As 2012 ends and we dive into another year, let's take a moment to look back at some significant infectious disease outbreaks from 2012. Please keep in mind that this list is by no means all-inclusive, and is ordered by chronology and not importance or impact.
Whooping Cough in the United States
Between 2011 and 2012, cases of pertussis, or whooping cough, doubled in the United States. Some states in particular suffered dramatic increases in the preventable disease: cases in Wisconsin were ten times higher than they were in 2011, and Washington requested federal assistance for its surge of whooping cough cases.
In many ways, the whooping cough outbreaks across the United States are an artifact of other trends. Whooping cough is preventable, and over 80 percent of children in the United States receive the vaccine. However, low vaccine booster rates among adults – as low as 8 percent – and parents opting for philosophical exemptions to vaccines for their children are poking holes in the protection we receive as a population when nearly everyone is vaccinated. Regardless of the driving mechanism, it was evident in 2012 that whooping cough is making a dramatic return in the United States.
Disease Daily reporting on whooping cough in the United States:
Enterovirus 71 in Cambodia
In early July of this year, a mysterious respiratory illness spread rapidly among Cambodia’s young children. Samples sent to the Institut Pasteur du Cambodge revealed that enterovirus 71 (EV-71) was causing a severe form of Hand, Foot and Mouth disease (HFMD).
A total of 78 cases were identified, most from Kantha Bopha hospital in Phnom Penh, and 54 died. Most of the cases were children under three years old, and were spread across fourteen different provinces.
As a result of this outbreak, HMFD is now a condition reportable to the Ministry of Health in Cambodia. The Ministry is working on guidelines and training courses for health care workers to improve surveillance of and care for HMFD.
Disease Daily reporting on EV-71 in Cambodia:
Ebola in Uganda, Democratic Republic of Congo
On July 26, Ugandan media picked up stories of a strange disease killing people in the Kibaale district. Ahura Mujuni Mark wrote in Uganda Picks that a family experienced diarrhea, vomiting, stomach ache and bleeding from gums and nose prior to death.
Two days later, the Associated Press reported that a World Health Organization official declared the mystery disease to be Ebola hemorrhagic fever. On July 30, the Office of the President of Uganda affirmed that the Ebola strain affecting the Kibaale District was the Sudan strain.
A few weeks later, the WHO reported that the Democratic Republic of Congo was in the midst of its own Ebola outbreak. An initial ten suspected cases and six suspected deaths were recorded from Province Orientale, in the eastern part of the country. Laboratory investigations revealed that the Ebola strain affecting the DRC was the Bundibugyo strain, different from what was circulating simultaneously in Uganda.
The outbreak of Ebola-Sudan in Uganda was declared over by the WHO on Oct. 4. The final case count was 24 probable cases and 17 deaths.
The latest update from the WHO on the outbreak in the DR Congo reported 52 cases (35 confirmed by laboratory tests, 17 probable) and 25 deaths (12 confirmed by laboratory tests, 13 probable).
After a brief respite from Ebola (although not from hemorrhagic fevers, as Marburg sprung up in Uganda in late October), the virus was detected again in Uganda. On Nov. 17, the WHO shared reports from the Uganda Ministry of Health stating that four cases and three deaths due to Ebola-Sudan had been detected in the Luweero district of Central Uganda. According to the WHO’s latest report, there are seven cases and four deaths in Luweero.
Disease Daily reporting on Ebola in Uganda and Democratic Republic of Congo:
West Nile Virus in the United States
In August 2012, Dr. Lyle Peterson of the CDC indicated we were in the middle of “one of the largest West Nile virus outbreaks ever seen in the United States.” This year, the United States recorded 1118 cases of the mosquito-borne disease, and 41 deaths. Eighty percent of the total cases occurred in Texas, Mississippi, and Oklahoma. Dallas County, Texas, declared a state of emergency and reported 141 cases and 8 deaths.
West Nile virus is relatively new in the United States. In fact, the CDC reports the disease only making it to this population in the summer of 1999. However, seasonal spikes in West Nile cases occur most summers, and the disease has been recorded in 42 states.
Disease Daily reporting on West Nile virus in the United States:
Hantavirus in Yosemite
In addition to beautiful scenery and natural wonders, this summer, Yosemite National Park offered some visitors a lesson in infectious disease.
The National Park Service (NPS) announced, in late August, three confirmed cases of Hantavirus Pulmonary Syndrome. The cases had stayed in Yosemite’s Curry Village. In the days following the announcement, NPS and the California Department of Public Health contacted visitors who stayed in Curry Village over the summer and asked that anyone exhibiting symptoms of HPS seek medical attention.
