Health Informer - Medical News: August 2012

Friday, August 31, 2012

1st death linked to new swine flu is Ohioan, 61 - KRMG

The death of a 61-year-old Ohio woman is the first in the nation associated with a new swine flu strain, the state Department of Health said Friday.

The woman, whose identity was not released, was from central Ohio's Madison County and died this week following an illness she contracted after having contact with hogs at the Ross County Fair.

The woman had underlying medical conditions, but the H3N2v influenza virus may have contributed to her death, the department said.

The strain was found in U.S. pigs in 2010 and people in July 2011, and it appears to spread more easily from swine to humans than other flu viruses, the Centers for Disease Control and Prevention has said.

The death was among 12 new cases of the virus in the country this week, the CDC reported. Ohio saw two other cases. Wisconsin had seven, and Minnesota and Pennsylvania each had one.

Ohio and Indiana lead the nation with infections for the year; Ohio has had 101, while Indiana has had 138, according to the CDC.

Twelve people across the nation were infected last year, compared with 289 so far this year, according to the CDC.

Ted Wymyslo, director of the Ohio Department of Health, said most of Ohio's cases have been mild illnesses. People from 6 months to 61 years old have been infected, and many of them have been linked to contact with hogs at fairs.

Wymyslo urged at-risk groups to avoid swine exhibits and take other precautions. Those groups include young children, older residents, pregnant woman and people with weakened immune systems or underlying medical conditions.

Lynn Finelli, the lead for the surveillance and outbreak response team in the CDC's influenza division, said in a statement that the agency was saddened to hear of the Ohio death.

"Like with seasonal flu, we have been â€" and continue to be â€" particularly concerned about people with factors that put them at high risk of serious complications if they get the flu," she said. "These people should absolutely not have contact with pigs or visit pig arenas at fairs this summer."

As with seasonal flu, the CDC recommends that people with high-risk conditions who develop flu-like symptoms contact their doctor immediately.

"Prompt antiviral treatment in a high risk person can mean the difference between having a milder illness versus a very serious illness that could result in a hospital stay or even death," Finelli said.

Symptoms of H3N2v include fever, cough, sore throat, runny or stuffy nose, body aches, headaches, and fatigue.

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Follow Amanda Lee Myers on Twitter at https://twitter.com/AmandaLeeAP

Yosemite officials warn more visitors about hantavirus - Los Angeles Times

Yosemite officials have sent about 200 more notifications to visitors who may have been exposed to hantavirus, as the confirmed cases traced to the park rose to six.

Officials have now contacted 3,100 people by letter or email, up from 2,900 earlier this week, said park spokesman Scott Gediman. Of the six hantavirus cases that have been linked to the park, two have been fatal. The remaining cases involve California residents who are recovering, said Yosemite spokeswoman Kari Cobb.

Officials have shut down the 91 "signature tent cabins" in Curry Village, the origin of four of the six cases. The origin of the two other cases remains under investigation.

Gaps that allowed access to deer mice, whose droppings carry the virus, have been plugged in the 91 cabins, but Gediman said the park would wait for more information before deciding what to do next. If problems continue, he said, the cabins could be moved or closed.

Officials say all six hantavirus infections occurred between June 10 and Aug. 24.

About one-third of the 587 hantavirus cases confirmed in the U.S. between 1993 and 2011 have been fatal.

Cobb said the park's emergency phone line, opened Tuesday to respond to questions, has received 1,700 calls.

Hantavirus spreads via mice droppings, saliva or urine, often through dirt and dust. Symptoms take one to six weeks to show in humans. Initially flu-like, the ailment can turn deadly as lungs begin to fill with fluid.

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-- Kate Mather, in Yosemite

Photo: Glenn Dean, a national parks occupational safety and health specialist, inspects tent cabins Tuesday at Curry Village at Yosemite National Park. Credit: Michael Macor/San Francisco Chronicle

First Death Is Reported From New Pig Flu Strain - New York Times

The first human death from a new strain of pig flu was reported Friday by state health officials in Ohio.

Federal health officials confirmed the death of a 61-year-old Ohio woman and said 14 other victims had been hospitalized by the new strain.

