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Public Health News in Brief


Another case of plague has been reported in the United States (June 14th Oregon, St Charles Medical Centre) and the international media have made their concern clear. The facts are, however, entirely reassuring. Although the plague Bacillus which caused medieval pandemics continues to exist in low levels in rodents in the south west of America, the conditions for it to go on to cause a pandemic through rats and fleas simply do not exist in the modern world.

The local American public are well aware that cases of plague will be contracted from wild animals from time to time – and they attend their doctor accordingly to receive antibiotic treatment. Due to an incorrect understanding of the mechanisms of disease, there has been an overreaction in the media – which is understandable, but unfounded – and may be causing undue worry to some people.



Yet another food contamination incident in China has occurred, with mercury being detected in infant milk powder from a major dairy firm in the Inner Mongolian city of Hohhot. This is likely to have happened during preparation and serves to illustrate just how widespread a food hazard can become in todays mass-market food distribution networks.

The 2008 scandal, when contamination by melamine killed six babies and made 300,000 ill, caused a heavy blow to China’s milk industry and unfortunately this current incident takes place during China’s “Food Safety Week” and a day after the cabinet introduced fresh measures to tighten food safety control.



The ongoing outbreak of Legionnaires’ disease in Scotland, which has so far caused two deaths, is of clear concern. The authorities have been unable to identify the source or perhaps unwilling to reveal their findings, which does nothing to reassure the public. It’s important to note that the Heath and Safety Executive are involved in the investigation.

Professor Lightfoot comments, ‘I’m surprised by the handling of the outbreak on two counts. Firstly, that reverse epidemiology methods as developed by the HPA modeling team at Porton Down (using case postcodes and movements) have not been called in to help identify geographic location. Great success was achieved using this method in the Hereford Legionnaires’ outbreak a few years ago. And secondly, if we clearly learnt these lessons years ago, why is this happening again? It is of vital importance that lessons are identified and learned, and if necessary, steps taken towards enforcement.’



A new case of Anthrax has been reported in a heroin user in Germany. Similar cases occurred in the UK last year, mainly in Glasgow. Although Anthrax has not been detected in the heroin itself in Germany, Professor Lightfoot explains how the infection is likely to have begun, ‘I still believe that the contamination occurs during the collection of the Opium poppies in animal skins, which we know are often contaminated with Anthrax spores in Afghanistan. This is not surprising, because although inhalation anthrax has an infectious dose of 10,000 organisms, when injected into the skin, one single Anthrax spore is enough to cause infection.’



There are three serious events of illness due to unknown causes still occurring worldwide; the skin disease in Vietnam, which may be due to arsenic poisoning; the nodding disease in Uganda, which still evades identification although infection with a parasitic worm called Onchocercus has been postulated; and there is an ongoing outbreak of suspected but as yet unproven Japanese Encephalitis in India, resulting in over 100 deaths so far. These deserve more attention – we must learn lessons for the benefit of future public health and we need to collaborate internationally to identify the loopholes which continue to prevent early diagnosis in developing countries.


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