News Scan for Jul 10, 2017

Cholera outbreaks expand
;
Tick-borne diseases in US
;
Zika and HIV co-infection
;
Chikungunya in the Americas

Cholera outbreaks expand; Yemen's total nears 300,000

Cholera outbreaks in countries in the World Health Organization (WHO) Eastern Mediterranean region have reached a critical point, and the WHO and its partners are scaling up efforts to reduce the risk of spread to unaffected areas and neighboring countries, the agency said in a statement today.

Mahmoud Fikri, the WHO's Eastern Mediterranean office director, said the number of cholera and acute watery diarrhea cases in the region so far this year has exceeded the global total for all of 2016. The WHO said cholera has spread to Somalia's northern region, which had been free of the disease for more than a decade. In Sudan, acute watery diarrhea was recently reported in a refugee camp in Darfur. The agency warned that an increasing number of people are at risk for the disease, due to worsening humanitarian conditions and lack of access to safe water and sanitation.

The WHO and UNICEF hosted a meeting in Lebanon on Jul 8 and 9 that focused on scaling up preparedness and response to the outbreaks in the region. They adopted a regional roadmap that focused on strengthening coordination, enhancing multisector response teams, decentralizing and expanding lab testing, reinforcing guidelines for case management and infection control, scaling up water and sanitation activities at the household level, and beefing up risk communication at the community level.

As of Jul 7 the cholera total in Yemen, the region's worst-hit country, rose to 297,438 cases, 1,706 of them fatal, the WHO said in a Jul 8 epidemiologic update. Cases have been reported in all but one of Yemen's 23 governorates. About 5,000 new suspected cases have been reported each day in the conflict-affected country.
Jul 10 WHO statement
Jul 8 WHO epidemiological
update

 

Rare tick-borne virus cases reported in Arkansas, Missouri

Recent reports from the Arkansas and Missouri departments of health describe infections with Heartland and Bourbon viruses, two rare tick-borne illnesses. One case was fatal.

Heartland virus is a newer illness transmitted via the bite of the Lone Star tick. The Arkansas Department of Health said late last week that a person living in the northwestern part of the state had been diagnosed with the disease, marking the state's first case. The disease has no specific treatment, but the person has made a full recovery after receiving supportive therapies at a local hospital.

To date, more than 20 people in the US have been diagnosed with Heartland virus infection, mostly in the southern and southeastern states. There has been one recorded death.

The virus causes a flu-like illness, including fever, headache, muscle aches, diarrhea, appetite loss, and fatigue.

In Missouri, state officials said a park worker has been diagnosed as having Bourbon disease, another tick-borne illness. A Jul 7 online newspaper report said the woman, who was a superintendent at Meramec State Park, died from complications of Bourbon virus after getting bitten sometime around Memorial Day.

Bourbon virus was discovered in Bourbon County, Kansas, in 2014, and there are no known treatments or vaccines for the disease. The virus can cause severe flu-like symptoms.
Jul 7 Arkansas Department of Health statement
Jun 30 Missouri Department of Health statement
Jul 7 eMissourian story

 

 

New study looks at Zika and HIV co-infection in pregnancy

The National Institutes of Health (NIH) launched a new prospective study today that looks at how maternal Zika virus and HIV co-infections in pregnancy affect outcomes for both mother and child.

According to a press release from the NIH, the study will enroll women with confirmed infections of both viruses, and look at how drugs used to treat HIV could exacerbate Zika infections.

The study will run for 4 to 6 years, and be conducted at research sites in Puerto Rico, Brazil, and the United States. An initial 200 women will be enrolled; they will be followed during pregnancy and for 6 months postpartum, and babies will be followed for up to 1 year after birth.

In other Zika news, the first case of the mosquito-borne disease was confirmed in Tamil Nadu, the southernmost state in India, the Times of India reported today. The World Health Organization announced in May that India had its first confirmed case of Zika. The new case is the fourth in the country.

Finally today, a new study conducted in pregnant mice showed that the malaria medicine hydroxychloroquine blocked maternal-fetal transmission of Zika virus. The study was published today in The Journal of Experimental Medicine.

Researchers hypothesized that hydroxychloroquine would suppress the autophagy response, a cellular waste-disposal process that the Zika virus seems to be able to turn to its advantage, according to a press release from the Washington University School of Medicine, site of the study. Mice treated with hydroxychloroquine on day 9 of their pregnancies had no Zika infection detected in placental samples and healthy offspring.
Jul 10 NIH press release
Jul 10 Times of India story
Jul 10 Washington University School of Medicine
press release

 

PAHO notes small rise in Americas chikungunya cases

Countries in the Americas reported 311 more chikungunya cases over the past week, according to a recent update from the Pan American Health Organization (PAHO).

The weekly total is down a bit from the 488 new cases reported by PAHO in the previous week. Totals each week can vary greatly, depending on how often countries report, especially bigger ones such as Brazil, where the mosquito-borne virus is still circulating.

Some of the new cases were from French Guiana, which reported 9 weeks' worth of cases, raising its number of suspected cases to 135 and the count of confirmed infections to 37. Other countries reporting small numbers of new cases include Costa Rica, El Salvador, Bolivia, Colombia, and Peru.

Nations in the Americas have reported 89,246 confirmed, suspected, and imported cases this year, mostly from Brazil. The death toll remained at 13.

Since the Americas outbreak began in 2013 in the Caribbean, the virus has sickened 2,476,274 people.
Jul 10 PAHO update

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