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Constructing artificial intelligence: The Human Droid

Mind-controlled nanobots could release drugs inside your brain

A man has used thought alone to control nanorobots inside a living creature for the first time. The technology released a drug inside cockroaches in response to the man’s brain activity – a technique that may be useful for treating brain disorders such as schizophrenia and ADHD.

Getting drugs to where they need to be exactly when you want them is a challenge. Most drugs diffuse through the blood stream over time – and you’re stuck with the side effects until the drug wears off.

Now, a team at the Interdisciplinary Center, in Herzliya, and Bar Ilan University, in Ramat Gan, both in Israel, have developed a system that allows precise control over when a drug is active in the body.

The group has built nanorobots out of DNA, forming shell-like shapes that drugs can be tethered to. The bots also have a gate, which has a lock made from iron oxide nanoparticles. The lock opens when heated using electromagnetic energy, exposing the drug to the environment. Because the drug remains tethered to the DNA parcel, a body’s exposure to the drug can be controlled by closing and opening the gate.

Mind medicine

To get the DNA bots to respond to a person’s thoughts, the team trained a computer algorithm to distinguish between a person’s brain activity when resting and when doing mental arithmetic.

The team then attached a fluorescent drug to the bots and injected them into a cockroach sat inside an electromagnetic coil. A person wearing an EEG cap that measures brain activity was then instructed either to do mental calculations, or rest.  The cap was connected to the electromagnetic coil, switching it on when the man was calculating and off when he was resting.

By examining when fluorescence appeared inside different cockroaches, the team confirmed that this worked.

The algorithm could be trained to track other types of brain activity, says Sachar Arnon, a member of the team at the Interdisciplinary Center. “It could track brain states that underlie ADHD or schizophrenia, for example. It could be modified to suit your needs.”

The idea would be to automatically trigger the release of a drug when it is needed. For example, some people don’t always know when they need medication – before a violent episode of schizophrenia, for instance. If an EEG could detect it was coming, it could stimulate the release of a preventative drug.

Triggered release

Because the bots can open and close when required, the technology should minimise unwanted side effects. Tweaking the DNA bots could also ensure they only target specific cells in the body, minimising harmful interactions elsewhere in the body. This could be done by attaching molecules to the surface of the bots that bind to specific receptors on the outside of certain types of cell.

But the technology isn’t ready to be used in humans yet. To work, the setup needs a smaller, more portable method of measuring brain activity – something Arnon says isn’t far away. The team envisions a person wearing a small, hearing aid-like EEG device to monitor brain activity and detect when drugs are needed – for example, when a person with ADHD’s concentration begins to lapse. A smart watch would then create the electromagnetic field required to release a dose of Ritalin.

Such a combination of devices could be used to treat depression and other brain conditions that are difficult to treat. It could also allow people to actively trigger when they want a drug to be released by summoning specific thoughts.

“People could take this in all different directions,” says Arnon. “Imagine if you could deliver the exact amount of alcohol that you wanted to keep you in a happy state but not drunk. Kind of stupid, but this could happen. I think we’ve just scratched the surface.”

Journal reference: PLoS, DOI:10.1371/journal.pone.0161227

[Byline Helen Thomson]

New Scientist, Daily news 
25 August 2016

Biological Health Hazard: ISIS Hackers Publish a Step-by-Step “How to Guide for Muslims to Poison Westerners” — sharia unveiled

An existential threat is a threat to a people’s existence, freedom or survival.

Also.. be sure to watch the NEW ISIS Instructional Video below, where they teach Muslims how to attack “us” with screwdrivers, loaded syringes, etc… by, Charlie Bayliss | The Express UK | Blazing CatFur | The Clarion Project An Islamic State-supported group of hackers has used an encrypted app to encourage Daesh followers to […]

via ISIS Hackers Publish a Step-by-Step “How to Guide for Muslims to Poison Westerners” — sharia unveiled

Nuclear Event – Automatic Reactor Trip: H.B. Robinson Steam Electric Plant, Unit 2, South Carolina

North America – USA | State of South Carolina, H.B. Robinson Steam Electric Plant, Unit 2
Location: 34°24’10.0″N 80°09’30.0″W
Site Operational Age: ~46 years

File:Robinson Nuclear Station seen from Lake Robinson.JPG

Containment building for Robinson Nuclear Station. Image from the Wikimedia Commons

Nuclear Event in USA on Wednesday, 24 August, 2016 at 13:38 [EDT].


