Three new MERS cases reported in Saudi Arabia

Saudi Arabia's health ministry reported three new MERS-CoV cases so far in the first days of September, according to a post summarizing activity in epidemiologic week 36.

A 56-year-old woman from Albekeria was confirmed to have MERS-CoV (Middle East respiratory syndrome coronavirus) on Sep 2. She had no camel contact, and her case is listed as "primary, community acquired" meaning it's unlikely she contracted the virus in a healthcare setting.

On Sep 3, a 66-year-old man from Buraydah was also listed as a primary case-patient whose illness was likely acquired in the community. He is hospitalized. Today another man from Buraydah (age 52) was confirmed to have MERS. He did not have camel contact, but the source of his infection is under investigation.

On Aug 31, meanwhile, the World Health Organization (WHO) published a notice on a recent MERS case detected in the United Kingdom. The WHO said the patient is a Saudi man aged 80 to 89 who was visiting Great Britain. He reported a history of direct camel contact in Saudi Arabia. He is being treated in isolation in Liverpool.

The latest illnesses from Saudi Arabia, combined with the UK travel-related case, appear to lift the global MERS-CoV total to 2,246 cases and the number of deaths from the disease to 795.
Saudi MOH report for week 36
Aug 31 WHO notice

FDA enhanced testing finds Cyclospora in imported and domestic cilantro

Enhanced surveillance for Cyclospora by the US Food and Drug Administration (FDA) has identified the parasite for the first time in domestic produce, which involved cilantro, and recently identified the parasite on cilantro shipments from two cilantro producers from Mexico.

The FDA said so far it's not aware of any illnesses linked to contaminated domestic cilantro and that there don't appear to be any links to multistate Cyclospora outbreaks in the United States over the spring and summer. It also noted that inspectors refused entry to the contaminated Mexican cilantro shipments.

Both detections are part of stepped-up surveillance for contamination in several food commodities, which includes fresh herbs—especially basil, parsley, and cilantro—as well as sprouts, whole fresh avocados, raw milk cheese, cucumbers, and hot peppers. Part of the goal of the sampling in herbs was to assess baseline estimates for Salmonella and Escherichia coli prevalence. Also, the FDA has recently developed and validated a new method to test for Cyclospora cayetanensis. So far, it's not known how food and water become contaminated with Cyclospora, but earlier outbreak investigations found that produce was grown under insanitary conditions.

Regarding the positive tests in the two Mexican shipments, the FDA said it will take further steps to prevent contaminated cilantro from the firms from entering the United States and that the US and Mexico are working closely to investigate the contamination source.

Meanwhile, the finding in domestic cilantro occurred in July and involved a sample collected at a distributor. As part of the investigation into the positive test, investigators collected samples from the farm that produced the cilantro, which also were positive for Cyclospora. The FDA said it has worked closely with state officials to voluntarily recall and embargo the potentially affected product. "FDA will continue to inform consumers as additional information becomes available regarding investigations and other work related to Cyclospora," it said.
Aug 29 FDA statement

Four countries report high-path H5 avian flu outbreaks

In the latest highly pathogenic avian flu outbreak developments, Cambodia and Malaysia reported H5N1 in poultry, and Germany and the Netherlands each reported H5N6 detections, according to notifications from the World Organization for Animal Health (OIE).

Cambodia's H5N1 outbreak, its first since March, began on Aug 20 in backyard poultry in Kampong Cham province, located in the country's southeast. The virus killed 318 of 378 susceptible birds, and the surviving ones were culled to curb the spread of the virus. So far the source of the outbreak hasn't been found.

In Malaysia, which has been reporting sporadic H5N1 outbreaks since early August, officials detected the virus in poultry from three locations in Sabah state, where the earlier events occurred. All three of the outbreaks began on Aug 3, two in village poultry chicken and duck flocks and one at a farm. Between the three sites, the virus sickened 5 of 770 birds. All were destroyed as part of the response to the detections.

In Europe, Germany and the Netherlands reported new H5N6 detections, both likely involving a reassortant linked to H5N8, not the H5N6 virus that has killed birds and people in Asia. Germany's outbreak began on Aug 31 in a backyard flock of rare and endangered chickens, geese, and ducks in Mecklenburg-Vorpommern state in the country's northeast. The virus killed 14 of 133 susceptible birds, and the remaining ones were culled to control the spread of the virus. Germany reported its last H5N6 outbreak in May.

In another H5N6 development, the Netherlands said the strain was detected in a wild mallard found dead on Aug 31 in a village in North Holland province. The OIE report said the H5N6 is a reassortant linked to H5N8, not the Asian zoonotic H5N6 virus. The last similar detection in the Netherlands occurred in April.
Aug 31 OIE report on H5N1 in Cambodia
Sep 2 OIE report on H5N1 in Malaysia
Sep 4 OIE report on H5N6 in Germany
Sep 3 OIE report on H5N6 in the Netherlands