Also, in a shift, the Centers for Disease Control and Prevention conceded that there had been â€œlimited person-to-person spread of this virus.â€ As recently as three weeks ago, the agency insisted that all known cases had been caused by contact with pigs.

The Ohio woman had had direct contact with pigs at the Ross County Fair before falling ill, the Ohio Department of Health said. She also had other unspecified health problems that might have contributed to her death.

The new strain is known as H3N2v; the â€œvâ€ is for â€œvariant.â€ Thus far, it has proved no more deadly than seasonal flu and can be suppressed by Tamiflu and Relenza, the most common flu drugs.

Its origins are complex. It contains external genes (H for hemagglutinin and N for neuraminidase) that jumped from humans to pigs in the 1990s and circulated in them separately from the seasonal human H3N2. But it also contains one internal gene (the M for matrix) from the 2009 H1N1 pandemic flu that circled the globe and was very infectious but not very lethal.

Previous human â€œswine flusâ€ have been H1N1 strains, including the 1976 one that spawned a mass vaccine effort after a very small outbreak in Fort Dix, N.J., and the 2009 pandemic strain.

According to the disease agency, the new H3N2v was first found in pigs in 2010 and the first human case was confirmed in July 2011.

More than 90 percent of the 289 confirmed cases have occurred in families that raise and exhibit pigs, said Dr. Lynn Finelli, who leads the surveillance and outbreak response team of the agencyâ€™s flu division.

Most cases have been in Ohio and Indiana, but single ones have been confirmed as far away as Maine and Hawaii.

Minnesota State Fair: Pigs might've given people flu - CNN

A teenage girl is confirmed to have influenza after seeing pigs at the state fair
A boy and a woman in her 70s also became ill, and their test results are pending
All three people are OK
State health officials ask people at high risk for infection to avoid swine contact

(CNN) -- Three people appear to have become infected with a strain of influenza after exhibiting pigs or visiting the swine barn at the Minnesota State Fair, health officials said Friday.

Only one of the three cases has been confirmed to be an infection of the influenza variant H1N2, and test results are pending for the other two people, Minnesota health officials said.

"The H1N2v strain is different from the H3N2v strain that has prompted stepped up surveillance and prevention efforts nationwide, after causing 289 reported cases of illness and one death since the beginning of the year," state health officials said in a statement.

A teenage girl was confirmed to have the virus after she saw the pigs at the fair and became ill on August 26, officials said.

The other two cases involve an elementary-school-aged boy who became ill on August 27 after spending all day in the swine barn three days earlier and a woman in her late 70s who became ill on August 26 after spending a prolonged time in the swine barn and at the swine show in the Exhibit Hall on August 24, officials said.

The boy and woman had underlying health conditions and were treated with antiviral drugs, officials said. The woman was hospitalized and released.

All three patients have recovered or are recovering.

"For the past two weeks, we have been looking very hard for cases of influenza in people who have been exposed to swine," said Richard Danila, deputy state epidemiologist. "It is because of this careful surveillance that these cases have come to our attention.

"Right now, we don't have any basis for changing our recommendations to the public," Danila added.

Official are asking individuals at high risk for severe influenza to avoid swine contact at exhibitions, fairs and other venues, including the swine barn at the state fair. High risk individuals include children 5 or younger, pregnant women, people 65 or older, and those with chronic medical conditions, officials said.

Region goes all-out against West Nile virus - Philadelphia Inquirer

They're testing dead birds and insects, spraying pesticides, and conducting aerial and ground surveillance of breeding areas.

Across the region, authorities are ratcheting up the fight against the mosquito-borne West Nile virus as the Centers for Disease Control and Prevention reports about 1,600 human cases nationally through August, a record number since the virus was first detected in 1999 in the United States.

This year, 16 cases of the virus have been identified in Pennsylvania and eight in New Jersey, state officials said Friday. One of the Pennsylvania victims, an elderly Luzerne County man, has died.

The majority of cases in the country have been in six states - Texas, Louisiana, Mississippi, Michigan, Oklahoma, and South Dakota. Among the national total, 66 have died.

An unseasonably warm winter allowed mosquitoes to breed all year and is partly to blame for the problem, officials said.

