MERS infects 1 more in Saudi Arabia as WHO details 2 clusters

Saudi Arabia's Ministry of Health (MOH) reported another MERS-CoV case, which involves a 70-year-old woman from Riyadh, the country's capital. In a related development, the World Health Organization Eastern Mediterranean regional office (WHO EMRO) shared new details about a string of recent cases in the Saudi city of Khafji in April, which it said included two clusters.

Regarding the new Saudi case, the patient's history of contact with camels is unknown, and a May 11 update to the ministry's epidemiologic week 19 report lists her exposure as primary, meaning she isn't thought to have contracted MERS-CoV (Middle East respiratory syndrome coronavirus) from another patient. The woman's illness is the fourth to be reported in Riyadh since the middle of April.

Saudi Arabia has confirmed 138 MERS cases so far this year.
May 11 Saudi MOH epidemiologic week 19 report

WHO EMRO said 29 new Saudi MERS cases were reported in April, 11 of them fatal, and all were from Saudi Arabia. It said no new cases were reported in the large Wadi ad Dawasir outbreak, and that event is presumably over. It added, however, that a new outbreak occurred in Khafji, including one of its hospitals, totaling 13 cases, 6 of them fatal.

The Khafji cases reflect two clusters, one linked to the hospital that resulted in 10 cases, 5 of them involving healthcare workers, and three deaths. The second cluster involves three hospital-acquired cases, two of them fatal, plus one household contact.

Through April, the WHO had received 2,428 reports of lab-confirmed MERS-CoV cases globally, at least 838 of them fatal. About 84% were in Saudi Arabia, which has reported 2,037 cases and 760 related deaths.
April WHO EMRO MERS situation update


CDC creates education module for Rocky Mountain spotted fever

Today the US Centers for Disease Control and Prevention (CDC) announced the creation of an online educational module aimed to help inform clinicians about Rocky Mountain spotted fever (RMSF), a sometimes fatal tick-borne disease.

"Rocky Mountain spotted fever can be deadly if not treated early—yet cases often go unrecognized because the signs and symptoms are similar to those of many other diseases," said CDC Director Robert Redfield, MD, in a press release. "With tickborne diseases on the rise in the U.S., this training will better equip healthcare providers to identify, diagnose, and treat this potentially fatal disease."

In 2017 officials reported 6,248 cases of tick-borne spotted fever rickettsiosis, including RMSF, in the United States, up from 4,269 in 2016 and the highest ever. RMSF begins with vague symptoms, including fever and headache. One in five patients dies from their illness.

If caught early, within 5 days of symptom onset, the disease can be treated with doxycycline but if not treated can have devastating consequences.

The CDC's educational module will help clinicians and other healthcare professionals recognize the early signs of RMSF and is offered for continuing education credit.
May 13 CDC press release


WHO: Rift Valley fever outbreak on Mayotte infects 129

A Rift Valley fever (RVF) outbreak in the French overseas territory of Mayotte, an island off Africa's southeastern coast, has resulted in 129 lab-confirmed human cases since November 2018, the WHO said today.

Along with the human cases, 109 animal cases—affecting 23 small ruminants and 86 cows—have been reported. Virus activity steadily declined during the last 3 weeks of March, but officials observed a slight increase in April. As of May 3, one new human case and no new animal cases were reported.

The main focus of the human and animal RVF cases is in the center and northwest of Grande-Terre, the main island. Since late March, however, a few animal cases have been reported in eastern part of that island and on Pamanzi (Petite Terre), a smaller island.

Surveillance for human and animal cases has been expanded, and authorities have barred the sale of raw milk since Feb 27 and the export of cattle and raw meat and milk since Mar 20.

Illegal movement of animals and the presence of susceptible animals and a mosquito population favorable to virus spread have led to active circulation on Mayotte, the WHO said. Prolonged rain in the wake of Cyclone Kenneth may lead to an increase in cases, it added, noting that the Ramadan period, with its increase in illegal cattle importations, may lead to increased cases in May.

Livestock contract the virus from mosquitoes, and though humans can be infected by mosquitoes, the main route of infection is through direct or indirect contact with the blood, body fluids, tissues, and organs of infected animals, and the virus is highly contagious for humans who handle infected livestock.
May 13 WHO statement


NIAID awards $28 million grant to develop shorter TB, MDR-TB drugs

The National Institute of Allergy and Infectious Diseases (NIAID) has awarded TB Alliance and four research institutions a grant to develop novel drugs to shorten treatment for tuberculosis (TB), including multidrug-resistant (MDR) forms of the disease.

The 5-year Center for Excellence in Translational Research (CETR) grant, totaling up to $28.4 million by 2024, will support development of two new compounds that modulate protein synthesis and waste disposal in drug-sensitive TB and MDR-TB. TB Alliance suggests that drugs based on these compounds, in combination and with other novel medications, could reduce treatment time for all forms of TB to less than 2 months.

The current treatment regimen for drug-sensitive TB typically lasts 6 months, while MDR-TB treatment lasts from 9 months to 24 months.

The research is being carried out with the University of Chicago at Illinois, Harvard University, Johns Hopkins University, and Research Triangle Institute.

"Expanding the global portfolio of new TB drug candidates, from which we can assemble tomorrow's shorter and simpler cures, is crucial in the fight against TB," TB Alliance CEO and president Mel Spigelman, MD, said in a press release. "We are excited to advance this work with our partners and grateful for NIAID's support."
May 9 TB Alliance press release


Iowa reports canine brucellosis cases

Veterinary officials in Iowa have confirmed multiple cases of canine brucellosis linked to a small dog commercial breeding facility in Marion County in the south central part of the state.

The Iowa Department of Agriculture and Land Stewardship (IDALS) said in a May 10 statement that it is in the process of notifying people who have custody of the exposed dogs, and both dogs and the facilities are quarantined while the dogs undergo testing.

A zoonotic disease, brucellosis can pass from an infected animal to humans or other animals through contaminated reproductive fluids. Though the risk is very low to most pet owners, people who come in contact with blood, tissues, and fluid during the birthing process—such as dog breeders or veterinary staff—may be at higher risk and should consult their primary care doctor.

The department said pet owners who acquired a new small-breed dog from Marion County should contact their veterinarian.

Brucella canis causes reproductive problems in dogs and can survive for months under optimal conditions. Infections in humans are rare, but when they occur they results in flu-like signs, joint pain, and recurring fevers with long-term infection. Rare complications can affect the nervous system, eyes, or heart.
May 10 IDALS press release

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