An Israeli researcher working in Finland with Bank Voles, contracted an infectious viral disease and died. This was a rare event, but it is important to learn about this class of viruses and to be aware of the hazards while working in the field in close contact with wild animals. The virus termed Puumala belongs to the genus Hanta from the Bunyaviridae family. The natural reservoir is rodents, mice, rats and Bank Votes for the Puuamala strain. The disease is termed HFRS (hemorrhagic fever with renal syndrome), is prevalent in Asia and Europe, affecting 200,000 people a year, with 5-15% percent mortality (although in Finland mortality rate is 0.1%). The New World strains cause HPS (hemorrhagic pulmonary syndrome) affecting 200 people a year with 40% mortality. Virus is present in all rodents excretions, and route of infection is by aerosols, hand to mucus membranes contamination, by rodents bites and by contaminated food or water. More than 226 work related infections were documented. Treatment with Ribavirin helps in HFRS but not in HPS. The virus is stable in the environment for long periods, and research must be carried out at biosafety level 3. Working outdoors in rodent infested area, should be carried out using protective clothing, gloves, googles and face mask whenever aerosol producing tasks are performed. Both indoor and outdoor, it is important to adhere to self-hygienic procedures, especially hand washing.
BACKGROUND: In Israel, as in other developed countries, injuries are a leading cause of death and disabilities among children and youth between 1-19 years of age and the leading cause for Potential Years of Life Lost up to 65 years of age. In 1997, 225 children died as a result of accidental injuries, compared to 151 cases of death due to other internal causes. The most prevalent cause of death being motor vehicle accidents, rating 3:100,000: drowning--1:100,000 and falls, burns, suffocation and poisonings--less than 1:100,000 each. Mortality rates are just the tip of the iceberg, the most extreme outcome of an injury. Hospitalization rates and emergency room visits are higher. Injury was the cause for one out of 3 children to visit the emergency department. Hence, in 2001, there were 187,531 visits due to trauma, an annual rate of 712:10,000. The hospitalization rate due to injuries was 67:10,000 and the mortality rate was 8:100,000. Injuries in the community: Data concerning injuries in the community are relatively rare since no surveillance system exist. In their article "Childhood injuries in northern Israel--prevalence and risk factors", Miron at al. describe the prevalence, demographic variables and risk factors of injuries in the community of northern Israel. The article contributes to our knowledge of accidental injuries at the level of the primary care physician in the community. The findings indicate that falls and blows are the most common causes for mild injuries that usually occur in the home and backyard, and Arab children are at special risk for injuries, in general, and falls, in particular. These findings are consistent with existing data. Prevention is the way: 71-95% of all injuries can be prevented by simple means. This has been proven in many countries that managed to reduce mortality from accidental injuries by 10-20%. In the U.S.A., for example, the percentage was reduced to about 35% in a decade. In Sweden, 3 decades of constant preventive efforts combined with close monitoring of the data have proven effective in reducing rate of mortality due to accidental injuries in children by 80%. The strategies which have proven to be effective are education and publicity, safer products and surroundings, promoting public policy, enforcement, data collection, research and evaluation and empowerment. A combination of strategies is most effective. National Vision: Despite the dismal picture, accidental injuries in children can be prevented and are not inevitable. It is wise to look at injuries as a heterogeneous group of illnesses, with different etiology, risk groups, and 'preventive treatments'--a group of diseases which are all preventable. It is very important that a national strategy for child safety be established accompanied by an adequate budget. Above all, it requires a lot of faith and commitment for the only vision: making the world a safer place for children.