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October 11, 2019

Philippines: African Swine Fever

The sea has not been able to stop the march of African swine fever [ASF] in Asia. In September the virus was also confirmed in the Philippines. What happened on the islands exactly and what are some of the longer-term perspectives?

The total pig population of the Philippines is around 13 million head, including a 1.75 million sow population. Around 40% of this total current population consists of smaller groups of pigs held in numerous backyard farms.

Approximately 40% of the total pig inventory is concentrated in 3 regions: Central Luzon, northern Mindanao and western Visayas, which account for 17%, 13%, and 10% of the total inventory, respectively. Most of the commercial pig farms are located in these 3 areas.

However, the backyard population is spread more thinly across the Philippines, e.g., central Visayas and the Bicol regions both have 10% of the backyard population. Many of the backyard farms across the Philippines purchase weaner age pigs between 5 and 10 kg bodyweight and fatten them prior to sale at 30 kg or at 90 kg. Pigs are housed in simple backyard structures and fed a range of waste food or by-products, often with some commercial feed added.

Most pigs for sale are aggregated by local dealers and taken to local slaughterhouses or lechon processing facilities. On larger backyard farms, a number of sows may also be housed and used in breeding programs and piglet production.

Netherlands: Listeria

A total of 3 people have died and one woman has had a miscarriage after eating cold meat contaminated with Listeria, the public health institute RIVM [Netherlands National Institute for Public Health and the Environment] said on Oct. 4. All are thought to have become ill after eating meat products from the Offerman company over the past 2 years, the agency said.

In total, at least 20 people have become ill after eating Offerman cold cuts. The company issued a health warning Oct. 4, and Jumbo, which stocks 135 different products from Offerman, ordered an immediate recall. Aldi too has recalled its Offerman products, which were also widely sold to company canteens.

The source of the infection was traced by the RIVM and product safety board NVWA [Netherlands Food and Consumer Product Safety] after an analysis of the different types of Listeria infection this week. "It has only been recently possible to use this technique and without it, we would not have been able to identify the source," the RIVM said.

The factory where the bacteria originated is located in Aalsmeer and has been closed pending a thorough clean-up, the AD reported. According to broadcaster NOS, the NVWA had ordered Offerman to take extra hygiene measures because there were suspicions that something was going wrong. "But this would appear not to have done the job," an NVWA spokesman told the broadcaster.

Listeria is found in meat that has not been properly cooked and in raw foods that have been kept for a long time, the RIVM said. Most people suffer mild flu-like symptoms, but the bacteria can cause serious symptoms in the elderly, newborns and people with weak immune systems. It is particularly dangerous to pregnant women and can cause miscarriages. Every year about 80 cases of listeriosis are reported to the RIVM.

Canada: E. coli

Newfoundland and Labrador's provincial health department is advising residents of an outbreak of E. coli bacteria. There have been 22 cases of E. coli confirmed in the province this week, according to an advisory issued Oct. 4. The statement says provincial public health officials and regional authorities are investigating.

The Department of Health and Community Services advises people experiencing symptoms of E. coli, including severe or bloody diarrhea and abdominal pain, to seek medical attention. The illness spreads mostly through ingestion of contaminated food or water but can also spread through person-to-person contact.

A provincial medical officer of health says most cases are within the province's eastern health authority, including the capital city of St. John's, but others are in the central and western authorities.

Dr. Janice Fitzgerald said some of the cases are connected to an advisory issued by Memorial University earlier this week, saying Eastern Health was investigating reports of students experiencing gastrointestinal illness.

The university said Oct. 2 that test results indicated one student living in residence "may have contracted the E. coli bacteria" and 21 students had reported similar symptoms. Fitzgerald said it's too early in the investigation to determine a cause of the outbreak.

Congo: Plague

On Sept. 25, a rodent and guinea pig die-off was reported to the health authorities of the Aru Health Zone, Ituri Province, DRC, in the village of Omeyi in the Ongoyi health area. Subsequently a family cluster of 4 cases with the clinical symptoms consistent with the definition of bubonic plague was reported. Symptoms were high fever in 3 patients and high fever with a painful inguinal swollen lymph node in the 15-year-old patient. This family was admitted at the health center of Ekanga on Sept. 25; unfortunately, the 15-year-old boy died on Sept. 26. The other 3 patients were treated with doxycycline.

The DRC health zone team arrived on Sept. 27 to spray the houses with deltamethrin, take human and wildlife samples, and raise community awareness of the measures to be taken. In response to this situation, the head of the Health Center of Ekanga alerted the Central Office of the health zone, and 225 villagers were given doxycycline preventively. A plague rapid diagnostic test (RDT) was performed on the 3 other patients but only one was weakly positive, possibly due to antibiotic treatment. Two samples taken on the dying guinea pigs were strongly positive with the same RDT.

In total, 12 suspected plague cases and 3 deaths have been reported since Sept. 27: 7 cases and 3 deaths from Omeyi, 3 cases from Ongoyi, 1 case from Doro and 1 case from Alembele village.

The provincial division of health is closely monitoring the situation and should send a team to the outbreak site on Oct. 7. Rodent samples have been stored in ethanol for PCR diagnostic confirmation of bubonic plague.

The location of the village in proximity with the Ugandan border 12.4 miles and with people seeking treatment in Uganda presents an additional risk of transborder outbreak as earlier this year. In March, a 35-year-old woman died of pneumonic plague in Uganda after spending time in Atungulei village in DRC's Ituri province, and where her 4-year-old child had died days before. Further investigation revealed that finding her sick at her child's burial, her relatives took her to Uganda for treatment.

United States: Chronic Wasting Disease

The Wyoming Game and Fish Department confirmed chronic wasting disease (CWD) in deer hunt area 152, approximately 12 miles west of Bondurant on Willow Creek.

The mule deer buck testing positive was hunter-harvested. This is the first time CWD has been found in deer hunt area 152, part of the Sublette mule deer herd, and is in a hunt area close to wintering elk feed grounds. CWD is a fatal neurological disease of deer, elk, and moose.

"Seeing a deer test positive for CWD west of the continental divide again is concerning," said Scott Edberg, deputy chief of wildlife. "Game and Fish is always concerned about the spread of CWD. We have conducted CWD surveillance for more than 2 decades and have focused efforts on monitoring the disease, and those methods continue this year."

CWD has been previously detected in mule deer nearby hunt area 152: one south of Afton in 2016, one south of Pinedale in 2017, and one north of Jackson in 2019.

CWD has not been detected in elk wintering on any of Wyoming's 22 feed grounds or the National Elk Refuge to date. Game and Fish and the U.S. Fish and Wildlife Service have provided supplemental feed to elk during the winter months for more than 100 years. Feed grounds maintain elk population objectives while also maximizing the separation of elk from cattle to prevent property damage and minimize brucellosis transmission to cattle. However, feed grounds concentrate large numbers of elk in small areas for several months, increasing the potential for the spread of diseases among elk, including CWD. The prevalence rate of CWD is currently less in elk than in deer.

United States: West Nile Virus

The Colorado Department of Agriculture reported on Oct. 3 that 10 equine West Nile virus [WNV] cases have been confirmed in 8 Colorado counties, including one horse in Larimer County.

Three horses were found to have the disease in Weld County, and the others were in Adams, Garfield, Mesa, Montrose, Pueblo and Rio Blanco counties, according to a news release.

"Veterinarians report more of the horses seem to be acutely neurologic with severe symptoms. Four of the horses have been euthanized due to the severity of the clinical signs," the release stated.

The Colorado State Veterinarian's Office recommended vaccinating horses against West Nile, first with a 2-shot series, followed by annual booster shots.

Pakistan: Crimean Congo Hemmorhagic Fever

A local factory worker in Khyber-Pakhtunkhwa died of high grade-fever with the family blaming death on Crimean-Congo hemorrhagic fever.

Another villager also tested positive for CCHF. According to family sources, a 45-year-old resident of Hattar village, had suffered from high grade-fever for around a week, while he was treated at a local private hospital as a dengue patient. The man was later shifted to Islamabad's PIMS hospital, where he died. The family claimed that the PIMS doctors suspected its member suffered from Congo fever.

However, the health department rejected the claim. Also, a 60-year-old resident of Bandi Muneem village, was admitted to Pims, Islamabad, tested positive for CCHF. The doctors said the patient's condition was improving.

When contacted, Dr. Sher Bahadur, head of the dengue program at the Haripur, District Health Office, said a team of doctors had visited the house of the 45-year-old man and found out that he had died of blood cancer and pneumonia and not CCHF.

He said the team also visited the house of the 60-year-old and found him to be a patient of CCHF. Dr. Bahadur said the man was a farmer, who used to have direct contact with farm animals, so he got the infection after tick bite.

United States: Eastern Equine Encephalitis

A laboratory testing has confirmed the 8th horse infected with Eastern equine encephalitis (EEE) virus this year, the Massachusetts Department of Public Health said. The horse was stabled in Spencer in Worcester County, a community already considered at high risk for EEE, health officials said.

No change in risk levels is indicated. There are 35 communities now at critical risk, 53 at high risk, and 121 at moderate risk for the EEE virus in Massachusetts.

There have been 12 human cases of EEE this season in Massachusetts and 9 confirmed cases of EEE this year in animals -- 8 horses and a goat. State officials continue to remind residents throughout the commonwealth to take personal precautions to prevent mosquito bites.

EEE is a rare but serious and potentially fatal disease capable of affecting people of all ages. EEE occurs sporadically in Massachusetts, with the most recent outbreak years occurring from 2004 to 2006 and 2010 to 2012. There were 22 human cases of EEE infection during those 2 outbreaks.

United States: Plague

The New Mexico Department of Health's (NMDOH) Scientific Laboratory Division has confirmed a case of plague in a 72-year-old man from Torrance County, the first human case of plague in New Mexico this year.

Plague is a disease caused by the bacterium Yersinia pestis, which is generally transmitted to humans from the bites of infected fleas that live among rodents and rabbits. Plague can also be transmitted by direct contact with infected animals. Pet dogs and cats can become infected with plague when they eat an infected rodent or when they are bitten by an infected flea.

NMDOH staff have gone door-to-door in the affected area to inform neighbors about plague and provided them with education to reduce their risks.

"No matter where you call home in New Mexico, you can reduce the risk of plague by avoiding contact with rodents or their fleas, or outdoor pets by providing appropriate flea prevention for pets year-round," said Secretary of Health Kathy Kunkel.

Symptoms of plague in humans include sudden onset of a fever, chills, headache, and weakness usually within one to 7 days of becoming infected. There may be a painful swelling of the lymph node in the neck, armpit or groin areas, referred to as bubonic plague. The infection can also spread to the blood, causing septicemic plague, or to the lungs, causing pneumonic plague.

With prompt diagnosis and appropriate antibiotic treatment, the fatality rate in people and pets can be greatly reduced. Physicians who suspect plague should promptly report all cases to the New Mexico Department of Health.

Pakistan: Typhoid Fever

The U.S. Centers for Disease Control and Prevention (CDC) issued a level 1 travel alert regarding the ongoing outbreak in Pakistan of extensively drug-resistant (XDR) typhoid fever.

This "practice usual precautions" travel alert published on Sept. 30 is very important since XDR infections do not respond to most antibiotics, such as ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, ciprofloxacin, and ceftriaxone. And in rare cases typhoid fever can be fatal.

The CDC says people from the USA, Canada, United Kingdom, Denmark, and Australia with a travel history to Pakistan have reported XDR typhoid infections. According to the Pakistan Tourism Development Corporation, about 1.75 million tourists visited Pakistan in 2017 alone.

Pakistan is the world's 6th-most populous country with a population exceeding 210 million people, located in South Asia.

Pakistan's current XDR typhoid fever outbreak began in Hyderabad, which is a city of Sindh province, during November 2016.

The CDC says, "If you are going to South Asia, including Pakistan, protect yourself against typhoid infection by getting a typhoid fever vaccination." The CDC's Advisory Committee on Immunization Practices (ACIP) recommends 2 typhoid fever vaccines: an oral vaccine, Typhim, and an injectable vaccine, Typbar.

The oral vaccine Typhim is approved for people 6 years old or older, should be taken as directed, at least 1 week before departure. The injectable vaccine is approved for people 2 years old or older. Travelers should receive the injectable vaccine Typbar at least 2 weeks before departure.

Neither vaccine is 100% effective, so travelers should also practice safe eating and drinking while traveling abroad, says the ACIP.

Denmark: Malaria

Denmark has reported a travel-related case of malaria caused by Plasmodium cynomolgi in a Danish traveler returning from a visit to forested areas in peninsular Malaysia and Thailand during August-September 2018.

P. cynomolgi is a parasite causing disease among macaque monkeys across Southeast Asia but rarely infects humans.

The traveler was admitted to hospital with the suspicion of malaria. Routine initial tests for malaria and more in-depth tests were required to diagnose malaria caused by P. cynomolgi. After receiving treatment, symptoms resolved on the 2nd day and the patient recovered fully.

ECDC wants to raise awareness about the possibility of more human cases due to the presence of P. cynomolgi in macaques across Southeast Asia and the volume of tourists visiting these areas, including national parks. Since the diagnosis is challenging, advanced detection and identification techniques should be performed when all other tests show negative results.

Travelers to the region are advised to apply preventive measures against malaria such as taking chemoprophylaxis and using mosquito nets and insect repellents, wearing long sleeved shirts and trousers, and sleeping in air-conditioned rooms.

October 4, 2019

Nigeria: Yellow Fever

On July 16, the Ebonyi State Ministry of Health received information about suspected yellow fever cases in Izzi local government area Nigeria. The cases had symptoms of fever and jaundice, reported with onset since May 2019. As of 30 Aug 2019, a total of 84 suspected yellow fever cases, including 26 deaths (case fatality ratio: 31%), have been reported across 9 LGAs within Ebonyi state.

Of the suspected yellow fever cases, 55% (46/84) are male. The most affected age group is 0-9 years (28 cases, 33%), followed by age groups 20-29 years and above 30 years, each with 20 cases (24%). The 10-19-years age group has the least number of cases (16 cases, 19%). Of the suspected cases, 79% (66/84), including 7 confirmed cases positive by real-time polymerase chain reaction (RT-PCR), are reported from Izzi LGA, which is located in the northeastern part of the state, bordered with Cross River state in the east and Benue state in the north.

The assessment conducted by the LGA rapid response team and national agencies found low vaccination coverage and poor routine immunization documentation. Community surveys were conducted, and yellow fever vaccination coverage was estimated to be 56% (64% for children aged less than 5 years and 48% for those older than 5 years of age). Though Nigeria introduced routine vaccination for yellow fever into the immunization schedule in 2004, most adults remain susceptible, and overall population immunity is low. Although no entomological studies were conducted at the time, the geography and vegetation of the affected state is compatible with the presence of the Aedes mosquitoes, as illustrated by the transmission patterns.

Since September 2017, when the Nigeria Center for Disease Control informed WHO of a confirmed case of yellow fever in Kwara state, Nigeria has been responding to successive yellow fever outbreaks over a wide geographic area.

Germany: West Nile Virus

Germany has seen its first confirmed case of the mosquito-spread West Nile virus in a human.

"The person from Saxony suffered from encephalitis, was treated at the Klinikum St Georg in Leipzig, and has recovered," several institutions, including the Robert Koch Institute in Berlin, announced on Sept. 27.

The virus often does not cause symptoms in humans. Serious and deadly cases are rare and usually involve older people with pre-existing illnesses.

So far in Germany, there had only been cases involving travelers who contracted the disease in affected regions.

The virus, which originally stems from Africa, first occurred in Germany in animals in 2018. It is transmitted by certain breeds of mosquitoes. Owls, birds of prey, and ravens are the virus' most common hosts. However, it can also be transmitted to horses and humans.

Bangladesh: West Nile Virus

A new mosquito-borne virus, West Nile Virus (WNV), has been found in Bangladesh. However, detailed information about the virus has not been available yet as the government's concerned department didn't investigate to know its origin.

According to the experts, West Nile is a potentially life-threatening viral infection which can pass to animals and humans if they are bitten by an infected mosquito.

WNV is a virus of the Flaviviridae family, which includes the viruses responsible for Japanese encephalitis and dengue fever. It mainly affects birds, but it can also infect mammals and reptiles. Between 70-80% of people have no symptoms. Up to 1% of those who become ill have serious and potentially fatal complications, they added.

"We have asked the Institute of Epidemiology Disease Control and Research (IEDCR) to investigate the West Nile virus," said Dr. Sanya Tahmina Jhora, Director of the Disease Control unit of Directorate General of Health Services.

The DGHS sources said the West Nile virus infected patient was found in an area near Dhaka city.

According to the Centers for Disease Control and Prevention of the United States, West Nile virus (WNV) is the leading cause of mosquito-borne disease in the continental United States.

Pakistan: Crimean Congo Hemorrhagic Fever

A young woman suffering from Crimean-Congo hemorrhagic fever [CCHF], commonly referred to as Congo fever, died in Rawalpindi on Sept. 27, Dunya News reported.

According to details, the 32-year-old woman, a resident of Adiala Road, was brought to the emergency ward of a private clinic in critical condition where she died during treatment.

Congo fever is a tick-borne viral disease which is mainly transferred to humans from pets. Its symptoms include fever, flu, bloody urine, vomiting and nose bleeding.

Pakistan has confirmed cases of CCHF in almost every province: Sindh (Karachi), Punjab (Faisalabad, Multan, and Rawalpindi), Balochistan (Quetta) and Khyber Pakhtunkhwa (Peshawar) as well as Azad Jammu & Kashmir region.

Rapid climate change aroused by industrial, occupational, and agricultural activities to support the ever-growing human population has been considered the single most causative agent for emergence or re-emergence of CCHF in Pakistan, where it has biannual peaks between the months of March-May and August-October.

East Timor: African Swine Fever

On Sept. 27, the OIE, World Organization for Animal Health, confirmed outbreaks of African swine fever had occurred in East Timor.

The report identified 100 outbreaks with 405 deaths reported in the East Timor municipalities of Baucau and Liquica. The first outbreak occurred on Sept. 9.

It should be noted East Timor has a small pig population of close to 400,000 head.

The concern is the closeness of East Timor to Australia -- the distance from the 2 East Timor municipalities and Darwin is only 404 miles.

East Timor is the 10th nation in Asia to have the disease. The other nations include; China, Viet Nam, Laos, Myanmar, North Korea, South Korea, Mongolia, Philippines, and Cambodia.

The recent accelerated rate of contamination in China could see an estimated 70 percent of all pigs gone by the end of 2019 -- if using the same percentage of infection across all of Asia over a similar 16 month period this would equate to 365 million head or 48 percent of global pigs would be gone by mid next year.

United States: Eastern Equine Encephalitis

The Massachusetts Department of Public Health announced the 11th human case of eastern equine encephalitis [EEE] virus infection, a man in his 70s from Worcester County.

As a result, the communities of Auburn, Charlton, Dudley, Leicester, Southbridge, and Spencer have been elevated to high risk.

The Department of Public Health has also been recently notified by a hospital of a death from the virus of an Essex County resident. It marks the 4th death from eastern equine encephalitis virus this year [2019] in Massachusetts.

"Although mosquito populations are declining at this time of year, risk from EEE will continue until the first hard frost," said state epidemiologist Dr. Catherine Brown.

"We continue to emphasize the need for people to protect themselves from mosquito bites."

There are 35 communities now at critical risk, 46 at high risk and 122 at moderate risk for the virus in Massachusetts.

In addition to the 11 human cases of the virus this season in Massachusetts, there have also been 8 confirmed cases of in animals -- 7 horses and a goat.

State officials continue to remind residents to take personal precautions to prevent mosquito bites.

Eastern equine encephalitis is a rare but serious and potentially fatal disease that can affect people of all ages. The virus occurs sporadically in Massachusetts, with the most recent outbreak years occurring from 2004 to 2006 and 2010 to 2012. There were 22 human cases of infection during those 2 outbreak periods, with 14 cases occurring among residents of Bristol and Plymouth counties.

United States: Epizootic Hemorrhagic Disease

The Washington State Department of Agriculture (WSDA) said 4 cows in Franklin and Walla Walla counties were diagnosed this week with epizootic hemorrhagic disease (EHD), a potentially deadly virus primarily affecting wild deer, but occasionally crossing over to cattle.

The WSDA advises cattle owners to be on the lookout for EHD signs such as excessive drooling, lethargy, difficulty walking, or oral and nasal lesions with ulceration, which are similar to the much more devastating foot-and-mouth disease. Fever and anorexia due to the oral erosions were seen in the recently diagnosed cattle. Supportive care is the only treatment for infected cows.

Differentiating EHD from other animal diseases requires laboratory testing, so cattle owners should contact veterinarians if the signs are observed.

"Although EHD is seldom prevalent in cattle, we must show an abundance of caution and investigate each case due to the similarity of signs this disease has with the highly contagious and economically disastrous foot-and-mouth disease," Washington State Veterinarian Dr. Brian Joseph said.

EHD is not a threat to human health.

The disease usually occurs in cattle where environmental conditions support large populations of biting midges. Biting midges or Culicoides spp. gnats, commonly known as "no-see-ums" are the main way the disease is spread. Female biting midges can ingest blood from infected animals and then feed on uninfected animals. These midges typically breed near mud, so EHD outbreaks often occur when cattle congregate in wet areas.

September, 27 2019

Japan: Classical Swine Fever

In a major policy shift, agriculture minister Taku Eto announced Sept. 20 that the ministry now plans to vaccinate pigs against classical swine fever [CSF].

The ministry judged that doing so is inevitable if Japan is to stop the unabated spread of the infectious disease after the first outbreak in the country in 26 years was confirmed in September last year. Eto also said the ministry will ask pharmaceutical companies to increase production of [CSF] vaccines.

Currently, Japan has a stock of vaccines against the disease for about one million pigs, but the government believes increased output is necessary and that more areas will need vaccinations. The vaccination program is expected to mainly cover pig farms near areas where outbreaks of the disease have been recorded.

The disease affects only domestic pigs and wild boars, and has a high fatality rate. It does not affect humans even if meat from an infected animal is consumed.

