News Scan for May 26, 2015

News brief

H9N2 infects Egyptian boy

Egypt has reported an H9N2 avian influenza case involving a 7-year-old boy, the country's third such detection so far this year, according to a posting from ProMED Mail that is based on a notification from a United Nations Food and Agriculture Organization (FAO) database. ProMED Mail is the online reporting system of the International Society for Infectious Diseases.

The boy got sick on Apr 29, experiencing a high fever and a cough. His respiratory sample tested positive for H9N1 on May 7. The sample was also positive for influenza A and influenza B. An investigation found that the boy had a history of exposure to poultry at a live market. The boy recovered and was discharged.

According to the report, the case is Egypt's first documented co-infection with H9 and influenza B. The report didn't specify where the sick boy was from but noted that the other cases-patients this year were from Aswan and Cairo governorates and that the most recent outbreaks of H9N2 in poultry were in Cairo governorate in the first half of 2014.

In a February statement warning of flu co-circulation and avian flu outbreaks in birds, the World Health Organization (WHO) said H9N2 needs to be closely watched because it has provided "donor" genes to the H5N1 and H7N9 strains and has recently been implicated in human infections in China and Egypt.
May 22 ProMED Mail post
Feb 26 CIDRAP News story "WHO warns about influenza co-circulation, bird outbreaks"

PAHO: 16,000 new chikungunya outbreak cases

There have been more than 16,000 new chikungunya cases in the Americas, bringing the outbreak total to 1,446,750, according to the Pan American Health Organization's (PAHO's) weekly update on May 22.

The new numbers include a big jump in Colombia, which has been the outbreak hot spot for weeks. But they also include reductions in case numbers for several countries, so the net gain is 14,551 cases. The previous 3 weeks saw increases of about 5,600 to 13,000 new cases. The total so far this year is 309,803 cases.

Colombia reported 16,610 new chikungunya cases, for a total of 217,729. No other nation had an increase of even 100 cases. The largest downward adjustment in cases was in El Salvador, which reduced its case count from 10,583 in the previous week to 8,655 last week.

As in previous updates, many countries have not reported new cases in weeks. The outbreak began in December 2013 with the first locally acquired chikungunya case ever reported in the Americas, on St. Martin in the Caribbean.
May 22 PAHO update

Food Safety Scan for May 26, 2015

News brief

E coli at fairgrounds in Washington same as outbreak strain

The Washington State Department of Health (DOH) has announced that samples from 4 of 10 areas tested at the Whatcom County fairgrounds implicated in an outbreak of Shiga toxin–producing Escherichia coli (STEC) O157:H7 that began sickening people last month matched the outbreak strain, according to a May 22 update.

The Northwest Fairgrounds, located in Lynden, Washington, hosted the Milk Makers Fest Apr 21 through 23, which more than 1,300 children, most of them first graders, attended through school trips. Among the exhibits was a farm animal petting zoo.

To date, 25 people have fallen ill with E coli infections; 14 are children who attended the fair or individuals who worked there, and 9 are secondary cases (ie, they did not attend but are close contacts of those who did). Hospitalization has been necessary in 10 cases, including 4 involving hemolytic uremic syndrome, a potentially deadly kidney complication. Several more possible cases are under investigation.

A four-person team from the Centers for Disease Control and Prevention (CDC) has been in Washington since May 11 assisting in the investigation. No common source of the outbreak has been determined to date.
May 22 DOH update

Canadian Salmonella outbreak tied to baby chicks from Alberta hatchery

Officials are investigating a 34-case outbreak of Salmonella infection in three Canadian provinces linked to contact with live baby poultry from a hatchery in Alberta, the Public Health Agency of Canada (PHAC) announced yesterday.

Cases so far include 17 in Alberta, 13 in British Columbia, and 4 in Saskatchewan. Illness onsets occurred from Apr 5 to May 12. All case-patients have had contact with baby poultry, most of them from the Alberta hatchery.

The PHAC is leading the human health investigation, and the Alberta Agriculture and Forestry is involved in finding the source of the infection; informational letters have been sent to all hatchery customers who ordered live baby poultry from the hatchery from Mar 1 onward.

Young children are at increased risk for salmonellosis, both because of their immature immune systems and because they enjoy holding baby poultry and may put their fingers and other contaminated items near their mouths.

The PHAC is urging consumers to see a physician if they or their children have symptoms of Salmonella (fever, chills, diarrhea, cramping, headache, nausea, vomiting) and to always practice good hygiene (and help children do so) after contact with live poultry as well as after contact with and when cooking eggs and raw poultry meat.

A Reuters story today on the outbreak pointed out that "Trade in agricultural products can be sensitive to detection of salmonella, although Canadian poultry exports are limited due to the country's system of managing supply."
May 25 PHAC notice
May 26 Reuters story

Study: Rotavirus dropped markedly after vaccine introduced

Cases of rotavirus (RV) gastroenteritis in US children have decreased by well over 90% since introduction of RV vaccine in 2006, say results of a study published in the June issue of the Pediatric Infectious Disease Journal.

Study results were based on analysis of a large US health insurance claims database that the authors say represents about 3% to 4% of US annual birth cohorts. The researchers identified infants born from January 1, 2002, through July 31, 2011, and grouped them according to whether they had received RV vaccine, had received diphtheria, tetanus, and acellular pertussis (DTaP) vaccine before introduction of RV vaccine, or had received DTaP but no RV vaccine after the latter was available.

Mean peak incidence of medical encounters for rotavirus in RV-vaccinated children overall was 95% to 96% lower than in DTaP-vaccinated children who did not receive RV vaccine. In addition, the incidence of RV gastroenteritis in the children receiving DTaP was higher before RV vaccine was available (151 cases per 100,000 children) than after its introduction (110 per 100,000), suggesting herd immunity conveyed RV vaccination programs.

A pentavalent human-bovine reassortant RV vaccine (RV5) given to infants in a three-dose series was approved in February 2006 and recommended as a routine vaccination later that year, and a monovalent vaccine (RV1) given in a two-dose series was approved and recommended for routine use in April 2008. The authors note that RV vaccine coverage in 2012 was nearly 70% in the United States.
June Pediatr Infect Dis J study