News Scan for Jan 09, 2014

WHO confirms MERS death
Resistant H1N1 in Japan
Roaches at Foster Farms
Recreational water outbreaks
BioWatch detector technology

WHO: Omani MERS victim had contact with camels

The World Health Organization (WHO) today confirmed a fatal Middle East respiratory syndrome coronavirus (MERS-CoV) case in an Omani man that was reported by the media a week ago and revealed that he had extensive contact with camels.

The 59-year-old man developed a fever, cough, and shortness of breath on Dec 20, 2013, and was admitted to a hospital in Al Batinah North governorate on Dec 24. His conditioned worsened, and on Dec 28 he was transferred to an intensive care unit, where he was diagnosed as having pneumonia.

The patient died on Dec 31, and MERS-CoV lab confirmation was made on Jan 1.

The man, a heavy smoker, had daily exposure to camels and other farm animals and participated in camel races, the WHO said. Experts suspect that camels play a role in MERS-CoV transmission, and the virus and antibodies to it or a similar virus have been found in the animals.

The case brings the WHO-confirmed global MERS total to 178 cases, including 75 deaths.
Jan 9 WHO statement
Jan 2 CIDRAP News scan on the case


Japanese report H1N1 cluster resistant to oseltamivir, peramivir

Routine antiviral resistance testing in Japan has turned up a recent cluster of six 2009 H1N1 viruses from patients in the Sapporo area that show resistance to oseltamivir (Tamiflu) and peramivir, a Japanese research team reported today in Eurosurveillance.

All six of the viruses, plus another resistant 2009 H1N1 sample from a different part of the country, contained the H275Y mutation, which confers resistance to the two drugs. The resistant viruses from Sapporo were detected in November and December. Tests showed the viruses were sensitive to zanamivir (Relenza) and laninamivir, two other neuraminidase inhibitors.

No epidemiologic links were found among the patients, and one of them had been treated with neuraminidase inhibitors. Five of the patients had mild symptoms, but one of them is a previously healthy woman in her late 30s who is hospitalized in critical condition. Genetic analysis showed that the viruses were closely related, which suggests clonal spread of a single resistant virus, according to the report.

The team also compared the Japanese samples with 2009 H1N1 viruses carrying the same mutation collected from Australia in 2011 and from the United States during the current flu season. They said 5 of 10 US samples were detected in Louisiana and Mississippi and may be part of a cluster. Hemagglutinin and neuraminidase genes from H1N1 viruses carrying the resistance mutation were distinct for all three countries, the team reported.

Samples from Sapporo and the United States didn't have substitutions linked to increased pathogenicity, the group wrote.

The percentage of 2009 H1N1 patients with the H275Y substitution with no known exposure to neuraminidase inhibitors has increased from 16% to 44% during the postpandemic period, which hints that human-to-human transmission of the variants may be gradually increasing, the researchers concluded.
Jan 9 Eurosurveill report


Feds suspend Foster Farms poultry processing over roaches

One of the poultry-processing plants in California that has been linked to an ongoing nationwide outbreak of Salmonella Heidelberg was ordered by the US Department of Agriculture (USDA) yesterday to suspend poultry-processing operations because of "egregious insanitary conditions," according to the agency and news sources.

Live cockroaches were seen Jan 8 by inspectors from the USDA's Food Safety and Inspection Service (FSIS) at a sink near the processing line and the day before in a plastic tub directly exposed to product at the Livingston, Ca., facility, according to the suspension notice. Inspectors had noted the presence of cockroaches three other times since September 2013.

The 250,000-square-foot plant is one of three Foster Farms plants in the state under investigation in connection with a Salmonella outbreak that the Centers for Disease Control and Prevention (CDC) cites as sickening 416 people in 23 states and Puerto Rico since March 2013. The plant will remain closed until Foster Farms develops an acceptable plan for eliminating the insects and ensuring that they do not return.

Foster Farms responded to the notice by saying in a statement that the "USDA identified only five cockroaches," that the plant was treated, and that no other facilities were affected, according to a story in the Oregonian.

Cockroaches have not been implicated specifically in the Salmonella outbreak but are considered a threat to public health because of foodborne pathogens they can carry, the USDA notes in its suspension notice.

The Foster Farms facilities were linked with the outbreak in October 2013 but allowed to continue slaughter and processing of poultry because the company claims to have implemented changes in sanitary conditions. Foster Farms has not been ordered to recall and has not voluntarily recalled any of its products.
Jan 8 USDA suspension notice
Jan 8 Oregonian story
CDC page on Salmonella outbreak


Cryptosporidium top culprit in recreational water outbreaks

Most illness outbreaks and cases linked to recreational water use such as swimming in pools and lakes can be traced to treated water, and Cryptosporidium is the leading culprit, according to CDC data published today.

Health officials from 28 states and Puerto Rico reported 81 disease outbreaks linked to recreational water in 2009 and 2010, according to their report in Morbidity and Mortality Weekly Report (MMWR). Of the 81 outbreaks, 57 (70%) were associated with treated recreational water such as in pools or hot tubs. These outbreaks resulted in at least 1,030 cases and 40 hospitalizations.

That compares with 24 outbreaks associated with untreated water such as in lakes, which resulted in at least 296 cases and 22 hospitalizations.

Among the 57 outbreaks associated with treated recreational water, 24 (42%) were caused by Cryptosporidium. By comparison, 11 (46%) of the 24 outbreaks associated with untreated water were confirmed or suspected to have been caused by cyanobacterial algal toxins.

The authors say that the annual number of Cryptosporidium-related outbreaks year has significantly increased since the first one was detected in 1988. And the parasite has played at least a partial a role in driving a significant increase in the overall number of recreational water–associated disease outbreaks per year.
Jan 10 MMWR report


Report details 'Gen-3' BioWatch detector options

Several automated pathogen-detection systems could be candidates for use as next-generation detectors for the Department of Homeland Security's (DHS's) BioWatch program for detecting airborne pathogens, but none are perfect as is, according to a report released yesterday by the National Academies of Sciences (NAS).

The report is based on information shared in a workshop last June to explore how the BioWatch program might proceed toward so-called "generation 3" (Gen-3) technology—indoor or outdoor air-sampling collectors that internally process data without the need to send filters to labs for analysis.

Experts explored four types of potential Gen-3 technologies: (1) nucleic acid signatures, (2) protein signatures, (3) genomic sequencing, and (4) mass spectrometry. They noted that at least four systems under development are ready for field use, all of which employ nucleic acid or protein signatures. Participants noted, however, that genomic sequencing and mass spectrometry may also play some type of role.

To be fully operational, however, the detection systems would need to overcome some challenges to comply with DHS criteria for Gen-3 readiness, the workshop participants noted. They also raised the possibility of using some combination of the currently available systems.

BioWatch has been under congressional scrutiny since a 2012 series of Los Angeles Times articles questioned the effectiveness of current Gen-2 technology and the wisdom of developing a Gen-3 program. The controversy was the subject of several congressional hearings.
Jan 8 NAS report
Jun 18, 2013, CIDRAP News story "Doubts about BioWatch program aired in Congress again"

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