France sees bird flu cases double in less than a week

There has been cases of bird flu in France which has doubled since Friday as reported by the Ministry of Agriculture with a total of 61 on 22 December, 2015 compared with 30 at the end of previous week. In a statement, the Ministry of Agriculture said the 61 cases now covered six regions in south-west France, with the Haute-Pyrenees department the latest to have recorded cases close to the Spanish border.

although the French Minister for Agriculture Stephane Le Foll said that the outbreak was under control, farmers in the Landes region, which has 27 cases, have now lost tens of thousands of birds. However, the sequencing of the H5N1 strain detected in the first outbreak in the Dordogne at the end of November has confirmed the absence of key markers, meaning there is no danger to humans, the ministry confirmed.

According to the latest analysis published by the Animal Plant Health Agency (APHA), the risk of bird flu spreading from France to the UK remains low but heightened. APHA Head of Virology, Professor Ian Brown and Dr Helen Roberts, of APHA’s international disease monitoring team said the risk to the UK as a result of the French outbreaks was primarily around pathways which involve lapses in biosecurity or trade routes, rather than through wild birds. The pair said the French outbreaks were wholly of European origin.

The situation in France simply reinforces what we already know that low pathogenic avian influenza viruses [LPAI] circulate in wild birds and cause occasional spillover outbreaks in poultry. These may be difficult to detect in domestic waterfowl species and they may then mutate into [highly pathogenic avian influenza (HAPI)] viruses. The cases in a France may be related but whether the index case for LPAI and HPAI mutation has been found is unclear.

In the run-up to Christmas, the agency reminded poultry keepers to maintain high standards of biosecurity, remain vigilant and report any signs of animals showing sickness.

-Farmers weekly (http://www.fwi.co.uk/poultry/bird-flu-cases-in-france-double-in-less-than-a-week.htm)

Sexually transmitted diseases has exploded in recent years – CDC

Maggie Fox from NBC News has reported that common sexually transmitted diseases such as syphilis and gonorrhoea have exploded in recent years in USA, in part because of reduced funding for public health clinics. There are more than 1.4 million reported cases of Chlamydia last year which is the highest number of cases of any disease ever reported to the Centres for Disease Control and Prevention (CDC).  

CDC reported that the number of syphilis cases reported in 2014 were under 20,000, the highest rate since 1994 and a 15% increase over 2013. They also found 458 cases of syphilis in newborn babies which is a startling 27.5%t increase over 2013. In addition more than 350,000 cases of gonorrhoea were reported which is up 5% from 2013. "Certainly, this is the first time since 2006 that all three of our notifiable sexually transmitted diseases have increased," said the CDC's Dr. Gail Bolan. "Some of the increases are quite alarming." Most of the increases have been seen in young adults, who get infected soon after they first begin having sex.

The CDC estimates that half of the 20 million new sexually transmitted infections that occur every year are among people aged 15-24. Dr Bolan noted that Young people are the most vulnerable and women can lose their reproductive health for a lifetime from infection of Chlamydia or gonorrhoea. While antibiotics can treat the infections, they often do not cause symptoms until damage has been done.

What's going on to cause the increase? There are several factors, the CDC says. Budget cuts are a big factor.  Most recently, there have been significant erosions of state and local STD control programs. Most people don't recognize that the direct clinical care of individuals with sexually transmitted diseases is supported by state and local funds and federal funds. Just one example in October, the Illinois Department of Health stopped paying for STD tests at 100 jails and local health departments across the state. Dr Bolan acknowledged that in one year 7% of local health departments said they closed their STD clinics. And 43% said they had to cut back on the hours they could stay open. About a third had to raise fees and co-pays, something that's been shown to keep some people away.

