West Nile outbreak light in Ky. but 'one of the largest' in nation

U.S. health officials reported Wednesday three times the usual number of West Nile cases for this time of year and one expert told the Associated Press it was “one of the largest” outbreaks since the virus appeared in this country in 1999.

So far, 1,118 illnesses have been reported, about half of them in Texas, according to the Centers for Disease Control and Prevention. Kentucky has reported few cases.

In an average year, fewer than 300 cases are reported by mid-August. There have also been 41 deaths this year. Most infections are usually reported in August and September, so it’s too early to say how bad this year will end up, CDC officials said. AP reports that West Nile virus peaked in 2002 and 2003, when severe illnesses reached nearly 3,000 and deaths surpassed 260.

 The best way to prevent West Nile disease, say experts, is to avoid mosquito bites. Insect repellents, screens on doors and windows and wearing long sleeves and pants are some of the recommended strategies. Also, empty standing water from buckets, kiddie pools and other places to discourage breeding. (Read more)

More hospital-acquired infections are reported in patients cared for nurses who are overworked, study finds

Getty Images stock photo.

Overworked nurses dealing with heavy patient loads are associated with increases in hospital-acquired infections, say researchers with the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

"For each 10 percent jump in the proportion of nurses who logged high levels of burnout, there was roughly one additional catheter-associated urinary tract infection per 1,000 patients and almost two extra surgical site infections per 1,000," reports JoNel Aleccia for NBC News.

Researchers conducted a survey with 7,000 registered nurses at 161 Pennsylvania hospitals and matched that data with hospital infection rates and characteristics of hospitals nationwide. The study found more than a third of nurses said they feel high levels of burnout. They cared for an average of 5.7 patients each, and "when even one patient was added to that load, the result was an additional 1,351 infections within the hospital population studied," Aleccia reports.

The study, published in the American Journal of Infection Control, also found cutting down on burnout not only reduces infections but saves money. Cutting it by 30 percent decreased urinary tract infections by 4,000 and surgical site infections by more than 2,200, resulting in a savings of between $28 million and $69 million each year, researchers found.

When it comes to nurse-to-patient ratios, no one seems to be tracking the averages, Aleccia reports. They can range from one nurse for every one or two patients in intensive care units or a one-to-five ratio, as mandated in surgical units in California. (Read more)

Lyme disease in Ky. probably more common than reported

Nearly anyone who has spent considerable time in the woods this summer has later discovered they carried a visitor back with them — one the size of a freckle who latches on for dear life. Ticks are not uncommon in Kentucky, though Lyme disease, which is spread through the bite of a black-legged deer tick, is not commonly seen in the state.

But those numbers are likely under-reported, Keiara Carr reports for The Courier-Journal, in part because "Current medical guidelines say the disease is so rare in Kentucky that doctors should look for alternative causes for symptoms that might suggest Lyme disease."

Only five cases were reported in Kentucky in each of the past two years and there was just one case in 2009. But it's likely cases went under-reported because doctors don't give the blood test that diagnoses Lyme. They just don't feel it's necessary given the rarity of the disease in the area, Carr reports.

But Mike Gatton of Louisville knows all too well that it's possible. He got bitten by a tick while mowing his lawn two years ago. He developed a rash on his leg but when he went to the doctor he was tested for a variety of diseases, including West Nile, multiple sclerosis and Lou Gehrig disease, but not Lyme. "I was feeling more and more fatigued. I was having severe headaches. I was really concerned," he said.

When he got another tick bite a year ago and had the same reaction he had to the first bite, he put the tick in a vial and brought it to his doctor, who still dismissed the possibility of Lyme. He is now being treated with antibiotics he takes intravenously.

Symptoms of Lyme disease include fever, headache and fatigue. Sometimes, a rash that looks like a bull's eye around the tick bite can develop. Usually, people get better with large doses of antibiotics. If left untreated, "the infection can be painful and debilitating, causing arthritis or spreading to the heart and nervous system," Carr reports.

Guidelines by the Infectious Disease Society of America "to help doctors decide if a patient is eligible for treatment say the patient should have received the tick bite in an 'endemic area," Carr reports, which makes sense according to Paul Mead, a consulting physician for the Centers for Disease Control and Prevention. "For example, a physician in Africa evaluating a child for fever should have malaria at the top of his list; a physician in Kentucky should not," he said. (Read more)

Swine flu killed nearly 300,000 worldwide, study finds

The swine flu of 2009, often referred to as H1NI, killed an estimated 284,500 people, making it 15 times more deadly than it was thought at the time of the pandemic, a new study has found. The report, published Tuesday in the journal Lancet Infectious Diseases, said the numbers might be eventually be  as high as 579,000 people. The original count, tabulated by the World Health Organization, was a mere 18,500.

