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Undiagnosed Hemorrhagic Disease - China: (shandong), Request For Information

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  • #16
    Re: Undiagnosed Hemorrhagic Disease - China: (shandong), Request For Information

    Originally posted by rymich13 View Post
    so the call right now is that this hemorrhagic mystery disease is ecm?
    #13:
    "BEIJING -- Foreign media reports about an outbreak of Epidemic Cerebrospinal Meningitis (ECM) in Olympic co-host city Qingdao were groundless, a health official said here Friday ..."

    #12:
    "... large scale STSS outbreak among humans, Atypical PRRS in pigs ..."

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    • #17
      Re: Undiagnosed Hemorrhagic Disease - China: (shandong), Request For Information

      Frankly, I don't know why nobody from the health sector stressed MORE the WHO public relations for an deny, or aknowledgement of this fantomatic hemorrhagic illness in China.
      ___
      #1:
      "Promed
      UNDIAGNOSED HEMORRHAGIC DISEASE - CHINA: (SHANDONG), REQUEST FOR INFORMATION"

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      • #18
        Re: Undiagnosed Hemorrhagic Disease - China: (shandong), Request For Information

        There is a small possibility that this is a <i>Streptococcus suis</i> pathogen case report.

        Shandong and Sichuan (2005/1998) have some elements in common, including pig farming and feed production operations.

        "Streptococcus suis is a zoonotic microbe that can exist in pigs without causing illness but can occasionally cause disease. Serotype 2 is a dominant pathogenic serotype (1). Types 2 and 5 have been isolated from purulent lesions in the lungs and other extramammary sites in cattle, sheep, and goats (2). Infection may cause death in weaning piglets as well as growing pigs (3). The bacterium is isolated from an increasingly wide range of mammalian species, including horses, dogs, cats, and birds (4).

        Sporadic cases of S. suis infection may occur in humans, the most common clinical manifestations included purulent meningitis, septicemia, arthritis, and endocarditis; some infections lead to sequelae such as deafness and ataxia (5?7). To date, ≈200 human cases have been reported in areas of intensive pig rearing (the Netherlands, Denmark) or areas where large quantities of pork are eaten (Hong Kong, Thailand, Vietnam) (8). Most reported cases of human S. suis infections were associated with contact with pigs or pork products (5). Human S. suis infections do not normally cause major outbreaks.

        On July 11, 2005, a local hospital in Ziyang Prefecture of Sichuan Province reported a suspected case of hemorrhagic fever with renal syndrome. The patient was a 46-year-old male farmer with acute onset of high fever, lethargy, vomiting, and generalized purpura. The day before illness onset, the farmer slaughtered a pig that had died of an unknown cause. The farmer rapidly lapsed into coma. On further investigation, we identified 4 other patients with similar circumstances in the same hospital and more patients from other hospitals in the area. S. suis was isolated from blood cultures in some of these cases. We began an investigation of this outbreak to describe its epidemiologic, clinical, and microbiologic characteristics."

        See patient photo: http://www.cdc.gov/ncidod/EID/vol12n...05-1194_4t.jpg

        Quoted material from the sister publication to the one Kent cited above,
        Human Streptococcus suis Outbreak, Sichuan, China.


        Article above is cited in the correction to Kent's article:


        See also:

        Invasive Disease and Toxic Shock due to Zoonotic Streptococcus suis: An Emerging Infection in the East? Shiranee Sriskandan* and Josh D Slater.
        PLoS Med. 2006 May; 3(5): e187.

        Prevalence of Streptococcus suis Genotypes in Wild Boars of Northwestern Germany. Appl Environ Microbiol. 2007 February; 73(3): 711?717.


        Epidemiology and reported symptoms are consistent with *possible* cases of Strep suis in humans, spread by poor hospital worker hygiene OR contagious outbreak in swine spread to local pork farm operations workers. Note that the 2005 Sichuan case reports mention that multiple patients in the same hospital were discovered to have this condition (Strep suis Type 2, possibly toxic shock-like syndrome, TSLS).

        However, I also stand firm on previous comments that certain news sources deliberately manipulate casual information reports out of China for political purposes. The timing of these reports within weeks of the start of the Olympics is not coincidental. The Chinese government did NOT cover up it's medical reports of the Sichuan Strep suis human cases in 2005.

        The Chinese government monitors this website. Let us see how they respond to this thread.

        Comment


        • #19
          Re: Undiagnosed Hemorrhagic Disease - China: (shandong), Request For Information

          Thanks Oracle, I'm interested in the continuing elucidation of the STSS problem. The problem with lack of trust and transparency is certainly not limited to China. The US has multiple transparency problems. My point is more that the attribution of significant biological infectious events is often not successful if it is only done by one country. The point you make with people who would want to discredit the Chinese govt is one example. Cold war ideologies hindered many of these types of investigations. The WHO IHR was established to help deal with these. When China wouldn't let WHO or MSF or Institue Pasteur or US CDC help with the investigations of significant pathogens while an ongoing H5N1 problem was brewing doesn't lead to trust and confidence in these diagnoses.

          When a paper comes out on PRRS causing a huge problem in China and Vietnam and doesn't address influenza testing when influenza is known to be a significant swine problem on its own (with there being documented H5N1 positive cases in China) as well as a complicating factor with PRRS this also does not instill confidence. But China is certainly not alone in this lack of comprehensive testing.

          I wouldn't want to attribute any mystery disease to H5N1 without adequate lab analysis. But I think only a higher level of international cooperation will give us a better picture of what is going on as well as how to deal with it....

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          • #20
            Re: Undiagnosed Hemorrhagic Disease - China: (shandong), Request For Information

            Kent:

            Read this:


            Evolution of the core and pan-genome of Streptococcus: positive selection, recombination, and genome composition. Genome Biol. 2007; 8(5): R71.

            Noted: August 11, 2005 People's Daily, On-line edition. Short article on outbreak, noting case number.



            "The epidemic broke out in late June, first in Ziyang and Neijiang, and later spread to 10 cities including Jianyang and Chengdu, capital city of Sichuan. By August 2, 205 people in the province had contracted the disease, and 37 had died of it."

            Seasonal timing: farrowing in mid-to-late summer heat has been correlated with poor pig condition and infectious disease susceptibility in sows and piglets.

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            • #21
              Re: Undiagnosed Hemorrhagic Disease - China: (shandong), Request For Information

              From Oracle ref.

              Conclusion
              Recombination is an important evolutionary force in shaping Streptococcus genomes, not only in the acquisition of significant portions of the genome as lineage specific loci, but also in facilitating rapid evolution of the core-genome. Positive selection, although undoubtedly a slower process, has nonetheless played an important role in adaptation of the core-genome of different Streptococcus species to different hosts.
              Articles from Genome Biology

              Comment


              • #22
                Re: Undiagnosed Hemorrhagic Disease - China: (shandong), Request For Information

                Thanks Oracle and Snowy, much appreciated...

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