Emerging infections in 2001.

The California Journal of Emergency Medicine 112, April 2001 page 18 EMERGING IWFEC'FIQNS irz 2001 References continued .... 5. Addolorato G. Capuro F. Stefanini, Gasbarrini G. Gam:na-hydroxybutyric acid in the treatment of alcohol dependence: possible craving decelopment for the drug. Addictioi~ 1997: 92(8):1035-6. Robert W. Derlet. MD University of California, Davis Medical Center Campus. Sacramento, California 6. Gallo\vay 6P. Frederick SL. Staggers FE. Gonzales M. Stalcup SA, Smith DE. Galm~ia-liydroxybutyrdte: emerg- an ing drug of abuse that causes physical dependeiice. iiiklic- tiorl 1997: 92(1):89-96. 7. Hernandez M. McDaniel CH. Costanza CD. Hernandez OJ. GHR-induced delirium: a case report and review of the Al- literature on gamina hydroxybutyric acid. Ail! J Drri,~ cohcl Abzc.ce 1998; 24(i): 179-83. 8. Addoloraro G ) Caputo E Capristo E. Bernaardi M. Stefanini GF. Gasbair-ini 6. case of gamma-hydroxybu- A iyric acid withdrawal syndrome during alcohol addiction treatment: utility of diazepam adminisiration. Cliiz Netrrophanr? i999: 22(1):60-2. 9. Craig K. Gornez HE AdcMani~sJL. Bania TC. Severe gamma-hydroxybutyrate withdrawal: a case report arid lit- erature review. J Ei?zei;eMed 2000; 18(1):55-70. 10. Olmedo IS and Hoffman RS. Psychiatric emergencies: withdrawal syndromes. Emerg iided Clin North Arn 2000: 11. Price 6. In-patient detoxification a.fter CHB depen- dence. Brit J Psycii 2000: 177: 18 1. 12. Tunnicliff 6. of action of gamma-hydroxybiltyrate Sites (GMB)-a neuroactive drug ~ i ~ i abuse potcntia!. d Zsico! ih Cliil Toxic01 1997: 35(6):581-90. Emerging infections continues to be a hot topic in the infectious disease literature. Articles continue to be published revealing more insights ink) new diseases and disease processes. PCR and niolecular rech~iiques have made this detective work much reli- zbie and accurate. Some of the moye recent articles include the following: Transmission of Lyme disease. How long nwst a tick bike? Ticks can remain attached to humans for long periods of time feeding on blood. It has been debated hcw long a tick must remain attached for the Lyme spirochete Borrelia bzirgdo~feri to actu- aliy migrate through the tick and flow into the huinan host. In this study. (IJigt?er, d!D 2001. 183:773-8). infected ticks were ailowed to attach to mice and Lvere removed at 24 hour intervals up to 96 hours. Infectikity of both ticks and mice for Borreliu b~irgdo$er-i was tested using PCR techniques. No mice became infected if ticks were removed before 24 hours. Between 24 and 48 i~ours only 8% of mice became infected. Ticks allowed to feed 72 hours transmitted Lyme disease to 66% of host mice. Ticks allowed to feed 96 hours transmitted disease to 92% of host mice. If this can be correlated to humans. it would nleail that the chances of acquiring Lyme disease for a tick [hat had been attached for less than 48 hours would be minimal Wbai are the con~plications associated with La Crssse En- cepha#i$is ta Crosse Encephalitis is one ofthe more virulent forms of California Eircephalitis, a D~iizyi~,ii-,is wide-spread througlaout the United States. The disease hrs ac animal reser- voir an6 is transmitted to humans via !?osijultoes primarily ir! rr:rai areas. Some states have ngressive mosquito abatement control. in part for the control of potentiai!y serious diseases like La Crosse Encephalitis. 1Many children may present with only flu-like symptoms such as headache, fever. and discharge from an emergency room with a diagnosis of viral syndmme. However, a recent article by McJunkin suggests that some children cvho develop La Crosse Encephalitis may not fair so itre!! (McJili?kin, N Engl d Med, 314jll]:KOI-7). In an afiakysis of 127 patients. most were found to present with symptoms of headache, fever, vomiting. seizures. and disorientation during the summer months. Ten percent of children developed a complicated course includirlg intubation and ICU care. Although all children survived, 12% overall had significant permanem neuro!ogic problems including decreased IQ. paralysis, memory loss and behavioral changes or cerebral dysfunction 13. Gallirnberti L, Cibin M. Pagnin P. Sabbion K. Pani P'P, Pirastu R. Feerracira SD. Gessa GL. Gamma-hydroxybu- tyric acid for treatment of opiate withdrawal syndrome. N e ~ ~ r o p s y c l l o p h a ~ - ~ i ~ r 1993: o ~ r c o l 9:77-8 1. i 4. Gallimberti L, Gentile N. Cibin M, Fadda F. Canton 6. Ferri M. Ferral-a SD. Gessa GL. Gamma-hydro:r,>rbutyrrc acid for treatment of alcohol withdrawal syndrome. Lai~cet 15. Dyer JE and Andrews MM. Gamma hydroxybutyrate withdrawal. J Towicol Clin To.xico1 1997; 35(5):553-4.