News Scan for Jan 10, 2020

Ebola case in DRC
MERS illness, antiviral treatment
Polio in 3 countries
Gaza measles outbreak
; ; ; ;

New Ebola case in DRC lifts outbreak total to 3,393

A new Ebola case confirmed in the Democratic Republic of the Congo (DRC) has raised the outbreak total to 3,393 cases, and another death has raised the fatality total to 2,235.

Officials are still investigating 480 suspected cases, according to the World Health Organization's (WHO's) online Ebola dashboard.

In a weekly update yesterday, the WHO said 12 newly confirmed cases were reported in the outbreak from Jan 1 to Jan 7, with 5 cases in Butembo, 4 in Mambasa, 2 in Mangina, and 1 in Beni. The new case in Beni is linked to a large transmission chain that originated in the Aloya health area in Mabalako.

Seventy-six percent of recent cases (31 of 41) have known transmission chains. "The sources of exposure for five new cases reported in Kalunguta Health Zone and four new cases reported in Mambasa Health Zone in the past 21 days are currently under investigation," the WHO said.

The DRC's Ebola technical committee (CMRE) said in a report yesterday that vaccination efforts still continue, with 262,682 people vaccinated with Merck's rVSV-ZEBOV, and 4,802 people with Johnson & Johnson's Ebola vaccine.
WHO Ebola dashboard
Jan 9 WHO disease outbreak news udpate
Jan 9 CMRE


MERS infects 1 more in Saudi Arabia; antiviral study shows potential

Saudi Arabia's Ministry of Health (MOH) today reported one more MERS-CoV case, the third to be reported in January. Also today, researchers published a preclinical study showing that the broad-spectrum antiviral remdesivir as a potential treatment for MERS-CoV (Middle East respiratory syndrome coronavirus).

The patient is a 64-year-old man from the city of Buraydah in the central part of the country, about 200 miles northwest of Riyadh. No contact with camels before symptom onset was reported, and his exposure is listed as primary, meaning he didn't likely contract MERS from another patient.

In a recent update on MERS-CoV earlier this week, the WHO said it had received 2,494 cases since the virus was first detected in people in 2012, mostly from Saudi Arabia. At least 858 deaths have been reported.
Jan 10 Saudi MOH statement

Today's study, in Nature Communications, compared the experimental drug remdesivir against a combination treatment being studied in patients with the disease in Saudi Arabia and found that remdesivir showed superior antiviral activity against the virus in cell culture and in mice. Also, at therapeutic doses, remdesivir significantly reduced lung damage.

The combination treatment under study in Saudi Arabia is lopinavir, ritonavir, and interferon beta. In the new study, in vitro experiments found that remdesivir and interferon had superior antiviral activity to lopinavir and ritonavir. In transgenic mice, both prophylactic and therapeutic doses of remdesivir improved lung function and reduced lung viral loads and severe pathology.

The researchers also found that the prophylactic combination therapy slightly reduced viral loads without affecting other disease measures and that therapeutic combo therapy improved lung function but didn't reduce virus replication in severe disease. The team said the findings were similar to their earlier studies on remdesivir and severe acute respiratory syndrome coronavirus (SARS) and show evidence of the potential to treat MERS-CoV.

In a related blog post, the study's first author, Timothy Sheahan, PhD, of the University of North Carolina, wrote that the evolving coronavirus outbreak in Wuhan, China (see related story today), shows the need for drugs against emerging viruses, especially coronaviruses.
Jan 10 Nat Comm study
Jan 10 Nature Research Microbiology blog post on the study


Three countries report more polio cases, including 11 in Pakistan

Three countries—Afghanistan, Pakistan, and Zambia—reported new polio cases, according to the latest weekly update today from the Global Polio Eradication Initiative (GPEI).

Afghanistan reported two more wild poliovirus type 1 (WPV1) cases, one in Farah province with a Nov 25 paralysis onset and one in Kandahar province with a Dec 7 paralysis onset. The country has now reported 28 WPV1 cases for 2019, up from the 21 it reported in 2018.

Neighboring Pakistan reported 11 more WPV1 cases, including 3 in Sindh province, 6 in Khyber Pakhtunkhwa province, and 2 in Balochistan province. Paralysis onsets range from Nov 2 to Dec 22. The new cases lift the country's total for 2019 to 128, up sharply from the 12 it reported in the previous year.

Elsewhere, Zambia reported one more circulating vaccine-derived poliovirus type 2 case, which was reported from North-Western province involving a patient with a Nov 25 paralysis onset. The country now has two such cases in its first outbreak involving the strain.
Jan 10 GPEI update


Gaza Strip reports 124 measles cases in 2019

Through Dec 19 the Gaza Strip in the Middle East has had 124 lab-confirmed measles cases in 2019, including 2 deaths, the WHO said yesterday in an update, while European officials today reported a decline in cases in November.

Of the confirmed cases in the Gaza Strip, 49 patients (40%) required hospitalization and 12 (10%) involved healthcare workers. Fifty-seven patients (46%) were unvaccinated, including 28 infants. From 2009 to 2018, the region has had a 97% immunization coverage for the second dose of measles-containing vaccine, which is above the WHO's 95% target rate.

From 1986 to 2018, only one measles case was recorded in the Gaza Strip.
Jan 9 WHO update

The European Centre for Disease Prevention and Control (ECDC), meanwhile, said 17 European countries reported a total of 232 cases in November 2019, which is down from the previous 2 months. Romania (79 cases) and France (48) had the highest November case counts. Slovenia, which had no cases in September and October, confirmed 7 for November.

From Dec 1, 2018, to Nov 30, 2019, European officials reported 13,460 measles cases, of which 10,589 were lab-confirmed. During this period France had the most cases (2,674), followed by Romania (1,746), Italy (1,689), Poland (1,532), and Bulgaria (1,201). Ten of those infected during this period died, including 5 in Romania.
Jan 10 ECDC report

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