News Scan for Jan 08, 2019

News brief

Two more cases reported in DRC Ebola outbreak, 627 total

The Democratic Republic of the Congo's health ministry today reported two new cases, edging the outbreak total to 627 cases, including 579 confirmed and 48 probable infections. One of the new case-patients is from Oicha, and the other is from Katwa.

Health officials are still investigating 98 suspected Ebola cases.

Five more deaths were reported: three in Butembo and one each in Beni and Katwa. The fatality from Katwa involves someone who died in the community, a factor known to increase the risk of Ebola transmission.

The number of people who received the VSV-EBOV vaccine continues to rise. Since Aug 8, 58,866 people have been vaccinated.

The World Health Organization (WHO) African regional office said today in a weekly outbreak and health emergency report that Butembo, Katwa, and Oicha are the current main hot spots in the outbreak, which is now entering its sixth month. It said resumption in response activities in the wake of recent election protest disruptions is encouraging, but more interruptions could pose serious problems for timely containment of the outbreak.
Jan 8 DRC statement
Jan 8 WHO African regional office weekly


New filovirus identified in samples from Chinese bat

Tests on samples from a Rousettus bat in China have revealed a new filovirus, named Mengla virus, that is similar to Ebola and Marburg viruses, a team from Singapore's Duke-NUS Medical School and China reported yesterday in Nature Microbiology.

The new virus was found during analysis of filovirus diversity in the bat species, and researchers named it Mengla virus, because it was discovered in Mengla County in China's Yunnan province.

Genetic sequencing suggests Mengla virus is part of a new genus called Dianlovirus within the filovirus group and is genetically distinct, sharing just 32% to 54% genetic similarity with other known filoviruses. The team reported that it is found in different geographic locations compared to other filoviruses, could contain more one species, and sits between Ebola virus and Marburg virus on the evolutionary tree, Duke University Medical School said in a press release.

Functional tests using cell lines from different animal species found that, similar to other filoviruses, Mengla virus poses a risk of interspecies transmission. Characterization of genome organization revealed that Mengla virus uses the same molecular receptor, a protein called NPC1, as Ebola and Marburg do to enter cells and trigger infection. So far, the new filovirus has been found only in bats, and more tests will be done to better gauge the risk of transmission to other species.

Patrick Casey, PhD, senior vice dean of research at Duke-NUS Medical School, said in the press release, "With globalisation, it is important to identify and assess the risk of potential infectious disease outbreaks and, from it, develop effective controls strategies and treatments."
Jan 7 Nat Microbiol abstract
Jan 7 Duke University
press release


Study: Screening US blood donations for Zika not cost effective

A new study in Annals of Internal Medicine suggests that screening blood bank donations for Zika virus is cost effective only for donations made in Puerto Rico during high mosquito season, but not for donations in all 50 United States.

The study echoes work published in the New England Journal of Medicine (NEJM) last May, which showed that screening in the United States cost about $42 million in the 15 months after the Zika outbreak emerged and identified only nine Zika-positive donations.

In 2016, the US Food and Drug Administration recommended the universal screening of all blood donations for Zika, but researchers from Stanford University Vitalant Research Institute and the American Red Cross used a microsimulation to show that the screening was only effective during Puerto Rico's high mosquito season at $81,123 per quality-adjusted life-years (QALY)  (95% confidence interval [CI], −$49 138 to $978 242 per QALY).

"If the ZIKV rate among donors remained unchanged, we would expect transfusion transmission of ZIKV to result in 1 case of Guillain–Barre syndrome every 16 years in Puerto Rico (every 84 years in the 50 states) and 1 case of congenital Zika syndrome every 33 years in Puerto Rico (every 176 years in the 50 states) without screening," the authors concluded.
Jan 8 Ann Intern Med study
May 9, 2018, CIDRAP News story, "Study: Zika blood donation screening costly, finds few cases"


More than 400 new yellow fever cases reported in Nigeria

Since the previous update issued on Dec 18, Nigeria has recorded 494 new suspected cases and 31 additional deaths in an ongoing yellow fever outbreak.

According to an update today from the WHO African regional office, there have been 4,004 suspected cases of the virus recorded in Nigeria since September of 2017, including 33 deaths (case fatality ratio 0.8%). Among confirmed cases, the case-fatality rate is 16%.

All 36 of Nigeria's states have recorded cases, with Edo state recording 46 suspected cases in the last 3 weeks.

"The outbreak in Edo state is occurring close to the state capital, Benin city, which is densely populated with high population movements due to national and international trade. The high population mobility and suboptimal vaccination coverage within Nigeria and in neighbouring countries, represent risk factors for the continued transmission and further spread of the disease," the WHO said.

During the last week of December, more than 1.4 million Nigerians in Edo state and other targeted areas received the yellow fever vaccine as part of a broad campaign to stop the outbreak. Nigeria introduced the yellow fever vaccine into routine immunizations in 2016, but much of the population is still at risk for contracting the mosquito-borne virus.
Jan 8 WHO update

Flu Scan for Jan 08, 2019

News brief

Flu vaccine tied to fewer hospitalizations among COPD patients

Patients with chronic obstructive pulmonary disease (COPD) who received the seasonal influenza vaccine had a38% reduction in influenza-related hospitalizations compared with those who were unvaccinated. The findings, based on a Canadian study, are published in Chest.

The study looked at the vaccination status of 4,198 COPD patients hospitalized with any acute respiratory illness or exacerbation from 2011 to 2015 at 46 Canadian hospitals.

According to the study, the seasonal flu vaccine reduced influenza-related hospitalizations among patients with COPD by 37.5% (95% confidence interval, 27.3% to 46.2%) compared with unvaccinated patients.

Influenza-positive patients were more likely to suffer from severe infections and mortality if they were over the age of 75, had a cardiac comorbidity, or were a resident in long-term care facilities.
Jan 4 Chest study


WHO: Influenza activity jumps across much of Northern Hemisphere

In its latest global influenza update, the World Health Organization (WHO) reported an increase of influenza activity across most of the Northern Hemisphere, with the 2009 H1N1 strain predominating in North America and Eastern Asia.

In North America, influenza-like illness (ILI) in the United States is above the national baseline, and pediatric hospitalizations in Canada picked up, mirroring the 2011-2012 flu season. Mexico is also seeing increased H1N1 activity.

The WHO said the influenza season appears to have started in East Asia. "ILI activity increased further with mainly influenza A(H1N1)pdm09 reported in China and China, Hong Kong SAR. ILI levels sharply increased in the Republic of Korea, with mainly influenza A(H1N1)pdm09 detections," the agency said.

In Europe, both influenza A strains H1N1 and H3N2 were circulating in equal proportions. In Iran, activity increased because of circulating H3N2.

Of all flu specimens tested worldwide, 93.8% were influenza A and 6.2% were influenza B. Of subtyped influenza A viruses, 77% were 2009 H1N1 and 23% were H3N2.
Jan 8 WHO update

This week's top reads