States and counties are regularly checking for infected mosquitoes as a way of identifying areas that need spraying. On Friday, Pennsylvania reported finding 67 affected mosquitoes.

"We're on track to exceed the highest recorded year ever for mosquito infection," said Amanda Whitman, a spokeswoman for the Pennsylvania Department of Environmental Protection. "On average, each day, we're identifying 75 to 125 mosquitoes that test positive."

As in Pennsylvania, state officials in New Jersey are working closely with counties, providing lab testing and other assistance.

"West Nile virus cases tend to increase in the late summer and fall, and residents should take steps to prevent mosquito bites," said New Jersey Department of Health Commissioner Mary E. O'Dowd.

"Residents should protect themselves by using repellent, wearing long sleeves and pants, and avoiding outdoors during dawn and dusk, when mosquitoes are most active," she said.

Over the last few weeks, communities in the Philadelphia area have been sprayed even as health officials urged residents to work to reduce mosquito populations by eliminating standing water on their properties.

On Friday, some of Manhattan's most expensive neighborhoods - the Upper West Side and parts of Central Park - also were sprayed.

Older residents and those with compromised immune systems are the most vulnerable to the virus, which can lead to West Nile fever, encephalitis, and meningitis.

In Pennsylvania, one human case has been reported in Philadelphia, along with one each in Bucks, Chester, York, Centre, Franklin, Luzerne, and Lebanon Counties. Three additional cases were reported in Delaware County, three in Lancaster County, and two in Lehigh County. A total of seven were logged last year.

In New Jersey, eight cases have been reported: two in Essex County and one each in Bergen, Hudson, Mercer, Middlesex, Monmouth, and Ocean Counties. No deaths have been recorded. Seven cases were reported last year, with no fatalities.

"The surveillance and management of chronic mosquito-producing sites continues on a year-round basis, and includes wetlands management and the introduction of biological control agencies, such as mosquito-eating fish and tiny crustaceans, or copepods," said Bob Kent, administrator of the New Jersey DEP's Office of Mosquito Control Coordination.

The testing of the mosquito population "shows us where we have to focus our attention," Kent said Friday. "This has been a bad year, but we have an ambitious mosquito-control program."

But, he added, "we can't compare what's happening in the Northeast to Texas," which has 45 percent of the cases in the nation.

Testing birds for the virus will begin about mid-April and last until late October. Crows and blue jays are usually the focus, but the virus has also been found in hawks and robins.

In Gloucester County, one of four birds submitted to the state Department of Health on Wednesday tested positive for the virus, officials said Thursday.

"The mosquitoes started forming early this year," DEP spokesman Larry Ragonese said. "If you can't access [the breeding areas] by ground, you do flyovers. We provide funds and labs" for testing.

The majority of West Nile victims are infected between June and September, and 80 percent of them show no symptoms, CDC officials said. Those with mild or moderate symptoms have fever, headaches, rash, fatigue, nausea, and swollen lymph nodes. The symptoms appear three to 14 days after being bitten by an infected mosquito, the CDC said.

This week, New Jersey and Pennsylvania officials urged residents to clean out gutters and drains where water can accumulate and act as a breeding ground for insects. They also called on residents to dispose of old tires, turn over plastic wading pools and wheelbarrows, change birdbath water, and make sure all window and door screens are in good condition.

The West Nile season "goes on to Oct. 31," the Pennsylvania DEP's Whitman said. "We've still got two months to go."

Contact Edward Colimore

at 856-779-3833 or ecolimore@phillynews.com.

Want to cut down your drinking? Try a straight beer glass instead - Daily Mail

By Fiona Macrae

PUBLISHED: 19:34 EST, 31 August 2012 | UPDATED: 19:34 EST, 31 August 2012

If you want to cut down on your drinking without sacrificing nights out, the answer could be straight forward.

Research shows that lager is drunk much more slowly from a straight-sided glass than from a curved one.

In fact, it takes almost twice as long to enjoy a glassful.

Straight sided pint glasses slow down your drinking, according to new research

The finding means those who want to enjoy a night out without suffering a hangover the next day may do well to avoid the curved lager glasses that are often used in bars.

Social drinkers taking part in the Bristol University study were given a glass of lager or one of lemonade and told to drink it while they watched a nature documentary.

