Tag Archives: outbreaks

New York | Measles outbreaks reaching highest numbers in years – Vax importance emphasized

With the number of measles outbreaks for the first four months of 2014 at the highest level since 1996, Governor Andrew M. Cuomo and the State Department of Health today alerted New Yorkers about the importance of being vaccinated to protect against the dangerous disease.  

“Measles is a serious, highly contagious disease that is not just limited to young children,” Governor Cuomo said. “While many New Yorkers have likely already received measles vaccinations, with the number of outbreaks at a higher level in years the State is taking the opportunity to urge New Yorkers check with their healthcare provider to make sure they and all of their family members’ immunizations are up-to-date.”

The Centers for Disease Control and Prevention (CDC) reports that measles has infected 129 people in 13 states in 2014, the most in the first four months of any year since 1996; 29 of those infections have been in New York. In 2013, an outbreak of 58 cases in New York City was the largest reported localized outbreak of the measles in the U.S. since 1996.

About Measles

Measles is so contagious that if one person has it, 90 percent of the people close to that person who are not immune will also become infected with the measles virus   It is spread by contact with nasal or throat secretions of infected people. You can be infected by measles virus suspended in the air for an hour or more after the infected person has left the room. The most common complications of measles are diarrhea, pneumonia, and ear infection, but it may also cause brain damage and rarely death. It is particularly harmful to persons with immunosuppression, pregnant women and very young children.

Measles symptoms usually appear in 10 to 12 days, but can occur as late as 18 days after exposure. Symptoms generally appear in two stages:

  • In the first stage, which lasts two to four days, the individual may have a runny nose, cough and a slight fever. Eyes may become reddened and sensitive to light while the fever gradually rises each day, often peaking as high as 103° to 105° F. Small bluish white spots surrounded by a reddish area may also appear on the gums and inside of the cheeks.
  • The second stage begins on the third to seventh day, and consists of a red blotchy rash lasting five to six days. The rash usually begins on the face and then spreads downward and outward, reaching the hands and feet. The rash fades in the same order that it appeared, from head to extremities. Although measles is usually considered a childhood disease, it can be contracted at any age.

The single best way to prevent measles is to be vaccinated. Most New Yorkers have been vaccinated, but if unsure, they should check with their healthcare provider.  Individuals should receive 2 doses of Measles, Mumps, and Rubella (MMR) vaccine to be protected.  The first dose should be given at 12-15 months of age and the second dose is routinely given at 4 to 6 years of age, but may be given as soon as 28 days after the first dose. Anyone at any age who is not immune to measles, and has no condition that would prohibit receiving the vaccine, should receive 2 doses of MMR vaccine at least 28 days apart.

Individuals are not at-risk of contracting measles if they are immune. A person is considered immune if he or she has received two doses of MMR vaccine, or if he or she was born before January 1, 1957, or has a history of laboratory-confirmed measles, or has a blood test confirming measles immunity. Any of the above confers immunity.

It is also important to note that travelers should be up-to-date on their vaccinations; since January 2014 there have been 34 cases of measles reported in the United States from travelers to foreign countries.

More information about measles can be found at: http://www.health.ny.gov/diseases/communicable/measles/fact_sheet.htm.

More information about vaccine safety and the importance of vaccines can be found at:
http://www.health.ny.gov/prevention/immunization/vaccine_safety.

Denmark | Salmonella Enteritidis and Shigella sonnei in connection with vacation travels to Turkey in 2013

Since June, Statens Serum Institut has recorded an increasing number of patients who have been infected with Salmonella Enteritidis during vacation travels to Turkey. Concurrently, an outbreak at a hotel in Alanya was shown to have been caused by several pathogenic gastrointestinal bacteria including S. Enteritidis and Shigella sonnei.

In the course of the summer, subtyping of Salmonella Enteritidis has identified an increase of four closely related subtypes. By 3 September, bacterial strains had been received from a total of 81 persons who had been diagnosed with one of these four subtypes of S. Enteritidis since June 2013. Among these, 47 persons had known previous travels to Turkey. In the same period in 2010-2012, between 27 and 39 persons were recorded with S. Enteritidis infection after having travelled to Turkey. Interviews with the patients have shown that they lived in different towns and at different hotels in Turkey. Poor hygiene at a single hotel, restaurant or other establishment can therefore not explain the observed cases.

Additionally, over the course of the summer, cases of Shigella sonnei have been recorded in Denmark and in other Nordic countries in patients who had returned from Turkey. A joint Nordic epidemiological study – including all persons who have lived at a certain hotel in Alanya – is currently on-going aiming to identify the source of this probable outbreak. In a limited number of patients with gastroenteritis who had stayed at the hotel in question, other pathogenic gastrointestinal bacteria than Shigella sonnei were detected, including: S. Enteritidis and verocytotoxin-producing Escherichia coli (VTEC).

