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MMWR – Morbidity and Mortality Weekly Report

Emergence of Cryptococcus gattii — Pacific Northwest, 2004–2010

CDC Division of News and Electronic Media
Phone: (404) 639-3286

Cryptococcus gattii is an emerging infection in the United States Pacific Northwest. Unlike the more common Cryptococcus neoformans, most patients with C. gattii infection are not infected with HIV. Although C. gattii infections are rare, with only 60 infections reported since 2004, they can be severe or fatal. Common symptoms include prolonged cough, shortness of breath, headache, fever, and weight loss. Clinical signs can include pneumonia, meningitis, and cryptococcomas in the lungs, brain, and other tissues. If patients are experiencing these symptoms, they should visit their doctor. Clinicians should consider C. gattii as a possible etiology of cryptococcal infection among symptomatic patients, particularly HIV-negative patients, who live in or have visited the Pacific Northwest or other C. gattii-endemic areas during the past year. In addition, clinicians should report suspected cases of C. gattii infection to their state health department and seek speciation of isolates from patients with suspected C. gattii infection.

2. La Crosse Virus Neuroinvasive Disease — Missouri, 2009

Kit Wagar
Missouri Department of Health and Senior Services
Phone: (573) 751-6062

La Crosse virus (LACV) neuroinvasive disease is a rare mosquito-borne disease that occurs mostly in the upper Midwestern and mid-Atlantic states. In August, 2009, the Missouri Department of Health and Senior Services was notified of suspected LACV neuroinvasive disease in a boy aged 8 years from northwest Missouri. Laboratory testing at CDC confirmed LACV infection. An environmental examination identified multiple vector habitats, including tree holes and discarded tires near the patient's home. This is the first reported case of LACV neuroinvasive disease in Missouri since 2002. Because the mosquito vector (Aedes triseriatus) is distributed through Missouri and as far west as central Kansas and eastern Nebraska, health-care providers serving this region should consider LACV among patients with unexplained meningoencephalitis occurring during summer and fall.

3. Gastrointestinal Anthrax After an Animal-Hide Drumming Event — Massachusetts and New Hampshire, 2009

CDC Division of News and Electronic Media
Phone: (404) 639-3286

When investigating any anthrax case (cutaneous, inhalation, or gastrointestinal), public health agencies should consider that any exposure to animal-hide drums (making drum, playing drums, or participating in drumming events) carries a potential, although remote, risk for anthrax exposure. Cases of cutaneous and inhalation anthrax have been reported in persons who have had exposures to imported animal-hide drums contaminated with B. anthracis. But, this report describes the first gastrointestinal anthrax case related to animal-hide drum exposures. Therefore, when investigating any anthrax case, public health agencies should consider any exposure to animal-hide drums as potential exposure sources. However, it is important to keep in mind that drumming circles are common activities, and given the extreme rarity of cases like the one reported here, the risk for infection is considered very low. Lastly, detection of unknown gram-positive bacilli from patients with illnesses consistent with B. anthracis infection should result in immediate notification of the health-care provider, laboratorians, and public health officials.



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