November 30, 2001

E.coli O157:H7 phage type 32: Ontario
Ontario's Chief Medical Officer of Health has alerted physicians and hospitals across the province that there have been 11 confirmed cases of E.coli O157:H7 phage type 32. The cases have been confirmed by Health Canada's national reference laboratory in Winnipeg. The confirmed cases are located in the areas of Ottawa, Kingston, Simcoe County, Toronto, York Region, London-Middlesex and Windsor. They range in age from 6 to 71 years. Public health officials are working as quickly as possible to determine the cause of these cases. They are looking at all possible causes but the geographic distribution of the cases indicates a low probability of a water-based source and points to another cause. An outbreak implicating the same bacteria affected 70 people in Michigan and Virginia in the summer of 1997. In that incident, all cases had eaten alfalfa sprouts from the same source.
Source: Ontario Ministry of Health and Longterm Care, Press Release, 23 November 2001; PROMED, 24 November 2001

West Nile Virus (WNV) Encephalitis/Meningitis: United States
During 2001, a total of 45 human cases of WNV encephalitis or meningitis have been reported from New York (12), Florida (10), Connecticut (6), Maryland (6), New Jersey (6), Pennsylvania (3), Georgia (1), and Louisiana (1). Among these 45 cases, 24 (53%) were in men; the median age was 70 years (range: 36-90 years); dates of illness onset ranged from July 13-October 7; three persons died. A total of 4,517 crows and 1,474 other birds with WNV infection were reported from 26 states and the District of Columbia; 176 WNV infections in other animals (all horses) were reported from 14 states (Alabama, Connecticut, Florida, Georgia, Indiana, Kentucky, Louisiana, Massachusetts, Mississippi, New York, North Carolina, Pennsylvania, Tennessee, and Virginia). During 2001, 753 WNV-positive mosquito pools were reported from 15 states (Connecticut, Florida, Georgia, Illinois, Kentucky, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, and Virginia) and the District of Columbia.
Source: Morbidity and Mortality Weekly Report, Vol 50, No 45, 16 November 2001

Pertussis: Arkansas
With >400 cases of pertussis confirmed in Arkansas, the state is experiencing the worst outbreak since the early 1960s. So far, cases of pertussis have been found in 34 of the state's 75 counties. The outbreak appears to be concentrated in Arkansas; Tennessee's Department of Health has reported only a slight increase in pertussis cases, with 52 so far this year compared to 31 last year.
Source: Immunization Newsbriefs, 21 November 2001

Inhalational Anthrax: Connecticut
CDC was contacted by the Connecticut Department of Public Health about a respiratory illness in a 94-year-old female which preliminary tests had indicated to be anthrax. CDC conducted PCR (polymerase chain reaction) testing on specimens from the woman and confirmed inhalation anthrax. The woman lived alone in her home in Oxford, about 10 miles west of New Haven. She seldom left the house and had no known connection with the U.S. Postal Service. She was originally treated for pneumonia and admitted to hospital on November 21, 2001, where she died the following day. Most of the cases so far have been associated with handling contaminated mail; however, there is no obvious source of infection for this latest case or for 2 other cases, a hospital worker in New York City and an accountant in New Jersey. Before this, no cases had been detected since 7 November. In total, since 4 October, there have been 11 cases of inhalation anthrax, resulting in 5 deaths, and 7 confirmed and 5 suspected cases of cutaneous disease.
Source: Centres for Disease Control, Press Release, 21 November 2001; Eurosurveillance Weekly, Issue 47, 22 November 2001; PROMED, 20 November 2001

The details given are for information only and may be very provisional. Where incidents are considered of national importance and are ongoing, the initial report will be updated as new information becomes available.