News Scan for Apr 18, 2016

Hospital MERS detection
;
H7N9 cases in China
;
Healthcare visits and Ebola
;
Antimicrobial stewardship

MERS virus found in hospital air, swab samples during 2015 Korean outbreak

MERS virus was detected in hospital air samples and swabs of hard surfaces during the height of Korea's outbreak in 2015, according to a study today in Clinical Infectious Diseases.

A team of Korean researchers tested air and swab samples obtained on Jul 1, 2015, during an outbreak of MERS-CoV (Middle East respiratory syndrome coronavirus) in Korea that caused four hospital clusters. All three rooms tested were used to treat severely ill patients when the samples were obtained and had been cleaned 4 to 7 hours prior to sampling.

Air samples from all three rooms were positive for MERS-CoV on polymerase chain reaction tests. Four samples from two patient rooms, one patient restroom, and one hallway had viable virus. One air sample each from an air exhaust damper and an elevator also tested positive, the authors said.

Thirteen of 16 fomite swabs, along with 29 of 52 swabs taken from fixed structures (eg, doorknobs, bed guardrails), were positive for MERS-CoV by viral culture. Viable virus was cultured from eight fixed-structure swabs and from seven fomite swabs, including one taken from a stethoscope. Electron microscopy revealed intact viral particles in air and surface cultures, the authors said.

During the 2015 Korean outbreak, 82% of 186 confirmed MERS cases were related to hospital transmission, although many case-patients did not have close contact with infected people. Given the persistence of MERS-CoV in air and surface swabs, further investigation into aerosol and fomite transmission of the virus in healthcare settings is warranted, the authors said.
Apr 18 Clin Infect Dis study

 

China reports 2 new H7N9 cases

The Hong Kong Centre for Health Protection (CHP) today reported two more H7N9 avian flu infections in adults from China's mainland.

The cases involve a 43-year-old woman and her 23-year-old son, both of whom live in Jiangxi province and work in Fujian province. The two patients are hospitalized in stable condition in Jiangxi's city of Nanchang, the CHP said.

The CHP warns people to stay away from live-poultry markets and avoid contact with birds and their droppings.

The new cases lift the global total from the disease to 778, according to a case list maintained by FluTrackers, an infectious disease news message board.
Apr 18 CHP press release
FluTrackers H7N9 case list

 

2014 Ebola virus decreased healthcare visits in Gueckedou, Guinea

A study in Epidemiology and Infection today measured a "modest" decrease in non-hospital healthcare visits in Gueckedou, a prefecture in Guinea, during the 2014 Ebola virus disease (EVD) outbreak.

European and Guinean researchers found that a 7.4% and 4.8% and drop in visits in Gueckedou’s 13 health centers and 25 health posts during the EVD outbreak (measured from Apr 1 to Sep 30, 2014) compared with 2012 and 2013, respectively. For reference, N'Zerekore, another prefecture in Guinea's forest region, experienced half the normal amount of healthcare attendance during the EVD outbreak, according to the study. 

The researchers looked at data from January 2012 to March 2015, and the median monthly visits were 15,724. After the prefecture's last EVD notification in December 2014, visits increased to 12,540 in January and to 16,032 in March 2015, according to the study. Visits to hospitals and private-sector treatments, such as those involving traditional healers, were not taken into account.

The study also tracked the frequencies of the most-reported diagnoses and found that bloody diarrhea and intestinal schistosomiasis increased in the weeks before the EVD outbreak began. The researchers speculate over the shared symptoms of these and EVD, but ultimately the data cannot prove or disprove a connection, they wrote. An increase in measles also indicated that having a large outbreak such as EVD can make populations more vulnerable to other infectious diseases, the researchers said.

Overall, the authors argue that effective and efficient surveillance of healthcare systems is important for tracking outbreaks and responding to them. They add that, in the future, "social specificities" such as use of natural healers and how the healthcare system is viewed by patients should be considered.
Apr 18 Epidemiol Infect study

 

Asian Pacific unites to slow antimicrobial resistance

Health ministers from 12 Asian Pacific countries have agreed to work together to try to contain the trend of antimicrobial resistance, according to a World Health Organization Western Pacific Region (WHO WPRO) press release.

Similar to the 2015 World Health Assembly's Global Action Plan on Antimicrobial Resistance, the collaboration will work toward improving the research around and information dissemination about antimicrobial resistance, and the ministers hope to create effective guidelines and policies concerning the production, use, and regulation of antimicrobial treatments.

"Rapid economic development and socio-demographic and cultural changes, coupled with the health status, puts the population of the Asia Pacific region at higher risk," the agency said. The WPRO cited the occurrences of multidrug resistant strains of malaria and tuberculosis as examples of increasing antimicrobial resistance in the area.

Country representatives were from Australia, Bangladesh, China, India, Indonesia, Japan, Malaysia, Myanmar, Philippines, Republic of Korea, Thailand, and Vietnam. Preceding the ministerial meeting was a 2-day session involving experts from public health, agriculture, and animal health organizations.

The Japanese government and WHO organized the event with help from the United Nations Food and Agriculture Organization and the World Organization for Animal Health.
Apr 16 WHO WPRO press release

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