CO(2), CO, and Hg emissions from the Truman Shepherd and Ruth Mullins coal fires, eastern Kentucky, USA.

Carbon dioxide (CO(2)), carbon monoxide (CO), and mercury (Hg) emissions were quantified for two eastern Kentucky coal-seam fires, the Truman Shepherd fire in Floyd County and the Ruth Mullins fire in Perry County. This study is one of the first to estimate gas emissions from coal fires using field measurements at gas vents. The Truman Shepherd fire emissions are nearly 1400t CO(2)/yr and 16kg Hg/yr resulting from a coal combustion rate of 450-550t/yr. The sum of CO(2) emissions from seven vents at the Ruth Mullins fire is 726+/-72t/yr, suggesting that the fire is consuming about 250-280t coal/yr. Total Ruth Mullins fire CO and Hg emissions are estimated at 21+/-1.8t/yr and >840+/-170g/yr, respectively. The CO(2) emissions are environmentally significant, but low compared to coal-fired power plants; for example, 3.9x10(6)t CO(2)/yr for a 514-MW boiler in Kentucky. Using simple calculations, CO(2) and Hg emissions from coal-fires in the U.S. are estimated at 1.4x10(7)-2.9x10(8)t/yr and 0.58-11.5t/yr, respectively. This initial work indicates that coal fires may be an important source of CO(2), CO, Hg and other atmospheric constituents.

Eczema vaccinatum resulting from the transmission of vaccinia virus from a smallpox vaccinee: an investigation of potential fomites in the home environment.

On March 3, 2007, a 2-year-old boy was hospitalized with eczema vaccinatum. His two siblings, one with eczema, were subsequently removed from the home. Swabs of household items obtained on March 13th were analyzed for orthopoxvirus DNA signatures with real-time PCR. Virus culture was attempted on positive specimens. Eight of 25 household samples were positive by PCR for orthopoxvirus; of these, three yielded viable vaccinia virus in culture. Both siblings were found to have serologic evidence of orthopoxvirus exposure. These findings have implications for smallpox preparedness, especially in situations where some household members are not candidates for vaccination.

Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States.

BACKGROUND: Measles was declared eliminated from the United States in 2000 but remains endemic worldwide. In 2005, a 17-year-old unvaccinated girl who was incubating measles returned from Romania, creating the largest documented outbreak of measles in the United States since 1996. METHODS: We conducted a case-series investigation, molecular typing of viral isolates, surveys of rates of vaccination coverage, interviews regarding attitudes toward vaccination, and cost surveys. RESULTS: Approximately 500 persons attended a gathering with the index patient one day after her return home. Approximately 50 lacked evidence of measles immunity, of whom 16 (32 percent) acquired measles at the gathering. During the six weeks after the gathering, a total of 34 cases of measles were confirmed. Of the patients with confirmed measles, 94 percent were unvaccinated, 88 percent were less than 20 years of age, and 9 percent were hospitalized. Of the 28 patients who were 5 to 19 years of age, 71 percent were home-schooled. Vaccine failure occurred in two persons. The virus strain was genotype D4, which is endemic in Romania. Although containment measures began after 20 persons were already infectious, measles remained confined mostly to children whose parents had refused to have them vaccinated, primarily out of concern for adverse events from the vaccine. Seventy-one percent of patients were from four households. Levels of measles-vaccination coverage in Indiana were 92 percent for preschoolers and 98 percent for sixth graders. Estimated costs of containing the disease were at least 167,685 dollars, including 113,647 dollars at a hospital with an infected employee. CONCLUSIONS: This outbreak was caused by the importation of measles into a population of children whose parents had refused to have them vaccinated because of safety concerns about the vaccine. High vaccination levels in the surrounding community and low rates of vaccine failure averted an epidemic. Maintenance of high rates of vaccination coverage, including improved strategies of communication with persons who refuse vaccination, is necessary to prevent future outbreaks and sustain the elimination of measles in the United States.