the Institute for Genomic Research hope their work could lead to better diagnostic tests, and treatments for fungal infections. Their international collaboration is reported in the journal Nature.

Experts believe that A. fumigatus has become an increasing threat in recent years as more people with compromised immune systems are surviving.

These include transplant patients, and people with leukaemia and Aids. The fungus also appears to trigger asthma in some people with particularly sensitive immune systems.

It is unusual because it can thrive at a wide range of temperatures, from 70C - the temperature in a compost heap - to 37C, inside the human body. By altering ambient temperatures in the lab, scientists were able to track how different genes were turned on and off as the environment warmed.

The researchers, including scientists from the UK's Wellcome Trust Sanger Institute, discovered that the genome of the fungus is made up of eight chromosomes bearing a total of almost 10,000 genes.

They found 700 genes that were either significantly different, or did not occur at all in a similar, but less infectious, fungus, Neosartorya fischeri. They also identified for the first time nine allergy-causing substances produced by the fungus...

Scientists have analysed in close detail the structure of a key protein that helps the malaria parasite infect human cells. They found the protein has a unique atomic structure which, in theory, new drugs could target directly.

Malaria kills about 2m people each year, most of them children under five. There are concerns about growing resistance to established drugs. The research, by scientists from India and France, is published by Nature.

Malaria is caused by a one-celled organism called Plasmodium, which is passed to humans through the bite of Anopheles mosquitoes. The parasite replicates inside red blood cells, which eventually burst. In order to enter these cells, it first has to bind to the cell through protein interactions which take place on the surfaces of red blood cells and the parasite.

The latest research focuses on one particular protein on the surface of Plasmodium which plays a particularly key role. The researchers obtained crystals of a part of this protein - called the Duffy-Binding Like (DBL) domain - which directly interacts with a protein on red blood cells.

Using a technique called X-ray crystallography they were able to create an atom-by-atom map of the protein, which are too small to be seen by microscopes.

Researcher Dr Amit Sharma said: "Until now we have not had a close-up view of the precise surface where the two proteins interact. "That surface is absolutely crucial in permitting the parasite to enter the cell. "If we can determine its features in atomic detail, we may be able to find weak points that could make good targets for drugs."..