News Scan for Mar 28, 2014

More Ebola in Guinea
US, European flu activity
Cat-to-human bovine TB
UK scarlet fever surge

More Ebola cases, deaths reported in Guinea

Guinea's health officials, during a press briefing today on the country's Ebola outbreak, reported that the number of viral hemorrhagic fever cases has reached 112, 70 of them fatal, up from 88 cases and 66 deaths reported yesterday. An account of the press briefing appeared in a French-language report in the Guinea-based Le Jour newspaper, which was translated and posted by H5N1 Blog, an infectious disease news site.

The report said eight cases have now been reported from Conakry, the country's capital, up from four lab-confirmed cases and one suspected one reported yesterday. Earlier reports suggested that the Conakry cases were all linked to a funeral of another possibly infected patient in the central part of the country.

In other developments, the European Centre for Disease Prevention and Control (ECDC) released an epidemiologic update on the outbreak, which said 15 cases have now been confirmed by polymerase chain reaction (PCR) testing.

It said that as of yesterday Liberia was reporting eight suspected cases, including six deaths, and that Sierra Leone was reporting six suspected cases with five deaths. The ECDC noted that all of the suspected case-patients in the two countries have a travel history to Guinean districts affected by the outbreak.
Mar 28 H5N1 Blog post
Mar 28 ECDC update


US, European flu activity continues to slide

US influenza activity continued to abate last week, with most markers showing slight declines from the week before, the Centers for Disease Control and Prevention (CDC) said today. The percentage of respiratory specimens positive for flu, however, increased substantially.

The proportion of outpatient visits for influenza-like illness (ILI) was 1.6% for the week ending Mar 22, down from 1.7% the week before and below the national baseline of 2.0%. Four of 10 regions reported ILI at or above regional baselines, the same number as the previous week.

One state—Texas—and New York City experienced moderate ILI activity, 2 states (Minnesota and Utah) had low ILI activity, and 47 states reported minimal ILI activity. Those numbers were similar to data in the previous week's report.

Geographic spread of flu was down slightly from the previous week. Four states reported widespread activity (no change), Guam and 7 states reported regional activity, Washington, D.C., and 17 states reported local activity, and Puerto Rico and 22 states reported sporadic activity.

Of 4,977 respiratory specimens tested during the week ending Mar 22, 571 (11.5%) were positive for influenza. That number is up from 8.8% the week before.

Also, influenza B continued a late-season surge, which is not unusual. The strain constituted 39.1% of samples typed, up from 31.3% the week before. And 2009 H1N1 declined in prominence, accounting for 59.7% of influenza A viruses, with the rest being H3 strains. In the week before, 2009 H1N1 made up 76.0% of "A" strains.

The CDC also reported 4 new pediatric flu-related deaths, bringing that total for the season to 79, compared with 171 for all of last season. The agency detected 11 more viruses resistant to oseltamivir (Tamiflu), raising that total to 54.
Mar 28 CDC weekly FluView report
Mar 28 CDC situation update

In Europe, meanwhile, flu activity also continued to ebb, the ECDC said today in its weekly update. Of 29 countries providing data, only Estonia, Greece, and Romania reported medium-intensity flu activity. The others reported low-intensity activity.

Influenza B in Europe circulated at much lower levels than in the United States, with only 4% of viruses belonging to that type. And H3N2 was much more prevalent last week than in the United States, with 118 (71.5%) of 165 influenza viruses of that subtype, compared with 47 (28.5%) 2009 H1N1.
Mar 28 ECDC report


UK reports first cases of cat-to-human M bovis TB

Two people in England have contracted tuberculosis (TB) after contact with a domestic cat infected with Mycobacterium bovis, typically a cattle disease, representing the first known cat-to-human transmission of the pathogen. The country reported M bovis in nine pet cats recently, but British authorities say the risk to people is low.

The disease was detected in cats from Berkshire and Hampshire, and authorities from Public Health England (PHE) and the Animal Health and Veterinary Laboratories Agency (AHVLA) investigated the outbreak last year, according to a news release yesterday from the two agencies.

Public health investigations revealed the two human cases of M bovis TB, as well as two latent cases, which means two people were exposed to the bacterium but did not have active disease. The two people with active TB are responding to treatment, the PHE and AHLVA said.

Dilys Morgan, MFPHM, head of gastrointestinal, emerging, and zoonotic diseases at PHE, said, "It's important to remember that this was a very unusual cluster of TB in domestic cats. M bovis is still uncommon in cats—it mainly affects livestock animals. These are the first documented cases of cat-to-human transmission."

A report yesterday in the Veterinary Record, the journal of the British Veterinary Association, said the feline cases were detected from December 2012 to March 2013 within a 5-kilometer (3.1-mile) radius of each other. Six of the cats lived in the same housing complex within 250 meters (273 yards) of each other.

An accompanying editorial said feline TB is increasing in Great Britain. It said about 1% of recent feline tissue samples were found to have changes "consistent with mycobacteriosis," and 15% of those samples tested positive for M bovis.
Mar 27 PHE/AHVLA news release
Mar 27 Vet Rec report
Mar 27 Vet Rec editorial extract


UK scarlet fever cases up dramatically this season

The United Kingdom has seen an "exceptional increase" in cases of scarlet fever this season, with 3,752 cases so far, compared with 1,565 to 2,868 annually since 2008, according to a report in yesterday's issue of Eurosurveillance.

This season's cases are counted beginning in early September, and the 3,752 figure is through Mar 16 of this year. The nation logged 635 of those cases in the most recent week alone, which represents by far the busiest week yet for the disease, which is caused by group A Streptococcus.

Areas with the highest incidence per 100,000 population are Cheshire and Merseyside (13.0), East Midlands (11.9), Avon Gloucestershire and Wiltshire (10.6), Thames Valley (9.5), North East (9.7), and Northern Ireland (9.2).

The age and sex distribution is similar to previous years, with 87% of scarlet fever cases in children younger than 10 years. School outbreaks have been reported in several regions. Six percent of isolates have been found to be resistant to erythromycin.

The authors conclude, "Given the potential for this to signal a population increase in invasive group A streptococcal disease, close monitoring of invasive disease is essential. . . . It remains possible that the increase or part of the increase is attributable to changes in virulence of circulating strains or increased incidence in particular risk groups."
Mar 27 Eurosurveillance report

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