The lager served in a curved glass was finished in almost half the time, the journal PLoS ONE reports.

In later tests, the men and women, aged 18 to 40, were shown pictures of pairs of glasses and asked whether they were more or less than half full.

They tended to get the answer wrong, judging them to be fuller than they actually were.

Which glass? If you choose the curved one you're more likely to drink it faster and end up with a hangover

Those shown the curved glasses, which hold much more liquid at the top than at the bottom, did particularly badly.

The researchers said pub-goers might find it more difficult to judge how much they have drunk if their glass is much wider at the top than at the bottom, leading to them downing their lager more quickly.

If this is the case, something as simple as marking the half-way point on curved glasses could have substantial public health benefits andÂ help prevent binge-drinking.

The researchers said: â€˜Drinking time is slowed by almost 60 per cent when an alcoholic beverage is presented in a straight glass compared with a curved glass.

â€˜Clearly, many other factors will influence drinking rate, including social context. However, even aÂ modest reduction in drinking rate, when achieved over a large number of individuals, might lead to aÂ substantial reduction in alcohol-related harm.â€™

Interestingly, the type of glass used did not affect how quickly the lemonade was drunk â€" perhaps because we have less reason to pace ourselves with a soft drink.

Up to 10000 Yosemite visitors at risk of mouse-borne virus - USA TODAY

FRESNO, Calif. â€" More than 1,000 calls a day are coming into Yosemite National Park as visitors frightened about a growing outbreak of a deadly mouse-borne virus flood phone lines seeking reassurance.

DNC Parks and Resorts at Yosemite Inc. via AP

Yosemite National Park expanded efforts to notify visitors to a complex of tent cabins that they may have been exposed to a deadly virus.

DNC Parks and Resorts at Yosemite Inc. via AP

Yosemite National Park expanded efforts to notify visitors to a complex of tent cabins that they may have been exposed to a deadly virus.

At least six rangers, and often more, are staffing phones this week to answer questions from visitors wondering whether they're in danger of exposure to hantavirus pulmonary syndrome, park spokesman Scott Gediman said.

"We're reaching out and they are reaching out to us, and we are trying in every way shape and form to be transparent and forthright," he said. "We want to tell people this is what we know. The most important thing is the safety of park visitors and employees."

On Thursday, the California Department of Public Health confirmed that a total of six people have contracted the disease at Yosemite, up from four suspected cases earlier in the week. Two of those people have died from the illness that can cause rapid acute respiratory and organ failure.

Alerts sent to state and county public health agencies, as well as local doctors and hospitals, have turned up other suspected cases that have not yet been confirmed, according to the Centers for Disease Control and Prevention.

"Additional suspected cases are being investigated from multiple health jurisdictions," the CDC said in an advisory issued to health care providers.

The illness can take six weeks to incubate. There is no cure, and anyone exhibiting the symptoms must be hospitalized. More than 36% of people who contract the rare illness will die from it.

All of the victims confirmed so far stayed in insulated "Signature" tent cabins in the park's historic Curry Village section between mid-June and early July. The victims' cabins were within about 100 feet of each other, park officials said.

Park concessionaire Delaware North Co. sent letters and e-mails this week to nearly 3,000 people who stayed in the affected area between June and August warning them that they might have been exposed. It tells them to seek treatment if they exhibit symptoms: chills, fever, gastric problems and muscle ache, followed rapidly by difficulty breathing.

At least 7,000 people stayed in other "Signature" cabins separate from the outbreak area during the same period, the CDC said.

Park officials worked quickly to disinfect all 400 of the Curry Village cabins when the outbreak first was detected earlier this month. When the outbreak was narrowed to the 91 double-walled insulated cabins, the California Department of Public Health ordered them shut down Tuesday.

Park officials said the double-walled design of those particular cabins made it easy for mice to nest between the walls. The disease is carried in the feces, urine and saliva of deer mice and other rodents and carried on airborne aerosol particles and dust.

As the busy Labor Day weekend launches and word about the outbreak spread, some guests were canceling lodging reservations at the park. But Gediman says others on waiting lists for hard-to-get accommodations are snapping them up.

The hantavirus outbreak occurred despite park officials' efforts to step up protections.

