News Scan for Jun 30, 2016

More yellow fever
Saudi MERS cases
New chikungunya cases
FDA on raw dough
H5N1 in Ghana
Hand sanitizer rule

WHO reports more than 350 new cases of yellow fever in Angola, DRC

Yellow fever continues to sweep across border areas between Angola and the Democratic Republic of the Congo (DRC), according to the World Health Organization's (WHO's) weekly yellow fever situation report.

The WHO said there was a total of 3,464 suspected cases in Angola, of which 868 are lab-confirmed. That's 170 more cases than the organization reported last week. There were 6 more suspected deaths from the disease, bringing the total number of reported fatalities to 353 since the outbreak began in Luanda in January. Local transmission is occurring in 16 of the country's 18 provinces, with all provinces reporting cases of the mosquito-borne disease.

The report also notes that while yellow fever has mostly spread in urban areas in Angola, there's a high risk of neighboring countries experiencing an outbreak in the coming months. Many of those countries, including Namibia and Zambia, have low vaccination rates.

The DRC reports 201 new suspected cases and no new deaths. The total number of suspected cases is 1,307, with 68 confirmed cases and 75 reported deaths. Of the 68-lab confirmed cases, 59 were important from Angola.

A massive vaccination campaign is under way in both countries, as the WHO and Gavi, the Vaccine Alliance try to prevent an outbreak of yellow fever in Kinshasa, DRC, one of the biggest cities in Africa. On Jul 2, 3.3 million doses of yellow fever vaccine will be delivered in to the Kisenso district of Kinshasa.
Jun 30 WHO report
Related Jun 23 CIDRAP news story


Saudi Arabia: MERS outside of Riyadh, more asymptomatic cases

Saudi Arabia's Ministry of Health (MOH) reported two new MERS cases today, one of them fatal. The MOH described both patients as having primary exposure to the virus.

The first patient is a 40-year-old Saudi man from Dammam. He had symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus) and is in critical condition.

A 38-year-old man from Al Bahah died from his MERS-CoV infection. He was a non-national. Neither men were healthcare workers, nor connected to the current outbreak in Riyadh that began at King Khalid University hospital.

On Jun 28 the MOH released its weekly MERS report and noted that, of the 28 patients linked to the King Khalid University hospital this month, 21 had no symptoms. This could mean that efforts to screen healthcare workers who've had contact with MERS patients are improving, or the disease is weakening, the report said.

As of today, Saudi Arabia's MERS-CoV total cases since 2012 are 1,408, including 598 deaths (42.3% of cases).
Jun 30 daily MOH report
Jun 26 weekly MOH report


PAHO notes only 950 new chikungunya cases

The Pan American Health Organization (PAHO) late last week reported only 950 new chikungunya cases, bringing the 2016 total in the Americas to 149,403 infections.

In the previous 2 updates the agency had reported increases of 9,424 and 21,200 suspected and confirmed cases, respectively. PAHO's latest update was posted on Jun 24.

Colombia reported the most new cases, 449, to bring it to 16,747 cases for the year. Ecuador was next, with 134 new cases and 1,351 for the year. Of note, many countries have not updated their numbers for weeks.

PAHO reported no new chikungunya-related deaths, leaving that number at 17 for the year, 16 of which have been in Brazil.

The outbreak began in December 2013 on St. Martin in the Caribbean with the first recorded cases of the disease in the Americas. Since then PAHO has reported 2,029,370 suspected or confirmed cases, including 285 deaths.
Jun 24 PAHO update


FDA emphasizes risks posed by eating raw dough

In the wake of a multistate Escherichia coli O121 outbreak, the Food and Drug Administration (FDA) issued a special consumer warning yesterday about the danger of eating raw dough, pointing out that flour can carry live bacteria.

"People often understand the dangers of eating raw dough due to the presence of raw eggs and the associated risk with Salmonella," the agency said. "However, consumers should be aware that there are additional risks associated with the consumption of raw dough, such as particularly harmful strains of E coli in a product like flour."

The grains used to make flour come directly from the field and typically are not treated to kill bacteria, said Leslie Smoot, PhD, a senior advisor in the FDA's Office of Food Safety and a specialist in the microbiological safety of processed foods. "So if an animal heeds the call of nature in the field, bacteria from the animal waste could contaminate the grain, which is then harvested and milled into flour."

The agency warned against eating raw cookie dough or giving children raw dough or baking mixes that contain flour to play with.

On May 31 General Mills recalled 10 million pounds of flour because of the recent E coli O121 outbreak, which involved 38 cases in 20 states. Ten people were hospitalized, but no one died or suffered hemolytic uremic syndrome. The flour was sold nationwide under the brand names Gold Medal, Signature Kitchens, and Gold Medal Wondra.

The FDA said some of the recalled flours had been sold to restaurants that allow children to play with dough made from the raw flour while waiting for their meals. The agency added that the Centers for Disease Control and Prevention is advising restaurants not to give customers raw dough.
Jun 29 FDA statement


Two more poultry farms in Ghana hit by H5N1

Two farms in Ghana have lost more than 5,700 poultry as a result of the latest H5N1 avian influenza outbreaks there, according to a report the country's government filed with the World Organization for Animal Health (OIE) on Jun 28.

The larger of the two outbreaks started Jun 10 on a farm in south-central Ghana's Ashanti region that housed 4,808 birds, including chickens of various ages, ducks, turkeys, geese, and quail chicks. Officials said 3,132 birds died of the infection, and the rest were destroyed to stop its spread.

A farm in the area of Accra, the coastal capital, was the site of the other outbreak, which began Jun 11. The farm had 900 birds with the same mix of species as the other farm. Officials said 812 birds died, and the rest were culled as a precaution.

The H5N1 virus has caused a number of outbreaks in Ghana since it re-emerged there in June 2015.
Jun 28 OIE report


FDA seeks more scientific data on hand sanitizers

Consumer use of over-the-counter (OTC) topical antiseptic rubs (hand sanitizers) has increased faster than the data supporting their efficacy and safety, as reflected by a new FDA proposed rule seeking additional scientific data from manufacturers as to the products' efficacy and their safety for repeated daily use, issued yesterday.

No hand sanitizers are being removed from the market with the new rule, but companies marketing the products under the FDA's OTC Drug Product Review Process must now provide data on the safety of the agents' active ingredients, including absorption rates, and their effectiveness at removing bacteria from the skin, the FDA said in a press release. Of particular interest is the safety of daily long-term use and of use in particular populations, such as pregnant women and children, says the FDA.

Topical antiseptics, in use since the 1970s, have become more and more common for hand cleaning in a variety of settings, such as homes, schools, work, and other public places, where soap and water are not available or where the sanitizers are deemed more convenient. "Millions of Americans use antiseptic rubs daily, sometimes multiple times a day," says the release.

The new rule, intended to make sure that FDA's evaluations are "consistent, up-to-date and appropriately reflect current scientific knowledge and increasing use patterns," is based on input from an independent advisory committee.

Information is requested on three active ingredients—alcohol (ethanol or ethyl alcohol), isopropyl alcohol, and benzalkonium chloride, the FDA said. The rule will be open for public comment for 180 days, and companies will have 1 year to submit new data and information.
Jun 29 FDA press release
Jun 30 Federal Register proposed rule (with instructions for submission of comments)

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