News Scan for Jan 07, 2020

Ebola in DRC
Bacterial infections in drug users

Ebola case count hits 3,391 in DRC

After some fluctuations, the World Health Organization's (WHO's) online Ebola dashboard shows a case count of 3,391 today, with a single newly confirmed case since yesterday. One new death was also recorded, bringing the toll to 2,234 in an outbreak that has now lasted 17 months in the eastern region of the Democratic Republic of the Congo (DRC).

The WHO said 568 suspected cases are currently under investigation. The DRC's Ebola technical committee (CMRE) said two cases confirmed yesterday were in Mambasa, a village that had gone more than 2 months without local Ebola transmission until this week.

"The new confirmed cases in Mambasa are of concern, since there had been no new confirmed cases in Ituri Province for 66 days. Resistance to response activities continues, particularly in North Kivu Province," the WHO African regional office said in its weekly report yesterday. The regional office said six health zones and 11 health areas reported confirmed cases in the past 21 days, and officials confirmed 13 new cases and one new death from Dec 29 to Jan 5.

Katwa, Kalunguta, Butembo, Mambasa, and Mabalako have all reported confirmed cases in the past week.

Vaccination efforts continue throughout the outbreak region. The CMRE said that, as of Jan 2, 4,802 people had been vaccinated with the Johnson & Johnson vaccine, and 261,596 people have been vaccinated with Merck's rVSV-ZEBOV vaccine.
WHO Ebola
Jan 6 CMRE report
Jan 5 WHO African regional office report


Serious bacterial infections rising in those with substance use disorders

A study today in Clinical Infectious Diseases says substance use disorders (SUDs) rose from 19.9% in 2012 to 39.4% in 2017 in US adults, and that increase is tied to rising rates of hospitalization for severe infections in those patients.

The study was conducted by researchers from the Centers for Disease Control and Prevention with data from the Premier Healthcare Database, which includes more than 800 American hospitals in both rural and urban settings.

The authors looked at adult patients with a hospital discharge diagnosis of bacterial infections and secondary SUD diagnoses. Most notably, they found that, among patients ages 18 to 44 with SUD, rates of infective endocarditis (IE) doubled during the 5-year study period.

In general, the rate of hospitalizations with SUD increased from 1.1 to 2.1 per 100,000 people for IE, 1.4 to 2.4 per 100,000 people for osteomyelitis, 0.5 to 0.9 per 100,000 people for central nervous system abscesses, and 24.4 to 32.9 per 100,000 people for skin and other soft-tissue infections (SSTIs). In the general population (without SUD), rates of IE, osteomyelitis, central nervous system abscesses, and SSTIs remained stable between 2012 and 2017.

The authors found the microbiology of infections among SUD patients was different from that in non-SUD patients, which is likely because of the rise of SUD patients who inject drugs. "The finding that S. aureus and viridans streptococci were the most common pathogens among IE-SUD patients suggests that additional emphasis on strategies to prevent infections caused by inadvertent injection of skin and mouth flora could be important for prevention of endocarditis," they said.
Jan 7 Clin Infect Dis study

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