Luzerne County, Pennsylvania, reports first CWD cases

News brief
White-tailed buck on deer farm
Deb Watson / Flickr cc

Two male deer have tested positive for chronic wasting disease (CWD) in Luzerne County, Pennsylvania, the county's first detections of the fatal neurologic disease, the Pennsylvania Game Commission announced late last week.

Luzerne County is located in the northeastern part of the state, 40 miles from the closest CWD identification in a wild deer.

One of the two adult bucks was harvested by a hunter, and the other was identified on a deer-breeding farm on December 16. The farm is under quarantine for 5 years, which requires testing of deer who die on the farm and prohibits movement of deer to or from the farm, the commission said. The detections will lead to disease-management-area changes in the spring.

Spreads through direct contact, environment

CWD, which affects cervids such as deer, elk, and moose, is caused by infectious misfolded proteins called prions. The disease spreads among cervids through direct contact and environmental contamination. 

No CWD infections have been reported in people, but the US Centers for Disease Control and Prevention recommends against the consumption of infected animals.

Uganda launches Ebola Sudan vaccine trial; sequencing shows no link to 2022 outbreak

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Ugandas health ministry, with support from the World Health Organization (WHO) and its partners, today launched a vaccine trial against the Ebola Sudan virus, the first to assess the clinical efficacy of a vaccine specific to the Ebola Sudan virus.

Ebola vaccination
NIAID/Flickr cc

Tedros Adhanom Ghebreyesus, PhD, WHO director-general, on X today said the trial will enroll contacts of sick people as well as contacts of contacts, known as a ring vaccination strategy. 

This vaccination trial was initiated with record speed, only three days since the outbreak was declared, while ensuring full compliance with international and national regulatory and ethical requirements,” he said, adding that the WHO will continue supporting Ugandas government in its response to the outbreak.

In a January 31 statement, the WHO said the first 2,160 doses of the candidate vaccine, as well as treatments, were already prepositioned in Kampala as part of outbreak preparedness. Uganda has experienced five earlier Ebola Sudan outbreaks. 

Uganda declared the outbreak on January 30. In a February 1 outbreak notice, the WHO revealed more details, including that that male nurses fever symptoms began between January 20 and January 21, and he had sought care from a traditional healer, as well as multiple health facilities before he was hospitalized after his condition worsened.

So far, 45 contacts have been identified, including 34 health workers and 11 family members.

Initial sequencing suggests no links to 2022 outbreak

In another new development, a scientist from Ugandas Central Public Health Laboratory shared preliminary sequencing findings on Virological, an online hub for prepublication data designed to assist with public health activities and research. Stephen Kanyerezi, MSc, a bioinformatics scientist with Makerere University, wrote that sequencing was conducted the same day samples were collected on the day the patient died, which was January 29. 

Phylogenetic analysis suggest that 2025 strain does not cluster with Ebola Sudan sequences from the countrys last outbreak in 2022. However, it shows a strong relationship to sequences from the 2012 Luwero lineage, suggesting a shared epidemiologic source, possibly a common zoonotic reservoir, or an independent spillover event. 

These findings refute the possibility of sustained human-to-human transmission from the 2022 outbreak and raise questions regarding the current outbreaks source and transmission dynamics,” the group said.

TB cases linked to high schools in Michigan, California

News brief
TB drugs
uliia Mikhalitskaia / iStock

Health officials in Michigan's Kalamazoo County are investigating an active tuberculosis (TB) case in a local high school student, and San Diego officials are warning of possible TB exposure at a high school last year, according to a press release published late last week. 

Kalamazoo County Health & Community Services Department (HCS) said it notified

Kalamazoo Public Schools of the case and that the patient is isolated from others and currently undergoing treatment.

Testing of case contacts will take place this week at the school.

Although tuberculosis can be a serious disease, it is a treatable infection.

"Although tuberculosis can be a serious disease, it is a treatable infection. We are working closely with Kalamazoo Public Schools to ensure the safety and health of all staff and students," said William Nettleton, MD, medical director of Kalamazoo County HCS.

San Diego exposure in high school 

Also late last week, San Diego health officials warned of possible tuberculosis exposure at a high school during the 2023-24 academic year. Officials are notifying students, employees, and contractors potentially exposed to tuberculosis at Palomar High School from February 24 to June 5, 2024. 

In 2023, 243 people were reported with active TB disease in San Diego County, the highest level in 5 years, according to a news report. Active infections had been steadily declining since 2000 but increased starting in 2020, health officials said.

An estimated 175,000 people in San Diego County have latent TB infections, of which 5% to 10% may become active in their lifetimes. 

ECDC warns of rise in carbapenem-resistant Enterobacterales infections

News brief
Carbapenem-resistant Enterobacterales
Stephanie Rossow / CDC

The European Centre for Disease Prevention and Control (ECDC) issued a warning today about a rising incidence of carbapenem-resistant Enterobacterales (CRE) infections, saying the risk of further spread is high. 

In a rapid risk assessment, the ECDC said the epidemiologic situation has been deteriorating since 2019. Signs of deterioration include an increase in the incidence of carbapenem-resistant Klebsiella pneumoniae bloodstream infections in 23 European Union/European Economic Area (EU/EEA) nations due to the continued transmission of high-risk lineages of carbapenem-resistant K pneumoniae in hospitals. The agency also notes that a hypervirulent strain of K pneumoniae—sequence type (ST)23—has become resistant to carbapenems.

In addition, the ECDC said carbapenemase genes have been identified in high-risk lineages of Escherichia coli that pose a risk for spread in the community, as well as in newly emerging Enterobacterales species.

High risk of death

CRE infections are resistant to multiple classes of antibiotics, leaving clinicians with few effective treatment options. As a result, CRE bloodstream infections are associated with a high level of attributable mortality.

"These findings indicate a high probability of further spread of CRE in the EU/EEA, both in hospital settings and in community, a worrying trend since CRE infections are linked to high mortality," ECDC Chief Scientist Piotr Kramarz said in an ECDC press release. "Immediate action is essential to control this problem and protect patients from infections that are becoming increasingly difficult to treat."

The ECDC is urging EU/EEA countries to implement enhanced infection prevention and control efforts in hospitals to interrupt transmission of carbapenem-resistant K pneumoniae and other CRE, develop a CRE management plan, strengthen national coordination of control measures between hospitals and regions, bolster genomic surveillance, and apply antimicrobial stewardship to preserve the effectiveness of carbapenems.

"ECDC calls on all EU/EEA countries and hospitals to intensify their efforts to address this deteriorating epidemiological situation, mitigate the high risk of further CRE spread and, ultimately, protect patients and communities," the agency said.

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