News Scan for Oct 30, 2018

Acute flaccid myelitis cases
;
Zika in monkeys
;
Evidence of MERS in camel workers
;
Bipartisan public health support

Suspected AFM reports climb to 191 as more cases confirmed

In its weekly update yesterday the US Centers for Disease Control and Prevention (CDC) said 36 more suspected acute flaccid myelitis (AFM) cases are under investigation, raising the national total since the first of the year to 191.

Also, 10 more suspected cases were confirmed as AFM, which requires a detailed review of a patient's clinical syndrome and radiographic findings, raising that number to 72. The confirmed cases are from 24 states, an increase of 2 from the previous week.

Earlier this month the CDC said that it and state health officials were investigating a spike in AFM, similar to steep rises that occurred in 2014 and 2016. The condition, marked by a sudden onset of polio-like symptoms that include limb weakness and decreased muscle tone, is extremely rare. So far, no consistent common cause has been found, but researchers are exploring possible roles for infectious diseases such as enterovirus D68 (EV-D68) and environmental toxins.

Most patients with AFM recover quickly, but paralysis symptoms persist for some, requiring ongoing care.

A recent study that compared the neurologic effects of past and recent EV-D68 clades in mice found that only the 2014 isolate from the United States damaged neuronal cells and that only the recent US strain caused paralysis symptoms in mice.
Oct 29 CDC AFM investigation update
Oct 16 CIDRAP News story "CDC, partners probe 127 polio-like cases in 22 states"

 

Brazilian monkeys infected with Zika hint at sylvatic transmission

Several Brazilian monkeys killed because of suspected yellow fever infections actually had Zika virus, which hints at a possible sylvatic transmission cycle previously unknown to researchers. Information on the discovery was published today in Scientific Reports.

Investigators looked at 82 non-human primate carcasses collected from January to June of 2017 in Brazil. Thirty-two (39%) tested positive for Zika in at least one tissue sample. Infected animals were found in Sao Jose do Rio Preto, Sao Paulo state; and in Belo Horizonte, Minas Gerais state. Viral loads were highest in the animals' kidneys, spleens, and brains.

"If the wild cycle is confirmed, it completely changes the epidemiology of Zika because it means there's a natural reservoir from which the virus can reinfect the human population much more frequently," said Mauricio Lacerda Nogueira, MD, PhD, principal investigator for the study, in a press release from the Sao Paulo Research Foundation (FAPESP), which funded the study

This is the first known discovery of the virus in monkeys since the current outbreak began in Brazil during the winter of 2015-16.
Oct 30 Sci Rep study
Oct 30 FAPESP press release

 

Study: Half of Saudi camel workers harbor MERS-CoV antibodies

A study today in mBio analyzed blood samples from 30 Saudi Arabian camel workers (CWs) and showed that half (15) tested positive for a MERS-CoV immune response but had no history of significant respiratory disease.

Another four CWs who tested seronegative for MERS-CoV (Middle East respiratory syndrome coronavirus) had specific T-cell responses, which indicated previous MERS-CoV infection. 

The study subjects were all adult males who worked at the Riyadh New Camel Market and reported contact with camel oral and nasal secretions and urine. Results were compared with samples collected from healthy controls in Riyadh and Iowa.

Though camel contact is a known risk factor for MERS transmission, a minority of MERS cases involve direct camel exposure. CWs, the authors suggest, may be acting as human reservoirs of the virus and exposing people who do not have direct camel contact.

"Our results indicate that a high proportion of CWs are infected, and this, combined with data demonstrating that patients with subclinical MERS are contagious, suggests a plausible mechanism for how patients without documented camel exposure become infected," the authors said. "It is possible that some healthy contacts of CWs are subclinically infected, while exposed individuals with underlying comorbidities or who are otherwise more susceptible develop clinical disease."
Oct 30 mBio study

 

Survey shows 89% of Americans deem public health important

Public health is a bipartisan issue, according to a new survey conducted by the de Beaumont Foundation, which found that 89% of participants said public health played an important role in the health of their community.

Two thirds of survey respondents said state government should ensure that citizens have access to basic public health protections, including clean air and water, government emergency services, and maternal and child health. Fifty-seven percent of those polled said they would pay more in taxes to ensure greater access to public health protections, according to the survey by the de Beaumont Foundation.

"Americans overwhelmingly value the protections public health departments deliver and want to ensure that every community has them,” said de Beaumont CEO Brian C. Castrucci, DrPH, MA, in a press release today. "While Americans seem divided on so many issues this election year, they are united in their support for public health because they understand the vital role it plays in their communities."

The survey was conducted via telephone between Aug 31 and Sep 8 of this year and included 1,000 voters nationally, with an over-sample of 498 voters in rural areas. It has a margin of error of plus or minus 3.1% for the national sample and 3.7% for the rural over-sample.
Oct 30 de Beaumont Foundation press release

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