News Scan for Nov 04, 2015

New chikungunya illnesses
More Chipotle E coli cases
Drug-resistant gonorrhea
CDC polio travel alerts

PAHO reports more than 13,000 new chikungunya cases

Nations in the Americas and Caribbean reported 13,476 new cases of chikungunya, bringing the outbreak total to 1,760,798, according to a Pan American Health Organization (PAHO) update from late last week that was not posted till yesterday.

PAHO's last two updates included 2,464 and 2,095 new cases, respectively. The new numbers in the Oct 30 report bring the total this year to 614,029 suspected and confirmed cases. PAHO also reported 5 new chikungunya deaths, bringing this year's total to 68.

Nicaragua, reporting 4 weeks' worth of data, had the highest increase: 9,992 new infections. It now has 56,904 cases this year. Brazil was second, with 1,500 new cases over 2 weeks, bringing its total to 13,144. Colombia, which often tops the list, had 1,345 new cases last week, and its 2015 total now stands at 342,333.

The epidemic began in December 2013 with the first locally acquired chikungunya case ever reported in the Americas, on St. Martin in the Caribbean.
Oct 30 PAHO update


Chipotle E coli cases increase to 41

Cases of Escherichia coli infections linked to Chipotle restaurants in Washington and Oregon increased by 19, to 41 cases, according to updates today and yesterday from health officials in the two states.

Patients in Washington range in age from 1 to 67 years, and nearly all of the 25 patients reported eating at Chipotle before falling ill, according to the Washington State Department of Health (WSDH). Eleven patients are hospitalized. The agency had reported 19 outbreak cases on Oct 31.

The cases are tied to five restaurants in four cities, and the chain has closed a number of restaurants in the state. Today's update includes the first case reported from Whatcom County, raising the number of counties reporting cases to six.

Three of the 12 E coli patients in Oregon have required hospitalization, the Oregon Health Authority (OHA) said in a news release. The OHA had reported 3 outbreak cases on Oct 31.

"Chipotle has closed at least 14 of its restaurants in the Portland metro area (Multnomah, Clackamas and Washington counties) to assist public health agencies with their investigation," the OHA said.
Nov 4 WSDH news release
Nov 3 OHA news release


Drug-resistant gonorrhea bacteria increased in 2014

The decline seen in resistance of Neisseria gonorrhoeae—which causes gonorrhea—to cephalosporin treatment from 2011 to 2013 came to an end in 2014, when levels increased, according to a study yesterday in JAMA.

Researchers from the US Centers for Disease Control and Prevention (CDC) analyzed data from the CDC's Gonococcal Isolate Surveillance Project, a system that monitors antimicrobial susceptibility in isolates from men being treated for gonorrhea.

They analyzed data on 51,144 isolates collected in 34 cities from 2006 through 2014. The percentage of isolates with reduced cephalosporin susceptibility increased from 0.1% in 2006 to 1.4% in 2011, then dropped to 0.4% in 2013. In 2014, however, the percentage increased to 0.8%.

The CDC said in 2012 that cephalosporin-based combination treatment is the single recommended therapy for gonorrhea.

"Although this improvement in susceptibility appears temporally correlated with treatment guideline changes, we cannot establish a causal relationship," the authors write. "The 2014 data, however, suggest that improvements in susceptibility may be short-lived."
Nov 3 JAMA study
Nov 3 JAMA news release


CDC updates polio travel advice for Madagascar, Ukraine, Laos, Guinea

The CDC yesterday raised its travel alert level for Madagascar, Ukraine, Laos, and Guinea because of local vaccine-derived polio cases in each country. The level for the countries is at "Alert," which is the second level of notice (above "Watch" and below "Warning").

Madagascar had had 9 recent polio cases, Ukraine 2, and Laos and Guinea 1. Level 2 advice from the CDC is to practice enhanced precautions, such as get vaccinated, eat safe food and drink safe liquids, and practice good hygiene.

Other regions at the Alert level are Sierra Leone because of Ebola and the Arabian Peninsula for MERS (Middle East respiratory syndrome). Guinea is at the Warning level because of Ebola.
Nov 3 CDC notices for Madagascar, Ukraine, Laos, and Guinea

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