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pusher | 05-07-2009 10:34 PM
Wired Science News for Your Neurons Another Swine Bug Raises Scientists� Concerns http://www.wired.com/wiredscience/2009/05/strepsuis/ Wired Science News for Your Neurons Another Swine Bug Raises Scientists� Concerns * By Brandon Keim Email Author * May 6, 2009 | * 3:28 pm | * Categories: Agriculture, Health strepsuis Public health experts worry that another potentially lethal pig-borne disease could establish itself among farmworkers in the United States. Unlike the new swine flu virus, Streptococcus suis doesn�t pass from person to person. But it�s also more virulent, killing about one in 10 people in whom infection progresses to full-blown disease. �There�s potential for that pathogen to cause serious human disease,� said Gregory Gray, a University of Iowa specialist in animal-borne disease epidemiology. Since its identification in 1969, S. suis has been found in pigs throughout the world. Fatal to piglets, the disease spreads to people only through close contact with infected pigs. This has largely limited its human toll to Asia, where the daily proximity of small farmers to their livestock and a tradition of eating ill animals makes infection more likely. The disease strikes North American pigs, but American humans were assumed to be safe. Only two human cases have been reported in the United States, where farmers keep a greater distance from their livestock, and dispose of meat known to come from sick animals. Nevertheless, the assumption of safety may be false. In a study published last year in Emerging Infectious Diseases, Gray and fellow University of Iowa epidemiologist Tara Smith described the first search for S. suis in a U.S. population. Seven out of 73 Iowa hog-farm workers tested positive for exposure, compared to just one positive test in a 67-person control group. Smith and Gray didn�t extrapolate national exposure levels from those geographically limited findings, but it�s not unreasonable to think a comparable ratio of pig farmers are affected nationwide. The S. suis microbe is common, able to live in the tonsils for years without causing symptoms, difficult to eradicate with antibiotics and spread by the cross-country transportation of millions of pigs every year. �You could say that between 5 and 10 percent of workers in the U.S. might be infected,� said Marcelo Gottschalk, a University of Montreal veterinary pathologist and one of the world�s foremost S. suis researchers. �I don�t know if it�s true, but the extrapolation is fair enough.� The researchers may even have under-counted exposure in Iowa. Workers in the study came from relatively small farms, rather than the big facilities that dominate the U.S. meat industry. �They typically have 100 to 500 pigs,� said Smith of her study�s farms. �Confinement facilities ramp that up another notch. Instead of 500 pigs, there�s 5,000. There�s a potential for more disease.� How many of those workers will become ill is difficult to foretell. In some infected people, S. suis microbes lurk for years until a moment of immunological weakness. In other cases, the microbes stay in the tonsils without ever causing problems. In other cases, they wreak immediate havoc. But even if the current generation of S. suis-infected farm workers escape unscathed, the disease will almost certainly evolve. A cautionary story comes from rural China, where an outbreak of S. suis three years ago sickened 200 people. Thirty-eight people died, and scores of others were wracked by meningitis, a crippling inflammation of brain and spinal-cord tissue coverings that is a common S. suis complication. Several other complications, such as septic shock and comas, were seen for the first time. Researchers say the unprecedented size and severity of the outbreak likely reflected the evolution of strain of a S. suis into a more virulent form. Researchers next hope to determine exactly how many people have S. suis, and make sure that health workers know to look for it. According to Smith and Gottschalk, many cases may now be misdiagnosed as meningitis or a different Streptococcus bug, such as the microbe that causes Streptococcal pneumonia. Unfortunately, the most at-risk human population barely registers on the public-health radar. �Disease surveillance, especially in rural agriculture workers, is minimal,� said Gray. Workers may face multiple barriers to health care, from language to immigration status to poor employer coverage, and hog companies don�t always want researchers snooping around their operations. �We need to figure out a way to include these people.� Publicity generated by the swine flu, linked ancestrally to farm-evolved virus strains, may prompt health officials to pay closer attention to diseases like Streptococcus suis. �It�s something we�re keeping an eye on. In China, it came out of the blue,� said Smith.

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