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  Press Summaries

MMWR
August 20, 1999

MMWR articles are embargoed until 4 p.m. Eastern time on Thursday.


MMWR Synopsis
  1. Carbon Monoxide Poisoning Deaths Associated with Camping Georgia, March 1999
  2. Four Pediatric Deaths from Community-Acquired Methicillin-Resistant Staphylococcus aureus Minnesota and North Dakota, 19971999
  3. Gastrointestinal Basidiobolomycosis Arizona, 19941999
  4. Iron Deficiency Anemia in Alaska Native Children Hooper Bay, Alaska, 1999
Fact Sheet Gastrointestinal Basidiobolomycosis

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Synopsis August 20, 1999

Carbon Monoxide Poisoning Deaths Associated with Camping Georgia, March 1999
Camping stoves and heaters, lanterns, and charcoal grills should never be used inside a tent, camper, or other enclosed shelter.

PRESS CONTACT:
W. Randolph Daley, D.V.M., M.P.H.
CDC, National Center for Environmental Health
(770) 4887350
From 19901884 in the United States, portable camp stoves and lanterns were involved in from 10 to 17 carbon monoxide poisoning deaths annually. During March 1999, six people died from carbon monoxide poisoning in the state of Georgia while camping. These deaths occurred in two separate incidents, due to a propane camping stove in one and a charcoal grill in the other. These devices had been brought inside a tent to provide warmth while sleeping. To avoid hazardous carbon monoxide exposures, camping stoves, camping heaters, lanterns, and charcoal grills should never be used inside a tent, camper, or other enclosed shelter. Rather, people should always ensure that they have adequate bedding and clothing to provide warmth before leaving home.

  Four Pediatric Deaths from Community-Acquired Methicillin-Resistant Staphylococcus aureus Minnesota and North Dakota, 19971999
Healthcare providers should be aware that MRSA can cause severe illness and even death in otherwise healthy children.
PRESS CONTACT:
Timothy Naimi, M.D., M.P.H.
CDC, Epidemiology Program Office
(612) 6765414
(Secondary: Dr. Kirk Smith, Minnesota Department of Health, same phone number)
MRSA is an emerging, community acquired infection. In Minnesota and North Dakota, four cases of MRSA infection have been identified among children who did not have established risk factors. All four children died; 7-year-old girl, 16-month-old girl, 13-year-old girl, and 1-year-old boy. Traditionally, these infections have been restricted to patients with serious medical problems, recent or current hospitalization, or residence in long-term care facilities. Additionally, all four children had been treated with cephalosporin and cephalosporin resistance may have contributed to their clinical deterioration. Healthcare providers should consider MRSA in cases of severe pediatric pneumonia or sepsis syndromes in areas where community MRSA infections have been reported.

  Gastrointestinal Basidiobolomycosis Arizona, 19941999
A rare, severe, fungal disease, basidiobolomycosis may initially be misdiagnosed as cancer or inflammatory bowel disease.
PRESS CONTACT:
Marshall Lyon, M.D.
CDC, National Center for Infectious Diseases
(404) 6392499
Basidiobolomycosis is a rare fungal infection that can cause disease under the skin or involve the stomach or colon. The fungus that causes this disease is found throughout the world and the United States, often in association with amphibians or reptiles and their excrement. In Arizona over the last 5 years, 6 persons with gastrointestinal basidiobolomycosis infection have been identified; three in the first 3 months of 1999. All of these patients were initially misdiagnosed. Healthcare providers should consider basidiobolomycosis when caring for patients with gastrointestinal disease that doesn't respond to the usual treatment, or when a patient is diagnosed with an unusual, non-cancerous abdominal tumor. Based on case reports, following surgical excision of the affected areas, the patients responded to treatment with itraconazole. The latter therapy should continue for several months.

  Iron Deficiency Anemia in Alaska Native Children Hooper Bay, Alaska, 1999
Anemia and iron deficiency are significant public health problems among Alaska Native children.
PRESS CONTACT:
Ann DiGirolamo, Ph.D.
CDC, National Center for Chronic Disease Prevention & Health Promotion
(770) 4885820
Despite the decline in childhood iron deficiency anemia in the United States over the past 3 decades, anemia continues to be a prevalent problem among Alaska Native children. This investigation indicated that the estimated prevalence of anemia among children, 12 to 71 months old , in Hooper Bay, Alaska was more than twice the U.S. average. The study also confirmed that the anemia was strongly related to iron deficiency. Factors that were significantly associated with anemia in these children included lower intake of foods that enhance iron absorption such as citrus juices, and seropositivity for Helicobacter pylori infection which was also highly prevalent among these children. H. pylori infection is a bacterial infection shown to be associated with stomach inflammation and ulcers in people worldwide. The extent to which H. pylori infection may contribute to anemia in other populations requires further investigation.

Facts About Gastrointestinal Basidiobolomycosis

August 20, 1999
Contact: Division of Media Relations
(404) 639-3286

  • Basidiobolomycosis of the gastrointestinal tract is a new or emerging infection that may have been previously unrecognized. Cases of gastrointestinal basidiobolomycosis are often misdiagnosed as cancer and inflammatory bowel disease.
  • Basidiobolomycosis of the gastrointestinal tract is very rare in people. Only 6 cases have been described in the world's medical literature. Those cases were reported from Brazil (3), Kuwait (1), and the United States (2). Half of the case-patients died despite medical therapy.
  • Basidiobolomycosis of the gastrointestinal tract usually begins with pain, and sometimes a mass can be felt in the abdomen. Treatment is not standardized, but should include itraconazole or ketoconazole possibly with surgical removal of the mass.
  • A more common form of basidiobolomycosis causes chronic, subcutaneous, fungal infection that usually affects people and some animals (such as horses and dogs). The name of the specific fungus is Basidiobolus ranarum.
  • The fungus is found mainly in the soil and on decaying vegetation. It has also been isolated from the river banks of tropical rivers in West Africa, and has also been found in association with some insects. The fungus is known to be present in the gastrointestinal tracts of reptiles, amphibians, and some bat species.
  • Subcutaneous disease is found most commonly among adolescent males in East and West Africa and Southeast Asia. The mechanism of transmission is thought to be traumatic inoculation.
  • The disease usually starts as a painless nodule or "lump" underneath the skin on the trunk or limbs. The nodule grows slowly and can become large and disfiguring. Sometimes the nodules can block the lymphatic drainage from the limb causing swelling or elephantiasis.
  • Several medicines have been successfully used to treat basidiobolomycosis; these include: itraconazole, ketoconazole, co-trimoxazole, and potassium chloride. All of these medications are given by mouth, but they require many months of treatment. Treatment usually continues for at least 1 month after the lesions disappear.

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