New UNMEER leader appointed as Ebola cases increase

United Nations (UN) Secretary-General Ban Ki-moon on Apr 25 appointed Peter Jan Graaff to lead the UN Mission for Ebola Emergency Response (UNMEER), taking the place of Ismail Ould Cheikh Ahmed of Mauritania, who had held the position since late December. Ould Cheikh Ahmed succeeded UNMEER's first chief, Anthony Banbury.

Graaff, from the Netherlands, had been working as the UN's Ebola crisis manager for Liberia since October. He has worked with the World Health Organization (WHO) in several African countries, as well as Afghanistan and Haiti. The UN said Graaff will work closely with the UN's special Ebola envoy, David Nabarro, MD.

Meanwhile, Ould Cheikh Ahmed has been appointed as Ban's special envoy for Yemen. In the statement, the UN leader praised the outgoing UNMEER head for his exceptional work and leadership.

In other developments, the WHO said the number of confirmed, probable, and suspected Ebola cases in the outbreak region has grown to 26,159, including 10,842 deaths. The numbers reflect increases of 58 cases and 18 deaths since the WHO's last update on Apr 24. Today's totals include data from Sierra Leone as of Apr 25, Guinea as of Apr 24, and Liberia as of Apr 19.
Apr 25 UN press release
Apr 27 WHO situation update


Nearly 30,000 new chikungunya cases reported, mainly in Latin America

After a modest increase in reported case numbers for chikungunya the previous week (700-plus), last week's rise of 29,434 is more in line with recent trends in the continuing outbreak. The Pan American Health Organization (PAHO) published new numbers Apr 24.

The week-by-week count may be misleading, because not all countries and territories report each week. For example, the largest increase this past week was reported by Colombia, with 18,516 new suspected and 65 new confirmed cases; however, that number reflects new cases over a 2-week period.

Countries with the next highest increases were Honduras, with 4,729 new suspected cases, and Guatemala, with 4,337 new suspected and confirmed cases; neither country reported to PAHO last week.

The cumulative case count as of Apr 24 stands at 1,401,560, which includes 1,367,343 suspected, 30,580 confirmed, and 3,637 imported cases, most of the latter in the United States.
Apr 24 PAHO update


China's Hubei province reports first H7N9 case

China's Hubei province yesterday reported its first H7N9 avian flu case, in a 50-year-old man who works with and slaughters poultry, according to media and official sources. Hubei is in east-central China.

According to a provincial health department statement translated and posted by FluTrackers, an infectious disease news message board, the man is hospitalized in stable condition. His infection triggered a county emergency response, which included live-poultry market closures, culling, and enhanced surveillance at hospitals.

The man's illness appears to be the fourth H7N9 infection reported in China this month. The case lifts the global total to 658, according to FluTrackers' case list.
Apr 27 FluTrackers thread
Apr 27 Xinhua story
FluTrackers H7N9 case list


Avian flu hits poultry in Taiwan and Vietnam

Three different varieties of avian influenza viruses recently struck poultry in Taiwan and Vietnam, and H5N1 was found in wild birds in Russia, according to reports the governments filed with the World Organization for Animal Health (OIE) in the past few days.

After battling numerous highly pathogenic (HP) H5N2 outbreaks over the winter, Taiwan reported three more to the OIE Apr 24. The incidents involved a goose farm and a chicken farm in Yunlin County and chickens in an abbatoir in Pingtung County.

Of 25,780 birds at the three sites, 13,137 died of the infection, and the rest were culled to stop further transmission, the report said. The sites were cleaned and disinfected, and poultry farms within 3 kilometers of them will be under increased surveillance for 3 months.

Taiwan also was afflicted by a number of HP H5N8 outbreaks over the winter, and on Apr 24 it reported two more on goose farms in Yunlin and Changhua counties. The two flocks included 7,140 birds, of which 3,695 were killed by the virus and the rest were destroyed as a precaution, officials told the OIE.
Apr 24 OIE report on H5N2 in Taiwan
Apr 24
OIE report on H5N8 in Taiwan

In Vietnam, the H5N6 virus struck a village poultry flock in the northern province of Ha Nam, sickening all 1,606 birds and killing 301, according to another OIE report. The surviving birds were destroyed.

