Vitamin A insufficiency linked to hand, foot and mouth disease
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Vitamin A status is associated with immunity to, and pathogenic condition of, hand, foot, and mouth disease (HFMD) in children, say researchers whose study results show that the majority of those with the infectious disease also had vitamin A insufficiency. Furthermore, the complication rate was higher and duration of hospitalization longer among children with HFMD and vitamin A levels of 0.7 micromoles/L or less -- the level generally considered to indicate deficiency -- compared with those whose levels were higher, remarks the team in Clinical Nutrition.
Vitamin A is "an essential micronutrient with established roles in embryogenesis, growth, reproduction, maintenance of epithelial integrity, and optimal function of the immune system," explain Weiping Wang, from the Children's Hospital of Fudan University in Shanghai, the People's Republic of China, and co-investigators. The last 2 functions are particularly concerning when considering the potential impact of vitamin A deficiency on HFMD infection, which is characterized by pathologic damage to the skin and mucous membranes, they add.
The team assessed dietary intake and serum concentrations of vitamin A in a group of 450 hospitalized HFMD patients aged a median 25 months at disease onset. Participants all weighed in the normal range for their age and none were malnourished. The cohort had a mean serum vitamin A concentration of 0.73 micromoles/L, measured by blood test, and 52.7 percent of patients presented with concentrations of 0.70 micromoles/L or lower, a "remarkably high number," say Wang and colleagues.
Mean length of hospital stay was significantly longer among vitamin A deficient than sufficient HFMD patients, at 3.5 versus 3.2 days. When the cohort was categorized according to vitamin A deficiency, the rate of disease complications was significantly higher in the deficiency group, at 46 percent versus 29 percent in the nondeficient group.
Results of an enzyme-linked immunosorbent assay showed that serum concentrations of interferon (IFN)-alpha were significantly lower in patients with complications than in those without, at 67.1 versus 87.7 pg/mL. More importantly, serum IFN-alpha concentration positively associated with vitamin A concentration, remark Wang et al.
"The mechanisms are unclear, but low vitamin A levels may be due to decreased intake, increased consumption, or increased catabolism," write the authors. They suggest that further studies are needed to determine the reasons for their findings, so that "appropriate interventions can be implemented to improve the vitamin A status of individuals with HFMD."
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Orange County health officials are investigating a cluster of illnesses
linked to Walt Disney World's "Wild Africa Trek" experience,
a boutique tour in which small groups of people get up-close access to some of
the wildlife in Disney's Animal Kingdom and a catered meal served
on the theme park's manmade savannah.
Investigators have documented "several dozens of cases" of illnesses among guests who took the Disney tour in June and July, said Dain Weister, a spokesman for the Orange County Health Department.
The source of the illness remains a mystery.
"It appears to be some kind of stomach bug," Weister said. "It could be
food-borne, it could be water-borne, it could be something that's passed on
person-to-person, it could be something that's picked up by surface."
Disney has taken several precautionary steps, including "deep cleaning" various surfaces that guests touch, distributing more hand sanitizers, and re-emphasizing hand-washing policies to guests and employees.
"We are working closely with the Orange County Health Department to review the situation," Disney spokeswoman Andrea Finger said...
The county Health Department was alerted to the outbreak on June 11. Weister said the agency immediately inspected the kitchen at Disney World where employees prepare the food served on the trek, but they found no problems.
....Investigators also began contacting guests who took the tour, beginning with those who did so during the first two weeks of June and the first week of July. A majority of the cases they found occurred during the first week in June, though a handful were also found in July, so investigators are now surveying people who took the tour in the latter half of June...
..One of those who posted said he or she was "extremely sick" by midnight the day after taking the tour, with vomiting that lasted for about five hours and pain, cramping and diarrhea that endured for more than a week. Another said his wife had to take him to the emergency room because of complications....
http://www.orlandosentinel.com/the-daily-disney/os-disney-wild-africa-trek-illness-20120725,0,5555612.story
Investigators have documented "several dozens of cases" of illnesses among guests who took the Disney tour in June and July, said Dain Weister, a spokesman for the Orange County Health Department.
The source of the illness remains a mystery.
Disney has taken several precautionary steps, including "deep cleaning" various surfaces that guests touch, distributing more hand sanitizers, and re-emphasizing hand-washing policies to guests and employees.
"We are working closely with the Orange County Health Department to review the situation," Disney spokeswoman Andrea Finger said...
The county Health Department was alerted to the outbreak on June 11. Weister said the agency immediately inspected the kitchen at Disney World where employees prepare the food served on the trek, but they found no problems.
....Investigators also began contacting guests who took the tour, beginning with those who did so during the first two weeks of June and the first week of July. A majority of the cases they found occurred during the first week in June, though a handful were also found in July, so investigators are now surveying people who took the tour in the latter half of June...
..One of those who posted said he or she was "extremely sick" by midnight the day after taking the tour, with vomiting that lasted for about five hours and pain, cramping and diarrhea that endured for more than a week. Another said his wife had to take him to the emergency room because of complications....
http://www.orlandosentinel.com/the-daily-disney/os-disney-wild-africa-trek-illness-20120725,0,5555612.story