“At 1338 [EDT] on 08/24/2016, a turbine trip, and a subsequent reactor trip occurred. The cause is under investigation. Following the reactor trip, the Auxiliary Feedwater System actuated as expected on low steam generator level. At the time of the trip, the plant was in Mode 1. As of 1643 [EDT], the Plant is in Mode 3. The current RCS [Reactor Coolant System] Temperature is 548 degrees F (Average), and the Steam Generator Levels are in the range of 40 to 45% (normal range) with levels controlled by the Main Feedwater System. All systems and equipment operated as expected.

“Due to the automatic actuation of the Reactor Protection System, this event is being reported as a 4 hour Non-Emergency per 10 CFR 50.72(b)(2)(iv)(B). Due to the valid actuation of Auxiliary Feedwater System, this event is also being reported as an 8 hour Non-Emergency per 10 CFR 50.72(b)(3)(iv)(A)(B)(6). At no time during this occurrence was the public or plant staff at risk as a result of this event.

“The NRC Resident Inspector has been notified.”

Source: NRC  Event Number: 52198

Nuclear Event – Manual Reactor Trip: Watts Bar Nuclear Plant, Unit 2

North America – USA | State of Tennessee, Rhea County, Spring City, Watts Bar Nuclear Plant
Location: 35°36’10.0″N 84°47’22.0″W
Site Operational Age: ~31 years

Nuclear Event in USA on Tuesday, 23 August, 2016 at 13:56 [EDT].


“On August 23, 2016, at 1356 EDT, Watts Bar Nuclear Plant [WBN] Unit 2 reactor was manually tripped due to a loss of main feedwater.

“Concurrent with the reactor trip, the Auxiliary Feedwater system actuated as designed.

“All control and shutdown rods fully inserted. All safety systems responded as designed. The unit is currently stable in Mode 3, with decay heat removal via Auxiliary Feedwater and main steam dump systems. Unit 2 is in a normal shutdown electrical alignment.

“The cause is currently under investigation.

“This is being reported under 10CFR 50.72(b)(3)(iv)(A) and 10CFR 50.72(b)(2)(iv)(B).

“There was no effect on WBN Unit 1.

“The NRC Senior Resident Inspector has been notified.”

Source: NRC  Event Number: 52194


Previous Events

Nuclear Event in USA on Monday, 20 June, 2016 at 15:40 [EDT]. RPS ACTUATION – CRITICAL/AUTOMATIC REACTOR TRIP


Nuclear Event in USA on Tuesday, 22 March, 2016 at 11:31 [EDT]. WATTS BAR AUTOMATIC REACTOR TRIP UNIT 1 [due to the actuation of the Over Temperature Delta Temperature bistables.]

Nuclear Event in USA on Thursday, 17 March, 2016 at 01:15 [EDT]. LOSS OF EMERGENCY AND AUXILIARY GAS TREATMENT SYSTEMS – UNIT 1

Nuclear Event in USA on Wednesday, 09 March, 2016 at 03:42 [EST]. UNUSUAL EVENT DECLARED DUE TO A FIRE GREATER THAN 15 MINUTES – UNIT 2

Equality, Unity, Diversity, Desegregation, Assimilation, etc, etc …

Reality :

 Reality Check

Segregation – Racism Reality Check. Image:

The Tyranny of Race

There are a limited number of ways to govern a multi-ethnic or multi-racial society. As much as modern elites believe they are wrestling with new problems, the issues the West faces today are common throughout history. The very first settled human societies were multi-ethnic. The “cradle of civilization” was full of tribal people with identities different from one another, often with different languages. One tribe would come to dominate the others, but the subjugated people maintained their identities. They just paid tribute to the dominant tribe.