A 2010 report from the state health department warned park officials that rodent inspection efforts should be increased after a visitor to the Tuolumne Meadows area of the park fell ill.

The report revealed 18% of mice trapped for testing at various locations around the park were positive for hantavirus.

"Inspections for rodent infestations and appropriate exclusion efforts, particularly for buildings where people sleep, should be enhanced," it said.

The park's new hantavirus policy, enacted April 25, was designed to provide a safe place, "free from recognized hazards that may cause serious physical harm or death."

The 91 insulated, high-end canvas cabins in the century-old Curry Village are new to the park. They were constructed in 2009 to replace some that had been closed or damaged after parts of Curry Village, which sits below the 3,000-foot Glacier Point promontory, were determined to be in a rock-fall hazard zone.

Upon taking them apart for cleaning, park employees found evidence of mouse nests in the insulation.

The deer mice most prone to carrying the virus can squeeze through holes just one-quarter-inch in diameter. They are distinguished from solid-colored house mice by their white bellies and gray and brown bodies.

In 2011, half of the 24 U.S. hantavirus cases ended in death. But since 1993, when the virus first was identified, the average death rate is 36%, according to the CDC.

Thousands call Yosemite hotline to ask about virus - The Associated Press

Health officials probe virus exposure at Yosemite

By JASON DEAREN, Associated Press â€" 1 hour agoÂ

FRESNO, Calif. (AP) â€" Two more Yosemite National Park visitors have been found with a mouse-borne virus blamed for the deaths of two people, bringing the total number of infections to six, state health officials said.

The new discoveries were made during the agency's investigation into cases of hantavirus pulmonary syndrome at the famed park, California Department of Public Health Anita Gore spokeswoman said.

The infections spurred park officials to close 91 tent cabins at Curry Village in Yosemite Valley, where five of the six infections occurred. Gore said one of the infected people may have been in another area of the park.

"Our investigation is trying to determine which area of the park that person visited," she said.

Over the past three weeks, two people have died of hantavirus pulmonary syndrome after staying in cabins at Curry Village in Yosemite Valley.

Park officials said the double-walled design of the cabins that were closed Tuesday made it easy for mice to nest between the walls. The disease is carried in the feces, urine and saliva of deer mice and other rodents.

The illness begins as flu-like symptoms but can quickly affect the lungs. It can take up to six weeks to incubate.

Five of the people who fell ill are known to have stayed in the tent cabins in June or July, and warnings have gone out to visitors who stayed in Curry Village in June, July or August.

The hantavirus outbreak occurred despite efforts by park officials to step up protection efforts last April. A 2010 report from the state health department warned park officials that rodent inspection efforts should be increased after a visitor to the Tuolumne Meadows area of the park fell ill.

The new hantavirus policy, enacted April 25, was designed to provide a safe place, "free from recognized hazards that may cause serious physical harm or death."

It came after the state report revealed that 18 percent of mice trapped for testing at various locations around the park were positive for hantavirus.

"Inspections for rodent infestations and appropriate exclusion efforts, particularly for buildings where people sleep, should be enhanced," it said.

In 2009, the park installed the 91 new, higher-end cabins to replace some that had been closed or damaged after parts of Curry Village, which sits below the 3,000-foot Glacier Point promontory, were determined to be in a rock-fall hazard zone.

The new cabins have canvas exteriors and drywall or plywood inside, with insulation in between. Park officials found this week when they tried to shore up some of the cabins that mice had built nests in the walls.

The park sent warning emails and letters Wednesday to another 1,000 people who stayed in tent cabins, after officials found that a computer glitch had stopped the notices from going out with the original 1,700 warnings Monday. The warning says anyone with flu-like symptoms or respiratory problems should seek immediate medical attention.

In 2011, half of the 24 U.S. hantavirus cases ended in death. But since 1993, when the virus first was identified, the average death rate is 36.39 percent, according to the Centers for Disease Control.

Dearen reported from San Francisco.

Thousands call Yosemite hotline to ask about virus - USA TODAY

DNC Parks and Resorts at Yosemite Inc. via AP

Yosemite National Park expanded efforts to notify visitors to a complex of tent cabins that they may have been exposed to a deadly virus.