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The Other Swine InfectionSwine Flu has been making headlines all over the world, curtailing travel andtrade, and killing a small number of people in several countries. Eventually, it could become a global menace or, like bird flu, continue to percolate in distant pockets of theglobe. No one knows what will happen or when, but this spring’s swine flu episode isanother reminder that many pathogens can make the leap from bird and animal to people.Another pathogen that has made the leap is Streptococcus suis. It is not a virus, but a bacterium whose natural host is the pig. Among the crowded pens of snorting,slobbering porkers, the bacteria are readily exchanged orally and nasally. In piglets, the bacteria sometimes will cause fatal infections such as sepsis, pneumonia and meningitis.The first recognized case of S. suis in pigs was in 1954; the first case in humans was in1969.Since then, there have been more than 700 human cases. Most of them haveoccurred in Southeast Asia where both the pig and the pig-eating populations haveexploded. According to Minnesota epidemiologist Mike Osterholm, China had 790million people and 5.2 million pigs in 1968. Today, they have 1.3 billion people and 508million pigs. (The population of the U.S. is 300 million.) Perhaps it was no surprise thenthat China recently had a large outbreak of S. suis infections. That 2005 outbreak sickened 215 people and killed 38. Most of the deaths were due to meningitis.In people, S. suis frequently causes meningitis, with symptoms of headache,fever, and vomiting. Hearing loss, endocarditis and arthritis may occur in some cases,and a severe form of septic or toxic shock also has been seen. In Hong Kong, S. suis isthe third most common cause of bacterial meningitis.1
 
 Not surprisingly, most of the patients with S. suis infections tend to be older menwho work around pigs: farmers, veterinarians and butchers. That does not mean,however, that many Asian women handling raw pork at home or in fresh meat marketsare not at risk for infection.Infections from this bacterium usually are treated with penicillin, ceftriaxone,vancomycin, and other common antibiotics. There is no vaccine for people or pigs, and itis not clear just how useful one would be. S. suis is not transmitted person-to-person sothere is little fear of a contagious outbreak among people. (Unlike with swine flu.) Pigsspread the bacteria among themselves and carry it naturally and asymptomatically. Avaccine may not eliminate those carried bacteria or, worse, may eliminate the carriedstrains and create openings for more pathogenic strains.People who work around pigs also may carry the bacteria. Among 132 studiedslaughterhouse workers in Germany, 5.3% were found to be carrying S. suis in their noses or throats. A 1999 study in the Netherlands found 6% of vets and 1% of pigfarmers had antibody to S. suis bacteria. They may not have been carriers, but they hadenough exposure to the bacteria to provoke antibody immune responses.In the United States, the first human case of S. suis meningitis was reported inFebruary 2007. The patient was a 59-year-old farmer from upstate New York. He mayhave been the first recognized patient, but he may not be the only patient. For example, a2008 survey of Iowa hog-farm workers found seven of 73 who tested positive for prior exposure to S. suis bacteria.So the bacteria are present in U.S. pig populations and U.S. workers are beingexposed to the bacteria. Because millions of pigs are transported across the U.S. each2
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