News Scan for Jan 25, 2017

News brief

Another MERS case reported in Saudi Arabia

The Saudi Arabian Ministry of Health (MOH) today reported a new case of MERS-CoV in the city of Jeddah.

A 48-year-old expatriate man is in critical condition after presenting with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus).The source of his infection is listed as primary, meaning he did not contract the disease from another person.

MERS-CoV is a severe respiratory virus that can be transmitted easily in healthcare settings and households. Contact with camels, including drinking raw camel milk, has also been linked to transmission of the virus.

The new case raises Saudi Arabia's MERS-CoV total to 1,545 infections, including 641 deaths. Eight people are still in treatment or monitoring.
Jan 25 MOH update

WHO board narrows director-general list to 3 candidates

The World Health Organization's (WHO's) executive board meeting in Geneva today interviewed five candidates for the next director-general and voted to narrow the list to three, according to a statement today. The short list, up for a member-nation vote at the World Health Assembly (WHA) in May, includes:

Tedros Adhanom Ghebreyesus, PhD, from Ethiopia, who is currently the country's foreign affairs minister and was its former health minister
David Nabarro, MD, from the United Kingdom, who is currently a special adviser to the United Nations secretary-general and has led UN and WHO infectious disease and health emergency efforts
Sania Nishtar, MD, from Pakistan, who is a former health minister and leads a nonprofit group aimed at improving health systems in Pakistan.

The three candidates, all of whom have extensive experience in global health, will participate in interviews tomorrow with the media ahead of the WHA vote. The new director-general will take office on Jul 1.
Jan 25 WHO statement

Probe into rat-linked Seoul virus infections spreads to more states

The investigation into the nation's first known outbreak of Seoul virus linked to rats from breeding facilities has spread beyond Illinois and Wisconsin to 10 more states that have received the animals, the US Centers for Disease Control and Prevention (CDC) said yesterday in a Health Alert Network (HAN) notice to health providers.

The hantavirus infected six people in Illinois and two in Wisconsin who were involved with rat-breeding operations, and the ongoing investigation into where the rats were distributed to identify people at risk found that residents of the following states may also have infected rates: Alabama, Arkansas, Colorado, Indiana, Louisiana, Michigan, Minnesota, South Carolina, Tennessee, and Utah.

No new cases have been reported since the CDC's initial outbreak announcement on Jan 20 of the eight cases.

In its HAN notice, the CDC included testing recommendations, covering those who have recent or current symptoms after handling rats from facilities that sold infected animals. In general, the agency recommends that clinicians consider hantavirus testing in all people with Seoul virus infection and rat contact, even if the rats aren't linked to a breeder connected to the outbreak.
Jan 24 CDC HAN notice
Jan 20 CIDRAP News scan "CDC: Rat-linked Seoul virus cases reported in 2 states"

Study shows nasal MRSA in med students before healthcare exposure

A small study from Israel showed that carriage of methicillin-resistant Staphylococcus aureus (MRSA) can occur in the noses of medical students even before they have healthcare exposure, indicating community acquisition of hospital strains, according to the findings in Antimicrobial Resistance and Infection Control.

The investigators followed 58 medical students for 19 months, noting that S aureus carriage steadily increased in their nasal specimens, from 33% at baseline to 38% at 13 months and 41% at 19 months. They also noted that 7 students (12%) carried 13 MRSA isolates, and that MRSA was found in 4 of them before they began their clinical rotations. Two of those students carried different MRSA strains at various times, and 1 had persistent nasal carriage of MRSA.

The authors concluded, "Compared with previous reports, higher rates of MRSA carriage were evident. . . . carriage occurred largely before healthcare exposure, implying community-acquisition of hospital strains."
Jan 23 Antimicrob Resist Infect Control study

Flu Scan for Jan 25, 2017

News brief

China's H7N9 avian flu cases continue to climb

With novel H7N9 avian influenza cases in China this month already topping an early, steep surge seen in December, two provinces reported four more cases, according to official sources, as US officials posted a travel alert because of the spike in infections.

China is in its fifth wave of H7N9 activity and is just days away from the Lunar New Year holiday, a time of increased poultry trade and consumption, as well as travel. The United Nations Food and Agriculture Organization (FAO) yesterday posted an update on human illnesses and poultry developments, which included an epidemiologic curve showing cases this month running ahead of December. The FAO said 109 new human cases have been reported since its last update on Jan 10, boosting the global overall total since the virus emerged in 2013 to 1,040 cases, 368 of them fatal.

The FAO report also said provincial and agriculture ministry sampling has turned up the virus in markets, a farm, and a slaughterhouse, with a 9.42% positive rate in Guangdong province market samples. A serology study of poultry in several Chinese provinces (Gansu, Jiangsu, Qinghai, Shanxi, and Liaoning) found 349 positive H7 samples. More cities in Guangdong, Zhejiang, and Anhui province have temporarily suspended poultry trade.

Meanwhile, in the newest developments with human cases, Hong Kong's Centre for Health Protection (CHP) said two more H7N9 cases have been reported in Henan, both involvnig men, ages 59 and 36, who died from their infections. And Hubei province yesterday reported two new infections, in a 65-year-old man who had poultry market exposure, and a 78-year-old woman, according to a provincial health department statement translated and posted by FluTrackers, an infectious disease news message board.

The US Centers for Disease Control and Prevention (CDC), meanwhile, published an H7N9-related travel alert for visitors to China, Hong Kong, and Macau, all of which have reported cases this year. The alert is for the lowest level of the three possible: "watch," which means that travelers should practice "usual precautions."
Jan 24 FAO H7N9 update
Jan 25 CHP statement
Jan 25 FluTrackers thread
Jan 25 CDC travel alert

Flu numbers rise in most of Northern Hemisphere

Influenza cases continue to rise in North America, while an early start to the flu season in Asia and Europe has led to a steady stream of cases in those regions, according to the World Health Organization's (WHO's) weekly flu update yesterday.

According to the update, the H3N2 strain is predominating in North America. In the United States, influenza-like illnesslevels were above the seasonal thresholds and respiratory syncytial virus activity was still being reported. So far, most influenza samples tested in North America have been antigenically matched to the reference viruses used in the 2016-17 flu vaccine.

H3N2 is also the most prominent subtype circulating in Europe and East Asia. The WHO said several Eastern European countries reported a steep rise in cases in early 2017.

Worldwide, 96.4% of tested samples collected between Dec 26 and Jan 8 were typed as influenza A and 3.6% as influenza B. Only West Africa is reporting more influenza B activity than influenza A. Of the "A" viruses subtyped, 97.4% were H3N2.
Jan 24 WHO flu update