From Craigs Blog;
January 25, 2010
A next big step for grassroots democracy
We need a government that listens to us, and online discussion boards make that doable, at least for people that can get online. (We'll need other solutions for everyone else.)
Problem with conventional discussion boards is that it's hard to find the good stuff, and it's also very easy for a bad guy to disrupt the discussion, maybe to fake a consensus. We're hoping that can be solved with discussion boards which allow people to vote up the good stuff. That works if you have a lot of people getting involved.
With the new Federal Open Government Initiative, people have been experimenting with such a discussion board, IdeaScale, which might facilitate tens of millions of people working together. Now, government agencies will start to implement it broadly.
The big challenge... getting actual results from the government based on citizen feedback.
http://www.cnewmark.com/2010/01/a-next-big-step-for-grassroots-democracy.html
Monday, January 25, 2010
Sunday, January 24, 2010
Protest Rally v. Gas Drilling in NY - 1/25 Albany
Worried about the dangers of natural gas drilling in New York? If so, join us in Albany on Monday, January 25, 2010, to rally to protect New York's drinking water.
This is your chance to join concerned citizens from across the state to rally at the Capitol. Once you're in the Capitol, hear from state lawmakers, county legislators and environmental groups about the consequences of natural gas drilling in the Catskills, Central New York and the Southern Tier.
Please join us!
WHO: Environmental Advocates of New York, Citizens Campaign for the Environment, Sierra Club-Atlantic Chapter, Catskill Mountainkeeper, and dozens of environmental and conservation groups from across the state.
WHAT: Rally to Protect New York State from Natural Gas Drilling
WHEN: Monday, January 25, 2010
Rally 10:30 am to NOON
WHERE: Meet us on the west side of the New York State Capitol building in West Capitol Park
WHY: In other parts of the country, natural gas drilling has polluted wells, lakes and streams and poisoned landscapes. We can’t let that happen in New York.
HOW TO GET THERE: Environmental groups across the state have organized buses to bring people to the rally. The cost is $10 per person. Click on the corresponding link below and you will be prompted to send information via email. If you have questions about the bus, please include them in your email. Buses are first-come, first-served and space is limited!
If you are coming from Syracuse, click here.
If you are coming from Horseheads, click here.
If you care coming from Ithaca, click here.
If you are coming from New York City, click here. The New York City bus will leave from the corner of 33rd Street and 8thAve (Penn Station) at 6:30 am.
If you are coming from Sullivan County, Oneonta or Binghamton, click here. You will be prompted to register, upon registration, select the appropriate bus.
Please note: registration for meetings with legislators is closed. We cannot schedule additional meetings but encourage you to attend the rally. Please join us!
Thank you.
Katherine Nadeau
Water & Natural Resources Program Associate
Environmental Advocates of New York
PLEASE ALSO NOTE: Gas Explosion at New Plant in Conneticut kills 5, Injures many more;
click on title above for full report
This is your chance to join concerned citizens from across the state to rally at the Capitol. Once you're in the Capitol, hear from state lawmakers, county legislators and environmental groups about the consequences of natural gas drilling in the Catskills, Central New York and the Southern Tier.
Please join us!
WHO: Environmental Advocates of New York, Citizens Campaign for the Environment, Sierra Club-Atlantic Chapter, Catskill Mountainkeeper, and dozens of environmental and conservation groups from across the state.
WHAT: Rally to Protect New York State from Natural Gas Drilling
WHEN: Monday, January 25, 2010
Rally 10:30 am to NOON
WHERE: Meet us on the west side of the New York State Capitol building in West Capitol Park
WHY: In other parts of the country, natural gas drilling has polluted wells, lakes and streams and poisoned landscapes. We can’t let that happen in New York.
HOW TO GET THERE: Environmental groups across the state have organized buses to bring people to the rally. The cost is $10 per person. Click on the corresponding link below and you will be prompted to send information via email. If you have questions about the bus, please include them in your email. Buses are first-come, first-served and space is limited!
If you are coming from Syracuse, click here.
If you are coming from Horseheads, click here.
If you care coming from Ithaca, click here.
If you are coming from New York City, click here. The New York City bus will leave from the corner of 33rd Street and 8thAve (Penn Station) at 6:30 am.
If you are coming from Sullivan County, Oneonta or Binghamton, click here. You will be prompted to register, upon registration, select the appropriate bus.
Please note: registration for meetings with legislators is closed. We cannot schedule additional meetings but encourage you to attend the rally. Please join us!
Thank you.
Katherine Nadeau
Water & Natural Resources Program Associate
Environmental Advocates of New York
PLEASE ALSO NOTE: Gas Explosion at New Plant in Conneticut kills 5, Injures many more;
click on title above for full report
Thursday, January 21, 2010
French/Haitian Crowd Accuse U.S. of Monopolizing Airport to Evacuate U.S. Citizens
Anger at US builds at Port-au-Prince airport
By Deborah Pasmantier (AFP) – 4 days ago
PORT-AU-PRINCE — Anger built Saturday at Haiti's US-controlled main airport, where aid flights were still being turned away and poor coordination continued to hamper the relief effort four days on.
"Let's take over the runway," shouted one voice. "We need to send a message to (US President Barack) Obama," cried another.
Control remained in the hands of US forces, who face criticism for the continued disarray at the overwhelmed airfield.
Dozens of French citizens and dual Haitian-French nationals crowded the airport Saturday seeking to be evacuated after Tuesday's massive 7.0 earthquake, which leveled much of the capital Port-au-Prince.
But at the last minute, a plane due to take them to the French island of Guadeloupe was prevented from landing, leaving them to sleep on the tarmac, waiting for a way out.
"They're repatriating the Americans and not anyone else," said Charles Misteder, 50. "The American monopoly has to end. They are dominating us and not allowing us to return home."
The crowd accused American forces, who were handed control of the airport by Haitian authorities, of monopolizing the airfield's single runway to evacuate their own citizens.
The US embassy denied it was putting the evacuation of the approximately 40,000 to 45,000 American citizens in the country first.
Others waiting for a way out were taken aback by the chaotic scenes confronted them when they arrived at the Toussaint L'Ouverture airport.
