News Scan for Dec 03, 2014

Saudi MERS cases continue
Chikungunya hot spots
Cholera in the Caribbean
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Saudi Arabia reports two more MERS cases, one fatal

A fairly steady trickle of MERS-CoV cases in Saudi Arabia continued today with a report of two more, one of them fatal.

One case is in a 71-year-old man in Riyadh who is in critical condition and has a preexisting disease, according to the Saudi Ministry of Health (MOH). He is not a healthcare worker and had no exposure to animals, and authorities are investigating whether he had contact with other MERS-CoV (Middle East respiratory syndrome coronavirus) patients.

The fatal case involved a 52-year-old Saudi man in Bruidah, which is northwest of Riyadh. He had a preexisting disease, was not a health worker, and had no contact with animals or other MERS patients, the MOH said.

The two cases raise Saudi Arabia's MERS tally to 817, with 351 deaths and 9 patients still being treated, the agency said.
Dec 3 MOH statement

In other developments, researchers found no evidence of MERS-CoV antibodies in serum samples collected in July 2012 from 300 animal workers, 17% of whom had daily exposure to camels, according to a study today in Influenza and Other Respiratory Viruses. The samples were gathered about the time the first MERS cases were identified.

The team used a pseudoparticle MERS-CoV spike protein neutralization assay to test the 300 animal workers as well as 50 controls who had no animal exposure; none of the samples reacted with the protein.

Since MERS-CoV has been found in camels and they are regarded as a likely reservoir for the virus, the results were surprising, the authors said, but they note that several other recent studies failed to find MERS-CoV antibodies in groups exposed to domestic animals.

They suggest several possible explanations for the findings: Other mammals may serve as vehicles to carry MERS-CoV from camels to humans, the virus may provoke weak or transient immunity following mild infection, only a subset of humans may be predisposed to MERS-CoV infection, or the virus was only beginning to adapt to human hosts in 2012.
Dec 3 Influenza Other Respir Viruses report


Chikungunya cases increase in French Polynesia, Colombia

About 18,000 chikungunya cases and 4 deaths have been reported in French Polynesia since October, according to a Reuters story.

Public health surveillance head Henri-Pierre Mallet estimates that half of French Polynesia's 268,000 people will be affected by this outbreak. Samoa has reported more than 2,500 chikungunya cases since July, and the islands of American Samoa and Tokelau have also experienced significant outbreaks.

As chikungunya cases in the Caribbean and Americas approach 1 million, outbreaks in French Polynesia are expected to continue and spread to neighboring islands during the rainy season, the story said.
Dec 2 Reuters article

In related news, northeastern regions of Colombia have seen steep increases in chikungunya cases since September, according to a story yesterday in Colombia Reports.

About 20,000 people have sought treatment for chikungunya symptoms in Colombia, a sharp increase from the 5,000 cases reported in September. Patients from more than 40 towns in the state of Norte de Santander, which lies on the border with Venezuela, have overwhelmed medical centers in the state capital of Cucuta, the article said.

In the coastal Caribbean city of Santa Marta, entire neighborhoods have been affected by the disease, the story said. The District Department of Health has isolated Santa Marta's Luis Carlos Galan neighborhood after about 350 residents were diagnosed as having chikungunya.

Although local authorities are attempting to control mosquito populations and manage waste water, the National Association of Hospital Workers of Colombia (Anthoc) is urging greater preventive and sanitary practices in the affected regions.
Dec 2 Colombia Reports article


Cholera cases increase in Haiti and Dominican Republic

Haiti and the Dominican Republic have reported increases in cholera cases over the last several months, and Mexico has reported 14 cases since mid-2014, according to a report yesterday from the Pan American Health Organization (PAHO).

The Dominican provinces of San Juan and Azua reported their first cholera cases of 2014, with 8 suspected cases in Azua and 112 suspected cases and 2 deaths in San Juan. During 2014, the Dominican Republic reported 231 suspected cholera cases and 5 deaths, a lower incidence than was reported in previous years.

According to PAHO, cholera cases in Haiti increased sharply from September to mid-November, with an average of 918 cases reported per week. The Haitian departments of Artibonite, Centre, Ouest, and Nord accounted for 90% of cholera cases during 2014, with Ouest representing 36% of cases. The four departments had a combined hospitalization rate of 70%.

From mid-2014 to mid-November, Mexico reported 14 cholera cases, 13 of which occurred in the state of Hidalgo and 1 in Queretano.

Since the onset of the cholera outbreak on Hispaniola in Oct 2010, Haiti has seen 717,203 cholera case-patients, of which 56% have been hospitalized and 8,721 have died. Total case numbers from the Dominican Republic include 31,703 suspected cases and 472 deaths.
Dec 2 PAHO update

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