News Scan for May 22, 2014

H7N9 cases in China
H5N1 death in Indonesia
Valley fever in Washington state
WHA hepatitis resolution

H7N9 sickens two from Anhui province

Two new H7N9 influenza infections were reported in China today, both from Anhui province, according to a health department statement translated and posted by FluTrackers, an infectious disease news message board.

Both patients are men, ages 69 and 58, who are hospitalized in critical condition. The cases are the second and third to be reported in Anhui province this week and lift its overall number of H7N9 cases to 14.

The two new cases increase the H7N9 outbreak total to 445 cases. So far 309 infections have been reported during the outbreak's current second wave, compared with 136 in the first last spring.

In other developments, the World Health Organization (WHO) today provided more details about four H7N9 cases reported in China on May 19, three from Guangdong province and one from Jiangsu province.

All of the patients are men, and their ages range from 37 to 86. Three are in critical condition, and one has a mild illness. Illness onsets range from Apr 20 to May 12, and hospital admission dates range from Apr 25 to May 12.

All four had a history of exposure to live poultry.
May 22 FluTrackers thread
FluTrackers human H7N9 case count
May 22 WHO statement


Indonesian tot dies from H5N1

A 2-year-old boy died of H5N1 avian flu in Indonesia last month, the WHO said in an update posted yesterday.

The boy, from Central Java, first had symptoms on Apr 10, was hospitalized Apr 13, and died Apr 20, the WHO said in its most recent "Influenza at the Human-Animal Interface" report, dated May 5. "In the weeks before disease onset of the child, some backyard chickens died around the house," the report said.

The boy's death represents the first case of H5N1 this year in Indonesia, a country that has seen as many as 55 confirmed cases in a year (in 2006), but last year reported only 3.

In the report, the WHO placed the global number of lab-confirmed H5N1 cases since 2003 at 665, 392 of which have been fatal. That number represents 15 new cases and 6 newly reported deaths since the agency last updated its case count, on Jan 24.

The 15 cases not included in the WHO's Jan 24 count reflect 9 in Cambodia, 3 in Egypt, and 1 each in Canada, Vietnam, and China, according to previous news reports. In addition, Hong Kong officials on Feb 25 reported an H5 infection in a child in mainland China but did not issue a follow-up report about the specific strain.
May 5 WHO report
Jan 24 WHO global case count


Valley fever in Washington shows fungus has moved north

Three cases of valley fever (coccidiodomycosis) in Washington state led to the discovery of the disease-causing fungus there, far north of its recognized range in the US Southwest, according to a new report.

Valley fever is caused by inhaling spores of the soil-dwelling fungi Coccidioides immitis or Coccidoides posadasii, notes an article today in Morbidity and Mortality Weekly Report (MMWR). The disease is endemic in the Southwest and in hot, arid regions of Central and South America. US cases reported in 2012 totaled 17,802.

Three valley fever cases in south-central Washington in 2010 and 2011 appeared to be locally acquired, because the patients had not traveled recently to areas where the disease is endemic, the report says.

No reliable test for soil-dwelling Coccidoides was available when the cases were first investigated in late 2010, but investigators took and preserved soil samples from sites where the patients had been active. In 2013 the samples were sent to the Centers for Disease Control and Prevention (CDC), where a new polymerase chain reaction test developed by the Translational Genomics Research Institute was used to detect Coccidoides DNA in 6 of 22 samples.

Viable C immitis was then isolated from four of the six samples, and whole-genome sequencing showed that the strain was identical to C immitis from one of the patients, the report says. "This is new direct evidence that the infections were acquired in Washington and that C. immitis exists in this environment clearly outside the recognized endemic area," it states.
May 23 MMWR article


WHA approves hepatitis control resolution

The World Health Assembly (WHA) today approved a resolution to improve the control of hepatitis, a disease that's responsible for 1.4 million global deaths each year, with an estimated 500 million people each year living with chronic infections, the WHO said today in a statement.

Today's resolution underscores the importance of expanding hepatitis A and B vaccinations and shoring up infection control practices in healthcare settings. It also notes the importance of steps to protect groups such as those who inject drugs by improving their access to testing and treatment. The action also acknowledges the need to improve screening, because most people with chronic hepatitis B and C don't know they're infected.

WHA members said they would consider a host of measures to improve access to quality, affordable tests and treatments while keeping in mind intellectual property rights. They asked the WHO secretary to help countries develop and track the progress of hepatitis control programs.

The WHA is the decision-making group of the WHO, held each year in Geneva. About 3,000 participants help set policy decisions on issues such as disease prevention, monitoring health improvement progress, and the WHO's budget. The meeting started May 19 and goes through May 24.
May 22 WHO statement

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