"I haven't been able to tell my family that I'm alive. The coordination is a joke," said Wilfried Brevil, a 33-year-old housekeeper.
"I was at the Christopher Hotel," said Daniele Saada, referring to the headquarters of the UN peacekeeping force in Haiti, MINUSTAH.
"I was extremely shaken up. I was pulled out, the others weren't," added Saada, 65, a MINUSTAH employee.
"I decided to return to France. I have nothing and now I am stuck," she said, caught between fury at the chaos and sheer exhaustion.
The disorder even appeared to cause diplomatic ripples, with French Secretary of State for Cooperation Alain Joyandet telling reporters he had lodged a complaint with the United States over its handling of the Port-au-Prince airport.
"I have made an official protest to the Americans through the US embassy," he said at the Haitian airport after a French plane carrying a field hospital was turned away.
A spokesman for the French foreign ministry later denied France had registered protest, saying "Franco-US coordination in emergency aid for Haiti is being handled in the best way possible given the serious difficulties."
The US ambassador to Haiti defended American efforts at the small airport, which was up-and-running 24 hours after the massive quake, even though the air traffic control tower was damaged.
"We're working in coordination with the United Nations and the Haitians," said Ambassador Kenneth Merten, though he acknowledged some difficulties.
"Clearly it's necessary to prioritize the planes. It's clear that there's a problem."
Despite the chaos, a group of French citizens was eventually able to take off on Saturday, and the French plane carrying a field hospital landed safely around noon.
Still, with aid continuing to flood into the quake-stricken country, concern remains about the lack of coordination at the airport, and across devastated Port-au-Prince.
"The Haitians haven't been notified about the arrival of planes. And when they do land, there's no one to take charge and a large amount of goods are arriving without coordination," said Haitian government official Michel Chancy.
On Port-au-Prince's streets, the consequences of the coordination breakdown are clear, as traumatized and starving quake survivors approached passing foreigner and begged them for food.
Click on title above for full artice;
http://www.google.com/hostednews/afp/article/ALeqM5guma2WKnHthswP2UVPiCIuLm_ocQ
By Deborah Pasmantier (AFP) – 4 days ago
PORT-AU-PRINCE — Anger built Saturday at Haiti's US-controlled main airport, where aid flights were still being turned away and poor coordination continued to hamper the relief effort four days on.
"Let's take over the runway," shouted one voice. "We need to send a message to (US President Barack) Obama," cried another.
Control remained in the hands of US forces, who face criticism for the continued disarray at the overwhelmed airfield.
Dozens of French citizens and dual Haitian-French nationals crowded the airport Saturday seeking to be evacuated after Tuesday's massive 7.0 earthquake, which leveled much of the capital Port-au-Prince.
But at the last minute, a plane due to take them to the French island of Guadeloupe was prevented from landing, leaving them to sleep on the tarmac, waiting for a way out.
"They're repatriating the Americans and not anyone else," said Charles Misteder, 50. "The American monopoly has to end. They are dominating us and not allowing us to return home."
The crowd accused American forces, who were handed control of the airport by Haitian authorities, of monopolizing the airfield's single runway to evacuate their own citizens.
The US embassy denied it was putting the evacuation of the approximately 40,000 to 45,000 American citizens in the country first.
Others waiting for a way out were taken aback by the chaotic scenes confronted them when they arrived at the Toussaint L'Ouverture airport.
"I haven't been able to tell my family that I'm alive. The coordination is a joke," said Wilfried Brevil, a 33-year-old housekeeper.
"I was at the Christopher Hotel," said Daniele Saada, referring to the headquarters of the UN peacekeeping force in Haiti, MINUSTAH.
"I was extremely shaken up. I was pulled out, the others weren't," added Saada, 65, a MINUSTAH employee.
"I decided to return to France. I have nothing and now I am stuck," she said, caught between fury at the chaos and sheer exhaustion.
The disorder even appeared to cause diplomatic ripples, with French Secretary of State for Cooperation Alain Joyandet telling reporters he had lodged a complaint with the United States over its handling of the Port-au-Prince airport.
"I have made an official protest to the Americans through the US embassy," he said at the Haitian airport after a French plane carrying a field hospital was turned away.
A spokesman for the French foreign ministry later denied France had registered protest, saying "Franco-US coordination in emergency aid for Haiti is being handled in the best way possible given the serious difficulties."
The US ambassador to Haiti defended American efforts at the small airport, which was up-and-running 24 hours after the massive quake, even though the air traffic control tower was damaged.
"We're working in coordination with the United Nations and the Haitians," said Ambassador Kenneth Merten, though he acknowledged some difficulties.
"Clearly it's necessary to prioritize the planes. It's clear that there's a problem."
Despite the chaos, a group of French citizens was eventually able to take off on Saturday, and the French plane carrying a field hospital landed safely around noon.
Still, with aid continuing to flood into the quake-stricken country, concern remains about the lack of coordination at the airport, and across devastated Port-au-Prince.
"The Haitians haven't been notified about the arrival of planes. And when they do land, there's no one to take charge and a large amount of goods are arriving without coordination," said Haitian government official Michel Chancy.
On Port-au-Prince's streets, the consequences of the coordination breakdown are clear, as traumatized and starving quake survivors approached passing foreigner and begged them for food.
Click on title above for full artice;
http://www.google.com/hostednews/afp/article/ALeqM5guma2WKnHthswP2UVPiCIuLm_ocQ
Wednesday, January 20, 2010
Shame on US: The Real Tragedy in Haiti; Un-Necessary Deaths
Iceland 1st to Respond / Boots on the Ground w/in Hours
Click on title above to see this article;
Crowd Accuses US of Monopolizing Hatian Airport to Evacuate US Citizens;
http://www.freewillblog.com/index.php/weblog/comments/7827/
Desperate Haitians Flood Port in Attempt to Escape Devestation;
http://www.cnn.com/2010/WORLD/americas/01/20/haiti.port.refugees/index.html?hpt=P1
Friday, January 8, 2010
UpDate: White-Nose Syndrome in Bats
WHITE NOSE SYNDROME, BATS - FRANCE: 1st IDENTIFICATION, NON-LETHAL
******************************************************************
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri 8 Jan 2010
Source: Science, Vol. 327. no. 5962, p. 132 [edited]
(subscription)
Europe's Bats Resist Fungal Scourge of North America
----------------------------------------------------
The same fungus that has devastated bat colonies in the northeastern
United States has been identified for the 1st time in Europe -- in a
healthy bat. "The astonishing thing is that [the fungus] affects
North American bats so devastatingly, but that European bats can get
along with it," says Christian Voigt, a bat physiologist at the
Leibniz Institute for Zoo and Wildlife Research (IZW) in Berlin.
