NEWS SCAN: Second strain in Salmonella outbreak, scarlet fever in Hong Kong, vaccine-derived polio, Powassan virus death, state shutdown and disease control

Jun 30, 2011

Second Salmonella strain linked to chick-related outbreak
The US Centers for Disease Control and Prevention (CDC) yesterday reported a second Salmonella strain in an outbreak of illnesses linked to contact with chicks and ducklings obtained from the same national chain store and mail-order supplier. In an outbreak update, the CDC said 22 people with Salmonella Johannesburg infections have been reported from 12 states, most of them from southeastern and eastern regions. Fourteen of 19 people with available information had contacts with chicks, ducklings, or both. Trace-back investigations on 9 of 12 patients showed that the poultry were purchased at the same locations that were the source of a recent Salmonella Altona outbreak, which the CDC said has now sickened 49 people in 16 states. The new information signals an increase of 10 patients, with New Hampshire reporting its first case. No deaths have been reported in the outbreaks. The outbreak patterns are similar, except that in the S Johannesburg outbreak a greater percentage of children ages 5 and under have been affected, and the illness onsets had a narrower range, between Mar 19 and May 24. The CDC said customers in both outbreaks bought the birds at the same national feed store chain, which was previously identified by other sources as Tractor Supply Co. It added that birds linked to both outbreaks were sourced by a single mail-order hatchery, identified in earlier reports as Mt. Healthy Hatchery, based in Cincinnati.
Jun 20 CDC outbreak update
Jun 10 CIDRAP News Scan report

Scarlet fever case count in Hong Kong reaches 672
Another 18 cases of scarlet fever were reported in Hong Kong today, bringing the number for the past week to 126, according to the region's Centre for Health Protection. The total so far this year has reached 672. The latest cases involve 14 boys and 4 girls, ranging in age from 1 to 11 years, the CHP reported. Three of the cases were at one primary school. There were no new deaths and no admissions to intensive care units, the CHP said. Two children have died in the unusual epidemic so far.
Jun 30 CHP update

New outbreaks of vaccine-derived polioviruses cited
Outbreaks of circulating vaccine-derived polioviruses (VDPVs) ranging from 6 to 16 cases have occurred in Afghanistan, Ethiopia, and India since the last surveillance summary, according to an update in tomorrow's Morbidity and Mortality Weekly Report (MMWR). In addition, previously reported outbreaks in Nigeria, the Democratic Republic of Congo (DRC), and Somalia continued through late 2010 or into 2011 and caused 355, 37, and 13 cases, respectively. The report points out that although live, attenuated oral poliovirus vaccine (OPV) is widely available and in use all over the world, playing a large role in the goal of eradicating poliomyelitis, it does carry a risk of vaccine-associated disease among vaccine recipients and of the emergence of VDPVs. Discontinuation of OPV use is planned once the goal of stopping transmission of all wild polioviruses has been achieved. "All countries should maintain high poliovirus vaccination coverage against all three poliovirus serotypes," says the update, and "sensitive poliovirus surveillance to detect VDPVs will continue to increase in importance."
Jul 1 MMWR update

Minnesota reports death from rare tick-borne virus
The state's first death from a Powassan virus infection of the brain was reported yesterday by the Minnesota Department of Health (MDH). The victim was a woman in her 60s who lived in the northern part of the state and noticed tick bites after spending time outdoors. Powassan virus is related to West Nile virus and can be transmitted by the blacklegged tick, or deer tick. Transmission can occur within minutes of an infected tick's attachment to a person. The virus is named after the town in Ontario where it was first identified in 1958. About 60 cases have occurred since, mainly in eastern Canada and the northeastern United States. During the past decade, cases have been reported in Michigan, Wisconsin, and Minnesota. The infection is fatal in about 10% of cases and may cause long-term neurologic problems in survivors. Minnesota State Epidemiologist Ruth Lynfield commented, "Powassan disease is caused by a virus and is not treatable with antibiotics, so preventing tick bites is crucial."
Jun 29 MDH press release

If state shutdown comes, Minnesota will reduce disease-control efforts
Activities to control infectious diseases will be reduced but not completely suspended if Minnesota's government goes into a partial shutdown tomorrow for lack of a budget agreement, according to the Minnesota Department of Health (MDH). Gov. Mark Dayton, a Democrat, and legislative Republicans are at an impasse over the state budget, and a partial government shutdown will begin tomorrow if no agreement is reached today. But MDH would continue a number of functions on a limited basis during a shutdown, including vaccine distribution, core public health laboratory capacity, response to disease outbreaks and other public health emergencies, and food inspection, according to an online fact sheet. MDH spokesman Doug Schultz said a state judge has approved continuation of a list of critical state services submitted by Dayton, including a number of MDH functions. Schultz said the department would have a "skeleton crew" for disease detection. "I think I can say that restaurant inspections will be done on an extremely limited basis, and response to emergencies and complaints may have higher priority," he told CIDRAP News. But he noted that some local governments handle their own restaurant inspections on a fee basis, and those would probably continue. MDH expects to keep about 189 of its 1,450 employees working during a shutdown, according to the fact sheet.
MDH fact sheet on shutdown

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