One way humans have met this challenge is through hard segregation. This is when areas are carved out for specific groups of people and only those people. The governing authority helps the groups defend their turf from any encroachment from the others. One group is dominant, but a big part of how they maintain their dominance is by keeping the peace between the rest of the groups. The Arab world still functions under this model for the most part. One tribe dominates, but the other tribes run their own turf for the most part.

The opposite of this is compulsory assimilation, where everyone is blended into one identity. The English banning Welsh and other local languages from government is an example of how the ruling group can force assimilation. The Romans would settle barbarians in the Empire with the goal of assimilation. This meant sprinkling them around in small groups so they would adopt the local language and customs and lose their native identity. Their inability to do this with the Goths is often held up as one of the causes of the collapse.

The third most common method for confronting the problems of diversity is soft segregation where you end up with a multi-tier social order. The dominant group gets all the privileges and benefits of society. The lower orders are barred from positions of authority and perhaps have fewer legal rights. Muslims prefer this model. Europeans used to treat the Jews as a guest race of people, with limited legal rights. In America, this was the mode employed after the Civil War to manage blacks. In the North it was implicit and in the South it was explicit.

None of these models are seen as legitimate or moral by modern Western leaders. America still maintains reservations for Indians, but that’s only because no one knows how to get rid of them. The Europeans still have a gypsy problem, but like the Indian problem, no one knows what to do about it so it is ignored. Otherwise, the West has no interest in segregation or compulsory assimilation when it comes to the challenges of diversity. In fact, diversity is viewed as an unalloyed good so any attempt to temper it is forbidden.

That has resulted in the current way of meeting the challenge of diversity in the West, which is Proportionalism. This is where the costs of violating liberal principles are weighed against the perceived benefits from violating the principles. For instance, legal discrimination is wrong as a principle, but quotas and set asides allegedly have benefits that are too valuable to pass up, so the state engages in active racism in hiring. Because the scales are entirely subjective based on one’s point of view and the moment in time, there can be no fixed rules, just a mindset.

A good recent example is the Freddy Gray case in Baltimore. The city charged every cop involved with the highest possible count, even though little evidence suggested they did anything wrong, much less deliberately criminal. The victim was black so the city violated the rights of the cops and ruined their lives because the city thought the benefits outweighed the rights of the cops. In other words, naked racism to counter the consequences of perceived racism was justified based on expected outcomes in this particular case.

The result of this mode of thought, this philosophical outlook, is a thicket of rules and precedents that are incoherent in isolation because they exist only in the moment. America is a land where you can be sued for discriminating against blacks in favor of whites, while simultaneously being sued for discriminating against whites in favor of blacks. Since there are no set rules that apply all the time, you could lose both cases in the same courthouse. It all depends upon the judge and the circumstances.

There’s a word for arbitrary application of the law. It’s called tyranny. That is the inevitable end of Proportionalism because benefits and costs are always subjective. The City of Baltimore looked at the lives of six police officers and said they were not worth another riot. The family of the police officers had a very different valuation of these things. The dozens of dead black guys would probably have a different calculation, but the police went on a silent strike so those black guys got killed and no longer have a say.

The reason tyranny eventually collapses is it devolves into a recursive use of resources in order to maintain itself. Once the law becomes arbitrary, the violations of the law, and the willingness to flaunt flout the law, increase exponentially. The only thing everyone knows is that voluntary compliance has no benefit. This requires an exponential growth of authority to maintain order. Eventually, the cost of order exceeds the resources available to the authority and collapse ensues. It’s why authoritarian regimes tend not to live long past their founder.

