Elizabethkingia anophelis Outbreak in Wisconsin: A Mystery for CDC Disease Detectives
By Barbara M. Soule, RN, MPA, CIC, FSHEA, Fred M. Reiff, PE and Ralph Morris, MD, MPH

What causes a bacterium that is ubiquitous in soil, rivers, water reservoirs and the guts of mosquitoes to suddenly cause an outbreak of human infection? The bacterium is Elizabethkingia anophelis1, and the outbreak is affecting at least 12 Wisconsin counties. The common source of the outbreak remains a mystery at this time. According to the World Health Organization, the current US outbreak (it also includes one case each in Illinois and Michigan) is the largest of Elizabethkingia anophelis on record.

A Very Rare Infection

Although it is common in the environment, Elizabethkingia anophelis only rarely makes people sick, according to the US Centers for Disease Control and Prevention (CDC). In fact, most states typically report no more than five to ten Elizabethkingia anophelis infections per year. Currently, the Wisconsin Department of Health Services website notes 59 confirmed and four possible cases of infection, including 19 deaths.  … READ MORE >>


Aedes Mosquitoes: A Force in Human History
By Ralph Morris, MD, MPH and Barbara M. Soule, R.N. MPA, CIC, FSHEA

Aedes aegypti mosquito The female mosquito draws blood with a long, pointed mouthpart called a proboscis.
Image courtesy of the CDC website.

At the center of the current Zika virus epidemic is the humble insect vector, the Aedes mosquito, both aegypti and albopictus species.  The female Aedes 1acquires and transmits the virus by simply doing what she does—extracting blood from people, birds and other animals to obtain proteins needed to develop her eggs.  To many of us, mosquitoes are just a warm weather nuisance, but in his 2010 book, “Mosquito Empires:  Ecology and War in the Greater Caribbean,”2 J. R. McNeill demonstrates that the mosquito has impacted the course of human history.

A Mosquito’s Role in HistoryZika virus is only one of several flaviviruses spread by Aedes mosquitoes.  Aedes also transmit the viruses that cause yellow fever, dengue and chikungunya.   Most of these diseases originated … READ MORE >>


Activated Carbon and Water Treatment
Fred Reiff, PE

Drinking water treatment facilities employ a host of technologies to convert “raw” water from rivers, lakes and underground sources into safe, potable water.  At the treatment plant, these technologies are applied in a particular order, known as a “treatment train,” to produce water of optimum quality for the consumer.  This article focuses on one of these technologies, adsorption with activated carbon, which removes unwanted substances from water in a purely physical way.

What is activated carbon?

Activated Carbon

Activated carbon is used by water treatment facilities to help improve water quality.  Many home water treatment devices also employ activated carbon, especially to help reduce water odor and taste.

Imagine a substance that has an extremely high surface area per unit mass, a highly porous substance.  One gram (or about ½ teaspoon) of activated carbon contains about 5,400 square feet of surface area!  That’s roughly twice the area of the average American home (see National Association of Home Builders website).  That is a lot of “nooks and crannies,” places where water contaminants can get stuck and “adsorbed” onto the carbon in response to attractive forces.  In general, access to the surface area improves with decreasing carbon particle size, thereby increasing the adsorption rate.

Activated carbon can be prepared from many common substances that are high in carbon, and bituminous coal is a typical starting point.  First, coal is heated in the absence of oxygen...



Legionella in Flint’s Drinking Water
Joan B. Rose, PhD and Chris Wiant, MPH PhD

Much has been written about Flint, Michigan’s lead-contaminated drinking water, but we should not overlook another health risk associated with Flint in the recent past, and that is the possibility of Legionella bacteria in the city’s drinking water.  The unchecked corrosivity of Flint’s drinking water may have led to more than one serious water quality issue.  This article focuses on the potential causes of two illness outbreaks in Flint caused by Legionella bacteria.

Between June, 2014 and November, 2015, there were 87 cases of legionellosis* in Genesee County.  Cases peaked during the warm summer weather; 10 of the cases resulted in death.  In previous years, the county numbered between six and 13 illness cases.1

The figure above is from the Michigan Department of Health and Human Services, Genesee County Health Department report, ”Legionellosis Outbreak-Genesee County, May, 2015 – November, 2015, Summary Analysis”. 

*Legionellosis refers to any Legionella infection,


Preparing for the Summer of Zika Virus

Fig. 1. U.S. map showing 1) Ae. aegypti potential abundance for Jan/July (colored circles), 2) approximate maximum known range of Ae. aegypti (shaded regions) and Ae. albopictus (gray dashed lines), and 3) monthly average number arrivals to the U.S. by air and land from countries on the CDC Zika travel advisory. Additional details can be found in the text. Figure reproduced with permission of PLOS Currents Outbreaks.


Are you curious about your risk of contracting Zika virus this summer?  The figure above is from a brand new study1 on the projected spread of the Aedes aegypti mosquito, the main Zika virus “vector”2. Based on meteorological models, mosquito-breeding patterns, air travel and socioeconomic status, the study compares the January, 2016 abundance of the mosquito (upper hemisphere of each circle) in each geographical location with its projected abundance this July (lower hemisphere of each circle).  The area … READ MORE >>


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