NEWS SCAN: Tajikistan polio outbreak, virulent fungus, Salmonella in raw tuna

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Apr 23, 2010

WHO warns of polio outbreak in Tajikistan
The World Health Organization (WHO) announced today that wild poliovirus type 1 has been detected in patients in Tajikistan who had acute flaccid paralysis (AFP), representing the first importation of the virus into the WHO European Region (which includes much of Asia) since it was declared polio-free in 2002. Of 120 patients with AFP since Apr 21, most started having symptoms within the last 2 weeks, which prompted the government to notify the WHO that an outbreak is occurring. Ten children have died, and most cases are children under age 5. Initial data suggest more than 45% had four or more doses of oral polio vaccine. The type 1 virus has been isolated in specimens from seven patients, all of whom were from the southwestern part of the country that borders Afghanistan and Uzbekistan. Though Afghanistan is one of four remaining countries where polio is endemic, no cases have been reported in the area of the country that borders Tajikistan. Three AFP cases have been reported in Uzbekistan near the Tajikistan border, but lab testing has not isolated the virus.The most recent data showed trivalent oral polio vaccine (OPV3) coverage in Tajikistan was 87%. The country has asked the WHO for technical guidance and support, and UNICEF is prepositioning enough vaccine in the country for three outbreak response rounds. The WHO said it is warning countries in the region and asking them to strengthen AFP surveillance and analyze their polio vaccine coverage to identify any gaps. AFP surveillance indicators in Tajikistan meet national certification standards. The WHO emphasizes that countries focus vaccine efforts in areas at high risk for importation and where OPV3 coverage is below 80%.
Apr 23 WHO statement

Oregon hit with virulent fungus
A strain of Cryptococcus gattii fungus has caused deaths in otherwise healthy people in Oregon and may be on the verge of entering northern California, a group from Duke University reported in PloS Pathogens. The fungus, typically found only in immunocompromised persons, is airborne and far more virulent than the more common Cryptococcus neoformans. Mortality rate in 21 recent cases of the novel Oregon fungus, termed C gattii VGIIc, has been about 25%. Less virulent strains have been identified in British Columbia and Washington in recent years. VGIIc has infected animals as well as humans in Oregon. The infection can be treated but not prevented, so physicians and veterinarians are encouraged to be vigilant. No source for the fungus has yet been identified.
Apr 22 PLoS Pathogens article
Apr 22 EurekAlert release

Raw tuna blamed for Salmonella cases in Hawaii, elsewhere
Illness caused by Salmonella paratyphi B has been confirmed in 10 patients on Oahu by Hawaii's State Department of Health (DOH). All patients had eaten previously frozen raw ahi tuna, often prepared as poke, from various sources. Illness caused by the same organism have been identified in five other states—California, Maryland, Pennsylvania, Massachusetts, and New York. DOH and the Centers for Disease Control and Prevention (CDC) are working to determine whether raw tuna was the cause in these other cases and to investigate international sources of frozen raw ahi. About 2 years ago, a cluster of 35 cases of illness caused by the same organism was found in Oahu, also in people who had eaten raw frozen ahi. No source was definitively established at that time.
Apr 22 Hawaii DOH press release

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