News Scan for Jul 26, 2017

Saudi MERS case
Flu vaccine and frailty
Papaya Salmonella advisory

New MERS case reported in Riyadh

Saudi Arabia’s Ministry of Health (MOH) reported a new MERS case today, the first case since Jul 11.

The patient is a 57-year-old expatriate man from Riyadh.  He presented with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus) infection and is in stable condition. The probable source of his infection is listed as primary, which means it's unlikely he contracted the virus from someone else. He is not a healthcare worker.  

As of today, Saudi Arabia's MERS-CoV total cases since 2012 total 1,680, including 684 deaths. Three people are still being treated for infections.
Jul 26 MOH report


Study: flu vaccine effectiveness in seniors declines as frailty rises

Trivalent flu vaccine afforded good protection against influenza in healthy older adults, but the benefit diminished in those who were frailer, Canadian researchers reported today in the Journal of Infectious Diseases.

The prospective, test-negative case-control study included patients age 65 or older from 38 academic and community hospitals from six provinces, mainly from Ontario, during the 2011-12 flu season. The research team used a validated index to measure frailty. They enrolled 320 cases and 564 controls; 601 had been vaccinated. The mean age was 80.6 and 78.7 years, respectively. Cases had a higher frailty baseline than controls.

In their adjusted model, the investigators found that vaccine effectiveness (VE) against hospitalization was 58.0% (95% confidence interval [CI], 34.2% to 73.2%). Adjusting for just frailty yielded a VE estimate of 58.7% (95% CI, 36.2% to 73.2%). However, among healthy older people, VE was 77.6%, declining as frailty increased.

The researchers concluded that the findings challenge commonly held views that VE is poor in older adults and that it helps prevent hospitalization, but with an effect that declines as seniors become frailer. They suggested that frailty is the most important confounder when estimating VE for older adults, and future studies on the impact of flu vaccine in older age-groups should account for frailty.
Jul 26 J Infect Dis abstract


Federal officials urge avoidance of Caribena Maradol papayas from Mexico

In an update into a papaya-linked Salmonella outbreak investigation, the Food and Drug Administration (FDA) yesterday warned consumers to avoid all Caribena brand Maradol papayas. The FDA said it took the step because Texas-based Grande Produce, which distributes the brand, has initiated a limited recall but has not issued a press release to notify consumers about it.

The FDA said Grande Produce's recall affects papayas it distributed nationwide from Jul 7 to Jul 18. The FDA also said illnesses have been reported in states where Grande Produce did not distribute papayas and that it's continuing its investigation.

In an update yesterday the CDC said epidemiologic and lab evidence points to Maradol papayas imported from Mexico as the source of the outbreak. It said so far Caribena brand papayas from Mexico have been identified in the outbreak, but additional brands will be announced as the information becomes available. It urged consumers not to eat, restaurants not to serve, and retailers not to sell Maradol papayas from Mexico.

On Jul 21 the US Centers for Disease Control and Prevention (CDC) announced that a Salmonella Kiambu outbreak likely linked to Maradol papayas has sickened 47 people in 12 states, one of them fatally. The large, oval fruits weigh 3 or more pounds and have green skin that turns yellow when the fruit is ripe. The papayas have salmon-colored flesh.
Jul 25 FDA update
Jul 25 CDC update
Jul 24 CIDRAP News story "Papaya-linked Salmonella outbreak sickens 47 in 12 states"

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