Two Cases of Lymphogranuloma Venereum Reported in New York

3 February (Reuters Health)—Two New Yorkers have been diagnosed with lymphogranuloma venereum, which is rare in the region but is spreading among gay and bisexual men in Europe, the city health commissioner said.

The US Centers for Disease Control and Prevention in Atlanta has confirmed 6 recent cases in the United States, including 3 cases in San Francisco and 1 in Atlanta.

Among the cases identified thus far, most have also had HIV infection.

Most people infected report having multiple sex partners and engaging in unprotected anal intercourse and other highrisk practices, officials said.

Editor's comment. Althoughlymphogranuloma venereum is seldom seen outside of poor, tropical nations, doctors in Rotterdam, The Netherlands, reported 92 cases among gay men during a 17- month period that ended in September 2004. Isolated cases have also been reported in Belgium, France, Sweden, and Britain and in Houston, San Francisco, Atlanta, and now New York in the United States. Health care professionals should be vigilant for lymphogranuloma venereum, especially among men who have sex with men and/or individuals who have had sexual contact with persons from Europe.

New York Officials Bar Rabbi from Circumcision Ritual

3 February (Reuters Health [Larry Fine])—New York City health officials have gone to court to stop a rabbi from performing a type of ritual circumcision they believe may have led to the death of a baby boy from herpes.

The baby was 1 of 3 infants found to have contracted herpes simplex virus after being circumcised by the rabbi, who used his mouth to draw blood from the infant's wound, a traditional Orthodox practice during the bris, or religious circumcision.

The complaint filed by the department of health in Manhattan Supreme Court asked that the rabbi submit blood samples to be tested for the herpes virus and no longer engage in the specific practice until an investigation is completed.

Ten days after the rabbi circumcised twins last October, one died of herpes and the other tested positive for the virus, according to the court papers. A third baby circumcised was later found to have also tested positive for herpes, health officials said.

An affidavit submitted to the court by Dr. Susan Blank, assistant commissioner of the health department, noted that the herpes virus, which is common in adults and often causes lesions known as “fever blisters” or “cold sores” is easily transmitted but not usually a serious illness in adults. In newborn infants, however, herpes can cause severe illness and may be fatal, she said.

Low Risk to Human Health from BSE Goat Case: EU

31 January (Reuters Health [Aine Gallagher])— The world's first case of “mad cow disease” found in a goat poses only a minimal risk to human health, and the brain-wasting disease is unlikely to jump species to sheep, officials said.

The European Commission announced that a French goat slaughtered in 2002 had bovine spongiformencephalopathy (BSE), the first time the disease has been found in animals other than cattle, raising fears it could jump next to sheep.

“Sheep and goats are different species,” said Commission food safety spokesman Philip Tod. “We have tested over 1 million sheep and have yet to detect a single case.”

The Commission, the European Union's (EU's) executive arm, wants to test 200,000 goats for BSE in the next 6 months, focusing on countries that are already fighting the disease among cattle.

The EU is home to some 11.6 million goats with the largest herds in France, Greece, and Spain, primarily reared for dairy items such as milk, yogurt, and cheese, with little meat consumed.

According to the EU's food safety authority EFSA, dairy products made from goat's milk would be unlikely to pose a risk for human health if the milk came from a healthy animal.

Under EU food safety rules, milk and meat from a goat that is infected with BSE or scrapie may not be used in a food product. The same rule applies to sheep that are scrapie-positive.

Tod said the French BSE goat was reared before the full entry into force of EU rules banning the use of animal parts in feed and removing high risk material such as spinal chord, intestines, and brain from the food and feed chain.

Most goats alive now would have been born after the total feed ban entered effect in 2001, he added.

Editor's comment. Shortly after the above article was published, British sources said that a goat for which the brain-wasting disease scrapie was diagnosed in 1990 may have had mad cow disease, but up to 2 years of additional testing would be required to confirm this, because only a sliver of its brain remained. In comments about the British goat, the UK Department for the Environment, Food, and Rural Affairs Chief Veterinary Officer Debby Reynolds stated that “it is important to put this finding into context. It dates back to 1990, which was at the height of the BSE outbreak in cattle and before the reinforced feed ban was introduced. This means that there is a distinct possibility that the animal, if infected with BSE, was exposed to contaminated feed.”

