Harmful algal bloom-related 311 calls, Cape Coral, Florida 2018-2019

Harmful algal blooms (HABs) can adversely impact water quality and threaten human and animal health. People working or living along waterways with prolonged HAB contamination may face elevated toxin exposures and breathing complications. Monitoring HABs and potential adverse human health effects is notoriously difficult due to routes and levels of exposure that vary widely across time and space. This study examines the utility of 311 calls to enhance HAB surveillance and monitoring. The study focuses on Cape Coral, FL, USA, located along the banks of the Caloosahatchee River and Estuary and the Gulf of Mexico. The wider study area experienced a prolonged cyanobacteria bloom in 2018. The present study examines the relationship between weekly water quality characteristics (temperature, dissolved oxygen, pH, microcystin-LR) and municipal requests for information or services (algal 311 calls). Each 1 μg/L increase in waterborne microcystin-LR concentrations corresponded with 9% more algal 311 calls (95% confidence interval: 1.03-1.15, p = 0.002). The results suggest water quality monitoring and the 311 dispatch systems may be further integrated to improve public health surveillance.

A large-scale, rapid public health response to rabies in an organ recipient and the previously undiagnosed organ donor

This article describes and contrasts the public health response to two human rabies cases: one organ recipient diagnosed within days of symptom onset and the transplant donor who was diagnosed 18 months post-symptom onset. In response to an organ-transplant-related rabies case diagnosed in 2013, organ donor and recipient investigations were conducted by multiple public health agencies. Persons with potential exposure to infectious patient materials were assessed for rabies virus exposure. An exposure investigation was conducted to determine the source of the organ donor's infection. Over 100 persons from more than 20 agencies spent over 2700 h conducting contact investigations in healthcare, military and community settings. The 564 persons assessed include 417 healthcare workers [5.8% recommended for post-exposure prophylaxis (PEP)], 96 community contacts (15.6% recommended for PEP), 30 autopsy personnel (50% recommended for PEP), and 21 other persons (4.8% recommended for PEP). Donor contacts represented 188 assessed with 20.2% recommended for PEP, compared with 5.6% of 306 recipient contacts recommended for PEP. Human rabies cases result in substantial use of public health and medical resources, especially when diagnosis is delayed. Although rare, clinicians should consider rabies in cases of encephalitis of unexplained aetiology, particularly for cases that may result in organ donation.

Toxin producing Vibrio cholerae O75 outbreak, United States, March to April 2011

The Florida Department of Health, Florida, United States, is investigating a Vibrio cholerae O75 outbreak. Ten cases with disease onsets from 23 March to 13 April 2011, presented with gastrointestinal symptoms of diarrhoea, nausea, vomiting, cramps, chills, and/or fever, after consuming raw or lightly cooked oysters harvested from Apalachicola Bay, Florida. Symptoms were milder than those during outbreaks of epidemic (serogroup O1 and O139) Vibrio cholerae; no case required rehydration treatment or hospitalisation.

Toxin producing Vibrio cholerae O75 outbreak, United States, March to April 2011

The Florida Department of Health, Florida, United States, is investigating a Vibrio cholerae O75 outbreak. Ten cases with disease onsets from 23 March to 13 April 2011, presented with gastrointestinal symptoms of diarrhoea, nausea, vomiting, cramps, chills, and/or fever, after consuming raw or lightly cooked oysters harvested from Apalachicola Bay, Florida. Symptoms were milder than those during outbreaks of epidemic (serogroup O1 and O139) Vibrio cholerae; no case required rehydration treatment or hospitalisation.

Effect of Infectious Bursal Disease Virus Insult on Iron, Copper, and Zinc Concentration in Liver, Bursa of Fabricius, Spleen, Pancreas, and Serum of Chickens

The effect of a systemic disease on the dynamics of iron, zinc, and copper in chickens fed ad libitum was examined by infecting 10-day-old specific pathogen-free chickens with infectious bursal disease virus (IBDV). Liver, bursa of Fabricius, pancreas, spleen, and serum were sampled in 10 controls and 10 challenged chickens at 3-day intervals postinfection (PI) for 15 days. The samples were analyzed using atomic absorption spectroscopy. Serum levels were similar to that reported in the literature. Concentrations of iron and zinc did not change significantly in the pancreas, but there was an increase in copper in infected pancreatic tissue on days 9 and 15 PI. Iron concentration in the spleen showed a significant increase on days 6, 9, and 15 PI, whereas zinc was only significantly increased on day 15 PI. There was no significant change in copper concentrations in the spleens of infected chickens vs. controls. This finding is in line with previously reported data. The results showed that the liver was not a major tissue where iron and zinc were sequestered, as previous data have shown in mammals. Instead, the bursa of Fabricius had significantly increased levels of both iron and zinc in infected tissue vs. control tissue from 9 days PI on. Furthermore, the bursa had increased levels of copper in the latter portion of the study. These findings suggest that the bursa of Fabricius rather than the liver is the major organ for metallic ion sequestering during IBDV infection.

Marijuana use and social networks in a community outbreak of meningococcal disease

BACKGROUND

We examined the role of social networks and marijuana smoking in a community outbreak of infections due to Neisseria meningitidis.