Basic responses to [CSF] outbreaks stipulated under the government's epidemic prevention guidelines for the disease are to cull pigs at affected farms, including uninfected pigs, and at present these guidelines do not allow preventive vaccinations to be administered. The ministry plans to review the guidelines.

But it is believed to be difficult to eradicate the [CSF] virus as long as there are wild boars around, which are said to carry the virus and pass it on to domesticated pigs. Therefore, a vaccination program may have to be carried out over a long period of time, and related costs could be high.

Some experts caution that vaccinations would make it difficult to distinguish between infected and uninfected pigs, possibly leading to a delay in responding to new outbreaks.

Russia: African Swine Fever

A new outbreak of African swine fever [ASF] has been found at a privately held farm in a village in Russia's Primorsk[y] region near the border with China, Russia's agriculture watchdog [Rosselkhoznadzor] said on Sept. 20.

The virus -- which is highly contagious among pigs but not dangerous to humans -- has been detected in several areas in the region in recent months.

China has reported 157 outbreaks of the incurable disease since it was first found in the country in August last year.

Russia's most recent follow-up report addressed 5 new outbreaks; one of them related to a backyard holding including 2 pigs, of which one died and the other one was culled. This holding is located in the village of Zharikovo, Primorskiy Kray, the same province named in the above new report.

Heilongjiang province has been reported as ASF infected since Aug 2018; notably, one of the events in this province, in December 2018, involved farmed wild boars in pasture.

United States: Eastern Equine Encephalitis

Additional developments in the s spread of Eastern Equine Encephalitis were reported in New Jersey and Michigan this week.

The New Jersey Department of Health is encouraging residents to take steps to protect themselves from all mosquito-borne diseases after 2 more human cases of eastern equine encephalitis were confirmed in the state. The new cases were confirmed in Union and Atlantic counties on Sept. 19. The department confirmed the first human case of eastern equine encephalitis in August.

Earlier this week, eastern equine encephalitis (EEE) was found in a mosquito pool in Berkley Heights, New Jersey, authorities said. The mosquito pool was found in the Emerson Lane area of Union County near the border with Warren.

Union County officials said they would continue to aggressively spray in Berkley Heights Township. To date, eastern equine encephalitis has been detected in 65 mosquito samples in 13 New Jersey counties.

In Ohio, health officials are monitoring developments in Michigan, where Eastern Equine Encephalitis has killed three people.

"We've had 3 horses infected that have died from Triple-E," said Dr. Tony Forshey, state veterinarian with the Ohio Department of Agriculture.

Most persons infected with eastern equine encephalitis have no apparent illness; however, some can be very ill. Severe cases of eastern equine encephalitis (involving encephalitis, an inflammation of the brain) begin with the sudden onset of headache, high fever, chills, and vomiting 4-10 days after a mosquito bite. The illness may then progress to disorientation, seizures, or coma.

Eastern equine encephalitis has been diagnosed in 21 people in 6 states, and 5 people have died. The infection is being seen only in certain counties within a small number of states. The US each year has seen 7 illnesses and 3 deaths, on average.

Taiwan: Avian Influenza

More than 3,000 mule, or sterile, ducks have been culled due to an H5N5 subtype infection of the highly pathogenic avian influenza, which is the first reported case in Taiwan.

Tu Wen-chen, deputy director-general of the Bureau of Animal and Plant Health Inspection and Quarantine, said 3,583 ducks from a farm in the Qishan district of Kaohsiung City were confirmed as having the H5N5 virus on Sept. 13 and killed by the authorities. The bureau later also inspected 5 other duck farms within a 3 km distance.

The sampled ducks did not show any symptoms of infection when they were taken for examination. The bureau visited 30 duck farms in 6 cities and counties in southern Taiwan to test if any poultry had contracted seasonal diseases.

According to Chiou Chwei-jang, director-general of the Animal Health Research Institute, the H5N5 virus could have been transmitted through infected wild birds from Europe, Asia, or other parts of the world. China reported H5N5 infections in 2008, and there have been a handful of H5N5 cases found in wild birds or poultry farms in Europe over the past 2 years, he added.

The H5N5 virus does not affect human beings but is highly pathogenic and fatal to poultry. Tu Wen-chen said the bureau will continue carrying out inspections at poultry farms across Taiwan and conduct sample tests in avian flu-affected areas.

Nigeria: Yellow Fever

A health official in Nigeria on Sept. 19 confirmed 6 cases of yellow fever in the northeast state of Gombe. Nuhu Vile, an epidemiologist with the state health authorities, told media the confirmed patients were treated and discharged.

Yellow fever cases have been reported in northeastern Nigeria, including the states of Bauchi and Borno, since Aug. 29.

No death case has been recorded in the state, he said, noting that an investigation conducted by experts showed that the case originated from Yankari, neighboring Bauchi state.

The state government had set up a team to address the problem, the health expert said, while calling on the people to always report cases of fever to health facilities for quick examination and treatment.

According to [Vile], yellow fever was caused by a virus transmitted by mosquitoes and therefore urged people to sanitize their environment.

Vile advised parents to ensure they vaccinated their children from an early age during the routine immunization. He said once a child was immunized before he or she attained 9 months, chances of getting infected would be minimal.

To date, 243 suspected cases have been reported in 42 local government areas in 5 states: Bauchi (84), Borno (82), Gombe (7), Kano (4) and Katsina (66).

India: Japanese Encephalitis

An official has confirmed that 2 children have died after a fresh bout of acute encephalitis syndrome (AES) struck north Bihar again this week.

"Children afflicted with AES are coming to the hospital at regular intervals, but only 2 have died in the past one week," Sunil Kumar Shahi, superintendent of the state-run Sri Krishna Medical College and Hospital (SKMCH) in Muzaffarpur, said over the phone on Sept. 20.

SKMCH is the only advanced medical facility equipped to treat encephalitis cases in the district, which has been the center of AES cases earlier this year.

So far, health experts had been primarily blaming litchis that grow abundantly in Muzaffarpur district to be behind the spread of AES. However, its sudden outbreak in September, when the litchi season had been long over, has confused and confounded them.

"Hypoglycemia, excessive heat and malnutrition could be the reasons behind the AES strike, but we can't give the exact reason. Research is on," Shahi said.

He added: "At present, 12 children are admitted to the pediatric intensive care unit of the SKMCH. They suffer from convulsions and sudden bouts of high fever, which are similar to the AES. While tests have confirmed 3 of them are suffering from AES, the pathological tests of other children are being conducted to ascertain the cause."

According to him, 30 cases were reported in July, 18 in August, while at least 12 cases have been reported this month. In all, 647 cases have been reported from this year out of which 161 children died.

Canada: West Nile Virus

This year, 2 cases of the West Nile virus have been reported in BC: one human, one horse.

The B.C. Centre for Disease Control told CTV News the human case was reported on Vancouver Island in August, and is the only instance reported in B.C. so far this year.

The horse-related case was reported in the Princeton area.

Few details were provided for privacy reasons, but the BC CDC said both cases were travel-related. Both were tied to the U.S. It is not known where in the U.S. they travelled, but there was a small outbreak in eastern Oregon this year.

Oregon Public Broadcasting reports there were 5 human cases and 4 horse cases this year in Harney, Deschutes and Malheur counties. Mosquitoes trapped in Ontario earlier this year tested positive, and a man near Toronto was confirmed to have the virus on Sept. 19. Another case was reported in that city in August.

The virus spread by mosquitoes is rare in B.C. Prior to this year, the BC CDC's data show there were 2 human cases in 2017, one in 2016 and none in 2015. There have been more horse cases reported in those years, and 2 ravens, a blue jay and one horse were infected last year.

United States: Typhoid Fever

Hours after Collin County, Tex., Health Care Services released information about a travel-related case of typhoid fever confirmed in August in McKinney, the Frisco ISD said it is currently investigating a possible case at an elementary school.

Collin County health officials said that people who ate at the Hat Creek Burger Co., between Aug. 19-22 may have come in contact with the extremely drug-resistant strain of XDR Salmonella Typhi and could still develop symptoms.

Pam Ritz, a spokesperson for the restaurant, said a worker who contracted the virus had traveled out of the country and only became ill 3 days after returning to work. Ritz said the worker was sent home when he became ill and was later confirmed to be suffering from typhoid fever. No other employees or customers have reported symptoms of the illness in the past month, and strict sanitation procedures have been followed at the restaurant, the spokesperson said.

Friday afternoon, officials with the Frisco Independent School District said a student at Talley Elementary is being investigated for having typhoid fever as well. The district said the student is only suspected of having contracted the virus and that it has not yet been confirmed. Frisco ISD told parents in a letter that the Talley campus is being disinfected. It is not clear whether the cases are related or the strains of the bacterium are the same.

Dr. Jawaid Asghar, chief epidemiologist for Collin County Health Care Services, said the disease could be transmitted by a sick person who did not wash their hands after using a toilet before touching the food of a healthy person. He said the McKinney case is the first confirmation of the XDR Salmonella Typhi strain in Texas. "This is extremely drug resistant," Asghar said. "It is resistant to drugs we can normally give for typhoid." The worker is still receiving care for the illness and has not returned to work but has improved, Asghar said.

Ashgar said the risk of transmission of the disease from that one sick person is very low, but the press was notified to warn people who were in the restaurant during those 3 days to seek medical attention if they become ill.

Bangladesh: Anthrax

Several hundred cattle died of anthrax, and another several hundred were infected with the disease in Meherpur, according to the Department of Livestock.

Livestock department officials said they had already taken preventive measures to contain the disease so that it could not spread to other districts.

The department director general, Hiresh Ranjan Bhowmik, told New Age Sept. 20 that they were aware of sporadic infections of anthrax at Gangni in Meherpur. He said a team of experts comprising veterinary specialists from the livestock department had already been sent to Meherpur to examine the ground situation. Besides, the team would bring samples for further examination in Dhaka, he said, adding that the farmers were advised to vaccinate their cattle against anthrax.

Hiresh also said a few goats died of anthrax, as the farmers did not vaccinate them earlier.

"There are enough vaccines ready to provide," he said, adding that anthrax vaccines were provided to farmers at a nominal price. He said due to lack of awareness, the cattle farmers were not interested in vaccinating their cattle against the disease.

Officials said that anthrax, an infection by the bacterium Bacillus anthracis, was usually transmitted from animals to animals and animals to humans. The deadly disease could affect human health and causes disorders of skin, lung, and bowel, they said.

Nigeria: Lassa Fever

In the reporting Sept. 9-15, 7 new confirmed cases were reported from Edo (3), Ondo (2), Ebonyi (1) and Benue (1) states, 2 new deaths reported from Edo and Benue states.

This year, a total of 3,728 suspected cases have been reported from 23 states. Of these, 694 were confirmed positive, 18 probable and 3,002 negative.

Since the onset of the 2019 outbreak, there have been 149 deaths in confirmed cases. Case fatality ratio in confirmed cases is 21.5%.

September 20, 2019

United States: Eastern Equine Encephalitis

Rhode Island officials said Sept. 11 that Eastern equine encephalitis had been detected in a deer in Richmond, the 2nd such case in Rhode Island during the current outbreak of the mosquito-borne virus. The state Department of Environmental Management (DEM) reported the first deer infection a day earlier in Coventry.

With deer season opening, DEM said it was emailing about 1,200 hunters who have recently purchased 2019 deer licenses to offer personal precautionary information when field dressing animals. EEE is not considered to be a threat to the state's deer populations. Deer, like horses, cannot transmit EEE to humans, but the transmission of EEE to deer reinforces that 2019 is a higher-than-average risk year for mosquito-borne disease, DEM spokesman Michael J. Healey said.

Massachusetts public health officials say laboratory testing has confirmed the state's 8th human case of eastern equine encephalitis [EEE] this season.

The state Department of Public Health said Sept. 13 that the latest case of the mosquito-borne disease is in a man in his 50s from northeastern Bristol County. Of the previous 7 cases, one was in a 5-year-old girl, and another in an adult woman was fatal.

In addition to the 8 human cases of EEE, there have also been 8 confirmed cases of EEE in animals and one human case of West Nile virus.

There are 35 communities in the state now at critical risk for EEE, 38 at high risk, and 120 at moderate risk.

Health officials urge residents to use insect repellent when mosquitoes are at their most active.

In Connecticut, the state Department of Public Health is warning that an adult resident of East Lyme has tested positive for eastern equine encephalitis (EEE). This is the first human case of EEE identified in Connecticut this season.

The patient became ill during the last week of August with encephalitis and remains hospitalized. Laboratory tests, which were completed today at the Centers for Disease Control and Prevention (CDC) Laboratory in Ft. Collins, Colorado, confirmed the presence of antibodies to the virus that causes EEE.

The EEE virus has been identified in mosquitoes in 12 towns and in horses in 2 other towns.

EEE is a rare but serious illness that spreads when people are bitten by infected mosquitoes.

Nigeria: Yellow Fever

The Bauchi State Government Sept. 14 unveiled an anti-yellow fever campaign to immunize 500,000 people in Alkaleri and Tafawa Balewa Local Government Areas to curtail the spread of the acute viral hemorrhagic disease transmitted by infected mosquitoes.

The state governor, Senator Bala Mohammed disclosed the plan at the unveiling of aerial spray of Quella birds, mosquitoes and reactive vaccination in response to yellow fever at the Sir Abubakar Tafawa Balewa International Airport, Bauchi.

Mohammed explained that the exercise, which involved spray of affected areas and vaccination against yellow fever, was a testimony of the commitment of the administration to health issues and response to emergency.

The governor stated that the vaccination would be conducted for people in high risks areas of Alkaleri and Tafawa Balewa LGAs, thereby urging people living there to come forward for the vaccination.

India: Japanese Encephalitis

Japanese encephalitis has killed 154 people in Assam in 2019, the highest in 5 years officials said even as they claimed that the outbreak, which peaked in July and August, was subsiding and only a few fresh cases were reported in September.

A top state government official also said a state-wide adult vaccination campaign will begin in November covering all districts after the Centre agreed to provide around 5.7 million vaccines.

"From Nov. 15, we plan to start an intensive adult vaccination campaign covering the whole state. We plan to conclude it by March 15," Samir Sinha, Principal Secretary, Health and Family Welfare Department said. The campaign is likely to be announced in a week.

On Thursday Sept. 12, while no fresh JE cases were reported, one person from Kamrup (Rural) succumbed to the disease that is spread by Culex mosquitoes, according to the daily bulletin from the office of JVN Subramanyam, Director, National Health Mission, Assam.

The state recorded 614 JE positive cases in 2015, 427 in 2016, 605 in 2017 and 509 in 2018. In 2015, the number of deaths due to JE stood at 135; in 2016 the number came down to 92 and further decreased to 87 in 2017. In 2018, the state saw 94 deaths due to the vector-borne disease. In 2014, the state recorded 165 deaths due to JE.

The bulletin from NHM said through Sept. 12, the total number of persons who have been affected by JE stood at 630, out of which 154 people have died. While 13 persons who died belonged to Goalpara, 11 came from Kamrup (Rural), the 2 neighboring districts in lower Assam where maximum fatalities have been recorded this year. Kokrajhar, in Bodo Territorial Administrative District, has not reported any JE positive case for the 1st time in the last 6 years, even as the rest of the state has been affected in the 2019 outbreak.

Japan: Classical Swine Fever

Japan's agriculture ministry said Sept. 13 that classical swine fever infections have occurred at a pig farm in the city of Chichibu, Saitama Prefecture, part of the country's Kanto eastern region, which also includes Tokyo.

It is the first time that a CSF fever case has been confirmed in Kanto since the first outbreak of the infectious disease in the country in 26 years was detected in September 2018, in the central prefecture of Gifu.

The latest outbreak marked the 41st case of swine fever since the confirmation of the Gifu case.

Pakistan: Crimean Congo Hemorrhagic Fever

A Crimean-Congo Hemorrhagic Fever (CCHF) patient died in a private hospital of Karachi. The death toll from the tick-born viral disease has climbed to 17 in the megacity this year. Sindh Health Department confirmed the death of a 52-year old man, a resident of Lyari area of Karachi who died in a private hospital of the city due to CCHF. The patient was brought to the hospital a few days ago with fever where he was diagnosed.

The tick-born viral disease had infected 36 people this year, of which 17 died. Currently, a 62 year old man is under treatment in a private hospital. CCHF is a fatal viral disease that spreads through a tick bite. The CCHF is mainly contracted by people who deal with cattle and livestock. The symptoms include backache, joints pain, pain in the abdomen, high grade fever and bleeding from any part of the body.

Greece: West Nile Virus

The death toll from the West Nile virus since June this year has risen to 20, according to this week's report by the National Health Organization (EODY).

Through Sept. 12, authorities had diagnosed a total of 176 cases of the mosquito-borne virus. Of these, 109 developed illnesses affecting the central nervous system such as encephalitis or meningitis.

EODY is urging the public to spray insect repellent on bare skin and clothing, to install mosquito nets and screens, to remove stagnant water from basins, vases and gutters, to regularly mow lawns and to water plants in the morning.

Philippines: African Swine Fever

More cases of African swine fever [ASF] have been confirmed, this time in Quezon City.

Speaking to CNN Philippines Sept. 14, Quezon City mayor Joy Belmonte verified 13 mortalities already in Barangay Bagong Silangan, and they have been tested positive for African swine fever.

Belmonte added she also received reports of dead pigs in Barangay Payatas, but did not know how many there were.

The mayor clarified piggeries are not allowed in Quezon City, as zoning laws do not provide for agricultural zones. She said she has already given orders to close these down; however, given these are backyard industries and she did not want families to suffer from loss of income, she gave them a "few months" to comply.

Belmonte said given the developments, they will have to act "more swiftly." "If there are validated cases, within a one-kilometer [0.62 mi] radius, all pigs within that radius must be culled," she said, adding around 2,500 pigs will be affected.

United States: Tularemia

A rabbit in Lafayette has tested positive for tularemia, public officials announced Sept. 13.

Tularemia is caused by the bacteria Francisella tularensis and is typically found in animals, especially rabbits, rodents, and hares.

Symptoms in humans include skin ulcers, swollen and painful lymph glands, inflamed eyes, sore throat, mouth sores, and more. Symptoms can also include abrupt onset of fever, chills, headache, muscle aches, joint pain, dry cough, difficulty breathing, and more.

Tularemia can be treated when detected in early stages, officials said.

People can become infected with tularemia through the bite of infected insects, most commonly ticks and deer flies, or through skin contact with infected animal tissue. Bacteria can also be inhaled when an infected animal is broken into small particles and spread through the air, such as when an infected carcass is mowed over.

"It's always important to avoid contact with wild animals because of the risk of many diseases," said Lane Drager, Boulder County Public Health Consumer Protection Program coordinator, in a statement. "Although tularemia is rare, it is still a risk, especially considering the number of wild rabbits in our communities."

Five people in Colorado have been diagnosed with tularemia in 2019. So far, 3 rabbits have been tested positive in the state.

Chile: Avian Influenza

The importing of Chilean turkey meat has been restricted in Argentina, Peru, and Hong Kong due to an outbreak of bird flu in central Chile. The outbreak, of a low-pathogenic avian influenza (LPAI) virus, is under control, the Chilean State Agricultural and Livestock Service (SAG) reported Sept. 11.

"Regarding shipments of poultry and its products from Chile to various markets, the SAG has been notified of restrictions only on the part of Argentina, Peru, and Hong Kong," the SAG said in a statement.

The 3 nations made the determination after an outbreak was detected on Aug. 27 in a turkey pen at the Sopraval company, located in the Los Nogales commune, Valparaiso, about 75 miles west of Santiago. Some 65,000 animals were slaughtered as the authorities took control.

"From the point of view of the population's health, this event does not represent a risk, given that the consumption of meat and poultry byproducts does not pose any danger of transmission to humans," added the SAG.

Chilean officials will now conduct an investigation to determine the causes of the occurrence of bird flu in Chile. Surveillance will also be carried out within a radius of 2 km [1.2 mi] from the area where the outbreak occurred.

United States: Leptospirosis

More than a dozen dogs in a Utah city are infected with leptospirosis, a potentially deadly bacterial disease that can spread to humans.

There have been at least 13 confirmed cases of leptospirosis in dogs in St. George, KSL reports. Ten of the cases involve dogs being treated at the local veterinary clinic Red Hills Animal Hospital, while the 3 remaining cases are at other veterinary facilities in the area.

Veterinarians think an infected dog, possibly from Arizona, that stayed at a local boarding center called Red Rock Pet Resort may have spread the illness to other dogs.

"Leptospirosis did not originate at our facility; it can exist everywhere in nature. It's the No. 1 zoonotic disease in the world. It was likely carried into our facility by an infected dog and then passed on to other dogs," Red Rock Pet Resort said in a statement on Facebook.

Officials at the facility suspect the infected dog urinated in a "doggie pool" and subsequently infected other dogs.

"We're unable to determine which dog introduced this disease to our facility," the statement said.

Kazakhstan: Anthrax

A total of 4 shepherds were hospitalized with anthrax in Zhambyl region, Informbureau reports. The diagnosis was confirmed by laboratory examination. Patients came to the hospital with eruptions on their bodies.

"The patients work on one of the farms and have direct contact with animals. All of them were took part in the slaughtering of a cow, and 7-10 days after that they started complaining of these signs," said Gulfaira Mirzabekova, an employee of the Zhambyl regional infectious hospital. According to doctors, those infected sought medical aid in time. Anthrax just started damaging the organs. They will be treated for at least 10 days, they said.

Local authorities are not going to quarantine in the village of Shakpak, where the patients were infected. No anthrax cases were registered among cattle, they claim.

France: Listeriosis

The 7 people in France part of a Listeria outbreak linked to organic dairy products fell ill over a period of 18 months, according to public health authorities. Those infected with the same strain of Listeria were identified by the National Reference Center for Listeria, with an 8th case still under investigation.

Sante Publique France [Public Health France] reported 2 people have died, but the agency does not have any evidence to attribute the deaths to Listeria infection.

People fell ill between February 2018 and August 2019 and are aged between 36 and 93 years old; 5 are women. Four live in Alsace, while Burgundy, Ile-de-France, and Provence-Alpes-Cote d'Azur all have one case.