Biological Health Hazard – Swine influenza, sub-type H3N2V (human infection): Michigan and Ohio

Published Date: 2016-08-17 15:34:54
Subject: PRO/AH/EDR> Influenza, swine (04): USA (MI, OH), human cases H3N2V
Archive Number: 20160817.4420280

Date: 13 Aug 2016
Source: Outbreak News Today [edited]

Four human infections with influenza viruses that normally circulate in swine (swine influenza) were reported by CDC this week. When swine influenza viruses are detected in people, they are called “variant” viruses and are designated with a letter v at the end of the virus subtype. The 4 human infections were caused by H3N2v viruses in Ohio (2) and Michigan (2). All 4 patients reported attending fairs where they had exposure to pigs during the week preceding illness onset. Pigs at the fairs have reportedly tested positive for swine influenza A (H3N2) infection. The Ohio patients are not related other than that both of them reported having attended the same fair in Ohio. Similarly, the Michigan cases both attended the same fair in Michigan but are otherwise unrelated to each other.

CDC is working with state public health officials to support their human health responses and has recommendations for the public on what steps they can take to help protect against H3N2v and other swine influenza viruses.

Swine influenza is a respiratory disease of pigs caused by type A influenza viruses that cause outbreaks in pigs. Signs of swine flu in pigs can include fever, coughing (barking), sneezing, breathing difficulties, eye redness or inflammation, and not eating. Some pigs infected with influenza, however, may show no signs of illness at all.

Swine flu viruses do not normally infect people; however, sporadic human infections with these viruses have occurred. Human infections with H1N1v, H3N2v and H1N2v viruses have been detected in the United States. Spread between pigs and people is thought to happen mainly when an infected pig (or human) coughs or sneezes and droplets with influenza virus in them spread through the air. If these droplets land in the nose or mouth, or are inhaled, that person (or pig) could be infected. There also is some evidence that the virus might spread by touching something that has virus on it and then touching the mouth or nose. A 3rd way to possibly get infected is to inhale particles containing influenza virus. Influenza has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs.

Most commonly, human infections with variant viruses occur in people with exposure to infected pigs (e.g., at a fair or at work). Illness associated with variant virus infection includes symptoms similar to those of seasonal flu. Most illness has been mild, but as with seasonal flu, hospitalization and death can occur. There have been documented cases of multiple people becoming sick after exposure to one or more infected pigs and also cases of limited spread of variant influenza viruses from person to person.

Human infections with a non-human influenza virus should be fully investigated to be sure that such viruses are not spreading in humans in an efficient and ongoing way, and to limit further exposure of humans to infected animals if infected animals are identified. At this time, the epidemiology of the human infections reported this week seems consistent with what has been in the past. None of the most recent infections were hospitalized, and there were no deaths. CDC is conducting laboratory studies to find out more about these viruses.

Agricultural fairs take place across the United States every year, primarily during the summer months and into early fall. Many fairs have swine exhibitions, where pigs from different places come in close contact with each other and with people. These venues may magnify the risk of spread of influenza viruses between pigs and people. The number of variant virus infections reported in humans has varied from season to season. During the summer of 2012, 309 human infections with H3N2v viruses were detected. Subsequently, 19 infections of H3N2v were detected in 2013, and only 3 infections each were detected during 2014 and 2015.

Some people are at high risk of developing serious illness from variant virus infections, just as they are from seasonal influenza. This includes young children, people with underlying health conditions like asthma, diabetes or heart disease, pregnant women and people who are 65 and older. In order to reduce the possible risk of serious illness to people posed by interactions between people and pigs at fairs, CDC recommends that people at high risk for serious flu complications avoid pigs and swine barns at fairs. During the 2012 H3N2v outbreaks, 16 people were hospitalized, and one person died from H3N2v infection. Most of those people were at high risk for serious flu complications.

The 2016-2017 seasonal flu vaccine is not formulated to provide protection against H3N2v. CDC recommends annual seasonal influenza vaccination for everyone 6 months and older to protect against seasonal flu viruses. The same influenza antiviral drugs used to treat seasonal flu can be used to treat variant virus infection in children and adults. The currently recommended drugs — oseltamivir, peramivir, and zanamivir — are available by prescription only. Early treatment works better and is especially important for people who are very ill or who are at high risk of serious flu complications.

Communicated by:

[The cases from Michigan mentioned in the above report have already been reported in the ProMED post “Influenza, swine (02): USA (MI) human case, H3N2v 20160807.4399461.” All the reported cases had history of exposure to pigs at fairs a few days prior to onset of illness.

