News Scan for Oct 09, 2019

Further US STD rise
Yellow fever in Nigeria
XDR typhoid in travelers
Sudan cholera outbreak

Group issues urgent call for battle against continued, dramatic STD rise

Based on new data from the US Centers for Disease Control and Prevention (CDC) showing that sexually transmitted disease (STD) levels hit an all-time high in 2018, the National Coalition of STD Directors (NCSD) yesterday issued an urgent call for more federal funding to battle the diseases.

In a press release, the NCSD said the increase follows 5 straight years of dramatic increases that it said are due to local, state, and federal cutbacks in funding for public health infrastructure that isn't well equipped to handle the growing threat.

The NCSD called for Congress to increase funding for the CDC's STD prevention services by $70 million, which it says is the bare minimum for responding to the crisis. It also called on the Department of Health and Human Services (HHS) to finalize and immediately implement the Federal Action Plan on STIs that it announced earlier this year.

Chlamydia, gonorrhea, and syphilis infections are nearing 2.4 million cases each year, up 30% in 5 years. According to CDC data, congenital syphilis cases rose 40% between 2017 and 2018, with deaths from the condition rising by 22%.

The CDC said yesterday in a press release that multiple factors are driving a continued increase in STDs. They include social problems, such as drug use, poverty, stigma, and unstable housing that can reduce access to STD prevention and care. Two other key factors are decreased condom use and cuts to public health programs.

David Harvey, the NCSD's executive director, said in the NCSD news release, "Babies dying from preventable conditions, like congenital syphilis, is not an outcome we can accept. This is a heartbreaking symptom of our nation's STD crisis. Without a radical shift in how we prioritize sexual health in the United States, we can only expect things to get worse."
Oct 8 NCSD press release
Oct 8 CDC
press release
CDC 2018 STD surveillance page


WHO: Yellow fever outbreak in Nigeria connected to game reserve

According to a World Health Organization (WHO) update yesterday, Nigeria is battling a new yellow fever outbreak involving 231 suspected cases near the Yankari game reserve in Alkaleri. 

"This is the first time that cases have been reported in relation to this area since the outbreak started in Nigeria in September 2017," the WHO said. "This outbreak is unique in the broad geographic distribution of cases, most with linkage through travel, work or residence in, or close to, the Yankari game reserve, which is an ecological zone highly prone to yellow fever virus circulation."

Nigeria is also facing an ongoing yellow fever outbreak based in Ebonyi state, which, as of late September, had at least 84 suspected cases and 26 deaths.

The Nigerian Centre for Disease Control said four states have recorded cases in the Yankari outbreak: Bauchi, Borno, Gombe, and Kano. Of the 24 confirmed cases in this outbreak, 6 patients have died, resulting in a case-fatality rate of 25%.

From Jan 1 to Aug 31 of this year, Nigeria has tracked 2,254 suspected yellow fever cases across the country. Yellow fever immunizations were introduced into the national vaccine schedule in 2004, but population coverage is still lacking throughout most of the country, the WHO said.
Oct 8 WHO


ECDC, CDC warn of extensively drug-resistant typhoid in Pakistan 

Several countries around the world have reported an uptick of extensively drug-resistant (XDR) typhoid fever, the European Centre for Disease Prevention and Control (ECDC) said in a news release today.

According to the ECDC, recent visitors to Pakistan from the United States, Canada, United Kingdom, Denmark, Taiwan, and Australia have contracted XDR typhoid in Pakistan, a strain unresponsive to most antibiotics, such as ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, ciprofloxacin, and ceftriaxone. 

In today's release, the ECDC provided details on cases in Ireland. Irish authorities have reported 23 typhoid cases have in 2019, of which 12 involved recent travel to Pakistan. Three of the 12 patients with travel history in Pakistan were infected with XDR strains, the ECDC said.

The US Centers for Disease Control and Prevention (CDC), meanwhile, has issued a level 1 travel alert over XDR typhoid cases tied to travel to Pakistan. 

The CDC recommends all travelers planning a trip to Pakistan get a typhoid fever vaccination at least 2 weeks before traveling. A level 1 "watch" alert is the lowest of the CDC's three stages and means travelers should practice "usual precautions."

Typhoid fever is caused by the bacterium Salmonella Typhi and spread through contaminated food and water.
Oct 9 ECDC
news release
Sep 30 CDC


More cholera seen in Sudan outbreak 

Officials in Sudan's Blue Nile state have recorded 32 more suspected cases of cholera in an ongoing outbreak in Blue Nile State, according to the latest update from the WHO today.

From Aug 28 to Oct 8, officials have noted 247 suspected cholera cases, including 8 deaths (case-fatality rate of 3.2%).

"The current outbreak was reported following recent severe rainstorms and flooding in 15 out of 18 States. As a result of the flooding, the country reported widespread damage to infrastructure, thus more cholera cases can be expected in the future. Although Blue Nile State shares borders with Ethiopia and South Sudan, there is currently no evidence of cross-border spread of the outbreak," the WHO said. 

Cholera is caused by ingesting food or water contaminated with the Vibrio cholerae bacterium. Patients who develop cholera experience watery diarrhea, which can lead to severe dehydration and death. Sudan last saw a major cholera outbreak from 2016 to 2018, which involved 37,000 cases and 823 deaths.
Oct 9 WHO

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