NEWS SCAN: H5N1 cases in Egypt, outbreak in China; home anthrax response; MRSA in moms and newborns

Apr 3, 2012

Global H5N1 case count hits 600 with 2 cases in Egypt
Egypt's Ministry of Health and Population has confirmed two new cases of H5N1 avian flu, one of which was fatal, the World Health Organization (WHO) said yesterday, bringing the global total to 600 cases. The first case is in a 2-year-old girl from Damietta governorate. She developed symptoms Mar 19 and was hospitalized Mar 20, received oseltamivir (Tamiflu), and is reported to be in good condition. She had exposure to dead backyard poultry. The second case was in a 15-year-old girl from Giza governorate who first had symptoms Mar 25, was hospitalized in critical condition and received oseltamivir on Mar 29, and died Mar 31. Investigation into the source of her infection is under way. H5N1 was confirmed in both cases by the country's Central Public Health Laboratories. Egypt in 2012 has confirmed eight H5N1 cases (four fatal), the most of any country, and has led the world in cases the previous 3 years, as well. Since 2006 the country has had 166 WHO-confirmed cases, including 59 deaths, second most after Indonesia, which has 188 cases (but 156 fatalities). Of the 600 cases confirmed globally by the WHO since 2003, 353 have been fatal.
Apr 2 WHO update
Apr 2 WHO global H5N1 case count

China reports H5N1 farm outbreak
Officials in southern China have culled more than 35,000 farm poultry after highly pathogenic H5N1 avian flu was confirmed in two birds in the flock, according to a report filed with the World Organization of Animal Health (OIE). The outbreak began Mar 27 near Yuxi city in Yunnan province, and workers culled the entire flock of 35,018 birds to prevent disease spread. A national avian influenza reference lab confirmed the virus. The last H5N1 outbreak in mainland China was in 2009, according to OIE data.
Mar 31 OIE report

FDA ponders home anthrax-response kits
The US Food and Drug Administration (FDA) this week is weighing whether making anthrax response kits available to all 114 million US households is good preparedness for a bioterrorist attack or may lead to antibiotic misuse and elevate public fear, Bloomberg News reported today. The FDA met with a panel of scientists and academicians to consider whether kits containing a 10-day supply of doxycycline should be available to all Americans to store in their homes. The Biomedical Advanced Research and Development Authority (BARDA) of the Department of Health and Human Services must partner with a drug company to steer the kit through the FDA approval process before a date can be set for rolling it out, the story said. BARDA plans to start by making kits available to 10 million first responders and their households before making them available to all. Thomas Moore, chair of the FDA committee hearing the arguments, said, "People may infer an anthrax attack is imminent," and others said improper use of doxycycline could lead to antibiotic resistance. A trial in 2007 involving about 4,200 households in the St. Louis area revealed a few instances of misuse.
Apr 3 Bloomberg story

Study: MRSA colonization common in pregnant women, newborns
Colonization with Staphylococcus aureus, including methicillin-resistant S aureus (MRSA) is common in pregnant women, and MRSA colonization in newborns can be as high as 21%, according to a study in Pediatrics. US researchers studied women in their third trimester of pregnancy at two Tennessee medical centers from 2007 to 2009. In all, they compared data from 473 mother-infant pairs at enrollment and delivery, 462 at discharge, 311 two months postpartum, and 246 four months postpartum. The mothers had the following rates of S aureus and MRSA, respectively: at enrollment, 39% and 17%; at delivery, 40% and 11%; at 2 months postpartum, 49% and 13%; and at 4 months postpartum, 45% and 16%. The respective rates for infants were: at birth, 9% and 3%; 2 months old, 39% and 21%; 4 months old, 26% and 13%. The authors conclude, "S aureus colonization (including MRSA) was extremely common in this cohort of maternal-infant pairs. Infants born to mothers with staphylococcal colonization were more likely to be colonized, and early postnatal acquisition appeared to be the primary mechanism."
Apr 2 Pediatrics abstract

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