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• Read full coverage of the swine flu outbreak, including tips on preventing it.

Health officials confirmed this morning that they are investigating a probable case of swine flu in Columbus and two in Ross County.

Columbus Public Health officials met this morning to discuss the case and review information they received from the physician involved in the local case.

If all are confirmed by the Centers for Disease Control and Prevention, there would be four cases of the virus in Ohio.

The one confirmed case of swine flu is a 9-year-old Elyria boy who had traveled to Mexico with his family. State officials said he had a mild case and was recovering at home. His elementary school is closed this week.

There are 91 confirmed cases in 10 states, federal officials reported this morning.

The first U.S. death was recorded earlier today, a 23-month-old boy died in Texas from the new, deadly flu strain.

Columbus Public Health Commissioner Dr. Teresa Long and Franklin County Board of Health Commissioner Susan Tilgner have requested the Franklin County Emergency Management & Homeland Security Agency to activate the county's Emergency Operations Center and the Joint Information Center at 3 p.m. today.

Swine-flu details

Key developments yesterday on swine-flu outbreaks:

Deaths: 103, all in Mexico; at least 22 officially confirmed as swine flu.

Confirmed or suspected cases: About 1,600 in Mexico, 20 in the U.S., 13 in New Zealand, seven in Spain, six in Canada and one each in France, Israel and Brazil.

Locations in the U.S.: Ohio (1), New York (8), California (7), Kansas (2), Texas (2).

Associated Press

COLUMBUS (AP) — The Ohio Department of Natural Resources says it has found a fast-spreading fish virus for the first time in a waterway outside the Great Lakes basin.

Viral hemorrhagic septicemia has caused large fish kills in four of the five Great Lakes and several inland lakes in the basin.

The DNR says confirmation in muskellunge fish in the Clear Fork Reservoir in central Ohio marks the first isolation of the virus outside the basin. It was found during routine egg collection in April and confirmed through tests by federal agencies.

The reservoir is in Richland and Morrow counties. The DNR says the virus has not caused a fish kill in the reservoir.

Of the Great Lakes, only Lake Superior has avoided the disease.

The virus causes fish to bleed to death. It does not pose a threat to humans.

Is it just me or does this sound like Ebola for fish?  I was disconcerted to realize I spend so much time being interested in human diseases that I never even knew this existed!  What is more, zoonoses are often some of the worst pathogens in humankind.  If this puppy ever decided to mutate, it would be interesting, no? 

And how could I possibly ignore what is one of the biggest stories in public health at the moment?

FDA: Part of Mexico cleared in salmonella probe

A dengue epidemic has claimed at least 54 lives in Rio de Janeiro state since January, health officials said Thursday.

Hospitals have reported a total of 114 deaths from the mosquito-borne disease, but 60 of those cases are still being investigated.

Brazilian Health Care Secretary Jose Noronha said that 1,200 soldiers from the army, air force and navy would be deployed next week to set up three field hospitals, while an additional 500 would spray insecticide and place poison in standing puddles of water where the mosquitoes breed.

"The intensity of the epidemic has brought intolerable death tolls," Noronha told reporters after a meeting with armed forces commanders.

The majority of the confirmed deaths, 31, have been in the city of Rio de Janeiro — Brazil's biggest resort city. Rio has seen a 25 percent drop in tourism as a result, the Brazilian Hotel Association said.

About half of the victims were children under the age of 13.

More than 43,000 people have contracted disease since January in Rio de Janeiro state — nearly double the 25,107 cases reported in all of 2007. The state is home to 16 million people.

State health official Victor Berbara said the outbreak highlights the importance of fighting the dengue-carrying Aedes aegypti mosquito all year — not just between November and May when most infections occur.

"If nothing is done ... next year is going to be much worse," he told reporters.

Earlier this week, federal officials sent hundreds of health workers to Rio de Janeiro state to help care for victims in the state's overcrowded emergency rooms, and set up special tents with extra hospital beds in the city.

On Wednesday, Rio de Janeiro state Gov. Sergio Cabral ordered health officials to break into homes suspected of containing standing bodies of water if the owners could not be found.

Dengue, which has no vaccine, can incapacitate patients for over a week with severe headaches and joint pains, but is not usually fatal.

The last line is very important--dengue is usually not fatal.  Most of those who have died have been children, which only adds to the burden and difficulties.  When the health official said that this needs to be treated preventatively, by dealing with the mosquitoes year round, he was absolutely correct.  Prevention costs less in the end than dealing with the ramifications of NOT using preventive medicine.  Then another question came to mind.  I have to wonder, with the onset and continuation of global warming, if this issue will only become worse.  Areas that are endemic for mosquito-bourne illnesses will only get warmer and those areas that now are not endemic may change in such a way (warmer temps, more moisture in the air) that this becomes a problem in NEW areas.  Something to ponder.  As always, let me know what you think!

