News Scan for Jan 17, 2014

MERS death in Saudi Arabia
H5N1 reappears in South Korea
Polio hotspot in Pakistan
MRSA near large swine holdings

Report: Bangladeshi doctor died of MERS-CoV in Saudi Arabia

A Bangladeshi doctor who was working in Riyadh, Saudi Arabia, died of a Middle East respiratory coronavirus (MERS-CoV) infection on Jan 15, according to an Arab News report today. The case has not yet been announced by Saudi authorities.

Mohammed Humayun Kabeer, 55, who was working as a surgeon at Prince Salman Hospital, died after 9 days of hospitalization, the story said, citing unnamed hospital personnel as the source of the information.

Kabeer had what was thought to be a cold when he was first hospitalized, but he was later moved to the intensive care unit, the story said. He died of multiple-organ failure caused by MERS-CoV.

The story ends a 2-week lull in reports of MERS-CoV cases; the most recent case was reported on Jan 3 and involved a 33-year-old male healthcare worker in Dubai, United Arab Emirates. The story is unusual in that it names the patient, which is rarely if ever done in Saudi media reports on MERS-CoV.

If the new case is confirmed, it will raise Saudi Arabia's MERS-CoV count to 142 cases and 58 deaths. The Saudi Ministry of Health has not announced any new cases since Dec 25. The World Health Organization's (WHO's) global tally, which does not yet include the doctor's case, stands at 178 confirmed cases and 75 deaths.
Jan 17 Arab News story


H5N1 avian flu found in South Korean ducks after 2-plus-year lull

South Korea, declared avian flu–free for the second time in September 2011, has lost that status with a report of H5N1 avian influenza on a duck farm 300 kilometers from Seoul, according to a story in the Korea Herald today.

More than 20,000 ducks on the farm in Gochang-gun, North Jeolla province, have been culled. The source is thought to be excreta of a flock of birds that flew over the farm Jan 6.

More than 3 million poultry are being raised in the area around the farm. The Ministry of Agriculture, Food and Rural Affairs says 24 farms and 1 slaughterhouse have bought a total of 173,000 ducks from the farm over the past 3 weeks.

Since 2006, 23 outbreaks avian flu have been reported from North Jeolla, with damages of an estimated $104 million, says the story. The most recent outbreak, in the first half of 2011, resulted in the culling of 3 million birds.
Jan 17 Korea Herald story
Latest (May 18, 2011) CIDRAP News scan on H5N1 in South Korean poultry


WHO calls Peshawar top poliovirus reservoir

Peshawar, a large city in northwestern Pakistan and the capital of Khyber Pakhtunkhwa province, contains the largest reservoir of endemic poliovirus in the world, the WHO said today, according to Reuters.

Polio eradication efforts in Pakistan have been plagued by attacks on vaccination teams from the Taliban and other extremists who have denounced immunization campaigns as Western plots to sterilize Muslim children. Northwestern Pakistan has been especially hard hit by the violence, and some of the attacks have come in Peshawar.

The old city of Peshawar is crowded and dirty, with open sewers, Reuters reported, making it a fertile breeding ground for polio. Peshawar has had 45 polio cases in the past 5 years, The Hindu reported today.

"The virus has not been seen in all parts of Pakistan. It's in very limited areas that we have problems in accessing," Elias Durry, MD, head of the WHO's polio eradication efforts in Pakistan, told Reuters.

Pakistan, Afghanistan, and Nigeria are the only countries in the world in which polio is endemic, but Pakistan was the only country to see an increase in cases from 2012 to 2013.
Jan 17 Reuters report
Jan 17 Hindu story


Study: MRSA risk almost 3 times higher near large pig holdings

The risk of methicillin-resistant Staphylococcus aureus (MRSA) colonization may be almost three times higher in people who live near large facilities that house swine, according to an Iowa study published yesterday in Infection Control and Hospital Epidemiology (ICHE).

The investigators analyzed data from 1,036 MRSA patients admitted to the Iowa City Veterans Affairs Health Care System from Jan 1, 2009, through Dec 31, 2011. The overall incidence of MRSA carriage among rural patients was 6.8%.

The researchers found that living within 1 mile of a swine concentrated animal feeding operation (CAFO) was associated with a relative risk of 1.9 of MRSA colonization. After they controlled for multiple admissions and age, the relative risk rose to 2.8. The authors said that Iowa is home to about 7,000 swine CAFOs.

The authors concluded, "Although the exact mechanism by which residential proximity to large swine CAFOs increased risk of MRSA is unknown, it appears that there is potential for drug-resistant strains of S. aureus in animals to transmit to people living at close distances. . . . Typically, in Iowa, manure is spread on surrounding fields, and MRSA can be aerosolized from this manure to human food or water sources."

They note, however, that they were unable to control for direct livestock contact with patients or indirect contact via household members.

Last September, a different US group reported in JAMA Internal Medicine that living near farms where swine manure is used as fertilizer or near high-density livestock operations may increase a person's risk of having a MRSA infection. The authors said that study was the first to suggest such a link.
Jan 16 ICHE study
Sep 16, 2013, CIDRAP News story on JAMA Intern Med study


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