News Scan for May 17, 2019

Ebola in the DRC
Yellow fever mortality
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DRC confirms 17 new Ebola cases, total rises 1,777

The Democratic Republic of the Congo's (DRC's) ministry of health confirmed 17 new cases of Ebola today and 16 more deaths in the ongoing outbreak in North Kivu and Ituri provinces.

The new cases raise the outbreak total to 1,777 cases, including 1,177 deaths. A total of 333 suspected cases are still under investigation. Nine of the 16 deaths occurred in the community, which raises the risk of further transmission.

Five of the new cases originated in Butembo, four in Mabalako, two each in Katwa and Beni, and one case each in Vuhovi, Musienene, Biena, and Kalunguta.

Vaccination continues throughout the region. As of today, 118,029 people have been vaccine with Merck's VSV-EBOV vaccine.
May 17 DRC report


Study: Older age, high viral load associated with yellow fever deaths

A study published yesterday in The Lancet Infectious Diseases tracked the clinical outcomes of 76 Brazilian patients with yellow fever to establish predictors of mortality and found older age, elevated neutrophil count, and higher viral load all tied to higher death rates.

Yellow fever is a mosquito-borne virus with a 30% case-fatality rate. For the past 2 years Brazil has reported increased yellow fever transmission in a number of states; between January 2016 and June 2018, officials recorded 2,153 confirmed cases and 744 deaths in the country.

To conduct the study, researchers recruited 76 patients with lab-confirmed yellow fever treated at two tertiary hospitals in Sao Paolo City from January through May of 2018. Twenty-seven (36%) of the patients died within 2 months of hospital admission.

The authors found that all 11 patients with neutrophil counts of 4,000 cells per milliliter (mL) or greater and viral loads of 5.1 log10 copies/mL or greater died (95% confidence interval, 72% to 100%). Most of the patients who died were also men and older than 45 years.

"Identification of poor outcome markers could help guide resource allocation and strategies to provide intensive care for patients with potentially severe disease, supporting a rational approach during disease outbreaks," the authors concluded. The study was funded by the Sao Paulo Research Foundation.
May 16 Lancet Infect Dis study

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