News Scan for May 05, 2014

H7N9 case, death in China
BSE in Brazil
More Caribbean chikungunya
Pertussis vaccination

H7N9 sickens one, kills one in China

China's Guangdong province reported another H7N9 influenza infection, along with a death in a previously reported case, according to a May 2 health department statement translated and posted by FluTrackers, an infectious disease news message board.

The patient is a 53-year-old woman from Shenzhen who suffers from chronic bronchitis. She is hospitalized in stable condition.

The case of an H7N9 patient who died on Apr 21 was first reported on Apr 9, which appears to be a 71-year-old woman from Heyuan who had been hospitalized in critical condition.

The latest cases pushes the overall H7N9 outbreak total to 435, according to a running case list maintained by FluTrackers. So far 299 cases have been reported during the current second wave of activity, compared with 136 in the first wave last spring. The new death lifts the unofficial fatality count to 130.
May 5 FluTrackers thread
FluTrackers human H7N9 case list


Brazil reports its second BSE case

Brazilian surveillance for bovine spongiform encephalopathy (BSE, or "mad cow" disease) has identified the prion marker in a 12-year-old female cow who was tested after it was found fallen on arrival at a slaughterhouse and following problems during transport, the country's agriculture ministry said in May 2 statement to the World Organization for Animal Health (OIE).

The event occurred in Mato Grosso state, in west central Brazil. The cow was born and raised on the same beef farm that had extensive grazing, with a population of 1,177 cattle and 11 buffaloes.

Investigators found that animals from the same birth cohort had been moved to 10 other properties in three different cities in Mato Grosso. None of the 49 animals in the birth cohort showed any signs of disease, but were culled. Tests on their nervous system tissues were negative for BSE.

The cow is Brazil's second BSE case. In December 2012 tests were positive for a 13-year-old cow in Parana state that had limb stiffness and was unable to stand before its death in 2010. However, the investigation found that the animal's death wasn't caused by BSE and that the test findings could reflect an atypical case of the disease occurring in the oldest animals.
May 2 OIE report
Dec 7, 2012, CIDRAP News scan "Brazil reports its first BSE case, in a cow that died in 2010"


Chikungunya cases in the Caribbean approach 40,000

The Caribbean chikungunya outbreak grew by 6,683 cases in the past week, reaching 39,943 suspected, probable, or confirmed cases, according to an update today from the European Centre for Disease Prevention and Control (ECDC).

The case count is up from 33,260 a week ago, and the surge was led by large increases in suspected cases in the Dominican Republic and on Martinique and Guadeloupe.

Martinique continues to report the largest numbers by far, with 19,700 suspected (up from 17,630) and 1,515 confirmed or probable cases, the ECDC said. Guadeloupe is next, with 8,000 suspected (up from 6,000) and 1,328 confirmed or probable cases.

The French side of St. Martin continues to report small but steady increases in cases, with 3,160 (up from 3,030) suspected and 793 confirmed or probable cases. The Dominican Republic's suspected cases, in contrast, jumped from 767 to 3,015, while its confirmed cases held at 17.

Also reporting cases are Dominica, 1,252 suspected and 105 confirmed cases; St. Barthelemy, 485 suspected and 135 confirmed or probable cases; the Dutch side of St. Martin, 301 confirmed cases; French Guiana, 43 confirmed locally acquired and 22 imported cases; St. Vincent and the Grenadines, 24 suspected and 3 confirmed cases; Anguilla, 33 locally acquired confirmed cases and 1 likely imported case; British Virgin Islands, 9 confirmed cases; and Aruba, St. Lucia, and St. Kitts and Nevis, each with 1 confirmed case.

The chikungunya outbreak is the first known in the Americas and began in December 2013 on the French side of St. Martin. Six outbreak deaths have been reported.
May 5 ECDC update


Study: Outbreak doesn't increase pertussis vaccine uptake

A large outbreak of pertussis (whooping cough) in Washington state in late 2011 through 2012 did not increase vaccination rates, researchers reported today at the Pediatric Academic Societies annual meeting in Vancouver, British Columbia, according to the study's abstract.

Washington researchers determined diphtheria–tetanus toxoid–acellular pertussis (DTaP) vaccination rates in children 3 to 8 months old before and during a pertussis epidemic that lasted from Oct 1, 2011, through 2012 and included about 5,000 cases.

They studied 39,500 children before the epidemic and 40,811 during. They found only a 2.1% absolute difference between the groups, which was not significant.

Lead researcher Elizabeth R. Wolf, MD, a University of Washington pediatrician, said in a press release from the American Academy of Pediatrics (AAP), "We don't fully understand what improves vaccine acceptance. This study found no significant increase in vaccination coverage statewide during the 2011-2012 pertussis epidemic. This finding may challenge the assumption that vaccine acceptance uniformly increases when risk of disease is high."
May 5 study abstract
May 5 AAP press release

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