News Scan for Apr 03, 2014

Ebola deaths in Liberia
US West Nile monitoring
LA County meningitis alert

Liberia's Ebola deaths rise to seven

A Liberian health official said today that three more deaths have been reported among suspected and confirmed Ebola virus disease (EVD) cases, raising the number so far to seven, AllAfrica News reported today.

Dr. Walter Gwenigale, Liberia's health minister, said at a press briefing today that the deaths include a woman who had recently traveled with her child to another district by taxi, a woman from Foyah who had been under observation but was taken away by her family, and a 25-year-old man who had traveled to Tappita.

Gwenigale said the fatal cases have not been lab-confirmed. He also said the child who had traveled with his or her mother is sick and is under quarantine and observation.

The World Health Organization (WHO) in its latest update yesterday said Liberia's overall total was eight cases, two of them confirmed.

In other developments, the WHO posted a background and summary document on EVD and on the current outbreak. It said the outbreak is rapidly evolving and that the small number of suspected cases and deaths in neighboring countries all involve border crossings from Guinea. It said confirmed cases have been reported from only Guinea and Liberia.

The WHO warned that nearly all transmission to health workers has been reported when lapses in basic infection control measures have been observed. It urged healthcare workers to observe standard precautions and avoid exposure to patients' blood and body fluids. It also emphasized the importance of prompt and safe burial of patients who have died from EVD.
Apr 3 AllAfrica story
Apr 3 WHO Ebola background and summary


US report: West Nile surveillance down since 2004

State-level surveillance for West Nile virus (WNV) has declined substantially since 2004, US researchers report today in Morbidity and Mortality Weekly Report (MMWR).

The team assessed WNV monitoring capacity for 56 jurisdictions—all 50 states plus 6 large city/county areas. They found that the share having an active component of human surveillance fell from 51% in 2004 (28 of 55) to 29% in 2012 (16 of 56). The jurisdictions were also less likely to report contacting neurologists (65% in 2004 vs 54% in 2012) or infectious disease specialists (84% vs 63%) to encourage disease reporting.

In addition, mosquito surveillance lessened from 2004 to 2012, but less dramatically. Rates fell for several markers: jurisdictions that had their own mosquito surveillance systems (from 95% to 82%), access to a medical entomologist either within the agency or through contract with another agency (71% to 64%), local-level information collection (94% to 88%), 50% or higher rate of local surveillance for adult mosquitoes (48% to 34%), and calculation of minimum mosquito infection rates (58% to 46%).

Only the number of jurisdictions that received information about the species of trapped mosquitoes increased, from 82% to 86%.

The authors also reported that in 2012, of public health laboratories that routinely tested human specimens for WNV, 27 of 47 (57%) also tested for other arboviruses. But of the 27, only 6 routinely tested for arboviruses other than St. Louis or eastern equine encephalitis.

A commentary in the report says the decrease in surveillance could compromise public health's ability to respond to WNV at an especially bad time: 2012 saw the highest levels of WNV in the country since 1999.
Apr 4 MMWR report


LA County confirms 8 meningitis cases, recommends vaccination

The Los Angeles County Department of Public Health (LACDPH) yesterday advised at-risk men who have sex with men (MSM) to get vaccinated against invasive meningococcal disease (IMD) after an uptick in cases.

The LACDPH has confirmed 8 IMD cases in the county this year, including 4 in MSM, 3 of whom were HIV-positive. Of the four IMD cases in MSM, three men reported either residence in, or socializing near, West Hollywood and North Hollywood, and three were 27 or 28 years old, while the fourth was 50. Such commonalities were not found in IMD cases in 2012 and 2013, the department said in a news release.

"All HIV-positive MSM and all MSM, regardless of HIV status, who regularly have close or intimate contact with multiple partners, or who seek partners through the use of digital applications, particularly those who share cigarettes, marijuana or use illegal drugs, should visit their health provider to be vaccinated against invasive meningococcal disease," said LACDPH Director Jonathan E. Fielding, MD, MPH. He said the LACDPH will provide the vaccine free for targeted MSM who don't have insurance.

The agency added that the IMD risk is very low for the general population. The county had 12 IMD cases in all of 2012, the last year for which data are available, but 4 of them proved fatal.
Apr 2 LACDPH press release
Apr 2 LACDPH provider alert
LACDPH report on 2012 IMD cases


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