White-nose syndrome was 1st identified in a cave in upstate New York
in 2006. Since then, it has spread across 9 states and caused
unprecedented mortalities. Affected bats emerge from hibernation too
frequently and lose body fat, and many starve to death. Last year, a
group led by microbiologist David Blehert of the U.S. Geological
Survey in Madison, Wisconsin, identified the fungus associated with
the syndrome as _Geomyces destructans_, but many puzzles remain about
the nature of the disease, such as whether the bats' immune systems
were compromised (Science, 29 May 2009, p. 1134).
European researchers watched the U.S. outbreak with alarm. "I
thought, 'Oh my God, we've got a huge nightmare on our hands,'"
recalls Kate Jones of the Zoological Society of London. So far, no
mass casualties have been detected among Europe's species, but
researchers did find anecdotal reports of bats with white fungus that
no one had paid attention to previously.
On 12 Mar [2009], Sebastien Puechmaille of University College Dublin
(UCD) spotted a mouse-eared bat (_Myotis myotis_) covered with fungus
in a cave 130 km [80 miles] northeast of Bordeaux, France.
Microscopic examination of the spores and 2 molecular markers showed
that it was _G. destructans_, the team reported online 29 Dec 2009 in
Emerging Infectious Diseases [see commentary]. Another group, led by
Gudrun Wibbelt of IZW, has also identified the fungus in bats from 3
other European countries, none reporting bat deaths. Their results
have been submitted to the same journal.
Now the challenge is to figure out why most European bats are not
infected and why those that are remain healthy -- and whether that
knowledge can be used to help ailing bat populations in the United
States. One scenario is that _G. destructans_ has been present in
Europe for a long time, and European bat species have evolved
immunity, says Emma Teeling of UCD, the senior author of the December
paper. Or perhaps the fungus evolved greater virulence after arriving
in North America, a possibility that could be investigated with
further sequencing.
Whatever the explanation, the European reports are "great news," says
Alan Hicks, a mammal specialist with New York's Department of
Environmental Conservation in Albany, [New York], who has charted the
decline of the state's once-massive bat colonies. Eventually, an
understanding of these differences could help lead to the development
of a vaccine or treatments for endangered bats, Blehert says.
Meanwhile, researchers are beginning once again to survey hibernating
bats in the Northeast United States. Hicks says the signs so far are
that deaths are continuing.
[Byline: Erik Stokstad]
--
Communicated by:
ProMED-mail
[The on-line published paper is:
Sebastien J. Puechmaille, Pascal Verdeyroux, Hubert Fuller, Meriadeg
Ar Gouilh, Michael Bekaert, and Emma C. Teeling. White-nose syndrome
fungus (Geomyces destructans) in bat, France. Emerg Infect Dis. 2010
Feb; [Epub ahead of print].
. -Mod.AS]
[see also:
2009
----
White nose syndrome, bats - USA (14) 20091014.3538
White nose syndrome, bats - USA (13): (NJ) 20090712.2495
White nose syndrome, bats - USA (12) 20090510.1750
White nose syndrome, bats - USA (11) 20090510.1743
White-nose syndrome, bats - USA (10): cave closings 20090507.1703
White-nose syndrome, bats - USA (09): (VA)susp. 20090427.1590
White-nose syndrome, bats - USA (08): (MA) 20090414.1413
White-nose syndrome, bats - USA (07) 20090320.1110
White-nose syndrome, bats - USA (06): (PA) RFI 20090311.1011
White-nose syndrome, bats - USA (05): (PA) 20090309.0975
White-nose syndrome, bats - USA (04): (PA) 20090306.0931
White-nose syndrome, bats - USA (03): (WV) susp 20090220.0711
White-nose syndrome, bats - USA (02): (northeast) 20090208.0578
White-nose syndrome, bats - USA: (Northeast) 20090129.0401
2008
---
White-nose syndrome, bats - USA (07): (Northeast) 20081102.3448
White-nose syndrome, bats - USA (06): (Northeast) 20080331.1195
White-nose syndrome, bats - USA (05): (Northeast) 20080304.0898
White-nose syndrome, bats - USA (04): (Northeast) 20080304.0880
White-nose syndrome, bats - USA (03): 2004 Dorset bat colony gate 20080221.0709
White-nose syndrome, bats - USA (02): (Northeast) 20080220.0687
White-nose syndrome, bats - USA: (Northeast) 20080219.0675]]
....................arn/ejp/dk
*##########################################################*
************************************************************
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Become a ProMED-mail Premium Subscriber at
************************************************************
Visit ProMED-mail's web site at.
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
############################################################
############################################################
******************************************************************
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri 8 Jan 2010
Source: Science, Vol. 327. no. 5962, p. 132 [edited]
(subscription)
Europe's Bats Resist Fungal Scourge of North America
----------------------------------------------------
The same fungus that has devastated bat colonies in the northeastern
United States has been identified for the 1st time in Europe -- in a
healthy bat. "The astonishing thing is that [the fungus] affects
North American bats so devastatingly, but that European bats can get
along with it," says Christian Voigt, a bat physiologist at the
Leibniz Institute for Zoo and Wildlife Research (IZW) in Berlin.
White-nose syndrome was 1st identified in a cave in upstate New York
in 2006. Since then, it has spread across 9 states and caused
unprecedented mortalities. Affected bats emerge from hibernation too
frequently and lose body fat, and many starve to death. Last year, a
group led by microbiologist David Blehert of the U.S. Geological
Survey in Madison, Wisconsin, identified the fungus associated with
the syndrome as _Geomyces destructans_, but many puzzles remain about
the nature of the disease, such as whether the bats' immune systems
were compromised (Science, 29 May 2009, p. 1134).
