News Scan for Apr 26, 2017

Raw milk burden
Saudi MERS case
H9N2 case in China
New polio vaccine
Chikungunya in Pakistan

Study finds raw milk causes 840 times more illness than pasteurized

As more and more Americans consume unpasteurized, or "raw," milk and cheese, a new study in Emerging Infectious Disease found that the unpasteurized products cause 840 times more illnesses and 45 times more hospitalizations than their pasteurized counterparts.

Raw milk products are touted by alternative health enthusiasts, and an increasing number of states have decriminalized their sale and distribution.

The study used data from 2009 to 2014 to estimate outbreaks caused by Campylobacter, Salmonella, Shiga toxin–producing Escherichia coli (STEC), and Listeria monocytogenes in raw cow's milk and cheese made from cow's milk. Researchers used outbreak data from the National Outbreak Reporting System from 2009 through, and found a total of 87 outbreaks causing 750 laboratory-confirmed illnesses and 215 hospitalizations. Unpasteurized dairy products caused 96% of all outbreaks analyzed.

The authors said these numbers underrepresent the true burden of risk as they only considered four pathogens and many mild illnesses caused by the consumption of raw milk likely went unreported.

"Unpasteurized products are consumed by a small percentage of the US dairy consumers but cause 95% of illnesses," the authors concluded. "Therefore, outbreak-related illnesses will increase steadily as unpasteurized dairy consumption grows, likely driven largely by salmonellosis and campylobacteriosis."
Apr 26 Emerg Infect Dis study


Household contact case of MERS in Saudi Arabia

The Saudi Arabian Ministry of Health (MOH) identified another case of MERS-CoV related to the Wadi Aldwasir hospital outbreak.

The patient was a 26-year-old expatriate man who is in stable condition. The patient was asymptomatic and listed as a secondary household contact of a previously reported case.

The new cases raise Saudi Arabia's overall total to 1,597 Middle East Respiratory syndrome coronavirus (MERS-CoV) cases, 661 of them fatal. Three people are still being treated for their illnesses.
Apr 26 MOH update


H9N2 avian flu infects baby in China

China has reported a new H9N2 avian influenza case to the World Health Organization (WHO), involving an 11-month-old boy from Gansu province. The WHO noted the details in its monthly report on flu transmitted between animals and humans, spanning cases reported between Mar 16 and Apr 20.

The boy's symptoms began on Feb 6, and he was hospitalized with mild symptoms and recovered. An investigation revealed that he had been exposed to backyard poultry before becoming ill. The WHO said the illness marks the first H9N2 infection from Gansu province, which is located in northwestern China. H9N2 is endemic in Chinese poultry.

China's last H9N2 infection also involved a baby, a 7-month-old girl from Guangdong province who contracted her infection in the middle of December. Unlike H7N9, many of the H9N2 cases have been in children.
Apr 20 WHO flu at the animal-human interface report


New polio vaccine shows promise in phase 2 trial

A new inactivated polio vaccine with a reduced amount of antigen was found to be safe and effective during a phase 2 trial of the drug in the Dominican Republic. Results from the trial were published today in The Lancet Infectious Diseases.

Inactivated polio vaccines (IPVs) are a cornerstone of the polio eradication campaign because, unlike oral polio vaccines, they carry no risk of vaccine-related disease. Introducing IPVs into the developing world can be a costly task, however. This study measured the effectiveness of IPV alone and with various levels of aluminium hydroxide (Al) adjuvant as a dose-sparing measure.

More than 800 healthy infants over the age of 6 months were recruited to receive one of four IPV formulations (3-times reduced dose of Al, 5-times reduced dose, 10-times reduced dose, or IPV without Al) at 6, 10,  or 14 weeks of age. All three IPV-Al formulations were non-inferior to IPV, with absolute differences in percentage seroconversion for polio virus types 1, 2, and 3 to be above 94.6%.

"The results from our trial strongly support a dose sparing strategy of three doses of aluminium hydroxide adjuvanted 1/10 IPV-Al," the authors wrote. "The results of this phase 2 trial should be a first step to help achieve and sustain polio eradication in the long term by addressing the issue of availability of effective vaccine choices."
Apr 26 Lancet Infect Dis study
Apr 26 Lancet Infect Dis


Chikungunya spreads to second Pakistani province

The WHO and Pakistan's health ministry over the past few weeks have been investigating a chikungunya outbreaks in Balochistan, the second area in the country to report the disease. An earlier outbreak in Karachi has been under way since December.

A statement from the WHO's Eastern Mediterranean regional office yesterday said that, of 1,962 suspected cases in Balochistan, 28 blood samples have tested positive so far. A sudden rise in acute febrile illnesses in the city of Gwadar prompted the investigation and testing. A field investigation suggests that Balochistan's first cases came from Karachi via travel and that subsequent cases reflect local transmission.

In Karachi as of Apr 14, a total of 1,419 suspected cases have been reported so far, none of them fatal.

The WHO said because chikungunya is new to the populations, there is a fear that a large number of cases could occur within a short period without the control measures needed to contain the disease.
Apr 25 WHO EMRO statement

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