Saudi Arabia reports another MERS case in Hofuf outbreak

Saudi Arabia’s Ministry of Health (MOH) today announced one new MERS-CoV infection, yet another case linked to an outbreak in the city of Hofuf, which has reported clusters linked to healthcare facilities and at least one family.

The patient is a 41-year-old Saudi man who is a household contact of an earlier reported case. He is not a healthcare worker and is hospitalized in stable condition.

Two day ago the MOH reported one additional MERS-CoV (Middle East respiratory syndrome coronavirus) death in a previously reported patient, a 61-year-old woman in Hofuf.

The latest illness and death lift Saudi Arabia's MERS-CoV totals to 1,039 cases and 460 fatalities. The MOH said four people are still being treated for their infections, and over the course of the outbreak 575 have recovered.
Jun 25 MOH update
Jun 23 MOH update

 

ACIP recommends a year between pneumococcal shots in elderly

The US Advisory Committee on Immunization Practices (ACIP) today fine-tuned its recommendation on pneumococcal vaccinations for elderly people to stipulate that there should always be a 1-year interval between the two types of immunizations.

People age 65 and older are advised to receive the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23). The current official recommendation is that those who have received neither vaccine should get PCV13 first, followed by PPSV23 between 6 and 12 months later.

The ACIP today voted to recommend that there should be at least a 1-year wait between receipt of PCV13 and PPSV23, instead of 6 to 12 months, according to Alison Albert, a spokeswoman for the Centers for Disease Control and Prevention's (CDC's) National Center for Immunization and Respiratory Diseases.

For elderly people who have received PPSV23 but not PCV13, the existing recommendation is that there should be a 1-year wait, and today's ACIP action doesn't change that, Albert said.

Today's ACIP vote "will allow the recommended interval between these vaccinations to match, regardless of which vaccine is administered first," she said.

The committee advises the CDC on immunization issues, and its recommendations routinely become official CDC policy.
CDC adult immunization schedules

 

Waterborne pathogens—notably Crypto—sickened 1,800 in 2 years

Disease outbreaks associated with recreational water use caused at least 1,788 infections, 95 hospitalizations, and 1 death in the United States in 2011 and 2012, with Cryptosporidium the leading culprit, federal researchers said today.

Investigators from the CDC and the Environmental Protection Agency noted 90 outbreaks during the 2 years, 69 of which (77%) occurred in treated pools, according to their summary in Morbidity and Mortality Weekly Report (MMWR).

The median number of cases in treated-water outbreaks was 7 (range, 2 to 144). Thirteen outbreaks occurred in hotels, and 10 were associated at least partly with a spa. Thirty-six (52%) were caused by Cryptosporidium, followed by Legionella, which caused 9.

In the 21 outbreaks involving untreated water bodies like lakes, the median number of cases was 16 (range, 2 to 125). Five outbreaks were caused by Escherichia coli, while only 1 was attributed to Cryptosporidium.

In all outbreaks combined, Cryptosporidium caused by far the most illnesses. It accounted for 890 cases, followed by norovirus at 175 and norovirus combined with Giardia intestinalis at 125. The parasites Cryptosporidium, Giardia, and avian schistosomes accounted entirely or in part for 1,092 of the 1,788 cases, or 61%.

Cryptosporidium can survive in water for more than 10 days at CDC-recommended chlorine and pH levels, the report says.
Jun 26 MMWR report

 

Rotavirus vaccine might reduce seizures in young kids

Rotavirus vaccine might reduce hospitalizations due to seizures in preschoolers, according to a study today in the Pediatric Infectious Disease Journal.

Spanish scientists looked at hospitalization rates for any kind of seizure in 6,149 children younger than 5 years from 2003 to 2013 in Spain. Rotavirus vaccine was introduced in 2007.

They found that seizure-related hospitalizations declined by rates ranging from 16% in 2007 to 34% in 2010 compared with the median rate over the pre-vaccine years. The drop in rates for convulsions (also called tonic-clonic seizures) among hospitalized preschoolers ranged from 19% in 2007 to 43% in 2012. Those declines were all statistically significant and appeared to be more marked in the youngest infants.
July Ped Infect Dis J study

Flu Scan for Jun 25, 2015

News brief

Respite from H5N2 outbreaks continues for Minnesota, Iowa

The predicted summer break in H5N2 avian influenza activity is growing longer in hard-hit Minnesota and Iowa, allowing more areas to be released from quarantine and more poultry farms to restock their barns.

Minnesota has now gone 20 days with no new outbreaks, while Iowa has gone 9 days. Several weeks ago, animal health officials predicted that the outbreaks would fade with warmer summer weather and increased sunshine, conditions less favorable for the virus.

In a weekly update today, the Minnesota Board of Animal Health (MBAH) said seven farms in five counties (Kandiyohi, Meeker, Ottertail, Pope, and Stearns) have now been cleared to restock with poultry. Several other farms plan to restock next week.

In addition, uninfected farms in control zones around outbreak farms in nine counties have been released from quarantine, meaning they can move birds again, according to the MBAH. Six control areas have been released in the past week—four in Stearns County and one each in Lyon and Watonwan counties.

Minnesota has had outbreaks on 108 farms in 23 counties, while Iowa has had 77 in 18 counties.

Among other affected states, Nebraska reported its latest H5N2 outbreak Jun 16, while South Dakota's last one was reported May 28. In Wisconsin and North Dakota, the latest incidents date back to May 4 and Apr 24. None of those states have had more than 10 events.
MBAH avian flu information

 

H5N1 sickens two more in Egypt, one fatally

Egyptian authorities have reported two more human H5N1 avian flu infections, involving a 40-year-old woman in Sohag governorate who died from her illness and an individual from Faiyum governorate.

The cases were among new database listings from the United Nations Food and Agriculture Organization (FAO) that were flagged by FluTrackers, an infectious disease news message board. The FAO listings are based on reports from national authorities.

The case in Sohag appears to be the same one reported by the Egyptian media yesterday. No other details were available about the latest patient from Faiyum, other than that the observation date was Jun 13.

The two new cases increase Egypt's H5N1 total so far this year to 146 cases, according to a running list kept by FluTrackers.
Jun 24 FluTrackers thread
Jun 24 Cairo Post story
FluTrackers H5N1 in Egypt case list

 

Study: Single mutation may have led to poor H3N2 vaccine response

A single mutation in the H3N2 virus circulating this past flu season might be largely responsible for the low effectiveness of last year's flu vaccine, researchers said today in Cell Reports.

The US researchers used reverse engineering to convert the 2014-15 H3N2 vaccine strain into a panel of H3N2 strains that have hemagglutinin mutations found in currently circulating H3N2 strains. They then tested whether the viruses would be recognized by antibodies in blood cells taken from ferrets and sheep that had been exposed to the H3N2 vaccine strain.

They found that a single mutation in the F159S amino acid residue of hemagglutinin diminished antibody recognition by as much as 75% compared with antibody recognition of the unaltered H3N2 vaccine strain.

The investigators then assayed human blood samples taken before and after exposure to the 2014-15 vaccine. They found that vaccination was significantly less effective at increasing antibody recognition of the F159S-mutant strain compared with the unaltered strain.

"We find that some human immune responses are heavily focused on single regions of the flu virus and that single viral mutations can evade these immune responses," said senior author Scott E. Hensley, PhD, of the University of Pennsylvania, in a Cell Press news release. "Influenza viruses might have evolved in a way that promotes the generation of narrow immune responses that are easy to circumvent via single viral mutations."
Jun 25 Cell Rep abstract
Jun 25 Cell Press news release

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