Vietnam has had several H5N6 outbreaks since the virus first surfaced there last August. The virus was first identified in China in March 2014 and has caused a few poultry outbreaks there and in Laos, as well as Vietnam. China has had three human H5N6 cases, two of them fatal.
Apr 27 OIE report on H5N6 in Vietnam

In other news, Russian officials told the OIE today that they found the H5N1 virus in five dead Dalmatian pelicans in the Astrakhan region, which is in southern Russia near the northern shores of the Caspian Sea. Partial genetic sequencing indicated the isolates were similar to H5N1 viruses found in Russia last year and in Vietnam and China from 2012 to 2014.
Apr 27 OIE report on H5N1 in Russia


CDC posts travel notices for dengue, Ross River virus

Late last week the Centers for Disease Control and Prevention (CDC) issued two travel notices about mosquito-borne diseases: dengue in Malaysia and Ross River virus disease (RRVD) in Australia.

Both alerts are at the "watch" level, the lowest of the three travel notices that the CDC issues; the others are "alert" and "warning." For a watch, the CDC recommends that travelers practice "usual precautions."

The agency said that Malaysia has had more than 30,800 cases of dengue fever this year through Mar 21, including 308 deaths. Case numbers are up 41% over the same period in 2014.

In Australia, meanwhile, 6,054 RRVD cases have been reported in 2015 through Apr 17, the largest number since 1996, the CDC said in the other travel notice. Most cases have been in Brisbane and the surrounding areas of Queensland. From 55% to 75% of people who get infected with RRVD don't feel sick, the CDC noted. Of those who do feel ill, symptoms can include joint pain and swelling, muscle pain, fever, tiredness, and rash.

For both outbreaks, the CDC advised travelers to practice mosquito-prevention steps, such as covering skin and using insect repellents.
Apr 24 CDC dengue-in-Malaysia travel notice
Apr 24 CDC RRVD-in-Australia travel notice

Food Safety Scan for Apr 27, 2015

News brief

More botulism cases, food suspects found in Ohio outbreak

Health officials in Ohio have confirmed botulism as the illness that sickened several people and killed one who attended the same church lunch in Lancaster, Ohio, on Apr 19, the Lancaster Eagle-Gazette reported on Apr 25.

Five more illnesses have been identified since the outbreak was first reported about a week ago, raising the total 29, according to the report, which said 20 of the cases have been confirmed and 9 are suspected.

The event linked to the outbreak was a lunch on Apr 19 at Cross Pointe Free Will Baptist Church, which was attended by 50 to 60 people, some of whom started getting sick on Apr 21. The fatal case involved a 54-year-old woman.

Cassie Bala, a spokeswoman for the Ohio Department of Health said investigators are still exploring what food source was contaminated, but she said early lab tests yielded six positive specimens and narrowed the list of suspected foods to three: potato salad, spaghetti pasta salad, and macaroni and cheese, according to the report. She added that the results are preliminary and that because the food items were found and retrieved from trash bins, there is a chance of cross-contamination.

Botulism, which is caused by the botulinum toxin produced by Clostridium bacteria, can result from low-acid home-canned foods such as beans that have not been canned properly. According to earlier reports, the US Centers for Disease Control and Prevention is assisting state health officials with the investigation and sent a large quantity of botulism antitoxin for treatment.
Apr 25 Eagle-Gazette story
Apr 22 CIDRAP News scan "Botulism suspected in 24-case church outbreak in Ohio"


Up to 60% of raw frozen shrimp found to harbor bacteria

A new report in Consumer Reports (CR) found that 60% of raw frozen shrimp and 16% of cooked frozen shrimp contained various types of bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), and a number of the samples contained residues of antibiotics.

A total of 284 packages of raw frozen and 58 packages of cooked frozen shrimp were purchased from grocery stores in 27 American cities and tested for Vibrio, S aureus, Escherichia coli, Listeria, and Salmonella, as well as for antibiotic residue. The stores included chain, big-box, and "natural" markets. No never-frozen shrimp, which represents only a small portion of what US consumers purchase, was tested.

About 60% of the raw shrimp was found to contain bacteria, as was 16% of the cooked shrimp. The authors note that the cooking process should kill most bacteria, raising "real questions about how shrimp is raised, processed, and regulated," said Urvashi Rangan, PhD, executive director of the CR Food Safety and Sustainability Center, in the article.

Eleven of the 205 raw shrimp samples that were imported contained one or more antibiotics. And six farmed samples and one wild sample showed traces of MRSA.

About 94% of shrimp eaten by US consumers is imported, largely from Asian countries including India, Indonesia, and Thailand. The feeding of antibiotics to farmed shrimp in the United States is illegal, as is the import of antibiotic-fed shrimp. Only 0.7% of imported shrimp shipments were tested by the Food and Drug Administration (FDA) in 2014, says the article.

The CR researchers term their findings a "cause for concern," but note that their testing of raw chicken breasts in 2013 found that 97% of samples contained bacteria.

CR sent a copy of the article to the FDA with the request that inspections of imported shrimp as well as overall regulation be increased.
Apr 24 Consumer Reports article

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