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An outbreak of severe diarrhea in rural central Haiti has killed at least 135 people and sickened hundreds more who overwhelmed a crowded hospital Thursday seeking treatment.

Hundreds of patients lay on blankets in a parking lot outside St. Nicholas hospital in the port city of St. Marc with IVs in their arms for rehydration. As rain began to fall in the afternoon, nurses rushed to carry them inside.

Doctors were testing for cholera, typhoid and other illnesses in the Caribbean country’s deadliest outbreak since a January earthquake that killed as many as 300,000 people.

“What we know is that people have diarrhea, and they are vomiting, and [they] can go quickly if they are not seen in time,” said Catherine Huck, country deputy for the UN Office for the Co-ordination of Humanitarian Affairs. She said doctors were still awaiting lab results to pinpoint the cause.

The president of the Haitian Medical Association, Claude Surena, said his unofficial count based on information from doctors and hospitals in the region indicated as many as 135 people had died and 1,500 were infected. He said the cause appeared to be cholera, but that had not been confirmed by the government.

“The concern is that it could go from one place to another place, and it could affect more people or move from one region to another one,” he said.

Cholera, a bacterial infection that spreads through contaminated water, causes severe diarrhea and vomiting that can lead to dehydration and death within hours. Treatment involves administering a salt- and sugar-based rehydration serum.

Drank from public canal

The sick at St. Nicholas hospital have come from across Haiti’s rural Artibonite region, which did not experience significant damage in the Jan. 12 quake but has absorbed thousands of refugees from the devastated capital, Port-au-Prince, 70 kilometres south of St. Marc. Government figures list a total of 54 people dead and 619 ill, said Yolaine Surena, a co-ordinator for Haiti’s civil protection department.

Some patients said they drank water from a public canal, while others said they bought purified water. All complained of symptoms including fever, vomiting and severe diarrhea.

“I ran to the bathroom four times last night vomiting,” said 70-year-old Belismene Jean Baptiste.

Trucks loaded with medical supplies, including rehydration salts, were to be sent from Port-au-Prince to the hospital, said Jessica DuPlessis, a UN spokeswoman. Doctors at the hospital said they also needed more personnel to handle the flood of patients.

Elyneth Tranckil was among dozens of relatives standing outside the hospital gate as new patients arrived near death.

“Police have blocked the entry to the hospital, so I can’t get in to see my wife,” Tranckil said.

The U.S. Embassy in Port-au-Prince issued an advisory urging people to drink only bottled or boiled water and eat only food that has been thoroughly cooked.

By cbc.ca

People receive rehydration serum in the parking lot of the St. Nicholas hospital in Saint Marc, Haiti, on Thursday. Health officials say an outbreak of severe diarrhea has killed at least 54 and sickened hundreds more. (Dieu Nalio Chery/Associated Press)

Health experts warned Wednesday of a stroke crisis in Europe which is already costing the region’s economy an estimated 38 billion euros ($56 billion) a year, with numbers expected to rise as populations age.

In a report for the European Parliament, medical experts working with the campaign group Action for Stroke Prevention, said atrial fibrillation (AF), the most common form of abnormal heart rhythm, affects more than six million people in Europe and increases the risk of stroke by five times.

The economic and health impact of stroke is predicted to grow as the number of people with AF is expected to rise two and a half times by 2050 due to aging populations, the report said.

It the said economic burden created by patients suffering strokes accounts for 2 to 3 percent of total healthcare spending in the European Union and AF is responsible for 15 to 20 percent of all strokes caused by blood clots.

“This burden will increase in years to come, due to both the improved survival of patients with conditions such as heart attacks and Europe’s aging population,” the report said.

Gregory Lip, professor of cardiovascular medicine at the University of Birmingham, said the majority of such strokes were preventable, but under-diagnosis and poor care of AF patients, as well as under-use of medicines and the side-effects of drugs means stroke creates “an unnecessary and heavy burden” on patients, carers and health systems.

