Thursday, November 17, 2005

Emerging infectious diseases focus of forum

bangornews.com
AUGUSTA - Avian flu may be the hot topic in most public health circles these days, but it got little more than passing mention Tuesday at a daylong conference on emerging infectious diseases in Maine.

The event, presented by the Maine Center for Disease Control and Prevention, offered updates on reportable diseases that Maine physicians are more likely to encounter in their work, such as food-borne illnesses, hepatitis, antibiotic-resistant infections and vector-borne diseases such as Lyme disease.

It also provided an opportunity for the state's public health office to demonstrate some of the work it does to ward off widespread illnesses, detect outbreaks and keep track of threats to public health.

The agenda included a review of a September golf tournament at which more than 40 people became acutely ill after partaking of an elegant luncheon buffet. Although it was almost two weeks before the outbreak was reported to the state's Bureau of Public Health, epidemiologists were eventually able to trace the bacteria that caused the diarrheal illness, Shigella flexneri, to the beef skewers served at the buffet. Inspection of the catering facility found numerous food handling violations, though it seemed likely that the beef had been contaminated, probably with human feces, before its arrival at the caterers' kitchen.

Also showcased was a private summer camp in midcoast Maine where a 14-year-old-girl from Japan arrived this past summer with a full-blown case of mumps. As is required, the case was reported to the state. Public health officials found that 95 percent of the camp's 240 vaccination records were incomplete and were faced with the daunting task of tracking down each camper's physician to determine whether she had been immunized against the potentially dangerous disease.

Then campers' parents, many of whom were away on vacations of their own, had to be notified. Within two days, 39 people - five campers and 34 staff - received a mumps vaccine. The Japanese camper spent her three-week Maine vacation in medical isolation.

About 275 Maine physicians and other clinicians participated in the daylong conference at the Augusta Civic Center. Presenters included public health experts from the federal Centers for Disease Control and Prevention in Atlanta and the Lenox Hill Hospital in New York City, as well as from Maine's own public health division.

Just before lunch, participants were treated to a distressingly graphic treatise on noroviruses - notoriously fast-acting food-borne pathogens that have taken all the fun out of many an ocean cruise. "You can tell the people who are seasick from those who have norovirus - people who are seasick make it to the railings," quipped presenter Marc-Alain Widdowson of the CDC.

New York physician Michael Tapper discussed the growing concern over antibiotic-resistant infections that are increasing in incidence and severity. Robert Smith, an infectious diseases specialist at Maine Medical Center in Portland, cautioned practitioners to be on the lookout for more cases of tick-carried Lyme disease, which he said is moving north and inland.

And avian flu? Attendees were given a brief overview of the state's recently released pandemic influenza plan, and some attended an optional question-and-answer session after lunch.

State epidemiologist Kathleen Gensheimer said the possibility of a devastating global outbreak of bird flu is real and extremely serious, but the purpose of Tuesday's gathering was to update Maine physicians and other health care clinicians on diseases they're more likely to encounter on a day-to-day basis.

"We ask the health care community to take the time and trouble to report certain diseases to us; once a year, we give the information back to them," Gensheimer said. "It's hard to pick the specific topics, but we try to focus on diseases of public health significance in Maine."