On this basis, Salmonella, Shigella and VTEC infections should be suspected in patients with symptoms that are consistent with bacterial gastroenteritis following travel to Turkey. For Shigella and VTEC, specific guidelines are in place for persons in sensitive occupations EPI-NEWS 50/03. General travel advice for the prevention of food-borne diseases is avaliable at the SSI’s website.

Commentary

Previously, S. Enteritidis was the most frequently occurring salmonella type in Denmark. However, over the past 15 years, the number of S. Enteritidis infections has decreased steadily, EPI-NEWS 12/13. Since Danish chickens and egg-layers were declared salmonella-free, the majority of the recorded cases of infection have been acquired abroad, and the latest recorded outbreak of S. Enteritidis associated with a Danish source occurred in 2009, EPI-NEWS 36/09.

In Denmark, the country of infection of all salmonella cases has been monitored through telephone interviews since 2008. In the 2008-2012-period, a total of 37% of all salmonella cases with known country of infection were acquired abroad. In the same period, however, a total of 60% of all S. Enteritidis cases with known country of infection were acquired abroad. Since 2010, more than 75% of all S. Enteritidis cases with known country of infection have been acquired abroad.

Every summer sees an increase in the number of S. Enteritidis patients who have become infected during travels to Turkey, Figure 1. The numbers for 2013 were not included in the figure as the country of infection has yet to be established in a considerable number of cases. It remains unclear if the currently observed increase in S. Enteritidis cases from Turkey indicates a higher than normal level of food safety issues at the destinations, or if the cause is increased travelling activity to destinations in Turkey. Unfortunately, the total number of Danish tourists who have visited Turkey annually over the years is not known.

(S. Gillesberg Lassen, S. Ethelberg, and L. Müller, Department of Infectious Disease Epidemiology, M. Torpdahl and S. Persson, Microbiological Monitoring and Research)

North Carolina | Pertussis outbreaks continue across state

After continued outbreaks of pertussis (whooping cough) across the state, state health officials are encouraging people of all ages to be immunized against this highly contagious but preventable respiratory disease.

As of August 14, state public health officials had tracked 326 cases of pertussis, including 50 cases in infants.

Because of high numbers of pertussis cases in Davidson, Forsyth and Rockingham counties, DHHS has authorized local health departments in those counties to provide vaccine at no charge to anyone, regardless of insurance status.

“State law requires that kindergartners and all rising 6th graders be up to date on pertussis vaccination before going to school,” said Acting State Health Director Robin Cummings, M.D. “But as parents are getting their children ready to go back to school, it is also a good opportunity for parents to check on immunizations for the whole family. Any adults or older siblings, especially those who will be around newborns, should be vaccinated against pertussis.”

Infants who are not fully vaccinated against pertussis are susceptible to severe complications. According to the U.S. Centers for Disease Control, in infants younger than 1 year of age who get pertussis, about half are hospitalized. Of those infants who are hospitalized, 1 or 2 in 100 will die.

T-dap vaccination is especially important for the following groups:

  • women who are pregnant or may become pregnant
  • all close contacts of infants under 12 months of age (parents, siblings, grandparents, household contacts, child care providers)
  • anyone with pre-existing, chronic respiratory disease; and
  • healthcare providers

Some children through the age of 18 are eligible to receive their immunizations at no cost through the federally funded Vaccines for Children (VFC) program which provides vaccines to those who are Medicaid eligible, American Indian or Alaskan Native, uninsured or underinsured. There is no fee for the cost of the VFC vaccine for eligible children; however a provider may charge an administration fee.

In addition to pertussis, all school children in North Carolina must be vaccinated against:

Diphtheria
Hepatitis B
Hib Disease
Measles
Mumps
Polio
Rubella
Tetanus
Varicella (chickenpox)

Individuals should contact their health care provider or local health department to determine what vaccines they should receive or visit www.immunize.nc.gov for more information.

Tennessee | Measles and mumps outbreaks reported – MMR vax urged

Recent outbreaks of measles and mumps in several states are prompting health officials to issue reminders about the importance of Measles-Mumps-Rubella, or MMR, vaccinations. 

While some may think of measles and mumps as diseases of the past, the viruses are still common in much of the world, including Western Europe. Both are very contagious and can infect anyone who has not had measles or mumps and has not been properly vaccinated.

“We urge everyone to be vaccinated for measles and mumps, especially those traveling abroad, not just to protect themselves, but to protect all people they may come in contact with when they return,” said Kelly Moore, MD, MPH, medical director of the Tennessee Immunization Program. “While many people assume they have been properly immunized, some may not have the adequate protection needed.”