No one died, and regulators said the public was never at risk during these incidents. But the documented cases reflect poorly on procedures and oversight at high-security labs, some of which work with organisms and poisons so dangerous that illnesses they cause have no cure. In some cases, labs have failed to report accidents as required by law.

The mishaps include workers bitten or scratched by infected animals, skin cuts, needle sticks and more, according to a review by The Associated Press of confidential reports submitted to federal regulators. They describe accidents involving anthrax, bird flu virus, monkeypox and plague-causing bacteria at 44 labs in 24 states. More than two-dozen incidents were still under investigation.

The number of accidents has risen steadily. Through August, the most recent period covered in the reports obtained by the AP, labs reported 36 accidents and lost shipments during 2007 — nearly double the number reported during all of 2004.

Research labs have worked for years to find cures and treatments for diseases. However, the expansion of the lab network has been dramatic since President Bush announced an upgrade of the nation's bio-warfare defense program five years ago. The National Institute of Allergy and Infectious Diseases, which funds much of the lab research and construction, was spending spent about $41 million on bio-defense labs in 2001. By last year, the spending had risen to $1.6 billion.

The number of labs approved by the government to handle the deadliest substances has nearly doubled to 409 since 2004. Labs are routinely inspected by federal regulators just once every three years, but accidents trigger interim inspections.

"It may be only a matter of time before our nation has a public health incident with potentially catastrophic results," said Rep. Bart Stupak, D-Mich., chairman of the House Energy and Commerce investigations subcommittee. Stupak's panel has been investigating the lab incidents and will conduct a hearing Thursday.

Lab accidents have affected the outside world: Britain's health and safety agency concluded there was a "strong probability" a leaking pipe at a British lab manufacturing vaccines for foot-and-mouth disease was the source of an outbreak of the illness in livestock earlier this year. Britain was forced to suspend exports of livestock, meat and milk products and destroy livestock. The disease does not infect humans.

Accidents aren't the only concern. While medical experts consider it unlikely that a lab employee will become sick and infect others, these labs have strict rules to prevent anyone from stealing organisms or toxins and using them for bioterrorism.

The reports were so sensitive the Bush administration refused to release them under the Freedom of Information Act, citing an anti-bioterrorism law aimed at preventing terrorists from locating stockpiles of poisons and learning who handles them.

Among the previously undisclosed accidents:

_In Rockville, Md., ferret No. 992, inoculated with bird flu virus, bit a technician at Bioqual Inc. on the right thumb in July. The worker was placed on home quarantine for five days and directed to wear a mask to protect others.

_An Oklahoma State University lab in Stillwater in December could not account for a dead mouse inoculated with bacteria that causes joint pain, weakness, lymph node swelling and pneumonia. The rodent — one of 30 to be incinerated — was never found, but the lab said an employee "must have forgotten to remove the dead mouse from the cage" before the cage was sterilized.

_In Albuquerque, N.M., an employee at the Lovelace Respiratory Research Institute was bitten on the left hand by an infected monkey in September 2006. The animal was ill from an infection of bacteria that causes plague. "When the gloves were removed, the skin appeared to be broken in 2 or 3 places," the report said. The worker was referred to a doctor, but nothing more was disclosed.

_In Fort Collins, Colo., a worker at a federal Centers for Disease Control and Prevention facility found, in January 2004, three broken vials of Russian spring-summer encephalitis virus. Wearing only a laboratory coat and gloves, he used tweezers to remove broken glass and moved the materials to a special container. The virus, a potential bio-warfare agent, could cause brain inflammation and is supposed to be handled in a lab requiring pressure suits that resemble space suits. The report did not say whether the worker became ill.

Other reports describe leaks of contaminated waste, dropped containers with cultures of bacteria and viruses, and defective seals on airtight containers. Some recount missing or lost shipments, including plague bacteria that was supposed to be delivered to the Armed Forces Institute of Pathology in 2003. The wayward shipment was discovered eventually in Belgium and incinerated safely.

The reports must be submitted to regulators whenever a lab suffers a theft, loss or release of any of 72 substances known as "select agents" — a government list of germs and toxins that represent the horror stories of the world's worst medical tragedies for humans and animals.