AF causes the two upper chambers of the heart to quiver instead of beating properly, resulting in blood pooling and potentially forming clots that can cause stroke. Patients can be given anticoagulants, or blood thinners, to help prevent clots.

Stroke is the most common cardiovascular problem after heart disease and kills an estimated 5.7 million people worldwide each year. Current trends suggest the number of strokes in the European Union will rise from 1.1 million a year in 2000 to 1.5 million a year by 2025, the report said.

Action for Stroke Prevention, an alliance of cardiologists, neurologists, family doctors and patient groups, urged EU policymakers to improve stroke risk assessment and diagnosis of atrial fibrillation before the increasing frequency of strokes becomes “a major public health crisis.” Hard money training.

The infectious bacterial disease brucellosis has been found in a beef cow in eastern Idaho, and state agriculture officials are scrambling to see if the infection is isolated or if it has spread to other herds.

Idaho Department of Agriculture state veterinarian Bill Barton sent a memo Monday saying that a beef cow from a newly assembled 600-head herd tested positive for the disease, which is rarely transmitted to humans but can cause spontaneous abortions, infertility, decreased milk production and weight loss in cattle, elk, bison and other mammals.

No calves or bred females have been sold from the herd, according to Barton’s memo.

The herd has been quarantined and is being tested, and epidemiologists are trying to determine the source of the infection, Barton told The Associated Press on Tuesday.

“We’ve got just a few more head to do, and we’ll be finishing that testing and have the results back in a few more days,” he said.

Barton said the herd’s owner, who lives in the Rigby area, was cooperating. None of his cattle had been sold, other than directly to slaughter, Barton said.

The infected animal and other cattle in the herd had been vaccinated for brucellosis, Barton said.

“The vaccine is fairly efficacious in preventing disease, but it’s not 100 percent,” he said.

The animals came from a variety of sources, including private sales and livestock markets, Barton said. Officials had not yet determined where the man purchased the infected animal.

Barton declined to detail what prompted the state to begin testing the animals, simply saying “there was an indication that this herd needed a whole-herd test.”

A spokeswoman for the federal agency that oversees livestock diseases said an investigation has been launched into whether the infection has spread to other herds. How long that investigation could take was uncertain, said Lindsay Cole with the Agriculture Department’s Animal and Plant Health Inspection Service.

The infection comes as government officials are considering softening restrictions that apply to states with brucellosis infections.

Because the disease has been eliminated nationwide except for Yellowstone National Park and surrounding counties in Idaho, Montana and Wyoming, the government has proposed turning that area into a brucellosis “hot zone.” That would shield cattle producers outside the area from costly testing requirements for animals they ship out of state.

A public comment period on that proposal ends Friday. No timeline has been set for putting it into place.

Idaho was granted brucellosis-free status in 2007 after losing the status in 2006, when the disease was found in a cattle herd in Swan Valley near the Wyoming border. Wyoming lost its brucellosis-free status in 2003 when the disease was found in a herd of cattle near Pinedale but was granted it again in 2006. Montana gained brucellosis-free status in September after losing the designation in 2008. Hard money training.

When the nation’s swine flu vaccination program began in early October, health officials predicted it was going to be “messy.” They were right.

The program has been plagued with problems and information gaps:

* Health officials have been terrible at predicting when and how much vaccine would be available. Only about 44 million doses have been shipped so far. Initially, officials said more than three times that would be out by now.
* At times vaccine shipments have been inexplicably lopsided. For example, smaller counties in Illinois and California have received the same amount delivered to counties with seven times as many people.
* Health officials have stressed that people most at risk for swine flu complications should go to the head of the line, but they haven’t tried to make sure that actually happened.
* And despite pledges that they would be transparent about the vaccine program, some health officials have refused to disclose where all the doses are going, and they have held back on public service announcements telling people who should be coming in for shots. Also, many states were slow to establish Web sites that give vaccination locations.

To be fair, health officials say, the government deserves credit for a herculean effort to develop and distribute a safe and effective vaccine against a deadly virus that was first identified only seven months ago.

