Same Pathogen In N.O.
BioLab Shows
Up In Evacuees
Vibrio Pathogens In New Orleans

Patricia Doyle, PhD
Hello Jeff - I notice in the second part of this email the author describes using cultures of vibrio cholera obtained from the N.O. Public Health Lab.
It is therefore noted that cultrues of V. Cholera strains were, indeed, kept at the N.O. Public Health Lab...the one that was cracked open with bolt cutters. Then again, I am sure a little chlorox did the trick. Sure. Interesting that the same strain as the culture seems to be infecting some of the evacuees in Tennessee and around the country.
I also note a Hep A vaccine shortage. They recommend getting the HAV vaccine, and, all of a suddent, there is a shortage. One way to keep the price up and ensure that ONLY those who can pay get the vaccine.
I just heard a talk show host on WABC NY confirm that Mayor Nagin went to Dallas and purchased a new home for his family. He moved his family to Dallas and claims that he will live in New Orleans during the work week but the family will remain in Dallas where the children will go to school.
Now what does that tell you about the safety of New Orleans? What does he KNOW that the public doesn't?
From ProMed Mail
From Jim Diaz
_Vibrio cholerae_ is not endemic in Louisiana, but more pathogenic non-cholera Vibrios are, and they have already killed and will continue to do so. I have been [back] to New Orleans, and there are no mosquitoes now; all larvae were killed by floating petrochemicals.
The ARBOR diseases will return soon, principally West Nile virus -- worse than in Mississippi -- and spraying will be required later when the floodwaters recede.
Current mild diarrheal diseases are viral and secondary to poor sanitation and endemic RNA enteric viruses. More serious dysenteric disease outbreaks could follow among those who are not evacuating flooded areas and who are consuming contaminated food and water. Dysenteric diseases should not be a problem in well-run shelters. Baton Rouge will probably have a hepatitis A outbreak in 4-6 weeks so get vaccinated for HAV now, because there are inadequate stocks of IgG and HAV vaccine to respond to an outbreak.
As we enter flu season, viral URIs will become a problem among the elderly in shelters and may result in community acquired pneumonias.
Since many TB+ homeless persons and ex-prisoners may have been sheltered with the elderly, infants, and the immunosuppressed, MDR-TB could be transmitted to these susceptible populations. Reactivation of non-MDR TB in the elderly is usually more of a problem, especially among older immigrants from countries where TB is endemic (Viet Nam, Mexico, etc.) and primary infections were acquired during childhood. The elderly often baby sit the infants, who are highly susceptible to TB. TB should not be as much of a problem as viral URIs and secondary pneumonias.
[He added:] I have never seen a case of cholera in 30 years of practice, but plenty of non-cholera _Vibrio_ infections; many were fatal, especially in immunosuppressed transplant patients. _V. vulnificus_ septicemia is especially problematic, because it can be transmitted through lacerations, ingestion, and, probably, transconjunctivally.
Jim Diaz, MD, PhD
Professor of Public Health
Department of Environmental & Occupational Health
LSU Health Sciences Center
New Orleans
I hate to disagree with Jim, as we have known each other for many years, but in the past, there have been outbreaks in southern Louisiana of _V. cholerae_ "El Tor" of a specific phage type common from Apalachicola Bay to Galveston Bay, and usually south of Interstate highway 10 (I-10). We used it in a trial involving frog legs: see Sang, F.C.; Hugh-Jones, M.E.; Hagstad, H.V. 1987. A Research Note: Viability of Vibrio cholerae 01 on Frog Legs under Frozen and Refrigerated Conditions and Low Dose Radiation Treatment. Journal of Food Protection, 50:662-664. We obtained the culture from the NO PH Laboratory which had recovered it from some prior outbreak. It was never very virulent in the various outbreaks, and its recovery depended more on clinician awareness than anything else. I haven't seen it reported for some time now. Those outbreaks followed a lack of rain and thus presumably salt-water intrusion into the oyster bays and blue crab trapping areas. It was largely south of the I-10, presumably because of the Cajun propensity to under cook their crabs. _V. cholerae_ non-01 strains are still recovered occasionally. But, in reality, Jim is absolutely correct about the present status of cholera in Louisiana.
His advice about getting vaccinated for hepatitis A is valid, but the vaccine appears to be unavailable in Baton Rouge. Our shared grad student was unable to get any for her daughter this morning. - Mod. MHJ
Patricia A. Doyle, PhD
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Zhan le Devlesa tai sastimasa
Go with God and in Good Health



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