METHODS

We interviewed all patients and their contacts. Isolates were tested by pulsed field electrophoresis and multilocus enzyme electrophoresis.

RESULTS

Nine cases of meningococcal disease occurred in the outbreak; isolates from seven cases with positive cultures were identical. Multiple overlapping social networks were found for case-patients and their contacts. All case-patients were linked by the marijuana-related activities of their contacts.

CONCLUSION

Investigation of social networks and marijuana exposure might help identify close contacts of patients with meningococcal disease and help prevent secondary infections.

Modulation of the cleavage of the gastrin precursor by prohormone phosphorylation

BACKGROUND & AIMS

Amidated gastrins are acid secretagogues and growth factors. Their precursor, progastrin, is a growth factor but not a secretagogue. Cleavage of progastrin at Arg94/95 determines the expression of these two alternative patterns of biological activity. We examined the hypothesis that cleavage at Arg94/95 is regulated by phosphorylation of the adjacent Ser96 residue.

METHODS

Hamster insulinoma cells were stably transfected with wild-type rat preprogastrin and phosphorylation site mutants; biosynthesis was studied by a pulse-chase protocol.

RESULTS

Rates of cleavage at Arg94/95 were increased in Ser96-->Ala compared with wild-type progastrin. Mutation of Glu98 to Ala inhibited incorporation of [32P]phosphate into progastrin and increased the rate of cleavage at Arg94/95. Conversely, mutation of Ser96 to Asp reduced rates of cleavage at Arg94/95. Depletion of calcium stores decreased phosphorylation of Ser96 and increased cleavage at Arg94/95. Modulation of Ser96 phosphorylation also directly influenced the ratio of progastrin-cleavage products (progastrin/CFP; G17Gly/G34Gly) secreted into the medium.

CONCLUSIONS

Phosphorylation of progastrin is dependent on calcium stores, determines prohormone cleavage rates, and thereby controls the production of the alternative active products of preprogastrin translation.

Management of the contralateral testis in patients with testicular germ cell cancer

Patients with testicular germ cell tumours (TGCT) are at increased risk of developing a tumour in the contralateral testis. Such a tumour may be preceded by carcinoma in situ (CIS), which is more common in patients with infertility, atrophic testis or a history of cryptorchism. Of 1219 patients with TGCT seen at the Royal Marsden Hospital between 1962 and 1984 in whom the contralateral testis was managed by surveillance, 38 (3.1%) developed a second tumour and 8 died of germ cell tumours. Seventeen of 26 assessable patients (65%) exhibited at least one of the known aetiological risk factors for carcinoma in situ. Diagnosis of carcinoma in situ may lead to more appropriate management of the contralateral testis.

Magnetic relaxation in blood and blood clots

Nuclear magnetic relaxation rates are measured for whole blood, blood plasma, whole blood clots, and plasma clots in vitro. Relaxation rates are linear in the hematocrit and transverse relaxation rates are significantly greater than longitudinal relaxation rates. Longitudinal relaxation rates measured from 0.01 to 42 MHz for proton Larmor frequencies are found to decline monotonically with increasing magnetic field strength; however, the dispersion curves do not follow a simple Lorentzian behavior, which is anticipated in a suspension of particles in a solution of proteins having a distribution of molecular weights. The transverse relaxation rate is a function of the acquisition parameters, in particular, the choice of TE in either Hahn echo experiments or in echo-train experiments. The origin of this dependence of T2 on TE or the interpulse spacing in an echo train is identified with the exchange of water from inside the red blood cell to the outside and is only an important relaxation mechanism in the case where the blood cell membrane is intact and the cell contains deoxygenated hemoglobin. The dependence of the apparent transverse relaxation rate on the interpulse spacing in a Meiboom-Gill-Carr-Purcell pulse sequence provides the estimate that the mean residence time of water inside the blood cell is about 10 ms. These data provide a sound basis for understanding the dependence of magnetic images on magnetic field strength and the choices of the image acquisition parameters, TE and TR.

Etoposide and cisplatin with or without bleomycin as first-line chemotherapy for patients with small-volume metastases of testicular nonseminoma

Between December 1981 and September 1982, a phase II study of etoposide and cisplatin was carried out in 17 patients with small-volume metastases of testicular nonseminoma to see whether the toxicity associated with bleomycin could be avoided without loss of therapeutic effect. Of 16 evaluable patients followed for 13-23 months (median, 18.5), four failed to achieve complete remission and three had disease progression. Conversely, all 18 equivalent patients treated with bleomycin, etoposide, and cisplatin between January 1981 and November 1982 (observation time, 12-34 months; median, 25) achieved complete remission and have been continuously disease-free since treatment (P = 0.07). The results suggest that bleomycin contributes significantly to the combination chemotherapy for testicular nonseminoma, and although its omission led to a marked reduction in toxicity, loss of therapeutic activity was also apparent. Prolongation of the intervals between cycles of etoposide and cisplatin from 3 to 4 weeks may significantly reduce the effectiveness of the two-drug combination, whereas no evidence of this was seen in patients treated with bleomycin, etoposide, and cisplatin.