MERS hospitalizes another in Riyadh

In an ongoing trickle of MERS-CoV cases, especially from the Riyadh area, Saudi Arabia's health ministry today reported another infection. The latest case involves a 38-year-old Saudi man, and though he is from Riyadh, it's not clear whether his illness is part of recent transmission occurring in the city's hospitals or is from the community.

Investigation so far reveals that he isn't a healthcare worker and didn't have known contact with suspected or confirmed cases in the community or hospitals. The man is hospitalized in critical condition.

The latest illness pushes Saudi Arabia's Middle East respiratory syndrome coronavirus (MERS-CoV) total to 1,064 cases, including 471 deaths. Ten people are still in treatment and 583 have recovered from their infections.
Aug 5 Saudi MOH update


CDC reports more cyclosporiasis cases in multistate outbreak

The Centers for Disease Control and Prevention (CDC) yesterday reported 26 new cases of cyclosporiasis in an outbreak that has sickened 384 people in 26 states.

More than half (226, or 59%) of people became ill with the intestinal parasite Cyclospora cayetanensis after May 1 and did not have a history of recent international travel.

The CDC is investigating case clusters in Texas, Wisconsin, and Georgia and has preliminarily identified cilantro as the source of Cyclospora in the Wisconsin and Texas clusters.

An Aug 4 update from the Texas Department of State Health Services (TDSHS) lists 224 cases of cyclosporiasis in the state this year.
Aug 4 CDC update
July 31 CIDRAP News scan on Cyclospora outbreak
Aug 4 TDSHS update


Respiratory viruses detected more frequently in large households

Young children are more likely to become infected by respiratory viruses and experience severe symptoms and longer duration of illness than other age-groups, according to a study yesterday in Clinical Infectious Diseases.

The University of Utah's Utah Better Identification of Germs-Longitudinal Viral Epidemiology (BIG-LoVE) study analyzed symptom reports and nasal swabs from 26 households comprising 108 individuals over 52 weeks (4,166 person-weeks). Participants ranged in age from 1 day to 57 years, and 85% of households had at least one child.

Researchers used polymerase chain reaction (PCR) testing to detect 16 respiratory viruses from 2009 to 2010, a period that included the second wave of the 2009 H1N1 pandemic.

Respiratory viruses were detected 783 times in participants over the year, and 440 (56%) of those infections were symptomatic. Individuals had an average of five respiratory viruses per year.

Children under age 5 tested positive for respiratory viruses in 50% of person-weeks, and children aged 5 to 17 had positive results in 25% of person-weeks. Respiratory viruses in adults were detected in 16% of person-weeks.

Children under 5 were 2.5 times more likely to report symptoms (95% confidence interval, 2.08-2.94) and experience more severe symptoms such as fever and wheezing.

Viral infection lasted an average of 1.7 weeks, yet households with children under 5 experienced infections that lasted an additional 3 weeks on average.

Respiratory viruses most commonly associated with reported symptoms included influenza A (76%), human metapneumovirus (83%), coronavirus HKU1 (64%), and coronavirus OC43 (61%). Rhinoviruses and bocaviruses were more likely to be asymptomatic, although children under 5 years of age reported rhinovirus symptoms more frequently (67%) than other age groups (51%).

During the study, 30% of individuals sought medical care for a respiratory infection. Researchers highlighted the need for community-based studies of circulating respiratory viruses, saying that studies in clinical settings may be biased toward detecting severe or symptomatic illness.
Aug 4 Clin Infect Dis abstract


Two Nigerian H5N1 outbreaks bring total to 170

Two more outbreaks of H5N1 avian influenza on chicken farms have been reported to the World Organization for Animal Health (OIE) by Nigeria's chief veterinarian.

One farm, in the far southwest coastal region of the country near Lagos, housed 7,700 cockerels and pullets, 6,786 of which died. The other farm, also located in the southern coastal region but further east, had 350 fatal cases out of a flock of 1,850 18-month-old laying hens. The remaining, unifected birds at both farms were destroyed.

The apparent morbidity, mortality, and case-fatality rates for the two farms combined were 74.72%, 74.72%, and 100%, respectively.

Control measures undertaken were quarantine, disinfection of the premises, destruction of carcasses and animal products, and modified stamping out. The report notes that biosecurity on the farms was poor.
Including the current outbreaks, Nigeria has reported 170 outbreaks since January of this year, following a break in cases since 2008.
Aug 4 OIE report
Most recent (Jul 31)
CIDRAP News item on Nigerian outbreaks


Report: KSU lab safety concerns cast shadow on new federal lab

Kansas State University (KSU), where construction is under way on the new $1.25 billion National Bio and Agro-Defense Facility (NBAF), has had brushes in the past with federal lab safety regulators, a concern because of the research on dangerous pathogens that will be done at NBAF, said a story yesterday in USA Today.

USA Today obtained records showing that KSU has had a "history of non-compliance" over numerous inspections. A March 2014 letter to KSU from federal lab regulators, which reportedly had a "harsh tone," threatened to suspend KSU's permits to do research on dangerous pathogens if it did not embark on a federal performance improvement program.

KSU officials claim that most of the violations involved in the past inspections involved paperwork problems that did not pose safety risks, that violations have been corrected, and the institution was released from the improvement program in April.

NBAF, which is expected to be completed in about 7 years, broke ground in May after many delays. Controversy over the new lab has centered around the advisability of doing research on highly dangerous agricultural diseases (eg, foot-and-mouth disease, Rift Valley fever) at a location directly in US agricultural heartland.

The facility, which will cover 570,000 square feet, will replace Plum Island Animal Disease Center off the coast of Long Island, New York. It will be run independently from KSU by the Department of Homeland Security and, according to KSU, will take over research on several dangerous pathogens now under study at the academic institution.

USA Today has done extensive investigative reporting recently on lab-safety issues stemming from the recently discovered transport of live anthrax from federal labs to nearly 200 labs around the country.
Aug 4 USA Today story

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