Flu Scan for Dec 05, 2014

News brief

Some US flu activity indicators up slightly

Influenza activity in the United States has picked up slightly but is still well below epidemic levels, while the mismatch between circulating H3N2 viruses and the vaccine strain rose to 58%, the Centers for Disease Control and Prevention (CDC) said in its weekly update today.

Of 13,398 specimens tested by US labs, 2,274 (17.0%) were positive for influenza for the week that ended Nov 29. That's up from 12.6% the week before. And 5.4% of all deaths were attributed to pneumonia and influenza, which is up from 5.3% the week before but below the epidemic threshold of 6.5%.

Eight of the 10 US regions experienced elevated activity of influenza-like illness (ILI) in outpatient settings, compared with only 4 the week before. And Puerto Rico and six states (Alabama, Florida, Georgia, Louisiana, Mississippi, and Texas) reported high ILI activity. The week before only Louisiana and Puerto Rico had high ILI activity.

Finally, six states—Alaska, Florida, Illinois, Louisiana, Maryland, and North Carolina—and Puerto Rico reported widespread flu activity, up from two states.

Among the 2,274 influenza-positive specimens, 2,129 (93.6%) were influenza A and 145 (6.4%) were influenza B. Of the 661 "A" viruses that were subtyped, 656 (99.2%) were H3N2 and only 5 (0.8%) were 2009 H1N1.

A total of 66 of 114 H3N2 viruses tested, or 58%, did not match well with the H3N2 component in the vaccine, a phenomenon reported by the CDC yesterday (see related story). That is up from 52% the week before.

No new pediatric flu deaths were reported, leaving the season total at five.
Dec 5 CDC FluView update

India reports 4th H5N1 outbreak; Japan detects H5N8 in wild bird

Highly pathogenic H5N1 avian flu has struck a fourth duck flock in India's Kerala state, while Japan has detected H5N8 avian flu in a wild-bird sample, according to separate reports posted yesterday by the World Organization for Animal Health (OIE).

Of the village flock of 5,500, 500 ducks died, and testing on Dec 3 confirmed H5N1 as the culprit, the report said. The flock is in Kottayam in the southwest part of the country. The previous three outbreaks, the first of which was reported Nov 25, were also in Kerala state.

Officials have begun control efforts such as disinfection and control of poultry movement within the country in response to the most recent outbreak, the OIE report said. It began on Nov 20, the same date as the other reported outbreaks.
Dec 4 OIE report on India outbreak

In related news, highly pathogenic H5N8 has again been detected in Japan in a fecal sample of a bird in the Anatidae family, which includes ducks, geese, and swans, according to the second OIE report. Officials were not able to identify the exact species.

The sample was collected in Tottori prefecture. Japanese officials also have recently detected H5N8 in fecal samples in neighboring Shimane prefecture and in Chiba prefectures, near Tokyo.
Dec 4 OIE report on Japan detection

News Scan for Dec 05, 2014

News brief

Saudi Arabia reports new MERS case, international investigation in Taif

Saudi Arabia's Ministry of Health (MOH) reported a new MERS-CoV case today, bringing the country's total to 818 cases.

The new case-patient is a 70-year-old Saudi woman from Taif who is hospitalized in critical condition. She has an underlying medical condition and is not a healthcare worker. She had no contact with MERS-CoV (Middle East respiratory syndrome coronavirus) patients in the community, and the MOH is investigating whether she had any animal exposure or contact with MERS cases in clinical settings.

The MOH also reported today that a 62-year-old Saudi man from Rafha and Arar in the Northern Borders Province has recovered from the disease. He is not a healthcare worker and had no preexisting disease.

Nine Saudi MERS cases remain active, 458 people have recovered, and 351 have died.
Dec 5 MOH update

In related news, an international team of experts ruled out the possibility of widespread community MERS transmission in the northern city of Taif, home of today's case, according to a Dec 3 MOH report.

The team included officials from the MOH and the US Centers for Disease Control and Prevention (CDC), along with World Health Organization representative Hassan El Bushra, MD.

Although experts continue to investigate the increase in MERS cases in Taif during October, they have traced most of the new patients to three or four primary contacts. They are also advising the MOH's Command and Control Center on MERS prevention and response, helping to support Saudi Arabia's recent investments in healthcare worker training and infection control programs.
Dec 3 MOH report

Multistate sprout-related Salmonella outbreak grows to 87 cases

An outbreak of Salmonella Enteriditis linked to contaminated bean sprouts has, as of Dec 2, sickened 19 new patients since the CDC's last report on Nov 25, bringing the total to 87 illnesses in 11 states, CDC said in an update yesterday.

Nearly all the illnesses have occurred in northeastern states; those involved to date are Connecticut (7 cases), Maine (3), Massachusetts (35), Montana (1; this patient traveled to the East), New Hampshire (4), New York (14), Ohio (3), Pennsylvania (10), Rhode Island (6), Vermont (3), and Virginia (1).

In interviews, 54 affected patients reported eating bean sprouts or items containing them within a week before becoming ill. An investigation pointed to Wonton Food, Inc, of Brooklyn, N.Y., as the likely source of the sprouts. The company is cooperating with officials and agreed on Nov 21 to destroy remaining product and to clean and sanitize its operation. Wonton restarted production after this was completed and resumed shipping on Nov 29.

Illness-onset dates range from Sep 30 to Nov 14, and patient ages range from 1 year to 83 years, with a median of 32. Hospitalization has been required in 14 (27%) of the 52 persons for whom information is available; no deaths have occurred.

With a 12-day shelf life, any bean sprouts produced before the break in production are likely no longer available, the CDC said. The agency notes, however, that illnesses occurring after Nov 12 may not have been reported yet.

Testing has shown the outbreak Salmonella strains to be susceptible to antibiotics. The investigation is continuing, the CDC said.
Dec 4 CDC update

CDC adds 2 cases, ends investigation of Listeria in cheese

The investigation into Mexican-style cheese that sickened five people with listeriosis and caused one death has ended, according to a CDC update yesterday.

Food and Drug Administration sampling found the Listeria monocytogenes outbreak strain in fresh-curd cheese produced by Miami-based Oasis Brands, Inc. The producer has recalled all soft cheese sold under the Lacteos Santa Martha and HonduCrema brands.

One case of listeriosis was reported in September 2013, and the other cases emerged from June to October 2014. Two cases were identified following the August and October recall of affected cheese.

Four people needed to be hospitalized, and one case-patient died. Three listeriosis cases were related to pregnancy, including one in a newborn.

Cases occurred in Georgia, New York, Tennessee, and Texas. All people affected were of Hispanic ethnicity and reported eating fresh-curd cheese before falling ill.
Dec 4 CDC update