News Scan for Jan 10, 2014

H5N1 patient was young woman
;
US preparedness funding
;
Jump in chikungunya cases
;
Anthrax in republic of Georgia

Newspaper says Canadian H5N1 patient was young nurse

The victim of the first human H5N1 infection reported in the Americas was a woman in her 20s from Red Deer, Alta., who was a nurse at a hospital there, according to reports in the local newspaper, the Red Deer Advocate.

The patient died Jan 3 after returning to Edmonton, Alta., on Dec 27 from a trip to Beijing, Canadian authorities announced Jan 8. Authorities have withheld all personal information about her in an effort to protect her privacy.

Stories in the Advocate said the woman was born in China, earned a nursing degree in Red Deer, and worked as a registered nurse in the operating room at the Red Deer Regional Hospital. Red Deer is a city of about 90,000 located roughly halfway between Edmonton and Calgary.

The woman's family released a statement through Alberta Health Services today, calling her "a hard-working, independent young woman" who was "driven and passionate," the Advocate reported. The statement said she traveled to China in December with her mother. The family appealed to the media not to reveal her name.

How the woman was exposed to the virus remains unknown. She stayed in Beijing during her 3-week visit and did not visit any poultry farms or live-poultry markets, officials have said. Authorities rate the risk of additional cases related to her illness as very low.
Jan 10 Advocate story
Jan 9 Advocate story

 

IOM panel offers suggestions on preparedness funding

US preparedness funding must be allocated strategically during current difficult times, a report from an Institute of Medicine (IOM) forum published yesterday concluded.

The group noted that preparedness funding has fallen considerably since 2008 after rising during the previous years. They add that disaster funding distribution is deeply inefficient, with cash infusions rising substantially after a disaster, only to drop dramatically when interest wanes.

"With more limited government funding in the foreseeable future, the government needs to be smarter about how it spends its money on emergency preparedness in this country," said Seth Seabury, PhD, of the University of Southern California (USC), in a George Washington University (GWU) press release. "We need to know which communities are prepared and which aren't, when money is spent, and whether it's really making these communities better off in handling a disaster."

USC, GWU, and the Cabarrus Health Alliance contributed to the report. The authors make seven recommendations to address the situation:

  1. The federal government should develop and assess measures of emergency preparedness both at the community level and across communities.
  2. Federal measures should be used to conduct a nationwide gap analysis of community preparedness.
  3. Alternative ways of distributing funding that are fair to all communities should be considered.
  4. Grant money should come with clear metrics of grant effectiveness.
  5. There should be better coordination at the federal level.
  6. Local communities should build or use existing coalitions to foster public-private partnerships with local hospitals and other businesses.
  7. Communities should be encouraged to finance local preparedness efforts.

Jan 9 IOM report
Jan 9 GWU press release

 

St. Martin chikungunya outbreak grows to 203 cases

The number of confirmed or probable chikungunya cases on the Caribbean island of St. Martin has almost doubled in less than a week, according to an update today from the European Centre for Disease Prevention and Control (ECDC).

The island now has 201 probable or confirmed cases on the French side, and two confirmed cases on the Dutch side. That compares with 89 confirmed and 20 probable cases on the French side and one confirmed case on the Dutch side reported in the last ECDC update on Jan 4.

The ECDC also reported marked increases in confirmed or probable chikungunya cases on nearby islands: 48 on Martinique, 25 on St. Barthelemy, and 10 on Guadeloupe. The agency also said that French Guiana had an imported case from Martinique.

The outbreak was first detected Dec 5, 2013, during dengue surveillance. The ECDC said, "Dengue and chikungunya viruses are transmitted by the same Aedes aegyptimosquito species. The naive population, the presence of an effective vector in the region, and the movement of people in and between islands are factors that make it likely the outbreak will continue to spread geographically and increase in numbers."
Jan 10 ECDC update
Jan 6 CIDRAP News scan on previous ECDC update

 

Cutaneous anthrax cases in Georgia increase, particularly near cities

The incidence of human cutaneous anthrax (HCA) in the country of Georgia has increased recently even as the disease has reportedly declined worldwide, say findings of a study published this week in Emerging Infectious Diseases.

The authors studied passive surveillance data on HCA cases reported to Georgia's National Center for Disease Control and Public Health from 2010 through 2012. A total of 251 HCA cases were reported during that time, as well as 74 cases in livestock, with the number of cases peaking in 2012. The risk for HCA was found to be higher during the study period than in 2007-09.

HCA occurred predominantly in males (209 cases, or 84%). The risk of HCA did not differ between patients who butchered/slaughtered cattle and those who processed/handled meat, although exposure through the former was more common in males and through the latter in females. Persons 50 to 64 years of age were at higher risk for infection, which, according to the authors, could "reflect changing sociocultural practices related to an agrarian lifestyle."

HCA cases were concentrated in specific areas associated with agriculture but in close proximity to urban areas. Among possible factors at play in the urban concentration are reliance on these areas for commerce, increases in agricultural employment, and access to quick slaughter and sale of meat from sick and dying animals to mitigate economic losses.

The authors suggest that decreased public health funding and agricultural reforms that have resulted in a shift from collective to private farming may be among the factors behind the increase in HCA cases. In addition, limited veterinary control and cessation of compulsory livestock vaccination may have contributed.
Jan 8 Emerg Infect Dis study

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