US Cites Poor Water Quality on More Airliners

20 January (Reuters Health [John Crawley])— The US government has found for the second time in recent months that water from a sampling of commercial aircraft galleys and bathrooms was not safe for use.

Tests last November and December by the Environmental Protection Agency (EPA) on a fraction of the thousands of planes in the domestic and international commercial fleet found samples failed to meet government drinking water standards.

The EPA said the results of the latest testing showed the scope of the problem and reinforced the agency's decision to forge agreements with airlines to more closely monitor water systems and tighten sanitary measures.

The agreements, which include testing protocols, are not fully in place yet. They will govern drinking water safety until new regulations are devised.

Tests last summer found that 12% of 158 randomly selected aircraft operated by domestic and international carriers tested positive for coliform bacteria, which by itself may not pose a health risk. But coliform bacteria in drinking water indicates that other disease-causing organisms, or pathogens, may be present. Water on 2 planes tested last summer contained Escherichia coli.

At the time, EPA officials called the results surprising and moved to alert the public, negotiate water testing agreements with major carriers, and launch a secondround of sampling.

The latest tests last fall found that water on 17% of 169 randomly selected planes was positive for coliforms. E. coli was not found in any samples this time, the EPA said. The airlines were not identified.

The latest tests evaluated samples from galleys and bathrooms of each plane. The initial analysis was not similarly controlled. Most of the positive samples from the second test came from aircraft bathrooms, the EPA said.

An airline industry group, the Air Transport Association, pointed out the new results produced no positive results for E. coli and called the agency's testing methods outdated.

Editor's comment. Testing water from bathroom sinks is dirty pool (no pun intended). Hopefully, people know better than to drink water from a bathroom sink in which multitudes of people wash their hands. Clearly, carbonated beverages, coffee, tea, and, preferentially, wine are the drinks of choice on an airliner.

Disease Risk Still High in Indonesia's Aceh: WHO

31 January (Reuters Health [Tomi Soetjipto])— Tsunami-stricken Indonesia has escaped major disease outbreaks so far, but hundreds of thousands of people are at high risk due to poor conditions in refugee camps, the World Health Organization (WHO) said.

Health officials have feared epidemics since the December 26 disaster that may have killed 230,000 people in Aceh province and left hundreds of thousands homeless, forcing them to live in makeshift camps with poor sanitation.

United Nations officials credited a swift response to the tsunami disaster with preventing epidemics that some feared could cause a second wave of death after the tsunami, in which nearly 300,000 people died or disappeared around the Indian Ocean region.

The tsunami destroyed hospitals and medical clinics and killed doctors and nurses. Refugee camps lack enough toilets, and clean water is in short supply, keeping the risk of disease high.

People will remain at risk as long as they are not transferred to shelters with better access to health care, said Eigil Sorensen, the WHO special envoy to Indonesia.

WHO and other international health organizations have said measles and the mosquito-borne disease malaria are the most dangerous illnesses threatening the camp population in Aceh, the province at the northern tip of Sumatra island that bore the brunt of the tsunami. Measles kills more children than any other vaccinepreventable disease, according to UNICEF (United Nations Children's Fund).

Working with the Indonesian Ministry of Health, WHO has launched an intensive campaign to offer measles vaccination in Banda Aceh and surrounding areas, aiming to immunize 65,000 children by the end of this week, said Pem Namgyal, WHO medical officer for vaccine-preventable diseases.

Pools of stagnant water were a common sight in Aceh after the tsunami. Relief workers have been spraying with pesticides to hold down the mosquito population, which raised concerns about outbreaks of malaria and dengue fever.

Health officials said the most prevalent diseases found among Acehnese living in the camps were less deadly illnesses such as diarrhea, respiratory problems, and skin infections.

“These are the sort of regular illnesses found in other locations with problems of hygiene, although they are not deadly diseases, but it could potentially lead to more serious problems if there are no efforts to improve the camp conditions,” said Gunawan, deputy chief of Indonesia's Red Crescent in Aceh.

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