News Scan for Feb 03, 2014

News brief

Saudi Arabia reports MERS case in Riyadh

A 67-year-old Saudi Arabian citizen in Riyadh is hospitalized for treatment of a Middle East respiratory syndrome coronavirus (MERS-CoV) infection, the Saudi Ministry of Health (MOH) announced yesterday.

In a statement dated yesterday, the ministry said the man has a chronic disease and is being treated in an intensive care unit. It gave no details about his possible sources of exposure to the virus or when he fell ill.

The two latest previous MERS cases in Saudi Arabia also involved men in Riyadh. On Jan 28 Saudi officials announced the death of a 60-year-old man at a Riyadh hospital. Before that, a 54-year-old male healthcare worker from Riyadh died of MERS on Jan 14, according to a Jan 27 statement from the World Health Organization.

The country's MERS-CoV tally now stands at 144 cases with 59 deaths, according to the MOH. Unofficially, the new case raises the global MERS count to 182 cases and 79 deaths.
Feb 2 Saudi MOH statement
Jan 29 CIDRAP News story on previous case

Chikungunya cases in Caribbean top 1,000

The count of confirmed and probable chikungunya cases on Caribbean islands and neighboring areas has reached 1,035, a jump of 249 in the past 10 days, the European Centre for Disease Prevention and Control (ECDC) reported today.

The outbreak, which began on St. Martin and has spread to neighboring islands, is the first known instance of indigenous cases of the mosquito-borne disease in the Americas.

In its weekly Communicable Disease Threat Report, the ECDC said the case count on St. Martin has reached 476 on the French side of the island, including 83 new cases, and 9 on the Dutch side.

The agency listed the following overall tallies for other places: British Virgin Islands, 3; Martinique, 364 (97 new cases); Saint Barthelemy, 56 (11 new); Guadeloupe, 119 (51); Dominica, 1 imported case and 3 new indigenous cases; and French Guyana (in northeastern South America), 4 imported cases (2 new).

The new total of 1,035 is 249 more than the 786 cases reported Jan 24 by the Pan American Health Organization (PAHO).
Feb 3 ECDC report

CDC says Salmonella outbreak tied to cashew cheese is over

An outbreak of Salmonella Stanley infections linked to cashew cheese appears to be over after sparking 17 cases in three states, the Centers for Disease Control and Prevention (CDC) reported Jan 31.

The CDC counted 15 cases in California and 1 each in Nevada and Wyoming. The total includes three new cases, all reported in California, since the previous CDC update on Jan 3.

Three patients in the outbreak were hospitalized, but none died. Illness-onset dates ranged from Nov 13, 2013, to Jan 3, 2014, and those infected ranged from 2 to 83 years old, the CDC reported.

Investigators determined that raw cashew cheese made by The Cultured Kitchen of West Sacramento, Calif., was the source of the outbreak. The item is a non-dairy product made from raw cashews and other ingredients.

The Cultured Kitchen voluntarily recalled its raw cashew cheese on Dec 31 because of a risk of Salmonella contamination. The CDC said the outbreak appears to be over, but cautioned that cashew cheese products have a long shelf life and may still be in people's homes.

California investigators found the outbreak strain of Salmonella Stanley, a rare serotype, in an opened package of Cultured Kitchen cashew cheese from a patient's home, the CDC said. In addition, testing of cashew cheese samples collected at the company facility revealed Salmonella Weltevreden, but no one involved in the outbreak was found to be infected with this serotype, the agency said.

The CDC said the source of the cashews blamed for the outbreak has not been determined. It noted that cashews are a tropical tree nut and not produced commercially in the United States.
Jan 31 CDC statement
Related Jan 6 CIDRAP News item

Flu Scan for Feb 03, 2014

News brief

Vietnam, China report H5N1 cases

Vietnam and China have each confirmed a case of H5N1 avian flu in recent days, with Vietnam's case proving fatal.

In Vietnam, a 60-year-old woman in Dong Thap province in the Mekong Delta died of the deadly virus on Jan 27, Than Nien News reported yesterday. The woman developed a fever and other symptoms on Jan 22, authorities said. She was hospitalized on Jan 23 in neighboring An Gian province on Jan 23, where she died.

The Pasteur Institute in Ho Chi Minh City confirmed H5N1 avian flu on Jan 29. The case is the second in Vietnam this year; a 52-year-old man from Binh Phuoc province died of H5N1 on Jan 18.

Vietnam has the third-highest number of confirmed H5N1 cases in the world, at 125, behind Indonesia and Egypt, according to the World Health Organization's latest count, published Jan 24. If the WHO confirms this case, however, the country will tie Egypt for the second-most fatalities, at 63.
Feb 2 Than Nien News story
Jan 21 CIDRAP News scan on previous case
Jan 24 WHO global H5N1 case count

Meanwhile, a 75-year-old man has contracted H5N1 avian flu in China, according to machine-translated local news stories posted recently on the H5N1 and Avian Flu Diary blogs.

The man, from Guangxi province in southern China, which borders Vietnam, was hospitalized on Jan 27 with acute respiratory illness, and officials confirmed H5N1 influenza on Feb 1.

His case is the province's first since 2009, the news reports said. China reported 2 cases last year, both fatal, and has confirmed 45 since 2003, 30 of which have been fatal, according to WHO data.

If both the Vietnamese and Chinese H5N1 cases are confirmed by the WHO, they will raise the global total to 652 cases and 387 deaths.
Feb 2 H5N1 blog post
Feb 1 Avian Flu Diary blog post

Study: H7N9 patients much older than H5N1, H1N1 patients

An international team that compared patients hospitalized with H7N9 avian flu, H5N1, or 2009 H1N1 flu found that H7N9 patients were much older and much more likely to be male, according to a new study in Clinical Infectious Diseases. The study also found that heart disease was associated with an increased risk of hospitalization with H7N9 flu.

The researchers analyzed data from 123 H7N9 patients hospitalized last spring, 119 H5N1 patients from China and Vietnam, and 3,486 patients in China who had 2009 H1N1.

They noted that the median age of H7N9 patients was 63 years, compared with 26 for H5N1 and 25 for 2009 H1N1. The proportion of male H7N9 patients was 71%, compared with 56% for both H5N1 and 2009 H1N1 patients.

The authors also noted marked differences in clinical presentation among the three groups, with H7N9 patients having the highest prevalence of chronic medical conditions traditionally associated with severe cases of seasonal flu. They also found an almost 10-fold increased risk for being hospitalized with H7N9 in patients with chronic heart disease.

The group speculated that the significantly higher median age in H7N9 patients might be associated with increased environmental exposure or because elderly people may have a greater propensity to become infected or severely ill following virus exposure.
Jan 31 Clin Infect Dis abstract