News Scan for Aug 10, 2015

News brief

Canadian cyclosporiasis outbreak numbers 83 cases

A total of 83 Cyclospora infections have been reported from four Canadian provinces, according to an Aug 8 press release from the Public Health Agency of Canada (PHAC).

The preponderance of cases so far have been in Ontario with 74, followed by Quebec with 5, British Columbia with 3, and Alberta with 1. The outbreak began May 9; most cases occurred between late June and early July, with the last reported case Jul 18, said a press release.

Two cases have required hospitalization, but no deaths have occurred.

The PHAC is investigating the outbreak, but no source of the infection has yet been identified. Because previous Cyclospora outbreaks have been linked with imported fresh produce, officials are urging the public to practice good food hygiene, including proper cleaning and storage of fresh fruits and vegetables.

People at increased risk of complications include those with a weakened immune system, young children, and older adults. The infection can be treated with antibiotics.

A large cyclosporiasis outbreak is ongoing in the United States, with 384 cases in 26 states as of Aug 4; the majority have occurred in Texas. No updates from the Centers for Disease Control and Prevention or the Texas Department of State Health Services have been issued since Aug 4.
Aug 8 PHAC press release
Aug 5 CIDRAP News item on US outbreak


WHO notes increased flu activity in Southern Hemisphere and Cuba

Influenza activity is increasing in Australia, New Zealand, Cuba, Senegal, and Peru, the World Health Organization (WHO) said in an update today.

While overall global flu detections remain low or are decreasing, activity in Australia and New Zealand continues to rise, with H3N2 and influenza B both circulating. New Zealand is also reporting increased detections of influenza-like illness (ILI) and severe acute respiratory infections (SARI).

Senegal has reported high levels of influenza B viruses, although influenza detections in other reporting African countries remain low or are decreasing. Cuba saw an increase in 2009 pandemic H1N1 and parainfluenza viruses, and Peru reported a small increase in 2009 H1N1 and H3N2.

Low or decreasing levels of flu were reported in western and temperate Asia, with inter-seasonal co-circulating levels of 2009 H1N1 and flu B. While flu levels in Southeast Asia remain low, Laos and Vietnam reported elevated levels of H3N2 co-circulating with flu B. Northern China, where flu levels have risen over the past month, reported a decrease in detections.

Flu detections continue to decrease in temperate South America, where 2009 H1N1 and H3N2 are circulating. Flu levels in Chile and Paraguay are elevated, yet low. Uruguay 's flu detections are low, yet it is experiencing increases in ILI and SARI hospitalizations and intensive care admissions.

Of 2,699 specimens worldwide that tested positive for flu, 83% were influenza A and 17% influenza B. Of the A viruses, 97% were H3N2. Almost all B viruses (91%) belonged to the Yamagata lineage.
Aug 10 WHO update


Black healthcare workers have higher flu vaccine concerns, lower uptake

Black healthcare workers (HCWs) were less likely to be vaccinated against influenza because of high concerns about the vaccine as compared with non-Hispanic whites, according to a recent study in the American Journal of Public Health.

Researchers surveyed 2,003 HCWs at St. Jude Children's Research Hospital in Memphis, Tenn., about flu vaccine concerns and uptake during the 2012-13 flu season. The majority of respondents identified as female (71%) and non-Hispanic white (72%); 16% of respondents identified as non-Hispanic black.

Nearly one-third (32%) of respondents had direct patient contact, and 82% supported mandatory flu vaccination for HCWs.

Overall, 87% of the study population received the flu vaccine during the 2012-13 season. Of these, 90% were non-Hispanic whites and 77% were non-Hispanic blacks. Most HCWs with direct patient contact (97%) were vaccinated.

HCWs who expressed a high level of concern with the vaccine (13% of the study population, or 263) believed that the vaccine might cause influenza (63%), cause serious side effects (97%), be ineffective (52%), or be unnecessary (28%).

A decision not to be vaccinated because of vaccine concerns was associated with race and ethnicity. Non-Hispanic HCWs had a 13% lower uptake rate, and vaccine uptake was below 50% for non-Hispanic black HCWs who expressed high concern with the vaccine.

Researchers said that the promotion of trust and mediation of common flu vaccine concerns may help in future efforts to reduce racial and ethnic disparities in HCW vaccination.
Sep 2015 Am J Public Health study

This week's top reads