News Scan for Jun 19, 2014

News brief

Dengue identified as source of Sudan febrile illness outbreak

An outbreak of an unknown febrile illness that initially prompted suspicion for hemorrhagic fever or Middle East respiratory syndrome coronavirus (MERS-CoV) has been diagnosed as dengue fever, the World Health Organization (WHO) said yesterday in a statement.

As of Jun 17, 738 cases, including 6 deaths, had been reported. Health officials received reports of 57 new suspected cases on Jun 16 and Jun 17—36 from Port Sudan and 21 from Tokar, both in Red Sea state.

The WHO said no suspected MERS-CoV cases have been reported from Red Sea state and that hemorrhagic fever cases reported earlier were determined to be dengue fever. It said the area has been hit by dengue outbreaks several times since 2003, with the worst one in 2010 that sickened 4,008 people and killed 12.

Red Sea state, one of 15 states in Sudan, is in the northeastern part of the country on the Red Sea coast and is across from Saudi Arabia. A serologic study of dromedary camels in Egypt that had been imported from Sudan published last fall found evidence that some were infected with MERS-CoV or a closely related virus.

Despite no MERS-CoV detections, health officials are actively looking for cases in hospitals and clinics, the WHO said.

Over the past few weeks Sudan's health ministry, the state health ministry, and the WHO have put control measures in place to curb transmission in the affected area, such as strengthening the surveillance system and conducting training activities aimed at improving diagnosis and case management. The WHO said health officials have also endorsed a joint action plan, with the support of global health partners, that addresses vector control and health promotion.

Nearby South Sudan has been battling a cholera outbreak centered in Juba county that as of Jun 4 had sickened 1,306 people, 29 of them fatally. The outbreak began on Apr 23, with 11 districts of Juba county reporting cases. The WHO in a Jun 4 statement said the risk of spread to surrounding states is high, but the surveillance and response capabilities outside of Juba are poor.
Jun 18 WHO statement
Sep 5, 2013, CIDRAP News story "Study reveals more signs of MERS-CoV in camels"
Jun 4 WHO statement


US chikungunya cases jump to 80 as Cuba notes first cases

US cases of chikungunya have doubled, to 80, the Centers for Disease Control and Prevention (CDC) said, and Cuba has reported its first cases.

The 80 US cases include 23 locally acquired infections in Puerto Rico and 57 imported cases, the CDC said in a Jun 17 update. One imported case was in a traveler to Indonesia; the rest were in patients who had visited the Caribbean, the site of a 170,000-plus-case outbreak.

"To date, no local transmission has been identified in the continental United States," the agency said of the mosquito-bornedisease. Last week the CDC reported 39 cases, including only 1 from Puerto Rico.

Florida has the most chikungunya cases, 34, followed by 6 in Virginia. No other state has more than 3 cases.
Jun 17 CDC update

Cuba's ministry of health, meanwhile, has confirmed six chikungunya cases. Five of the patients had recently returned from Haiti, while the sixth had traveled to the Dominican Republic, according to a Miami Herald Cuba story yesterday.

Most cases were linked to "illicit commerce," the health ministry said, adding that all patients are recovering.
Jun 18 Miami Herald story


Arbovirus profile shows big drop in severe WNV infections

A profile of US arboviral diseases that occurred in 2013 found a big decline in the incidence of severe West Nile virus (WNV) infections from 2012, the year a large multistate outbreak occurred, according to a CDC report today in Morbidity and Mortality Weekly Report (MMWR).

While WNV was the most common cause of arboviral neuroinvasive disease in adults, La Crosse virus was the most likely cause of the disease in children, according to the CDC. WNV activity was still localized in 2013, with more than half of neuroinvasive cases reported from just six states: California, Texas, Colorado, Illinois, North Dakota, and Oklahoma.

CDC researchers noted that more Jamestown Canyon virus disease cases—22 of them—were reported in 2013 than in any other year, with first cases reported in eight states: Georgia, Idaho, Massachusetts, Minnesota, New Hampshire, Oregon, Pennsylvania, and Rhode Island. The agency said, however, that the increase could reflect the new availability of an immunoglobulin test for the disease and that incidence reported in earlier years could be underestimates.

Two states, Arkansas and Connecticut, reported their first eastern equine encephalitis virus cases last year.

Arbovirus disease numbers vary from year to year, and the complex ecology makes outbreaks difficult to predict, the CDC said. Because no vaccines are available, surveillance and prevention efforts are the keys to preventing the diseases.
Jun 19 MMWR report


Maker of candidate flu drug enters licensing agreement

Boston-based Vertex Pharmaceuticals has entered a licensing agreement with Janssen Pharmaceuticals of Titusville, N.J., for global development and sales of its VX-787 influenza drug candidate, Vertex said in a press release yesterday.

"Vertex will receive an up-front payment of $30 million from Janssen and has the potential to receive additional development and commercial milestone payments as well as royalties on future product sales," the release said. VX-787 is a new class of flu drug that is designed to inhibit virus replication, including recent H1 and H5 strains, the company added.

Vertex announced in March 2013 that a phase 2a study of VX-787 showed statistically significant improvements in viral and clinical measures of flu infection, but the high-dose arm of the study—whose participants received 1,200 milligrams (mg) of the drug for 1 day and 600 mg for 4 days—contained only 14 people.
Jun 19 Vertex news release
Mar 4, 2013, Vertex news release on phase 2a trial

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