Endemic, Notifiable Bioterrorism-Related Diseases, United States, 1992–1999

Little information is available in the United States regarding the incidence and distribution of diseases caused by critical microbiologic agents with the potential for use in acts of terrorism. We describe disease-specific, demographic, geographic, and seasonal distribution of selected bioterrorism-related conditions (anthrax, botulism, brucellosis, cholera, plague, tularemia, and viral encephalitides) reported to the National Notifiable Diseases Surveillance System in 1992–1999. Tularemia and brucellosis were the most frequently reported diseases. Anthrax, plague, western equine encephalitis, and eastern equine encephalitis were rare. Higher incidence rates for cholera and plague were noted in the western United States and for tularemia in the central United States. Overall, the incidence of conditions caused by these critical agents in the United States is low. Individual case reports should be considered sentinel events. For potential bioterrorism-related conditions that are endemic and have low incidence, the use of nontraditional surveillance methods and complementary data sources may enhance our ability to rapidly detect changes in disease incidence

Gene–environment interactions in Leber hereditary optic neuropathy

Leber hereditary optic neuropathy (LHON) is a genetic disorder primarily due to mutations of mitochondrial DNA (mtDNA). Environmental factors are thought to precipitate the visual failure and explain the marked incomplete penetrance of LHON, but previous small studies have failed to confirm this to be the case. LHON has no treatment, so identifying environmental triggers is the key to disease prevention, whilst potentially revealing new mechanisms amenable to therapeutic manipulation. To address this issue, we conducted a large, multicentre epidemiological study of 196 affected and 206 unaffected carriers from 125 LHON pedigrees known to harbour one of the three primary pathogenic mtDNA mutations: m.3460G>A, m.11778G>A and m.14484T>C. A comprehensive history of exposure to smoking, alcohol and other putative environmental insults was collected using a structured questionnaire. We identified a strong and consistent association between visual loss and smoking, independent of gender and alcohol intake, leading to a clinical penetrance of 93% in men who smoked. There was a trend towards increased visual failure with alcohol, but only with a heavy intake. Based on these findings, asymptomatic carriers of a LHON mtDNA mutation should be strongly advised not to smoke and to moderate their alcohol intake

Sterile neutrino production via active-sterile oscillations: the quantum Zeno effect

We study several aspects of the kinetic approach to sterile neutrino production via active-sterile mixing. We obtain the neutrino propagator in the medium including self-energy corrections up to $\mathcal{O}(G^2_F)$, from which we extract the dispersion relations and damping rates of the propagating modes. The dispersion relations are the usual ones in terms of the index of refraction in the medium, and the damping rates are $\Gamma_1(k) = \Gamma_{aa}(k) \cos^2\theta_m(k); \Gamma_2(k) = \Gamma_{aa}(k) \sin^2\theta_m(k)$ where $\Gamma_{aa}(k)\propto G^2_F k T^4$ is the active neutrino scattering rate and $\theta_m(k)$ is the mixing angle in the medium. We provide a generalization of the transition probability in the \emph{medium from expectation values in the density matrix}: $P_{a\to s}(t) = \frac{\sin^22\theta_m}{4}[e^{-\Gamma_1t} + e^{-\Gamma_2 t}-2e^{-{1/2}(\Gamma_1+\Gamma_2)t} \cos\big(\Delta E t\big)]$ and study the conditions for its quantum Zeno suppression directly in real time. We find the general conditions for quantum Zeno suppression, which for $m_s\sim \textrm{keV}$ sterile neutrinos with $\sin2\theta \lesssim 10^{-3}$ \emph{may only be} fulfilled near an MSW resonance. We discuss the implications for sterile neutrino production and argue that in the early Universe the wide separation of relaxation scales far away from MSW resonances suggests the breakdown of the current kinetic approach.Comment: version to appear in JHE

Characteristics of Non-typhoidal Salmonella Isolates from Human and Broiler-chickens in Southwestern Seoul, Korea

Non-typhoidal Salmonella (NTS) is an important commensal microorganism. The purpose of this study was to determine the epidemiological relation between NTS isolates from livestock and NTS isolates from human by analyzing antimicrobial susceptibilities and performing molecular typing. We determined the serotypes of 36 human clinical isolates and 64 livestock isolates, performed antimicrobial susceptibility testing against 8 antibiotics, and determined the molecular types of isolated NTS spp. by pulsed field gel electrophoresis (PFGE). In human isolates, S. enteritidis was the most common serotype (17 isolates; 47.2%) and S. typhimurium the second most (8 isolates; 22.2%). In livestock isolates, S. typhimurium was the most common serotype (15 isolates; 23.44%), and S. enteritidis was the second most (14 isolates; 21.88%). Ampicillin and tetracycline resistance were 50% (32/64 isolates) each among broiler-chicken NTS isolates. No human or livestock NTS isolates showed resistance to ciprofloxacin, TMP-SMX, or ceftriaxone. However, 19.4% (7/36) and 46.8% (30/64) of the human and livestock NTS isolates were resistant to nalidixic acid (MIC ≥16 mg/mL), respectively. The presence of the three identical PFGE molecular types from human and broiler-chicken NTS isolates suggests the possibility of transmission from livestock to humans

A Case of Recurrent Neuro-Behçet's Disease after Tooth Extraction

We report a 39-yr-old man with neuro-Behçet's disease (NBD) in remission who developed left-sided ataxia with a sensory deficit about 10 days after tooth extraction. Several years ago, he experienced a similar episode of relapse after tooth extraction. Brain magnetic resonance imaging showed a newly developed right thalamic lesion. In cerebrospinal fluid, lymphocyte-dominant pleocytosis and mild elevation of IgG were found. Immunologic factors may be important in the pathogenesis of NBD because of the time delay between tooth extraction and relapse. Careful observation and prevention are needed before dental procedures in patients with NBD