News Scan for Dec 05, 2017

News brief

New MERS case reported in Saudi Arabia

The Saudi Arabian Ministry of Health (MOH) reported a new case of MERS-CoV in Sakaka, a city in the northwestern corner of the country.

A 64-year-old Saudi man is in stable condition after presenting with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus) infection. His source of infection is listed as "primary," meaning it's unlikely he contracted the virus from another person.

Saudi Arabia's MERS-CoV case count since 2012 has now reached 1,753, including 709 deaths. Five patients are still being treated, according to the MOH.
Dec 4 MOH report

WHO to conduct full review of Dengvaxia

Yesterday the World Health Organization (WHO) announced it will be conducting a full review of Dengvaxia, the Sanofi Pasteur dengue vaccine, by the end of the year.

Last week, Sanofi said the vaccine should only be administered to people who had a previous dengue infection, because for dengue-naive recipients, the vaccine could cause more severe disease. The WHO reiterated this recommendation on Nov 30, according to a news story from Reuters.

Dengvaxia was a promising dengue vaccine more than 20 years and $1 billion in the making. Results from phase 3 trials, however, showed that the vaccine was related to more severe disease in patients, including children, who were immunized before acquiring a dengue infection.

The Manila Times is reporting that the Philippine's Food and Drug Administration ordered a recall of Dengvaxia yesterday. The Philippines was the first country to halt dengue immunizations after Sanofi's announcement last week. According to the Manila Times, the vaccine has been administered to more than 700,000 people in the Philippines in recent years.
Dec 4 Reuters story
Dec 4 Manila Times story

WHO: Plague contained in Madagascar

In an update yesterday, the WHO said that although the plague outbreak in Madagascar is now contained, sporadic cases can be expected throughout the plague season, and it noted dozens of newly reported cases.

From Nov 20 to Nov 27, 72 plague cases, including 1 confirmed, were reported. Six cases were labeled "probable" and 65 "suspect." Since Aug 1, a total of 2,417 confirmed, probable, and suspected cases of plague, including 209 deaths (case fatality rate 9%), have been reported in 57 of 114 (50%) districts in Madagascar. About 77% of cases have been classified as pneumonic plague.

The WHO said the number of plague cases has steadily declined since mid-October, but plague season can last until April in the country. The date of symptom onset for the most recently diagnosed case was Nov 19.

"While the number of new cases and hospitalizations are declining, evidence suggests that the epidemic phase of the acute urban pneumonic plague outbreak is ending," the WHO said.
Dec 4 WHO update

Angola reports 42 microcephaly cases but no Zika involvement

Angola is experiencing a "slow but gradually increasing" incidence of microcephaly, especially in the suburbs of Luanda, the country's capital, that might be tied to Zika virus infections, the WHO's African Region said in an update yesterday.

Officials first noted an uptick of cases in late September, when a cluster of seven instances of microcephaly—a condition in which infants' heads are abnormally small and they often have brain abnormalities—were reported. As of Nov 29, officials in the African nation have reported 42 cases, 39 in live births and 3 in stillbirths. All but 3 of the cases have been in Luanda province, notably in the southern part of the city.

All 15 blood specimens to date have tested negative for Zika by polymerase chain reaction (PCR). "Nonetheless, the negative test result does not necessarily rule out the possibility of Zika infection during pregnancy," the WHO report said.

The WHO also reported that two Zika cases were confirmed by PCR in Luanda province in January, one in an adult who had a febrile illness and the other in a stillborn with malformation of the central nervous system. No genotyping of the virus was performed to determine the strain. Officials have seen no evidence of ongoing active Zika transmission, the WHO said.

The country's health ministry has strengthened its Zika surveillance and will ramp up mosquito-control efforts, the report noted.
Dec 4 WHO African Region update

Flu Scan for Dec 05, 2017

News brief

Updated guidance for pandemic flu includes new ways to track cases

For the first time since 2009, the World Health Organization (WHO) updated its pandemic influenza guidance, emphasizing the need for better tracking during the human-to-human transmission phase. The new guidance was published yesterday.

The WHO defined and named phases of an influenza pandemic. In the alert phase, when human-to-human transmission begins, the agency said there is no need for case-counting.

"Case-based reporting (the counting of individual cases) should cease once there is broad community transmission in a country—at this point, syndromic data from sentinel sites, hospital-based data and systematic laboratory testing should be used instead," the WHO said.

Case definitions are also newly emphasized in this guidance. Included in the guidance is a sample for a clinical intake description used at the initial phase of a pandemic to rapidly collect and configure data related to the virus. This form is based on deficits in reporting during the 2009 pandemic.
Dec 4 WHO guidance

Taiwan detects new H5N6 avian flu reassortant in wild bird

Taiwan today reported its first detection of a reassortant highly pathogenic H5N6 avian flu strain that was recently found in South Korea and Japan, and two European countries—Italy and France—reported new outbreaks involving other strains.

Taiwan's detection involved a black-faced spoonbill found dead on Dec 1 in Taijiang National Park, according to a notification today from the World Organization for Animal Health (OIE). Tests yesterday confirmed the H5N6 subtype, and a preliminary analysis suggest the H5N6 virus is different than the one last linked to an outbreak in Taiwan in February 2017.

The virus is closely linked to a strain found in Japan in November and is a reassortant of H5N8 that triggered outbreaks across Europe last season and an N6 strain similar to those widely distributed in Eurasian waterfowl.

Officials have completed sampling at four chicken farms within a 5-kilometer radius of the spot where the dead bird was found, and all flocks are clinically healthy. Officials ordered heightened surveillance for the next 3 months to monitor for possible spread of the virus.
Dec 5 OIE report on H5N6 in Taiwan

In Europe, Italy reported another highly pathogenic H5N8 outbreak, this time involving backyard poultry including broilers, geese, peacocks, layer hens, and ducks at a location in Veneto region, according to a Dec 1 OIE report. The outbreak began on Nov 22, killing 70 of 142 birds. Authorities culled the remaining poultry.

In a separate OIE report yesterday, French officials confirmed a low-pathogenic H5N3 outbreak involving a farm raising ducks for foie gras production in Lot-et-Garonne department in the country's southwest. The outbreak began on Dec 1, and the virus was found during routine sampling before the ducks were moved. The animals didn't show any clinical signs. The flock is slated for culling, and authorities have temporarily banned poultry movement in the country and have stepped up surveillance.
Dec 1 OIE report on H5N8 in Italy
Dec 4 OIE report on H5N3 in France