An outbreak of a hemorrhagic disease in white-tailed deer in Kentucky.

In 1971, an outbreak of a hemorrhagic disease occurred in captive and free-ranging white-tailed deer (Odocoileus virginianus) in Mammoth Cave National Park, Kentucky, Clinical signs and gross pathological lesions were consistent with those of epizootic hemorrhagic disease and bluetongue, as were serological and histopathological findings for samples sent to other laboratories. The infection rate among the 104 captive deer was 88-92%, and that among the free-ranging Park deer appeared to be similar. Mortality was negligible in the Park deer, but 65 (62%) of the captive deer died. The deaths were bimodally distributed over a 36-day period, and the mortality rate decreased from 97-100% for deer clinically ill during the first 17 days of the outbreak to 58% for deer first exhibiting clinical signs on day 16 or later. Mortality was equal in males and females, but less in yearlings than among fawns or adults. Winter mortality among survivors of the initial outbreak was associated with low ambient temperatures and sometimes fungal and bacterial abscesses, possibly sequelae or complications of the hemorrhagic disease. The pregnancy and birth rates among surviving does appeared to be normal.     

Antigenic analysis of acute hemorrhagic conjunctivitis viruses (enterovirus type 70).

The antigenic characteristics of enterovirus type 70 (EV 70) were investigated by means of cross and kinetic neutralization tests (NT). Twelve strains of EV 70 isolated in a period from 1971 to 1976 were analyzed using seven rabbit and one monkey hyper-immune sera. All the strains investigated were found to possess a common and prime variant antigens in varying proportions. Accordingly, EV 70 isolates were devided intratypically into three antigenic sub groups; (1) prototype-like (four strain from 1971 to 1972), (2) intermediate, G-10/72-like (two strains from 1972 to 1973), and (3) prime variant, G-2/74-like (six strains from 1974 to 1976) groups. Thus it was considered that EV 70 might represent a virus type with antigenic heterogeneity, and that antigenic drift from the prototype to the prime type may have occurred successively after 1971.     

An outbreak of VHSV (viral hemorrhagic septicemia virus) infection in farmed Japanese flounder Paralichthys olivaceus in Japan.

A rhabdoviral disease occurred in farmed populations of market sized Japanese flounder (hirame) Paralichthys olivaceus in the Seto Inland Sea of Japan in 1996. The causative agent was identified as viral hemorrhagic septicemia virus (VHSV) based on morphological, immunological, and genetic analyses. Diseased fish that were artificially injected with a representative virus isolate showed the same pathological signs and high mortality as observed in the natural outbreak. This is the first report of an outbreak of VHSV infection in cultured fish in Japan. Clinical signs of diseased fish included dark body coloration, an expanded abdomen due to ascites, congested liver, splenomegaly, and a swollen kidney. Myocardial necrosis was most prominent and accompanied by inflammatory reactions. Necrotic lesions also occurred in the liver, spleen and hematopoietic tissue, and were accompanied by circulatory disturbances due to cardiac failure. Hemorrhagic lesions did not always appear in the lateral musculature. Transmission electron microscopy revealed many rhabdovirus particles and associated inclusion bodies containing nucleocapsids in the necrotized myocardium. The histopathological findings indicated that the necrotizing myocarditis could be considered a pathognomonic sign of VHSV infection in Japanese flounder.     

Epizootiology of an epizootic hemorrhagic disease outbreak in West Virginia

An outbreak of epizootic hemorrhagic disease virus, serotype 2 (EHDV-2) was responsible for localized white-tailed deer (Odocoileus virginianus) mortality in Hardy and Hampshire counties, West Virginia (USA), in the summer and fall of 1993. Using available historical data on regional herd immunity, data opportunistically collected during the epizootic, and postepizootic sampling of hunter-harvested deer, we grossly estimate certain epidemiologic parameters and compare findings to a hypothesis about hemorrhagic disease outbreaks in the Appalachian Mountains. During the epizootic, 57.9 km(2) were actively searched and 228 dead deer were found. Epizootic hemorrhagic disease virus, serotype 2 was isolated from seven of nine deer sampled in Hardy and Hampshire counties. Preepizootic exposure of deer to EHD viruses was unknown, but available data suggest that it was negligible. The geographic distribution of the outbreak was defined by plotting the locations of dead deer found during the outbreak, as well as the locations of deer harvested by hunters after the outbreak that had antibodies to EHDV-2 on a map sectioned into 16.65 km(2) rectangular sections. Sections that included one or more dead deer or hunter-harvested deer with antibodies to EHDV-2 were included in the defined outbreak area. Postoutbreak sampling revealed monospecific EHDV-2 antibodies in 12% of deer harvested by hunters within the defined outbreak area. Based on the available data and accepting certain assumptions, gross calculations suggest that this outbreak appears to have been isolated and probably killed a high percentage of the deer that were infected. This is consistent with the hypothesis that sporadic hemorrhagic disease outbreaks in the Appalachian Mountains are usually localized and severe.     

The first epidemic of acute hemorrhagic conjunctivitis due to a coxsackievirus A24 variant in Okinawa, Japan, in 1985-1986

Epidemics of acute hemorrhagic conjunctivitis due to a coxsackievirus A24 variant occurred in July-November, 1985 and August-October, 1986 in Okinawa Prefecture, Japan. This is the first report of an acute hemorrhagic conjunctivitis epidemic due to a coxsackievirus A24 variant in Japan The epidemic involved most islands of the prefecture. The prefectural surveillance center was notified of 9,952 cases in 1985 and 6,096 cases in 1986 from three sentinel eye clinics. The neutralizing antibody-positive rate against the coxsackievirus A24 variant of the serum samples collected before and immediately after the 1985 epidemic rose from 1.0% to 8.5%. The coxsackievirus A24 variant was isolated from 48 out of 68 conjunctival swabs collected during the epidemics. The isolates were indistinguishable antigenically in the plaque reduction test from the prototype strain, EH24/70, but had a markedly distinct oligonucleotide pattern.     

