Yellow fever transmission continues in southern Africa
Yellow fever case totals in Angola and the Democratic Republic of Congo (DRC) continue to climb, with Namibia now reporting its first suspected case, according to a World Health Organization (WHO) situation report yesterday.
Though nearly 6 million people have been vaccinated, yellow fever transmission is ongoing in six Angolan provinces, including Luanda, where the outbreak began in December 2015. As of May 4, totals in that country reached 2,149 suspected and 661 confirmed cases and 277 fatalities, the WHO said.
Angola's outbreak has been tied to 37 cases of yellow fever in the DRC, 11 cases in China, and 2 in Kenya. On Apr 28, Namibia, which shares a porous border with Angola, reported its first suspected yellow fever case in a 27-year-old woman who was initially hospitalized in Angola's Benguela province, the WHO said.
The DRC government, which declared a yellow fever outbreak on Apr 23, has linked 44 cases to Angola's outbreak, 37 of which were imported. Two cases, one each in Kinshasa and Kongo provinces, were locally acquired, and an additional 10 possible locally acquired cases in DRC are under investigation.
Elsewhere, seven lab-confirmed yellow fever cases in Uganda don't appear to be linked to Angola's outbreak, the WHO said.
The agency said that insufficient vaccination coverage in Angola's hardest-hit provinces of Luanda, Benguela, and Huambo continues to spur transmission within the country and across its borders. More than 1.5 million vaccines are scheduled to be sent to Angola, and 2.2 million vaccines will arrive in the DRC by mid-May.
May 5 WHO situation report
May 2 CIDRAP News item on the outbreak
MCR-1 gene detected in British pig farm samples
Bacterial sampling as part of investigation into fatal diarrheal illnesses at a pig farm in Great Britain found multidrug resistance, including to the drug colistin, in three isolates, and two harbored the MCR-1 gene, researchers reported in the Journal of Antimicrobial Chemotherapy.
Two Escherichia coli samples and one Salmonella Copenhagen isolate were resistant to colistin, an antibiotic often used in raising animals that is considered a last-line treatment for multidrug-resistant infections in humans. Whole-genome sequencing revealed that one E coli and the Salmonella isolate contained the MCR-1 gene, first described by Chinese scientists toward the end of 2015.
The team also found that the two E coli samples harbored beta-lactamase resistance but did not specify when the samples were collected.
The farm had a history of post-weaning diarrhea, and the pigs that were sampled in the study had zinc oxide and florfenicol in feed and colistin in water and had shown poor response to treatment.
The authors concluded that colistin use probably created selective pressure at the farm and that multidrug-resistance contributed to poor treatment outcomes alongside rotavirus enteritis. Also, they said their findings support the concept of global distribution within a variety of MCR-1 plasmids.
May 4 J Antimicrob Chemother abstract