Almost everyone born before 1957 had these diseases in childhood. Those born more recently who are unsure should discuss vaccinations with their health care provider, who may suggest at least one dose before traveling abroad. Two doses of MMR vaccine are recommended for the best protection, and middle-aged adults might have had only one because the second dose was first recommended in 1989.

Parents traveling internationally with infants that are at least six months old should be sure the infant gets a dose of the MMR vaccine before traveling. If the infant is between six and 12 months of age, he or she will still have to get their usual two doses later, but the early dose will help protect the infant. Infants younger than six months cannot be vaccinated, and the Tennessee Department of Health recommends they should not be taken on international trips into risk areas.

In addition to measles, the MMR vaccine also provides protection against the mumps virus, another infection of childhood that is rare in the United States but common overseas. Outbreaks of mumps are currently known among students in multiple colleges in Virginia and Maryland, highlighting the fact that, once introduced, this virus also readily spreads among susceptible people.

Some parents may have lingering concerns about the MMR vaccine because of old allegations that the vaccine might be associated with the development of autism. These claims have repeatedly been disproven by medical research over the last decade; there is no evidence of any connection between MMR vaccine and autism-related conditions. On the other hand, children who do not receive or delay MMR vaccine can develop serious illness if they come in contact with a sick person; they also can spread measles or mumps to children or adults with weak immune systems, or vulnerable infants who are too young to be protected by vaccine.

MMR vaccines are required in Tennessee for children attending daycare, all school children and college students, and two doses have been required since 1990. Children routinely get the first dose at 12 to 15 months of age and the second dose before Kindergarten.

Symptoms of measles typically include high fever, cough and runny nose for up to three or four days before red eyes develop and a red rash starts on the head and chest. If a patient develops symptoms like measles, he or she should call ahead to their doctor’s office or ER so the staff can put them directly in a room away from other patients. Because the virus easily spreads in the air to others, this step is very important to protect other patients from exposure. Unfortunately, measles can cause death in some patients.

Symptoms of mumps include low-grade fever, muscle aches, headaches, feeling weak or tired, losing appetite and most typically, swelling of cheeks due to inflammation of salivary glands near the jawline. Complications may occur and are more prevalent in those who have reached puberty. Complications may include inflammation of the testicles, brain, the covering of the brain and spinal cord, ovaries or breasts. Temporary or permanent deafness may occur.

Vaccines and immunization services are available through all county health departments in Tennessee and at more than 1,500 physicians’ offices across the state. Doctors enrolled in the federal Vaccines for Children program may give free, federally-funded vaccine to eligible children from birth through 18 years of age.

For additional information about measles, please visit:

www.medicinenet.com/measles_rubeola/page2.htm#what_are_other_names_for_measles

For additional information about mumps, go to www.cdc.gov/mumps/

England | Measles at highest level for 18 years

There were 2,016 confirmed cases of measles in England and Wales reported to the Health Protection Agency (HPA) in 2012, which is the highest annual total since 1994.

The measles cases identified during 2012 have been associated with prolonged outbreaks in Merseyside and Sussex, as well as several smaller outbreaks in travelling communities across England and Wales.

The UK along with France, Italy, Spain and Romania accounted for 87 per cent of the total 7,392 measles cases reported throughout the European Union countries up to the end of November 2012.

Dr Mary Ramsay, head of immunisation at the HPA, said: “Coverage of MMR is now at historically high levels but measles is highly infectious and can spread easily among communities that are poorly vaccinated, and can affect anyone who is susceptible, including toddlers in whom vaccination has been delayed. Older children who were not vaccinated at the routine age, who may now be teenagers, are at particular risk of becoming exposed, while at school for example.

“Measles continues to circulate in several European countries that are popular with holidaymakers. Measles is a highly infectious disease so the only way to prevent outbreaks is to make sure the UK has good uptake of the MMR vaccine, and that when cases are reported, immediate public health action is taken to target unvaccinated individuals in the vicinity as soon as possible.”

Symptoms of measles include:

  • cold-like symptoms
  • red eyes and sensitivity to light
  • fever
  • greyish white spots in the mouth and throat
  • After a few days a red-brown spotty rash will appear. It usually starts behind the ears, then spreads around the head and neck before spreading to the legs and the rest of the body.

Dr Ramsay continued: “Measles is often associated with being a disease of the past and as a result people may be unaware that it is a dangerous infection that can lead to death in severe cases. Parents should ensure their children are fully protected against measles, mumps and rubella with two doses of the MMR vaccine. Parents of unvaccinated children, as well as older teenagers and adults who may have missed MMR vaccination, should make an appointment with their GP to get vaccinated.

