News Scan for Feb 27, 2018

Lassa fever in Nigeria
Kenya chikungunya outbreak
Spread of resistant Pseudomonas

Nigeria Lassa fever outbreak grows, with 68 new cases reported

The Lassa fever outbreak in Nigeria continues this week with 68 new confirmed cases, including 4 deaths, according to the latest weekly update by the World Health Organization (WHO) Regional Office for Africa. That's up from 19 confirmed cases the week before.

Between Jan 1 and Feb 18, Nigeria has reported a total of 913 suspected cases and 73 deaths (case-fatality rate, 8%). The median age is 32, and two thirds of patients are male.

Though 17 states have reported suspected cases, Edo, Ondo and Ebonyi states are the outbreak hot spots, with Edo and Ondo accounting for 74% of confirmed cases. Those three states have established Lassa fever treatment centers, the WHO said. A total of 14 healthcare workers have been infected during this outbreak, 4 of them fatally.

Lassa fever is endemic in Nigeria, but this is an unusually large outbreak. The virus, which can cause hemorrhagic symptoms that mimic Ebola, is generally spread through contact with infected rats or via the bodily fluids of an infected person.
Feb 23 WHO


Chikungunya outbreak strikes Kenya's second-largest city

The WHO today said a chikungunya outbreak that began in the middle of December in Mombasa, Kenya's second-largest city, has so far sickened 453 people, with 32 of the cases confirmed by lab tests.

This is the first time that active chikungunya circulation has been confirmed in Mombasa, which has a population of 1.2 million and is rapidly growing, leading to overcrowding. The WHO said numerous dump sites, inadequate drainage, and stagnant water offer ample breeding sites for the mosquitoes that transmit the disease. The WHO also said vector-control programs are inadequate.

Health officials first noticed the outbreak when an increasing number of patients in Mombasa County sought medical care for high-grade fever, joint pain, and weakness. Of eight blood samples collected on Dec 13, 2017, and tested at a lab in Nairobi, four were positive for dengue and four for chikungunya. Of 32 more samples collected in early January, 27 were positive for chikungunya.

In response to the outbreak, the WHO said it is helping Kenya's health ministry write a chikungunya response plan and assist the national emergency operations center in analyzing data and developing situation reports. Authorities are stepping up vector control, and health officials have sent alerts and fact sheets to health facilities in affected areas.

The WHO said it can't rule out the risk of more transmission in affected areas and spread to unaffected areas.
Feb 27 WHO statement


Study: Drug-resistant Pseudomonas aeruginosa spreads on hospital wards

A new single-center study shows that most antibiotic-resistant Pseudomonas aeruginosa infections were transmitted on hospital wards, but researchers failed to identify a persistent source for the bacteria. The study was published today in Antimicrobial Resistance & Infection Control.

In 2003, multidrug-resistant strains of P aeruginosa emerged as a growing concern in the Dutch hospital studied, as they led to high rates of morbidity and mortality in hospitalized patients, especially those being treated in intensive care units (ICUs). This study aimed to identify epidemiologic relationships between patients infected with this strain and common transmission routes.

The researchers retrospectively matched cases at the Erasmus MC University Medical Centre in Rotterdam from 2003 to 2015. Of the 144 case-patients identified, 87 (60.4%) acquired their infection in general adult ICUs. But no relationship was identified between infection and room sharing, patient admission date, or medical staff.

"Our hypothesis is that persistent sources in the innate environment play an important role in the route of transmission of this pathogen," the authors said. "This is in agreement with current knowledge on the behaviour of this bacterium, as well as previous outbreak reports that identified the environment as source/reservoir."
Feb 27 Antimicrob Resist Infect Control

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