Yellow fever transmission continues in Angola, with high risk of spread
Cases continue to rise in yellow fever outbreaks affecting Angola, Democratic Republic of Congo (DRC), and Uganda, compelling the World Health Organization (WHO) to say yesterday there is high risk of the disease's spread to other provinces and neighboring countries.
Of the 2,536 cases reported in Angola, 747 have been laboratory-confirmed, and 301 people have died, the WHO said. Fifteen of the country's 18 provinces have confirmed cases, and suspected cases have been reported in all provinces.
Angola's Luanda Norte province recently confirmed its first five illnesses since the outbreak began in December 2015. The five cases occurred across Coango and Chitato districts, where the WHO says there is high risk of transmission between Angola and DRC due to diamond mining transit.
Though vaccination campaigns have covered more than 7 million people in Luanda, Huambo, and Benguela provinces, the virus continues to circulate in these regions, the WHO said. Vaccination campaigns began last week for people living in the provinces of Cuanza Sul, Huila, and Uige.
DRC has reported 48 confirmed yellow fever cases, 41 of which were imported from Angola. Three probable cases in DRC are under investigation, the WHO said.
Elsewhere, Uganda's case numbers have not risen since it last reported 60 suspected and 7 confirmed cases on May 19. The country's outbreak is not linked to Angola's, the WHO said.
The WHO said the outbreaks in Angola and DRC pose a serious risk of spread to other regions, owing to porous borders, mining transit, and unvaccinated travelers and foreign workers. Angola received 11.7 million doses of yellow fever vaccine on May 18 to supplement its ongoing campaigns, and DRC and Uganda recently have received 2.2 million and 700,000 doses, respectively.
Angola's neighboring countries of Namibia and Zambia—the latter of which also shares a border with DRC—have requested 450,000 and 50,000 doses, respectively, to vaccinate travelers, the WHO said.
May 26 WHO report
May 24 CIDRAP News item on Ugandan vaccination campaign
May 20 CIDRAP News item on yellow fever outbreaks
US flu activity approaches summertime levels
Influenza activity settled down close to summertime levels across the United States last week, although two more flu-related deaths in children were reported, according to the weekly update from the Centers for Disease Control and Prevention (CDC) today.
Just 1.3% of visits to sentinel clinics were prompted by influenza-like illnesses (ILI) last week, down from 1.4% a week earlier and well below the national baseline of 2.1%, the CDC said. All 10 CDC regions had ILI levels below their baselines, whereas the Southeast had still been above its baseline the previous week.
No states reported high ILI activity, and 46 states had minimal activity, the CDC said. As was true a week earlier, Puerto Rico was the only jurisdiction reporting moderate ILI activity.
At the same time, New York state and Puerto Rico still cited geographically widespread flu cases. A week earlier that group had included Delaware along with New York and Puerto Rico.
The two flu-related deaths in children compared with one the previous week and raised the season total to 70. One death occurred in February and involved an influenza A/H1N1 virus; the other one occurred earlier this month and involved an unspecified type A virus.
Overall deaths attributed to pneumonia and flu, as reported by the 122 Cities Mortality Reporting system, dropped to 6.0% last week from 6.6% the previous week. The designated epidemic threshold for the week is 6.6%.
Clinical labs found flu viruses in 6.3% of 9,917 respiratory samples tested last week, versus 7.1% of 10,510 specimens a week earlier. Among subtyped samples, influenza B accounted for 68.5%, down from 72.3% the week before. For the season overall, 68.1% of tested isolates were type A and 31.9% were type B, which often mounts a late-season surge.
May 27 CDC FluView report
GAO calls for improvements in FDA's handling of imported food risk data
In a report released yesterday, the US Government Accountability Office (GAO) requested that the US Food and Drug Administration (FDA) develop standards for how it will use open source data to predict risks posed by imported food.
The GAO, which serves as Congress's investigative arm, evaluated how data is collected and used by the FDA's Predictive Risk-based Evaluation for Dynamic Import Compliance Targeting (PREDICT), which generates risk scores for imported food based on information from government agencies and open-source tools (eg, domestic news, food recalls, and natural disaster reports).
The FDA used a standard protocol to collect and evaluate open-source data until 2015, after which it was replaced with informal methods, the GAO said. Though the GAO said that PREDICT appears to be working as intended, the agency expressed concern with the FDA's lack of documented processes for open-source information.
A 2013 FDA evaluation of PREDICT found 24 areas of improvement, though recommendations to reform 9 of those areas have not been fully implemented, the GAO said. The GAO recommended that the FDA document its process for identifying, collecting, and using open-source data and establish a timeline for implementing the 9 remaining improvements to PREDICT.
Approximately 15% of the nation's food supply is imported, a proportion that rises to 94% of seafood and 50% of fresh fruit. From 2012 to 2014, PREDICT risk scoring led to refusal of about 0.1% of imported food, the GAO said.
May 26 GAO report