News Scan for Apr 14, 2014

E coli levels in US
MERS virus in camels
Hepatitis A outbreak in Europe

Study: Northern states have higher E coli O157 isolation rates

Northern states appear to have higher rates of Escherichia coli O157 than southern states do, and young children appear to be infected most often, according to data from the Centers for Disease Control and Prevention (CDC) published today in Epidemiology & Infection.

The team analyzed data from 1996, when public health labs first began reporting on the pathogen, through 2011. The authors found a national isolation rate of 0.84 per 100,000 population, but the rate varied from 0.43 in southern states to 1.52 in northern regions.

They also found that counties with more than three fourths of the population living in rural areas have lower rates. Counties with a 76% or higher rural population had an isolation rate of 0.67, compared with rates from 0.81 to 0.92 for more urban counties. The researchers also noted that isolation rates in kids 1 to 4 years old were highest, at 3.19.

The investigators said they do not know the reason for the higher rate in northern states but said the finding is consistent with other studies.
Apr 14 Epidemiol Infect abstract


Camel farm tests point to MERS viral load, antibody patterns

A study of adult and baby dromedary camels at two farms in Saudi Arabia during the peak of the most recent calving season found that Middle East respiratory syndrome coronavirus (MERS-CoV) was more commonly isolated from nasal swabs than from feces, while blood tests found that preexisting antibodies didn't always protect against infection. A research team from Saudi Arabia, Egypt, and Hong Kong published their findings today in the latest online edition of Emerging Infectious Diseases.

The herds were located 4 to 5 km apart in Al-Hasa governorate, and the peak calving season spanned December 2013 through February 2014. To gauge virologic features of MERS-CoV in the animals, researchers collected samples from animals at the bigger of the two farms—nasal, oral, and rectal swabs, plus blood—at five different times from November through February. Camels in the smaller herd were sampled in February.

Of 70 animals in the larger herd, 10 tested positive for MERS-CoV. Results were negative for the camels at the smaller farm. Tests suggested likely reinfection for two of the adults, and, in calves, that maternal antibodies might not provide complete protection. Researchers were able to isolate viruses from two nasal swabs and one fecal swab.

Full genome sequencing found 99.9% similarity to those of human clade B MERS-CoV.

The authors concluded that viruses were more frequently isolated from the nose than the feces, but that both could be possible sources of transmission to humans or other animals. The team added that although their preliminary findings suggest that preexisting MERS-CoV antibodies might not protect camels against reinfection, the issue needs more investigation.
Apr 14 Emerg Infect Dis study


Berry-linked hepatitis A still sickening Europeans

A hepatitis A outbreak that was first reported in travelers to Italy in 2013 has now grown to 1,315 cases in 11 countries, 7 of which have reported patients infected with the virus who didn't have a history travel in the previous 12 months, according to an update from the European Center for Disease Prevention and Control (ECDC) and the European Food Safety Authority (ESFA).

The outbreak is one of four berry-linked hepatitis A events reported last year, all involving unique outbreak strains. One affected Scandinavian countries, a second was reported in Europeans who had traveled to Egypt, and a third in the United States was linked to pomegranate seeds imported from Turkey. The Italian-linked outbreak involves the IA subtype and has an identical or closely related genetic sequence.

ECDC and EFSA issued their first report on the outbreak in May, when 15 cases had been reported from 3 countries, all in people who had traveled to northern Italy. In July, the groups reported that as many as 200 infections in Italy were likely part of the outbreak, along with 3 in Ireland in those who had no travel history, suggesting exposure to the same contaminated food vehicle.

Since then, France, Germany, Norway, the Netherlands, Sweden, and the United Kingdom have all reported cases with no travel history in the past 12 months. The most recent illness onsets occurred in February and March in patients from Norway.

So far the epidemiologic investigations suggest that frozen berries are the infection source and that the event could represent a single outbreak linked to a common, continuous source in Europe, the groups said. However, they said other sources can't be ruled out, including cross-contamination during food production.
Apr 11 ECDC report


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