Investigations by Sante Publique France found these people had consumed organic dairy products in the weeks before contracting listeriosis. Analysis of food samples from a company, based in Bas-Rhin, Alsace confirmed contamination with Listeria. Raw milk cheeses are the suspected source of the contamination.

Testing by the National Reference Center for Listeria confirmed strains found in products had the same genetic characteristics as those isolated in the patients. Consumption of Ferme Durr products was also confirmed by several patients.

Ferme Durr recalled all dates of Durr brand organic dairy items, including natural yogurt and yogurt with fruit, cream, cottage cheese, and cheese. Products were sold directly at the firm, in markets and stores throughout France. Products were also distributed in Belgium, Germany, and Luxembourg.

September 13 2019

United States: E. coli

The Philadelphia Department of Public Health announced an outbreak of E. coli infections that have sickened 14 people so far. In a statement released Sept. 5, city health officials said their ongoing investigation "has identified a few shared restaurant exposures." They have not named specific restaurants. All 14 affected people, ranging in age from 7 to 90 years old, "presented with signs of acute gastroenteritis with bloody and non-bloody diarrhea," according to the statement.

The health department said the illnesses were due to Shiga-toxin E. coli. Symptoms usually start with non-bloody diarrhea, which can progress to bloody diarrhea after 2 to 3 days. Severe abdominal pain without much fever may also occur. Exposure to the bacteria often occurs through contact with food or water contaminated by human or animal stool or through contact with an infected person. Outbreaks have been associated with consuming undercooked beef, unpasteurized milk, or raw leafy vegetables, as well as exposure at petting zoos.

A significant possible complication of this strain of E. coli exposure is hemolytic-uremic syndrome (HUS) -- a condition that affects the blood vessels in the kidneys -- which can cause hemolytic anemia, low platelets and acute renal dysfunction. HUS usually develops 7 to 14 days after diarrhea begins and can result in kidney failure, seizures, coma or death. About 6% of the people infected by the E. coli strain will develop HUS, according to the health department. Children ages 1 to 4 are at highest risk for HUS.

Denmark: E. coli

Two children -- one on the island of Funen and another in the Copenhagen area -- died due to a rare complication related to EHEC, a strain of the E. coli bacteria. Both children died of kidney failure, but the 2 cases are not connected. A third child also contracted kidney failure but survived, DPSA said.

A consultant doctor and head of department at Copenhagen infectious disease research institute SSI stressed that the cases were not evidence of an outbreak and that the number of cases was not improbable. "At this time, we have knowledge of 3 cases of kidney failure from August to September 2019. That is not more than we would expect at this time of year. Fortunately there is nothing to suggest they are connected," Tyra Grove Krause said.

"They were not infected with the same bacteria, so there is no common source of infection. So it is not an outbreak, but a chance coincidence," Krause added.

DPSA has confirmed it has consulted parents of children who attend relevant schools or daycare facilities, and that authorities are working to gain a clearer understanding of the circumstances surrounding the cases.

Sweden: Tularemia

In a follow-up on the tularemia, or harpest situation in Sweden, a little over 120 people have become ill with tularemia over the past week, bringing the total to around 690 in 2019.

Compared to the previous weeks, there is a slight slowdown in the number of new cases, while compared to previous years there are still an unusually high number of people who fall sick with the bacterial infection, according to Folkhalsomyndigheten.

Most new cases of illness are reported from the Dalarna and Gavleborg region, which together now have over 400 cases, while the number of new cases from Orebro counties has decreased.

According to the CDC, tularemia is a disease that can infect animals and people. Rabbits, hares, and rodents are especially susceptible and often die in large numbers during outbreaks. People can become infected in several ways, including: tick and deer fly bites, skin contact with infected animals, drinking contaminated water and inhaling contaminated aerosols or agricultural and landscaping dust.

Symptoms vary depending how the person was infected. Tularemia can be life-threatening, but most infections can be treated successfully with antimicrobials.

Philippines: Leptospirosis

Amid flooding incidents due to recent heavy rains, the Department of Health (DOH)-Davao has recorded 44 suspected leptospirosis cases with 4 deaths in Davao Region this year.

DOH-Davao director Dr. Annabelle Yumang said on Sept. 3 that the number of suspected leptospirosis cases is highest in Davao City with 14 patients and 3 who have died; Davao del Norte has 13 cases with no death recorded; Compostela Valley Province with 11 cases and 1 death; Davao del Sur and Davao Oriental recorded 1 case each.

Leptospirosis is an infection spread mainly through contact with water or soil contaminated with the urine of infected animals, particularly rats. Persons can get the disease by swimming or wading in fresh unchlorinated water contaminated with animal urine or by coming into contact with wet soil or plants contaminated with animal urine.

In the past weeks, Davao Region experienced a series of heavy downpour particularly in Davao City that has caused massive flooding. With this, Yumang advised the public and the flood victims to remain vigilant during the rainy season to prevent from acquiring this fatal disease.

DOH has given the flood victims doxycycline, the antibiotic drug used as standard prophylaxis for leptospirosis patients. She further assured that there is no shortage of the antibiotic and they are ready to respond should there is a need for these medicines to prevent the disease from being acquired which is caused by the flood.

The symptoms of the infection include fever, chills and severe headache, which usually appear four to 14 days after being exposed to contaminated floodwaters or mud. Aside from that, an infected individual may manifest red eyes, jaundice, tea-colored urine and difficulty to urinate.

United States: Vaping-related illness

There's something dangerous going on in the lungs of hundreds of vapers, and their vape juice might be to blame. At least 215 cases of serious vaping-related lung issues have been reported to the CDC this summer [2019] alone across 25 US states.

So far, the lung problems have led to several medically induced comas, and at least one death was reported in Illinois in August. Another fatality is now being investigated in Oregon.

"We don't yet know the exact cause of these illnesses -- whether they're caused by contaminants, ingredients in the liquid or something else, such as the device itself," Dr. Ann Thomas, a public health physician with the Oregon Health Authority said.

No specific vaping brands have been called out, but many of the vaping illnesses have involved cannabinoid liquids like THC.

Experts aren't sure yet exactly why this is happening, but they have a hunch the illnesses may be nothing new. Because the vaping industry is largely unregulated, there are hundreds of different chemicals in vape liquids on the market, making it impossible for people to know whether the ones they're using are safe.

"We haven't been able to analyze e-liquid from these people, so we don't know what's in them," Professor Robert Tarran, who studies vaping at the University of North Carolina Marisco Lung Institute, said.

Tarran says despite all the variation in what vapers inhale, there are 2 common ingredients in e-cigarettes: nicotine (dosed in varying concentrations) and propylene glycol/vegetable glycerin (PG-VG). "That kind of narrows it down," he said.

Nicotine isn't always in cannabis-derived e-liquids, suggesting vegetable oils and other liquid solvents -- which are used to deliver drugs in all kinds of vape pens, whether there is nicotine inside them or not -- could be playing a major role in the lung illnesses.

Federal and state health officials are now worried about the presence of vitamin E acetate in many sick patients' vapes, according to a report out from the Washington Post.

 Spain: Listeriosis

A third death has been reported in Spain's biggest Listeria outbreak, which has seen 200 cases of infection reported so far. A man has reportedly died after eating tainted meat in Spain. This is the third fatality in the outbreak, which comes on top of the deaths of two elderly women. The outbreak has also seen 5 women lose their babies due to the food-borne bacteria.

The 1st possible case of listeriosis outside of Spain as part of the current outbreak has also been reported. The potential victim is a Briton who may have become infected with the bacteria while in the focal point of the ongoing outbreak, Andalusia, before traveling to France, where he was diagnosed with listeriosis and spent several days in hospital, then returning to his home country.

The source of the outbreak has been traced to a pork product stuffed with garlic and other condiments sold under the commercial name "la Mecha", which is made by the company Magrudis, based in Seville. Its factory has since been closed and its meat recalled from shops.

The company said they are "in a state of shock," and "couldn't explain what happened" in a press release reportedly released by Magrudis. The company also claims to have been in compliance with all sanitary regulations, with recent lab reports proving negative test results from just days before the product in question was packaged.

United States: Hantavirus

Hantavirus infection has claimed the life of a teenager in northwestern New Mexico.

The state Department of Health said the death of a 15-year-old McKinley County boy is the 3rd case of hantavirus in New Mexico this year and the 2nd death.

Hantavirus is a deadly disease transmitted by infected rodents through urine, droppings, or saliva. People can contract the disease when they breathe in the virus that is suspended in the air.

Health Secretary Kathy Kunkel says people need to avoid contact with mice and other rodents and be careful when cleaning up and avoid disturbing rodent droppings and nests, particularly in closed spaces such as sheds.

The department says the deer mouse Peromyscus maniculatus is the main source for the hantavirus strain most commonly found in New Mexico.

 Philippines: Japanese encephalitis

A 14-year-old girl from Pangasinan province in the northern Philippines died of the mosquito-borne disease, Japanese encephalitis. It is the 1st such fatality in the province. According to a PhilStar report, the girl was hospitalized for several days for suspected dengue at a Dagupan hospital, before succumbing to it.

Health officials in Pangasinan are working with officials in Tarlac, where the girl studied, to see if other students are infected as well.

Japanese encephalitis is a mosquito-borne viral disease and is the leading cause of viral encephalitis in Asia. Children are more prone to this vector-borne disease.

According to the Philippines Department of Health, one in in every 250 infected with the virus succumbs. The onset is characterized by flu-like symptoms (sudden onset of high fever, chills, headache, and tiredness). Disease may rapidly progress to severe encephalitis (infection of the brain). At this stage, the patient may experience symptoms such as mental disturbances and progressive decline in consciousness to coma.

More than half of those who are diagnosed show serious residual neurologic, psychosocial, intellectual, and/or physical disabilities such as paralysis, recurrent seizures, or inability to speak. The Japanese encephalitis virus is transmitted by Culex mosquitoes that breed in water pools and flooded rice fields. People who live close to rice fields and pig farms are more prone to fall prey to this vector-borne disease.

The Philippines is endemic for Japanese encephalitis, with a number of cases tested positive in every region in the country

Greece: West Nile Virus

Infections with West Nile virus have climbed to 40 in the region of central Macedonia in northern Greece, according to local authorities.

Deputy Regional Governor for Public Health Dimitris Hatzivrettas said the latest data refer to the period stretching from May until Aug. 22. Most of the cases were reported in the region of Imathia and in Thessaloniki.

"Thirty have already left hospital, but we had 2 deaths in Imathia of people aged over 70," said Hatzivrettas.

The official said extensive rainfall in the region has led to an increase in the number of mosquitoes carrying the virus.

Last week, the Center for Disease Prevention and Control said the spread of the West Nile virus in Greece is reaching alarming levels, with 107 reported cases that have resulted in 11 deaths so far this year.

Philippines: African Swine Fever

The Philippines confirmed that African swine fever [ASF] caused the deaths of hundreds of pigs in towns near its capital, becoming the latest Asian country to be affected by the highly contagious viral disease.

"We are still waiting on whether the virus affecting the hog areas in the country is weak or virulent," agriculture secretary William Dar said in a briefing Sept. 9. He said the majority of the 20 blood samples sent to the UK Pirbright tested positive for the virus.

President Rodrigo Duterte approved the formation of a task force that will include the police and the military to prevent an outbreak, Dar said. The virus potentially came from hotels, restaurants, or even overseas Filipino workers bringing pork products from affected countries, he said.

The agriculture department on Aug. 19 opened a probe following increased swine deaths from backyard raisers and ordered that all pigs within a 1 km radius of the infected farms be culled. Economic planning secretary Ernesto Pernia last month said the possible entry of the deadly swine disease that's spreading across Asia is among the risks to inflation this year. The virus isn't known to harm humans.

"We are not in an epidemic stage yet," Dar said, adding that there are new incident areas from initially 3 locations in Rizal and Bulacan provinces. "We have yet to see how fast the virus can spread."

Hog raisers must promptly report unusual animal deaths in their farms, Dar said. The Philippines' $5 billion swine industry provides livelihood to millions of Filipinos as small backyard raisers account for 65% of the industry, the agriculture department said.

Livestock accounts for 17% of Philippine agricultural output. Philippine hog production was more than 2.3 million metric tons based on live weight in 2018, valued at $4.7 billion. As of July, the nation's hog inventory was estimated at 12.7 million head, little changed from a year ago.

Yemen: Cholera

The Ministry of Public Health and Population of Yemen reported 16,308 suspected cases and 14 associated deaths during the week of Aug. 5-12. Twelve percent of the cases were severe. The cumulative total number of suspected cholera cases since Jan. 1, 2018, is 936,822, with 1,313 associated deaths. Children under 5 represent 24.5 % of total suspected cases during 2019.

The outbreak has affected 22 of 23 governorates and 305 of 333 districts in Yemen. From week 8 in 2019, the trend of weekly reported suspected cholera cases started increasing and reached to more than 29,500 cases in week 14. These were the maximum number of cases reported so far. The trend of suspected cases has been fluctuating over the past weeks. Starting from week 23, the number of cases increased with the start of the rainy season. However, since week 27, fewer cases were reported every week.

Norway: E. coli

Norwegian authorities are investigating an outbreak of E. coli where 4 people have developed hemolytic uremic syndrome.

The Norwegian Institute of Public Health (Folkehelseinstituttet) has identified the same type of enterohemorrhagic E. coli (EHEC) in 3 people since August 2019, and investigations are ongoing for 2 other cases. The outbreak is caused by Shiga toxin-producing E. coli.

An outbreak investigation has been started with the relevant municipal agencies, the Veterinary Institute, and Norwegian Food Safety Authority (Mattilsynet) as the source is unknown.

The DNA profile of the bacteria in the outbreak has not been seen in Norway before. The Norwegian Institute of Public Health has contacted international partners to see whether other countries have been affected.

In 2018, 494 EHEC infections were reported to the Norwegian Institute of Public Health, but only 8 developed the serious complication of HUS.

Nigeria: Yellow Fever

The federal government, in collaboration with the World Health Organization (WHO), Gavi, the Vaccine Alliance, and partners, is launching a yellow fever (YF) reactive vaccination campaign in 3 states to help control an expanding outbreak in Nigeria.

The 10-day campaign targets vaccination of 1.6 million people (aged 9 months to 44 years old) to contain the outbreak in affected areas. The campaign, supported by Gavi, will use 1,802,044 vaccine doses provided by the International Coordination Group (ICG) on Vaccine Provision, funded by Gavi, the Vaccine Alliance.

"This vaccination campaign will be a crucial activity to stop the spread of the outbreak and ensure that all people at highest risk are safe," says Dr. Clement Peter, Officer in Charge, WHO Nigeria. "We encourage all eligible persons in the target LGAs to come forward and get vaccinated,"

Since May 2019, more than 55 suspected cases have been reported across 8 LGAs in Ebonyi State, most of which have been reported in recent weeks from Izzi LGA.

A rapid response team under the leadership of the National Primary Health Care Development Agency and Nigeria Centre for Disease Control, composed of Ebonyi State health authorities, WHO and other partners, was deployed to investigate the cases, strengthen efforts to control virus circulation and sensitize health workers and communities on prevention methods against yellow fever.

 United States: Eastern Equine Encephalitis

Massachusetts officials confirmed 2 more human cases of eastern equine encephalitis [EEE] Friday, including a 5-year-old Sudbury girl and a Northborough woman in her 60s, and one state scientist said she expects more cases in coming weeks.

According to Sudbury town officials, the child is in critical condition at an area hospital. All outdoor evening town and school activities in Sudbury were cancelled Friday. Outdoor events for Lincoln-Sudbury Regional High School were also cancelled.

Northborough's health agent confirmed in a statement that the other new case of EEE was a town resident.

The new cases brought the state's tally to 7 and caused risk levels to be raised in a number of Massachusetts communities. In Framingham, Marlborough, Northborough, and Sudbury, the risk levels were raised to critical, while the levels in Berlin, Boylston, Hudson, Maynard, Stow, and Wayland have been raised to high

EEE is a rare but potentially fatal disease that can cause brain inflammation and is transmitted to humans bitten by infected mosquitoes, according to federal authorities. Those who recover from it often live with severe and devastating neurological complications. There is no treatment.

United States: Newcastle Disease

Virulent Newcastle disease was detected last weekend at a property in central San Diego County, a state veterinarian said Sept. 1. The detection was identified when a private veterinarian submitted dead birds to the California Animal Health and Food Safety Laboratory System, according to state veterinarian Dr. Annette Jones.

An ongoing investigation determined that infected birds moved from within the VND quarantine area in Riverside County and are now confirmed in the Ramona area of San Diego County. This bird movement occurred in violation of the quarantine. Any bird movement within a quarantined area is prohibited by law, and violators are subject to fines ranging from $100 to $2,500 if a violator is proven to have moved the virus.

"While we continue our surveillance and testing in the Ramona area, we are hopeful the rapid actions of responsible poultry owners and the CDFA/USDA VND response team have effectively contained the virus to a small area. Bird owners under quarantine are not permitted to move their birds, because exposed birds may appear healthy but could be in the early stages of infection and highly contagious to other birds. We are counting on community cooperation to help us stop the spread of VND and eradicate the disease," said Jones in a statement.

Mandatory euthanasia of infected and exposed poultry in connection with this incident has occurred at properties in San Diego and Riverside counties. The VND response team is conducting mandatory testing in the immediate areas surrounding the new cases, as well as conducting ongoing surveillance and testing within the quarantined areas in Riverside, San Bernardino, and Los Angeles counties.

September 6, 2019

Canada: Anthrax

Saskatchewan's Ministry of Agriculture says 7 farm animals are dead due to anthrax. The province says the case was confirmed in an area about 87 miles southeast of Regina. It says lab results confirmed anthrax caused the sudden death of 7 animals. Dr. Betty Althouse, the ministry's chief veterinary officer, says the animals were farmed livestock.

She says the last cases of animal anthrax that resulted in death occurred in 2015. Althouse says there have been a few other suspected cases of anthrax throughout the summer, but all of them turned out negative. "We do suspect anthrax in the summer on pasture when there's sudden deaths in animals. It is important to get a veterinary diagnosis to confirm whether it is or not, so this is the first case that was confirmed."

Anthrax is caused by a bacterium that can survive for decades as spores in soil. The province is warning farmers to be on the lookout for anthrax as changes in soil moisture from flooding or drying can cause spores to build up on pastures. The ministry say animals are more at risk of being exposed to anthrax in drier years. Althouse says the livestock that died were grazing in a slough on a pasture.

She adds the veterinarian dealing with the herd is considering whether to relocate the rest of the animals off the contaminated pasture. A short-term treatment may also be needed.

The province says animal cases pose little risk to humans, but people can become infected through direct contact with sick animals or their carcasses. Anthrax can be prevented through vaccination, Saskatchewan notes. Althouse couldn't confirm whether the livestock that died were vaccinated.

United States: Vesicular Stomatitis Virus

Vesicular stomatitis has been confirmed in 26 Colorado counties: Adams, Alamosa, Arapahoe, Archuleta, Boulder, Broomfield, Chaffee, Conejos, Delta, Douglas, Fremont, Gilpin, Grand, Gunnison, Jefferson, La Plata, Larimer, Mesa, Mineral, Montezuma, Montrose, Morgan, Ouray, Park, Pueblo, and Weld.

"While we have an overall greater number of premises that have been released from quarantine, we still have a steady number of cases being reported on a daily basis," said State Veterinarian Dr. Keith Roehr. "We are seeing increasing numbers in different areas and new counties across the state. It is important to remain diligent in checking your horses and livestock for VSV [vesicular stomatitis virus] lesions and contacting your veterinarian."

All VSV cases are important for the epidemiology and management of this outbreak and must be reported to the State Veterinarian's Office regardless whether the owner and veterinarian decide to have their livestock tested or choose to manage as positive premises based on the presence of typical clinical signs without testing. The only cases that may be managed as suspect positive are equine cases located in counties that have confirmed cases.

Equine owners and livestock producers across the state are impacted by VSV; all livestock owners should carefully watch the case numbers and affected counties to gauge their level of risk and institute mitigation measures.

Armenia: Anthrax

The Ministry of Health has received information that 2 residents of Getashen rural community of Armavir Province were transferred to the capital city Yerevan infection hospital, and with boil-like wounds (cutaneous anthrax symptoms) on their fingers and wrists, the ministry informed.

The patients reported that a few days earlier, they had taken part in the skinning of the cow of a fellow villager, and the processing of the meat of this cow.

A total of 6 more fellow villagers were found with complaints characteristic of cutaneous anthrax. All were referred to the Yerevan infection hospital for clinical evaluation. The DNA of the causative agent of anthrax was detected in 5 of these patients.

Medical supervision has been set up in this rural community. Work is in progress to prevent the spread of this disease.

United States: Eastern Equine Encephalitis

Several new outbreaks of Eastern Equine Encephalitis have been reported.

Ohio Department of Agriculture state veterinarian Tony Forshey recently confirmed one case in a horse in Ashtabula County and is urging horse owners to contact their veterinarian to ensure their animals' vaccine and boosters are up-to-date.

Public health officials say a Rhode Island man has also tested positive.

And the office of the Indiana state veterinarian reported 2 Elkhart County horses were confirmed.

The virus responsible for the disease is transmitted to horses by mosquitoes and attacks the animal's central nervous system. In horses, onset is abrupt and usually fatal. Signs include unsteadiness, erratic behavior, a marked loss of coordination, and seizures. Horses are particularly susceptible, but the virus can also cause serious illness in people as well as other animals such as poultry and deer.

Because the disease can also be transmitted to humans by the bite of infected mosquitoes, animals sick from the disease are a sign that people should also take steps to guard themselves against mosquitoes by applying repellent and wearing protective clothing. The disease is very rare in humans, and only a few cases are reported in the U.S. each year. There are no confirmed human cases associated with this outbreak in Ohio.

Rhode Island officials said the human case was confirmed in a man over 50 from West Warwick. It's the 1st human case in Rhode Island since 2010.

Eastern equine encephalomyelitis is caused by the eastern equine encephalitis virus, for which wild birds are a natural reservoir. Mosquitoes that feed on EEE-infected birds can transmit the virus to humans, horses, and other birds. Horses do not develop high enough levels of these viruses in their blood to be contagious to other animals or humans. Because of the high mortality rate in horses and humans, EEE is regarded as one of the most serious mosquito-borne diseases in the United States.

