News Scan for Jun 28, 2017

H7N9 illness cluster
Lassa fever in Nigeria
Somalia cholera outbreak
Jail order for egg execs
Hantavirus in Washington

WHO notes one more cluster among recent H7N9 cases in China

One more illness cluster has been reported among 21 recent H7N9 avian flu infections reported in China, the World Health Organization (WHO) said in an update today. Its report covers 9 lab-confirmed cases reported to the WHO by China on Jun 2 as well as 12 cases reported on Jun 9.

The cluster was reported in Shaanxi province in central China, involving a 68-year-old man who was sick in late May and his 67-year-old wife. Both had a history of exposure in neighboring Inner Mongolia province to chickens that they purchased at a market, then raised in their backyard. Some of the chickens died shortly after purchase by the couple, who had slaughtered some of them.

The WHO said the illnesses mark the first time Inner Mongolia has been reported as the location of likely H7N9 exposure and that the province had recently detected the virus for the first time, based on samples from live-bird markets. In early June, the first human case was reported in the province, involving a man from Bayannur City who was exposed to backyard poultry.

Also in today's report, the WHO said illness onsets for the 21 cases ranged from May 12 to Jun 3. One death was reported, and 17 patients had been exposed to poultry or their environments. Eight patients were reported to have pneumonia, while nine had severe pneumonia.

China is currently experiencing its fifth and largest wave of H7N9 activity, with at least 742 cases reported so far. According to the WHO, it has been notified of 1,533 cases since 2013, when the virus was first detected in humans.
Jun 28 WHO report


Nigeria's Lassa fever outbreak tops 500 suspected cases

In Nigeria, where Lassa fever is seasonal and endemic, health officials as of Jun 9 have reported 501 suspected cases, 104 of them fatal, since December 2016, the WHO said today.

Among the reported cases, 175 are lab-confirmed, 59 of them fatal. Also, 14 of the suspected cases, all fatal, have been classified as probable.

The outbreak has affected 17 of Nigeria's 36 states, and as of Jun 9 the disease is still active in 9 of them: Anambra, Bauchi, Cross-River, Edo, Taraba, Nasarawa, Ondo, Plateau, and Kano. Federal and state health officials are coordinating the outbreak response with the involvement of the WHO, the US Centers for Disease Control and Prevention (CDC), the University of Texas Medical Branch, and the African Field Epidemiology Network. Authorities have established Lassa fever treatment centers in affected states.

With the Lassa season almost past the seasonal peak months and cases declining, the risk of large-scale outbreaks isn't very high, the WHO said. However, it recommended that responders continue close follow-up, including active case findings, contact tracing, and support for lab activities and disease awareness.

Lassa fever is a viral hemorrhagic illness transmitted to humans through contact with food or household items contaminated with rodent urine or feces. The virus can also spread from human to human and via laboratory transmission.
Jun 28 WHO statement


Somalia cholera outbreak climbs to more than 53,000 cases

Though Somalia reported 1,979 cases of acute watery diarrhea or cholera cases last week, 13 of them fatal, cases declined 19% from the previous week, owing to the impact of interventions over the past months, the WHO's Eastern Mediterranean office said yesterday in an update.

Of the latest cases, 377 (17%) were in Wadajir district in Banadir region, one of four hard-hit regions. The others are Mudug, Galgadud, and Lower Shebelle.

Since Somalia's outbreak began in January, the country has recorded 53,015 cases, including 795 deaths. Just over half (53%) of the infections have been in children. The WHO added that the case-fatality rate of 1.5% is still above the 1% emergency threshold.

As part of the response, WHO and health ministry efforts have trained 54 health workers, and emergency response teams have treated 1,140 patients, including 75 who received care at cholera treatment centers and hospitals. More than 62 tons of emergency supplies and disease kits have been prepositioned in high-risk areas in all of Somalia's regions.

Severe drought in Somalia has displaced hundreds of thousands of people, creating a humanitarian emergency that has put 5.5 million people at risk of contracting waterborne diseases such as cholera.
Jun 27 WHO statement


Egg execs linked to Salmonella outbreak exhaust jail sentence appeals

Two egg industry executives who received prison sentences for their role in a 1,900-case Salmonella outbreak in 2010 must now serve their time, since the US Supreme Court in May declined to take up the appeal of their sentence.

US District Court Judge Mark Bennett signed incarceration orders for Jack DeCoster, age 82, and his 53-year-old son, Peter, Food Safety News (FSN) reported yesterday. In April 2015 after pleading guilty to a federal count of selling adulterated food, Bennett sentenced them to 3 months in jail. The plea agreement also included fines. Jail time for company executives is unusual for foodborne diseases cases.

According to the FSN report, the judge's order stipulates that the son will serve his sentence in a South Dakota prison, and his father will serve his sentence at a facility in New Hampshire.
Jun 27 FSN report
Apr 15, 2015, CIDRAP News scan "Egg execs face jail time for roles in 2010 Salmonella outbreak"


Washington state reports fourth hantavirus case of the year

A Skagit County resident has contracted the fourth case of hantavirus infection in Washington state this year, according to county health officials.

The patient, who was not identified, has recovered from the illness. Officials did not say whether the person had hantavirus pulmonary syndrome (HPS), a serious respiratory manifestation of the disease that can be deadly. The virus can also cause hemorrhagic fever with renal syndrome.

The new case is the first in the county this year but the fourth in the state, according to a Skagit County news release. Two of the 2017 cases were in King County, near Seattle, and involved HPS, according to a Public Health–Seattle & King County Apr 4 press release. Hantavirus is typically contracted through contact with the urine or feces of one of several rodents, including deer mice.

"We always encourage people to take precautions when cleaning old storage areas or buildings where mice can build nests," said Joanne Lynn, Skagit County environmental health manager. Skagit County is in northwestern Washington, north of Seattle.

The US Centers for Disease Control and Prevention does not track annual hantavirus infections, but last year it reported 659 HPS cases from 1993 through 2015, or about 29 cases a year.
Jun 26 Skagit County news release
Apr 4 Public Health–Seattle & King County press release
CDC information on hantavirus
CDC 2016 report on annual CPS cases

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