News Scan for Sep 22, 2014

EV-D68 in 22 states
2 more MERS cases, 1 death
FAO concerned about H5N6
University meningitis B death
Peanut company convictions

EV-D68 count reaches 160 cases in 22 states, CDC says

The national count of confirmed enterovirus D68 (EV-D68) cases reached 160 in 22 states on Sep 19, which is seven more cases and three more states than reported a day earlier, according to the Centers for Disease Control and Prevention (CDC).

The latest states to join the list were Georgia, Michigan, and Washington, the agency's update showed. Cases have been confirmed by the CDC or by state labs that report their results to the agency.

EV-D68, a respiratory virus that was fairly rare until now, causes cold-like symptoms but can lead to serious breathing difficulty, especially in children who have asthma. Infants, children, and teenagers are most at risk for symptomatic EV-D68 infections.

The CDC continues to predict that more states will have confirmed EV-D68 cases, noting that several states are investigating clusters of severe respiratory illness and that testing is complex and slow.
Sep 19 CDC update


Rash of MERS cases in Saudi Arabia continues

Saudi Arabia's Ministry of Health (MOH) reported two new cases of MERS-CoV today and over the weekend, continuing a rash of illnesses that broke a summer lull, plus one more death in a previously reported case.

The case announced today is in a 37-year-old male healthcare worker from the city of Taif, the site of three cases since Sep 17. The man, who is hospitalized, had no preexisting disease and no animal exposure.

The new case confirmed yesterday was in Riyadh; no further details were given.

The death, announced Sep 20, was in a 27-year-old man in Taif. He had a preexisting disease but was not a healthcare worker. It is not clear whether his was one of the recently reported cases in the city.

These latest reports bring the number of MERS-CoV (Middle East respiratory syndrome coronavirus) cases in Saudi Arabia since June 2012 to 751 and the death toll to 317. There are currently 10 active cases being followed; 317 patients have recovered.

Recent MERS-CoV cases in Saudi Arabia are of special concern because of the upcoming (early October) Hajj pilgrimage to Mecca, which brings hundreds of thousands of people to the country.
Sep 22 MOH update
Sep 21 MOH update
Sep 20 MOH update
Previous (Sep 19) CIDRAP News scan on situation


FAO calls H5N6 virus a threat that needs close watching

The H5N6 virus that has cropped up in poultry in three Asian countries this year heralds a new threat to animal health and livelihoods and bears close watching, the United Nations Food and Agriculture Organization (FAO) said in a statement today.

The virus was first reported in China in April and has since surfaced in Vietnam and Laos, the FAO noted. The outbreak in Laos was reported just last week.

"Influenza viruses are constantly mixing and recombining to form new threats," FAO Chief Veterinary Officer Juan Lubroth said in the statement. "However, H5N6 is particularly worrisome, since it has been detected in several places so far from one another, and because it is so highly pathogenic, meaning infected poultry quickly become sick and, within 72 hours, death rates are very high."

The agency said the virus's high virulence in chickens and geese and its presence in widely separated places suggest it is "a real threat to poultry-related livelihoods."

The FAO said one human H5N6 case has been reported so far, involving a person who was exposed to poultry shortly after the virus surfaced in China. Although that person died, "it is unlikely that H5N6 represents an immediate and significant threat to human health," the statement said.

Elizabeth Mumford, a World Health Organization epidemiologist, said in the statement that the identification of just one human case "suggests that the virus does not easily jump from animals to humans. Of course, we still need to remain vigilant, because prevalence in poultry and therefore human exposure could increase during the winter."

H5N6 outbreaks could potentially overwhelm animal health systems in Southeast Asia, the FAO said, noting that the highly pathogenic H5N1 avian flu virus has already affected the livelihoods of millions of people and caused billions of dollars of damage.
Sep 22 FAO statement


Tests reveal serogroup B in Georgetown University meningitis death

Georgetown University health officials said today that meningococcal serogroup B has been implicated in the Sep 16 meningitis death of a sophomore woman. The college is the fourth to report a case involving serogroup B, a strain that isn't covered by meningococcal vaccines approved for use in the United States.

The school said no other cases have been detected and that it is working with the CDC and the District of Columbia Department of Health to respond to the case. The initial notification went to students, faculty, and staff on Sep 16. Health officials were identifying the woman's close contacts to ensure that they receive antibiotic prophylaxis.

In March, serogroup B was involved in the death of a student from Drexel University, and in 2013, outbreaks at Princeton University and the University of California at Santa Barbara prompted immunization campaigns using an unlicensed serogroup B vaccine, Bexsero, made by Novartis.

Two meningitis serogroup B vaccines are under expedited review by the Food and Drug Administration (FDA): Bexsero and one made by Pfizer. In June both companies applied to the FDA for approval of their vaccines against Neisseria meningitidis. Currently, the quadrivalent meningitis vaccine protects only against serogroups A, C, Y, and W.

Georgetown said that according to CDC guidance, use of the investigational vaccine is warranted only in an outbreak setting.
Sep 22 Georgetown meningitis Q and A
Sep 16 Georgetown
public health alert


Peanut company executives found guilty of conspiracy, fraud

Guilty was the verdict issued Sep 19 against three people from the now-defunct Peanut Corp. of America, the first federal felony conviction of company executives in a food safety case, according to media reports. The business was the source of a multistate outbreak of salmonellosis linked to peanut butter and peanut butter–containing products in 2008-09 that caused more than 700 illnesses and 9 deaths.

Those convicted were Stewart Parnell, who was owner of the company; his brother Michael Parnell, who worked at the company, and quality control manager Mary Wilkerson. The three were indicted Feb 21, 2013, after a 4-year criminal investigation that led to 76 counts of mail and wire fraud, introduction of adulterated and misbranded food into interstate commerce with intent to defraud or mislead, and conspiracy, says a Food Safety News (FSN) story.

Stewart Parnell was found guilty on 67 felony counts, Michael Parnell on 30 felony counts, and Wilkerson on 1 count of obstruction of justice. The three were accused of a "mammoth conspiracy that involved fraud, wire fraud, obstruction of justice, and knowingly introducing both adulterated and misbranded food into interstate commerce," says the FSN story.

The convictions came from a 12-member federal jury in Albany, Ga., after a 7-week trial. Sentencing will come later, but with each count carrying a maximum sentence of 5 to 10 years in prison, the Parnells could each face life terms and Wilkerson could face a maximum of 10 years and a fine of $250,000.

The outbreak involved 714 cases of salmonellosis in 46 states, including 9 deaths, with the latest illness reported in March 2009. The defendants were not specifically accused of causing illnesses and deaths, only of knowingly shipping contaminated products. Some products had false labeling and fabricated safety documentation, according to a Department of Justice (DOJ) news release at the time of indictment.

"I don't view [Stewart Parnell's] conduct as any different than poisoning people or drunk driving," a CNN story quoted trial lawyer Fred Pritzker as saying. The story also says that prosecutor Michael Moore hopes the trial sends "a strong message to the food industry that its officials are now on notice that they'll be held accountable for foodborne illnesses."
Sep 19 Food Safety (FSN) story
Sep 19 CNN story
Feb 21, 2013, DOJ news release on indictment
May 11, 2010, final update on outbreak from CDC


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