News Scan for Nov 30, 2015

News brief

New Saudi MERS case, blood study in Kazakh camels

Saudi Arabia reported a new MERS-CoV infection yesterday in the city of Buraidah, while an international team of researchers found no serologic evidence that the virus is endemic in Kazakh camel herds.

The Saudi Ministry of Health (MOH) reported yesterday that a 35-year-old Saudi woman from the north-central city of Buraidah is in critical condition with a MERS-CoV (Middle East respiratory syndrome coronavirus) infection. She is not a healthcare worker and was not exposed to other MERS patients, the ministry said. No other risk factors were noted.

The woman's illness was Saudi Arabia's first case to be reported in 17 days.

Saudi Arabia has now has 1,277 MERS cases since 2012, the MOH said. Of the total number, 728 have recovered, 549 have died, and one person remains under treatment.
Nov 28 MOH update

Writing in Emerging Infectious Diseases on Nov 25, an international team of researchers found a lack of evidence for MERS-CoV infection in dromedary and Bactrian camel herds living in Kazakhstan.

Investigators conducted a seroepidemiologic study of 455 dromedary camels living in 9 herds in 4 Kazakh cities, along with 95 Bactrian camels living in 2 herds in 2 Kazakh cities. Dromedary camels are assumed to be the natural MERS-CoV host, with the virus present in herds living in the Arabian Peninsula and several African regions.

Though blood samples from 10 dromedary camels were positive for bovine coronavirus neutralizing antibodies, all camels lacked evidence of MERS-CoV infection following a validated MERS-CoV (strain EMC) spike pseudo particle neutralization test.

The researchers said that their results imply that dromedary camels may only maintain the virus, while another animal or environment likely serves as the ultimate natural reservoir for MERS-CoV.
Nov 25 Emerg Infect Dis study

 

Chikungunya encephalitis complications noted in infants, elderly

Infants and elderly people who experience neurologic symptoms with chikungunya virus infection may be at increased risk of encephalitis and death, according to findings published online Nov 25 in Neurology.

An international team of researchers conducted a cohort study of people affected by the 2005-06 chikungunya virus (CHIKV) outbreak on Reunion Island, which lies off the coast of Madagascar. Approximately 300,000 people were infected with CHIKV during the epidemic, and investigators monitored people reporting neurologic symptoms at disease onset for long-term central nervous system (CNS) effects until 2009.

Of the 57 people with CNS symptoms, 24 people (Incidence Rate [IR]: 8.6 per 100,000) had encephalitis associated with CHIKV infection. Infants younger than 1 year had a drastically higher incidence rate of encephalitis (187 per 100,000), as did people over the age of 65 (37 per 100,000).

During the outbreak, 16.6% of people with CHIKV-associated encephalitis died, while 30% to 45% of people with encephalitis experienced long-term disabilities, such as behavioral change and memory problems in infants and dementia in previously healthy older people.

Researchers said that the CHIKV-associated encephalitis rates during the Reunion Island outbreak were higher than encephalitis rates from all causes in the United States, calling for greater surveillance and monitoring of people presenting with CHIKV infection and CNS symptoms.
Nov 25 Neurology study

 

Celery from Costco chicken salad linked to 7-state E coli outbreak

A celery and onion mix used in rotisserie chicken salad sold at Costco stores has been identified as the probable source of Shiga toxin-producing Escherichia coli O157:H7 that has sickened 19 people in seven states, according to a Nov 27 announcement from the Centers for Disease Control and Prevention (CDC).

The Montana Public Health Laboratory identified E coli O157:H7 in the diced celery and onion blend, which was produced by Taylor Farms Pacific, Inc. in Tracy, Calif. The US Food and Drug Administration (FDA) reported on Nov 27 that Taylor Farms Pacific, Inc. has recalled 71 products containing celery.

As of Nov 23, the outbreak had sickened 19 people from seven states. Five people required hospitalization, and 2 became ill with hemolytic uremic syndrome associated with the E coli infection.

States affected by the outbreak include Montana (6 cases), Utah (5), Colorado (4), California (1), Missouri (1), Virginia (1), and Washington (1). Of the 16 ill people interviewed, 14 reported consuming rotisserie chicken salad purchased at Costco stores.

Costco has removed all rotisserie chicken salad sold as item number 37719 from its stores. The FDA advises consumers to discard any Costco rotisserie chicken salad or products containing celery affected by the Taylor Farms Pacific recall.
Nov 27 CDC update
Nov 27 FDA update and recall information
Nov 24 CIDRAP News scan on the outbreak

 

Iraq and Tanzania implement vaccination, surveillance for cholera outbreaks

Laboratory-confirmed cases of cholera caused by the outbreak strain Vibrio cholera 01 Inaba have reached 2,810 in Iraq, according to a Nov 26 World Health Organization (WHO) update. The total reflects an increase of 1,547 from a WHO update on Oct 12.