A senior CDC official, Dr. Richard Besser, said his agency is committed to ensuring that U.S. labs are safe and that all such incidents are disclosed to the government. He said he was unaware of any risk to the public resulting from infections among workers at the high-security labs, but he acknowledged that regulators are worried about accidents that could go unreported.

"If you're asking if it's possible for someone to not report an infection, and have it missed, that clearly is a concern that we have," Besser said.

Texas A&M's laboratory failed to report, until this year, one case of a lab worker's infection from Brucella bacteria last year and three others' previous infection with Q fever — missteps documented in news reports earlier this year. The illnesses are characterized by high fevers and flu-like symptoms that sometimes cause more serious complications.

"The major problems at Texas A&M went undetected and unreported, and we don't think that it was an isolated event," critic Edward Hammond said. He runs the Sunshine Project, which has tracked incidents at other labs for years and first revealed the Texas A&M illnesses that the school failed to report.

Rules for working in the labs are tough and are getting more restrictive as the bio-safety levels rise. The highest is Level 4, where labs study substances that pose a "high risk of life-threatening disease for which no vaccine or therapy is available." Besides wearing wear full-body, air-supplied suits, workers undergo extensive background checks and carry special identification cards.

"The risk that a killer agent could be set loose in the general population is real," Hammond said.

In other lab accidents recounted in the reports, the Public Health Research Institute in Newark, N.J., was investigated by the FBI in 2005 when it couldn't account for three of 24 mice infected with plague bacteria. The lab and the CDC concluded the mice were cannibalized by other plague-infested mice or buried under bedding when the cage was sterilized with high temperatures.

The lab's director, Dr. David Perlin, told the AP it would be impossible for mice to escape from the building and said a worker failed to record their deaths.

"I feel 99 percent comfortable that was the case," Perlin said. "The animals become badly cannibalized. You only see bits and pieces. They're in cages with shredded newspaper. You really have to search hard with gloves and masks."

A worker at the Army's biological facility in Fort Detrick, Md., was grazed by a needle in February 2004 and exposed to the deadly Ebola virus after a mouse kicked a syringe. She was placed in an isolation ward called "The Slammer," but the Army said she did not become ill.

In other previously undisclosed accidents:

In Decatur, Ga., a worker at the Georgia Public Health Laboratory handled a Brucella culture in April 2004 without high-level precautions. She became feverish months later and tested positive for exposure at a hospital emergency room in July. She eventually returned to work. The lab's confidential report defended her: "The technologist is a good laboratorian and has good technique."

In April this year at the Loveless facility in Albuquerque, an African green monkey infected intentionally with plague-causing bacteria reached with its free hand and scratched at a Velcro restraining strap, cutting into the gloved hand of a lab worker. The injured worker at the Lovelace Respiratory Research Institute received medical treatment, including an antibiotic.

The National Animal Disease Center in Ames, Iowa, reported leaks of contaminated waste three times in November and December 2006. While one worker was preparing a pipe for repairs, he cut his middle finger, possibly exposing him to Brucella, according to the confidential reports.

A researcher at the CDC's lab in Fort Collins, Colo., dropped two containers on the floor last November, including one with plague bacteria.

A worker at Walter Reed Army Institute of Research-Naval Medical Research Center in Silver Spring, Md., sliced through two pair of gloves while handling a rat carcass infected with plague bacteria. The May 2005 report said she was sent to an emergency room, which released her and asked her to return for a follow-up visit.

I was not aware of the ebola mouse incident in 2004.  Interesting stuff!  It still seems entirely too easy for someone to pick up a deadly virus or bacteria either in the form of an illness or an incident.  As I've said in the past, we can only prevent SO MUCH. 

It sounds like the plot for a scary B-movie: Germs go into space on a rocket and come back stronger and deadlier than ever. Except, it really happened.

The germ: Salmonella, best known as a culprit of food poisoning. The trip: Space Shuttle STS-115, September 2006. The reason: Scientists wanted to see how space travel affects germs, so they took some along — carefully wrapped — for the ride. The result: Mice fed the space germs were three times more likely to get sick and died quicker than others fed identical germs that had remained behind on Earth.

"Wherever humans go, microbes go, you can't sterilize humans. Wherever we go, under the oceans or orbiting the earth, the microbes go with us, and it's important that we understand ... how they're going to change," explained Cheryl Nickerson, an associate professor at the Center for Infectious Diseases and Vaccinology at Arizona State University.

Nickerson added, in a telephone interview, that learning more about changes in germs has the potential to lead to novel new countermeasures for infectious disease.

She reports the results of the salmonella study in Tuesday's edition of Proceedings of the National Academy of Sciences.

