NEWS SCAN: H5N1 in cats, H1N1 surveillance, joint cholera efforts, Ukraine measles outbreak, fecal transplants

Mar 15, 2012

Israel reports H5N1 in cats
Veterinary officials in Israel today reported H5N1 avian influenza in cats found dead and sick near pens where an outbreak of the disease in turkeys recently occurred, according to a report to the World Organization for Animal Health (OIE). On Mar 9 before the turkeys were culled, cats were seen eating some of the carcasses, according to the report. Yesterday, about a week after cats were seen eating infected birds, four were found dead, and others showed respiratory signs and weakness. Authorities caught 16 cats found roaming around the area today and euthanized them. H5N1 in samples from the cats was confirmed at Kimron Veterinary Institute. Though H5N1 infections in cats haven't been reported recently, other instances have been documented: in house cats in Germany, Thailand, Austria, Indonesia, and South Korea, and in a leopard and tigers at a zoo near Bangkok. Studies have shown that cat-to-cat transmission can occur in a lab setting, and some experts have said cat-to-human transmission is theoretically possible.
Mar 15 OIE report
Oct 10, 2006, CIDRAP News story
Jul 25, 2008, CIDRAP News story

University ILI surveillance worked well in 2009 H1N1 pandemic
A system of influenza-like illness (ILI) surveillance that was set up at eight university health systems before the 2009 H1N1 pandemic worked well during the pandemic, according to a study yesterday in the American Journal of Infection Control  by researchers from the University of Virginia. Most of the sites used a symptom-based definition of ILI, while some used a system based on definitions in medical records. Results of the entire network correlated well with the onset and peak of reported US cases and compared with state and regional data. They also closely approximated lab-confirmed cases. In addition, data from the university network were available several days sooner than data from other surveillance systems. The authors conclude, "The system was an important supplement to state and regional influenza surveillance."
Mar 14 Am J Infect Control abstract

Haiti, Dominican Republic leaders pledge joint cholera efforts
The health ministers of Haiti and the Dominican Republic pledged continued support for joint efforts to eradicate cholera from Hispaniola, the island that the two countries share, according to a ReliefWeb report yesterday. Their joint statement came after a 2-day meeting in Port-au-Prince during which the ministers agreed on a joint elimination strategy that includes improved access to safe drinking water and sanitation and to bolster the countries' healthcare infrastructure. "I want to join the two ministers in committing ourselves not only to eliminating cholera from Hispaniola, recognizing our shared epidemiology, but also to working together to promote both countries' development," said Dr. Socorro Gross, assistant director of the Pan American Health Organization. Representatives of UNICEF and the US Centers for Disease Control and Prevention also attended the meeting.
Mar 14 ReliefWeb report

ECDC weighs in on Ukraine measles outbreak
The Ukraine has reported more than 5,000 measles cases so far this year, with the pace of infections expected to pick up during peak measles season, which runs through June, the European Centre for Prevention and Control (ECDC) said yesterday in a risk assessment. It warned EU citizens to ensure that they are fully vaccinated against measles before they visit the Ukraine, which is cohosting a soccer tournament with Poland through most of June that will draw teams from 16 different countries in the region. The ECDC said most of the measles activity in the Ukraine is occurring in the western part of the country near its borders with Hungary, Poland, and Slovakia. It said the Ukrainian government has been experiencing a shortage of vaccines for routine immunization since 2010 and, according to unofficial sources, a strong anti-vaccine lobby is active in the country. Skepticism over vaccines has driven immunization rates down and appears to have been fueled by a fatal incident and hospitalizations involving the measles, mumps, and rubella (MMR) vaccine in 2008. An emergency task force and enhanced surveillance have been formed to address the situation, according to the report. The ECDC said due to overall low vaccine coverage in the Ukraine, the risk of outbreaks of measles and other vaccine-preventable diseases with spread to other European countries is elevated.
Mar 14 ECDC risk assessment

Fecal transplants show promise for repeat C diff infections
Researchers from Finland who analyzed the results of fecal transplant treatment in 70 patients who had recurrent Clostridium difficile infections found that symptoms resolved in all but 4, according to a study in the March issue of Gastroenterology. The findings add to a small but growing number of published reports on the treatment for refractory C diff infections. The authors wrote that since C diff ribotype 027 emerged in Finland in 2007, more patients have experienced relapses with infections that are more difficult to treat. In 2010, the authors published their early findings on 37 patients, and their new study presents their retrospective study of 70 patients who were treated at five different centers. The mean age of the patients was 73 years, and the 027 ribotype was found in 36 (51%). Patients were pretreated with vancomycin or metronidazole, with the drug discontinued 36 hours before transplant. Patients underwent colonic lavage, then received donor stool by colonoscopy. During 12 weeks of follow up, symptoms resolved in all patients except 4 who had the 027 ribotype, all of whom had serious conditions and died within 3 months of transplantation. After 1-year follow-up, 4 patients had a relapse, including 2 who were treated for antibiotics for other conditions. Researchers found no safety issues or serious adverse events. They concluded that fecal transplantation showed an "outstanding result" that appears to be clearly better than other options for recurrent C diff infections, even in those with underlying conditions.
March Gastroenterology abstract

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