http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6042a4.htm?s_cid=mm6042a4_e&source=govdelivery

Notes from the Field: Outbreaks of Rotavirus Gastroenteritis Among Elderly Adults in Two Retirement Communities — Illinois, 2011

WeeklyOctober 28, 2011 / 60(42);1456-1456

In February 2011, three residents of a retirement community in Illinois were hospitalized for acute gastroenteritis. The admitting physicians ordered testing of stool specimens for several pathogens, including rotavirus. The hospital laboratory detected rotavirus antigen in specimens from each patient, and the hospital infection control practitioner reported that information to the Cook County Department of Public Health. Two additional residents were hospitalized for rotavirus gastroenteritis shortly thereafter. The health department sent stool specimens from the five patients to CDC for testing for rotavirus and norovirus. Rotavirus was detected in each specimen; norovirus was not detected. During a subsequent investigation, all available residents were queried regarding recent diarrheal symptoms. Preliminary data indicated that 22% of residents had confirmed or probable rotavirus disease and 10 residents were hospitalized. In May 2011, another outbreak of rotavirus gastroenteritis was detected at a second retirement community in the county. On preliminary analysis, the overall attack rate in the second retirement community was 11%, and 20 residents were hospitalized. No deaths were identified in either outbreak. Based on preliminary results of the investigations and general knowledge of rotavirus transmission, within each community, rotavirus likely was transmitted from person to person via contaminated hands or fomites (e.g., environmental surfaces). The outbreaks lasted ≥4 weeks.

Rotavirus is well recognized as a major cause of severe gastroenteritis in young children. Rotavirus also can cause gastroenteritis in adults (1), but estimates of the disease burden are imprecise because rotavirus testing of adults rarely is performed. The extent to which rotavirus outbreaks occur among elderly adults in residential facilities (e.g., retirement communities and assisted living facilities) in the United States (2,3) also is unknown because rotavirus testing usually is not performed during outbreak investigations of diarrheal disease in these settings and rotavirus outbreaks are not nationally reportable. Norovirus, however, frequently has been reported as a cause of diarrhea outbreaks among elderly persons in assisted living or long-term–care facilities. From 1998 to 2000, CDC screened specimens from 263 gastroenteritis outbreaks (not restricted to outbreaks among elderly adults). Specimens from all but 32 (12%) of those outbreaks tested positive for norovirus, and rotavirus was identified as the causative agent in three of the remaining 32 outbreaks (1% of the overall 263 outbreaks) (3).

Health professionals who care for elderly persons in residential facilities or who investigate diarrheal disease outbreaks should consider rotavirus as a possible cause of acute diarrhea, especially during the months when rotavirus circulates (usually January to June). If an outbreak of rotavirus gastroenteritis is identified, good hand hygiene practices among residents and staff members should be reinforced. Environmental surfaces should be disinfected using a freshly made solution of 1 part household bleach to 2 parts water (providing approximately 20,000 ppm of free chlorine) or another product that has confirmed virucidal activity against rotavirus (4,5). Surfaces visibly contaminated with fecal material should be cleaned to remove the material and then disinfected. CDC is gathering information about rotavirus outbreaks among elderly adults in residential facilities. State and local public health agencies involved in these investigations of suspected or confirmed rotavirus outbreaks are encouraged to contact the CDC’s Division of Viral Diseases at 404-639-8253 begin_of_the_skype_highlighting 404-639-8253 end_of_the_skype_highlighting.

References

1. Anderson EJ, Weber SG. Rotavirus infection in adults. Lancet Infect Dis 2004;4:91–9.
2. Edmonson LM, Ebbert JO, Evans JM. Report of a rotavirus outbreak in an adult nursing home population. J Am Med Dir Assoc 2000;1:175–9.
3. Griffin DD, Fletcher M, Levy ME, et al. Outbreaks of adult gastroenteritis traced to a single genotype of rotavirus. J Infect Dis 2002;185:1502–5.
4. Rao GG. Control of outbreaks in viral diarrhoea in hospitals—a practical approach. J Hosp Infect 1995;30:1–6.
5. Springthorpe VS, Grenier JL, Lloyd-Evans N, Sattar SA. Chemical disinfection of human rotaviruses: efficacy of commercially available products in suspension tests. J Hyg (Lond) 1986;97:139–61.

http://www.medicalnewstoday.com/articles/236627.php

MNT

“….The newer kinds of pills, which contain the progestin hormones drospirenone, desogestrel, or gestodene along with estrogen, doubled the risk again, making it six to seven times as high as women who weren’t using hormonal forms of birth control. On average, roughly 10 out of 10,000 women taking newer kinds of birth control pills had venous thromboembolism within a year.