It is important that the public be educated on specific exposures/risk behaviors in relation to swine that may lead to infection or risk of spread. Reinforcing the message for annual vaccination against human seasonal influenza, particularly in high risk groups, will also be helpful. – Mod.UBA

ProMED HealthMaps:
Ohio, United States:
Michigan, United States:]

See Also

Influenza, swine (03): USA (MI) 20160811.4408096
Influenza, swine (02): USA (MI) human case, H3N2V 20160807.4399461
Influenza, swine-origin (02): USA (WN, MN) H1N2v human cases 20160703.4323386
Influenza, swine-origin: USA (MN) human case, H1N2v 20160515.4222769
Influenza, swine: USA (MN,IA) study 20160114.3936806
Influenza, porcine – China: Eurasian avian-like H1N1 swine influenza virus, pandemic potential 20160102.3904985
Influenza, swine (05): USA (MI,MN) novel strains, human case H3N2v 20150905.3626427
Influenza, swine (04): USA (IA) novel strains H1N1v, H3N2v, human infection 20150830.3612253
Influenza, swine (03): USA, evolutionary dynamics IAV in swine, human threat 20150806.3562409
Influenza, swine (02): USA (MN) novel strains, human infection 20150804.3556121
Influenza, swine – USA: (MN) novel strains, human case H3N2v 20150726.3537522
Influenza, swine – USA: novel strains, H3N1, alert 20140916.2776180
Influenza (101): USA (OH), A(H3N2)v, swine to human transmission 20121026.1367194
Influenza (86): swine H1N2, virulence & transmissibility in ferrets 20120912.1291427
Influenza (85): USA: (MN) swine H1N2 influenza, human cases 20120911.1290389
Influenza (65): swine influenza, A/(H3N2)v, OIE status 20120806.1229963
Influenza (78): USA, swine-origin H3N2 reassortants update 20111224.3669
Influenza (74): swine-origin H3N2 reassortant, vaccine candidate 20111203.3526
Influenza (72): Europe, swine-origin H3N2 reassortant, risk assessment 20111130.3494
Influenza (71): USA (IA) swine-origin H3N2 reassortant, WHO 20111125.3448
Influenza (70): USA (IA) swine-origin H3N2 reassortant 20111124.3438
Influenza (69): USA (IA) swine-origin H3N2 reassortant 20111123.3430
Influenza (68): Hong Kong swine-origin H3N2 reassortant 20111119.3411
Influenza (66): USA swine-origin H3N2 reassortant, update 20111105.3298
Influenza (63): USA (ME, NOT NH) swine-origin H3N2 reassortant 20111102.3260
Influenza (60): USA (ME) swine-origin H3N2 reassortant 20111021.3134
Influenza (54): (PA) swine-origin H3N2 reassortant, comment 20110913.2789
Influenza (52): (PA), swine-origin H3N2 reassortant, 3 cases 20110906.2723
Influenza (51): swine-origin H3N2 reassortant, children 20110902.2685
Influenza (14): swine origin (tr) H3N2 viruses 20101112.4117
Influenza pandemic (H1N1), animal (07): Finland, swine, OIE 20100901.3114
Influenza pandemic (H1N1) (42): reassortment, swine 20100618.2055
Influenza pandemic (H1N1), animal (06): Korea, swine 20100422.1296
Influenza H3N2, new, swine, human – USA: (IA) 20100116.0189
Influenza pandemic (H1N1) 2009, animal (01): China, swine, canine 20100101.0014
Influenza pandemic (H1N1) 2009, animal (42): USA (NC) swine 20091228.4372
Influenza pandemic (H1N1) 2009, animal (41): Russia (CV) swine, OIE 20091226.4353
Influenza pandemic (H1N1) 2009, animal (39): Germany, swine, OIE 20091211.4220
Influenza pandemic (H1N1) 2009, animal (38): Mexico, swine, OIE 20091211.4214
Influenza pandemic (H1N1) 2009, animal (35): Italy, swine, OIE 20091205.4144
Influenza pandemic (H1N1) 2009, animal health (31): Finland, swine, OIE 20091201.4106
Influenza pandemic (H1N1) 2009, animal health (09): Indonesia, swine 20091127.4071
Influenza pandemic (H1N1) 2009, animal (22): USA, swine 20091106.3834
Influenza pandemic (H1N1) 2009, animal (19): Iceland swine, OIE 20091028.3737
Influenza pandemic (H1N1) 2009, animal (13): USA swine, conf. 20091020.3600
Influenza pandemic (H1N1) 2009, animal (12): USA swine, susp 20091019.3592
Influenza pandemic (H1N1) 2009, animal (09): UK (NI) swine, OIE 20090918.3280
Influenza pandemic (H1N1) 2009, animal health (08): Singapore, swine 20090904.3114
Influenza pandemic (H1N1) 2009, animal health (06): Canada, swine 20090828.3027
Influenza pandemic (H1N1) 2009, animal health (05): Austr., swine 20090826.2999
Influenza pandemic (H1N1) 2009, animal health (02): Austr., swine 20090820.2951
Influenza A (H3N2), swine, human – USA: (KS) 20090808.2812
Influenza pandemic (H1N1) 2009 (22): Australia (NSW), swine 20090801.2698
Influenza pandemic (H1N1) 2009 (15): Canada (AB) swine workers 20090723.2603
Influenza pandemic (H1N1) 2009 (07): Argentina, swine, alert 20090718.2557
Influenza A (H1N1): animal health (16), Argentina, swine, OIE 20090626.2322
Influenza A (H1N1): animal health (13) swine, Canada, origin, RFI 20090615.2215
Influenza A (H1N1): animal health (12) swine trial inf. 20090605.2088
Influenza A (H1N1): animal health (11) swine trial inf. 20090604.2067
Influenza A (H1N1) – worldwide (50): swine immunity 20090528.1987
Influenza A (H1N1): animal health (10) swine, Canada, cull 20090514.1813

