NEWS SCAN: Marburg in Uganda, fungal meningitis update, Haiti-Nepal cholera strains, FMD vaccine contract

Oct 22, 2012

WHO reports 9 Marburg cases and 5 deaths in Uganda
Nine probable and confirmed cases of Marburg hemorrhagic fever, with five deaths, have been reported in southwestern Uganda, the World Health Organization (WHO) reported today, and a media report said one patient is being treated in a Kampala hospital, far from the origin of the outbreak. Three of the cases have been confirmed by the Uganda Virus Research Institute (UVRI), the WHO said in a statement. The outbreak is in Kitumba sub-county of Kabale district, where an Ebola outbreak killed 17 people in August. The Observer, a Ugandan news outlet, reported Oct 20 that all the victims have been from the same family. Patrick Tusiime, the Kabale district health officer, said the latest victim died Oct 20 and was quickly buried by a team of health officials to prevent the spread of the disease, according to the story. A Reuters report today said a woman with a confirmed Marburg infection is being treated in Mulago Hospital in the capital, 270 miles northeast of Kabale, where she arrived about 5 days ago. Investigators have not determined the source of the virus, the story said. In an Oct 21 statement, the WHO said it and the Ugandan health ministry sent a team to the district to support the investigation and response, including contact tracing. The agency did not recommend that any travel or trade restrictions be imposed on Uganda. The Reuters report said two Ugandan miners died in a Marburg outbreak in 2007 and that an outbreak in the country in 2000 involved 425 cases, nearly half of which were fatal.
Oct 22 WHO statement
Oct 22 Reuters story
Oct 21 Observer story
Oct 21 WHO statement

Fungal meningitis outbreak total climbs to 297
Twenty-six more patients have been sickened in a multistate fungal meningitis outbreak linked to tainted steroid injections since the US Centers for Disease Control and Prevention's (CDC's) update on Oct 19. The new cases raise the outbreak total to 297, and 2 more deaths were reported, pushing the fatality toll to 23, the CDC said in a statement today. The number of affected states remained at 16. Health officials have linked the outbreak to three lots of recalled methylprednisolone acetate, which were used in epidural injections for back pain and to treat peripheral joint problems. So far three of the infections are related to peripheral joint infections. As of Oct 17, 47 cases of fungal meningitis have been confirmed with lab tests. Exserohilum rostratum, a type of black mold, has been implicated in all but two of the cases. Of the 14,000 patients who may have been exposed to the contaminated medication, 97% have been contacted by medical teams for further follow-up, the CDC said.
Oct 22 CDC outbreak update
In another development, the US Food and Drug Administration (FDA) today released two lists of customers who received products from the New England Compounding Center (NECC) that have been implicated in the outbreak. One is a list of customer names and addresses by state, and the other contains the same information but is organized alphabetically by customer name and includes products and quantities shipped, as well as shipping date. The FDA said the information is from the NECC, and the agency can't ensure its accuracy or completeness. "Nevertheless, this is the best information we have available, at this time, to help inform facilities and healthcare providers of NECC products shipped to their facilities since May 21, 2012," the FDA said.
Oct 22 FDA statement

Gene data strengthens UN camp role in Haiti cholera outbreak
A US scientist who has reviewed new genetic sequencing data of the cholera strain responsible for Haiti's outbreak said it matches the strain found in Nepal, BBC News reported today. Daniele Lantagne, PhD, of Tufts University in Medford, Mass., told the BBC that the findings bolster previous reports that a United Nations (UN) peacekeeping camp housing soldiers from Nepal was the likely source of the outbreak. Lantagne was part of a UN-commissioned expert panel in 2011 that reviewed the outbreak and stopped short of blaming the Nepalese soldiers, adding that a combination of factors led to the outbreak. She told the BBC that the new genetic data and other evidence has sharpened her view on the source of the outbreak since the UN's earlier report. "We can now say that the most likely source of introduction of cholera into Haiti was someone infected with the Nepal strain of cholera and associated with the United Nations Mirabalais camp," she said. Nigel Fisher, who heads the UN's humanitarian affairs in Haiti, told the BBC that he was aware of new scientific information, but the investigation is still with the UN's legal office and he was unable to comment.
Oct 22 BBC report
May 5, 2011, CIDRAP News story "Experts link Haiti cholera outbreak to human actions, foreign strain"

Iowa firm wins DHS contract to develop foot-and-mouth vaccine
Harrisvaccines of Ames, Iowa, announced recently that it won a $1.114 million contract from the US Department of Homeland Security to develop an RNA particle (RP) vaccine to protect US livestock from foot-and-mouth disease (FMD). In a press release, the company said its RP platform technology allows it to make a vaccine using only a gene sequence, not the whole FMD virus. Production of FMD vaccines using traditional methods is not allowed in the United States because of the risk of releasing the highly contagious virus, it noted. Kurt Kamrud, PhD, vice president of research and chief scientific officer for Harrisvaccines, said in the release, "Because only a portion of the FMDV genetic information is required to generate a vaccine, the RP-based approach will allow for the differentiation of infected from vaccinated animals (DIVA) when used with current and next generation FMD serology-based diagnostic assays, which is very important in the event of an outbreak." The United States has been free of FMD since 1929, but the disease remains endemic in many countries and represents a significant threat to US agriculture.
Oct 18 Harrisvaccines press release

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