Cases in multistate cucumber Salmonella outbreak near 700

The Centers for Disease Control and Prevention (CDC) received reports of 113 additional cases of salmonellosis likely linked to cucumbers in the past week, raising the outbreak total to 671, the agency said in an update yesterday.

Alabama was added to the list of affected states, bringing that total to 34 (see CDC map). California and Arizona have by far the highest caseload, with 164 and 112, respectively. Utah is next with 51 cases. The outbreak strains are Salmonella Poona.

Illness-onset dates range from Jul 3 to Sep 21, and patients' ages vary from less than 1 year to 99, with a median age of 17 years. Of 459 patients with available information, 131 (29%) required hospitalization. Three deaths have been reported, a number that did not change since the CDC's previous report a week ago.

The outbreak has been linked to cucumbers imported from Mexico by Andrew & Williamson Fresh Produce of San Diego. The company announced a voluntary recall of its cucumbers on Sep 4.
Sep 29 CDC update


WHO: 6 recent Saudi MERS cases include 2 in health workers

The World Health Organization (WHO) today supplied details on 6 recent Saudi MERS-CoV cases, 4 of them in Riyadh, 2 of which involve healthcare workers (HCWs). The agency received notification of the cases from Saudi health officials from Sep 20 to Sep 26.

The four Riyadh MERS-CoV (Middle East respiratory syndrome coronavirus) patients include a 44-year-old male HCW in stable condition, a 27-year-old female asymptomatic HCW, a 59-year-old woman, and a 48-year-old man. The latter two are in stable condition in home isolation, have other medical conditions, and had contact with another MERS-CoV patient.

The HCWs are both foreigners. The man had occupational contact with a MERS patient, while the woman worked in a hospital that treated MERS patients. Her exact exposure is under investigation.

The other two patients are a 46-year-old man in Al-Oyoon who is hospitalized in stable condition and a 90-year-old from Najran who died. The younger man has a history of frequent contact with camels and consumption of raw camel milk. He had pre-existing disease.

The man who died likewise had pre-existing disease. He developed symptoms on Sep 13, tested positive for MERS-CoV on Sep 19, and died on Sep 25. Investigation into his possible exposure to risk factors is ongoing.

Since the outbreak began in September 2012, the WHO has been notified of 1,589 lab-confirmed MERS cases, including at least 567 deaths. Saudi Arabia, which has now gone 4 days without reporting a new case, has confirmed 1,250 cases and 536 deaths.
Sep 30 WHO update


Nigeria reports 6 more H5N1 outbreaks

Nigeria has notified the World Organization for Animal Health (OIE) of 6 new outbreaks of H5N1 avian flu in poultry, bringing its total for the year to 84, according to an OIE report yesterday.

The outbreaks affected 13,300 birds total, killing 2,748 of them. The rest of the flocks were culled to limit disease spread. They began Sep 18 through Sep 22.

Five of the outbreaks occurred in Rivers state, which has been hit hard. The other outbreak was in adjoining Abia. Both states are in the south.

The affected flocks range in size from 800 to 3,300 egg-laying and broiler chickens. The OIE report said that poor farm biosecurity was a factor in at least one of the outbreaks. The country's usual response efforts like disinfection and quarantine are being implemented.
Sep 29 OIE report


Gates Foundation pledges funds for RSV vaccine, access in poor nations

Yesterday the Bill and Melinda Gates Foundation announced it will spend up to $89 million to fund the development of a Novavax candidate vaccine against pneumonia caused by respiratory syncytial virus (RSV) in return for making the vaccine affordable in developing countries, according to a Forbes story.

Keith Klugman, director for pneumonia at the Gates Foundation, said, "We felt that this was a worthwhile investment to make sure that if the vaccine does work, and if it is licensed, that it will be made available to infants in the developing world virtually simultaneously with the developed world."

RSV, for which no vaccine exists, is the top cause of pneumonia in children under 1 and kills 160,000 children worldwide each year, the story said. It is a leading cause of hospitalization in the United States and can cause problems in the elderly, as well.

Novavax, of Gaithersburg, Md., yesterday announced that the RSV vaccine was well tolerated and highly immunogenic in a phase 1 trial involving 32 children 2 to 6 years old. It also said in a second press release that the vaccine produced similar results in 50 pregnant women in their third trimester who were enrolled in a phase 2 clinical trial. That study found that the women's babies had an immune response almost as strong as their mothers'.
Sep 29 Forbes story
Sep 29 Novavax news release on phase 1 trial

Sep 29 Novavax news release on phase 2 trial

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