USA: Antibiotic-resistant gonorrhea not ‘worse than AIDS,’ experts say

Antibiotic-resistant gon­or­rhea is a seri­ous pub­lic health issue, but com­par­ing the ill­ness to AIDS, as a recent arti­cle did, is mis­lead­ing, experts say.

A recent CNBC arti­cle with the head­line “Sex Super­bug Could Be ‘Worse Than AIDS’” quoted Alan Chris­tian­son, a natur­o­pathic doc­tor, as say­ing that an antibiotic-resistant strain of the sex­u­ally trans­mit­ted dis­ease gon­or­rhea “might be a lot worse than AIDS in the short run because the bac­te­ria is more aggres­sive and will affect more peo­ple quickly.”

How­ever, some experts called the com­par­i­son hyper­bolic. “I dis­agree with the gen­eral com­par­i­son,” said Dr. Bruce Hirsch, an attend­ing physi­cian in infec­tious dis­eases at North Shore Uni­ver­sity Hos­pi­tal in Man­has­set, N.Y. “The rate of com­pli­ca­tions from gon­or­rhea in terms of sys­temic prob­lems is so much lower than the rate of com­pli­ca­tions from untreated AIDS infec­tion,” Hirsch said. The CNBC arti­cle says that this par­tic­u­lar strain of gon­or­rhea “might put some­one into sep­tic shock and death in a mat­ter of days.” But Hirsch said that the rate of life-threatening com­pli­ca­tions, such as sep­sis, from gon­or­rhea, is about 1% while the rate of death from untreated AIDS is 98%. “At this point in time, AIDS is a fatal infec­tion,” while gon­or­rhea patients very rarely die from the con­di­tion, said Dr. Car­los del Rio, chair of the Global Health Depart­ment at Emory University’s Rollins School of Pub­lic Health. How­ever, both experts stressed that antibiotic-resistant gon­or­rhea was a very seri­ous prob­lem. “There really is no rea­son to com­pare it to any­thing else,” del Rio said.

Gon­or­rhea is becom­ing increas­ingly resis­tant to the antibi­otics doc­tors have to treat it. In 2012, the Cen­ters for Dis­ease Con­trol and Pre­ven­tion said that there is just one drug left that can be used as a first-line treat­ment for the dis­ease. The drug, cef­tri­ax­one (an antibi­otic deliv­ered by injec­tion) is rec­om­mended to be used along with other antibi­otics, such as such as azithromycin or doxy­cy­cline, for seven days.

So far, the United States has not seen any cases of gon­or­rhea that were com­pletely resis­tant to antibi­otics, the CDC said. In 2011, there were more than 300,000 cases of gon­or­rhea reported to the CDC. Gon­or­rhea is caused by the bac­terium Neis­se­ria gon­or­rhea and is spread through sex­ual activ­ity. Peo­ple with gon­or­rhea often show no symp­toms (men are more likely to have symp­toms than women). In some cases, the dis­ease can cause seri­ous com­pli­ca­tions, includ­ing infer­til­ity and chronic pelvic pain in women, and in men, epi­didymi­tis, a painful inflam­ma­tion of the ducts attached to the tes­ti­cles if left untreated, accord­ing to the CDC.

If gon­or­rhea becomes resis­tant to all antibi­otics, “then we’re going to be in the same sit­u­a­tions that were we in the 1800s,” Hirsch said. The CDC says urgent action is needed to stop the spread of antibiotic-resistant gon­or­rhea, includ­ing the iden­ti­fi­ca­tion and study of new antibi­otics treatments.

Proper use of con­doms can reduce the risk of get­ting gon­or­rhea. The best way to pre­vent the dis­ease is not to have sex, or to be in a monog­a­mous rela­tion­ship with a part­ner who has been tested for the dis­ease and is known not to be infected, the CDC says.

(Fox News 5/7/2013)

USA: California investigating valley fever outbreak that sickened 28 workers at solar plant sites

Cal­i­for­nia author­i­ties are inves­ti­gat­ing a val­ley fever (coc­cid­ioidomy­co­sis) out­break that sick­ened 28 work­ers at solar power plants under con­struc­tion in cen­tral Cal­i­for­nia. Pub­lic health and work safety staff vis­ited two sites in San Luis Obispo County in March 2013.

Val­ley fever is con­tracted by breath­ing spores from a fun­gus found in desert soil. It can cause flu-like symp­toms and death in extreme cases. Mark Simonin of an elec­tri­cal work­ers union says one infected worker was an elec­tri­cian who inhaled dust while dig­ging at one site.

Cal­i­for­nia is try­ing to stem a val­ley fever out­break that has caused dozens of deaths among Cen­tral Val­ley pris­on­ers since 2006. Dur­ing the week of 29 April 2013, fed­eral offi­cials ordered more than 3,000 inmates relocated.

The full arti­cle may be accessed at http://www.promedmail.org/direct.php?id=20130503.1688449

(ProMED 5/3/2013)

USA: Five more sick in multistate E. coli O121 outbreak

The US Cen­ters for Dis­ease Con­trol and Pre­ven­tion (CDC) recently announced five more Escherichia coli O121 infec­tions linked to Farm Rich frozen food snacks, rais­ing the out­break total to 32. Accord­ing to an 26 April 2013 update, three more states are report­ing cases, lift­ing the affected num­ber to 18. States report­ing their first cases include Cal­i­for­nia, Col­orado, and Florida. Nine patients have been hos­pi­tal­ized so far, two of them with hemolytic ure­mic syn­drome, a poten­tially fatal kid­ney com­pli­ca­tion. Inves­ti­ga­tions so far point to the Farm Rich prod­ucts as one likely infec­tion source, but the CDC and state offi­cials are inter­view­ing sick patients to deter­mine what other expo­sures they had the week before they became ill. Ear­lier stages of the inves­ti­ga­tion found the E. coli O121 out­break strain in two dif­fer­ent prod­ucts from the homes of sick patients. The out­break was first announced on 29 March 2013, and the com­pany has recalled more than 10.5 mil­lion pounds of not fully cooked frozen mini meals and snack items.

Addi­tional infor­ma­tion avail­able at http://www.cdc.gov/ecoli/2013/O121-03–13/index.html

(CIDRAP 4/29/2013)