News Scan for Feb 29, 2016

News brief

Scottish nurse discharged after second hospitalization for Ebola complications

A Scottish nurse who was recently hospitalized with Ebola complications for a second time has been released from Royal Free Hospital in London yesterday, according to a statement from the facility.

Few details were available about her hospitalization, other than that her admission was related to her previous Ebola infection. The hospital confirmed that the nurse, Pauline Cafferkey, is not infectious.

The woman had been hospitalized twice before at the Royal Free: one for her initial infection in December 2014 after returning from Sierra Leone and again in October 2015 for Ebola-related meningitis.
Feb 28 Royal Free London statement
Feb 23 CIDRAP News scan "UK nurse hospitalized a third time for Ebola complications"

In other Ebola survivor developments, the risk of contracting Ebola from a survivor is very low, according to findings from a literature review by an Australian research team that looked at how long the virus persisted in different body locations.

From 6,831 studies on persistence of Ebola and other filoviruses, the investigators focused on 33 that met their criteria. They published their findings today in the latest online edition of PLoS Neglected Tropical Diseases.

The studies they examined included several different body fluids, including blood, urine, semen, sweat, breast milk, feces, and vaginal fluids. Blood was the most infectious fluid and carried the highest viral loads, but only 5% of patients still had detectable virus levels after 16 days of illness, the longest being 29 days. The team said that translates to a low risk of infection from contact with a survivor.

The biggest risk seemed to be related to sexual transmission. About 70% of semen samples from male survivors still tested positive for the virus in the first 7 months after illness, according to studies from before the middle of 2015. The authors said most other body fluids posed a low risk of infection, but that there was too little evidence to draw a conclusion about breast milk.
Feb 29 PLoS Negl Trop Dis abstract
Feb 29 University of East Anglia press release on the study

PAHO reports 1,800 new chikungunya cases in the Americas

Countries and territories in the Americas reported 1,804 new chikungunya cases, the Pan American Health Organization (PAHO) said in an update late last week

The new numbers bring the 2016 outbreak total to 18,472 confirmed and suspected cases, and the agency added 55 late-reported cases to its 2015 total, which now stands at 726,533 infections. The new cases, reported on Feb 26, bring the overall outbreak total to 1,892,631 cases.

Colombia reported the largest gain last week, with 803 new cases and 6,555 for the year so far. Guatemala was next with 495 new cases and 737 total. Ecuador noted 242 new cases and 381 total, while Costa Rica reported 112 new cases, raising its 2016 total to 962.

No chikungunya-related deaths have yet been reported for 2016. The outbreak began in December 2013 on St. Martin in the Caribbean with the first recorded cases of the disease in the Americas.
Feb 26 PAHO update
Latest PAHO 2015 cumulative case numbers

Flu Scan for Feb 29, 2016

News brief

H5N1 avian flu kills more than 1,000 Vietnam birds

An outbreak of highly pathogenic H5N1 avian flu accounting for the death of more than 1,000 birds of unspecified variety in southern Vietnam and was reported Feb 26 to the World Organization for Animal Health (OIE) by health officials in the country.

The outbreak occurred in Tan Binh in Tra Vinh province, in the far southern Mekong Delta region of the country. Of 1,100 susceptible birds, 796 were infected and died, for apparent morbidity and mortality rates of 72.36%. The remaining 304 birds were destroyed.

Control measures applied included vaccination, disinfection, and surveillance, according to the report.

The most recent previous H5N1 outbreak in Vietnam was reported in December 2015, but the country has battled a handful of H5N6 outbreaks this year.
Feb 26 OIE report

Dutch researchers note societal impact of ILI in families with preschoolers

Influenza-like illness (ILI) in preschool children has considerable societal impact in terms of healthcare consumption as well as lost work time for parents, found a Dutch study published in the March issue of Pediatric Infectious Disease Journal.

The study population comprised 8,768 child-parent pairs in randomly selected households with preschool children in the Netherlands. Surveys were administered from October 2012 to October 2014 to determine the frequency of flu-like symptoms, related medical care, and lost time at work or in daycare.

The monthly incidence of ILI was estimated at 13.2% in parents and 21.6% in children, for an overall rate of 1.72 episodes per parent-year (95% confidence interval [CI], 1.61-1.84) and 2.81 per child-year (95% CI, 2.70-2.93). The rates peaked in winter and were higher than those found in surveys of the general Dutch population in previous years, say the authors.

Among the child-parent pairs with ILI episodes, 35.7% sought medical care for children and 17.7% for parents. Median duration of symptoms was 6 days for parents and 5 days for children.

Work absenteeism was reported by 45.7% of parents with ILI (median workdays lost, 2); absenteeism from daycare was reported for 22.8% of children with ILI (median days missed, 1). About one third of parents and children with ILI took medications.

Risk factors for ILI noted by the researchers included chronic respiratory symptoms, developmental disabilities, parental occupation in healthcare or child care, more than one child in the family, and attendance at daycare for a year or less. Daycare attendance for more than 2 years afforded some ILI protection, as did breastfeeding in infants 6 months of age or younger.
March Pediatr Infect Dis J study