News Scan for Aug 05, 2013

News brief

Saudi patient caught MERs-CoV virus from unknown source in hospital

The first patient in a three-person family cluster of MERS-CoV (Middle East respiratory syndrome coronavirus) cases in Riyadh, Saudi Arabia, apparently caught the virus from some unknown source while in the hospital, according to a report in the International Journal of Infectious Diseases. The cases occurred in February and March.

The index patient, a 51-year-old man with obesity and type 2 diabetes, experienced respiratory symptoms 2 weeks after he was admitted to a hospital for back pain and other non-respiratory symptoms, and 11 days later he was dead of multiple-organ failure, the report says. The man was not tested for the virus, but his signs and symptoms were consistent with the infection.

The MERS-CoV incubation period is believed to be no longer than 14 days, suggesting that the patient contracted the virus in the hospital from a healthcare worker, another patient, or a visitor, the author say.

Subsequently, two of the man's brothers, ages 39 and 40, fell ill with respiratory symptoms and fever, and MERS-CoV infection was confirmed. The 39-year-old died, but the 40-year-old survived. Both of them had substantially less contact with the index patient than other family members did, but none of the other relatives got sick, the report says. No other contacts of any of the patients inside or outside the hospital are known to have acquired the infection.

"MERS-CoV acquisition from unrecognized mild or asymptomatic cases may be a more important contributor to ongoing transmission than previously appreciated," the authors conclude.
Aug 2 Int J Infect Dis abstract

Israel launches polio vaccine campaign

Israel's health ministry announced yesterday that it will launch a campaign to administer 150,000 doses of polio vaccine to children in the southern part of the country where sewage samples suggest that there could be as many as 2,000 carriers of the disease, Reuters reported yesterday. So far no polio infections have been detected.

The ministry said the campaign, which starts today, will include oral drops of a weakened active virus vaccine—a type of vaccine administered in countries where the disease is endemic or where the transmission risk is considered high.

In other polio developments, the British government announced today that it will provide $9.2 million (6 million British pounds) to assist with a polio vaccination campaign in Somalia and Kenya, according to a press release. The money is targeted to a World Health Organization (WHO) campaign to vaccinate more than 6 million people in response to an outbreak in the two countries.

The outbreak is Somalia's first since 2007, and global health officials have warned that the event poses a risk of further spread of the virus across East Africa. The recent cases in Kenya are the first since 2011.
Aug 4 Reuters story
Aug 5 UK government statement

First H5N3 detection in Taiwan poultry

Surveillance testing related to a low-pathogenic H5N2 outbreak at a duck farm in Taiwan recently turned up a low-pathogenic H5N3 virus, marking the first such finding on the island, animal health officials said in an Aug 2 report to the World Organization for Animal Health (OIE).

Investigators at the Hua-Lien county farm found that the ducks appeared healthy, with no abnormal clinical signs. Tests obtained in the middle of July found the H5N3 virus in 20 ducks. There were 13,400 susceptible ducks on the farm. Teams are conducting tests at more poultry sites in the area to determine if any other flocks are infected with the H5N3 strain.

Meanwhile, animal health authorities described the H5N2 outbreak at the nearby farm in a separate Aug 2 report to the OIE. Of 11,672 ducks at the facility, 20 tested positive for the virus. The birds appeared healthy.

Surveillance of other farms in the area is ongoing. Taiwanese livestock officials have filed seven reports with the OIE on H5N2 outbreaks so far this year.
Aug 2 OIE report on H5N3 detection
Aug 2 OIE report on H5N2 detection

Poultry outbreaks of H5N1 spread in Nepal, India

Avian influenza H5N1 has been discovered on six more poultry farms in Nepal and two in India, say news sources.

The Nepal farms are in Bhaktapur, where hundreds of birds were destroyed, according to an Aug 3 story from Nepalnews.com.. Because of a recent spate of H5N1 outbreaks in Nepal, the government placed a 1-week ban on the sale and transportation of poultry in the Kathmandu Valley late last week and may extend it.

A story yesterday in The Himalayan Times said some experts blame the spread of H5N1 on ineffective government efforts to contain the virus.

Meanwhile, Indian has reported two H5N1 outbreaks to the World Organization for Animal Health (OIE), one on a poultry production unit in Anjora in Maharashtra state and one on a government-run poultry farm in Jagadalpur in Chhattisgarh state. The number of birds infected was more than 4,000, and nearly 3,000 died. The farms are in east-central India.
Aug 3 nepalnews.com story
Aug 4 story in The Himalayan Times
Aug 5 OIE outbreak reports

Food Outbreak Scan for Aug 05, 2013

News brief

Cyclospora cases rise to 425 as feds add investigative help

The number of patients sickened in a multistate Cyclospora outbreak has climbed to 425, according to an update today from the US Centers for Disease Control and Prevention (CDC). The number of affected states remained at 16, with Iowa, Texas, Nebraska, and Florida as the hardest hit. So far 24 patients have been hospitalized, but no deaths have been reported.

On Aug 2, the Texas Department of State Health Services (TDSHS) reported 140 cases, 13 more than the 127 shown for the state in today's CDC total, which would boost the national total to 438. Most of the illness onset dates range from the middle of June through early July.

The CDC said it's not clear if illnesses from all the states are part of the same outbreak. Illness clusters linked to restaurants in Iowa and Nebraska have been traced to a prepackaged lettuce mix from a Mexican production facility that packages produce for the food service industry. The facility is one of 11 plants owned by Taylor Farms, a Salinas, Calif.–based company.

In recent updates, federal officials said they were directing more resources toward investigating the outbreak. The CDC said it has dedicated a team of epidemiologists and other experts to work on the outbreak full time and deployed an Epidemic Intelligence Service officer and a Public Health Prevention Service fellow to Texas to help that state investigate its cases. So far the TDSHS has not found a common source for the infections.

The US Food and Drug Administration (FDA) said in an Aug 3 update that Mexican food regulatory authorities were collaborating with it on the investigation. The agency has also assigned a 21-person team at its headquarters to help solve the outbreak.
Aug 5 CDC update
Aug 3 FDA update
Aug 5 TDSHS update
Aug 2 CIDRAP News story "FDA: Salad cited in Cyclospora cases came from Mexican supplier"

Berry-related hepatitis A outbreak up to 158 cases

An update from the Centers for Disease Control and Prevention (CDC) says the number of cases of hepatitis A linked with a frozen berry mix containing pomegranate seeds now numbers 158 from 10 states, 5 more cases and 1 more state (New Jersey) than reported in the last update Jul 25.

States reporting cases include Arizona (23), California (77), Colorado (28), Hawaii (8), New Hampshire (1; exposure occurred in Nevada), New Jersey (1,in a household contact of a case in Colorado), New Mexico (9), Nevada (6), Utah (3), and Wisconsin (2; exposure occurred in California).

Patient ages range from 1 to 84 years, with 90 (57%) between 40 and 64 years. Hospitalization was required in 69 cases, but no one has died.

Illness onset dates range from Mar 31 through Jul 14. Six of the case-patients are household contacts of other case-patients.

The food source identified in the outbreak is Townsend Farms Organic Antioxidant Blend, which was recalled by Townsend in June. All of the patients so far bought the product at Costco, but it is sold through Harris Teeter stores as well.

The berry mix contains pomegranate seeds from Giknur Foodstuffs Import Export Trading in Turkey, considered to be the most likely vehicle for the hepatitis virus.
Aug 2 CDC update