News Scan for Jun 30, 2014

MERS case-control study
Sprout-linked E coli
Declining cholera in Haiti

Saudi Arabia launching MERS case-control study at last

Saudi Arabia has begun work on a case-control study to try to pinpoint how people contract MERS-CoV, something that critics of the government's response have been demanding for many months, according to a Reuters report today.

Also, the Saudi Ministry of Health (MOH) reported one new MERS-CoV (Middle East respiratory syndrome coronavirus) case today, involving a 15-year-old Saudi boy in Jeddah. He has symptoms but is isolated at home.

The case raises the MOH's MERS count to 712 cases, while the death toll remains at 292.

Tariq Madani, head of the scientific advisory board for the MOH Command and Control Centre for MERS, told Reuters that 10 cases and 40 controls have been enrolled so far in the case-control study, which will compare the histories of patients and healthy people.

The study will focus on primary cases, meaning patients who had no known contact with other MERS patients, healthcare facilities, or people with unexplained respiratory illnesses that might have been MERS, Madani said.

The study team includes several scientists who helped develop the World Health Organization's 22-page guidance for MERS case-control studies, he added.

Madani said the study is the centerpiece of a 25-study MERS-CoV research agenda, which includes studies of human-animal interactions, hospital outbreaks, and treatment strategies. Sixteen studies are under way, with 120 scientists participating, he added.

He said the study is part of a "180-degree" policy change on MERS, following the government's change of health minsters in April. "This should have been done long ago, but unfortunately it wasn't," he told Reuters. "So it was the top-priority research project we started with."
Jun 30 Reuters story
Jun 30 MOH statement


CDC: E coli outbreak tied to clover sprouts grows to 18 cases

An outbreak of Escherichia coli O121 infections linked to raw clover sprouts has grown to 18 cases in five states, the Centers for Disease Control and Prevention (CDC) said in a Jun 27 update, with the addition of 1 new case, in Washington state.

Illness-onset dates range from May 1 to May 20, and patients' ages range from 11 to 45 years, with a median age of 27. Fourteen of the patients (78%) are female.

Among the 16 people with available information, 7 (44%) have been hospitalized. No case-patients have developed hemolytic uremic syndrome, a potentially fatal kidney complication, and no deaths have been reported.

The numbers of cases per state are: Idaho, 3; Michigan, 1; Montana, 2; Utah, 1; and Washington, 11. The CDC's previous update was on Jun 10.

The CDC said, "Epidemiology and traceback investigations conducted by local, state, and federal officials indicated that contaminated raw clover sprouts produced by Evergreen Fresh Sprouts, LLC of Idaho are the likely source of this outbreak," but added that the company had not recalled its clover sprouts.

Representatives of the CDC and Food and Drug Administration on Jun 26 met with the owner of Evergreen Fresh Sprouts, who said the company planned to stop using the sprout seed lot linked to the outbreak.
Jun 27 CDC update


PAHO says cholera cases dropping in Haiti, Dominican Republic

The pace of cholera cases in Haiti and the Dominican Republic so far this year is well below last year's level, according to the Pan American Health Organization (PAHO).

Cases in Haiti this year have averaged 291 per week, with 1 death, compared with 993 cases and 8 deaths per week in the same period in 2013, PAHO reported in a Jun 27 update. In the neighboring Dominican Republic, cases this year have averaged 31 per month, with a total of 4 deaths, versus 130 cases per month and a total of 13 deaths in the same period last year.

The two countries, which share the island of Hispaniola, have been battling cholera since October 2010. The figures for this year show a continuing decline since 2011. The downward trend in cases is nationwide in both countries.

In the first 23 weeks of this year, Haiti recorded 6,689 cholera cases, with 31 deaths, PAHO reported. Two of the nation's 10 departments, Nippes and Nord Est, have not recorded any new cases since week 19.

The cumulative total of cases in Haiti since the epidemic began has reached 703,510, including 8,562 deaths and 393,012 hospitalizations. The Dominican Republic has had a total of 31,628 suspected cases and 471 deaths.

PAHO also said that Mexico on Jun 13 reported three cases of cholera in people who had eaten street foods before they got sick on Jun 4. The three individuals are all members of one family living in Hidalgo state. No additional cases have been reported.
Jun 27 PAHO update

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