European researchers watched the U.S. outbreak with alarm. "I
thought, 'Oh my God, we've got a huge nightmare on our hands,'"
recalls Kate Jones of the Zoological Society of London. So far, no
mass casualties have been detected among Europe's species, but
researchers did find anecdotal reports of bats with white fungus that
no one had paid attention to previously.
On 12 Mar [2009], Sebastien Puechmaille of University College Dublin
(UCD) spotted a mouse-eared bat (_Myotis myotis_) covered with fungus
in a cave 130 km [80 miles] northeast of Bordeaux, France.
Microscopic examination of the spores and 2 molecular markers showed
that it was _G. destructans_, the team reported online 29 Dec 2009 in
Emerging Infectious Diseases [see commentary]. Another group, led by
Gudrun Wibbelt of IZW, has also identified the fungus in bats from 3
other European countries, none reporting bat deaths. Their results
have been submitted to the same journal.
Now the challenge is to figure out why most European bats are not
infected and why those that are remain healthy -- and whether that
knowledge can be used to help ailing bat populations in the United
States. One scenario is that _G. destructans_ has been present in
Europe for a long time, and European bat species have evolved
immunity, says Emma Teeling of UCD, the senior author of the December
paper. Or perhaps the fungus evolved greater virulence after arriving
in North America, a possibility that could be investigated with
further sequencing.
Whatever the explanation, the European reports are "great news," says
Alan Hicks, a mammal specialist with New York's Department of
Environmental Conservation in Albany, [New York], who has charted the
decline of the state's once-massive bat colonies. Eventually, an
understanding of these differences could help lead to the development
of a vaccine or treatments for endangered bats, Blehert says.
Meanwhile, researchers are beginning once again to survey hibernating
bats in the Northeast United States. Hicks says the signs so far are
that deaths are continuing.
[Byline: Erik Stokstad]
--
Communicated by:
ProMED-mail
[The on-line published paper is:
Sebastien J. Puechmaille, Pascal Verdeyroux, Hubert Fuller, Meriadeg
Ar Gouilh, Michael Bekaert, and Emma C. Teeling. White-nose syndrome
fungus (Geomyces destructans) in bat, France. Emerg Infect Dis. 2010
Feb; [Epub ahead of print].
[see also:
2009
----
White nose syndrome, bats - USA (14) 20091014.3538
White nose syndrome, bats - USA (13): (NJ) 20090712.2495
White nose syndrome, bats - USA (12) 20090510.1750
White nose syndrome, bats - USA (11) 20090510.1743
White-nose syndrome, bats - USA (10): cave closings 20090507.1703
White-nose syndrome, bats - USA (09): (VA)susp. 20090427.1590
White-nose syndrome, bats - USA (08): (MA) 20090414.1413
White-nose syndrome, bats - USA (07) 20090320.1110
White-nose syndrome, bats - USA (06): (PA) RFI 20090311.1011
White-nose syndrome, bats - USA (05): (PA) 20090309.0975
White-nose syndrome, bats - USA (04): (PA) 20090306.0931
White-nose syndrome, bats - USA (03): (WV) susp 20090220.0711
White-nose syndrome, bats - USA (02): (northeast) 20090208.0578
White-nose syndrome, bats - USA: (Northeast) 20090129.0401
2008
---
White-nose syndrome, bats - USA (07): (Northeast) 20081102.3448
White-nose syndrome, bats - USA (06): (Northeast) 20080331.1195
White-nose syndrome, bats - USA (05): (Northeast) 20080304.0898
White-nose syndrome, bats - USA (04): (Northeast) 20080304.0880
White-nose syndrome, bats - USA (03): 2004 Dorset bat colony gate 20080221.0709
White-nose syndrome, bats - USA (02): (Northeast) 20080220.0687
White-nose syndrome, bats - USA: (Northeast) 20080219.0675]]
....................arn/ejp/dk
*##########################################################*
************************************************************
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Become a ProMED-mail Premium Subscriber at
************************************************************
Visit ProMED-mail's web site at
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
############################################################
############################################################
Frogs Found Contaminated w/ Salmonella
Of course, its in our water!
SALMONELLOSIS, SEROTYPE TYPHIMURIUM - USA: FROGS, 2009
******************************************************
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Thu 7 Jan 2010
Source: Morbidity Mortality Weekly Report 2010;58: 1433-1436 [edited]
During April-July 2009, the Utah Department of Health identified 5
cases of _Salmonella [enterica_ serotype] Typhimurium infection with
indistinguishable pulsed-field gel electrophoresis (PFGE) patterns,
predominantly among children. In August 2009, the Centers for Disease
Control and Infection (CDC) began a multistate outbreak investigation
to determine the source of the infections. This report summarizes the
results of this ongoing investigation, which, as of 30 Dec 2009, had
identified 85 _S._ Typhimurium human isolates with the outbreak
strain from 31 states.
In a multistate case-control study, exposure to frogs was found to be
significantly associated with illness (63 percent of cases versus 3
percent of controls; matched odds ratio = 24.4). Among 14
case-patients who knew the type of frog, all had exposure to an
exclusively aquatic frog species, the African dwarf frog.
Environmental samples from aquariums containing aquatic frogs in 4
homes of case-patients yielded _S._ Typhimurium isolates matching the
outbreak strain. Preliminary traceback information has indicated
these frogs likely came from the same breeder in California. Reptiles
(e.g., turtles) and amphibians (e.g., frogs) have long been
recognized as Salmonella carriers (1,2), and 3 multistate outbreaks
of human Salmonella infections associated with turtle contact have
occurred since 2006 (3,4). However, this is the 1st reported
multistate outbreak of Salmonella infections associated with
amphibians. Educational materials aimed at preventing salmonellosis
from contact with reptiles should be expanded to include amphibians,
such as aquatic frogs.