A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases

Biological Health Hazard – Elizabethkingia anophelis (fatal): Wisconsin (Update 2016-08-18)

Published Date: 2016-08-18 16:43:08
Subject: PRO/EDR> Elizabethkingia anophelis – USA (19): (WI) fatal, community acquired
Archive Number: 20160818.4422637

Date: Wed 17 Aug 2016
Source: American Council on Science and Health (ACSH) [edited]

Elizabethkingia: Is This Mysterious Disease Coming from Hospitals?
Occasionally, a rare or unknown microbe rears its ugly head and causes disease in humans. Whether it is due to a previously harmless microbe mutating, a disease of animals jumping into humans, or mankind encountering new habitats (and hence, new microbes), epidemiologists lump these bugs into a broad category called “emerging and re-emerging infectious diseases.”

Some of the latest inductee into this nefarious club is the bacterium _Elizabethkingia anophelis_, named in honor of microbiologist Elizabeth King. The microbe is common in the environment, initially found in the guts of _Anopheles_ mosquitoes [_A. gambiae_ – Mod.LL]. There are 4 known species, but the most problematic for humans appears to be _E. anophelis_, which is resistant to multiple antimicrobials. According to the CDC, the bacterium is responsible for at least 20 deaths in an ongoing outbreak in the American Midwest, mostly [in Wisconsin – Mod.LL] among elderly people with poor health. Currently, no one has identified the source of the outbreak.

In order to gain a better understanding of these enigmatic bacteria, a group of mostly French researchers sequenced the genomes of 2 _E. anophelis_ isolates from Central African Republic that caused meningitis in newborn infants. Then, they compared these sequences with those already known from other _Elizabethkingia_ isolates elsewhere in the world. Their results were reported in the journal Scientific Reports.

The authors used the genome sequences to build a phylogenetic tree (think: family tree), from which they inferred both evolutionary relationships as well as potential geographical histories of the isolates. This genomic analysis divides _E. anophelis_ into 2 lineages, A and B. Lineage A, which contains the African samples (sublineage 5), also contains sublineages isolated from Hong Kong (sublineage 4) and Singapore (sublineage 2), as well as from mosquitoes (sublineage 1). The phylogenetic tree suggests that sublineages 1, 4, and 5 are most closely related, which means the African samples are closest to those strains isolated from Hong Kong and from mosquitoes.

