News Scan for Nov 21, 2014

Plague in Madagascar
New EV-D68 cases, paralysis cases
International food safety rankings

Plague outbreak in Madagascar sickens 119, kills 40

An outbreak of plague in Madagascar comprising 119 cases with 40 deaths as of Nov 16 has spread to Antananarivo, the country's capital and largest city, greatly increasing the risk of further spread, according to an alert today from the World Health Organization (WHO).

Cases have been reported in 16 districts of seven regions. Two cases, one of them fatal, have occurred in Antananarivo. A weak healthcare system there and its high population density make for conditions where more cases are likely, says the report. It adds that a high level of resistance to the insecticide deltamethrin, which is used to control fleas, the main carriers, adds to the risk.

The large majority of cases are bubonic, a form that is treatable with antibiotics if caught early, with only 2% pneumonic at this point. The latter occurs when the causal agent, Yersinia pestis, reaches the lungs. The pneumonic form is lethal and transmissible from person to person through droplets spread by coughing.

Madagascar has activated a national task force that is receiving technical and human resources support from the WHO and other organizations as well as financial support from the African Development Bank. Control measures, including provision of personal protective equipment, insecticides, and antibiotics, are being implemented.
Nov 21 WHO alert


EV-D68 count reaches 1,121, possibly related polio-like illness adds 13

Five more cases of enterovirus D68 (EV-D68) infections associated with severe respiratory illness have occurred over the past week, bringing the total since mid-August to 1,121 in 47 states and the District of Columbia, according to a weekly update yesterday from the Centers for Disease Control and Prevention (CDC).

No new deaths associated with the virus were reported this week, keeping that total at 12.

The CDC notes that decreased EV-D68-like illness is being reported by most states over the past couple of months but added that cases could continue through late fall. EV-D68 infection has been far more common this year than is typical for the rare disease; cases have occurred almost exclusively in children and are most serious in those with asthma or a history of wheezing.

In potentially related news, 13 new cases of an acute polio-like illness of unknown cause have occurred in the past week, bringing that total to 88 since August 1, according to a separate CDC update. Three more states have been added to those affected by the illness, although they are not specified in the update.

EV-D68 was found in 4 of 10 patients with the mysterious neurologic disease in the early weeks of the outbreak, so it is one possible cause being investigated.
Nov 20 CDC EV-D68 update
Nov 20 CDC paralysis investigation update


Canadian report ranks 17 countries on food safety performance

Canada and Ireland received the highest scores when evaluated with 10 food safety performance measures, according to a report issued yesterday from the Conference Board of Canada's Centre for Food.

In collaboration with the University of Guelph's Food Institute, the Conference Board ranked 17 countries based on food safety risk assessment, risk management, and communications. All countries are members of the Organisation for Economic Cooperation and Development (OECD), and measures evaluated each nation's food safety progress since 2010.

Other countries joining Canada and Ireland in the top tier of performance included France, the United Kingdom, Norway, and the United States, the report said.

Austria, Canada, France, Ireland, Japan, the United Kingdom, and the United States all showed significant improvement in reporting the incidence of Campylobacter, Salmonella, Yersinia, Escherichia coli, and Listeria. Sweden, Norway, and Germany ranked lowest in this area, suggesting a decline in pathogen reporting within the last 5 years, the report said.

The report also looked at public trust in a country's ability to prevent and respond to food safety and allergen issues. Canada and Ireland experienced an increase in public trust, while the evaluation found that public trust had declined in Australia, France, Italy, and the United States.

Evaluators used common elements of food safety systems across all 17 countries to conduct their evaluation, while noting the need for greater consensus on multinational food safety standards.
Nov 20 Conference Board of Canada
Nov 21 Food Safety News article on the report

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