NEWS SCAN: More fungal meningitis cases, dengue in Portugal, Ebola in DR Congo, Hispaniola cholera plan

Oct 9, 2012

Fungal meningitis outbreak cases grow to 119 in 10 states
Fourteen more cases and three more deaths have been reported in a fungal meningitis outbreak linked to steroid injections for back pain, the US Centers for Disease Control and Prevention (CDC) said in an update today. The latest cases push the illness total to 119 and the death toll to 11. New Jersey reported its first case, raising the number of states affected to 10. The CDC's latest map of clinics that received the recalled drug includes 76 clinics in 23 states. In another development, the agency yesterday posted instructions for clinical teams on diagnostic testing and submitting samples to the CDC. So far cultures or histopathologic studies have confirmed fungal infections in nine patients, including Aspergillus and Exserohilum. The CDC said the range of pathogens in the outbreak may not be fully known yet, and it urged clinicians to do a thorough work up with an algorithm it suggests as a supplement to testing and protocols ordered by clinical teams. The outbreak, not considered contagious, is linked to three lots of the preservative-free methylprednisolone acetate prepared by New England Compounding Center in Framingham, Mass. The CDC said recently that the drug was also used for joint-space injections, but so far no illnesses related to those procedures have been reported.
Oct 9 CDC outbreak update
Oct 8 CDC healthcare facility map
Oct 8 CDC testing and sample submission guidance

ECDC: Two dengue cases in Portugal appear locally acquired
Two people in Madeira, a Portuguese resort island in the Atlantic, have dengue virus infections that appear to be locally acquired, which would be the first such cases in Europe since 2010, the European Centre for Disease Prevention and Control (ECDC) announced today. The Public Health Authority of Portugal reported the two cases on Oct 3, saying the patients had no recent history of travel abroad, the ECDC said. Investigations are ongoing to determine whether the cases are indeed indigenous. Also, some additional cases have been reported by the news media and are under investigation, the ECDC reported. "This is the first known occurrence of locally transmitted dengue infection in Madeira, and consequently a new geographical area reporting autochthonous cases in the EU," the agency said. "There have been no reports of confirmed autochthonous dengue infections in the rest of Europe since the 2010 cases in France and Croatia."
Oct 9 ECDC statement

More deaths from Ebola in DRC
The number of Ebola cases in the Democratic Republic of Congo (DRC) as of Oct 7 stood at 49, with 31 confirmed and 18 probable, said an alert yesterday from the World Health Organization (WHO). There have been 24 fatalities (10 in laboratory-confirmed and 14 in probable cases), which is four more than reported by WHO in a Sep 27 update. The cases are from Isiro and Viadana health zones in Haut-Ulele district of Orientale province. The DRC Ministry of Health and an international group of partners, including the US CDC, are examining all possible chains of transmission in hopes of stopping the outbreak. Experts have been deployed to the DRC, and response work in such areas as infection control, surveillance, case management, and training of healthcare workers is ongoing, the WHO said. The CDC continues to provide support in rapid diagnosis through a field laboratory the agency established in Isiro soon after the outbreak was first reported in August.
Oct 8 WHO alert

Haiti, Dominican Republic aim to oust cholera by 2022
The governments of Haiti and the Dominican Republic are working on a plan to eliminate cholera from their shared island of Hispaniola by 2022, the Associated Press (AP) reported yesterday. Dominican Deputy Minister of Public Health Rafael Schiffino said the plan will include substantial spending on clean water and sanitation. A bilateral meeting to work on the plan started yesterday in the Dominican Republic. Since cholera surfaced in Haiti in October 2010, it has struck about 560,000 people and killed about 7,300, according to previous reports. The Dominican Republic has had 22,000 cases and 350 deaths since then, the AP story said. The disease was probably introduced in Haiti by United Nations peacekeepers.
Oct 8 AP story

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