Diabetes services in Yugoslavia.

The Socialist Federal Republic of Yugoslavia lies in south east Europe between the Soviet block and the free enterprise countries of Western Europe. It was originally established as a confederation of independent Balkan states after the first world war; after the second world war it became an independent federation of the socialist republics of Bosnia, Herzegovnia, Montenegro, Croatia (including Dalmatia), Slovenia, and Serbia, together with the two small autonomous provinces of Kosovo and Vojvodina. In the subsequent 30 years the trend towards decentralised decision making and institutional self management has continued. Nevertheless, the federal authorities retain major control over economic decision making and policies. For example, they forbid anyone from owning more than two houses or 10 hectares of land, and no factory owner may employ more than 10 people. Capitalism in any other than this minor form is not allowed, and any businessman whose business expands must become involved in frustrating negotiations with the local government to set up a state industry. I recently visited Yugoslavia as a guest of the Institute for Diabetes, Endocrinology, and Metabolic Diseases and of the medical faculty of the University of Zagreb and visited various health care units which provide services for diabetics in Croatia. As well as Zagreb itself I visited units in Split on the Adriatic coast and at Varazdin, near the Hungarian border. Necessarily my observations are based on the diabetes services in Croatia, but although the other republics may have less developed services they follow similar principles.     

An outbreak of illness among aerospace workers.

A multispecialty panel of physicians evaluated a case series of 53 composite-materials workers in a large aircraft manufacturing facility who filed workers'' compensation claims for illness labeled by the media as the "aerospace syndrome." Possible skin and respiratory tract exposures included formaldehyde, phenol, particulates, epoxy resins, and trace organic solvents, but measured concentrations were well below all regulatory and consensus standards. Most workers had histories of transient skin or respiratory tract irritation consistent with the known potential toxicity of these materials. None of the workers tested had immunoglobulin IgG or IgE antibodies to human serum albumin complexed with formaldehyde. A majority (74%) met DSM-III-R [Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised] criteria for major depression, panic disorder, or both. Most of these psychiatric disorders were of a recent onset, correlating in time with the use of phenol- and formaldehyde-impregnated composite material. Psychosocial factors were thought to have played a major role in the high prevalence of illness in this group and should be evaluated directly in well-controlled epidemiologic studies of similar crisis-building situations in the future.     

An outbreak of Q fever in the Basque country.

The main clinical manifestations of 42 cases of Q fever occurring in an outbreak in Valmaseda, Spain during March, April and May 1982 are described in this paper. The benign character of the acute disease is emphasized. Further epidemiologic studies must be done to determine the incidence of Q fever in the Basque country.     

An outbreak of trichinellosis in Hungary

In a small village of Hungary, a human trichinellosis outbreak (affecting eight people) occurred in January-February, 2009. In the outbreak investigation (i) Trichinella spiralis larvae were detected in meat products derived from the pigs slaughtered in the backyard of one of the patients (a foxhunter) in December 2008, and in a brown rat captured in the same backyard; (ii) sera of 24 pigs held in 11 yards of the village and that of some dogs of the foxhunter were found Trichinella-positive; (iii) sera of five villagers who could not be infected in the particular outbreak were also found reactive in Trichinella-specific laboratory tests. The followings helped the rise of an outbreak: the geographical position and the presence of empty houses favoured the multiplication of rats; there was no extermination of rats in the previous years; there was no meat inspection; raw meat and improperly processed meat products were tasted at the pig-slaughter; villagers gave tastes to each other. People were informed on the symptoms, the way of transmission, and the possibilities of prevention of trichinellosis by experts. With the help of local authorities, all the properties including the grounds with empty houses were involved in the extermination of rodents.     

Geographical distribution of arboviruses in Yugoslavia.

Studies of arboviruses started in Yugoslavia in 1953 following the isolation of TBE virus which caused a severe epidemic that year. Until now the following viruses have been proven to circulate in the country: tick-borne encephalitis (TBE), Crimean-Congo hemorrhagic fever (CCHF), Bhanja (BHA), sandfly fever (SF), Tahyna (TAH), Calovo (CVO), West Nile (WN), dengue (DEN), Jug Bogdanovac (JB), and Hantaviruses. TBE virus is endemic in the north-west part of the country, causing also epidemics in cyclical intervals. Its typical clinical picture is aseptic meningitis, but severe cases with paralysis have also been described. The bite of ticks is confirmed in about 80% of cases. CCF caused a small epidemic with ten clinical cases in Macedonia in 1976. Bhanja virus was isolated on the Dalmatian island of Brac in 1977, the antibody rate there, determined by the HI method, being about 31%. The first human disease in the world was caused by the Yugoslav Bhanja virus strain. Sandfly fever is still active in the country. The Naples type is prevailing and has proved hazardous for newcomers. Hantaviruses have been studied since 1980. They caused severe epidemics (1967, 1980, 1989) and sporadic cases all over the country. Three different strains are in circulation. Further studies are needed for the rest of the above mentioned viruses to learn more about their significance in human pathology.