Spain: Listeriosis

Three pregnant women have suffered miscarriages, and nearly 200 people have been hospitalized with listeriosis as an outbreak of the infection grips Spain's holiday spots.

A nationwide alert has been sent out after Listeria, bacteria which can cause a type of food poisoning called listeriosis, were suspected in packaged pork. Listeriosis can cause severe illness, including severe sepsis, meningitis and sometimes results in lifelong harm or even death.

Two of the miscarriages happened in Seville and the other in Madrid. Most of the 197 cases have occurred in the southern Spanish region of Andalusia, but people have fallen ill across the country, from Madrid to the island of Tenerife.

Spanish authorities have said that as many as 5 pregnant women may have lost their babies to the outbreak, and 3 people may have died, but stats are yet to be confirmed. At least 67 people have been hospitalized, the majority in Seville. Of these, 23 are pregnant women who are under antibiotic treatment, and 3 are patients admitted to intensive care units.

Authorities are investigating whether a pork product sold by Seville-based Magrudis could be the source of the outbreak after several of those struck down were found to have eaten it. The product under investigation is a pack of meat called "Mecha," of which a batch of 2,000 are thought to be the source of the contamination.

Pregnant women are especially vulnerable to listeria, when bacteria may cross the placenta to infect the baby, who has no immunity. Spain's Health Minister Maria Luisa Carcedo said: "We are monitoring this; alerts have been sent out, and we've ordered that all products (that have come) from this factory since May 2019 be pulled from shelves." She said an investigation is looking into how the meat evaded what she called "strict food safety controls."

India: Crimean Congo Hemorrhagic Fever

Another 2 women have fallen victims to Crimean-Congo hemorrhagic fever (CCHF), known as Congo fever, in a week, taking the total toll due to the virus to 3, the state government said Wednesday. New cases also have come to light, it added.

Speaking at a press conference, deputy chief minister Nitin Patel, who also holds the health portfolio, said, "Till Aug. 27, 2 deaths were reported from Surendran-agar district. The latest deceased hailed from Bhavnagar district."

Three new cases have been reported -- one at Jamda village near Limdi and 2 others near Halvad village. Among them, a 55 year old is undergoing treatment at Civil Hospital, Ahmedabad, while 2 others are being treated at SVP Hospital.

According to the state health department, 17 samples were tested at the National Institute of Virology (NIV), Pune, of which 6 tested positive. 3 of them succumbed to CCHF, while 3 others are undergoing treatment. The samples of 11 others, including doctors, staff nurse, lab technicians, and others who came in close contact with the patients, tested negative.

Dr. Bhavin Solanki, medical officer with the Ahmedabad Municipal Corporation (AMC), said,  “15 people were treated at the SVP Hospital, of which 10 are paramedical staff and doctors who came in contact with the patients. All 10 are stable. another 3 patients are from Halvad, one a local (Ahmedabad) patient and one who expired." All 15 samples have not been tested yet.

Health commissioner Jayanti Ravi said since cattle-rearers are more susceptible to the CCHF virus, which is responsible for the infection, preventive measures are being taken.

According to the World Health Organization (WHO) website, "CCHF spreads to humans either by tick bites or through contact with infected animal tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. Human-to-human transmission can occur from close contact with the blood, secretions, organs, or other bodily fluids of infected persons. Hospital-acquired infections can also occur due to improper sterilization of medical equipment, reuse of needles, and contamination of medical supplies."

Liberia: Lassa Fever

Authorities at the Ministry of Health (MoH) have confirmed an outbreak of Lassa fever across the country.

The situation is so serious that Chief Medical Officer Dr. Francis Nah Kateh, has warned Liberians to take the necessary preventive measures, "even though this is what we have been taking care of all the while. For the disease to spread to Grand Kru County, gives health authorities the cause for concern."

A total of 92 suspected cases have been reported since Jan 1, with 21 deaths.

"We are concerned about the sporadic increase of Lassa fever cases outside the Lassa Belt in Liberia," meaning Nimba, Bong, and Grand Gedeh counties.

"For Lassa fever to affect Grand Kru other than those counties it has previously affected, gives us the fear to raise the alert," Dr Kateh told the Daily Observer.

United States: Newcastle Disease

Virulent Newcastle disease was detected this weekend at a property in central San Diego County, a state veterinarian said Sept. 1.

The detection was identified when a private veterinarian submitted dead birds to the California Animal Health and Food Safety Laboratory System, according to state veterinarian Dr. Annette Jones.

Newcastle disease is an infection of domestic poultry and other bird species leading to respiratory disease, nervous manifestations, or diarrhea.

Response team members from the California Department of Food and Agriculture and the U.S. Department of Agriculture worked through the Labor Day weekend on control measures, including restriction of bird movement, mandatory euthanasia of infected and exposed birds, and surveillance testing near the property where infection was detected.

"We are moving quickly to investigate the origin of disease as well as any movement of birds or equipment possibly carrying infection," Jones said in a statement.

Detections of virulent Newcastle disease have decreased greatly over the last few months, she said.

Uganda: African Swine Fever

A suspected African Swine Fever [ASF] outbreak has been reported in Rubanda district. The disease has been reported in Nyamweru, Hamurwa and Bubaare sub-counties.

According to Joanita Kobugabe, Rubanda District Information Officer, about 53 pigs have died in Igomanda parish, Nyamwweru Sub County last weekend.

Cosma Twesigwome, Rubanda District Agriculture Officer says that many pigs in the affected sub-counties have been observed with ASF-like symptoms. Twesigwome says that some of the symptoms include: high fever, depression and loss of appetite, reddening of the skin, particularly ears and snout, vomiting and diarrhoea.

She also added that samples from the carcasses and infected pigs have been sent to the animal laboratory Centre in Mbarara branch for investigations and that they have also resolved to impose quarantine against the sale, consumption and movement of pigs.

August 30, 2019

United States: Vesicular Stomatitis Virus

On Aug. 15, the United States Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) said 6 states have confirmed cases of vesicular stomatitis: Colorado, Nebraska, New Mexico, Oklahoma, Texas, and Wyoming.

Vesicular stomatitis virus can cause blisters and sores in the mouth and on the tongue, muzzle, teats, or hooves of horses, cattle, swine, sheep, goats, llamas, and a number of other animals. Lesions usually heal in 2 or 3 weeks.

Because of the virus' contagious nature and its resemblance to other diseases such as foot-and-mouth disease, animal health officials urge livestock owners and caretakers to report these symptoms to their veterinarian immediately. Most animals recover with supportive care by a veterinarian.

"Vesicular stomatitis has been confirmed only in the Western Hemisphere," APHIS said on its website. "It is known to be an endemic disease in the warmer regions of North, Central, and South America, and outbreaks of the disease in other temperate geographic parts of the hemisphere occur sporadically. The southwestern and western United States have experienced a number of vesicular stomatitis outbreaks, (and) the most recent and largest outbreak occurred in 2015. Outbreaks usually occur during the warmer months, often along waterways."

Some states and other countries might restrict movement of, or impose additional requirements for, susceptible animals from states having known cases.

United States: Epizootic Hemorrhagic Disease

A white-tailed deer in west Kentucky is the state's first confirmed case of hemorrhagic disease  this year, according to the Kentucky Department of Fish and Wildlife Resources. Murray State University's Breathitt Veterinary Center confirmed a deceased deer from Graves County tested positive for epizootic hemorrhagic disease. Fish and wildlife officials are investigating 22 other possible cases in 11 counties and expect the number could grow in the coming weeks.

The disease is caused by a virus transmitted by small biting flies feeding on the deer. Outbreaks typically last from late summer to the first hard frost, which kills the flies.

The disease has been present in the USA for more than 60 years, officials say. It is not the same as chronic wasting disease. Most deer die from hemorrhagic disease within 24 to 36 hours after being bitten. Due to the rapid death, the carcasses can appear otherwise well-fed or normal. EHD cannot be transmitted to people or pets. Officials warn, however, deer with EHD can be susceptible to other diseases and caution against eating sick-looking deer.

Bulgaria: African Swine Fever

A total of 4 new outbreaks of African swine fever have been reported in Ruse, Darik News reports. "There are diseased animals in an industrial farm in the village of Karamanovo in the Municipality of Tsenovo. There are 4,500 animals raised, and their killing and burial began Aug. 21", said Dr Nikolay Nenov of the Regional Food Safety Directorate.

There are also 3 new outbreaks in feral pigs. They are in the villages Prosena, Mechka and Pisanets.

Two experts from Germany are in the area. They are examining all the affected industrial farms in Northern Bulgaria, and will conduct an epizootic study of where, when and how the virus came in.

A total of 70,440 pigs have been killed so far in Ruse.

Canada: Listeriosis

The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate an outbreak of Listeria monocytogenes infections involving three provinces: British Columbia, Manitoba and Ontario.

Based on the investigation findings to date, Rosemount brand cooked diced chicken has been identified as a likely source of the outbreak. Rosemount cooked diced chicken was supplied to institutions (including cafeterias, hospitals and nursing homes) where many of the individuals who became sick resided or visited before becoming ill.

On Aug. 18, the Canadian Food Inspection Agency issued a food recall warning for Rosemount brand cooked diced chicken meat. During the food safety investigation, the CFIA identified additional affected products, and updated food recall warnings have been issued.

Canadians are advised not to eat any of the recalled products or any foods containing the recalled products. Food service establishments are advised not to sell or serve any recalled products, or any items that may have been prepared or produced using recalled products.

The investigation is ongoing, and it is possible that more products linked to the outbreak investigation will be identified. The CFIA is continuing its food safety investigation, which may lead to the recall of other products. If other products are recalled, the CFIA will notify the public through updated food recall warnings.

United States: West Nile Virus

It's officially an outbreak. There are more West Nile virus infection cases in southern Nevada this year than ever before, and mosquito season is far from over. There's no clear-cut answer as to why it's so bad this year, but out of the nearly 40,000 mosquitoes the Southern Nevada Health District has tested all across the valley, 20% are carrying the virus.

"So think about that: one in every 5 mosquitoes is carrying a virus," said Devin Raman, a senior disease investigation and intervention specialist in the Office of Epidemiology with the Southern Nevada Health District. Raman said the district has confirmed 28 cases so far this season, more than most other states. "There are people at all levels of illness that we know are not reported to us."

West Nile causes flu-like symptoms, which is why Raman said many cases go unconfirmed. But 17 cases in southern Nevada have presented as a more serious neuroinvasive form of the disease. "The virus actually gets up into the brain and the spinal cord, and it causes things like meningitis and encephalitis. It can cause paralysis," Raman said.

So where are the mosquitoes coming from?

"Mosquitoes are terrible fliers. One hundred yards is a long way for them to go, so if you have mosquitoes, they're local," said Allen Gibbs, a UNLV professor who studies insects in the School of Life Sciences. Gibbs said mosquitoes have a lifespan of about a month, and it doesn't take much for them to move in. "Just this much water, and you can grow mosquitoes, so if you overwater your plants and leave standing water, you can be a mosquito farmer," he said.

United States: Eastern Equine Encephalitis

A woman from southern Bristol County has been diagnosed with eastern equine encephalitis (EEE), the Massachusetts Department of Public Health confirmed on Aug. 25. The woman is the 4th confirmed case of EEE in Massachusetts this summer.

The woman was treated at Tuft's Medical Center but died of EEE.

Prior to that incident, the state's Department of Public Health had confirmed a third human case of eastern equine encephalitis (EEE), this one from northern Franklin County. The third victim is a man older than 60.

The risk level in the towns of Heath and Colrain in Franklin County has been raised to critical. A horse in Mendon and a horse in Uxbridge, both towns in Worcester County, have also tested positive for the EEE virus. The risk in those towns has also been raised to critical. The threat caused Mendon to cancel Saturday night's "Mendonfest" because it's scheduled during peak biting hours.

"2019 is really turning out to be not just an active year, but a very active year," said state epidemiologist Dr. Catherine Brown. She said several factors are contributing, including changing temperatures and precipitation, along with the shifting types of mosquito species. "Because we're seeing an increase in the populations of the mammal-biting mosquitoes, we think that might be one of the reasons that the cycle is changing a little bit as well," Dr. Brown said.

DPH and the Department of Agricultural Resources said aerial spraying in specific areas of Worcester and Middlesex counties was to begin on Aug. 25. As a result of the elevated risk in several communities, the spray zone has been expanded.

Across Massachusetts, a total of 23 communities are now at critical risk, 22 at high risk, and 52 at moderate risk for the EEE virus. So far, EEE has been found in 330 mosquito samples this year, many of them from species that can spread the virus to humans.

There are also three suspected cases of the illness in Michigan residents, according to the Michigan Department of Health and Human Services [MDHHS].

The suspected cases are in residents from Kalamazoo and Berrien counties.

As of Aug. 26, six cases of EEE have been confirmed in horses in Barry, Kalamazoo, and St. Joseph counties. None of the horses were vaccinated against EEE and all animals died. An EEE vaccine is available to horses but not people. Additionally, 2 deer in Barry and Cass counties were diagnosed with EEE.

"Mosquito-borne diseases can cause long-term health effects in people and even death," said Dr. Mary Grace Stobierski, MDHHS state public health veterinarian and manager of the Zoonotic and Emerging Infectious Diseases Section. "These cases, along with confirmed cases in horses and deer in the state, stress the importance of taking precautions against mosquito bites."

Spain: Listeriosis

The listeriosis outbreak in Spain is thought to have claimed a second life. A 72 year old man with cancer died on Aug. 22. On Aug. 20, a 90 year old woman passed away. Both victims lived in Sevilla, the center of the outbreak.

At the moment, there is no confirmation that the man had eaten the La Mecha branded "carne mechada" that has been traced as the source of the outbreak that has so far affected 186 people. An investigation is under way to determine whether his death from listeriosis is linked. The outbreak has been traced to utensils used in the preparation of the food products.

Now experts say that the bacteria may be present in other products from the Magrudis factory in Sevilla. All its production has been recalled, with experts saying that at least 2 other products are at high risk of having been infected.

According to the latest data from the Junta de Andalucia regional government, 186 cases of listeriosis have been detected. Of these, 161 have occurred in Andalucia. The bulk (82 per cent) are in the province of Sevilla, with 153 cases. In the last 24 hours, there have been 25 more cases in total.

Of the 99 people in hospital, 18 have been confirmed as having listeriosis, with 4 in intensive care. The rest are suspected cases and are under observation.

Medical authorities say this strain of the bacterium is particularly virulent, taking 3 days to incubate. Normally, the incubation period is up to 70 days.

India: Lumpy Skin Disease

An unidentified disease affecting cattle has emerged as a major cause of concern for farmers of Mayurbhanj district.

The worst hit are the marginal farmers of Khunta block. With a few healthy bullocks left in the area, the farmers have to shell out extra money on tractors to prepare their fields for transplanting paddy saplings. However, the poor farmers, who cannot afford to spend on tractors, have not yet started farming activities on their land.

The farmers said blood blisters appear on cattle's skin that lead to wounds after a few days. These blisters initially appear on joints of front legs of the cattle. Sources said apart from Khunta, cattle in Badasahi, Gopabandhunagar, Dharampur and Nuasahi of the district have been affected by the disease.

Veterinary doctor of Sankerka in Badasahi block Subhrakanta Rath said the disease is caused by virus and is curable.

He said the cattle are possibly affected by Lumpy Skin Disease (LSD) or Postular Dermatitis. Rath said the farmers have been asked to take their cattle to the local veterinary hospital for immediate treatment. Additional Veterinary Officer Archana Sarangi said no cattle have yet died due to the disease.

Bulgaria: West Nile Virus

Two cases of the West Nile Virus [WNV] have been confirmed in Bulgaria, with one of the patients said to have lived in Cyprus during a part of the summer.

The Ministry of Foreign Affairs in Bulgaria has not issued an update as of Aug. 22, but according to Philenews, the health ministry in Bulgaria had issued a statement regarding a 48-year-old Bulgarian man who was diagnosed with WNV. The man, said to be from Pazardzhik in southern Bulgaria, is a construction worker who had been living for the last two months in Cyprus.

Upon his return to his country, according to Bulgarian officials, the worker started running a fever and generally feeling unwell. He was then immediately admitted to hospital with a known WNV infection.

Other towns were also on alert in Bulgaria, with an official statement saying clinics for infectious diseases in Belgrade and Nis have reported infected people. Most cases were associated with summer flu symptoms while the nervous system was affected in a number of other cases.

Based on additional media reports, there were other places besides Cyprus on the radar of Bulgarian officials regarding possible WNV infections.

According to State Medical Services of the Republic of Cyprus, 9 WNV cases have been confirmed in the south this year up. All cases involved the neuroinvasive disease of the virus, with 2 patients remaining critical and 4 others being discharged from hospital.

Philippines: Leptospirosis

The Department of Health (DOH) in Calabarzon urged residents to take precautionary measures as the number of leptospirosis cases in the region has reached 75, with 12 recorded deaths.

DOH Calabarzon regional director Eduardo C. Janairo also directed local health officials and local leaders to take the necessary precautions to prevent the spread of leptospirosis and the current dengue outbreak in the communities due to the rainy season. "Leptospirosis just like dengue is fatal but also preventable. All we need is to clean our surroundings, be sure that our garbage is well-attended and improve flood control measures in the community," Janairo said in his meeting with officials of the province of Cavite.

He also reminded parents of children to avoid playing outside their homes during rainy days to reduce risk of leptospirosis related to flooding. "If we have no business to go outside our homes, it is best to stay inside and be safe," he added.

The DOH Regional Epidemiology and Surveillance Unit (RESU) showed a total of 75 leptospirosis cases recorded in the region from [1 Jan to17 Aug] this year [2019]. This, however, is 62% lower compared with last year's [2018] 199 recorded cases during the same period.

The infectious disease caused by leptospira bacteria from urine of rats has already claimed 12 lives in the region, with Rizal province having the highest number of cases at 34 with 7 deaths. Cavite has recorded 18 cases and 2 deaths; Laguna with 14 cases and 1 death; Batangas - 9 cases and 2 deaths, while Quezon has no reported cases.

Congo: Ebola

Since the beginning of the epidemic, the cumulative number of cases is 2,950, of which 2,845 confirmed and 105 probable. In total, there were 1,980 deaths (1,869 confirmed and 105 probable) and 883 people healed.

There are 377 suspected cases under investigation.

There are 8 new confirmed cases, including 6 in North Kivu, including 4 in Beni, 1 in Katwa and 1 in Kalunguta and 2 in Ituri, including 1 in Mambasa, 1 in Lolwa.

There are 3 new confirmed deaths in North Kivu; No community deaths among new confirmed cases; 3 deaths in CTE, including North Kivu, including 2 in Katwa and 1 in Kayna;

United States: Chronic Wasting Disease

Based on test results from the National Veterinary Services Laboratory (NVSL) in Ames, Iowa, the Wisconsin Department of Agriculture, Trade and Consumer Protection (DATCP) confirms an elk from a breeding farm in Burnett County has tested positive for chronic wasting disease (CWD). The 6-year old male was euthanized due to an injury and showed no signs of the disease. As a result of the positive finding, DATCP has quarantined the farm and the remaining 5 elk in the herd. A quarantine means no animals may move in or out of the property and restricts movement of carcasses. No elk have left the farm since the herd was formed in 2014.

The owner will continue to test all elk that die, in order to monitor if the disease has spread to other animals in the herd. DATCP's Division of Animal Health will investigate the animal's health history and the premises to determine if any other herds may have been exposed to the CWD-positive elk.

India: Glanders

Four horses have tested positive for glanders -- a highly contagious and often fatal zoonotic disease -- in Chhattisgarh's Durg and Rajnandgaon, and the state administration has imposed restrictions on the movement of equines in and out of the 2 areas. One horse tested positive for glanders in Durg, and 3 horses tested positive in Rajnandgaon.

In response to an urgent letter from People for the Ethical Treatment of Animals (PETA) India regarding a report that the deadly zoonotic disease was detected in horses in the state, the animal husbandry department of Chhattisgarh issued a circular notifying the municipal corporation areas of Durg and Rajnandgaon as "controlled areas" and imposing restrictions on movement of equines in and out.

The circular directed that all disease-hit equines in the controlled area of a minimum 5 km [3.1 mi] radius be euthanized. It also directed that all equines in the controlled area and 25% of the equines beyond the controlled area, up to 25 km, be screened.

Taiwan: Hantavirus

A migrant worker in Taiwan has been diagnosed with a hantavirus infection, the first case in the country this year.

The afflicted individual, a male in his 20s, is a fisherman living in northern Taiwan. He has not traveled abroad recently, and his life is mostly spent at sea, said the Centers for Disease Control and Prevention.

The male started exhibiting symptoms of the disease on Aug. 3, including vomiting, diarrhea, and fatigue. He later developed liver and renal conditions before receiving a confirmed diagnosis of hantavirus infection.

Hantavirus is contracted through contact with rodent urine and feces or rodent bites. Signs and symptoms include fever, muscle pain, headache, abdomen pain, and flushing. Some patients may fall ill with symptoms like renal failure, hemorrhaging, and shock.

CDC noted that the individual has been discharged from hospital, and the health authorities have conducted sterilization and rodent control around locations he visited.

August 23, 2019

United States: Eastern Equine Encephalitis

New Jersey's Health Department has confirmed its first case of Eastern equine encephalitis in a human this summer. The department says an elderly Somerset County man was hospitalized, but has since been discharged for continued rehabilitation care.

Most people infected by the mosquito-borne illness have no apparent signs. But health officials say severe cases involving an inflammation of the brain begin with the sudden onset of headaches, high fevers, chills and vomiting. The illness may lead to disorientation, seizures or coma.

Eastern equine encephalitis has been detected in 22 mosquito samples and in 3 horses in the southern and eastern sections of New Jersey.

Kenya: Leishmaniasis

Kenya is reporting a large outbreak of the parasitic disease, visceral leishmaniasis (Kala Azar). From January through the first week of August, a total of 1,986 cases of leishmaniasis have been reported from Marsabit, Wajir and Garissa counties. Marsabit County has been hit the hardest, reporting 1,716 suspected cases with 19 deaths. Overall in Kenya, 27 deaths have been recorded.

Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. Leishmaniasis has several different forms.

Visceral leishmaniasis (VL) is the most serious manifestation, which affects some of the internal organs of the body (such as the spleen, liver, and bone marrow). VL is predominantly transmitted through the bite of an infected female phlebotomine sand fly, although congenital and parenteral transmissions (through blood transfusions and needle sharing) have been reported.

Spain: Listeriosis

Spanish authorities have linked an outbreak of Listeria that has affected more than 40 people to a brand of meat. The Ministry of Health and Families of Andalucia reported those ill lived in Seville and Huelva and became sick in the past 3 weeks.

The agency connected illnesses to the product by interviewing patients. It has a commercial name of "La Mecha" and is made by the company Magrudis, based in Seville. The item has been withdrawn from sale.

Local media reported that 44 people were affected. Half of them needed hospital treatment.

Previously, 16 Listeria infections were noted in 2 weeks in the 2 areas of Spain. Health authorities reported 12 listeriosis cases in Seville and 4 in Huelva with 4 people needing hospital treatment.

It can take up to 70 days after exposure to Listeria for symptoms of listeriosis to develop. Symptoms of infection can include vomiting, nausea, persistent fever, muscle aches, severe headache and neck stiffness.

Pregnant women, the elderly, young children, and people who have weakened immune systems are particularly at risk of serious illnesses, life-threatening infections and other complications. Although infected pregnant women may experience only mild, flulike symptoms, their infections can lead to premature delivery, infection of the newborn or even stillbirth.

United States: Vesicular Stomatitis Virus

Grand County, Colorado has its first case of the vesicular stomatitis virus, a viral disease affecting numerous horses along the Front Range and in other states.

The Grand County Colorado State University extension office warned of a suspected case of the virus in a horse last week when it sent an email blast to its members asking them to take precautions against the spread of the virus. The email detailed how the horse, which had recently attended an equine event in Fraser, showed signs of the virus, and a veterinarian had sent off blood samples to be tested.

Now, Colorado Department of Agriculture has Grand County listed on its website naming the affected counties with one active quarantine related to the virus, commonly known as VSV.

As of Aug. 8, there were 254 active quarantines across Colorado due to the virus. With 61, Larimer County had by far the most. It was followed by Boulder (28), Jefferson (25), Weld (25), Montezuma (23), La Platta (22), and Mesa (21) counties.

Boulder County had one confirmed bovine case; all others in Colorado were equine, though VSV can affect sheep, goats, llamas, and alpacas.

The virus causes blisters in an infected animal's mouth and on its lips, nostrils, tongue, hooves, and teats. The blisters are painful enough the infected animals often lose weight and show signs of lameness.

The virus can be transmitted through direct contact and indirect contact, including flies and other insects. For preventative measures, the extension office recommended horse and livestock owners use their fly spray liberally and refrain from sharing equipment like water buckets, hay bags, or bits.

United States: Newcastle Disease

California Department of Food & Agriculture (CDFA) state veterinarian Dr. Annette Jones disclosed on Aug. 15 that ongoing surveillance and testing in the virulent Newcastle disease (VND) outbreak in Southern California resulted in the detection of a new case at a retail feed store in western San Bernardino County.

Jones said this is the first detection of VND since 4 Jun 2019. She noted staff members from CDFA and the US Department of Agriculture (USDA) discovered the infected birds during a routine biosecurity check at the feed store, which has been closed temporarily while an investigation is conducted. The exposed birds have been euthanized.

"We are moving quickly to determine the origin of disease and working with the store to identify any customers who may have purchased infected birds and products like feed, equipment, or anything else possibly carrying the infection," Jones said

United States: Eastern Equine Encephalitis

The Massachusetts Department of Public Health confirmed a second human case of eastern equine encephalitis [EEE] in the state on Aug. 16. Officials also raised the risk level for EEE to "critical" in 10 more towns in central and eastern Massachusetts.

The department said the new EEE case is in a man between the ages of 19-30 in Grafton. As a result, Grafton, Hopkinton, Northbridge, Shrewsbury, Southboro, Upton, and Westboro are all at "critical risk" for EEE.

The wife of the Grafton man diagnosed with EEE says he is in his late 20s and lives near a farm..

A goat in Bristol County has also tested positive for EEE, leading officials to put Easton, Norton and Raynham at critical risk as well. A total of 19 communities across the state are at critical risk now, and 18 are at high risk.

The department said it is working with local boards of health and mosquito control experts to work on "appropriate public health response activities."

"The most intense level of EEE activity is still being seen in Bristol and Plymouth Counties," said Public Health Commissioner Monica Bharel in a statement. "However, in active EEE years, the virus may move outside of southeastern Massachusetts. This is evidence of that movement, and residents in the area of increased risk should use mosquito repellent and avoid outdoor activities at night."

Less than a week ago, the department confirmed the first human case of EEE in Massachusetts since 2013. The infected man is over 60 and lives in southern Plymouth County.

So far, EEE has been found in 288 mosquito samples.

Germany: Spotted Fever

The University of Hohenheim and the Bundeswehr Institute of Microbiology [IMB] have detected spotted fever in a hyalomma tick, the first time such a tick is suspected to have caused disease in a human in Germany.

This tick feeds on humans and can transmit a form of spotted fever in Germany.

It was probably no coincidence that this first case was in a horse owner. Tropical ticks of the genus Hyalomma feed on large mammals. For several years, these ticks have been on the rise in Germany. Now tick researchers report the first suspected case of spotted fever transmitted in Germany. "Not only do we now know for sure that the hyalomma tick is also targeting humans," says Prof. Dr. Med Ute Mackenstedt, a parasitologist at the University of Hohenheim, "but also that there is the urgent suspicion that the transmission of spotted fever by these ticks is actually possible here in Germany."

Kazakhstan: Anthrax

A total of 4 anthrax cases have been confirmed in the Akmola region, reports the health care department. "Up to [now] 5 [suspected cases of] anthrax have been recorded; lab tests have confirmed 4. The cause of contamination was cow butchering without a veterinary certificate in a private yard," said the interlocutor.

"Epidemiological situation in the Akmola region and Nur-Sultan is stable," said the department. "The situation is being constantly monitored by the committee," said Ludmila Burabekova, chairfigure of the committee of quality control and goods safety. "Anti-epidemic and anti-epizootic arrangements have been organized in the area," she added.

Philippines: African Swine Fever

The Philippines Department of Agriculture (DA) has ordered the culling of hogs in an unidentified area to contain what could be the entry of the African swine fever (ASF) virus in the country. In a press conference on Aug. 19, agriculture secretary William Dar neither confirmed nor denied reports that the ASF virus has infected hogs raised in Rizal, but noted that the agency received an incident report on Aug. 16 "on an increased mortality of pigs raised by farmers in their backyards".

An industry source told the Inquirer that the infected area was Barangay San Isidro in Rizal, wherein agency officials have already commenced quarantine and security practices. According to the Bureau of Animal Industry veterinarian Dr. Joy Lagayan -- who is also a member of the ASF task force -- the usual mortality rate for pigs is between 3% and 5%. In this case, however, the mortality rate in the area has spiked to as much as 20%.

Dar said he has already directed BAI to conduct further confirmatory laboratory tests, including sending blood samples to foreign laboratories to ascertain the cause of the animals' deaths. The test results are expected in 2 to 3 weeks, although Dar said some confirmatory tests could take as much as 3 months.

Following this development, BAI has already put the area under a "quarantine zone", which means the automatic depopulation of all hogs within 1 km from the virus' ground zero and the further surveillance of areas within 10 km. Agriculture undersecretary Ariel Cayanan said the agency will be strictly monitoring the entry and exit of agricultural commodities in the area, while disinfection of the quarantine zone is currently under way. Dar, however, assured consumers that the incident would not affect the supply and prices of pork in the market, and stressed that the ASF virus does not pose any health concerns to humans.

Nonetheless, the epidemic has no cure yet and given the government's lack of resources to address the problem and ensure against its contamination, its entry in the country may destroy the local livestock industry at a time when the latter has just secured trade agreements to supply pork to China and Singapore. "We have further upgraded our monitoring and vigilance, including the imposition of stricter quarantine measures all over the country's ports of entry, airports, and seaports," Dar said.

Mayotte Rift Valley Fever

Since the beginning of the circulation of the Rift Valley fever [RVF] virus in Mayotte, at the end of November 2018, 143 human cases have been reported to the regional health agency by the Mayotte hospital center laboratory, and 126 animal foci have been reported. As soon as the first cases arrived, preventive measures and vector control measures had been put in place on the island in order to limit the spread of the disease on the territory.

Although the number of cases has stabilized for several weeks, the Rift Valley fever virus still circulates in some communes of the island. Therefore, the health authorities reiterate the importance of continuing to respect preventive measures to prevent infection and prevent an epidemic recovery when the rainy season returns.

Armenia: Anthrax

A total of 5 people from Armenia's Gegharkunik Province have been diagnosed with anthrax, the Ministry of Healthcare said in a news release.

According to the healthcare ministry two villagers from Geghhovit sought medical treatment in the local hospital for what appeared to be the skin form of anthrax. The patients told the medics that a few days earlier they had slaughtered cattle in the village.

Experts from the Healthcare Ministry's National Center for Disease Control and Prevention were dispatched to the village to find out how and where the disease was contracted. During the visit another 6 people were suspected in having contracted the disease. A total of 5 were sent to the Nork Infectious Diseases Hospital in Yerevan for a confirmation. All were confirmed to have anthrax. According to the ministry all patients were treated and a medical supervision has been set for the village.

The Food Safety Inspection was immediately notified. Medics and food safety agents are working in the village.

Bulgaria: African Swine Fever

A second outbreak of African swine fever [ASF] has been registered in Alabak State Enterprise, Pazardzhik regional governor Stefan Mirev said after a meeting of the Regional Epizootic Commission.

Mirev said a sample of a second dead pig found in the Velingrad region on the territory of Alabak State Enterprise tested positive. "It is the second outbreak of ASF in the region of Velingrad. At the meeting, we made a thorough analysis and discussed all measures taken by the competent institutions. They are the same as those with the first outbreak."

"Today, an order will be issued by the director of the regional forestry department, which will ban access to the infected area. It will prohibit logging, mushroom picking, hiking, and any activities that could spread the infection," Stefan Mirev explained.

Australia: Hepatitis

Australian Capital Territory health officials are investigating a cluster of hepatitis A cases in Canberra's South Korean community. There have been 8 cases of the virus in the ACT and Sydney since June 2019. The cluster of cases comes as South Korea experiences a large outbreak of the virus, with more than 11,000 cases reported in the country in 2019.

ACT Health said it was working with its counterparts in New South Wales to investigate the cause of the outbreak. An ACT Health spokesman said most of the people affected by hepatitis A in recent weeks in Canberra had not reported travelling overseas recently. "Australia has a low incidence of hepatitis A, and when outbreaks occur, they are linked to consumption of contaminated food products or person-to-person spread," the spokesperson said. "However, at this stage of the investigation, no specific food has been connected to the outbreak."

Symptoms of the virus may include nausea, vomiting, fever and yellowing of the skin, dark urine and pale stools.

Pakistan: Crimean Congo Hemorrhagic Fever

One more case of Congo virus has been reported in Karachi as a young boy was diagnosed with the disease after being admitted at a hospital in Nazimabad area, ARY News reported on Aug. 18]. Doctors confirmed that the 17 year old boy, who is a resident of Sohrab Goth and worked at a dairy farm, was diagnosed with Congo virus during the initial medical examination tests.

The first case of Congo virus was reported on Feb. 11 in the metropolis.

In 2018, at least 16 deaths were reported in Karachi from the life-threatening virus, and 41 patients -- mainly from Quetta, Balochistan -- were diagnosed with it.

Earlier, a Congo virus alert had been issued for the metropolis, stipulating precautionary instructions for all those people who visit cattle farms.

The disease is caused when a tick attaches itself to the skin of cattle, and when that infected tick or animal comes in contact with people, the highly contagious virus is transmitted into the human body and the person falls ill. This disease has a 40% to 50% mortality rate. The initial symptoms of Congo fever include headache, high fever, rashes, back pain, joint pain, stomach pain and vomiting.

Canada: Eastern Equine Encephalitis

On Aug. 10, the Ontario Ministry of Agriculture, Food and Rural Affairs was notified of a confirmed case of eastern equine encephalitis (EEE) in a horse located in the United Counties of Leeds and Grenville. The unvaccinated mare was euthanized following the sudden onset and progression of neurological signs. Laboratory diagnostic testing confirmed infection with the EEE virus.

EEE is not transmissible from horses to people. Effective equine vaccines for EEE are available, and veterinarians should encourage clients to keep their horse's vaccinations current. Once clinical infection develops, treatment options are limited to supportive care. The mortality rate in unvaccinated horses is high.

Veterinarians in Ontario should consider EEE as a differential diagnosis in horses exhibiting neurological signs and can identify positive cases through appropriate testing. IgM antibodies to the EEEv can be detected in serum from horses with neurological signs.

Clinical signs of EEE, including circling, head-pressing, ataxia and depression, can mimic a variety of encephalitides, including rabies, West Nile virus (WNV), botulism, hepatic encephalopathy, equine protozoal myeloencephalitis, and equine herpes myeloencephalopathy. Most equine cases of EEE in Ontario occur between the months of August and October and end with the onset of frost.

EEEv affects mainly equine species in eastern North America but can rarely cause severe disease in humans. EEEv has also caused fatal infections in pheasants, quail, emus, alpacas, llamas and dogs. EEEv has been reported in horses in Ontario since 1938.

Spain: Listeriosis

Health authorities in Spain are on high alert after a 90 year old woman died amid a listeria outbreak in the southern region of Andalusia that has affected more than 110 people.

Jose Miguel Cisneros, director of the infectious disease department at Seville's Virgen del Rocio Hospital, on Aug. 20 announced the 1st casualty since the outbreak was declared on Aug. 15. Authorities have closed the pork meat supplier's plant and recalled all of its products. Cisneros said roughly half of the 114 people affected by the bacteria remain hospitalized.

Health minister Maria Luisa Carcedo said an investigation is looking into how the meat evaded what she called "strict food safety controls".

Listeria is a bacteria that usually causes mild illness in healthy people but can be dangerous to pregnant women and those with weakened immune systems.

August 16, 2019

Bulgaria: African Swine Fever

Bulgaria's Food Safety Agency (BFSA) said it has confirmed 3 new cases of African swine fever [ASF] in wild boar in the provinces of Smolyan, Shumen, and Veliko Tarnovo.

These are the first confirmed cases of ASF in wild boar in Smolyan and Shumen, the agency said in a statement Aug. 8.

Earlier this week, Bulgaria's agriculture ministry said that the country will receive 2.9 million Euros ($3.2 million) from the European Commission to finance the prevention of ASF spreading further.

Bulgaria's current event, which reportedly started uly 3, has already caused 43 outbreaks, affecting both domestic pigs as well as wild boars. The disease spread from the Romania border.

Bulgaria's first ASF event took place September 2018 - June 2019.

Australia: Leptospirosis

The University of Sydney has reported 6 confirmed cases of leptospirosis in dogs in the inner west. All the dogs died or were euthanized.

The specific suburbs where leptospirosis has been reported are Surry Hills, Glebe and Darlinghurst.

While it is thought the recent outbreak could be due to major construction occurring in Sydney and therefore increased exposure to rats and contamination of subterranean water, the current source of infection and the strain of bacteria involved are unknown.

The current recommendation is for all dog owners in inner Sydney and the inner west to have their dog vaccinated at their local vet.

The City of Sydney is doubling the number of rat bait stations. Lord Mayor Clover Moore said the City of Sydney is taking action to tackle the problem.

"We have been very concerned by the recent cases of leptospirosis in Sydney, affecting dogs in our local area so have decided to double the number of rat bait stations in public areas and increase inspections to monitor rat activity," the Lord Mayor said.

"We can't fight the rat problem on our own, because we can only install rat baits on our own land. The City has written to Sydney Trains, Property NSW, Sydney Water and NSW Land and Housing Corporation to urge them to increase baiting and monitoring of rats on their land.

Canada: West Nile Virus

A horse in Princeton, in B.C.'s South Okanagan, has tested positive for West Nile virus.

The Cascade Veterinary Clinic, operated by Dr. Ryan Ridgway and Dr. Lynn Smart, shared the information in a post on social media, along with a warning for horse owners to get their animals vaccinated.

"Thankfully it [the horse] was vaccinated, so it was not fatal. Had it not been vaccinated, it most likely would not have survived, or if it had, it would have had severe neurological issues. This is spread by mosquitoes, and all horses are at risk of contracting this often fatal disease," the post stated.

West Nile virus is a disease spreading from infected corvid birds (crows, ravens, magpies, and jays) to humans through mosquito bites.

Pakistan: Crimean Congo Hemorrhagic Fever

A teenage boy succumbed to Crimean-Congo hemorrhagic fever (CCHF) in the metropolis on Aug. 9.

The teenager, who was admitted 4 days ago in the Jinnah Hospital, was identified as a resident of Orangi Town.

United States: Tularemia

The Larimer County, Colo. Department of Health and Environment reported Aug. 9 that tularemia, also known as "rabbit fever," has been found in a rabbit in northern Larimer County.

Tularemia-causing bacteria from the droppings or urine of sick animals, usually rabbits, can contaminate soil and spread the disease, according to a news release from the health department.

A recent die-off of rabbits suggested a possible tularemia outbreak among the animals in that area, the agency said.

"Because tularemia is naturally occurring in Larimer County, precautions should always be taken to prevent infection, public health director Tom Gonzales said in the release. "It is important to keep children and pets away from wild animals."

In recent years, most human tularemia cases along the Front Range have been attributed to activities involving soil and vegetation, the health department said. The county has seen 18 human cases since 2009; 35 animals have tested positive for the disease since 2009.

Italy: Tularemia

An 18 month old girl suffered swollen lymph nodes and fever after being bitten by a tick. The child had always been previously in good health.

A tick bit her at the left shoulder, during a trip to a Dutch island was reported in June 2019. The tick was completely removed the following day, but she developed fever and rash 2 days later. No other signs or symptoms followed until approximately 30 days after the tick bite a supraclavicular swelling appeared. This initially showed intact skin, but progressive increased in size and the overlying skin developed hyperemia. Three days latter a left axillary swelling occurred as well. Since the child was temporarily in Italy, she was admitted at the Meyer Children's University Hospital in Florence.

Serology test for tularemia carried out at Meyer Children's Hospital and at Careggi Hospital in Florence were both positive. The molecular test carried out at the Microbiology Laboratory of the National Institute for Infectious Diseases "L. Spallanzani" in Rome detected the presence of Francisella tularensis in surgical drainage. Further microbiological and molecular investigations are ongoing.

United States: Anthrax

North Dakota agriculture officials say anthrax has been confirmed in a group of cows in a pasture in eastern Billings County. The case was confirmed Aug. 9. It is North Dakota's first reported case of anthrax this year.

North Dakota state veterinarian Susan Keller says producers in Billings County and surrounding areas should check with their veterinarians to see if they should start vaccinating their cattle for anthrax. Anthrax vaccines are readily available, but it takes about a week to establish immunity, and the vaccine must be administered annually. 

Anthrax is caused by bacterial spores that can lie dormant in the ground until they are activated by heavy rains, flooding or drought. Scattered heavy rains may have triggered the recent case. No anthrax cases were reported in North Dakota last year.

Spain: Tularemia

The detection of 3 new cases of tularemia in Villarramiel, Osorno and Palencia, brings to 23 the number of people affected by this disease associated with the overpopulation of voles in the province of Palencia, where they are studying 32 other possible cases.

The Epidemiology Surveillance Network of the Junta de Castilla y León confirmed on Aug. 12 3 new cases of tularemia in the province of Palencia, where 23 people have been affected since July 3, as reported by the territorial delegation of the Board in Palencia. The last confirmed cases have been detected in the Palencia towns of; Villarramiel, where there are already 4 people affected by tularemia; the basic health area of rural Palencia where the 2nd case has been detected; and Osorno, which recorded the 1st confirmed case of this sickness.

In total, the Epidemiology Surveillance Network has confirmed 12 cases of tularemia so far in August were added to the 11 confirmed throughout the month of July. The most affected localities are Paredes de Nava, with 11 confirmed cases, and Villarramiel with 4, while the basic areas of Saldaña, Palencia and Cervera de Pisuerga have confirmed 2 cases each and Villada and Osorno a single case in each locality. Only one of the people affected, in Cervera de Pisuerga, has needed hospital admission but has already been discharged.

In addition there are 32 other suspicious cases that are being studied while an active search for this disease, associated with overpopulation of voles, continues.

The Health Service does not expressly cite the overpopulation of voles that are currently in the province of Palencia, mainly in the region of Tierra de Campos, as a cause of this disease and points out that "environmental exposure could be the main factor."

India: Scrub Typhus

Scrub typhus has killed 4 people in Himachal Pradesh while 241 others have tested positive. Scrub typhus is an acute illness caused by a bacterium Orientia tsutsugamushi, which is transmitted by the bite of an infected mite larva [chigger] present in the soil having scrub vegetation. Himachal Pradesh is an endemic region as it has a large scrub vegetation.

Of the total deaths reported this year so far, 1 death has been reported from Mandi district, while 3 deaths have been reported from Shimla district. An 8-year-girl from Lakkar Bazar in Shimla died on Aug. 5. She was admitted to the hospital on Aug. 4 with the complaint of high fever and was in serious condition.

Of the total cases that have so far tested positive, 91 cases have been reported from Bilaspur district, followed by 47 cases from Hamirpur district and 43 cases from Kangra district. Mandi district has reported 31 positive cases while Shimla and Solan districts have reported 10 positive cases each. Chamba district has reported 6 positive cases while Kullu, Kinnaur, and Sirmaur districts have reported 1 positive case each.

Senior medical superintendent of Indira Gandhi Medical College and Hospital, Shimla, Dr. Janak Raj said that people should observe some precautions while going to the fields including wearing full-sleeved clothes as scrub typhus spreads during monsoon. He added that people should also cut grass around the houses and in case of fever, they should go for medical examination to the nearest health institute.

