News Scan for Mar 10, 2015

News brief

Saudi Arabia reports fatal MERS cases as more experts respond

A 72-year-old Saudi woman has died of MERS-CoV in Buraydah, and a previously reported MERS patient has also died, the country's Ministry of Health (MOH) said today as a top official noted more international help with the outbreak.

The woman in Buraydah had preexisting disease and no recent contact with animals or other MERS-CoV (Middle East respiratory syndrome coronavirus) cases in the community. Possible exposure to MERS patients in the healthcare setting, however, is under investigation. She was not a healthcare worker.

The previously reported MERS-CoV patient who died was a 74-year-old man from Riyadh. He likewise had preexisting disease and was not a healthcare worker.

The country has now confirmed 946 MERS cases, including 410 deaths, the MOH reported. Twenty-four patients are recovering or in home isolation. The agency has now confirmed 26 cases so far in March, compared with 75 MERS-CoV cases in all of February.
Mar 10 MOH update

In related news, Saudi Arabia will soon have as many as 33 international and Saudi consultants to assist with its MERS outbreak, Abdulaziz Abdullah Bin Saeed, PhD, MOH undersecretary and chair of the disease Command and Control Center, said in a Saudi Gazette story today.

He said 9 experts from the US Centers for Disease Control and Prevention will join 24 other consultants on a joint venture with the MOH and King Saud University in Riyadh. "The experts will run investigations and conduct research concerning the coronavirus," Saeed said.
Mar 10 Saudi Gazette story

Study indicates MRSA may linger in homes for years

Some folks wonder whether grown children will ever leave the nest. But once methicillin-resistant Staphylococcus aureus (MRSA) enters a home, it can linger and spread for years, evolving genetically to become unique to that household and serving as a disease reservoir, according to a study today in mBio.

US researchers performed whole-genome sequencing of 146 USA300 MRSA isolates, which is the nation's predominant community-transmitted MRSA form and is highly virulent and transmissible. The isolates were obtained from Chicago and Los Angeles households that had an index case involving an S aureus skin or soft-tissue infection.

They evaluated the samples to understand transmission dynamics, genetic relatedness, and microevolution of USA300 MRSA within households and compared these MRSA samples with previously published genome sequences of 35 USA300 MRSA isolates from San Diego and 277 USA300 MRSA isolates from New York City.

The investigators found that household isolates clustered into closely related groups, suggesting a single common USA300 ancestral strain in each household. They also determined that USA300 MRSA had persisted within the households for 2.3 to 8.3 years before samples were collected.

They also found that a large proportion of the USA300 isolates were resistant to fluoroquinolone antibiotics, in addition to having the typical resistance to beta-lactams.

"We found that USA300 MRSA strains within households were more similar to each other than those from different households. Our findings strongly suggest that unique USA300 MRSA isolates are transmitted within households that contain an individual with a skin infection," said senior author Michael Z. David, MD, PhD, of the University of Chicago, in a press release from the American Society for Microbiology (ASM), which publishes mBio.
Mar 10 mBio study
Mar 10 ASM press release

Flu Scan for Mar 10, 2015

News brief

Lawmakers push for more details on flu strain mismatch

Republican and Democratic lawmakers who head a House oversight and investigations subcommittee yesterday sent letters to five federal health officials asking how lessons learned from this flu season—with its flu vaccine mismatched to the main circulating strain—could be used to improve the nation's flu preparedness in time for the next season.

The letters, signed by chairman Tim Murphy, R-Penn., and Diana DeGette, D-Colo., was sent in the wake of a Feb 3 hearing on the topic before the House Energy and Commerce Subcommittee on Oversight and Investigations. They wrote that lessons from the current flu season, which saw the highest ever hospitalization level in seniors, might be used to save thousands of lives in a future severe flu season with a vaccine strain mismatch.

They sent the letters to the heads of the Department of Health and Human Services (HHS), the Food and Drug Administration, the Centers for Disease Control and Prevention (CDC), the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, and HHS's Biomedical Advanced Research and Development Authority.

Murphy and DeGette asked the CDC director under what circumstances the agency would support supplementing the seasonal flu vaccine with a monovalent vaccine if another drifted strain is detected. They also asked whether the CDC examined possible responses to the drifted H3N2 strain between May and November of 2014. Further, they asked federal officials about the possible role for an approval pathway for adjuvants.

Murphy and DeGette asked federal officials to respond to the letters by Mar 23.

The CDC has said a small number of drifted H3N2 viruses were first detected in March 2014, after the strain selection recommendations had been made by experts at the World Health Organization (WHO). It said it monitored the strains over the summer and that by September, when the push for seasonal flu vaccination began, about 50% matched the H3N2 component of the vaccine. Federal officials have said the mismatch played a role in the low effectiveness of this year's seasonal flu vaccines.
Mar 9 House subcommittee press release

WHO: Flu reaching peak levels in Europe

Influenza in Europe seems to have reached its pinnacle while it remains elevated in North America, and some nations in Africa, Asia, and southern Europe are seeing increased 2009 H1N1 activity even though H3N2 is predominating overall, the World Health Organization (WHO) said yesterday in its weekly global flu recap.

Countries in central and western Europe are seeing especially high flu levels, the WHO said. H3N2 continues to predominate in North America, Europe, and temperate Asia.

Flu activity continued to increase in India and Laos, and it remained high in southern China, Hong Kong, South Korea, and Iran. It is declining, however, in northern Africa, the Middle East, northern China, and Mongolia.

Flu activity remains low in the American tropics, and it continues at interseasonal levels in the Southern Hemisphere, the WHO said.

In recent weeks 75% of viruses typed globally have been influenza A. Of those, 79.5% were H3N2 and 20.5% 2009 H1N1. Fully 97% of influenza B viruses belonged to the Yamagata lineage, which matches the "B" strain in trivalent vaccines.
Mar 9 WHO update