Hantavirus is carried in the United States by rodents such as the deer mouse, the cotton rat, the rice rat and the white-footed mouse. Rodents shed the virus in droppings and urine. Tiny droplets of the virus become airborne and are transmitted to humans. Symptoms of HPS include fatigue, fever, muscle soreness, headaches, chills, nausea, vomiting, diarrhea and shortness of breath.
There is no specific treatment for HPS. According to the CDC, cases that have been diagnosed early, may have better outcomes.
As of Nov. 1, NPS reported ten confirmed cases and three deaths from exposure to infected rodents at Yosemite National Park.
Disease Daily Reporting on Hantavirus in Yosemite:
Cholera in Sierra Leone
In 2012, Sierra Leone suffered its worst cholera outbreak in fifteen years. Without proper water and sanitation measures, the Vibrio cholerae bacteria persist and are a significant threat in endemic countries. Spurred on by heavy rainfall, densely populated slums around Freetown suffered the largest impact.
As of Sept. 5, the World Health Organization’s Global Alert Response System recorded 16,360 cases and 255 deaths – yielding a case fatality rate of 1.6 percent. That month, Sierra Leone declared the outbreak a national emergency.
With the help of international organizations such as Doctors Without Borders, Sierra Leone’s government was able to stem the outbreak with water purification tablets and sanitation measures. However, in a country where only 55 percent of people drink from improved water sources, the threat of cholera is not gone.
Disease Daily reporting on cholera in Sierra Leone:
Discovery of Novel Coronavirus
During the month of September, shortly before the Hajj, a 49-year-old Qatari male puzzled doctors with acute respiratory symptoms and renal failure. The case had recently traveled to Saudi Arabia. On Sept. 11, he was transferred to the United Kingdom where the Health Protection Agency confirmed that he had been infected with a novel coronavirus.
In the days that followed, anxiety and panic rose, due in part to the discovery of an illness in Saudi Arabia just before the arrival of millions pilgrims to Mecca, and also to the fact that Severe Acute Respiratory Syndrome, or SARS, is also a part of the coronavirus family. Though, the common cold is a coronavirus as well.
The WHO has assured people that while this novel coronavirus does cause a severe illness presenting as pneumonia, it does not spread easily between people, like SARS.
As of late December, the WHO reports nine cases of human infection with the novel coronavirus (two cases in Qatar, five in Saudi Arabia and two in Jordan) and five deaths.
Disease Daily reporting on novel coronavirus:
Fungal Meningitis in United States
On Oct. 6, the New England Compounding Center (NECC) issued a voluntary recall of all its products that had been compounded in Framingham, Mass. due to possible contamination. Facilities in 23 states received vials of methylprednisolone acetate, an injectable medication used to treat pain and swelling caused by joint disorders, from NECC.
The medication was contaminated with fungi, predominantly the Exserohilum rostratum fungus, which cause a variety of invasive infections, particularly in people with weakened immune systems.
The result is, as of Dec. 28, 656 cases of fungal meningitis linked to steroid injections, and 39 deaths. Michigan and Tennessee were hit the hardest, with 232 and 139 cases, respectively.
Disease Daily reporting on fungal meningitis:
Marburg in Uganda
On Oct. 19, Uganda’s New Vision reported on the beginnings of a Marburg outbreak in Kabale district, Uganda. Shortly after the Uganda Virus Research Institute confirmed the presence of Marburg virus, a team of health workers began tracing all contacts of those infected, and the Ministry of Health discouraged unnecessary public gatherings.
Marburg hemorrhagic fever is caused by the Marburg virus, member of the filovirus family. It was first discovered in Germany in 1967, when scientists who were handling monkeys imported from Africa fell ill.
As of Nov. 23, a total of 20 cases and nine deaths were recorded in Uganda. According to the WHO, the last case was hospitalized on Oct. 31.
Disease Daily reporting on Marburg:
Yellow Fever in Sudan
In the fall of 2012, the Sudanese government declared seven districts of Central and South Darfur to be in a yellow fever epidemic. At that point, the government recorded 84 suspected cases and 32 deaths – an alarmingly high case fatality rate.
It is possible the yellow fever epidemic in Sudan was larger than anticipated. The disease is often confused with other mosquito-borne diseases because of its non-specific symptoms, which include fever, malaise, and chills.
To stop the burgeoning yellow fever epidemic, the WHO initiated a vaccination campaign in Sudan. Still, authorities recommended attention to bed nets and protective clothing, which could help prevent other mosquito-borne illnesses, such as malaria and dengue, which also affect the country.
Disease Daily reporting on yellow fever in Sudan:
written by Jason Hayes and Anna Tomasulo