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Hot topics in epidemiology
Hot Topics in Epidemiology
Excerpts from Colorado Department of Public Health and
CONTENTS: 1. UPDATE - Influenza Surveillance
o Mesa County o Colorado o National 2. Reports of Pediatric Influenza-related Neurologic Illness 3. NEJM - Emergence of Ciprofloxacin-Resistant Neisseria meningitides in North America
1. UPDATE - INFLUENZA SURVEILLANCE
Mesa County
The CDPHE counts only hospitalized cases of influenza. Currently, Mesa County has 10 hospitalized influenza cases (9 - type A and 1 - type B). Surveillance of local labs shows a decrease in testing for Influenza-Like Illness (ILI) over the past few weeks. The graph below shows the current season as well as last year’s season. Colorado For the week ending March 14, influenza activity continued to be “widespread” and at approximately the same level as the previous few weeks. Hospitalizations appear to have peaked during the week ending 2/28. Sentinel laboratory positivity plateaued (without any distinct peak) between the weeks ending 2/14 and 3/7. ILI rates in the Denver metro area plateaued between the weeks ending 2/14 and 2/28. For more information during the 2008-09 influenza season, please visit CDPHE’s Influenza Su National For the week ending March 7, influenza activity in the United States remained high, but at approximately the same level as in the previous week. Thirty-five states (including CO) reported widespread influenza activity. To view the full national weekly influenza surveillance report, go to: http://www.cdc.gov/flu/weekly/fluactivity.htm 2. Reports of Pediatric Influenza-related Neurologic Illness
Pediatric Infectious Disease physicians at the Children's Hospital in Aurora, Colorado, have consulted on two recent patients presenting with fever and significant neurological symptoms. Both of these patients tested positive upon admission for Influenza type B.
The first patient was a 6-year-old female who presented to the emergency department with a history of URI symptoms, sudden deterioration in mental status and fever. A MRI revealed marked abnormality in deep white matter, thalamus, posterior brainstem and cerebellar white matter consistent with acute necrotizing encephalitis, or acute disseminated encephalomyelitis. The second patient, aged 6 months, presented with fevers, URI symptoms, seizure activity and focal neurologic signs. Her MRI scan showed marked abnormality scattered throughout the white matter and thalami consistent with an infectious etiology such as multifocal encephalitis or acute disseminated encephalomyelitis. 3. NEJM - Emergence of Ciprofloxacin-Resistant Neisseria meningitides in North America We report on three cases of meningococcal disease caused by ciprofloxacin-resistant Neisseria meningitidis, one in North Dakota and two in Minnesota. The cases were caused by the same serogroup B strain. To assess local carriage of resistant N. meningitidis, we conducted a pharyngeal-carriage survey and isolated the resistant strain from one asymptomatic carrier. Sequencing of the gene encoding subunit A of DNA gyrase (gyrA) revealed a mutation associated with fluoroquinolone resistance and suggests that the resistance was acquired by means of horizontal gene transfer with the commensal N. lactamica. In susceptibility testing of invasive N. meningitidis isolates from the Active Bacterial Core surveillance system between January 2007 and January 2008, an additional ciprofloxacin-resistant isolate was found, in this case from California. Ciprofloxacin-resistant N. meningitides has emerged in North America. N Engl J Med 2009;360:886-92 (February 26, 2009) Please contact the Mesa County Health Department 24/7 Communicable Disease Reporting line with any questions at 254-4120.
FACHINFORMATION (Zusammenfassung der Merkmale des Arzneimittels) BEZEICHNUNG DES ARZNEIMITTELS Halomycetin Augensalbe QUALITATIVE UND QUANTITATIVE ZUSAMMENSETZUNG 1 g Augensalbe enthält 10 mg Chloramphenicol Die vol ständige Auflistung der sonstigen Bestandteile siehe Abschnitt 6.1. DARREICHUNGSFORM Weiße, homogene Suspensionssalbe KLINISCHE ANGABEN 4.1 Anwendungsgebie