“You have a brand-new disease that gets identified in April. By October, you have a vaccine for it. By any standards, it’s a miracle,” said Dr. Diane Helentjaris, director of the Virginia Department of Health office handling swine flu response.

But complaints have been mounting, with lawmakers this week holding hearings in Washington and elsewhere, pressing for explanations.

“Calls are still coming in to me about, ‘Why can’t I get the vaccine?’” said Andrea Stillman, a Connecticut state senator speaking at a Wednesday hearing in Hartford. Hard money training

American squeamishness about talking about sex has helped keep common sexually transmitted infections far too common, especially among vulnerable teens, U.S. researchers reported Monday.

Latest statistics on chlamydia, gonorrhea and syphilis show the three highly treatable infections continue to spread in the United States.

“Chlamydia and gonorrhea are stable at unacceptably high levels and syphilis is resurgent after almost being eliminated,” said John Douglas, director of the division of sexually transmitted diseases at the U.S. Centers for Disease Control and Prevention.

“We have among the highest rates of STDs of any developed country in the world,” Douglas added in a telephone interview.

The administration of President Barack Obama has signaled a willingness to move away from so-called abstinence-only sex education approaches promoted by his predecessor, George W. Bush, and conservative state and local governments.

Several studies have shown such approaches do not work well and that it is better to encourage abstinence while also offering children and teens information about how to protect themselves from diseases as well as pregnancy.

“We haven’t been promoting the full battery of messages,” Douglas said. “We have been sending people out with one seatbelt in the whole car.”

SOARING RATES

The CDC’s latest study on STDs found:

* 1.2 million cases of chlamydia were reported in 2008, up from 1.1 million in 2007.

* Nearly 337,000 cases of gonorrhea were reported.

* Adolescent girls 15 to 19 years had the most chlamydia and gonorrhea cases of any age group at 409,531.

* Blacks, who represent 12 percent of the U.S. population, accounted for about 71 percent of reported gonorrhea cases and almost half of all chlamydia and syphilis cases in 2008.

* Black women 15 to 19 had the highest rates of chlamydia and gonorrhea.

* 13,500 syphilis cases were reported in 2008, an almost 18 percent increase from 2007.

* 63 percent of syphilis cases were among men who have sex with men.

* Syphilis rates among women increased 36 percent from 2007 to 2008.

Syphilis, chlamydia and gonorrhea can all be treated with antibiotics but untreated can cause pelvic inflammatory disease, infertility, ectopic pregnancy and can infect newborns. Hard money training

An outbreak of food-borne illness, linked to dangerous bacteria in ground beef, sickened 28 people and caused at least one death, the U.S. Centers for Disease Control and Prevention said on Monday.

The CDC said a New York adult with underlying medical conditions had died and another possibly related death in New Hampshire was under investigation. State officials attribute the New Hampshire death to the O157:H7 E. coli bacteria.

All but three of the 28 cases listed by the CDC were in the U.S. Northeast and 18 were in the New England states. Sixteen hospitalizations were reported, said a CDC spokeswoman. The bacteria involved were from a common strain, so tests were under way to see if all of the reported cases were related.

Over the weekend, Fairbank Farms of Ashville, New York, recalled 545,699 lbs (248,450 kg) of ground beef products.

The Agriculture Department, which oversees meat safety, said an investigation led it to conclude “there is an association between the fresh ground beef products and illnesses in Connecticut, Maine and Massachusetts.” USDA worked with state and federal officials in examining a cluster of E. coli O157:H7 illnesses.

A potentially deadly bacteria, E. coli can cause bloody diarrhea, dehydration and, in severe cases, kidney failure. The very young, the elderly and people with weak immune systems are the most susceptible to foodborne illness.

A string of food-borne safety scares led the U.S. House of Representatives to pass legislation this summer to require more inspections and oversight of food manufacturers and would give the government new authority to order recalls.

Fairbank Farms announced the recall on Saturday. The beef was produced in mid-September and probably was labeled for sale before the end of the month, said USDA. Hard money training