Nepal: Anthrax

Anthrax spores have been detected in Koshi Tappu Wildlife Reserve, a sanctuary to a huge population of protected species of wild buffaloes, raising alarm among conservationists. The finding came following the test of blood samples collected from dead cattle found in the reserve. Some 44 cattle were found dead in the grassland here on Aug.  8.

Dr. Sanjaya Kumar Yadav of Livestock Disease Research Laboratory, Biratnagar, confirmed the bacteria in the dead animals. "Anthrax is an infectious disease and can spread from cattle to cattle and even to humans. As the disease can kill the patient if timely treatment is not provided, we must be cautious," said Dr. Yadav.

According to Dr. Manoj Kumar Mahato of Veterinary Hospital and Livestock Expert Center, Inaruwa, his office is all set to launch a campaign to stop the bacteria from spreading further. "The bacteria can easily spread from one place to another through wind, soil or water. To stop the disease from spreading further, it is necessary to inoculate all the livestock found in the wildlife reserve," he said. Mahato added that hardly any symptoms are seen before the infected cattle dies from bleeding from all orifices.

Ireland: Rabbit Hemorrhagic Disease

Rabbit hemorrhagic disease (RHD) a disease which is fatal to rabbits and hares but of no risk to humans, has been confirmed in the wild in Ireland for the first time.

RHD causes death within a few days of infection, with sick animals having swollen eyelids, partial paralysis and bleeding from the eyes and mouth. In the latter states close to death, animals exhibit unusual behavior such as emerging from cover into the open and convulsing or fitting before dying.

Irish domestic rabbits were first reported to have the disease in 2018, but it has now been confirmed in the wild from a rabbit in Co Wicklow and another in Co Clare. On Aug. 9, a hare in Co Wexford was also found to be infected by the virus.

In all cases individual animals were tested at Department of Agriculture, Food and Marine laboratories where RHD2 was subsequently confirmed. The National Parks and Wildlife Service (NPWS) is asking the public to report any suspected cases to them.

While all 3 locations continue to support apparently healthy wild populations, NPWS conservation rangers continue to monitor the situation.

The disease is highly contagious and can be spread directly between animals and in the feces and urine of infected animals, as well as by insects and on human clothing. In addition, the incubation period may last several days and seemingly uninfected animals may in fact be carriers.

Zambia: Foot and Mouth Disease

Foot and mouth disease [FMD] has broken out in Shamabele area in Chikankata district of Southern province. And Ministry of Livestock officials in Southern province have with immediate effect closed the famous Turn Pike Bata Co-operative Society Abattoir following the outbreak of disease.

This has been confirmed by Bata Co-operative Society Chairperson for Hides and Beef Traders Association, Daniel Bweupe in an interview with the Zambia News and Information Services (ZANIS) in Chikankata district in Southern province over the weekend.

Mr. Bweupe said cattle farmers are currently battling to contain FMDE using salt to treat their animals.

He revealed that the disease is suspected to have manifested from the abattoir and spread to Shamabele and the surrounding areas.

United States: Eastern Equine Encephalitis

A man in Massachusetts has been infected with a mosquito-borne virus called eastern equine encephalitis (EEE), health officials confirmed Aug. 10. It's the first human case reported in the state since 2013.

At least 9 towns are at "critical risk" of exposure to the rare but potentially fatal virus, which can cause brain swelling, according to the Massachusetts Department of Public Health.

It's the latest in a series of warnings from state officials about the virus, which has been detected in 227 samples of mosquitoes in 2019, the health department said.

Florida and Delaware issued similar advisories after the virus was detected in sentinel chickens, though neither state has seen any cases reported in humans.

Any virus transmitted from an insect bite is a big deal, but what is EEE, and what risk does it pose?

The virus isn't common, but it is serious. Every year on average, 7 cases are reported but about 30% of all cases are fatal, according to the Centers for Disease Control and Prevention.

EEE causes inflammation of the brain, which is often preceded by a high fever, chills, and vomiting. As the illness progresses, patients might experience seizures or a coma that can cause varying degrees of brain damage, the CDC said.

Sweden: Tularemia

Swedish health authorities have warned an outbreak of rabbit fever (tularemia) is expected to grow, with hundreds of people affected so far.

A total of 212 confirmed cases have been reported to The Public Health Agency of Sweden so far in 2019, sharply increasing from late July 2019. That is twice as many as in a normal year.

But Sweden has not yet seen the end of it, the authority warned on Aug. 12. "Since the number of cases (of rabbit fever) is usually at its highest in September, the outbreak is expected to grow further in the coming weeks," it wrote in a statement.

Most cases have been reported in Dalarna, Gavleborg, and Orebro counties in central Sweden, but in the past week Vasterbotten and Norrbotten have also seen an increase, often limited to a specific area.

Many of those affected by the disease have been infected via mosquito bites.

Nigeria: Yellow Fever

The Nigeria Center for Disease Control (NCDC) is aware of a suspected outbreak of yellow fever in Ebonyi state and has had a rapid response team supporting Ebonyi state's response in partnership with the World Health Organization (WHO).

Following a report of cases and deaths from fever of unknown origin in Izzi local government area (LGA) in Ebonyi state, the state public health team commenced an investigation. As of July 31, three cases had tested positive for yellow fever at NCDC's national reference laboratory, which triggered an immediate response.

The Ebonyi State Epidemiology Team is leading the response with support from the Nigeria Centre for Disease Control (NCDC), the National Primary Health Care Development Agency (NPHCDA), and the World Health Organization (WHO). In the course of investigation, it was discovered that between May 1 and Aug. 7, there had been cases that fit into the case definition for yellow fever and 20 deaths in Izzi LGA, Ebonyi state, indicating that the outbreak may have been going on for a few months, undetected by local health authorities. It was too late to collect samples for confirmation from these cases.

Yellow fever virus is spread through bites of an infected mosquito. There is no human-to-human transmission of the virus. Yellow fever is a completely vaccine-preventable disease, and a single shot provides immunity for a lifetime

Madagascar: Plague

In Madagascar, the plague season has started. The first 3 cases of bubonic plague have just been recorded 50 km west of the capital. No deaths have occurred for the moment, but the Ministry of Health is watching. As every year, awareness campaigns have started. The goal: to prevent the spread of epidemics like that of 2017, the black year, which had more than 200 victims and 2,400 people infected by the bacterium throughout the Malagasy territory.

"Do not repeat the mistakes of the past" is the stated ambition of the Ministry of Health. Contacted by telephone, the Director General of Preventive Medicine, Dr. Fidiniaina Randriatsarafara, said that "information and awareness activities have started. Radio clips are being broadcast on local radio stations to remind the public that the appearance of swelling, sudden fever, or chest pains require an immediate visit to the nearest health center. Clinics are sometimes several hours walking distance away, and patients more easily consult traditional healers.

At present, health centers in plague-endemic areas are all expected to be provided with drugs, since treatment exists to treat both forms of plague on the island. However, some clinics are still awaiting them, according to a ministry official.

Another important preventive measure is the requirement for road transport companies to register the name and telephone number of all passengers during the plague season. In 2017, it was a sick traveler who transmitted the pneumonic plague to other passengers, extending the epidemic to Tamatave. However, according to a regional carrier, many companies do not register passengers and are not sanctioned.

August 9, 2019

Greece: West Nile Virus

Two people over 80 were the first victims of West Nile virus in Greece this year, according to the weekly epidemiological surveillance report published by the National Public Health Organization.

From the beginning of epidemiological surveillance, 25 cases of West Nile virus infection have been diagnosed and studied in Greece. In 17 of the patients reported, the central nervous system was affected (encephalitis and/or meningitis/acute flaccid paralysis), while 8 had mild symptoms, such as fever.

The median age of patients with CNS symptoms is 77 years old. Of the 25 patients, 10 are hospitalized.

The areas where virus cases have been recorded in the country are Pieria, Katerini, Pella, Xanthi, Kavala, Larissa, Karditsa as well as East Attica and Mesogia.

West Nile virus is spread mainly through the bites of infected mosquitoes, experts say.

The implementation of mosquito control and personal protection programs is most appropriate for controlling the disease.

Uganda: Crimean Congo Hemorrhagic Fever

One person has been confirmed dead and 49 others currently are isolated following an outbreak of Crimean-Congo hemorrhagic fever (CCHF) in Lyantonde District.

According to the Lyantonde District Health Officer, Dr Moses Nkanika, a businessman dealing in cattle succumbed to the deadly disease on July 31.

"The blood samples we got from the deceased in Kasagama Sub County have tested positive for CCHF, not Ebola as earlier suspected," Dr Nkanika told Daily Monitor.

He said 49 residents who got in close contact with the deceased are currently isolated to avoid contacts with other people as health workers continue to monitor their health conditions.

"These people are expected to remain in isolation for 40 days until they are cleared by ministry of health," he said. He advised residents to be on alert and report any emergencies to the nearby health centers.

Emmanuel Ainebyoona, the Ministry of Health spokesperson, said he was not aware of the outbreak, but promised to crosscheck with other responsible authorities to confirm.

United States: Vesicular Stomatitis Virus

More than 250 animals have been quarantined after a viral disease was discovered in 14 counties, the Colorado Department of Agriculture said. Vesicular stomatitis [VSV], which primarily affects horses, spreads through insect bites.

Cases of the disease have been found in Adams, Archuleta, Boulder, Broomfield, Conejos, Delta, Jefferson, La Plata, Larimer, Mesa, Montezuma, Montrose, Morgan and Weld counties. A total of 93 cases were confirmed in Larimer County as of 1 Aug 2019, and 48 cases were found in Boulder County, officials said. Weld and La Plata counties had 43 and 42 cases, respectively.

Vesicular stomatitis primarily affects horses and cattle but can spread to goats, sheep and other livestock. The only bovine case was found in Boulder County. It's rare for humans to contract the disease. Symptoms of the disease include excessive salivation and blisters around the ears, tongue, muzzle, teats and coronary bands. The disease can cause the animals to refuse to drink and eat.

Vietnam: Avian Influenza

Vietnam's southern Ba Ria Vung Tau province has seen its first outbreaks of A/H5N6 bird flu, which have led to the culling of 10,500 chickens, local media reported Aug. 6.

The outbreaks were spotted in 2 communes in Xuyen Moc district, and then tests confirmed that some chickens were infected with the bird flu virus, Vietnam News Agency quoted the provincial Department of Livestock and Animal Health as reporting.

Relevant local agencies have culled 10,500 chickens raised by 2 households in the 2 communes, disinfected surrounding areas, and intensified vaccination among fowl in the district.

In late July 2019, the Vietnamese Ministry of Agriculture and Rural Development said that the outbreaks of A/H5N6 and A/H5N1 bird flu had been reported in 13 communes of 11 localities from the start of 2019, leading to the culling of more than 23,000 poultry.

The bird flu is forecast to widely spread in the remaining months of this year due to changing weather and surging poultry transportation in time ahead of the lunar new year holiday.

Pakistan: Crimean Congo Hemorrhagic Fever

A suspected Congo virus [Crimean-Congo hemorrhagic fever] patient brought to Quetta's Fatima Jinnah Chest Hospital passed away on Aug. 3, while another believed to be suffering from the disease was admitted.

The patient belonging to Loralai district was admitted to the hospital on Aug. 1 bleeding from mouth and nose and with high fever. A blood sample of the patient had been dispatched to Karachi for diagnosis but he did not survive and died before the results were concluded.

Another patient from Pishin district suffering from the same symptoms was brought to Fatima Jinnah Chest Hospital and had been diagnosed with Congo virus, the Head of the Congo ward said.

In the last 4 months, 25 patients suspected of having Congo fever have been brought to the hospital from different areas of the province and 12 of them have been confirmed as suffering from the disease after diagnosis.

In recent years, the Congo virus has hit Balochistan on the occasion of Eid-ul-Azha [Festival of the Sacrifice], as most of the affected patients had been engaged in the business of herding.

Although the current Balochistan government has yet to take any serious measures to counter the disease, governments in the past have been taking preemptive measures to stop the spread of the virus including spraying in cattle markets.

United States: Eastern Equine Encephalitis

A horse in Cumberland County, N.C. was euthanized after contracting a mosquito-borne disease, the state's Department of Agriculture said. The horse, a 4-year-old mare, was not vaccinated against eastern equine encephalomyelitis (EEE). It was the first case of the disease in North Carolina this year, the Department of Agriculture and Consumer Services said.

The disease causes inflammation of the brain and is usually fatal. It can take between 3 and 10 days for signs to show after a horse has been bitten by an infected mosquito. Signs include impaired vision, aimless wandering, inability to swallow, irregular gait, paralysis, convulsions and death.

State Veterinarian Dr. Doug Meckes said in a statement any horses with such signs to contact a veterinarian immediately. "It is imperative horse owners keep their vaccines current, talk to your veterinarian about vaccinating them as soon as possible against EEE and West Nile virus," Meckes said. He recommended a booster shot every 6 months.

Because mosquitos breed in puddles, removing standing water can reduce the chance of exposure to the disease. While people, horses and birds can become ill from an infected mosquito, there is no evidence horses can transmit the virus to other horses, birds or people through direct contact.

Japan: African Swine Fever

A Vietnamese exchange student has been arrested by police in Japan for illegally carrying fermented pork rolls containing the African swine fever [ASF] virus into the country. Hac Thi Phuong Linh, 23, is being held at a police station in Tokyo for violating the quarantine law, her family said.

Vietnamese newspaper VnExpress reported that she was caught at Haneda International Airport on trying to bring in 10 kg of the pork rolls and 360 fetal duck eggs into Japan without declaring them. Both items require quarantining before entry into Japan.

After testing, Japanese authorities revealed that the pork rolls contained the virus that causes ASF. This is the first case of pork containing the virus caught in Japan.

Tokyo Broadcasting System Television has reported that Ms. Linh told the police that the pork rolls were made by her mother for personal use, but the police suspected they were for selling to others. During the interrogation, she admitted that she was planning to sell the rolls online.

After ASF broke out in Vietnam last February, several countries, including Japan, imposed a ban on pork products from the country.

Passengers carrying raw or processed foods to Japan from Vietnam must have a certificate of safety, failing which they face 3 years imprisonment or a fine of one million yen ($9,413).

Congo: Ebola

The deadly Ebola virus has taken the lives of more than 500 children in the Democratic Republic of Congo, Save the Children said Aug. 6, with the number of deaths accelerating over the past 6 months. In total, around 737 children have been infected with the disease since Ebola surfaced in the DRC.

Today's figures show how the spread of the disease has accelerated: in the first 6 months after Aug. 1, 2018, just under 100 children died of Ebola. In the 6 months that followed, over 4 times as many children lost their lives.

Heather Kerr, Save the Children's Country Director in DRC, said: "This is another grim milestone in a crisis that is devastating children in its path, especially the youngest. Some 40% of children who have contracted the disease are under the age of 5, and many of them have died.

"The spread of Ebola is having a wider impact on children as well; because of the high fatality rate in this outbreak, thousands of children have lost at least one of their parents to the disease or were separated from their parents.

"The virus puts children at risk of being stigmatized, isolated or abandoned, in addition to suffering the unbearable trauma of losing a loved one. Children who are on their own face the very real danger of all kinds of abuse and exploitation, or of being recruited by armed groups.

Children aren't going to school because their parents have died and those taking care of them can't afford the school fees, or schools are closing due to insecurity.

August 2, 2019

Uganda: Elephantiasis

The Speaker of Parliament Rebecca Kadaga has directed the Health Minister Jane Aceng to dispatch a team to Kamwenge and Kitagwenda districts to respond to increasing cases of elephantiasis in the area.

Elephantiasis, also known as lymphatic filariasis, is one of the neglected tropical diseases caused by parasitic worms such as Wuchereria bancrofti, Brugia malayi, and Brugia timori, all of which are transmitted by mosquitoes. It causes the affected area, mostly the limbs or parts of the head, to swell abnormally.

During the plenary session on July 24, Kamwenge Woman MP Dorothy Azairwe Nshaija said that despite the matter being brought to the attention of the Ministry of Health, nothing has been done. Nshaija says that 12 people are reported to have died in the past few weeks.

Nshaija appealed for government's intervention in the affected areas of Busiriba Sub-County in Kamwenge District and Sub-Counties of Ntara and Buhanda in the new district of Kitagwenda. Kadaga directed Aceng to travel to Kamwenge and Kitagwenda districts to establish the causes of the disease and report back to Parliament on July 31.

Reports indicate that several farmers in the affected areas have abandoned their gardens due to the disease. Contrary to reports that elephantiasis was being caused by mosquitoes and worms, a 2015 study by the Ministry of Health indicated that volcanic minerals in soils were causing elephantiasis in Kamwenge. The study described the disease as a result of chronic exposure of skin to irritant minerals in volcanic soils causing itching and pain.

The Health Ministry then reported that 52 cases of people with elephantiasis had been identified and that these had the disease since 1980 since it takes longer for someone to realize it due to lack of awareness and its risk increases with older age. The report said that women were 5 times more affected than men since they move barefooted and spend more time in the farms touching the volcanic soils with minerals that cause this disease.

Venezuela: Malaria

More than 10 cases of malaria have been reported in the Boyaca III sector of Barcelona (Anzoategui, Venezuela) in the past 2 weeks. Of these cases, 2 are young children aged 1 and 2 years old, infected after the bite of the Aedes aegypti mosquito.

Maria Febres, a nurse and resident of the community, states that the malaria outbreak is due to the lack of weeding and cleaning in the channel that crosses the Boyaca III sector, where more than 500 families reside.

"We have 12 cases of malaria in the sector. We need them to come clean the canal, which has not received adequate maintenance for 2 years, putting many families at risk of contracting malaria due to the proliferation of mosquitoes," she said.

The nurse told the city correspondent] of El Pitazo, Eduardo Mora, that the sector has not been fumigated since 2018, and called on Public Health and Malariology officials to visit the area and verify what is happening.

"The most affected area is Boyaca III sector II, because we have a Simoncito [children's center -- so-called in honor of Simon Bolivar] there and the children who go every day are the ones most at risk of being bitten by an infected mosquito and, thus, getting malaria," said Maria.

Pakistan: Crimean Congo Hemorrhagic Fever

The number of deaths caused due to the Crimean-Congo hemorrhagic fever, CCHF has increased to 5 in Sindh. With Eid ul Azha drawing closer, a rise is observed in the number of Congo virus cases, which is mainly caused by ticks that inhabit the skin of different animals.

According to a report released by the Sindh health department, 8 cases of Congo virus have been reported in the province this year. Of these, 3 were brought to the Aga Khan University Hospital [AKUH] for treatment, 2 to Jinnah Postgraduate Medical Centre (JPMC), 2 to Dr. Ruth Pfau Civil Hospital and 1 to Dr. Ziauddin Hospital. All the patients who were being treated at the AKUH and JPMC succumbed to the disease.

The first death caused by Congo virus was reported in early June.

The 2nd death reported was of 36-year-old who hailed from Quetta. Complaining of high fever and bleeding from the mouth and nose, he had come to Karachi for treatment and was diagnosed with Congo virus.

He died on June 6, during treatment at the AKUH. About a week later, a third death was reported. The 20-year-old youth was a resident of Taiser Town and died during treatment at the AKUH on June 12.

Crimean-Congo hemorrhagic fever, commonly known as the Congo virus, causes bleeding in the human body. In case of excessive bleeding, death of an individual is likely to occur.

Greece: West Nile Virus

The number of people infected by the West Nile virus in Greece has risen to 10, the National Public Health Organization (NPHO) announced on July 25.

According to NPHO, 5 cases were recorded in only the past 5 days, while the first confirmed case was in late June. There have been no deaths linked to the virus so far.

It noted that the patients were all over 50 years old. The cases were reported in areas of northern Greece, while the Attika region was just added to the list.

The virus is reported to use wild birds as a main reservoir and was passed to humans via mosquito, rather than from or between infected humans.

Greek experts advised the public to take precautions against mosquitoes. The higher risk group that may exhibit more symptoms [includes] elderly people, patients with a suppressed immune system, and those with chronic illness.

In 2018, a record of 316 people were infected by the virus in the country, resulting in 50 fatal cases.

Singapore: Leptospirosis

It was supposed to be a fun school camp. Instead, the outdoor adventure turned into a harrowing ordeal for a 14-year-old student in Singapore when he contracted an unusual infection, likely from camp activities.

Weeks following his contact with murky water, the boy showed up at KK Women's and Children's Hospital (KKH) with fever, stomach pain, nausea and jaundice. Tests also showed a swollen liver and spleen. On the second day, his condition worsened and he was transferred to the intensive care unit. The infection causing his misery? Leptospirosis, a disease more commonly seen in rodents, livestock, dogs and cats but can also spread to humans.

As families spend time bonding on holidays overseas and adrenaline-seekers head outdoors and go on off-the-beaten tracks, health experts raised the possibility that they could expose themselves to less commonly seen infections such as leptospirosis.

In the last two years, 96 human cases of leptospirosis were notified in Singapore, based on data published by the Ministry of Health. It was added to the list of notifiable infectious diseases in September 2016.

The Leptospira bacteria, which is commonly found in tropical countries, can enter the body through cuts on the skin, the eye, or mucous membranes that line body parts such as the mouth, nose and windpipe. Associate Professor Chong Chia Yin, senior consultant at KKH's infectious disease service, said that besides exposure to urine or bodily fluids from infected animals, people may also get the disease if they are exposed to contaminated water during recreational activities such as swimming, water sports and rafting in contaminated lakes and rivers.

Dr. Chan Si Min, head and consultant at the division of pediatric infectious diseases at National University Hospital, said that leptospirosis can range in severity, from mild or asymptomatic (no symptoms) to severe and life-threatening, resulting in jaundice, kidney failure and bleeding in the lungs. It can also affect other organs such as the liver and heart. Assoc. Prof. Chong said that about 5% to 15% of cases will have life-threatening consequences. Death rate is the highest among people above 60 years old.

United States: Eastern Equine Encephalitis

South Carolina's state veterinarian announced July 22 that the state's first case this year 2019 of eastern equine encephalitis (EEE) has been confirmed in Chesterfield County. The infected horse, a year-old Appaloosa colt, had not been vaccinated and did not survive.

