News Scan for Jul 03, 2014

New MERS case
Studies on new tick-borne disease
Possible H7N9 precursor
Global TB strategy
Safe water in Syria

Saudi woman hospitalized with MERS-CoV infection

Saudi Arabia reported a new MERS-CoV (Middle East respiratory syndrome coronavirus) case today, in a 55-year-old Saudi national from the city of Wadi Aldwasir, located in the south central part of the country, according to a statement today from the Ministry of Health (MOH).

The woman isn't a healthcare worker and has symptoms, the MOH said. She has an underlying illness and is hospitalized in an intensive care unit.

The new case lifts Saudi Arabia's MERS-CoV total to 715 infections, of which 293 were fatal.

Currently, 38 patients are still being treated for their infections, and 384 have recovered, according to numbers posted on the ministry's main media page

The World Health Organization (WHO) in an update yesterday that the global number of lab-confirmed MERS-CoV infections is 824, including 286 fatalities.
Jul 3 MOH statement
Health ministry media page
Jul 2 WHO statement


Tick-borne SFTS: Antibodies in humans, possible new vectors

Emerging Infectious Diseases today published two studies on the newly identified tick-borne disease, severe fever with thrombocytopenia syndrome (SFTS), one that shows a 7% prevalence of antibodies to the SFTS virus (SFTSV) in people in China, and one that reports the virus in three species of ticks in Korea, potentially adding to the list of SFTSV vectors.

SFTSV was first reported in rural China in 2009.

In the first study, Chinese researchers analyzed the blood of 986 healthy people from six districts in Zhejiang province, which had a subclinical case in 2013. The study group included 54 people from the case-patient's village in Pujiang district.

The group found that 71 of the 986 patients (7.2%) had immunoglobulin G antibodies against SFTSV. Prevalence ranged from 3.0% in Taizhou district to 10.9% in Ningbo district, with 4 of the 54 patients in the patient's village (7.4%) having antibodies.

"This finding suggests that most natural infections with SFTSV are mild or subclinical," the authors conclude.
Jul 3 Emerg Infect Dis serology study

In the second study, South Korean investigators collected from humans 261 ticks, 212 of which (81.2%) were Haemaphysalis longicornis, a known SFTSV vector. Among the rest, 17 (6.5%) were Amblyomma testudinarium, 15 (5.7%) were Ixodes nipponensis, and 14 (5.4%) were H flava.

The researchers found that overall 6.9% of ticks tested positive for the medium segment gene of SFTSV by polymerase chain reaction, with an infection rate of 5.7% in H longicornis, 23.5% in A testudinarium, and 13.3% in Ix nipponensis. Recently fed ticks had an infection  prevalence of 18.2%, compared with 5.9% in those that hadn't fed recently.

The authors conclude, "On the basis of our findings, we propose that A testudinarium and Ix nipponensis ticks, from which we detected SFTSV, might serve as potential vectors of this virus in South Korea. However, the presence of viral RNA in a tick does not confirm that the tick can transmit the virus."
Jul 3 Emerg Infect Dis
study on SFTSV in ticks


Chinese boy might have been infected with H7N9 precursor

A 4-year-old boy who contracted avian flu in China last year might have been infected with an H7N9 precursor, according to a study today in Emerging Infectious Diseases.

The boy, from Shanghai, was first diagnosed as having H7N9 avian flu on Mar 31, 2013, after he had a high fever, cough, nasal drainage, and tonsillitis. He had been exposed to poultry.

Phylogenetic analysis, however, revealed a distinct H7N9 subtype, with more avian-like properties and fewer mammalian-adapting mutations than other known human 2013 H7N9 subtypes. Researchers described its neuraminidase gene as "waterfowl-like" and said most of its internal genes are more closely related to avian H9N2 subtypes isolated in 2011-12 than to other more recently emerged H7N9 types.

The authors write that the subtype "might be a precursor strain of the H7N9 virus that co-circulated with more evolved viruses, although we cannot exclude that [the boy's strain] may have been generated independently from the other H7N9 strains by reassortment of waterfowl strains with avian H9N2 strains and then transmitted directly to a human."
Jul 3 Emerg Infect Dis report


Groups unveil TB strategy for higher-resource countries

Two global health groups today released a new framework to eliminate tuberculosis (TB) in countries that already have low levels of the disease. The WHO and the European Respiratory Society (ERS) presented the plan at a meeting in Rome hosted by the two groups and Italy's health ministry, the WHO said in a press release.

The game plan targets 33 countries and territories that have fewer than 100 TB cases per 1 million population. The group includes 21 European countries; 7 from the Americas, including Canada and the United States; 3 from the WHO's Eastern Mediterranean region; and 2 from its Western Pacific region.

The effort was adapted from a new global TB strategy for 2016 through 2035 that the World Health Assembly adopted in May and includes eight key steps that can drive TB levels down even further, such as ensuring funding for planning and high-level services and addressing hard-to-reach groups, such as migrants, the homeless, illegal drug users, and prisoners.

G. B. Migliori, MD, with the ERS, said in the release that powerful antibiotics and better living standards have almost pushed the disease out of many high-income countries, but more work is needed.

"If we do the wrong things now, TB could rebound, including with more drug-resistant forms," he said. "But if we get it right, and recommit to fighting the disease, both at home and abroad, TB will eventually no longer be a public health threat."
Jul 3 WHO press release


Syrian war tactic of blocking safe water poses urgent health risk

The WHO and United Nations Children's Fund (UNICEF) have put out an urgent call to warring factions in Syria to stop using access to safe water as a tactic of war and to call a ceasefire immediately in the Aleppo City area so repairs can be made to water and sanitary infrastructure that sustained critical damage in an explosion last month, said a press release yesterday from WHO

Interruptions in access to safe water have wreaked havoc on hundreds of thousands of displaced and vulnerable Syrians, the release says. Such water- and food-borne illnesses as typhoid, hepatitis, chlolera, and other diarrhea-causing conditions are widespread and increasing as water and sanitation systems deteriorate and break down and as a drought termed "unprecedented" worsens the situation.

An explosion Jun 2 near Aleppo City damaged water, sewage, and electrical networks, leaving around 2 million people with no regular water supply. Repair has not yet been possible because of security concerns.

"We re-state the urgent need for unimpeded access for the delivery of life-saving humanitarian assistance, including safe water, health and hygiene supplies, to vulnerable populations to mitigate the risk of disease outbreaks this summer. Finally, we urge the international community to prioritise the dire humanitarian needs of the Syrian people and extend all of its influence and advocacy to end the targeting of water supplies and to immediately facilitate humanitarian access," the WHO and UNICEF said.
Jul 2 WHO press release

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