News Scan for Sep 12, 2016

New MERS cases
Chikungunya cases, study
Yellow fever slowdown
Bacteria in water

New MERS cases in Saudi Arabia, Austria

Yesterday the Saudi Arabia Ministry of Health (MOH) said there was a new case of MERS in the city of Arar, while Austrian officials reported a case in a tourist from Saudi Arabia.

A 56-year-old man is in stable condition after presenting with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus). He had direct contact with camels, prompting the MOH to describe him as a primary source of the disease. Contact with camels has been the main source of recent infections in the country, which has seen a slowdown of new cases this summer.

Saudi Arabia's MERS case count has now reached 1,451, including 610 deaths, and 2 patients are still being treated, according to the MOH.

In related news, today the Austrian Ministry of Health reported that a 67-year-old Saudi tourist was hospitalized and diagnosed as having MERS while visiting Salzburg, Outbreak News Today reported today. This is the second case of imported MERS in Austria; the first occurred in 2014.
Sep 11 MOH report
Sep 12 Outbreak News Today report


PAHO reports 510 new chikungunya cases

Countries and territories in the Americas reported only 510 new cases of chikungunya last week, raising the 2016 total to 253,020, the Pan American Health Organization (PAHO) reported late last week, while a new study notes that transmission from mothers to newborns is a concern.

Costa Rica reported the most new cases in the Sep 9 update. It had 223 new infections, bringing its 2016 total to 2,400 cases. Colombia was next with 138 new cases, and 18,697 total. Most countries, however, have not reported on their chikungunya cases for weeks, including Brazil, which has had by far the most cases this year (169,656).

The previous weekly PAHO updates included 1,428 and 290 new cases, respectively, in the Americas. PAHO reported no new deaths, keeping that number at 54.
Sep 9 PAHO report

In the study, published Sep 9 in the International Journal of Infectious Diseases, researchers analyzed data on 169 symptomatic newborns who had lab-confirmed chikungunya infections at four major hospitals in three Central and South American nations.

They found that the rates of transmission from mother to child ranged from 27.7% to 48.3%. Only one center reported deaths, for a case fatality rate in that hospital of 5.3%.
Sep 9 Int J Infect Dis study


No new cases of yellow fever in Angola, DRC

The World Health Organization (WHO) released its yellow fever situation report late last week, and Angola and the Democratic Republic of Congo (DRC) reported no new cases. The news comes 1 week after health officials in Uganda declared the yellow fever outbreak over in that country.

Angola reported its most recent case of yellow fever on Jun 23, and the DRC on Jul 12. On Aug 30, the WHO said that yellow fever still did not constitute a Public Health Emergency of International Concern (PHEIC).

The WHO said the massive vaccine campaign that began in mid-August in Kinshasa, DRC, has been successfully completed before the rainy season begins later this month. According to the WHO, administrative vaccine coverage reached 98.2% in Kinshasa, where fractioned doses of the yellow fever vaccine were used to target the city's 11 million inhabitants.

Four million additional doses of yellow fever vaccine are in the stockpile, the WHO said, enough to complete any remaining targeted vaccination campaigns.
Sep 9 WHO situation report
Aug 31 CIDRAP News Story "WHO: Yellow fever not a public health emergency"


Plumbing pathogens costly and increasingly resistant to antibiotics

A study today in the Journal of Public Health Policy examined US hospitalizations caused by opportunistic premise plumbing pathogens (OPPP) like legionellosis from 1991 to 2006 and found they are costly, especially among those over the age of 65. Additionally, growing antibiotic resistance to OPPP raises the economic burden of disease.

After looking at 100 million Medicare records, researchers identified 617,291 hospitalized infections caused by three OPPPs: Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa. Calculations showed that the three OPPP infections in elderly patients cost about $600 million per year over the study period. Antibiotic resistance was present in about 2% of those cases, but when it was present, it was resistant to multiple drugs.

The authors said that increased surveillance for OPPP is needed, especially because aging infrastructure allows pathogens to flourish in drinking water. They also note that infections with L pneumophila, which causes Legionnaires' disease, are on the rise. From 2001 to 2006 Legionella was responsible for 29% of drinking water outbreaks of OPPPs.

In related news, today the Minnesota Department of Health (MDH) said officials were investigating a cluster of five cases of Legionnaires' disease in Hopkins, Minnesota. All five patients were hospitalized. This is the first cluster of cases reported in 2016 in the state.

Investigators do not know the source of the outbreak but are looking at pumping systems, fountains, and cooling towers. Legionnaires' disease occurs when someone inhales an infected spray from a water source. It cannot be passed person-to-person.

The MDH said the state has already seen more than 60 cases this year, already surpassing the average of 50 cases per year.
Sep 12 J Public Health Policy study
Sep 9 MDH press release

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