The study which is probably going to trouble doctors, patients and drug companies alike, was published in BMJ, just as the FDA is reviewing the safety of newer birth control pills. The FDA birth control investigation was announced in May 2011 and is scheduled to be finished shortly……”

http://www.usaid.gov/press/releases/2011/ps111018.html

FOR IMMEDIATE RELEASE
October 18, 2011
Public Information: 202-712-4810
www.usaid.gov

SEATTLE, WA. – Dr. Rajiv Shah, Administrator of the U.S. Agency for International Development (USAID), issued the following statement on behalf of the United States at the Bill and Melinda Gates Malaria Forum.

“At USAID, we welcome the initial news of the Phase 3 efficacy trial published today confirming the RTS,S malaria vaccine is safe and effective. The vaccine, as a new addition to our present package malaria control interventions, could result in further major reductions in severe malaria cases and deaths. RTS,S as a first generation vaccine is an important first step in collaborative efforts to develop the next generation of even more effective vaccines.

An effective vaccine is a critical component of an integrated approach to malaria control, and USAID remains committed to supporting their development.

Over the past five years, global action to combat malaria has saved an estimated 1.1 million lives in sub-Saharan Africa. African countries are now poised to achieve the first great humanitarian victory of the 21st century—near zero child deaths from malaria. To do so we will need the collaboration of all stakeholders at all levels.

The United States is committed to supporting historic gains against child mortality. This catalytic effort will build on the success and platforms of the Presidents Malaria Initiative, PEPFAR, and the Global Health Initiative, saving lives of mothers and children from a preventable and curable disease that once ravaged our own nation and creating an important legacy for this Administration. These efforts will also create a generation of healthy children who have the opportunity now to benefit from education, lead productive lives, and contribute to their countries’ development.

At a technical level, the United States will work through PMI and the Global Health Initiative to accelerate ending malaria as a major public health problem across sub-Saharan Africa by intensifying current control efforts and extending the reach of malaria interventions to under-served populations in the most highly affected countries.

This work includes scaling up existing efforts and accelerating the delivery of critical, cost-effective health services by integrating and expanding facility and community-based health care service delivery. We can save millions of lives by supporting community case management and scaling up approaches for the diagnosis and treatment of malaria, pneumonia, diarrhea and malnutrition, including community-based distribution of Vitamin A and deworming tablets.

The United States Government is totally committed to the fight against malaria and will continue to work with partners to achieve the goal of removing malaria as a public health burden.

http://www.dhmh.state.md.us/pressreleases/2011/pr101211.html

Maryland Department of Health and Mental Hygiene, Press Release

10/12/11

Ocean City, MD (October 12, 2011) – Maryland Department of Health and Mental Hygiene (DHMH) Laboratories Administration testing confirmed the presence of Legionella bacteria in water collected at the Plim Plaza Hotel in Ocean City, Maryland. Legionella pneumophila, the bacteria that cause Legionnaires’ disease, was detected in water collected from various locations at the hotel.

An ongoing investigation by the Worcester County Health Department and DHMH has identified three additional cases of Legionnaires’ disease in people who had stayed at the hotel. This is in addition to the three cases announced by the health department last week, for a total of six confirmed cases. One person, an elderly out-of-state resident, died. The Worcester County Health Department and DHMH continue to work with the Plim Plaza Hotel management to investigate this situation.

Legionnaires’ disease, also called legionellosis, is a form of pneumonia caused by inhaling mist or vapor from water containing the Legionella bacteria. People may develop the disease approximately two to 14 days following exposure to the bacteria.

Although the hotel is currently closed for the season, anyone who was a guest at the Plim Plaza hotel in the month of September and is experiencing pneumonia-like symptoms should contact his or her health care provider to determine whether testing or treatment is recommended. The disease can be treated with commonly available antibiotics. Legionellosis is not spread from person to person.

There have been 93 confirmed cases of Legionnaires’ disease reported this year in Maryland. On average 100 -130 cases are reported statewide annually.

http://www.ems1.com/ems-management/articles/1165510-Report-Philly-medics-overworked-system-stressed/

 Report: Philly medics overworked, system stressed

PHILADELPHIA — “Four years ago, City Controller Alan Butkovitz released a report revealing a Philadelphia EMS system in crisis: Sick people waiting too long for ambulances; paramedics dangerously overworked; and non-emergency calls overwhelming the system.

The report echoed the pleas of paramedics who had long called for change, and recommended steps to relieve pressure on the stressed 911 system.

Four years later, little has changed, Butkovitz said Wednesday as he released a follow-up audit that analyzed Fire Department data from 2009…..”

http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2811%2970192-2/fulltext

http://www.wtop.com/?nid=267&sid=2578644

Wednesday – 10/5/2011, 4:11pm  ET