But, the African isolates almost certainly did not come from mosquitoes, since they were collected from newborn babies who were on ventilators in the hospital. Furthermore, some of the strains in sublineages 2 and 3 were also taken from a hospital environment. The authors worry that, despite being associated with mosquitoes and the environment, _Elizabethkingia_ can be transmitted in hospitals, just like several other nasty microbes [including the organism initially called _Flavobacterium meningosepticum_ now _E. meningoseptica_ which cannot be easily differentiated from _E. anophelis_- Mod.LL]. Given its resistance to multiple antimicrobials, that is not a welcome discovery. Midwestern public health officials should take note.

Source: Breurec, S. et al. Genomic epidemiology and global diversity of the emerging bacterial pathogen Elizabethkingia anophelis. Sci. Rep. 6, 30379; doi: 10.1038/srep30379 (2016).

[Byline: Alex Berezow]

Communicated by:
ProMED-mail from HealthMap Alerts

[The latest Wisconsin count remains at 67 total and has not changed since June 2016 (

Wisconsin 2016 _E. anophelis_ outbreak:
Case counts between 1 Nov 2015 and 17 Aug 2016
Confirmed = 63
Under investigation = 0
Possible cases = 4
Total cases reported to Wisconsin DPH = 67

Affected counties include Columbia, Dane, Dodge, Fond du Lac, Jefferson, Milwaukee, Ozaukee, Racine, Sheboygan, Washington, Waukesha, and Winnebago.

There have been 18 deaths among individuals with confirmed _E. anophelis_ infections and an additional one death among possible cases for a total of 19 deaths. It has not been determined if these deaths were caused by the infection or other serious pre-existing health problems. Counties where these deaths occurred are: Columbia, Dodge, Fond du Lac, Milwaukee, Ozaukee, Racine, Sheboygan, Washington, and Waukesha.

This investigation is ongoing. Case counts may change as additional illnesses are identified and more cases are laboratory confirmed.

The possible cases are cases that tested positive for _Elizabethkingia_, but will never be confirmed as the same strain of _E. anophelis_ because the outbreak specimens are no longer available to test.

The report cited and a parallel more clinical one are shown below with their abstracts but none of the isolates are from North America:

Breurec S, Criscuolo A, Diancourt L, et al: Genomic epidemiology and global diversity of the emerging bacterial pathogen Elizabethkingia anophelis. Sci Rep. 2016 Jul 27;6:30379. doi: 10.1038/srep30379

_Elizabethkingia anophelis_ is an emerging pathogen involved in human infections and outbreaks in distinct world regions. We investigated the phylogenetic relationships and pathogenesis-associated genomic features of 2 neonatal meningitis isolates isolated 5 years apart from one hospital in Central African Republic and compared them with _Elizabethkingia_ from other regions and sources. Average nucleotide identity firmly confirmed that _E. anophelis_, _E. meningoseptica_ and _E. miricola_ represent demarcated genomic species. A core genome multilocus sequence typing scheme, broadly applicable to _Elizabethkingia_ species, was developed and made publicly available ( Phylogenetic analysis revealed distinct E. anophelis sublineages and demonstrated high genetic relatedness between the African isolates, compatible with persistence of the strain in the hospital environment. CRISPR spacer variation between the African isolates was mirrored by the presence of a large mobile genetic element. The pan-genome of _E. anophelis_ comprised 6880 gene families, underlining genomic heterogeneity of this species. African isolates carried unique resistance genes acquired by horizontal transfer. We demonstrated the presence of extensive variation of the capsular polysaccharide synthesis gene cluster in _E. anophelis_. Our results demonstrate the dynamic evolution of this emerging pathogen and the power of genomic approaches for _Elizabethkingia_ identification, population biology and epidemiology.