"This is a clarion call for vaccinations against diseases like EEE and West Nile virus (WNV)," said Boyd Parr, South Carolina state veterinarian and director of Clemson University Livestock Poultry Health, a state agency responsible for protecting the health of animals and consumers through control of disease and inspection of meat and poultry products. "Horse owners should check with their veterinarian to be sure their horses' vaccinations are up-to-date."

The EEE and WNV viruses are mosquito-borne and fast acting. Symptoms of EEE in horses usually develop from 2-5 days after exposure. The signs include stumbling, circling, head pressing, depression or apprehension, weakness of legs, partial paralysis, the inability to stand, muscle twitching, or death.

"These diseases have a very high mortality rate in infected, unvaccinated horses: between 30% and 40% for West Nile and 90% for EEE," said Sean Eastman, veterinarian and director of field services for the Livestock Poultry Health Animal Health Programs. "Although not directly communicable from horses to people, both EEE and WNV have a human health significance, and cases can be prevented through effective vaccination and mosquito management strategies."

United States; Vesicular Stomatitis Virus

A virus making horses ill in Colorado has been found in 11 counties; Larimer County is the hardest-hit area, with 70 confirmed cases of vesicular stomatitis [VSV].

Other counties are Adams, Archuleta, Boulder, Broomfield, Delta, La Plata, Mesa, Montezuma, Morgan and Weld, according to a Colorado Department of Agriculture news release.

Vesicular stomatitis can make eating and drinking painful for the horses, and they and other affected animals are quarantined. One bovine case in Boulder County has been confirmed.

"We understand that the VSV outbreak and quarantines are impacting the ability for people to bring their horses and livestock to fairs and shows," said Dr. Keith Roehr, Colorado State veterinarian, in the release. "The quarantines and hold orders must be followed, however, for the health and protection of all equine and livestock in Colorado."

Boulder County has logged 40 confirmed cases, and Weld County 29 cases, state officials said. The other counties had lower numbers as of July 26.

The first case of vesicular stomatitis in Colorado this year was reported July 3 in Weld County. There are no USDA-approved vaccines for the virus, which likely is spread by insects.

India: Melioidosis

The cause of the death of 2 children at Badiyadka here a few days ago is suspected to be melioidosis, an infectious disease caused by a gram-negative bacterium, Burkholderia pseudomallei, found in soil and water, according to an official press release here.

An 8-month-old child and a 4-and-a-half-year-old boy, siblings, died on July 23 and 24, respectively, after they had been admitted to a hospital in Mangaluru following fever.

Health Department officials here said their preliminary assumption, based on the test results done at Father Mueller Hospital in Mangaluru, was that the deaths were caused by melioidosis, not by any viral infection. However, the disease would be confirmed only after the test results from the National Institute of Virology in Pune. The District Medical Office here said there was no need for panic as viral infection was not confirmed in the tests done in Mangaluru. Melioidosis could be treated if patients seek treatment in the early stages. People with compromised immunity, especially children, pregnant women, aged people and others with chronic diseases, are vulnerable to contracting melioidosis. The disease could be treated with antimicrobial drugs in normal patients.

The release said health workers, led by epidemiologists, examined the house of the deceased children and nearby areas to find the source of the bacterium. Animal Husbandry officials collected samples from domestic animals and soil samples for testing. Parents and relatives of the deceased children were being monitored at the Kannur Government Medical College Hospital at Pariyaram. At present, they had no health issues, they added.

Zimbabwe: Typhoid Fever

Officials in the capital city of Zimbabwe, Harare, report seeing 858 new typhoid cases in the last 6 months, with the suburbs of Glen View and Budiriro hit the hardest according to a report in The Herald. No deaths have been recorded.

The reason for the outbreak is failure to constantly supply clean water and delays in attending to sewer bursts or leakages, local authorities state. Harare Town Clerk Engineer Hosiah Chisango said: "The drivers for water-borne diseases (cholera and typhoid) have been water cuts or availability of municipal water, contaminated water, sewer bursts or leakages, use of shallow wells, illegal vending of cooked food, attending gatherings during an outbreak, poor hygiene practices, and household contact to a case."

Typhoid fever is a potentially life-threatening illness caused by the bacterium Salmonella Typhi. Salmonella Typhi lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed S. Typhi in their feces.

China: African Swine Fever

China's pig herd could halve by the end of 2019 from a year earlier as an epidemic of African swine fever [ASF] sweeps through the world's top pork producer, analysts at Dutch bank Rabobank forecast July 30.

The bank said China's herd, by far the world's biggest, was already estimated to have shrunk by 40% from a year ago, well above official estimates which have ranged from 15% to 26%.

The forecast comes amid industry speculation that the decline has been much worse than confirmed by agriculture officials, who this month launched an investigation of local authorities' efforts to contain the disease.

Rabobank said China's pork production in 2019 was expected to fall by 25% from the previous year, a smaller drop than pig herd loss due to the large number of animals slaughtered in 1st half of 2019.

Output of pork, China's favorite meat, will likely drop by a further 10% to 15% in 2020, it said in a report.

India: Malaria

Over 80 cases of malaria have been reported in Delhi this year so far, and about 39 of them have been recorded in July.

Doctors have advised people to take precautions and urged them to wear long sleeves and use mosquito nets. Water coolers should be dried up when not in use, as mosquitoes that carry the malaria parasite and transmit malaria between people usually breed there, a doctor said. Civic bodies had also organized a workshop recently on prevention of vector-borne diseases.

Mosquito-breeding has been reported in at least 48,039 households, and 46,580 legal notices have been issued this year.

India: Anthrax

Anthrax is suspected to be spreading its tentacles in the tribal areas of Koraput district, and 199 persons have become victims of the dreaded disease in the last 4 years. According to reports, the disease has assumed endemic proportions in spite of several awareness programs being undertaken in the district.

In the past couple of days, at least 20 persons have been reportedly affected by anthrax at Rupuguda in Mathapada panchayat of Boipariguda block. The affected villagers have developed swellings and blisters on their limbs, with pus oozing out of the sores. The affected persons include children and elderly persons.

According to health officials, the bacterium lies in the soil and affects cattle that consume it along with grass while grazing. The tribals collect beef from the carcass of the cattle and dry it under the sun for consumption throughout the year. The food habit of the tribals leads to the spread of the diseases among them.

Reports from the chief district medical officer’s office indicate that in 2016, the disease affected 67 persons, and one died from it. Similarly, in 2017, 75 persons were affected, and one person died of the disease. There were no deaths in 2018 and 2019, but 24 and 33 persons have been afflicted by the disease in 2018 and 2019, respectively. However, a private estimate said the actual number of affected persons and toll could be more than the stated government figures.

Ivory Coast: Yellow Fever

In recent weeks, 89 people have contracted yellow fever, and one person has died during an outbreak in Ivory Coast, the health ministry said July 30.

Most of the confirmed cases were in the West African country's economic capital Abidjan, the ministry said in a statement. It recommended that any unvaccinated people be vaccinated against yellow fever.

"The outbreak occurs in the context of a dengue outbreak," the ministry said, adding that dengue and yellow fever are viral diseases transmitted by the same mosquito.

"The vector control measures that have been implemented to deal with dengue also work for the yellow fever outbreak."

In early June, 130 cases of dengue were reported, including 2 deaths, with the authorities launching a major mosquito-control campaign.

Abidjan is going through the end of its rainy season, which spurs mosquito breeding.

United States: Rabbit Hemorrhagic Disease

The Washington State Department of Agriculture has confirmed rabbit hemorrhagic disease virus 2 in 3 feral domestic rabbits found dead on Orcas Island. The findings are part of the ongoing investigation into a case of the disease confirmed on the island earlier this month in a pet rabbit that died suddenly.

RHD is a viral disease that causes sudden death in rabbits and can be spread through contact with infected rabbits, their meat or their fur, or materials coming in contact with them. It poses no human health risk.

The Orcas Island outbreak response began on July 9 when the state vet's office received a report of a dead domestic pet rabbit from a veterinarian clinic on Orcas Island

Congo: Ebola

The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated July 30:

Since the beginning of the epidemic, the cumulative number of cases is 2,701, of which 2,607 are confirmed and 94 are probable. In total, there were 1,813 deaths (1,719 confirmed and 94 probable) and 776 people cured.

There are 293 suspected cases under investigation.

There have been 11 new confirmed cases, including 3 in Vuhovi [North Kivu], 1 in Mandima [Ituri], 1 in Mambasa [Ituri], 1 in Kalunguta [North Kivu] and 1 in Nyiragongo (Goma, [North Kivu].

There are 10 new deaths of confirmed cases, including 2 community deaths: -- 1 in Beni [North Kivu] and 1 in Mandima; 6 ETC deaths -- 3 in Beni, 2 in Mabalako and 1 in Butembo; 2 deaths at the CT of Beni.

July 26, 2019

United States: E. coli

Three people have been confirmed to have E. coli in Westminster, Col.; all ate at the same Westminster Red Robin. Two of them were hospitalized.

According to a news release from the Tri-County Health Department, the restaurant closed voluntarily for cleaning and sanitizing, food safety training for employees, and testing for employees who handle the food.

One adult and 2 children tested positive for the bacteria E. coli O157:H7, and all 3 had eaten at the restaurant, according to the release. The Tri-County Health Department says none of the individuals are related to each other, and all visited the restaurant on different nights in late June 2019.

A food safety inspection showed improper employee hand washing, improper cleaning and sanitizing of food preparation surfaces, and cross-contamination between raw meat and other prepared food, according to the release. The restaurant was cited with 5 critical health violations.

Ashley Richter, communicable disease epidemiology manager at the Tri-County Health Department, said the source of the E. coli has not been determined, but the Tri-County Health Department and the Colorado Department of Public Health and Environment are investigating the outbreak.

The departments ask people to contact their doctors or healthcare providers if they ate at that Red Robin since June 1 and developed an illness within 10 days of eating at the restaurant.

Northern Ireland: African Swine Fever

Traces of African swine fever (ASF) virus have been found in meat that was brought into Northern Ireland illegally by passengers in the month of June [2019].

In total, airport authorities seized over 300 kg [661 lb] of illegal meat in June. The Northern Irish Department of Agriculture, Environment and Rural Affairs (DAERA) said a sample of these seizures was tested at the Agri-Food and Biosciences Institute (AFBI), resulting in the detection of ASF virus DNA fragments. A DAERA spokesman confirmed: "DNA fragments of ASF were detected in a sausage from Asia."

DAERA said that while this type of discovery in itself does not pose a significant threat to the animal health status of Northern Ireland, nor does it affect the disease-free status from ASF, it does reinforce the importance of the controls on personal imports of meat and dairy products enforced by DAERA officials.

DAERA chief veterinary officer Dr. Robert Huey warned that it is illegal to bring certain food and plant products back into the country to avoid the risks of importing animal or plant disease. "I make no excuses for repeating this message," he said. "The greatest risk is to our agri-food industry and our environment, as any introduction of pests, diseases, and non-native species can have a potentially devastating impact."

DAERA warnings are clear at points of entry into Northern Ireland. They emphasize that meat and dairy products should not be brought into Northern Ireland in passenger's luggage, as such items may be seized by portal inspection branch staff at local ports and airports.

Kenya: Anthrax

One person has died of suspected anthrax and another is hospitalized in Kisumu, officials say. The disease was reported in Mowlem, Kisumu County government said in a statement released July 12.

"We have cases of suspected anthrax in the county. Two people were admitted to the hospital Thursday, and one has since died," Dr. Jonathan Billis, health officer in Kisumu Central Sub-county, said.

Dr. Billis called on all health workers in the county to be on high alert for patients exhibiting symptoms such as sores, swellings, nausea, vomiting, and abdominal pains. He urged locals to watch out for signs and symptoms, including face inflammation, breathing problems, and unexplained wounds.

Anthrax is caused by Bacillus anthracis bacterium. It affects livestock, wild animals, and humans and can kill within 24 hours.

Ireland: E. coli

A total of 16 children have been diagnosed with the bacterial infection, and concerns have been raised that tourists may spread it further, RUV [the Icelandic National Broadcasting Service] reports. The outbreak is purported to have originated in Efstadal 2, a farm and restaurant near Laugarvatn, after a group of schoolchildren visited the place, with some of them contracting Escherichia coli infection. To be clear: none of the food nor any of the employees tested positive for E. coli. Rather, it is all but certain the bacteria originated from the fecal matter of calves on the farm.

Health authorities have pointed out that there are many rural restaurants in Iceland that are located near farms, prompting a more thorough investigation into stopping the infection's spread. Further, these locations are visited by many tourists, which could potentially increase the risk of spreading E. coli. As it stands now, Efstadal 2 is [said to be] safe to visit; the cow sties have been quarantined and the restaurant is clean.

India: Japanese Encephalitis

With the death of 5 more patients on July 14, the toll in Japanese encephalitis (JE) cases in Assam rose to 76, a National Health Mission (NHM) bulletin stated. The registered positive JE cases across the state also increased to 348 from 334 on July 12. The 5 deaths were reported from Darrang, Nalbari, Tinsukia, Kamrup and Udalguri districts, the bulletin said.

Giving the cumulative figures for JE/AES (acute encephalitis syndrome), the bulletin said there [had been] 1,350 such cases since January, with 177 deaths.

Measures to control the mosquito-borne disease that affects the brain continued to be taken across the state, which is currently undergoing a transmission season for JE, NHM sources said. Health minister Dr Himanta Biswa Sarma has said the emergency measures taken to combat the JE/AES situation would exist till Sept. 30. Union health minister Harsh Vardhan had dispatched a central team to review the situation in the state. The health minister also said that his ministry is providing all logistical and technical support to the state government in terms of surveillance and diagnostic kits to strengthen their efforts in addressing JE.

Noting that community participation and empowerment are the most crucial in JE prevention, Vardhan urged all the stakeholders to start rigorous awareness campaigns regarding the preventive steps to be taken by the communities. For rehabilitation of JE-disabled patients, the central government has provided funds for the strengthening of 2 physical medicine and rehabilitation departments at Dibrugarh Medical College and Guwahati Medical College.

Congo: Ebola

The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated July 14:

Since the beginning of the epidemic, the number of accumulated cases is 2,501, including 2,407 confirmed and 94 probable. In total, there have been 1,668 deaths (1,574 in confirmed and 94 in probable cases) and 700 cases have recovered.

There are 292 suspected cases under investigation.

United States: Vesicular Stomatitis

The Colorado Department of Agriculture [CDA] has confirmed more cases of vesicular stomatitis (VSV) in La Plata, Larimer, and Weld counties. The Colorado State University Veterinary Diagnostic Laboratory in Fort Collins has been activated through the National Animal Health Laboratory Network (NAHLN) to receive and test samples for VSV suspect horses.

The total count of premises under quarantine for VSV by county is 2 in La Plata County, 5 in Larimer County, and 8 in Weld County. None of the animals in quarantine have yet been released.

"Horse and livestock owners should check with their veterinarian prior to traveling to another state," said Colorado state veterinarian Dr. Keith Roehr. "Many states have imposed import requirements for animals coming from VSV-affected states."

The first case of VSV in Colorado was reported on  July 3 in Weld County by a field veterinarian from the State Veterinarian's Office at the Colorado Department of Agriculture. An incursion of VSV-infected insect vectors is the likely source of infection. There are no USDA-approved vaccines for VSV.

Iran: Crimean Congo Hemorrhagic Fever

The Crimean-Congo hemorrhagic fever (CCHF) virus has been the cause of 100-plus human infections in Iran annually since it was first reported about a decade ago. Sine March, the Ministry of Health has reported 54 CCHF cases, including 5 deaths, The Tehran Times reports.

Behzad Amiri, head of zoonotic diseases department at the Ministry of Health noted the disease incidence is especially high over warm seasons because the ticks become more active. According to WHO, CCHF is a widespread disease caused by a tickborne virus Nairovirus of the Bunyaviridae family. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40%.

July 19, 2019

United States: E. coli

Three people have been confirmed to have E. coli in Westminster, Col.; all ate at the same Westminster Red Robin. Two of them were hospitalized.

According to a news release from the Tri-County Health Department, the restaurant closed voluntarily for cleaning and sanitizing, food safety training for employees, and testing for employees who handle the food.

One adult and 2 children tested positive for the bacteria E. coli O157:H7, and all 3 had eaten at the restaurant, according to the release. The Tri-County Health Department says none of the individuals are related to each other, and all visited the restaurant on different nights in late June 2019.

A food safety inspection showed improper employee hand washing, improper cleaning and sanitizing of food preparation surfaces, and cross-contamination between raw meat and other prepared food, according to the release. The restaurant was cited with 5 critical health violations.

Ashley Richter, communicable disease epidemiology manager at the Tri-County Health Department, said the source of the E. coli has not been determined, but the Tri-County Health Department and the Colorado Department of Public Health and Environment are investigating the outbreak.

The departments ask people to contact their doctors or healthcare providers if they ate at that Red Robin since June 1 and developed an illness within 10 days of eating at the restaurant.

Northern Ireland: African Swine Fever

Traces of African swine fever (ASF) virus have been found in meat that was brought into Northern Ireland illegally by passengers in the month of June [2019].

In total, airport authorities seized over 300 kg [661 lb] of illegal meat in June. The Northern Irish Department of Agriculture, Environment and Rural Affairs (DAERA) said a sample of these seizures was tested at the Agri-Food and Biosciences Institute (AFBI), resulting in the detection of ASF virus DNA fragments. A DAERA spokesman confirmed: "DNA fragments of ASF were detected in a sausage from Asia."

DAERA said that while this type of discovery in itself does not pose a significant threat to the animal health status of Northern Ireland, nor does it affect the disease-free status from ASF, it does reinforce the importance of the controls on personal imports of meat and dairy products enforced by DAERA officials.

DAERA chief veterinary officer Dr. Robert Huey warned that it is illegal to bring certain food and plant products back into the country to avoid the risks of importing animal or plant disease. "I make no excuses for repeating this message," he said. "The greatest risk is to our agri-food industry and our environment, as any introduction of pests, diseases, and non-native species can have a potentially devastating impact."

DAERA warnings are clear at points of entry into Northern Ireland. They emphasize that meat and dairy products should not be brought into Northern Ireland in passenger's luggage, as such items may be seized by portal inspection branch staff at local ports and airports.

Kenya: Anthrax

One person has died of suspected anthrax and another is hospitalized in Kisumu, officials say. The disease was reported in Mowlem, Kisumu County government said in a statement released July 12.

"We have cases of suspected anthrax in the county. Two people were admitted to the hospital Thursday, and one has since died," Dr. Jonathan Billis, health officer in Kisumu Central Sub-county, said.

Dr. Billis called on all health workers in the county to be on high alert for patients exhibiting symptoms such as sores, swellings, nausea, vomiting, and abdominal pains. He urged locals to watch out for signs and symptoms, including face inflammation, breathing problems, and unexplained wounds.

Anthrax is caused by Bacillus anthracis bacterium. It affects livestock, wild animals, and humans and can kill within 24 hours.

Ireland: E. coli

A total of 16 children have been diagnosed with the bacterial infection, and concerns have been raised that tourists may spread it further, RUV [the Icelandic National Broadcasting Service] reports. The outbreak is purported to have originated in Efstadal 2, a farm and restaurant near Laugarvatn, after a group of schoolchildren visited the place, with some of them contracting Escherichia coli infection. To be clear: none of the food nor any of the employees tested positive for E. coli. Rather, it is all but certain the bacteria originated from the fecal matter of calves on the farm.

Health authorities have pointed out that there are many rural restaurants in Iceland that are located near farms, prompting a more thorough investigation into stopping the infection's spread. Further, these locations are visited by many tourists, which could potentially increase the risk of spreading E. coli. As it stands now, Efstadal 2 is [said to be] safe to visit; the cow sties have been quarantined and the restaurant is clean.

India: Japanese Encephalitis

With the death of 5 more patients on July 14, the toll in Japanese encephalitis (JE) cases in Assam rose to 76, a National Health Mission (NHM) bulletin stated. The registered positive JE cases across the state also increased to 348 from 334 on July 12. The 5 deaths were reported from Darrang, Nalbari, Tinsukia, Kamrup and Udalguri districts, the bulletin said.

Giving the cumulative figures for JE/AES (acute encephalitis syndrome), the bulletin said there [had been] 1,350 such cases since January, with 177 deaths.

Measures to control the mosquito-borne disease that affects the brain continued to be taken across the state, which is currently undergoing a transmission season for JE, NHM sources said. Health minister Dr Himanta Biswa Sarma has said the emergency measures taken to combat the JE/AES situation would exist till Sept. 30. Union health minister Harsh Vardhan had dispatched a central team to review the situation in the state. The health minister also said that his ministry is providing all logistical and technical support to the state government in terms of surveillance and diagnostic kits to strengthen their efforts in addressing JE.

Noting that community participation and empowerment are the most crucial in JE prevention, Vardhan urged all the stakeholders to start rigorous awareness campaigns regarding the preventive steps to be taken by the communities. For rehabilitation of JE-disabled patients, the central government has provided funds for the strengthening of 2 physical medicine and rehabilitation departments at Dibrugarh Medical College and Guwahati Medical College.

Congo: Ebola

The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated July 14:

Since the beginning of the epidemic, the number of accumulated cases is 2,501, including 2,407 confirmed and 94 probable. In total, there have been 1,668 deaths (1,574 in confirmed and 94 in probable cases) and 700 cases have recovered.

There are 292 suspected cases under investigation.

United States: Vesicular Stomatitis

The Colorado Department of Agriculture [CDA] has confirmed more cases of vesicular stomatitis (VSV) in La Plata, Larimer, and Weld counties. The Colorado State University Veterinary Diagnostic Laboratory in Fort Collins has been activated through the National Animal Health Laboratory Network (NAHLN) to receive and test samples for VSV suspect horses.

The total count of premises under quarantine for VSV by county is 2 in La Plata County, 5 in Larimer County, and 8 in Weld County. None of the animals in quarantine have yet been released.

"Horse and livestock owners should check with their veterinarian prior to traveling to another state," said Colorado state veterinarian Dr. Keith Roehr. "Many states have imposed import requirements for animals coming from VSV-affected states."

