New Ebola cases boost West Africa total to 844, plus 518 deaths
The latest pattern in West Africa's Ebola virus disease (EVD) outbreak suggests a "mixed picture," with Guinea showing a drop-off in infections, but Sierra Leone and Liberia reporting several new cases, the World Health Organization (WHO) said today in its latest update.
From Jul 3 through Jul 6 the three countries reported 50 new EVD cases, including 25 deaths, developments that lift the overall outbreak total to 844 infections and 518 deaths, the WHO said.
Guinea has reported no new cases over the past 7 days, but 2 deaths occurred in previously reported patients. Sierra Leone reported 34 new cases, along with 14 deaths, and Liberia reported 16 new cases and 9 deaths.
West Africa has been grappling since March with its first Ebola outbreak, and health officials have had a difficult time containing the disease due to complex factors, which have included public denial about the disease and cultural practices that work against disease containment.
Health ministers and global health groups met in Ghana last week to form a new plan for battling the outbreak, which includes establishing a WHO center in Guinea to coordinate the response to all three countries.
Jul 8 WHO update
China reports new H7N9 case, positive samples from poultry
Chinese health officials yesterday reported H7N9 avian flu in a 55-year-old man from Hunan province, according to a provincial health statement translated and posted by FluTrackers, an infectious disease news message board. The patient, who lives in Yongzhou, had a history of exposure to live poultry and was admitted to the hospital on Jun 28, where he is in serious condition.
Though the number of human infections from H7N9 have tailed off in the summer, health officials have said they expect sporadic human infections to continue, because the virus is still circulating in poultry. The man's illness pushes the overall number of human infections from the virus to 452, according to a case list maintained by FluTrackers.
In poultry-testing developments, Chinese officials recently reported results from large-scale surveillance efforts from Jun 1 to Jun 20 involving serum and virologic sampling of poultry from 890 locations in 10 provinces. According to results posted on the WHO Western Pacific Regional Office (WPRO) Web site, 41 samples tested positive for H7.
Based on information from China's agriculture ministry, 39 of positive tests were on serum samples, suggesting that poultry had been exposed to the virus. One of the positive results was from a farm in Guangdong province, 29 were from live-bird markets, and 9 were from free-range birds from households in Shanghai.
WHO declares Mongolia measles-free
The WHO today declared Mongolia to be measles-free after it achieved a 95% population immunity level against the disease, the WPRO said in a news release.
The country joins Australia, Macao (an administrative region of China), and South Korea as the only other Western Pacific nations or areas to achieve that status.
"This is an important step towards measles elimination in the Western Pacific Region," said WPRO Director Dr. Shin Young-soo. "It demonstrates that measles elimination is not only theoretically feasible, but also achievable in middle- and low-income countries and areas of the Western Pacific."
Jul 8 WHO WPRO news release
Fungus tied to yogurt in 2013 outbreak more dangerous than thought
Researchers from Duke University have found that the fungus responsible for a 2013 outbreak of gastrointestinal (GI) disease linked to Chobani Greek yogurt can be dangerous in a wider range of patients than originally thought. The study was released today in the American Society for Microbiology's (ASM's) online publication mBio.
Chobani yogurt manufactured at an Idaho company plant was recalled in September 2013 after more than 200 customers experienced GI symptoms such as vomiting, nausea, and diarrhea. At the time, Mucor circinelloides was identified as the contaminant, but it was thought that only immunocompromised people were in danger.
The study authors, using multilocus sequence typing (MLST), were able to isolate M circinelloides f. circinelloides (Mcc), the most virulent subspecies of M circinelloides and the one associated with human infection, from a yogurt container that would have been subject to the September 2013 recall. Whole-genome sequence analysis showed that the strain could produce metabolites that were previously unknown.
The strain was then tested in mice and shown to be capable of causing lethal infections when spores were injected into the bloodstream and to survive passage through the GI tract when ingested orally.
The authors say their findings bring to light the fact that fungi are underestimated as foodborne pathogens and that more attention should be paid to them as potential contaminants, not only in immunocompromised but also immunocompetent individuals.
Jul 8 mBio article abstract
Jul 8 ASM press release
13-strain pneumococcal vaccine may have had little impact on kids
The 13-valent (13-strain) pneumococcal vaccine (PCV13) appears to have not changed clinical pneumonia outcomes much in Massachusetts children, although infection with non-vaccine serotypes appears more common in kids with underlying conditions, according to a study yesterday in Pediatrics.
Researchers from Massachusetts and Minnesota analyzed public health surveillance data in pre- (2007-09) and post-PCV13 (2010-12) years. They identified 168 pre-vaccine pediatric cases of invasive pneumococcal disease (IPD) and 85 post-PCV13 IPD cases.
Although a higher proportion of patients were hospitalized (57.6% vs 50.6%) and a higher proportion of children had comorbidity (23.5% vs 19.6%) in the post-vaccine years, neither difference was statistically significant, nor were comparisons of IPD caused by vaccine and non-vaccine types.
The investigators did find, however, that children with comorbidities had higher rates of IPD caused by a non-vaccine type (27.6% vs 17.2%; P = .085), were more likely to be hospitalized (80.4% vs 50%; P < .0001), and were more likely to have a longer hospital stay (median of 3 days vs 0.5 days; P = .0001).
The authors conclude, "Routine vaccination with PCV13 may not be enough to reduce the risk in patients with comorbidity."
Jul 7 Pediatrics abstract
Taliban bans polio vaccine teams in Afghanistan province
The Taliban has banned polio immunization activities in southern Helmand province in Afghanistan because it suspects vaccination teams of spying for the government at a time when the insurgent group has clashed heavily with government forces, the Taliban said on its Web site.
The previous time polio vaccination teams were blocked in parts of Afghanistan, the Taliban denied any role and said it supported polio immunization efforts, The Guardian, based in Britain, reported today. The newly announced ban is worrisome, because Taliban-affiliated groups have for years attacked and killed polio vaccine teams across the border in Pakistan but have as yet allowed the public health efforts in Afghanistan.
The Taliban said Helmand, which borders Pakistan, has been off limits to vaccinators since February.
So far this year Afghanistan has reported seven polio cases, according to the Global Polio Eradication Initiative, compared with three during the same period last year. Afghanistan, Pakistan, and Nigeria are the only nations in the world in which polio is endemic.
Jun 8 Guardian story