News Scan for Sep 01, 2017

Saudi MERS infection
New polio cases
ESBL E coli in Germany

Another asymptomatic MERS case reported in a Saudi household contact

The Saudi Arabian Ministry of Health (MOH) today reported another MERS-CoV case involving contact with another patient in Dumah Al Jandal.

It's not known if the new case is related to a hospital outbreak in that city first reported a month ago. The MOH on Aug 30 confirmed two similar MERS-CoV (Middle East respiratory syndrome coronavirus) cases in the same city.

Today's patient is a 21-year-old Saudi woman (the cases 2 days ago involved Saudi women 22 and 18 years old). As with the previous two cases, the 21-year-old woman is listed as a secondary household contact, has had no symptoms, and is in stable condition.

Yesterday the MOH reported the death of a previously announced MERS patient, a 69-year-old male expatriate in Jeddah. He was not a healthcare worker and had preexisting disease.

Saudi Arabia's MERS-CoV case count since 2012 has now reached 1,707, including 693 deaths. Seven patients are still being treated, according to the MOH.
Sep 1 Saudi MOH report
Aug 30 Saudi MOH


Syria, DRC report new vaccine-derived polio cases

According to the Global Polio Eradication Initiative (GPEI), Syria reported six new vaccine-derived polio cases (cVDPV2) this week, and the Democratic Republic of the Congo (DRC) reported one case of vaccine-derived polio. The new cases bring 2017's total number of vaccine-derived polio infections so far to 47, a dramatic increase from 2016's total of 3.

Syria has had 39 vaccine-derived cases in 2017. The six new cases confirmed this week are in Deir ez-Zour governorate, the epicenter of this year's outbreak activity. Paralysis onset was reported between Mar 3 and Jul 10. Healthcare workers are conducting a second round of oral polio vaccination in affected areas of Syria.

The DRC case was recorded in Haut Lomami province, with onset of paralysis on Jun 20. A total of 750,000 children under the age of 5 were targeted in vaccine campaigns throughout the summer.

The GPEI said it's likely both Syria and the DRC will report more vaccine-derived cases in the coming weeks.
Sep 1 GPEI update


Study: CTX-M-27 gene emerging in clinical E coli isolates in Germany

German researchers have found a significant increase in strains of Escherichia coli carrying a gene linked to extended-spectrum beta-lactamase (ESBL) production, according to a study yesterday in Emerging Infectious Diseases.

The researchers analyzed a representative subset of 953 sequenced isolates from ESBL-producing E coli isolates collected from livestock, humans, companion animals, food, and the environment during 2009 to 2016. They were specifically looking for the CTX-M-27 allele in E coli sequence type (ST) 131, which has emerged globally as a prevalent vehicle for ESBL. While ESBL production in certain clades of E coli ST131 associated with urinary tract infections and bacteremia is generally conferred by the CTX-M-15 allele, recent reports from Japan and France have documented an increase of C1-M27 clade isolates.

Multilocus sequence typing identified 159 (17%) of the 953 isolates as ST131. The most prevalent ESBL genes in the ST131 isolates were CTX-M-15 (73[46%]), CTX-M-27 (24[15%]), CTX-M-1 (18[11%]), and CTX-M-14 (15[9%]). CTX-M-27 was present exclusively in clinical isolates, and its incidence increased from 0% in 2009 to 45% in 2016, with 19 of the 24 isolates obtained in 2015 and 2016.

"The data suggest an ongoing shift in CTX-M alleles associated with ST131 infections worldwide that now warrants further attention," the authors write.
Aug 31 Emerg Infect Dis research letter

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