Illinois becomes third state to report Elizabethkingia infection
Health officials in Illinois yesterday reported a fatal Elizabethkingia anopheles bloodstream infection, noting that the strain matches the one implicated in Wisconsin's outbreak, according to state and federal sources. With the announcement from the Illinois Department of Public Health (IDPH), three states, including Michigan, are investigating cases.
In February and March the IDPH sent alerts to hospitals asking them to report all cases and save specimens for possible testing at public health labs.
It said Wisconsin has 57 confirmed cases, 18 of them fatal, and that Michigan has 1 confirmed case, which was fatal.
E anopheles can be present in soil and other environmental sources, and so far the source of the outbreak strain isn't known. IDPH Director Nirav Shah, MD, JD, said in yesterday's statement that the states are working closely with the Centers for Disease Control and Prevention (CDC) to investigate the outbreak and prevent more infections. The CDC has said it hasn't been determined if the deaths were related to the bacterium, patients' underlying health conditions, or both.
Though E anopheles is usually antibiotic resistant, the Wisconsin strain is susceptible to fluoroquinolones, rifampin, trimethoprim/sufamethoxazole, and minocycline. E anopheles is opportunistic, often affecting people who have underlying health conditions.
Apr 12 IDPH statement
CDC Elizabethkingia outbreak page
Saudi officials report 2 new MERS cases in Riyadh
Saudi Arabia's Ministry of Health (MOH) today reported two new MERS-CoV cases in Riyadh, one of which involved suspected hospital spread.
The MERS-CoV (Middle East respiratory syndrome coronavirus) infections involve men aged 73 and 25, neither of whom is a healthcare worker. The older man is hospitalized in critical condition. His infection source is listed as "primary," meaning he likely did not contract the disease from another person.
The 25-year-old man contracted MERS in a healthcare setting, the MOH said without providing further details. He is listed in stable condition. The agency also noted that a 60-year-old man who was part of a large MERS cluster in Buraydah has recovered from the disease. He had preexisting illness.
The country has now confirmed 1,374 cases since the outbreak began in 2012, including 587 fatalities, the MOH said. Eleven patients are still undergoing treatment.
Apr 13 Saudi MOH update
WHO flu report fills in Egyptian H5N1 case details
In a monthly update on zoonotic flu strains, the World Health Organization (WHO) recently noted reports of human cases of H5N1, H5N6, and H7N9 avian flu that it received between Feb 25 and Apr 4, all of which were acknowledged in earlier reports from various official sources.
The WHO, however, included more details about four recent H5N1 patients in Egypt—all female and three of them children, which fits with earlier patterns in the country.
The four Egyptian cases were previously reported but with very few epidemiologic details by the United Nations Food and Agricultural Organization. Health officials have been closely watching developments in Egypt, because the country had an unprecedented surge of cases at about this time last year.
Two of the H5N1 patients are from Giza governorate, a 70-year-old woman who is in critical condition and a 5-year-old girl who recovered. A 1-year-old girl in Sohag governorate and a 7-year-old girl in Cairo have also recovered.
The three girls were exposed to live or dead poultry, while the investigation into the virus source is still under investigation for the older woman, the WHO said. Since 2003 the agency has recorded 850 H5N1 infections, 449 of them fatal, in 16 countries.
Apr 4 WHO monthly flu at the human-animal interface report