“If you are unsure if you or your child has had two doses of the vaccine, speak to their GP who will have a record.”

Montana | Pertussis outbreaks continue as state passes 200 cases

Montana | 18 May 2012

The Montana Department of Public Health and Human Services (DPHHS) and local health agencies are continuing to report local outbreaks of pertussis, also known as whooping cough.  The number of cases has passed 200, the highest number since Montana’s 2005 outbreak that resulted in almost 600 cases.

Health officials are encouraging everyone, including adults, to take advantage of available vaccines and visit a medical provider if you have a persistent cough to help slow the spread of the disease.

Since January 2012, 18 of the state’s counties and tribal health jurisdictions have reported pertussis cases with outbreaks in Gallatin, Lewis and Clark, Ravalli, Lake , Missoula, Rosebud and Yellowstone counties. Local and state public health officials are concerned that the number of reported cases will continue to increase unless people take action to protect themselves and others.

According to DPHHS health officials, pertussis is a highly contagious respiratory illness spread by coughing and sneezing, but one that can be prevented by getting vaccinated. Although it initially resembles an ordinary cold, pertussis can turn more serious, particularly in infants.  Over half of infants diagnosed will require hospitalization.

Several states are reporting increases in reported pertussis, Washington State is leading the way with 1,300 cases reported this year.

“We continue to see cases of pertussis and most are preventable,” said DPHHS Director Anna Whiting Sorrell. “Making sure parents and caregivers are up to date on their vaccines is our best long term strategy. Anyone caring for children can take advantage of the vaccine to prevent spreading pertussis.”

People who are vaccinated are unlikely to become ill after an exposure or spread the illness to others.

Local health jurisdictions continue to follow-up on each case to help stop the spread of the disease to close contacts such as classmates and family members.  Close environments such as schools and daycares are ideal for easily and quickly spreading pertussis and present challenges to health officials.

“We are getting great cooperation from schools who assist us by referring ill children to providers and are helping with immunization reviews”  said Karl Milhon, manager of the state’s Communicable Disease Program.

Pertussis vaccination begins at age two months, but young infants are not adequately protected until they have received a series of vaccinations.  Because protection from the vaccine can fade over time, a booster is recommended for pre-kindergarten age, pre-teens, teens, and adults.  A relatively new pertussis vaccine is available and is now recommended for all teens and adults.

More information is available from local health providers and public health departments, or go to www.dphhs.mt.gov/publichealth/immunization/pertussis.shtml

Montana | Pertussis outbreaks continue to occur throughout the state

Helena | 30 April 2012

The Montana Department of Public Health and Human Services (DPHHS) reports that outbreaks of pertussis, also known as whooping cough, are being reported in several areas of Montana and is urging vaccines for all children and adults to help prevent the disease.

Since January 2012, nearly 90 cases of pertussis have been reported statewide, compared to approximately 50 cases for the same period last year.  Recent cases have been reported in Broadwater, Gallatin, Lewis and Clark, Ravalli, and Stillwater counties. Local and state public health officials are concerned that the number of reported cases will continue to increase unless people take action to protect themselves and others.

According to DPHHS health officials, pertussis is a highly contagious respiratory illness spread by coughing and sneezing, but one that may be prevented by getting vaccinated. Although it initially resembles an ordinary cold, pertussis can turn more serious, particularly in infants.  Over half of infants diagnosed will require hospitalization.

Washington State has reported a large increase in reported pertussis, with nearly 800 cases reported over the last 4 months.

Montana health officials do not want what is occurring in Washington State to happen here.

“Most cases of pertussis are preventable,” said DPHHS Director Anna Whiting Sorrell. “All parents and caregivers of children need to make sure their children are up to date on this and other vaccines. Anyone who cares for children should also be up to date on their vaccinations to prevent spreading pertussis.”

People who are vaccinated are unlikely to become ill after an exposure or spread the illness to others.
Local health jurisdictions with recent cases are working hard to control or stop the spread of the disease.  Close environments such as schools and daycares are ideal for easily and quickly spreading pertussis and present challenges to health officials.  “We encourage parents to not send children who are ill to schools and daycares because pertussis spreads quickly in these settings,” said Karl Milhon, manager of the DPHHS Communicable Disease Program.

Pertussis vaccination begins at age two months, but young infants are not adequately protected until they have received a series of vaccinations.Because protection from the vaccine can fade over time, a booster is recommended for pre-kindergarten age, pre-teens, teens, and adults.

More information is available from local health providers and public health departments, or go to
www.dphhs.mt.gov