Those nearly 300,000 deaths were confirmed by lab testing, which the WHO warned vastly underestimated the situation "because the deaths of people without access to the health system go uncounted, and because the virus is not always detectable after a victim dies," reports Sharon Begley for Reuters. In Kentucky, the Department for Public Health reported there were 41 confirmed H1N1-related deaths, said spokeswoman Beth Fisher.

More than 50 percent of swine flu deaths were in Africa and southeast Asia, though they only account for 38 percent of the world's population. Because vital statistics data are either non-existent or incomplete in poorer countries, researchers had to rely on estimates and assumptions but did start with hard data, including the number of health workers who went door-to-door to ask about flu-like symptoms in rural areas and obtained nasal and throat swab samples. They used these numbers to get an estimate on the proportion of a country's population infected with H1N1. Results show the flu killed two to three times more people in Africa than elsewhere. It infected children most, adults moderately and the elderly hardly at all. (Read more)

Measles is still around; rate in 2011 was highest in 15 years

Measles virus (Photo by Scott Camazine/CDC/Getty Images)

In 2000, the Centers for Disease Control and Prevention declared measles had been eliminated in the United States. But last year, the nation had the most cases of the infectious disease since 1997.

A report released last week shows there were 222 cases of measles and 17 measles outbreaks in 2011. In a typical year, there are usually just 50 to 60 cases. This year, there have already been 25 cases.

"Of the 222 reported cases, 50 percent were associated with the 17 outbreaks and 90 percent were associated with importations from foreign countries — 26 percent from U.S. residents traveling abroad and 10 percent from foreign visitors," reports Alexandra Sifferlin for Time magazine.

Each case is treated with intense investigation because of the highly contagious nature of the virus. "You can catch measles just by being in a room where someone with measles has been, even if they left," said Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diesease. "It's serious; one out of three people who got it last year had to be hospitalized." No one died, however.

Of the 196 U.S. residents who contracted the virus last year, 166 had not been or did not know if they had been vaccinated. More than 80 percent of them were eligible for vaccine.

"Many people think diseases like measles are gone and that they do not need to vaccinate themselves or their children," Sifferlin reports. "But the CDC warns measles is still prevalent worldwide. Globally, about 20 million people get measles each year." (Read more)

Kentucky second highest in antibiotic consumption in U.S.

The next time you ask your doctor for an antibiotic, or if he or she offers to give you one, think again. It might do your health no good, but could be bad for public health.

"Every time an antibiotic is used ... future effectiveness of that drug is diminished," but Kentuckians take antibiotics at the second highest rate in the country, with 1,205 prescriptions per 1,000 people, says a study by the Centers for Disease Dynamics, Economics and Policy. Only West Virginia had a higher rate, 1,214 per 1,000. 

Studies show 1 million antibiotics are prescribed unnecessarily every year. "Though antibiotics offer no benefits for colds and other viral infections, many people, including doctors, continue to view these drugs as a quick fix," said a press release by the Robert Wood Johnson Foundation, which helped fund the study.

The problem with the overuse of antibiotics is that bacterial infections become resistant to them. To illustrate the issue, CDDEP says, "High-level penicillin resistance in Streptococcus pneumonia in the United States has experienced a thousand-fold increase in the last 20 years," rising from 0.02 percent in 1987 to more than 20 percent in 2004. The prevalence of methicillin-resistant Staphylococcus aureus — known more commonly as staph — increased from about 2 percent in 1974 to 50 percent in many U.S. hospitals in 2004.

"The problem of resistance is an evolutionary game played between humans and microbes: we try to stay ahead by creating new antibiotics, and microbes develop resistance to our drugs," CDDEP reports. "Unfortunately for us, microbes evolve resistance to antibiotics faster than we can create new drugs, meaning that, in recent years, bacteria have been winning this 'arms race.'"

Though there is no cure to resistance, managing the levels at which people become resistant is possible through judicious prescribing, vaccination, hospital infection control, treatment strategies and new antibiotics. (Read more)