News Scan for May 17, 2016

MERS details
;
H7N9 cases in China
;
Yellow fever emergency panel
;
Salmonella tied to greens
;
Global meningitis seasonality

WHO reports details of Qatar, Saudi MERS-CoV cases

No new MERS-CoV cases have been reported today, but the World Health Organization (WHO) has posted information on the case reported recently from Qatar as well as details of several previously reported cases from Saudi Arabia.

The Qatar patient is a 40-year-old man who had frequent contact with dromedaries in his work but no other known risk factors, according to the WHO. He had been admitted to the hospital for an unrelated condition Apr 26 and tested positive for MERS-CoV (Middle East respiratory syndrome coronavirus) May 2 and 3. He is in stable condition and remains in isolation.

Contact monitoring has yielded no other MERS-CoV cases and the camels the man   worked with are being evaluated, says the WHO.

Qatar has had just one other MERS-CoV case this year.
May 16 WHO notice on Qatar case

Meanwhile, a separate update yesterday covers four Saudi MERS-CoV cases previously reported by the country's ministry of health.

  • A 55-year-old male national from Hofuf, whose symptoms started Apr 26, tested positive Apr 30 and died May 4. He had preexisting medical conditions and a history of contact with dromedaries and consumption of raw camel milk. The dromedaries are being evaluated.
  • A 39-year-old non-national from Riyadh was a household contact of the case-patient below. He was identified through contact tracing, testing positive on May 5. He has had no symptoms, has no comorbidities, and is in home isolation.
  • A 40-year-old non-national from Riyadh who had preexisting conditions is critically ill in an intensive care unit (ICU) but is not receiving mechanical ventilation. His symptoms began Apr 14 and he was admitted May 1, testing positive the next day. Exposure history for the 14 days before his admission is listed as ongoing.
  • A 70-year-old national from Hail who has comorbidities is receiving mechanical ventilation in an ICU. He experienced symptoms beginning Apr 26, was admitted Apr 29, and tested positive Apr 30. His exposure history is also listed as ongoing.

The WHO's count of confirmed MERS-CoV cases globally since September 2012 stands at 1,733 with at least 628 related deaths.
May 16 WHO notice on Saudi cases

 

WHO notes small cluster in overview of recent H7N9 cases from China

Of 11 recent H7N9 avian flu cases reported by China to the World Health Organization (WHO) on May 10, 2 were part of a cluster. In an update today, the WHO said 10 patients had a history of contact with live poultry or poultry markets—a common pattern in the disease—and 1 had a history of selling pork in a market.

The cases have been previously reported in disease updates from China, but the WHO report provides more epidemiologic details. Illness-onset dates ranged from Mar 23 to Apr 21, and patient ages vary from 23 to 69 years, with a median of 52. Seven of the patients are men, and the 11 patients hail from five provinces or cities: Jiangsu (6), Jiangxi (2), Anhui (1), Shandong (1), and Zhejiang (1).

Patients in the cluster are from Jiangxi province, a 23-year-old man who got sick on Apr 1 after buying live poultry at a market and a 43-year-old woman who became ill on Apr 5 after slaughtering poultry at a market, the WHO said, adding that although both had poultry exposure, human-to-human transmission can't be ruled out. The patients are hospitalized in critical condition.

The WHO said most people infected with the virus had contact with poultry, and though small clusters have been reported, so far there's no scientific evidence that the virus has gained the capacity for sustained infections in humans.
May 17 WHO statement

 

WHO convenes emergency committee to address yellow fever

The WHO announced today that it is convening an emergency committee under the International Health Regulations (IHR) on May 19 to address the global threat of Africa's yellow fever outbreak. In an e-mail to journalists, it said the experts will meet by teleconference, adding that it will brief the media afterward on the outcome of the meeting.

One of the topics emergency committees discuss as part of the IHR is whether the developments warrant a public health emergency of international concern (PHEIC). The emergency committee meetings also help draw international attention to emerging global health threats and allow experts to make temporary recommendations.

Angola's large outbreak has triggered an additional outbreak in the Democratic Republic of Congo, and health officials are very concerned that the disease could spread to other vulnerable African nations. The outbreak in Angola has been linked to several exported cases, including to China. Also, Uganda is experiencing an outbreak not linked to the event in Angola.
May 13 CIDRAP News story "Yellow fever expands in Angola; vaccination set for DRC, Uganda"

 

Report: 7-case leafy-green Salmonella outbreak in April never made public

A small Salmonella outbreak in Minnesota and Virginia that was not reported to the public when it was identified earlier this month involves organic greens grown by Taylor Farms of Salinas, Calif., and sold at Sam's Club, Food Safety News (FSN) reported today.

Seven people—six in Minnesota and one in Virginia—contracted Salmonella Enteritidis infections that have the same DNA fingerprint, according to the Centers for Disease Control and Prevention (CDC), FSN reported. The CDC did not notify the public about the outbreak. The illnesses began Apr 3 through Apr 26. All the Minnesota patients reported eating Taylor Farms Organic Kale Medley Power Greens Mix before they fell ill.

"In early May, Minnesota health officials notified CDC about an investigation into Salmonella infections in their state. CDC is monitoring PulseNet for any additional illness with the same DNA pattern nationally," the CDC told FSN.

"It has been several weeks since the last illness occurred. If additional cases of illness are identified, CDC will work with states to obtain information about foods consumed before becoming ill."

FSN became aware of the outbreak after a separate firm, Pacific Coast Fruit Company, inadvertently posted information about the outbreak on its Web site.

Minnesota officials said there was no need to make the outbreak public because customers were able to be notified quickly about the product. "The vehicle for this outbreak was identified with a small number of cases and extremely quickly, and every person who purchased the implicated product was notified that the product might be contaminated with Salmonella," Minnesota Department of Health spokesman Doug Schultz said. "Because Sam's Club had the ability to directly notify all customers who had purchased the product, a press release was not necessary to reach those who had been exposed."

Schultz said one of the Minnesota patients was hospitalized, and all are recovering.
May 17 FSN story

 

Study: Global meningitis cases peak annually in dry winter months

Bacterial meningitis incidence follows a yearly pattern, peaking in dry winter months, according to a study in the June issue of The Lancet Global Health.

A team led by Princeton University researchers compiled the first global database of monthly bacterial meningitis incidence comprising about 700,000 cases from 66 countries reported during the late 1990s and early 2000s. Of 51 countries reporting 5 or more years of continuous data and at least 40 meningitis cases per year, 49 displayed annual seasonal incidence patterns, the authors said.

In Europe, North America, and China, meningitis cases largely caused by Neisseria meningitidis peaked during January and February each year. Peak incidence in the African meningitis belt, which stretches from West Africa to Ethiopia, occurred during the dry season in February and March. The highest number of cases was observed from June to July in South America, Oceania, and South Africa, the authors said.

Seasonal patterns were associated with N meningitidis (25 countries), Streptococcus pneumoniae (5), Haemophilus influenzae (4), and unspecified strains (16, including 13 countries in the meningitis belt).

A commentary written by Mustapha M. Mustapha, MBBS, PhD, and Lee H. Harrison, MD, of the University of Pittsburgh's Microbial Genomic Epidemiology Laboratory in the same issue of The Lancet Global Health notes that while much is known about host and genetic factors associated with meningitis incidence, little is understood about ecological contributors. Future studies should attempt to increase understanding about the interplay between the environment and bacterial pathogens that cause meningococcal disease, the two authors said.
June Lancet Glob Health study
June Lancet Glob Health
commentary

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