News Scan for Dec 17, 2014

More Salmonella from sprouts
Plasma pathogen removal
Avian flu in Washington
H5N1 death in Egypt
Saudi MERS cases

Sprout-related Salmonella outbreak grows to 111 cases in 12 states

The Salmonella Enteritidis outbreak related to mung bean sprouts has grown by 24 cases since the CDC's last report on Dec 4, bringing the total to 111 cases in 12 states, according to yesterday's CDC update.

Maryland reported its first 5 cases as of Dec 15, and the outbreak has been largely confined to the northeastern United States. Affected states are Connecticut (8 cases), Maine (4), Maryland (5), Massachusetts (35), Montana (1), New Hampshire (6), New York (21), Ohio (3), Pennsylvania (17), Rhode Island (7), Vermont (3), and Virginia (1).

Investigators identified Brooklyn-based Wonton Foods Inc. as the likely source of the outbreak, and 48 people reported eating sprouts in the week prior to falling ill. In late November, the producer agreed to destroy remaining sprouts and sanitize the facility. Given their 12-day shelf life, it is unlikely that the contaminated sprouts are still available for purchase or consumption, the CDC said.

Salmonella cases related to this outbreak were reported from Sep 30 to Nov 22. People affected were from younger than 1 to 83 years old, and 19 people were hospitalized.

All Salmonella samples tested were susceptible to antibiotic treatment, the CDC said, also asking that people with compromised immune systems, pregnant women, children, and the elderly avoid eating raw sprouts.
Dec 16 CDC update


FDA approves device to remove some pathogens from donated plasma

The US Food and Drug Administration (FDA) approved the Intercept Blood System, a device that blood banks can use to remove some pathogens from plasma donations, according to an FDA press release yesterday.

Intercept uses a photochemical process involving ultraviolet light and the chemical amotosalen to inactivate pathogens. The device can be used on plasma obtained from whole blood and plasma obtained by apheresis.

Intercept's manufacturer, Cerus Corp., said that blood banks can use the process on site to inactivate viruses like HIV, hepatitis B and C, and West Nile virus. Other pathogens, such as human parvovirus B19 and some bacterial spores, however, remain active following the photochemical treatment.

The device is being tested in clinical trials in West Africa and at Emory University to inactivate potential pathogens such as HIV and malaria in plasma donations from Ebola survivors. The goal is to make antibody-containing plasma safe and available for Ebola patients, the New York Times reported.

Cerus also is seeking approval to treat platelets with Intercept and is evaluating its use in Puerto Rico, where platelet donation has suffered owing to mosquito-borne illnesses like chikungunya and dengue.

Concerns about the product's use in the United States range from the extra cost it would impose on nonprofit blood banks to the safety of introducing amotosalen into plasma and the potential for platelet damage, according to the Times. The FDA said that plasma is purified to remove the chemical and its byproducts following the inactivation of pathogens.

Cerus chief executive William M. Greenman acknowledged that use of Intercept on platelet donations results in a slight loss of platelets. He said that introducing Intercept in the United States would add $30 to the current $60 cost for obtaining a unit of plasma, and $50 to the current $500 cost for obtaining a unit of platelets, the Times reported.

FDA approval followed the device's evaluation in eight clinical trials involving 704 patients and the transfusion of Intercept-treated plasma in people who have acquired clotting disorders. Adverse events were similar to those experienced using plasma not treated with the device, the agency said.
Dec 16 FDA press release
Dec 16 New York Times article


Washington officials set meeting on avian flu

Washington state agriculture officials plan to hold a town hall meeting tomorrow in light of the discovery of two different highly pathogenic avian influenza (HPAI) viruses, H5N2 and H5N8, in wild birds.

Yesterday US officials reported finding an H5N2 virus in a wild pintail duck and an H5N8 virus in a captive gyrfalcon, both in northwestern Washington's Whatcom County, near the area of British Columbia hit recently by H5N2 outbreaks on poultry farms.

The Washington State Department of Agriculture (WSDA) announced yesterday it will hold a public meeting in Lynden, Wash., tomorrow to discuss avian flu and steps poultry owners can take to protect their birds. The meeting is set for 6 pm at the Lynden Rotary Club.

The Canadian outbreak prompted increased surveillance on the US side of the border, which led to detection of the two viruses in wild birds, the US Department of Agriculture (USDA) said yesterday.

In a statement today, the USDA said the gyrfalcon samples were collected after a local falconer reported illness in his birds. The northern pintail duck samples were collected by Washington wildlife officials after a waterfowl die-off at Wiser Lake, Washington, and testing was done by the US Geological Survey and the USDA.

The WSDA statement yesterday said the virus found in Washington is different from the one in the British Columbia outbreak. That contrasts with a USDA report released yesterday, which said the Washington H5N2 virus is similar to the Canadian one.

Neither virus strain has been found in US commercial poultry, and no human H5N8 or H5N2 infections have been reported anywhere, according to the USDA.

The United States has had at least one past outbreak of HPAI H5N2 in poultry, in Texas back in 2004. The outbreak forced the culling of 6,600 broiler chickens on a farm east of San Antonio but did not spread to other farms.
Dec 16 WSDA statement
Related Dec 16 CIDRAP News story
Feb 23, 2004, CIDRAP News story on H5N2 outbreak in Texas


Egypt reports another H5N1 death

A 20-year-old Egyptian woman has died of H5N1 avian flu, according to a report today by the Anadolu Agency (AA), Turkey's official press agency.

The woman was a student in Asyut city in Asyut governorate in central Egypt along the Nile River. She was hospitalized in critical condition 3 days ago after developing severe pneumonia, according to medical sources in Asyut. Her death was confirmed by Amr Qandil, head of preventive medicine with Egypt's health ministry.

The woman's death is the country's ninth this year caused by H5N1, and most media reports say Egypt has now confirmed 18 H5N1 cases this year. The H5N1 death toll since 2006 is 72, the AA story said.
Dec 17 AA story


WHO confirms 11 recent Saudi MERS cases, 4 deaths

The World Health Organization (WHO) today confirmed 11 MERS-CoV cases, including 4 deaths, reported by Saudi Arabia's Ministry of Health (MOH) from Nov 20 to Dec 7.

The patients are from all over the country, with 4 in Taif, 2 in Al-Kharj city, and 1 each in Riyadh, Buraidah, Najran, Rafha, and Sakakah. Only two are women, while eight are Saudi nationals. Their ages range from 28 to 79 years, with a median of 52.

One patient, a 40-year-old man from Taif, is a health worker, though his facility has not treated a confirmed case of MERS-CoV (Middle East respiratory syndrome coronavirus), the WHO said. Three patients reported exposure to other MERS patients before they contracted the virus. Five patients had pre-existing disease.

Three patients reported recent animal exposure, one to sheep, one to camels and sheep, and one—a 28-year-old man in Najran—to unspecified animals, though the report said, "He lives in an area with heavy presence of camels, although he has no history of contact with them." In addition, one patient, a 70-year-old woman in critical condition, had no history of contact with camels, "but her household contacts had frequent contact with animals."

Among the 8 surviving patients, 3 are currently in critical condition and 5 in stable condition, the WHO said, adding that contact tracing is ongoing for these cases.

In related news, the MOH reported no new MERS-CoV cases today, but it said a 28-year-old man in Najran has recovered from the disease. This appears to be the 28-year-old expatriate mentioned in today's WHO report, which lists the man in critical condition in an intensive care unit. The Saudi MERS count stands at 821 cases, including 355 deaths.
Dec 17 WHO statement
Dec 17 MOH update

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