News Scan for Dec 21, 2017

News brief

New MERS case reported in Saudi Arabia

The Saudi Arabian Ministry of Health (MOH) announced a new case of MERS-CoV in Taif today.

A 45-year-old Saudi woman is in stable condition after presenting with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus) infection. Her source of infection is listed as "primary," meaning it's unlikely she contracted the virus from another person. She is not a healthcare worker.

This is the first case recorded in Saudi Arabia since Dec. 4.

Saudi Arabia's MERS-CoV case count since 2012 has now reached 1,756, including 712 deaths. One patient is still being treated, according to the MOH.
Dec 21 MOH report


Cooling tower study shows Legionella illness potential across most of US

In the first large-scale study of Legionella in US cooling towers, researchers found that 84% had DNA evidence of the bacteria based on polymerase chain reaction (PCR) testing, with the strain linked to the most common disease-causing subtype cultured in nearly one in four of that group.

The team from the US Centers for Disease Control and Prevention (CDC) analyzed samples from 196 cooling towers across eight of nine US climate regions. They reported their findings yesterday in PLoS One.

The cooling tower samples were collected from July to September of 2016. After PCR screening, the investigators cultured the ones that were positive and characterized the Legionella isolates they found. DNA positives were linked to all of the climate regions tested, with culture tests isolating Legionella from 78 of them (47%.)

Of 144 unique Legionella isolates, 76 (53%) were Legionella pneumophilia, and of those, the most common was serogroup 1 (Lp1), found in 39 (51%). In a large number of culture-positive samples, that serogroup was found alongside other subtypes.

The researchers also analyzed the microbiome of the cooling tower samples to look at what other organisms may be present, finding that they were similar across climate regions.

The authors concluded that Legionnaires disease cases and outbreaks have the potential to occur across the United States, wherever cooling towers are colonized and susceptible people are in the vicinity. More research is needed to better understand bacterial and water system dynamics, they wrote, which would help shed light on the factors that cause Legionella to shift from an environmental bacterium to an outbreak pathogen.
Dec 20 PLoS One abstract


Now 1 million cholera cases recorded in Yemen

Yemen's cholera case count has surpassed 1 million, according to a tweet today from the International Committee of the Red Cross (ICRC).

This is now the largest cholera outbreak in modern history, surpassing Haiti's outbreak that began in 2010.

The Yemeni crisis began in October 2016 but picked up speed this April when approximately 5,000 cases were reported each day. According to the latest epidemiologic  report from the World Health Organization (WHO), the case-fatality rate for the outbreak is 0.22%.

As of Dec 17, officials had reported 994,751 suspected cholera cases and 2,226 associated deaths, the WHO said. Children under the age of 5 represent 28.3% of suspected cases. A significant proportion, approximately 17%, of all cases are classified as "severe."

For almost 3 years, war between a Saudi-led coalition and Houthi rebels has displaced thousands of Yemenis and made access to clean food and water impossible for 80% of the country's population. Saudi military blockades prevented humanitarian shipments of medicine and supplies until early November.
Dec 21 ICRC Twitter post
Dec 21 Al Jazeera story
Dec 19 WHO epi report


CDC issues travel notices for measles outbreaks in Europe

Travelers to England and Greece should be aware of new measles outbreaks in those countries, according to travel notices posted yesterday by the US CDC.

Both travel notices are under the CDC's level 1, "practice usual precautions," category. As of Dec 19, Public Health England reported 34 cases of measles in Liverpool, Leeds, and Birmingham. Greece has had nearly 500 cases since August, according to Outbreak News Today.

The CDC recommends all Americans traveling to those countries be current on their MMR (measles, mumps and rubella) immunizations. Before traveling, infants (6 through 11 months) should have one dose of MMR vaccine, and adults and children over 1 year should have two doses of MMR vaccine separated by at least 28 days.

"Clinicians should keep measles in mind when treating patients with fever and rash, especially if the patient has recently traveled internationally," the CDC said.

According to the CDC, most measles cases in the United States are contracted during international travel.
Dec 20 CDC England notice
Dec 20 CDC Greece notice
Dec 21 Gov.UK
Dec 9 Outbreak News Today
CDC measles

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