Cases have occurred in 17 Iraqi governorates, and the outbreak has significantly affected the large governorates of Baghdad (940 cases), Babylon (675), and Qadisiyyeh (442). Two deaths related to the outbreak strain have been reported. The illnesses were confirmed at the Central Public Health Laboratory in Baghdad. (A Nov 22 update from the WHO's Eastern Mediterranean Office said provincial labs had confirmed 4,858 cases.)

The Government of Iraq, along with the WHO and UNICEF, administered the first round of oral cholera vaccine to 229,000 internally displaced people and refugees in 13 governorates during the second week of October, reaching 93% of the target population. A second round of vaccine will be administered in early December.

Iraqi officials are planning water surveillance and case management activities to coincide with the pilgrimage of Arba'een on Dec 2, during which the city of Karbala will expect 10 million pilgrims.
Nov 26 WHO update on Iraq

Cholera cases in Tanzania have reached 9,871 in an outbreak that now affects 19 regions, along with 2 islands in the Zanzibar archipelago, and has caused 150 deaths, according to a Nov 26 WHO update.

The outbreak, which began in August, has significantly affected the urban center of Dar es Salaam, causing 4,482 cases in the city. The islands of Unguja and Pemba in the Zanzibar archipelago have reported 223 and 202 cases, respectively.

Tanzania's Ministry of Health and Social Welfare is conducting surveillance and water chlorination programs, while a team deployed from the International Centre for Diarrhoeal Disease Research in Bangladesh is providing emergency operations assistance within Tanzania.

Though cases are declining, the upcoming rainy season is likely to cause flooding and increased cholera transmission within affected regions.
Nov 26 WHO update on Tanzania

Flu Scan for Nov 30, 2015

News brief

Avian flu detected in Vietnam, Canada

Agriculture officials in Vietnam reported another highly pathogenic H5N1 outbreak in poultry, while Canadian authorities reported that low pathogenic H5N2 turned up in a hunter-shot duck in British Columbia.

Vietnam's latest of a long list of outbreaks occurred in backyard birds in Nghe An province, located in the north central part of the country, according to a Nov 27 report to the World Organization for Animal Health (OIE). The event began Nov 7 and killed 220 of 520 susceptible birds. The remaining ones were culled to curb the spread of the virus.

Meanwhile, a low pathogenic H5N2 virus has been detected in a wild duck shot by a hunter in Abbotsford, British Columbia, prompting a warning to the area's poultry producers to take extra biosecurity steps, according to a Nov 27 CBC News report. The area is near Fraser Valley, an area that was hit by a highly pathogenic H7 outbreak in 2004.

Random testing revealed the low path H5N2 finding in the duck, and an official with the BC Poultry Association told CBC that the strain is different than the highly pathogenic H5N2 virus that struck two farms in British Columbia last year. He added that the finding isn't surprising, because migrating birds are known to carry the strain.
Nov 27 OIE report
Nov 27 CBC News story

In other developments, preliminary sequencing on a highly pathogenic H5N1 virus detected in a recent outbreak in French poultry suggests that the virus is a mutated strain that is closely related to European low pathogenic avian influenza (LPAI) strains, according to a Nov 26 report from the United Kingdom's Department for Environment, Food, and Rural Affairs (DEFRA).

The report added that European lineage LPAI H5N1 has been detected sporadically in European poultry and wild birds, but that a mutation to high pathogenicity of the strains is a rare event.
Nov 26 DEFRA statement

 

CDC notes slight rise in US flu activity

For the second week in a row, flu activity in the United States rose slightly, with influenza A H3N2 as still the dominant strain, the US Centers for Disease Control and Prevention (CDC) said in its report for the week ending Nov 21.

The nation's overall marker for percentage of clinic visits for flulike illness held steady at 1.6%, still well below the national baseline of 2.1%, but two of the CDC's 10 regions were above their area-specific baselines: the middle Atlantic region centered around Maryland, Pennsylvania, and Virginia, and the south central area that includes Arkansas, Louisiana, Oklahoma, Texas, and New Mexico.

One more pediatric flu death was reported, raising the season's total so far to two. Overall deaths from flu and pneumonia, which typically lag behind other markers, is still well below the epidemic threshold.

South Carolina was the only state to report moderate flu activity, another measure of clinic visits for flu. Flu was widespread in Guam, regional in Puerto Rico, and reported as local in five states: Hawaii, Iowa, Kentucky, New Hampshire, and Utah.

The CDC and their state and local partners are gearing up their annual flu vaccination push as the nation heads into its holiday season and ahead of the busiest part of the flu season. National Influenza Vaccination Week (NIVW) activities are scheduled for Dec 6 through Dec 12.

Nov 30 CDC FluView report
Nov 24 CDC NIVW update

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