News Scan for Jun 15, 2015

News brief

Saudi Arabia reports 4 new MERS cases, 3 in Hofuf
Saudi Arabia's Minister of Health (MOH) reported four more MERS-CoV cases over the weekend and today—three in the hot spot city of Hofuf—in an outbreak that still simmers even as it gets overshadowed by MERS events in South Korea. The agency also reported three deaths in previously reported cases.

The Hofuf cases of MERS-CoV (Middle East respiratory syndrome coronavirus) involve Saudi women aged 54, 55, and 69, the MOH said in separate reports Jun 13, yesterday, and today. The 55-year-old is in critical condition, while the other two are listed as stable. None are healthcare workers, and possible exposure to other MERS patients is under review for all three.

Hofuf has had a series of MERS-CoV cases in recent weeks, including a family cluster that was reported May 11 and a number of hospital-related infections.

The fourth patient is a 46-year-old Saudi man in Riyadh. He is likewise not a health worker, and he had no recent exposure to other MERS patients, the MOH said yesterday. He is in stable condition.

The agency reported deaths today in two MERS male patients in Hofuf, aged 45 and 65. It reported yesterday that a 74-year-old Saudi man in Taif also died from the disease. All had preexisting conditions.

The MOH also reported yesterday that a 74-year-old Saudi man in Taif has recovered from MERS. The cases count is now at 1,033 in Saudi Arabia, with 454 deaths. Nine patients are still being treated, and 1 is in home isolation.
Jun 15 MOH update
Jun 14 MOH update
Jun 13 MOH update

Sierra Leone institutes Ebola-related curfew in 2 regions

The president of Sierra Leone has enacted curfews in the country's regions hardest hit by Ebola, according to Reuters and the United Nations Mission for Ebola Emergency Response (UNMEER).

"I have instructed the security to institute chiefdom-level curfew and restriction on movement from 6 pm to 6 am in Kambia and Port Loko districts, with immediate effect," said President Ernest Bai Koroma, according to Reuters. The two districts lie between the capital of Freetown and the country's border with Guinea.

In addition, community-based surveillance will increase in those districts, with heightened military and police patrols, UNMEER reported on Jun 12. President Koroma also eased restriction on trading throughout the country as cases have generally been declining overall, UNMEER added.
Jun 13 Reuters story
Jun 12 UNMEER report

ECDC reports lack of diphtheria antitoxin after case in Spain

A case of diphtheria in Spain—the country's first in almost 30 years—has highlighted not only the need for childhood vaccination but also an urgent lack of diphtheria antitoxin (DAT) in Europe, the European Centre for Disease Prevention and Control (ECDC) said in a rapid risk assessment today.

The case involved a 6-year-old unvaccinated child who was hospitalized on May 28. Diphtheria was confirmed on May 30.

"Unless healthcare providers in the EU have immediate access to DAT there is a risk that patients with toxigenic diphtheria do not receive DAT treatment soon enough for it to optimise its impact," the ECDC said in a press release. "DAT treatment initiated later than 48 hours after onset of systemic toxic symptoms has limited impact although DAT is, when necessary, offered at any stage of the disease."

The scarcity of DAT is because disease incidence has been so low in Europe, the agency said. It added that an inventory of DAT worldwide would be beneficial. "Another option is to assess the need for joint procurement of DAT products to be used in emergencies," the ECDC said in the release.

"The diphtheria case in Spain does not currently represent a serious cross-border threat to health in the EU," the ECDC concluded. Europe has seen a small but steady increase in diphtheria in recent years, to 31 cases in 2013, the most recent year for which data are available.
Jun 15 ECDC rapid risk assessment
Jun 15 ECDC news release

Avian Flu Scan for Jun 15, 2015

News brief

WHO profiles latest H7N9 cases in China

The World Health Organization (WHO) today released a snapshot of 15 H7N9 avian influenza cases, 3 of them fatal, that it received from China on Jun 12.

Today's report didn't include individual details about each patient, but rather a broad epidemiologic view of the most recent infections. The WHO said illness-onset dates range from Apr 19 to May 22 and all of the cases involved exposure to poultry environments.

The ages of patients range from 3 to 77 years, and eight of the people are male. No clusters were reported, and the cases were from seven provinces and cities: Anhui (4), Zhejiang (4), Jiangsu (3), Beijing (1), Fujian (1), Hubei (1), and Jiangxi (1).

The WHO said it is assessing the epidemiologic situation and conducting further risk assessment. It added, however, that the overall public health risk from H7N9 hasn't changed and that more cases are expected in affected areas and possibly neighboring locations.

The number of cases reported by the WHO today is similar to those mentioned in a recent China health ministry monthly update, some of which were reported earlier by provinces and cities, according to earlier statements translated and posted by FluTrackers, an infectious disease news message board.

An H7N9 case list maintained by FluTrackers puts the global total for the disease at 681 cases.
Jun 15 WHO update
Jun 11 CIDRAP News scan "China confirms 9 recent H7N9 cases, 1 death"
FluTrackers H7N9 case list

Iran reports H5N1 in backyard flock

Iran officials have confirmed H5N1 avian flu in a backyard free-range chicken flock in Mazandaran province, which lies along the Caspian Sea, according to a report posted today by the World Organization for Animal Health (OIE).

The outbreak, which began Jun 12, involved 19 sick birds in a flock of 25 in Nogardan village. Seventeen of those birds died, and the rest of the flock was destroyed to prevent disease spread.

Authorities have begun a post-outbreak investigation to trace the source of infection, and surveillance steps have been implemented to track possible spread, the report noted. Officials have also quarantined additional flocks and have initiated disinfection of the affected premises.

Iran has not reported an H5N1 outbreak since January 2012, according to OIE data.
Jun 15 OIE report

More H5N2 outbreaks strike 23,000 poultry in Taiwan

Three new H5N2 avian flu farm outbreaks have affected more than 23,000 poultry total in Taiwan—the latest H5N2 events in the hard-hit region—according to a separate OIE report published late last week.

All the outbreaks are in Yunlin County in the west, one of Taiwan's most-affected counties. They involve geese flocks of 1,500 and 3,380 birds, and a chicken farm of 18,648 birds. Of the 23,528 susceptible poultry, 8,894 were killed from the virus, and the rest were culled to contain the outbreaks, which began on May 28, May 30, and Jun 1.

Samples were sent to Taiwan's National Laboratory after the farms experienced increased poultry deaths. As is standard procedure, a 3-kilometer zone of intensified surveillance has been created around each farm.
Jun 12 OIE report