News Scan for Oct 22, 2014

New MERS case in Saudi Arabia
Flu virus mutation
Live-poultry Salmonella outbreak over

MERS cases in Saudi Arabia reach 772, with 329 deaths

A 46-year-old Saudi Arabian man has become the 772nd case of MERS-CoV in that country since June 2012. An update from the Saudi Ministry of health (MOH) today lists his case as well as the death of a previously reported MERS-CoV (Middle East respiratory syndrome coronovirus) case-patient.

The new case occurred in Medina. The man, who is hospitalized, is not a healthcare worker. He had no preexisting disease and no contact with animals, the MOH said.

The death occurred in a 56-year-old man in Taif. He was not a healthcare worker but did have preexisting disease. His death brings to 329 the total number of fatal cases in the current outbreak, according to the MOH.
Oct 22 MOH update

In related news, an epidemiologic update from the European Centre for Disease Prevention and Control (ECDC) today gives the total cases from all reporting countries as 906, with 361 deaths; these numbers do not reflect the new case and death in today's MOH report. The latest (Oct 16) World Health Organization (WHO) situation update listed 877 MERS cases worldwide, with at least 317 deaths.

ECDC's report notes a spate of cases in Saudi Arabia since Sep 1, listing 29 as the count, 15 of which have been in Taif. These followed a lull over the summer.

It also says that a MERS case in Austria earlier this month in a Saudi Arabian man and the first MERS case in Turkey, reported just days ago, also in a Saudi, "do not indicate a significant change in the epidemiology of the disease." It goes on to say, "Importation of MERS-CoV cases to the [European Union] remains possible. However, the risk of sustained human-to-human transmission remains very low in Europe."
Oct 22 ECDC update
Oct 20 CIDRAP News story on case in Turkey
Most recent (Oct 16) WHO update on MERS
Oct 2 WHO report of Austria case


Study: Middle-aged adults susceptible to recent flu virus mutation

A recent mutation in the 2009 H1N1 influenza virus may have been behind high infection rates in middle-aged adults during the 2013-14 flu season, according to a new Wistar Institute study published in the Proceedings of the National Academy of Science (PNAS).

The 2009 H1N1 strain, which now circulates seasonally, recently acquired a mutation to the section of hemagglutinin (HA) known as K166. The study found that more than 42% of US patients tested (54 patients) who were born from 1965 to 1979 possess antibodies that respond to the K166 region of HA, compared with 27% in those born from 1940 to 1984 and no detectable antibodies in the 49 people tested who were born from 1985 to 1997.

The K166-specific antibodies were unable to recognize or mount an immune system response to the strain containing the mutated region, the authors noted.

Study coordinators suggested that these results should be used to select viral strains for inclusion in seasonal influenza vaccines. Rather than relying exclusively on surveillance of circulating strains, vaccine developers should also match viral antigens to specific HA regions.

Antibodies to influenza are formed during an individual's first encounter with a flu virus, which partly explains why different age-groups have different immune system responses to circulating strains, according to a Wistar press release.
Oct 21 Wistar Institute press release
Oct 20 PNAS article


CDC declares outbreak of Salmonella from backyard poultry over

The recent outbreak of human Salmonella infections associated with backyard chicks, ducklings, and other live poultry purchased through a mail-order hatchery in Ohio appears to be over, according to the final update on the outbreak from the Centers for Disease Control and Prevention (CDC) yesterday.

During the outbreak, which was first reported in early May, 363 people in 43 states and Puerto Rico were infected. One third of the case-patients had to be hospitalized; no deaths occurred. The total represents 19 more cases and 1 more affected state since the CDC's previous update on Sep 25.

Outbreak strains included Salmonella Infantis, Newport, and Hadar.

Nearly three quarters of case-patients reported contact with live poultry during the week before their illness began. Trace-back investigations of live baby poultry in patients' homes led to Mt. Healthy Hatcheries in Ohio as the source of the chicks and ducklings, the CDC said.

The hatchery was associated with previous Salmonella outbreaks in 2012 and 2013.
Oct 21 CDC update
CDC information page on Salmonella risk posed by baby poultry
Sep 26 CIDRAP News scan on previous update

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