The 5 cases identified in July 2009 by the Utah Department of Health
all had isolates indistinguishable by pulsed field gel
electrophoresis and were identified with XbaI pattern JPXX01.0177.
The cases had occurred during April-July 2009. On 29 Sep 2009,
PulseNet, the national molecular subtyping network for foodborne
disease surveillance, identified a national increase of isolates with
this PFGE pattern (37 isolates from 19 states in 60 days).
Multiple-locus variable-number tandem repeat analysis (MLVA) provided
additional discrimination of the outbreak strain. For this
investigation, a case was defined as _S._ Typhimurium infection with
illness onset on or after 1 Apr 2009, with 1) PFGE pattern
indistinguishable from the cluster-defining pattern and 2) MLVA
pattern either matching that of the main outbreak strain, or MLVA unknown.
The multistate investigation began with in-depth, open-ended
interviews of salmonellosis patients regarding exposures in the week
before illness onset. A total of 11 interviews with patients were
conducted through November 2009. All 11 persons reported consumption
of cheese-flavored crackers; 8 reported exposure to aquatic animals,
including fish and aquatic frogs.
As of 30 Dec 2009, _S._ Typhimurium isolates with the outbreak strain
had been identified in 85 patients from 31 states, extending from
Massachusetts to California, with week of illness onset ranging from
22 Mar to 29 Nov 2009 (Figure 1 [for figures, use original URL -
Mod.LL]). Among the patients, 52 percent were male; median age was 5
years (range: 3 weeks-54 years), and 79 percent were aged less than
10 years. Among 47 patients with outcome information available, 16
(34 percent) had been hospitalized; no deaths were reported.
Case-Control Study
------------------
To examine possible associations between illness and consumption of
cheese crackers and exposure to aquatic pets, the CDC conducted a
nationwide case-control study during 30 Nov-7 Dec 2009. Patients
infected with _S._ Typhimurium with the outbreak strain who had
specimen collection dates after 15 Jul 2009 were enrolled. Controls
were persons with recent infection of Salmonella strains other than
the outbreak strain and matched to case-patients by age and county of
residence. Exposure histories were collected for 7 days before
illness onset for case-patients and for 7 days before interview for controls.
Investigators sought to match each case-patient with 2 controls. A
total of 19 case-patients (18 with stool specimens and one with a
urine specimen) and 31 matching controls were enrolled from 15
states. Case-patients were found to be significantly more likely than
controls to have had exposure to an aquatic pet, including fish and
frogs (74 percent of case-patients versus 35 percent of controls; mOR
= 4.7 and 95 percent confidence interval (CI) = 1.2-27.0). More
specifically, illness was found to be associated with exposure to
frogs (63 percent of case-patients versus 3 percent of controls; mOR
= 24.4 and CI = 4.0-infinity]). Exposure to fish was not
statistically significant (58 percent of case-patients versus 29
percent of controls, mOR = 3.1 and CI = 0.8--14.2). No association
was found between illness and consumption of any food item, including
cheese crackers.
Among 39 patients interviewed as of 9 Dec 2009, including some of the
19 case-patients enrolled in the case-control study, 14 knew the type
of frog involved in their exposure, and all 14 identified the frog as
an African dwarf frog (Figure 2). When asked about potential for
Salmonella infection, 19 of 36 (53 percent) patients reported
awareness of association between contact with reptiles and Salmonella
infection, but only 11 of 36 (31 percent) reported awareness of
association with amphibians. Among 20 patients from whom the
information was available, the frog's aquarium was cleaned in the
kitchen sink in the homes of 6 persons (30 percent) and in the
bathroom sink in the homes of 7 others (35 percent).
Environmental Testing and Traceback
-----------------------------------
Environmental samples taken from patient homes in 4 states yielded
the outbreak strain of _S._ Typhimurium. The Colorado Department of
Public Health obtained matched isolates from 2 African dwarf frogs,
and from a rock and water in the aquarium containing the 2 frogs. The
New Mexico Department of Health matched the outbreak strain with
isolates from the filtration system, gravel, and water from an
aquarium in a patient's home containing fish and a small water frog.
The Ohio Department of Health matched the outbreak strain with
isolates from a patient's deceased African dwarf frog, its water, and
the lid and edge of its aquarium. The Utah Department of Health
obtained matched isolates from a container used to clean African
dwarf frogs in a patient's home.
Traceback investigations of frogs associated with positive
environmental isolates have been completed. African dwarf frogs from
the homes of the Colorado patient and the Utah patient were prizes
from games at 2 different carnivals. The vendor who distributed the
frogs to both carnivals was from Utah and identified the source as a
breeder in California. Environmental sampling from the vendor's home
(of aquarium filters and skin previously shed from African dwarf
frogs) yielded multiple isolates matching the outbreak strain. The
aquatic frog from the home of the New Mexico patient was purchased
from a pet store chain, whose distributor identified the same breeder
as the source for all of its aquatic frogs. The family of the Ohio
patient purchased its African dwarf frog from a department store,
whose distributor identified the breeder as the ultimate source of its frogs.
Environmental sampling from the breeder's California facility yielded
_S._ Typhimurium isolates matching the outbreak strain. Positive
samples were collected from multiple locations in the facility,
including water tanks that contained African dwarf frogs and gravel
in the water filtration system.
[Byline: Hall J, Poulson M, Fawcett L, et al]
Editorial Note
--------------
Salmonella illness remains a major public health problem in the USA,
with an estimated 1.4 million human Salmonella infections, 15 000
hospitalizations, and 400 deaths annually (5). Although most
Salmonella infections are foodborne, animal contact is an important
source of human salmonellosis (6). Studies conducted during 1996-1997
determined that approximately 74 000 Salmonella infections each year
in the USA resulted from reptile and amphibian exposure (1). The
ongoing investigation described in this report documents the 1st
multistate outbreak of Salmonella infections associated with amphibians.
A case-control study described here found an association between
infections and exposure to aquatic pet frogs such as African dwarf
frogs. In addition, the outbreak strain was isolated from African
dwarf frogs in 2 patient homes, from a container used to clean
African dwarf frogs in a 3rd home, and from water in an aquarium
containing a small frog in a 4th home. Traceback investigations
converged on a breeder in California; environmental sampling of the
breeder's facility yielded the outbreak strain.
