News Scan for Feb 17, 2015

US measles cases rise
5 new Saudi MERS cases
More H7N9 in China
Botulism in heroin users

US measles case climb to 141, CDC says

The Centers for Disease Control and Prevention announced today that 141 measles cases have been reported so far this year, an increase of 20 since the agency's previous update on Feb 9.

Most of the cases—113 (80%)—are part of a multistate outbreak that originated with exposures at Disneyland, the CDC said. (The update does not name Disneyland, instead referring to it as an amusement park in California.)

Overall, cases have been reported in 17 states and the nation's capital, with California accounting for 98, the CDC said. The agency says most of the case-patients had not been vaccinated for measles. The source of the Disneyland-linked outbreak has not been found, but authorities suspect it began with someone who became infected while traveling overseas and then visited the park.

In addition to the Disneyland-related cases, officials have been tracking a much smaller outbreak related to a daycare center in the Chicago suburb of Palatine, Ill. Today the Illinois Department of Health (IDPH) said the number of cases in that outbreak has climbed to 14, from 10 reported last week. The CDC lists 11 cases in Illinois.
Feb 17 CDC update
Feb 17 IDPH update
Related Feb 16 CIDRAP News item


Five more Saudi MERS cases reported

Saudi Arabia reported 5 more MERS-CoV cases today, 1 fatal, for a 7-day total of 39, and the World Health Organization (WHO) yesterday provided details on 5 cases reported earlier this month by Saudi officials. The Saudi Ministry of Health (MOH) also noted the deaths of two previously reported case-patients.

The cases of MERS-CoV (Middle East respiratory syndrome coronavirus) reported by the MOH involve patients in Riyadh, Tabuk, Ar Rass, and Jubail. All are male Saudi nationals, and none are healthcare professionals or had recent contact with animals.

The two patients in Riyadh are 60 and 37, with the older man in critical and the younger man in stable condition. The patient who died, at age 76, was from Ar Rass. He had had contact with a suspected or confirmed case in a healthcare setting. The other two patients are a 65-year-old from Tabuk and a 41-year-old from Jubail. The latter was the only one of the five patients who did not have preexisting disease.

The five cases noted by the WHO, meanwhile, were reported Feb 5 through 7. The patients, four of whom are men, range in age from 34 to 62, with the youngest being the only one who did not have preexisting disease. Three are in Riyadh, with one each in Najran and Dammam.

They first had symptoms from Jan 25 to Feb 2, and all are still hospitalized, with three in critical and two in stable condition. The 62-year-old, a man from Riyadh, owns camels and has a history of frequent contact with them and consumption of raw camel milk. No others reported risk factors, including contact with other MERS patients.
Feb 17 MOH update
Feb 16 WHO update


H7N9 sickens four more in China

Four more H7N9 avian flu infections have been reported in two of China's provinces, including a new one from Guangdong and three that occurred in Zhejiang in January.

The patient from Guangdong province is a 33-year-old woman from Guangzhou who is hospitalized in critical condition, according to a statement today from Hong Kong's Centre for Health Protection (CHP), which cites mainland authorities. A provincial health department statement translated and posted by FluTrackers, an infectious disease news message board, said the woman is pregnant.

Meanwhile, the additional H7N9 cases from Zhejiang were noted in a monthly infectious disease report released by the provincial health department. A translation posted and cross-referenced by FluTrackers shows that three of the cases weren't previously reported. No details were listed for the three cases.

The four new infections raise the global H7N9 total to 597, according to a case list maintained by FluTrackers.
Feb 17 CHP statement
Feb 16 FluTrackers thread on Guangdong case
Feb 16 FluTrackers thread on Zhejiang cases
FluTrackers H7N9 case list


Norway and Scotland report wound botulism in heroin users

Norway and Scotland reported 23 cases of Clostridium botulinum wound infections in people who inject heroin, according to a risk assessment yesterday from the European Centre for Disease Prevention and Control (ECDC).

Norway reported 8 cases, and Scotland reported 6 confirmed and 9 probable cases of wound botulism among heroin users from Dec 2014 to Feb 10. Officials from the ECDC and the European Monitoring Centre for Drugs and Drug Addiction traced the infections to contaminated heroin bought in Oslo and Glasgow.

Most heroin users with wound botulism had used an intramuscular injection, while one patient reported smoking the drug.

The ECDC said that the risk of the contaminated batch of heroin affecting other countries is unknown and depends on the stage of heroin distribution where contamination occurred. Officials are increasing attempts to raise healthcare providers' awareness about wound botulism in heroin users and increasing the availability of antitoxin.

Norway experienced previous clusters of wound botulism among heroin users in 1997 (3 cases) and 2013 (7 cases). The United Kingdom reported 167 cases from 2000 to 2013.
Feb 16 ECDC report

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