News Scan for Mar 16, 2015

H5N1 in Egypt
Chikungunya cases spike
Meningitis in Nigeria
More US measles cases

H5N1 cases pile up in Egypt

Twelve more H5N1 avian influenza infections have been reported from Egypt over the past 5 days, according to translated governorate health department reports and a batch of notifications today from the United Nations Food and Agriculture Organization (FAO).

Three of the recent cases involve a 34-year-old woman from Asyut governorate, a 50-year-old woman from Qena governorate, and a 21-year-old woman from Sharqia governorate, according to separate health department reports translated and posted by FluTrackers, an infectious disease news message board. The group has been closely tracking media and official reports coming out of Egypt, and their totals closely match the official totals Egypt recently reported to the World Health Organization (WHO).

Few details are known about the 9 additional human cases, which were gleaned from the FAO reports. The reports note only that they are human cases and the locations, a variety of different governorates.

The new cases lift Egypt's H5N1 total this year to 103, according to a case list maintained by FluTrackers.
Mar 12 FluTrackers thread on Asyut case
Mar 14 FluTrackers thread on Qena case
Mar 14 FluTrackers thread on Sharqia case
Mar 16 FluTrackers thread on FAO notifications
FluTrackers Egypt H5N1 case list

Chikungunya total in Americas rises by more than 22,000

In a Mar 13 update, the Pan American Health Organization (WHO) reported a surge in chikungunya cases in the Americas, with an increase of 22,237 over the week before, lifting the overall total to 1,282,100. The increase the previous week was 9,038.

PAHO's latest total includes 1,253,184 suspected, 25,400 confirmed, and 3,516 imported cases, with the largest portion of the imported cases in the United States.

The death toll from the disease stayed level at 183.

Most of the gain in cases was in Colombia, which reported 20,389 new cases. The country now has 205,424 suspected and confirmed cases. Also, Bolivia reported 143 new suspected cases, which when combined with the 74 confirmed cases it already has, raises the country's total to 217.

The United States had 12 new chikungunya infections, all of them imported cases, which now total 2,536. The number of locally transmitted cases stayed the same at 11, all of them in Florida.
Mar 13 PAHO update
Mar 9 CIDRAP News story on previous week's numbers

Nigeria reports 652 cases of meningococcal disease, 50 deaths

Nigeria has been hit in the past several weeks by an outbreak of more than 600 cases of meningococcal disease, predominantly caused by Neisseria meningitidis serogroup C, with 50 deaths, according to a Mar 13 report from the World Health Organization (WHO).

The WHO was notified by the Nigeria Centre for Disease Control of 652 cases that occurred from Jan 26 through Mar 5  in Kebbi and Sokoto states. Zamfara state has seen an uptick in suspected cases recently, but those remain unconfirmed.

The WHO, along with Doctors without Borders and the United Nations Children’s Fund, is providing support to Nigeria’s government as a mass vaccination campaign and emergency control measures are implemented. More than 200,000 doses of vaccine and 5,000 vials of antibiotics have been provided by the International Crisis Group with support from GAVI, the Vaccine Alliance.

The vaccine MenAfrivac, which protects against N meningitides serogroup A, was used widely in Nigeria from 2011 to 2014, resulting in a significant decline in that type. The WHO report does not state what vaccine is being used in the current immunization campaign.
Mar 13 WHO report


US measles cases increase by 3, all in California

The case count for measles in the United States from Jan 1 through Mar 13 has reached 176, 3 more than last week, says an update from the Centers for Disease Prevention and Control (CDC) today.

Although nearly all the cases are part of four different outbreaks, 130 (74%) of the cases this year have been linked with California's Disneyland. Substandard vaccination is likely to blame, says a research letter published today in JAMA Pediatrics.

Cases have occurred in 17 states and the District of Columbia; the three new cases are all in California. Outbreaks outside the Disney-related one have occurred in Illinois, Nevada, and the state of Washington. The Disney outbreak began in December 2014. Last week an outbreak in Quebec was reported to include 188 cases related to Disneyland.
Mar 16 CDC update on cases this year
Mar 16 CDC
update on Disney-related cases
Mar 12 CIDRAP News
item on Montreal outbreak

The ongoing measles outbreak is likely the result of substandard (absent or incomplete) vaccination, says a research letter published today in JAMA Pediatrics. The authors estimate that the vaccination rates in the exposed population in which secondary cases have occurred may be as low as 50% and are likely no higher than 86%. To preserve herd immunity, vaccination rates for the highly contagious infection need to be 96% to 99%, say the authors.

"Clearly, [measles, mumps, and rubella] vaccination rates in many of the communities that have been affected by this outbreak fall below the necessary threshold to sustain herd immunity, thus placing the greater population at risk as well," the authors conclude.
Mar 15 JAMA Pediatr study abstract


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