The most likely source of transmission in this outbreak was contact
with water from the frogs' aquariums. Because African dwarf frogs are
small and tend to rest at the bottom of aquariums where children have
difficulty reaching them, direct handling as the source of
transmission is less likely. Amphibians are known carriers of
Salmonella (2). African dwarf frogs are purely aquatic animals,
typically less than 2 inches long from nose to tail stub, and sold as
ornamental aquarium pets. In one study, 21 percent of aquarium frogs
tested from 16 retailers were positive for Salmonella (2).
Furthermore, Salmonella bacteria shed from frogs are readily
recoverable from aquarium water where frogs are housed (2).
Salmonella can survive for an extended period in the environment, and
indirect transmission through environmental contamination might occur (1).
Although 53 percent of case-patients described in this report knew
that Salmonella infection could be acquired from reptiles, including
turtles, only 31 percent knew that Salmonella could be acquired from
amphibians. These findings are consistent with anecdotal reports of
persons buying frogs as pets as an alternative to pet turtles because
of concern over salmonellosis. Human exposure to Salmonella from
aquariums can occur in homes, but also in pet stores, retail stores,
schools, or child care centers (7). Public education regarding the
risk for illness associated with turtles and other reptiles should be
expanded to include the risk for salmonellosis from aquatic pet frogs
and other amphibians. Most notably, because children aged less than 5
years might be less likely to consistently practice proper hand
hygiene, prevention and control measures should be emphasized for
this age group.
Water contained in aquariums where frogs and other amphibians are
housed is an ideal environment for Salmonella growth (1,2,8).
Aquarium water should be changed regularly and aquariums should be
cleaned frequently. However, in this investigation, in 30 percent of
patient households, aquariums were cleaned in the kitchen sink,
posing a risk for cross-contamination with food preparation areas
(2). The CDC has published guidelines for consumers on how to reduce
the risk for Salmonella infection from amphibians and reptiles (available at
). Preventive
measures include washing hands thoroughly with soap and water after
touching animals or cleaning aquariums. No regulations prohibit the
sale of small frogs, but education measures might help reduce the
risk for Salmonella transmission.
References
----------
1. Mermin J, Hutwagner L, Vugia D, et al: Reptiles, amphibians, and
human Salmonella infection: a population-based, case-control study.
Clin Infect Dis 2004;38(Suppl 3): S253-261.
2. Bartlett KH, Trust TJ, Lior H: Small pet aquarium frogs as a
source of Salmonella. Appl Environ Microbiol 1977;33: 1026-1029.
3. CDC: Multistate outbreak of human Salmonella infections associated
with exposure to turtles---United States, 2007--2008. MMWR 2008;57: 69-72.
4. CDC: Turtle-associated salmonellosis in humans---United States,
2006--2007. MMWR 2007;56: 649-652.
5. Voetsch AC, Van Gilder TJ, Angulo FJ, et al: FoodNet estimate of
the burden of illness caused by nontyphoidal Salmonella infections in
the United States. Clin Infect Dis 2004;38(Suppl 3): S127-134.
6. CDC: Compendium of measures to prevent disease associated with
animals in public settings, 2009: National Association of State
Public Health Veterinarians, Inc. (NASPHV). MMWR 2009;58(No. RR-5).
7. Trust TJ, Bartlett KH, Lior H: Importation of salmonellae with
aquarium species. Can J Microbiol 1981;27: 500-504.
8. Mann PH, Bjotvedt G: Salmonella organisms isolated from water used
for storage of pet turtles. Can J Comp Med Vet Sci 1967;31:43-45.
Communicated by:
ProMED-mail
[The formal CDC report on this outbreak of ornamental frog-associated
salmonellosis previously reported on ProMED. A picture of the African
dwarf frog can be found at:
. - Mod.LL]
[see also:
2009
----
Salmonellosis, serotype Typhimurium - USA (13): frogs 20091208.4178
Salmonellosis, serotype Typhimurium - USA (12): poss. lettuce source
20090927.3382
Salmonellosis, serotype Newport - USA: ground beef, alert, recall 20090806.2779
Salmonellosis, serotype Saintpaul - USA (03): sprouts, geo. spread
20090310.0992
Salmonellosis, serotype Saintpaul - USA (02): sprouts recall 20090306.0929
Salmonellosis, serotype Saintpaul - USA: (NE) 20090303.0873
Salmonellosis, serotype Typhimurium - USA (11): peanut butter 20090210.0606
Salmonellosis, serotype Typhimurium - USA: RFI 20090108.0077
2008
----
Salmonellosis, human, pet turtles - USA (05) 20081023.3356
Salmonellosis, human, pet turtles - USA 20080125.0317
2007
----
Salmonellosis, human, pet turtles - USA (multistate): 2006-2007 20070709.2186
Salmonellosis, human, fatal, pet turtles - USA (FL): FDA 20070409.1182
2005
----
Salmonellosis, human, pet turtles, 2004 - USA (WI, WY) 20050311.0715]
...................................ll/ejp/dk
*##########################################################*
************************************************************
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Become a ProMED-mail Premium Subscriber at
************************************************************
Visit ProMED-mail's web site at.
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
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############################################################
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SALMONELLOSIS, SEROTYPE TYPHIMURIUM - USA: FROGS, 2009
******************************************************
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Thu 7 Jan 2010
Source: Morbidity Mortality Weekly Report 2010;58: 1433-1436 [edited]
During April-July 2009, the Utah Department of Health identified 5
cases of _Salmonella [enterica_ serotype] Typhimurium infection with
indistinguishable pulsed-field gel electrophoresis (PFGE) patterns,
predominantly among children. In August 2009, the Centers for Disease
Control and Infection (CDC) began a multistate outbreak investigation
to determine the source of the infections. This report summarizes the
results of this ongoing investigation, which, as of 30 Dec 2009, had
identified 85 _S._ Typhimurium human isolates with the outbreak
strain from 31 states.
