Saudi Arabia: Another MERS case linked to camels

Saudi Arabia's Ministry of Health (MOH) reported a new case of MERS-CoV today that is not related to the current outbreak that began at the King Khalid University Hospital in Riyadh.

The MOH said a 86-year-old Saudi man from Al Aflaj is in stable condition after having symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus). This is the second case since May in Al Aflaj, located in the central part of the country.

The patient had indirect contact with camels, the MOH said. Direct contact with camels, or indirect contact—including drinking raw camel milk—is a known risk factor for contracting MERS, but researchers don't know exactly how the animals transmit the virus to humans.

The new case brings Saudi Arabia's MERS-CoV total to 1,438 cases, 604 of them fatal, since 2012. Eight patients are currently being treated for infection.
MOH Jul 14
May 18 CIDRAP news story on previous Al Aflaj case


WHO: More flu activity in South America

The latest global flu report from the World Health Organization (WHO) suggests flu has peaked in Brazil, but flu cases are steadily rising in parts of Latin America and in southern Africa.

The 2009 H1N1 virus and respiratory syncytial virus (RSV) are the main viruses detected in tropical South America, with Colombia and Bolivia reporting increased cases. Influenza detection has seemed to peak in Brazil, and flu activity and hospitalizations have decreased in both Peru and Ecuador.

In Central America, the number of hospitalizations due to pneumonia peaked in El Salvador. Over the past few weeks, Panama has reported decreasing levels of influenza A. Most Caribbean countries are also reporting decreased flu activity. According to the WHO, RSV activity continued in Costa Rica and Guatemala.

Influenza B detection increased in southern Africa, a trend noted in the WHO's Jun 29 update. The agency continues to report that flu activity remains low for this time of year in Australia and New Zealand.

Internationally, influenza A was responsible for 56.5 % of all flu cases, with influenza B causing the rest. Of influenza A viruses subtyped, 74% have been 2009 H1N1.
Jul 11 WHO global flu update


Algorithm may help identify drugs to treat resistant fungal infections

A team of Chinese scientists has developed an algorithm that can identify drug combinations to treat drug-resistant fungal infections.

In a study published today in PLoS Computational Biology, the researchers report that they have developed a novel algorithm—called Network-based Laplacian regularized Least Square Synergistic (NLLSS) drug combination prediction—that successfully identified 7 of 13 synergistic drug combinations to treat the fungal pathogen Candida albicans. The algorithm, which was experimentally confirmed, works by integrating different kinds of information such as known synergistic drug combinations, drug-target interactions, and drug chemical structures.

According to the study, fungal infections are one of the leading causes of hospital-acquired infections and are associated with high mortality, especially in patients with weakened immune systems. Moreover, drug resistance is becoming increasingly common in fungal infections. But synergistic drug combinations—in which the combination of two agents increases the effectiveness of a drug—have become a promising avenue of treatment for drug-resistant infections, the authors said.

The problem, however, is that effective drug combinations have traditionally been identified through screening all possible combinations of a pre-defined set of drugs, which is a timely, costly, and labor-intensive process. Developing an algorithm that can computationally screen and identify synergistic drug combinations to treat drug-resistant fungal infections, the authors said, could save time and money and provide new treatments for overcoming fungal resistance.
Jul 14 PLoS Comput Biol study

Reports note melioidosis, mycobacteria outbreaks tied to healthcare

In two separate reports in Emerging Infectious Diseases, researchers reported cases of melioidosis connected to wound irrigation fluid in Australia and a multistate US outbreak of mycobacterial infections tied to "medical tourism" plastic surgery clinics in the Dominican Republic.

In the first report, West Australia scientists described a patient in January 2012 and five additional patients from September through December 2013 who contracted melioidosis after receiving wound care at the same hospital. The disease typically occurs after environmental exposure to Burkholderia pseudomallei in the tropics.

Testing detected high levels of B pseudomallei in an opened bottle of saline wound irrigation fluid that had been reused even though instructions on the bottle said to discard it within 24 hours of opening. No further cases were detected after the bottle was removed.

The bottle was opened after the first patient received care, so the investigators could not determine the connection between that patient and the rest, even though their B pseudomallei isolated matched genetically.
Jul 8 Emerg Infect Dis report

In the second study, Maryland health officials reported two residents whose surgical sites were infected with rapidly growing mycobacteria after cosmetic surgery in the Dominican Republic.

In response, state and local health officials together with Centers for Disease Control and Prevention (CDC) experts initiated an investigation that turned up 21 patients in six states who had surgery in one of five Dominican Republic clinics, 13 of whom (62%) had surgery in the same clinic as the Maryland patients. Isolates from 12 of those patients were positive via culture testing for Mycobacterium abscessus complex.

Of 9 patients among those 13 who had data available, all required surgery to address the infection, 8 were hospitalized, and 7 required 3 months or more of antibiotics. The authors conclude, "Healthcare providers should consider infection with rapidly growing mycobacteria in patients who have surgical site infections unresponsive to standard treatment."
Jul 13 Emerg Infect Dis study


Study provides new evidence of EV-D68 link to acute flaccid myelitis

A CDC-led study yesterday in Emerging Infectious Diseases provides yet more evidence of the link between enterovirus D68 (EV-D68) and acute flaccid myelitis (AFM) in children during a 2014 outbreak.

Investigators studied 11 children who were hospitalized with AFM in Denver from Aug 8 through Oct 14, 2014. Ten of them had respiratory symptoms preceding their neuropathy, and nasopharyngeal specimens for 4 children tested positive for EV-D68.

Using case-control methodology, the team determined that the kids with AFM had 10.3 times the odds of having EV-D68 compared with children who had an acute respiratory infection, and 4.5 times the odds compared with kids with pertussis. The researchers noted no statistical association between acute flaccid myelitis and non–EV-D68 enterovirus or rhinovirus infection.
Jul 13 Emerg Infect Dis study
Mar 31, 2015, CIDRAP News story "Genetic study boosts evidence for EV-D68 in polio-like cases

This week's top reads

Our underwriters