Lau SK, Chow WN, Foo CH, et al: Elizabethkingia anophelis bacteremia is associated with clinically significant infections and high mortality. Sci Rep. 2016 May 17;6:26045. doi: 10.1038/srep26045

Unlike _Elizabethkingia meningoseptica_, the clinical importance of _E. anophelis_ is poorly understood. We determined the clinical and molecular epidemiology of bacteremia caused by _Elizabethkingia_-like species from 5 regional hospitals in Hong Kong. Among 45 episodes of _Elizabethkingia_-like bacteremia, 21 were caused by _Elizabethkingia_, including 17 _E. anophelis_, 3 _E. meningoseptica_ and one _E. miricola_; while 24 were caused by other diverse genera/species, as determined by 16S rRNA gene sequencing. Of the 17 cases of _E. anophelis_ bacteremia, 15 (88 percent) were clinically significant. The most common diagnosis was pneumonia (n = 5), followed by catheter-related bacteremia (n = 4), neonatal meningitis (n = 3), nosocomial bacteremia (n = 2) and neutropenic fever (n = 1). _E. anophelis_ bacteremia was commonly associated with complications and carried 23.5 percent mortality. In contrast, of the 24 episodes of bacteremia due to non-_Elizabethkingia_ species, 16 (67 percent) were clinically insignificant. Compared to non-_Elizabethkingia_ bacteremia, _Elizabethkingia_ bacteremia was associated with more clinically significant infections (P less than 0.01) and positive cultures from other sites (P less than 0.01), less polymicrobial bacteremia (P less than 0.01), and higher complication (P less than 0.05) and mortality (P less than 0.05) rates. _Elizabethkingia_ bacteremia is predominantly caused by _E. anophelis_ instead of _E. meningoseptica_. _Elizabethkingia_ bacteremia, especially due to _E. anophelis_, carries significant morbidity and mortality, and should be considered clinically significant unless proven otherwise.

In the May/June 2016 issue of Genetic Announcements, 4 of the North American 2015-2016 outbreak strains had complete genetic sequencing done. A number of reassortment configurations were found (Nicholson AC, Whitney AM, Emery BD, et al: Complete genome sequences of four strains from the 2015-2016 Elizabethkingia anopheles outbreak. Genome Annouc 2016;4 (3):e00563-16 doi:10.1128/genomeA.00563-16). – Mod.LL

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See Also

Elizabethkingia anophelis – USA (18): (WI) fatal, community acquired 20160622.4302947
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Elizabethkingia anophelis – USA (16): (WI) fatal, community acquired 20160505.4203699
Elizabethkingia anophelis – USA (15): (WI) possible neonatal case 20160429.4190297
Elizabethkingia anophelis – USA (14): (WI) fatal, community acquired 20160427.4187853
Elizabethkingia anophelis – USA (13): (WI,IL) fatal, community acq 20160422.4176668
Elizabethkingia anophelis – USA (12): (WI,IL) fatal, community acq 20160421.4174417
Elizabethkingia anophelis – USA (11): (WI) fatal, community acq 20160415.4162001
Elizabethkingia anophelis – USA (10): (WI, IL) fatal, community acquired 20160413.4158063
Elizabethkingia anophelis – USA (09): (WI) fatal, community acquired 20160408.4146997
Elizabethkingia anophelis – USA (08): (WI) fatal, community acquired 20160331.4129125
Elizabethkingia anophelis – USA (07): (WI,MI) fatal, community acq 20160324.4116626
Elizabethkingia anophelis – USA (06): (WI,MI) fatal, community acq 20160322.4110826
Elizabethkingia anophelis – USA (05): (WI,MI) fatal, community acquired 20160318.4104623
Elizabethkingia anophelis – USA (04): (WI) fatal, community acquired 20160317.4099438
Elizabethkingia anophelis – USA (03): (WI) fatal, community acquired 20160311.4083895
Elizabethkingia anophelis – USA (02): (WI) fatal, community acq., comment, RFI 20160309.4080818
Elizabethkingia anophelis – USA: (WI) fatalities, community acquired, RFI 20160303.4067424

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