In a multistate case-control study, exposure to frogs was found to be
significantly associated with illness (63 percent of cases versus 3
percent of controls; matched odds ratio = 24.4). Among 14
case-patients who knew the type of frog, all had exposure to an
exclusively aquatic frog species, the African dwarf frog.
Environmental samples from aquariums containing aquatic frogs in 4
homes of case-patients yielded _S._ Typhimurium isolates matching the
outbreak strain. Preliminary traceback information has indicated
these frogs likely came from the same breeder in California. Reptiles
(e.g., turtles) and amphibians (e.g., frogs) have long been
recognized as Salmonella carriers (1,2), and 3 multistate outbreaks
of human Salmonella infections associated with turtle contact have
occurred since 2006 (3,4). However, this is the 1st reported
multistate outbreak of Salmonella infections associated with
amphibians. Educational materials aimed at preventing salmonellosis
from contact with reptiles should be expanded to include amphibians,
such as aquatic frogs.
The 5 cases identified in July 2009 by the Utah Department of Health
all had isolates indistinguishable by pulsed field gel
electrophoresis and were identified with XbaI pattern JPXX01.0177.
The cases had occurred during April-July 2009. On 29 Sep 2009,
PulseNet, the national molecular subtyping network for foodborne
disease surveillance, identified a national increase of isolates with
this PFGE pattern (37 isolates from 19 states in 60 days).
Multiple-locus variable-number tandem repeat analysis (MLVA) provided
additional discrimination of the outbreak strain. For this
investigation, a case was defined as _S._ Typhimurium infection with
illness onset on or after 1 Apr 2009, with 1) PFGE pattern
indistinguishable from the cluster-defining pattern and 2) MLVA
pattern either matching that of the main outbreak strain, or MLVA unknown.
The multistate investigation began with in-depth, open-ended
interviews of salmonellosis patients regarding exposures in the week
before illness onset. A total of 11 interviews with patients were
conducted through November 2009. All 11 persons reported consumption
of cheese-flavored crackers; 8 reported exposure to aquatic animals,
including fish and aquatic frogs.
As of 30 Dec 2009, _S._ Typhimurium isolates with the outbreak strain
had been identified in 85 patients from 31 states, extending from
Massachusetts to California, with week of illness onset ranging from
22 Mar to 29 Nov 2009 (Figure 1 [for figures, use original URL -
Mod.LL]). Among the patients, 52 percent were male; median age was 5
years (range: 3 weeks-54 years), and 79 percent were aged less than
10 years. Among 47 patients with outcome information available, 16
(34 percent) had been hospitalized; no deaths were reported.
Case-Control Study
------------------
To examine possible associations between illness and consumption of
cheese crackers and exposure to aquatic pets, the CDC conducted a
nationwide case-control study during 30 Nov-7 Dec 2009. Patients
infected with _S._ Typhimurium with the outbreak strain who had
specimen collection dates after 15 Jul 2009 were enrolled. Controls
were persons with recent infection of Salmonella strains other than
the outbreak strain and matched to case-patients by age and county of
residence. Exposure histories were collected for 7 days before
illness onset for case-patients and for 7 days before interview for controls.
Investigators sought to match each case-patient with 2 controls. A
total of 19 case-patients (18 with stool specimens and one with a
urine specimen) and 31 matching controls were enrolled from 15
states. Case-patients were found to be significantly more likely than
controls to have had exposure to an aquatic pet, including fish and
frogs (74 percent of case-patients versus 35 percent of controls; mOR
= 4.7 and 95 percent confidence interval (CI) = 1.2-27.0). More
specifically, illness was found to be associated with exposure to
frogs (63 percent of case-patients versus 3 percent of controls; mOR
= 24.4 and CI = 4.0-infinity]). Exposure to fish was not
statistically significant (58 percent of case-patients versus 29
percent of controls, mOR = 3.1 and CI = 0.8--14.2). No association
was found between illness and consumption of any food item, including
cheese crackers.
Among 39 patients interviewed as of 9 Dec 2009, including some of the
19 case-patients enrolled in the case-control study, 14 knew the type
of frog involved in their exposure, and all 14 identified the frog as
an African dwarf frog (Figure 2). When asked about potential for
Salmonella infection, 19 of 36 (53 percent) patients reported
awareness of association between contact with reptiles and Salmonella
infection, but only 11 of 36 (31 percent) reported awareness of
association with amphibians. Among 20 patients from whom the
information was available, the frog's aquarium was cleaned in the
kitchen sink in the homes of 6 persons (30 percent) and in the
bathroom sink in the homes of 7 others (35 percent).
Environmental Testing and Traceback
-----------------------------------
Environmental samples taken from patient homes in 4 states yielded
the outbreak strain of _S._ Typhimurium. The Colorado Department of
Public Health obtained matched isolates from 2 African dwarf frogs,
and from a rock and water in the aquarium containing the 2 frogs. The
New Mexico Department of Health matched the outbreak strain with
isolates from the filtration system, gravel, and water from an
aquarium in a patient's home containing fish and a small water frog.
The Ohio Department of Health matched the outbreak strain with
isolates from a patient's deceased African dwarf frog, its water, and
the lid and edge of its aquarium. The Utah Department of Health
obtained matched isolates from a container used to clean African
dwarf frogs in a patient's home.
Traceback investigations of frogs associated with positive
environmental isolates have been completed. African dwarf frogs from
the homes of the Colorado patient and the Utah patient were prizes
from games at 2 different carnivals. The vendor who distributed the
frogs to both carnivals was from Utah and identified the source as a
breeder in California. Environmental sampling from the vendor's home
(of aquarium filters and skin previously shed from African dwarf
frogs) yielded multiple isolates matching the outbreak strain. The
aquatic frog from the home of the New Mexico patient was purchased
from a pet store chain, whose distributor identified the same breeder
as the source for all of its aquatic frogs. The family of the Ohio
patient purchased its African dwarf frog from a department store,
whose distributor identified the breeder as the ultimate source of its frogs.
Environmental sampling from the breeder's California facility yielded
_S._ Typhimurium isolates matching the outbreak strain. Positive
samples were collected from multiple locations in the facility,
including water tanks that contained African dwarf frogs and gravel
in the water filtration system.