The first case of VSV in Colorado was reported on  July 3 in Weld County by a field veterinarian from the State Veterinarian's Office at the Colorado Department of Agriculture. An incursion of VSV-infected insect vectors is the likely source of infection. There are no USDA-approved vaccines for VSV.

Iran: Crimean Congo Hemorrhagic Fever

The Crimean-Congo hemorrhagic fever (CCHF) virus has been the cause of 100-plus human infections in Iran annually since it was first reported about a decade ago. Sine March, the Ministry of Health has reported 54 CCHF cases, including 5 deaths, The Tehran Times reports.

Behzad Amiri, head of zoonotic diseases department at the Ministry of Health noted the disease incidence is especially high over warm seasons because the ticks become more active. According to WHO, CCHF is a widespread disease caused by a tickborne virus Nairovirus of the Bunyaviridae family. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40%.


July 5, 2019

India: Japanese Encephalitis

The National Health Mission said 45 people have died since the outbreak of Japanese encephalitis in Assam.

Most of upper Assam districts, including Jorhat, Golaghat, Dibrugarh, Lakhimpur, and the lower Assam district of Kamrup have been affected by the mosquito-borne disease.

"Assam is undergoing the transmission season for Japanese encephalitis cases. A total number of 45 Japanese encephalitis deaths have been reported, in the state," the National Health Mission (NHM) said in a statement.

It, however, said the situation in the state is under close watch and all preventive measures are being taken to combat the situation.

Diagnostic services for Japanese encephalitis with ELISA kits have been made available in all district hospitals and government medical college hospitals, awareness programs intensified, and fogging operations stepped up in areas from where Japanese encephalitis cases have been reported.

The NHM also said that free transportation is being provided to patients with suspected JE fever through 'Mrintunjoy 108 Ambulances'.

The Assam government is ensuring that treatment and diagnostic cost at medical colleges and district hospitals are borne by the state while a certain number of beds there have been reserved for Japanese encephalitis patients.

A round-the-clock central control room has been opened to deal with and monitor the situation and all deputy commissioners have been directed to step up surveillance activities.

Bolivia: Bolivian Hemorrhagic Fever

In 2019, a small outbreak of Bolivian hemorrhagic fever was reported at a hospital in La Paz. The following background data on Bolivian hemorrhagic fever are abstracted from Gideon www.GideonOnline.com and the Gideon e-book.

Bolivian hemorrhagic fever (BHF) is caused by Machupo virus (Arenaviridae, Tacaribe complex, Mammarenavirus). The disease was initially described in 1959 as a sporadic hemorrhagic illness in rural areas of Beni department, eastern Bolivia, and the virus itself was first identified in 1963. BHF is most common during April to July in the upper savanna region of Beni. Principal exposure occurs through rodents ([the large vesper mouse] Calomys callosus), which enter homes in endemic areas.

BHF is one of several human Arenavirus diseases reported in the Americas: Argentine hemorrhagic fever (Junin virus), Brazilian hemorrhagic fever (Sabia virus), lymphocytic choriomeningitis, Venezuelan hemorrhagic fever (Guanarito virus) and Whitewater Arroyo virus infection.

Infection of C. callosus results in asymptomatic viral shedding in saliva, urine, and feces; 50% of experimentally infected C. callosus are chronically viremic and shed virus in their bodily excretions or secretions. C. callosus acquires the virus after birth, and start shedding it through their urine and saliva while suckling. When mice acquire the virus as adults, they may develop immunity and no longer shed the virus.

Although the infectious dose of Machupo virus in humans is unknown, exposed persons may become infected by inhaling virus in aerosolized secretions or excretions of infected rodents, ingestion of food contaminated with rodent excreta, or by direct contact of excreta with abraded skin or oropharyngeal mucous membranes. Nosocomial and human-to-human spread have been documented. Hospital contact with a patient has resulted in person-to-person spread of Machupo virus to nursing and pathology laboratory staff.

Canada: Equine Infectious Anemia

An equine infectious anemia (EIA)-affected premises has been identified in the province of Alberta. On June 28, a positive EIA result was confirmed by the Canadian Food Inspection Agency (CFIA) national reference laboratory for a horse located on a premises in the County of St. Paul, in the province of Alberta.

The horse had been sampled by an accredited veterinarian because it was exhibiting clinical signs compatible with EIA infection. A CFIA investigation is underway and as per program policy, a quarantine has been placed on the infected horse and its on-premises contact animals. Initial reports indicate there are several equines on the affected premises.

The quarantine will remain until all disease response activities have been completed, including follow-up testing and ordering the destruction of positive cases. Trace-out activities may require the CFIA to undertake actions at additional premises as outlined in the current policy.

Zambia: Trypanosomiasis

A 19-year-old German woman was diagnosed with East African trypanosomiasis during a stay in Zambia.

The patient had been working since August 2018 in a school project close to Kabwe. From May 29 to June 4 she visited South Luangwa National Park. On May 31, she received a mildly painful insect bite on her calf during an afternoon game-viewing drive from Kafunta River Lodge.

She recalled seeing numerous tsetse flies during this drive but was told there had not been any cases of trypanosomiasis for years in this area. The bite initially healed well and she returned to Kabwe.

On the evening of June 11, she developed high fever, rigors, and severe headache. The site of the insect bite on her calf was swollen and showed livid discoloration. Several point-of-care tests for malaria were negative.

Antibiotic treatment at a local hospital led to no improvement of her symptoms. On June 16 she was admitted to Lusaka Coptic Hospital where African trypanosomiasis was diagnosed by blood microscopy. Central nervous system involvement was ruled out by spinal tap, and treatment with suramin was started on June 17. The patient returned in stable condition to Germany on July 2 where she sought further treatment and follow-up.

Bulgaria: African Swine Fever

The Bulgarian Food Safety Agency on July 5 confirmed a second outbreak of African swine fever [ASF] in domestic pigs in 3 days, and the third since 2018.

The disease was located in a backyard pig farm in the village of Novachene near the Danube River, only 16 km southeast of the village of Zhernov, where the previous case was confirmed, the agency said in a statement.

The BFSA took the necessary measures for the control and eradication of the disease according to the European and national legislation, the statement said.

Earlier on July 5, at a meeting of the Management Board of the State Fund Agriculture, the country's Minister of Agriculture, Food and Forestry, Desislava Taneva, called for rigorous implementation of prevention and control measures.

According to Taneva, this is a very dangerous disease that spreads quickly and easily; "there is no cure and vaccine for it, and the economic losses are enormous.''

The first outbreak of African swine fever in domestic pigs in Bulgaria was confirmed last August in the village of Tutrakantsi, some 250 km southeast of Novachene.

United States: Vesicular Stomatitis Virus

The Colorado Department of Agriculture reported that on July 3 the National Veterinary Services Laboratory reported positive test results for vesicular stomatitis virus on samples submitted from 2 horses in Weld County.

The 2 horses reside on separate locations in Weld County, and they both have been placed under quarantine. Both premises are private residences with horses as the only livestock species present.

The initial Colorado disease investigation was completed by a field veterinarian from the State Veterinarian's Office at the Colorado Department of Agriculture.

The index premises has one horse presenting with lesions on his sheath and no history of recent movements on or off the premises.

The subsequent positive premises has one of 3 horses presenting with lip and tongue lesions, and the only history of movement off the property was pleasure riding near the home premises 2 weeks prior to onset.

There are no additional animals at either location currently showing clinical signs of vesicular stomatitis.

Both premises are under state quarantine and will remain so until at least 14 days from the onset of lesions in the last affected animal on the premises.

Bolivia: Hantavirus

The Villa Montes municipal health technician, Samuel Quintasi, stated that a person from a rural area contracted a hantavirus infection and was sent to a third level hospital, although he did not specify whether it was in Tarija or in Santa Cruz del la Sierra.

Due to timely medical attention for the patient, this individual is in stable condition and has been released from the hospital with recommendations to avoid new infection on returning home.

"Health personnel have visited the area, where we are carrying out epidemiological surveillance," the municipal official explained.

Hantavirus infection causes an emerging zoonotic disease that is transmitted by rodents, including mice and rats. The disease is characterized by presentation of fever, muscle pain, and gastrointestinal disturbance, followed by the beginning of respiratory difficulty and hypotension.

Cases of hantavirus infection in humans in general occur in rural areas where one can encounter rodents that have the virus, but transmission is also possible in urban areas.

United States: White Nose Syndrome

For the first time, an invasive fungus that causes a deadly bat disease has been detected in California.

White-nose syndrome, one of the most consequential wildlife diseases of modern times, has killed more than 6 million bats in North America since it was first discovered in New York in 2006.

The disease, which has devastated bat populations in Pennsylvania, New York, and elsewhere in the Northeast, is caused by the fungus Pseudogymnoascus destructans. It is not known to be harmful to people or common house pets.

Environmental officials discovered low levels of the fungus in samples collected from little brown bats, a common hibernating species, in the Plumas County town of Chester, about 65 miles northeast of Chico. Four bats have been found with traces of the fungus, one in 2018 and 3 this year.

"We decided, 2 years in a row, even though they are low-level detection, we ought to call it. The fungus is here," said Scott Osborn, a senior environmental scientist with the California Department of Fish and Wildlife.

White-nose syndrome is a fungal infection that grows on the skin of bats while they hibernate. Osborn describes it as an "all-body case of athlete's foot." The infection irritates the bats, waking them from what should be a deep slumber.

They then use up their stored energy by grooming themselves. Because it's winter, most of the bugs and insects that make up their food supply aren't available, and the bats can't replenish themselves. They die of starvation.

Latvia: African Swine Fever

This year's first African swine fever  infection for domestic pigs has been registered in Latvia. The illness was uncovered in an enclosure in Durbe Parish, Vecpils County. A total of 49 pigs have been killed to halt the spread of the disease, as reported by Food and Veterinary Service.

The affected farm has been put under quarantine - a protection zone in a 3 km radius and an observation zone in a 10 km radius around it. All other enclosures in this area will be put under intense supervision for compliance with bio-security measures. Transportation of pigs and pork to and from this area will be put under increased control as well.

United States: Anthrax

Since June 19, the Texas Animal Health Commission (TAHC) has received confirmation of 3 additional anthrax cases in the area of Texas where anthrax is historically found. The first anthrax case of the year was confirmed in one captive antelope on a premises in Uvalde County on June 19. Since that time, anthrax was confirmed in goats on a new Uvalde County premises on June 24, one Sutton County horse was confirmed to have anthrax on July 3, and cattle were confirmed to have anthrax on a separate Sutton County premises on July 4.

All of the premises have been placed under quarantine, and producers were advised on vaccinating exposed animals and the proper disposal of affected carcasses, as outlined by TAHC's rules. Typically, quarantines are lifted 10 days from vaccination or the last death loss.

"It is common to see an increase in anthrax cases after periods of wet, cool weather, followed by hot, dry conditions," said Dr. Andy Schwartz, TAHC Executive Director. "During these conditions, animals ingest the anthrax bacteria when they consume contaminated grass and hay, or inhale the spores. Outbreaks usually end when cooler weather arrives."

Australia: Leptospirosis

At least 50 people have contracted a highly-contagious and potentially life-threatening disease spread through rat urine.

Leptospirosis is a bacterial disease having already claimed the lives of 7 dogs in the last year in inner-Sydney, New South Wales [NSW], but experts said it's now infecting people, Daily Telegraph reported.

University of Sydney professor of veterinary microbiology and infectious diseases Jacqueline Norris said the disease is 'shed out in the urine' and spreads easily from animals to humans.

'We haven't seen this disease in New South Wales in decades so it's a high likelihood there's a common environmental source,' she said.

'You can get direct contact, so directly splashed urine into a mucosal surface like your eye, mouth, or skin. But most frequently it's accessing the same external indirect surface, so out in the environment.'

Symptoms in humans vary, and can range from mild headaches to blood in the urine and skin hemorrhages.

Data from the National Notifiable Disease Surveillance System showed there have been 50 cases of leptospirosis this year and 144 last year, with most cases originating in Queensland, as the bacteria thrives in warm and humid climates.

A NSW Health spokeswoman said most cases reported are from regional areas 'often in association with floods or mouse plagues'.

'The most effective way to prevent any transmission from infected pets or another source of the infection to humans is for people to wash their hands with soap after touching animals,' she said.

'Keep cuts and scratches covered when there is a chance they could come in contact with animal urine.'

United States: West Nile Virus

Iowa Department of Agriculture and Land Stewardship State Veterinarian Jeff Kaisand has confirmed 2 cases of West Nile virus (WNV) have been detected in horses living in the southern part of the state. These are the first confirmed cases of WNV in Iowa horses this year [2019].

The Equine Disease Communication Center (EDCC) reported last week that cases were confirmed in Davis and Union counties.

In Davis county, a 15-year-old thoroughbred mare began displaying clinical signs, including hind-limb ataxia and muscle fasciculations on June 24, the EDCC said. Diagnostic testing confirmed WNV on June 28.

"The horse is being treated and reported (to be) recovering," the EDCC said. "The mare was not vaccinated for WNV this year but has a history of vaccination 2 years ago."

In Union county, a 2-year old quarter horse gelding in Union county tested positive for WNV on June 19. The gelding was displaying mild clinical signs and had no history of vaccination against WNV.

Vietnam: African Swine Fever

African swine fever (ASF) has hit Vietnam's southern Tay Ninh province, Vietnam News Agency reported on July 7.

A herd of 16 pigs raised by a household in Tay Ninh's Chau Thanh district have been tested positive to ASF virus, and then culled to prevent the disease from spreading.

ASF has spread to almost all cities and provinces across Viet Nam, leading to the culling of over 2.84 million pigs or 10.3 percent of the country's total pig population.

Vietnam will focus on developing cattle, poultry, and aquatic breeding to compensate for a shortage of pork which is expected to hit the country this year due to ASF, its Ministry of Agriculture and Rural Development said late last month.

Vietnam reported the first ASF outbreak in February in northern Hung Yen province.

ASF is a severe viral disease affecting domestic pigs and boars which can be spread by live or dead pigs and pork products. The ASF virus is harmless to humans, but causes hemorrhagic fever in pigs and wild boars that is almost fatal.

Belgium: African Swine Fever

For the first time, Belgium has reported a week without new cases of African swine fever (ASF) in its wild boar population. That was shown in the latest report to the World Organization for Animal Health (OIE).

Ever since mid-May the total number of infected animals had been relatively low. Over the whole of June, only 8 infected wild boar were found in Belgium's province of Luxembourg -- the lowest monthly score since the virus was discovered in September 2018. The total number of infected wild boar therefore remains 824. In total, 799 were found dead in the forest; an additional 25 were shot dead.

About 2 weeks ago, there also was a moment when there was no news about ASF from Belgium. That was caused by the fact that there was no update on the situation in Belgium reported to the OIE. Due to the presence of the virus, however, Belgium has to give updates, irrespective of new cases being found or not. There was an update about last week -- and that one, for the 1st time, was "empty."

Belgium recently announced it started shooting the remaining wild boar in the inner zone of the infected area. In doing so, Belgium follows EU policy to keep the virus concentrated in one zone as much as possible.

A similar approach proved to be successful in the Czech Republic, where the virus, just like in Belgium, was found only in the wild boar population. In total, in the Czech Republic, 230 wild boar died of ASF in Zlin province between June 2017 and April 2018. In February, the European Commission declared the Czech Republic to be free from ASF again. In doing so, the Czechs have been the only country in recent years to have done so.

June 28, 2019

South Africa: African Horse Sickness

Across Gauteng, a total of 236 cases of African horse sickness (AHS) have been reported between between Jan. 1 and June 18, according to the Gauteng Department of Agriculture and Rural Development -- and the illness has also hit closer to home.

The historic and internationally recognized horses of the South African Lipizzaners non-profit organisation (NPO), located in Kyalami, have been affected by the virus. So far, 4 Lipizzaners have died and one has managed to survive with treatment.

The NPO is appealing to the public for donations so they can buy medication and insect repellent needed to prevent further deaths at both the venue in Kyalami and at the organization's stud farm, where females and foals are kept.

"We've lost young and old horses so far," explained Dr. Karen Bohme, who is the head rider and veterinarian for the South African Lipizzaners. "We lost 2 brood mares. We also lost 2 colts within a day of each other in late April," she added.

AHS is caused by a virus that appears seasonally in warmer weather and is transferred by biting midges, according to a statement by Steve Galane of the Department of Agriculture, Forestry and Fisheries, which receives official reports of the disease. Galane added that AHS was particularly present in the country this year due to climatic factors such as rainfall and temperature.

"In most of South Africa, except for a part of the Western Cape province, AHS is endemic and the area is known as an AHS-infected zone. Unfortunately, outbreaks of AHS are expected to occur in the AHS-infected zone from November to May, often with a peak from February to April," the statement read in part.

United States: Anthrax

The Texas Department of State Health Services is reminding Texans to avoid sick or dead wildlife after 18 recent animal deaths in Uvalde County, including 2 which were confirmed anthrax-related cases.

The first anthrax case of the year in Texas was confirmed in a captive antelope on a premises in Uvalde County on June 19 -- in a triangular area of southwest Texas where anthrax is historically found in the soil. Since then, another anthrax-related case has been confirmed, and officials reported 18 recent animal deaths.

Uganda: Ebola

The epidemiological situation of the Ebola virus disease (EVD) in the provinces of North Kivu and Ituri dated June 27:

Since the beginning of the epidemic, the cumulative number of cases is 2,297, of which 2,203 are confirmed and 94 are probable. In total, there were 1,553 deaths (1,459 confirmed and 94 probable) and 641 people recovered.

A total of 364 suspected cases are under investigation.

There have been 13 new confirmed cases, including 7 in Beni, 3 in Masereka, 1 in Mabalako, 1 in Biena and 1 in Kulunguta.

There are 13 new confirmed case deaths: 4 community deaths, including 3 in Beni and 1 in Biena; 9 deaths in Ebola treatment centers (ETCs), including 3 in Beni, 2 in Mabalako, 2 in Butembo and 2 in Katwa.

Four people recovered from ETCs, including 3 in Beni and 1 in Butembo.

India: Japanese Encephalitis

A man died on June 28 at Guwahati's Nemcare hospital where he had been undergoing treatment for Japanese encephalitis for the past 8 days. He was a resident of Guwahati's Birkuchi area.

It should be noted that this is the first death reported in the city due to the brain infection this year. However, across Assam, 10 people have died because of the disease so far, and 35 more are infected with it.

Although most of the recent cases of Japanese encephalitis (JE) and acute encephalitis syndrome (AES) have been reported from Bijar state so far this year, Assam state is also endemic for JE.

United States: E. coli

The connections between the death of a 2-year-old boy and the violent illness suffered by 3 other children earlier this month weren't at first apparent. But on June 28, public health officials zeroed in on the common denominator: all 4 tested positive for E.coli bacteria and all 4 had visited animals at the San Diego County Fair.

The discovery prompted the closure of all animal exhibits, a safety measure that will remain in effect through the remainder of the fair's 2019 run set to end July 4. While the cluster of cases has not yet been definitively linked to fair animals, in part because testing is not yet complete, the decision to shut down the public livestock exhibits, including the popular petting zoo, seemed prudent. The livestock auction, which took place in a different area and does not allow the public to have direct contact with animals, went forward as scheduled.

"We have taken this step to restrict access to animals at the fair in an abundance of caution," Dr. Eric McDonald, a county public health official, said at a news conference. "We may find, as the investigation develops, as we develop genetic fingerprints of these organisms, that these cases are not related, that these just happened to be cases that occurred during the summer when it's more common for these types of cases to occur."

Brazil: Yellow Fever

The origin of the virus responsible for the ongoing yellow fever epidemic in Brazil, the worst for 40 years, has just been identified by scientists affiliated with 2 Brazilian institutions: Adolfo Lutz Institute (IAL) and the University of Sao Paulo (USP).

By means of a molecular study of yellow fever viruses found in dead monkeys and in mosquitoes, the group discovered that the strain behind the current epidemic originated in Para state in North Brazil in 1980.

The virus infected monkeys in Para and spread from there throughout the Amazon region until it reached Venezuela and Suriname. From 2000 on, always via infection of monkeys, the disease migrated to the Center-West and Southeast of Brazil, finally reaching Sao Paulo state in 2013. The first deaths of humans in Sao Paulo occurred in 2016.

Findings of the study, which was supported by Sao Paulo Research Foundation.

The investigation was led by Mariana Sequetin Cunha, a researcher in IAL's Vector-Borne Disease Group. Scientists at the University of Sao Paulo's Tropical Medicine Institute, the Federal University of Para and the Federal University of Sao Paulo also took part. The project was also funded by Brazil's National Council for Scientific and Technological Development.

Germany: Tuberculosis

Since the beginning of 2018, the health authorities in 2 districts of Lower Saxony (LK) have frequently registered cases of tuberculosis (TB) illness among slaughterhouse workers, the Robert Koch Institute (RKI) reports

Thirteen employees had become infected and one person had died as a result of the disease. The persons infected are predominantly Romanian workers.

During 2018 and up to Feb. 28, 7 slaughterhouse workers who slaughtered and processed pigs were diagnosed with active pulmonary TB, 3 of them in September and October 2018. One of the patients died in November 2018 as a result of TB.

In the neighboring district, 6 slaughterhouse workers with active pulmonary TB who were employed in slaughterhouse B were reported since the beginning of 2018. Slaughterhouse A and B are about 40 km apart.

After the infection became public, extensive investigations by health authorities followed. Of the 96 contact persons tested at slaughterhouse A, 59 (61%) showed a positive test result. At slaughterhouse B no additional case of TB requiring treatment were detected.

United States: White Nose Syndrome

The National Park Service says the fungus that causes a deadly disease in bats has been discovered in North Dakota.

The Bismarck Tribune reports the fungus was discovered after swab testing of a bat that was captured at Knife River Indian Villages National Historic Site near Stanton.

The fungus causes white-nose syndrome, which can lead to dehydration or other conditions that kill bats.

To date, 33 states have confirmed the disease since it was found in 2006 in New York. US Fish and Wildlife Service wildlife refuge specialist Catherine Hibbard says 4 states, including North Dakota, have discovered only the fungus.

South Dakota identified the fungus and disease for the 1st time last year.

Humans can transmit the fungus but aren't affected by it. It is spread easily among bats.