Another big factor is a change in behaviour among gay and bisexual men. The increase in syphilis among gay men is concerning because we have been seeing this increase for almost a decade, Dr Bolan said. It seems to correlate with the advent of HIV treatment. Dr Bolan also added that HIV treatment is not responsible for the change. HIV infection has become a chronic disease that can be managed with the cocktails of powerful HIV drugs that are now available, instead of a death sentence. HIV patients know they can stay healthy if they take the drugs, and that they are less likely to infect someone else and people are excited about it. And some may have stopped using condoms so consistently, because they are no longer afraid of a deadly infection. Unfortunately, HIV treatment has no impact on prevention of other STDs. The non consistent and correct use of condoms is putting people at risk for STDs.

Uninfected people can also take HIV drugs to protect themselves from infection. That might make people think they're even safer from HIV. Researchers across the country found that people at high risk of HIV who took the drugs in a practice called pre-exposure prophylaxis or PrEP almost never caught HIV, but they did catch syphilis and gonorrhoea. There is some data suggesting that there is less condom use in some populations now. As for Chlamydia, Dr Bolan thinks it's mostly a matter of better reporting that's driving the record numbers of reported cases. Chlamydia has been a very common sexually transmitted infection for years.

- Centers for Disease Control and Prevention (CDC)

- NBC News (http://www.nbcnews.com/health/sexual-health/cdc-sees-alarming-increase-sexually-transmitted-diseases-n465071)

Rise in untreatable multi-antimicrobial resistant gonorrhoea strain – BBC

England chief medical officer has warned that Gonorrhoea could become untreatable due to emergence of multi antimicrobial resistant strains termed "super-gonorrhoea" according to BBC

All GPs and pharmacies have been written to by Dame Sally Davies to ensure they are prescribing the correct drugs after the rise of "super-gonorrhoea" in Leeds. This warning came after concerns were raised that some patients were not getting both of the antibiotics needed to clear the infection. Sexual health doctors said gonorrhoea was "rapidly" developing resistance.

in March 2015, a highly drug-resistant strain of gonorrhoea was detected in the north of England. That strain is able to shrug off the antibiotic azithromycin, which is normally used alongside another drug, ceftriaxone.

In Dame Sally Davies letter, the chief medical officer said: "Gonorrhoea is at risk of becoming an untreatable disease due to the continuing emergence of antimicrobial resistance." But while an injection of ceftriaxone and an azithromycin pill are supposed to be used in combination, this may not always be the case for all patients.

The British Association for Sexual Health and HIV (BASHH) warned earlier this year that some online pharmacies were offereing oral medication options only. 

Using just one of the two drugs makes it easier for the bacterium to develop resistance. The letter, which is also signed by chief pharmaceutical officer Dr Keith Ridge, stated: "Gonorrhoea has rapidly acquired resistance to new antibiotics, leaving few alternatives to the current recommendations. "It is therefore extremely important that suboptimal treatment does not occur."

Gonorrhoea is caused by the bacterium called Neisseria gonorrhoeae. The infection is spread by unprotected vaginal, oral and anal sex. Symptoms can include a thick green or yellow discharge from sexual organs, pain when urinating and bleeding between periods. Often the person has no symptoms, however, but can still easily spread the disease to others. Untreated infection can lead to infertility, pelvic inflammatory disease and can be passed on to a child during pregnancy.

Gonorrhoea is the second most common sexually transmitted infection in England and cases are soaring. The number of infections increased by 19% from 29,419 in 2013 to 34,958 the following year.

Dr Jan Clarke, the president of BASHH, told the BBC News website: "We're really pleased that the chief medical officer has stressed that gonorrhoea needs this approach to treatment due to the rapid development of resistance."We need to protect what we've got and we need to encourage pharmacists and general practitioners to follow first-line treatment."

Dr Andrew Lee, from Public Health England, added: "Investigations are ongoing into a number of cases of anti-microbial resistant gonorrhoea. "Public Health England will continue to monitor, and act on, the spread of antimicrobial resistance and potential gonorrhoea treatment failures, to make sure they are identified and managed promptly."

- BBC