News Scan for May 19, 2017

Saudi MERS cases
Unfilled CDC positions
Dengue and preterm birth
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Two new MERS cases reported in Saudi Arabia

The Saudi Arabian Ministry of Health (MOH) reported two  new cases of MERS-CoV today.

A 63-year-old Saudi man in Riyadh is in stable condition after presenting with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus). The patient's infection is listed as  "primary," meaning it's unlikely he contracted the virus from another person. It is not known at this time if his case is linked to a small hospital outbreak occurring in Riyadh.

The second patient is a 43-year-old Saudi man from Al Muhanna. He is also in stable condition after presenting with symptoms. The man had direct contact with camels, a known risk factor for MERS.

The latest infections raise Saudi Arabia's number of MERS cases since the disease was first detected in humans in 2012 to 1,611, which now includes 666 deaths. Five people are still being treated for their infections.
Mar 19 MOH update


Federal hiring freeze has left 700 key CDC positions unfilled

Almost 700 positions have been left vacant at the US Centers for Disease Control and Prevention (CDC) because of a continuing Trump administration freeze on hiring, which hinders public health readiness, infectious disease control, and chronic disease prevention, the Washington Post reported today.

The freeze affects the Department of Health and Human Services (HHS) as a whole, the agency that oversees the CDC, Food and Drug Administration, National Institutes of Health, and other organizations. HHS also faces significant Trump administration budget cuts, and it must submit a plan by Jun 30 to constrict its civilian workforce.

Though HHS has exempted many positions from the freeze, including physicians and personnel who respond to public health emergencies, many crucial support positions have gone unfilled. Affected sectors include the Office of Public Health Preparedness and Response, the director's office, infectious disease offices, and the Office of Noncommunicable Diseases, Injury and Environmental Health.

An unnamed senior CDC official told the Post that unfilled positions include dozens of budget analysts and public health policy analysts, scientists, and advisers who provide administrative support. Their duties include tracking federal contracts awarded to state and local health departments and ensuring the supply of adequate lab equipment.

President Trump has yet to announce a permanent replacement for former CDC Director Tom Frieden, MD, MPH, who stepped down in January.
May 19 Washington Post story


Large study shows dengue in pregnancy might increase preterm births

Dengue infection during pregnancy might raise the risk of preterm birth but does not affect rates of congenital defects or low birth weight, according to the results of a large retrospective cohort study in Brazil published yesterday in The Lancet Infectious Diseases.

Brazilian researchers analyzed data from 2007 to 2013 involving 3,898 dengue-positive pregnant women, 3,165 dengue-negative pregnant women, and 3,898 newborn babies from the reference population.

After adjusting for multiple variables, they found the dengue-positive women had a 26% higher risk of preterm births than the dengue-negative women. And, reaffirming results that have been reported in smaller studies, they found no elevated rates of birth defects or of low birth weight. The study was funded by Sanofi Pasteur.

In an accompanying commentary, two Brazilian scientists not involved in the study wrote, "The association between preterm birth and dengue virus infection in pregnant woman is biologically plausible, because the intense inflammation reaction triggered by maternal infection can indirectly stimulate uterine contractions leading to preterm delivery. . . We recommend close monitoring of pregnancies in areas with concurrent circulation of several arboviruses and where differentiating between dengue, Zika, and chikungunya virus infections is challenging."

They add, "This is the largest dengue population studied so far, which provides baseline data before the introduction of chikungunya and Zika viruses to the country."
May 18 Lancet Infect Dis study
May 18 Lancet Infect Dis

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