NEWS SCAN: Novel coronavirus case definition update, enteric outbreak in Germany, invasive Salmonella findings

Oct 1, 2012

WHO updates novel coronavirus case definition
The World Health Organization (WHO) recently updated its interim case definition for a novel coronavirus (hCoV-EMC) that severely sickened two men with links to Saudi Arabia, one of them fatally. A Sep 29 WHO update revised the first case definition that the group put forward on Sep 25, a day after it first announced details about the two cases and the new virus. The new version spells out criteria for a patient under investigation and what constitutes probable and confirmed cases. It recommends that clinicians investigate patients who have a fever higher than 100.4 degrees F with a cough, clinical or radiological evidence of pulmonary parenchymal disease, a travel history to areas where hCoV-EMC infections have been reported, and an infection of unexplained etiology. Patients with suspected infections should undergo tests to detect the presence of other sources of pneumonia, such as Streptococcus pneumoniae. Health providers shouldn't wait for test results for other pathogens before ordering tests for hCoV-EMC. The new coronavirus has been sequenced, and diagnostic tests based on that information should be available for urgent testing within the coming days, the WHO said. In the meanwhile, the WHO can provide health officials with information about labs that can test for the agent.
Oct 1 WHO statement
Sep 28 CIDRAP News story "Scientists sequence new coronavirus, develop diagnostic tests"

Gastroenteritis hits thousands of German youngsters
Thousands of children in Germany have become ill with diarrhea and vomiting after eating in school cafeterias and daycare centers, according to an Associated Press (AP) report today. The outbreak was reported Sep 29 by authorities in Berlin and surrounding eastern German states, with case numbers rising from 4,500 to 8,400. The German news agency DAPD reported that 16 cases of norovirus were confirmed. The Berlin health department stated that most children recovered within 2 days with no hospitalization necessary. The Robert Koch Institute, Germany's national disease-control agency in Berlin, said Sep 28 that all facilities with which the illness was associated probably received food from a single supplier.
Oct 1 AP article

Study charts spread of invasive Salmonella illness in Africa
Genetic sequencing of invasive non-Typhoidal Salmonella (iNTS) disease in parts of Africa has suggested that immune susceptibility from other diseases such as HIV influenced the spread of the disease, according to a study published in the Sep 30 issue of Nature Genetics. The research group, led by investigators at Wellcome Trust Sanger Institute, also found that the bacteria had acquired genes that made it resistant to frontline drugs, which was another factor in spread of the disease. In sub-Saharan Africa, iNTS infections have a mortality rate as high as 45%, but the noninvasive form of the disease—typically found in the rest of the world—is self-limiting and rarely fatal. Using whole-gene sequencing and phylogenetic analysis they found that the bacteria responsible for iNTS spread from two hubs in Southern and Central Africa in two closely related waves starting 52 and 35 years ago, respectively. They suggested that the second wave appeared to resemble the spread of HIV across the region. Most of the samples from the second wave included a gene that made the Salmonella subtype resistant to chloramphenicaol, a key drug used to treat Salmonella. Gordon Dougan, PhD, lead author of the study, said in a Sep 30 EurekAlert press release that there is some evidence of human-to-human spread of iNTS. "Now the race is on to discover how NTS is actually transmitted in sub-Saharan Africa so that effective intervention strategies can be implemented," he added.
Sep 30 Nat Genet abstract
Sep 30 EurekAlert press release

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