Two new Ebola cases in DRC raise outbreak total to 3,418

The World Health Organization's (WHO's) online Ebola dashboard shows two newly confirmed cases of the virus in the Democratic Republic of the Congo (DRC). The outbreak totals now stand at 3,418 cases, including 2,240 deaths. A total of 494 suspected cases are still under investigation.

Yesterday the DRC's Ebola technical committee (CMRE) confirmed that one of the new cases was located in Beni.

The CMRE also updated vaccination numbers. As of yesterday 7,611 people had been vaccinated with Johnson & Johnson's Ebola vaccine, and 275,485 had received Merck's rVSV-ZEBOV. 
WHO Ebola dashboard
Jan 26 CMRE update


MERS infects 3 more in Saudi Arabia

Saudi Arabia's Ministry of Health (MOH) over the past few days reported three more MERS-CoV cases, one of them fatal and one of them apparently linked to a cluster of cases in Abha in the country's southwest.

In its Jan 25 update, the MOH said one of the patients is a 58-year-old woman from Buraydah who died from her illness. The woman's exposure to MERS-CoV (Middle East respiratory syndrome coronavirus) is listed as primary, meaning she probably didn't contract it from another known patient. Buraydah is in north-central Saudi Arabia.

Today, the MOH said MERS-CoV was detected in a 52-year-old woman from Abha, who had secondary exposure to the virus. She is not a healthcare worker. Over the past few weeks, five cases have been reported in Abha, three of them involving healthcare workers, hinting at a hospital-related outbreak.

The third patient is an 85-year-old man from Sakaka in Al Jowf region, located in the north. He didn't have recent contact with camels, and his exposure is thought to be primary.

Saudi Arabia has now reported 12 cases in January.

The WHO said in its latest monthly update that, since 2012, it has received reports of 2,499 MERS-CoV cases, at least 861 of them fatal.
Jan 25 Saudi MOH report
Jan 27 Saudi MOH report


FDA approves fidaxomicin for treating C difficile in children

Merck announced today that the US Food and Drug Administration (FDA) has approved the macrolide antibiotic fidaxomicin (Dificid) for the treatment of Clostridioides difficile in children.

According to a company press release, the FDA has approved the company's New Drug Application (NDA) for fidaxomicin for oral suspension and a supplemental NDA for the use of fidaxomicin tablets and oral suspension in children aged 6 months and older. The approval is based on results of the SUNSHINE study, a phase 3 clinical trial evaluating the safety and efficacy of fidaxomicin in children from 6 months and older. It was the first randomized controlled trial of C difficile treatment in children.

The trial randomized 142 patients to receive either fidaxomicin (suspension or tablets, twice daily) or vancomycin (suspension or tablets, four times daily) in a 2:1 ratio. The results showed that the clinical response in the overall pediatric population was similar between fidaxomicin and vancomycin (77.6% vs. 70.5%), while the sustained clinical response—defined as confirmed clinical response and no C difficile–associated diarrhea recurrence through 30 days after treatment—was higher for fidaxomicin (68.4% vs 50%).

Treatment discontinuation due to adverse reactions was reported in 7.9% of fidaxomicin patients in a phase 2, single-arm trial, and in 1% of patients in another phase 3 randomized trial.

"C. difficile is an important cause of health care- and community-associated diarrheal illness in children, and sustained cure is difficult to achieve in some patients," said Larry K. Kociolek, MD, associate medical director of infection prevention and control at Ann & Robert H. Lurie Children's Hospital of Chicago. "I am very excited to have a new C. difficile infection treatment option for my pediatric patients."

The FDA granted priority review for both applications in October 2019.
Jan 27 Merk press release


CDC warns of another Salmonella outbreak linked to pet turtles

Late last week the US Centers for Disease Control and Prevention (CDC) announced a Salmonella Typhimurium outbreak linked to pet turtles. So far 34 people in nine states have been sickened, including 11 hospitalizations.

"Children younger than 12 account for almost two-thirds of the illnesses," the CDC said. "People reported contact with turtles with shells less than 4 inches long."

Pet turtles have been the cause of Salmonella outbreaks in the past, most recently in October of 2019. The FDA bans the sale of turtles less than 4 inches long, but the animals are often bought online and at flea markets.

California has the most cases, with 18, followed by Illinois (4) and Nevada (3). Arizona, Connecticut, Kentucky, Pennsylvania, Texas, and Utah each reported 1 or 2 cases.
Jan 24 CDC update


Uganda confirms 4 yellow fever cases, 2 affected districts

Uganda's MOH has reported four yellow fever cases in two districts, both in the northwest, the WHO's African regional office said today in a statement. Three of the patients died.

Moyo district has two confirmed cases, both in young men, aged 18 and 21. The two, both in the timber trade, traveled from South Sudan to Moyo on Jan 2. They fell ill the next day and were admitted to Logobo Health Center III in Moyo district. They were later referred to Moyo General Hospital with fever, vomiting, diarrhea, fatigue, headache, abdominal and joint pain, confusion, and unexplained bleeding. Both died in Moyo General.

In Buliisa district, a 37-year-old man and his 38-year-old wife were infected. The husband was a cattle farmer who traded milk between the DRC and Uganda. He visited Buliisa Hospital on Oct 31, 2019, with a headache, vomiting, and abdominal pain and received supportive care. He died in the hospital on Nov 4.

After samples from the man tested positive for yellow fever on Dec 10, officials collected samples from seven of his contacts. His wife tested positive on Jan 22 but is doing well.

The WHO and the Uganda MOH have dispatched rapid response teams, and vaccination efforts are planned to begin in the next 2 weeks, the WHO said.
Jan 27 WHO Africa statement

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