Ebola sickens 1 more in DRC outbreak, 110 total, 47 fatal

One more Ebola case has been reported in the Democratic Republic of the Congo (DRC) Equateur province outbreak, lifting the overall total to 110, the World Health Organization (WHO) African regional office said in a Twitter update today.

No new deaths have been reported, keeping the outbreak's fatality count at 47.

The outbreak, the 11th involving Ebola in the DRC, was first detected in early June and is occurring in the same area in the country's northwest region as a similar outbreak in 2018, which led to 54 cases, 33 of them fatal. Investigations suggest that the new outbreak likely reflects a new jump from animals to people and doesn't seem related to the earlier outbreak or a recent large outbreak in the eastern DRC.
Sep 3 WHO African regional office tweet


US Salmonella outbreak linked to onions tops 1,000 cases

The Centers for Disease Control and Prevention (CDC) this week reported that 143 more people have been sickened with Salmonella infections linked to onions. The total number of people infected in the outbreak that began on Jun 19 is now 1,012, with cases reported in 47 states.

Epidemiologic and trace-back information indicates that red onions are the likely source of the outbreak strain of Salmonella Newport, but that white, yellow, or sweet yellow varieties are also likely to be contaminated because of the way onions are grown and harvested. In interviews, 90% of people reported eating onions or foods containing onions in the week before their illness started.

Thirty-four illness clusters have been identified in 13 states, and trace-back information from several of these clusters identified Thomson International, of Bakersfield, California, as the likely source of the red onions. The company recalled its onions on Aug 1, and other companies have since recalled foods made with recalled onions.

The CDC is urging consumers to check their homes for onions or other foods recalled by Thomson International and several other companies, including Food Lion, Giant Eagle, Kroger, Publix, Ralph's, Trader Joe's, and Walmart.

A total of 136 hospitalizations have been reported in the outbreak, with no deaths. Whole genome sequencing (WGS) of 732 bacterial isolates from ill people predicted antibiotic resistance in two isolates; one had predicted resistance to ampicillin, and the other to tetracycline. WGS also showed that an outbreak of Salmonella Newport in Canada is genetically related to the US outbreak.
Sep 1 CDC food safety alert


Wisconsin records first case of eastern equine encephalitis virus in 2020

The Wisconsin Department of Health Services (DHS) announced yesterday the state's first case of eastern equine encephalitis (EEE) virus this year, in a girl from Eau Claire County.

Last week the state announced that horses in three northwestern counties had also been diagnosed as having EEE, a mosquito-borne virus. The last human case in Wisconsin was in 2017.

Though human infections of EEE are rare, they can be deadly. According to the CDC, approximately 30% of those diagnosed with EEE die from the infection.

In addition to the Wisconsin case, three human cases of EEE have been recorded in Massachusetts this year, the CDC said.
Sep 2 DHS press release

COVID-19 Scan for Sep 03, 2020

News brief

Most US residents initially obeyed COVID-19 lockdowns, mobile data show

Residents ventured out about 98% less in most counties in the 42 US states and territories that issued stay-at-home orders to contain SARS-CoV-2, the virus that causes COVID-19. But after the first state relaxed those orders, more people were active outside of their homes in states that had not eased those orders, according to a study published today in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report (MMWR).

The study, conducted from Mar 1 to May 31, involved analysis of data from government websites and mobile devices. During the study period, 22 jurisdictions shifted from mandatory orders to advisories, 11 ended or allowed orders to expire, and 1 state's orders were overturned by its supreme court. The first state to end stay-at-home orders was Alaska, on Apr 24. Eight jurisdictions' mandatory orders applied to at least part of the population beyond May 31.

County-level differences in population movement varied by stay-at-home order date and urban or rural status. Stay-at-home orders resulted in less resident movement in 2,295 (97.6%) of the 2,351 counties that had data. Regardless of rural or urban county status, movement rose significantly immediately after orders were lifted or expired—even in states that still had lockdowns.

The authors said the findings show that lockdowns may reduce population movement and face-to-face contact in the community and that the implementation of public health policies in one state may also influence behaviors in other states. They added that it's important to recognize the individual and societal costs of stay-at-home orders.

"Although stay-at-home orders might assist in limiting potential exposure to SARS-CoV-2 and have had public support, such orders substantially disrupt daily life and have resulted in adverse economic impact," they wrote. "Further studies are needed to assess the timing and conditions under which stay-at-home orders might be best used to protect health, minimize negative impacts, and ensure equitable enforcement of community mitigation policies."
Sep 3 MMWR study


Indiana data: Non-whites, older people much more likely to die of COVID-19

The COVID-19 case-fatality rate (CFR) in community-dwelling Indiana residents was three times higher in non-whites and 2.5 times higher than that of flu in people 65 years and older, a study published yesterday in the Annals of Internal Medicine found.

Indiana University researchers analyzed coronavirus prevalence estimates of people 12 years and older from a random sample taken across their state and COVID-19 tests from Apr 25 to 29. Nursing home residents, which made up 54.9% of the state's deaths at that time, weren't counted because they would have been unable to leave their facilities for testing.

The overall CFR was 0.26%, falling to 0.01% in residents younger than 40 years but rising to 1.71% in those 60 and older. Whites' CFR was 0.18%, compared with 0.59% in non-whites.

The authors noted that death rates typically inflate the actual CFR because they are calculated on the basis of confirmed cases, which do not reflect true case numbers because so many COVID-19 infections generate no symptoms and thus go undetected.

"We found that the risk for death among infected persons increased with age," the researchers wrote. "Of note, the [CFR] for non-Whites is more than 3 times that for Whites, despite COVID-19 decedents in that group being 5.6 years younger on average."
Sep 2 Ann Intern Med research letter

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