Investigation of Inhalation Anthrax Case,United States

Inhalation anthrax occurred in a man who vacationed in 4 US states where anthrax is enzootic. Despite an extensive multi-agency investigation, the specific source was not detected, and no additional related human or animal cases were found. Although rare, inhalation anthrax can occur naturally in the United States.     

Molecular Epidemiologic Investigation of an Anthrax Outbreak among Heroin Users, Europe

In December 2009, two unusual cases of anthrax were diagnosed in heroin users in Scotland. A subsequent anthrax outbreak in heroin users emerged throughout Scotland and expanded into England and Germany, sparking concern of nefarious introduction of anthrax spores into the heroin supply. To better understand the outbreak origin, we used established genetic signatures that provided insights about strain origin. Next, we sequenced the whole genome of a representative Bacillus anthracis strain from a heroin user (Ba4599), developed Ba4599-specific single-nucleotide polymorphism assays, and genotyped all available material from other heroin users with anthrax. Of 34 case-patients with B. anthracis-positive PCR results, all shared the Ba4599 single-nucleotide polymorphism genotype. Phylogeographic analysis demonstrated that Ba4599 was closely related to strains from Turkey and not to previously identified isolates from Scotland or Afghanistan, the presumed origin of the heroin. Our results suggest accidental contamination along the drug trafficking route through a cutting agent or animal hides used to smuggle heroin into Europe.     

Case Study on Possible Falling Patterns of a Fatal Fall from Stairs

Considering a fatal case of an aged individual, who died due to falling down stairs,the cause of the fatal fall was investigated through experiments. A witness, who was withthe victim, when the fatal accident occurred, stated that the aged individual hadmiss-footed, lost balance at the top of the stairs, and fell accidently from an upperfloor to a lower floor. It was very questionable whether or not this witness’s statementswere true. The true cause of the fatal fall was unclear, because of the witness’sinconsistent statements, which showed discrepancies between the initial and laterstatements. The cause of a fatal fall can be presumed from external and internal damagesto the body and other circumstantial evidences. But it was difficult to prove the truecause of a fatal fall only from the results of the autopsy and investigation ofcircumstantial evidences. The author was officially requested to conduct experiments toelucidate possible falling patterns. Judging from the experimental results, deep questionsabout the witness’s statements arose. These experimental methods and analyses in thispaper could be applied to elucidate possible falling patterns of fatal falls from stairswhere the fatal causes are controversial.     

Fatal Case of Plasmodium vivax Malaria in a Splenectomized Patient

Malaria is a major problem in tropical and sub-tropical countries, with high morbidity and mortality. Splenectomy makes patients more susceptible to serious bacterial and parasitic infections. We report for the first time in Iran a fatal case of Plasmodium vivax malaria, confirmed by microscopic and molecular (Semi-nested multiplex PCR) tests in a patient who had undergone splenectomy due to hemolytic anemia.     

Lethal Factor and Anti-Protective Antigen IgG Levels Associated with Inhalation Anthrax,Minnesota, USA

Bacillus anthracis was identified in a 61-year-old man hospitalized in Minnesota, USA. Cooperation between the hospital and the state health agency enhanced prompt identification of the pathogen. Treatment comprising antimicrobial drugs, anthrax immune globulin, and pleural drainage led to full recovery; however, the role of passive immunization in anthrax treatment requires further evaluation.     

致死性机动车车祸流行病学特征及其多因素分析

本文描述了１９８５～１９８９年广州市区１５３２宗致死性机动车车祸的流行病学特征，并运用多元逐步回归方法分析某些有关致死性机动车车祸的影响因素。结果显示，３９．４９％的车祸是由于机动车与自行车相撞。车祸的死亡者中小于２５岁和大于５０岁者所占比例最大（各占２８．８５％和２８．４２％），１／３受伤者年龄在２５岁以下，伤亡者中均以农民为最多。车祸中负主要责任的驾驶员３６．８４％，年龄在２０～２４岁，显著高于其他年龄组。逐步回归分析表明，取ｄ＝０．５时，车祸发生数与机动车拥有量、车祸中主要及次要（无）责任者的男女比例、主要责任者平均年龄和主要责任驾驶员持驾驶证的平均年限呈正相关关系。取ｄ＝０．０６时，则机动车拥有量和男女性比例进入回归方程。     

Fatal chlorine gas exposure at a metal recycling facility: Case report

At least four workers at a metal recycling facility were hospitalized and one died after exposure to chlorine gas when it was accidentally released from an intact, closed‐valved cylinder being processed for scrap metal. This unintentional chlorine gas release marks at least the third such incident at a metal recycling facility in the United States since 2010. We describe the fatal case of the worker whose clinical course was consistent with acute respiratory distress syndrome (ARDS) following exposure to high concentrations of chlorine gas. This case report emphasizes the potential risk of chlorine gas exposure to metal recycling workers by accepting and processing intact, closed‐valved containers. The metal recycling industry should take steps to increase awareness of this established risk to prevent future chlorine gas releases. Additionally, public health practitioners and clinicians should be aware that metal recycling workers are at risk for chlorine gas exposure.

     

北京市中关村地区急性冠心病事件病死率的流行病学研究

目的对中关村地区1984—2000年急性冠心病事件病死率进行流行病学分析,为制定有效的降低病死率的防治措施提供依据。方法以北京地区人群心血管病动态监测方案中中关村地区近4万监测人群中1984—2000年发生的250例急性冠心病事件为研究样本,分析病死率的变化趋势及在不同特征人群中的分布情况。结论该地区急性冠心病事件总病死率为53.6%,医院内病死率为35.6%。有冠心病史人群病死率为65.0%,无此病史人群病死率为43.6%,差别有显著性(P<0.05);发病后1小时内猝死者占死亡总人数的50.7%,24小时内死亡者占死亡总人数77.6%。结论开展有针对性的健康知识宣教,争取并缩短院前诊治时间是降低病死率的重要措施。     

被动吸烟者吸入暴露的研究

按国际标准组装的模拟吸烟装置和测试方法,对4种纸烟主流烟气和侧流烟气中的焦油、尼古丁、~(210)Pb和~(210)Po含量进行测试,并估算了被动吸烟者的吸入暴露,与吸烟者比较。中等吸烟环境二者比值约为1/7～1/8。人员密集和吸烟人数多时,比值可达1/1.2。认为在号召戒烟的同时,应限制在公共场所吸烟。