The researchers placed identical strains of salmonella in containers and sent one into space aboard the shuttle, while the second was kept on Earth, under similar temperature conditions to the one in space.

After the shuttle returned, mice were given varying oral doses of the salmonella and then were watched.

After 25 days, 40 percent of the mice given the Earth-bound salmonella were still alive, compared with just 10 percent of those dosed with the germs from space. And the researchers found it took about one-third as much of the space germs to kill half the mice, compared with the germs that had been on Earth.

The researchers found 167 genes had changed in the salmonella that went to space.

Why?

"That's the 64 million dollar question," Nickerson said. "We do not know with 100 percent certainty what the mechanism is of space flight that's inducing these changes."

However, they think it's a force called fluid shear.

"Being cultured in microgravity means the force of the liquid passing over the cells is low." The cells "are responding not to microgravity, but indirectly to microgravity in the low fluid shear effects."

"There are areas in the body which are low shear, such as the gastrointestinal tract, where, obviously, salmonella finds itself," she went on. "So, it's clear this is an environment not just relevant to space flight, but to conditions here on Earth, including in the infected host."

She said it is an example of a response to a changed environment.

"These bugs can sense where they are by changes in their environment. The minute they sense a different environment, they change their genetic machinery so they can survive," she said.

The research was supported by the National Aeronautics and Space Administration, Louisiana Board of Regents, Arizona Proteomics Consortium, National Institute of Environmental Health Sciences, Southwest Environmental Health Sciences Center, National Institutes of Health and the University of Arizona.

I have to admit, it sounds like something from a Michael Crichton novel.  Andromeda Strain or maybe Sphere.  Way cool, though.  It isn't surprising, of course.  Cells and organisms tend to do what they can to survive in changing conditions.  No shock that they would adapt to their environment so they were better able to survive and thrive.  That's what we're biologically primed to do!

Villagers in southern Peru were struck by a mysterious illness after a meteorite made a fiery crash to Earth in their area, regional authorities said Monday.

Around midday Saturday, villagers were startled by an explosion and a fireball that many were convinced was an airplane crashing near their remote village, located in the high Andes department of Puno in the Desaguadero region, near the border with Bolivia.

Residents complained of headaches and vomiting brought on by a "strange odor," local health department official Jorge Lopez told Peruvian radio RPP.

Seven policemen who went to check on the reports also became ill and had to be given oxygen before being hospitalized, Lopez said.

Rescue teams and experts were dispatched to the scene, where the meteorite left a 100-foot-wide (30-meter-wide) and 20-foot-deep (six-meter-deep) crater, said local official Marco Limache.

"Boiling water started coming out of the crater and particles of rock and cinders were found nearby. Residents are very concerned," he said. Very interesting, indeed!  Anyone care to speculate about a cause for illness of these folks?  Headaches, vomiting, strange odor? I'd guess heavy metal poisoning or perhaps a chemical reaction that released some sort of noxious gas.  This wasn't a small meteor, either.  It was fairly large.  I hope they are able to prevent serious illness from this incident.  Have a wonderful day!  This is the best season of the year :) (Football season, of course!)

The World Health Organisation said Tuesday that five cases of the deadly Ebola virus had been confirmed in the Democratic Republic of Congo, after dozens of people succumbed to an unidentified illness in recent months.

The five cases of the viral haemorrhagic illness were confirmed in western Kasai in the centre of the vast African country, WHO spokeswoman Fadela Chaib told journalists in Geneva.

Ebola causes the patient to bleed under the skin and in severe cases, from the mouth, ears and eyes. The virus, which has no known cure, is highly infectious for those who come into contact with a victim's body fluids.

The WHO was not in a position to say whether the five people confirmed with Ebola are presently alive or dead, she added.

Separately, the public health minister of the DRC, Victor Makwenge, said the current Ebola epidemic had claimed 166 lives out of a total 372 cases since April 2007.

However, Chaib stressed to journalists in Geneva that another illness other than Ebola could yet be responsible for some of these deaths, possibly the Shigella infectious disease which is less deadly than Ebola.

"The priority for the WHO is to find those who are sick with Ebola, to isolate them and to trace the people with whom they have been in contact," Chaib said.

WHO teams on the ground will also help families of the deceased to bury their bodies in a secure fashion, she added.

Ebola has killed some 450 people in the DRC since 1976, and 1,200 people across the whole of Africa in the same period.

Local authorities said at the end of August that 68 people had died from an unknown illness within the space of four months in western Kasai.

A woman on the Indonesian island of Sumatra caught the H5N1 bird flu virus from poultry in May last year and passed it to relatives. (AFP: Mamat)