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Increase in Adverse Reactions Associated with Use of Synthetic Cannabinoids - Anchorage, Alaska, 2015-2016.

https://arctichealth.org/en/permalink/ahliterature279086
Source
MMWR Morb Mortal Wkly Rep. 2016 Oct 14;65(40):1108-1111
Publication Type
Article
Date
Oct-14-2016
Author
Yuri P Springer
Roy Gerona
Erich Scheunemann
Sarah L Shafer
Thomas Lin
Samuel D Banister
Michael P Cooper
Louisa J Castrodale
Michael Levy
Jay C Butler
Joseph B McLaughlin
Source
MMWR Morb Mortal Wkly Rep. 2016 Oct 14;65(40):1108-1111
Date
Oct-14-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska - epidemiology
Cannabinoids - adverse effects
Child
Designer Drugs - adverse effects
Disease Outbreaks
Drug-Related Side Effects and Adverse Reactions - epidemiology - therapy
Emergency Service, Hospital - statistics & numerical data
Female
Humans
Male
Middle Aged
Young Adult
Abstract
In July 2015, personnel in the Alaska Division of Public Health's Section of Epidemiology became aware of an increase in the number of patients being treated in Anchorage hospital emergency departments for adverse reactions associated with use of synthetic cannabinoids (SCs). SCs are a chemically diverse class of designer drugs that bind to the same cannabinoid receptors as tetrahydrocannabinol, the main psychoactive component of cannabis. A public health investigation was initiated to describe clinical outcomes, characterize the outbreak, and identify SC chemicals circulating in Anchorage. During July 15, 2015-March 15, 2016, a total of 1,351 ambulance transports to Anchorage emergency departments for adverse SC reactions were identified. A review of charts obtained from two Anchorage hospitals determined that among 167 emergency department visits for adverse SC reactions during July 15-September 30, 2015, 11 (6.6%) involved a patient who required endotracheal intubation, 17 (10.2%) involved a patient who was admitted to the intensive care unit, and 66 (39.5%) involved a patient classified as being homeless. Testing of 25 product and paraphernalia samples collected from patients at one hospital identified 11 different SC chemicals. Educational outreach campaigns focused on the considerable health risks of using SCs need to complement judicial and law enforcement actions to reduce SC use.
PubMed ID
27736839 View in PubMed
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Novel Orthopoxvirus Infection in an Alaska Resident.

https://arctichealth.org/en/permalink/ahliterature289944
Source
Clin Infect Dis. 2017 Jun 15; 64(12):1737-1741
Publication Type
Case Reports
Journal Article
Date
Jun-15-2017
Author
Yuri P Springer
Christopher H Hsu
Zachary R Werle
Link E Olson
Michael P Cooper
Louisa J Castrodale
Nisha Fowler
Andrea M McCollum
Cynthia S Goldsmith
Ginny L Emerson
Kimberly Wilkins
Jeffrey B Doty
Jillybeth Burgado
JinXin Gao
Nishi Patel
Matthew R Mauldin
Mary G Reynolds
Panayampalli S Satheshkumar
Whitni Davidson
Yu Li
Joseph B McLaughlin
Author Affiliation
Alaska Division of Public Health, Section of Epidemiology, Anchorage.
Source
Clin Infect Dis. 2017 Jun 15; 64(12):1737-1741
Date
Jun-15-2017
Language
English
Publication Type
Case Reports
Journal Article
Keywords
Alaska
Animals
Antibodies, Viral - blood
DNA, Viral - blood
Female
Fomites - virology
Humans
Mammals - virology
Microscopy, Electron
Middle Aged
Orthopoxvirus - classification - genetics - isolation & purification - ultrastructure
Phylogeny
Poxviridae Infections - diagnosis - virology
Sequence Analysis, DNA
Skin - pathology - virology
Abstract
Human infection by orthopoxviruses is being reported with increasing frequency, attributed in part to the cessation of smallpox vaccination and concomitant waning of population-level immunity. In July 2015, a female resident of interior Alaska presented to an urgent care clinic with a dermal lesion consistent with poxvirus infection. Laboratory testing of a virus isolated from the lesion confirmed infection by an Orthopoxvirus.
The virus isolate was characterized by using electron microscopy and nucleic acid sequencing. An epidemiologic investigation that included patient interviews, contact tracing, and serum testing, as well as environmental and small-mammal sampling, was conducted to identify the infection source and possible additional cases.
Neither signs of active infection nor evidence of recent prior infection were observed in any of the 4 patient contacts identified. The patient's infection source was not definitively identified. Potential routes of exposure included imported fomites from Azerbaijan via the patient's cohabiting partner or wild small mammals in or around the patient's residence. Phylogenetic analyses demonstrated that the virus represents a distinct and previously undescribed genetic lineage of Orthopoxvirus, which is most closely related to the Old World orthopoxviruses.
Investigation findings point to infection of the patient after exposure in or near Fairbanks. This conclusion raises questions about the geographic origins (Old World vs North American) of the genus Orthopoxvirus. Clinicians should remain vigilant for signs of poxvirus infection and alert public health officials when cases are suspected.
Notes
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PubMed ID
28329402 View in PubMed
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