[Byline: Hall J, Poulson M, Fawcett L, et al]
Editorial Note
--------------
Salmonella illness remains a major public health problem in the USA,
with an estimated 1.4 million human Salmonella infections, 15 000
hospitalizations, and 400 deaths annually (5). Although most
Salmonella infections are foodborne, animal contact is an important
source of human salmonellosis (6). Studies conducted during 1996-1997
determined that approximately 74 000 Salmonella infections each year
in the USA resulted from reptile and amphibian exposure (1). The
ongoing investigation described in this report documents the 1st
multistate outbreak of Salmonella infections associated with amphibians.
A case-control study described here found an association between
infections and exposure to aquatic pet frogs such as African dwarf
frogs. In addition, the outbreak strain was isolated from African
dwarf frogs in 2 patient homes, from a container used to clean
African dwarf frogs in a 3rd home, and from water in an aquarium
containing a small frog in a 4th home. Traceback investigations
converged on a breeder in California; environmental sampling of the
breeder's facility yielded the outbreak strain.
The most likely source of transmission in this outbreak was contact
with water from the frogs' aquariums. Because African dwarf frogs are
small and tend to rest at the bottom of aquariums where children have
difficulty reaching them, direct handling as the source of
transmission is less likely. Amphibians are known carriers of
Salmonella (2). African dwarf frogs are purely aquatic animals,
typically less than 2 inches long from nose to tail stub, and sold as
ornamental aquarium pets. In one study, 21 percent of aquarium frogs
tested from 16 retailers were positive for Salmonella (2).
Furthermore, Salmonella bacteria shed from frogs are readily
recoverable from aquarium water where frogs are housed (2).
Salmonella can survive for an extended period in the environment, and
indirect transmission through environmental contamination might occur (1).
Although 53 percent of case-patients described in this report knew
that Salmonella infection could be acquired from reptiles, including
turtles, only 31 percent knew that Salmonella could be acquired from
amphibians. These findings are consistent with anecdotal reports of
persons buying frogs as pets as an alternative to pet turtles because
of concern over salmonellosis. Human exposure to Salmonella from
aquariums can occur in homes, but also in pet stores, retail stores,
schools, or child care centers (7). Public education regarding the
risk for illness associated with turtles and other reptiles should be
expanded to include the risk for salmonellosis from aquatic pet frogs
and other amphibians. Most notably, because children aged less than 5
years might be less likely to consistently practice proper hand
hygiene, prevention and control measures should be emphasized for
this age group.
Water contained in aquariums where frogs and other amphibians are
housed is an ideal environment for Salmonella growth (1,2,8).
Aquarium water should be changed regularly and aquariums should be
cleaned frequently. However, in this investigation, in 30 percent of
patient households, aquariums were cleaned in the kitchen sink,
posing a risk for cross-contamination with food preparation areas
(2). The CDC has published guidelines for consumers on how to reduce
the risk for Salmonella infection from amphibians and reptiles (available at
measures include washing hands thoroughly with soap and water after
touching animals or cleaning aquariums. No regulations prohibit the
sale of small frogs, but education measures might help reduce the
risk for Salmonella transmission.
References
----------
1. Mermin J, Hutwagner L, Vugia D, et al: Reptiles, amphibians, and
human Salmonella infection: a population-based, case-control study.
Clin Infect Dis 2004;38(Suppl 3): S253-261.
2. Bartlett KH, Trust TJ, Lior H: Small pet aquarium frogs as a
source of Salmonella. Appl Environ Microbiol 1977;33: 1026-1029.
3. CDC: Multistate outbreak of human Salmonella infections associated
with exposure to turtles---United States, 2007--2008. MMWR 2008;57: 69-72.
4. CDC: Turtle-associated salmonellosis in humans---United States,
2006--2007. MMWR 2007;56: 649-652.
5. Voetsch AC, Van Gilder TJ, Angulo FJ, et al: FoodNet estimate of
the burden of illness caused by nontyphoidal Salmonella infections in
the United States. Clin Infect Dis 2004;38(Suppl 3): S127-134.
6. CDC: Compendium of measures to prevent disease associated with
animals in public settings, 2009: National Association of State
Public Health Veterinarians, Inc. (NASPHV). MMWR 2009;58(No. RR-5).
7. Trust TJ, Bartlett KH, Lior H: Importation of salmonellae with
aquarium species. Can J Microbiol 1981;27: 500-504.
8. Mann PH, Bjotvedt G: Salmonella organisms isolated from water used
for storage of pet turtles. Can J Comp Med Vet Sci 1967;31:43-45.
Communicated by:
ProMED-mail
[The formal CDC report on this outbreak of ornamental frog-associated
salmonellosis previously reported on ProMED. A picture of the African
dwarf frog can be found at:
[see also:
2009
----
Salmonellosis, serotype Typhimurium - USA (13): frogs 20091208.4178
Salmonellosis, serotype Typhimurium - USA (12): poss. lettuce source
20090927.3382
Salmonellosis, serotype Newport - USA: ground beef, alert, recall 20090806.2779
Salmonellosis, serotype Saintpaul - USA (03): sprouts, geo. spread
20090310.0992
Salmonellosis, serotype Saintpaul - USA (02): sprouts recall 20090306.0929
Salmonellosis, serotype Saintpaul - USA: (NE) 20090303.0873
Salmonellosis, serotype Typhimurium - USA (11): peanut butter 20090210.0606
Salmonellosis, serotype Typhimurium - USA: RFI 20090108.0077
2008
----
Salmonellosis, human, pet turtles - USA (05) 20081023.3356
Salmonellosis, human, pet turtles - USA 20080125.0317
2007
----
Salmonellosis, human, pet turtles - USA (multistate): 2006-2007 20070709.2186
Salmonellosis, human, fatal, pet turtles - USA (FL): FDA 20070409.1182
2005
----
Salmonellosis, human, pet turtles, 2004 - USA (WI, WY) 20050311.0715]
...................................ll/ejp/dk
*##########################################################*
************************************************************
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Become a ProMED-mail Premium Subscriber at
************************************************************
Visit ProMED-mail's web site at
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
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