News Scan for Apr 13, 2015

New strain in dog flu outbreak
Saudi MERS deaths, new health chief
More chikungunya
Drugs in food animals
Global Salmonella burden

New H3N2 virus implicated in Chicago canine flu outbreak

A canine influenza outbreak affecting dogs in Chicago and other Midwest locations is being fueled by a virus closely related to Asian H3N2 strains and not H3N8 as originally thought, researchers from Cornell University and the University of Wisconsin announced yesterday.

The H3N2 virus striking dogs in the Chicago region hasn't been detected before in North America, and the outbreak suggests a recent introduction of H3N2 from Asia, where it has been widely circulating in southern Chinese and South Korean dog populations since it was identified in 2006, according to a Cornell press release.

According to reports last week, the virus has sickened more than 1,000 dogs, killing at least 5, in the Chicago area. The Cornell and Wisconsin team said the outbreak suggests a recent introduction of the H3N2 virus from Asia, and there is no evidence that it can be transmitted to people, though it can infect and cause respiratory illness in cats.

Clinical samples from the outbreak were tested at the New York State Animal Diagnostic Laboratory at Cornell, which found that an influenza A virus was involved and led researchers to suspect a new strain. More testing at the Wisconsin Veterinary Diagnostic Laboratory identified the new subtype as H3N2. The National Veterinary Services Laboratories in Ames, Iowa, is sequencing two outbreak isolates to more fully characterize the viruses.

The H3N2 and H3N8 strains can both cause high fever, appetite loss, coughing, nasal discharge, and lethargy in dogs, but symptoms may be more severe with H3N2 infections. Some infected dogs may not show any symptoms.

Researchers said the broadly targeted influenza A matrix reverse transcriptase-polymerase chain assay (RT-PCR) can be useful for diagnostic testing, but the specific H3N8 test will not detect the new virus. Currently available serology tests may not detect signs of infection with H3N2, and an H3N2-specific assay is under development and will be available soon. So far scientists don't know if the current canine flu vaccine will protect against H3N2.
Apr 12 Cornell press release
Related Apr 6 CIDRAP News scan


Saudi Arabia reports 2 MERS deaths, new minister of health, response improvements

Saudi Arabia reported two MERS-CoV deaths in recent days, while it announced a new minister of health—its fourth in a year—and the formation of rapid response teams to combat the disease.

The country's Ministry of Health (MOH) confirmed deaths related to MERS-CoV (Middle East respiratory syndrome coronavirus) today in a Saudi man in Ha'if and on Apr 10 in a Saudi woman in Riyadh. Both of their cases were previously confirmed.

The man in Ha'if was 82, and the woman in Riyadh was 69. Neither was a healthcare worker, and both had preexisting diseases. The MOH also reported on Apr 11 than a 48-year-old Saudi woman in Riyadh has recovered from the diseases. She likewise was not a healthcare worker and had preexisting disease.

The MOH said the new numbers bring the total MERS deaths in the country since 2012 to 427, and 543 patients have now recovered. With no new cases in 4 days, that number remains at 977. Seven MERS patients are still undergoing treatment.
Apr 13 MOH update
Apr 10 MOH
Apr 11 MOH

Saudi Arabia's King Salman bin Abdulaziz Al Saud relieved Ahmed bin Aqeel Al-Khatib of his health ministry post and replaced him with the Minister of State, Mohammed bin Abdulmalik bin Abdullah Al Al-Sheikh, who will serve as acting minister of health, the Saudi Press Agency (SPA) announced on Apr 11. Al-Sheikh becomes the fourth minister of health in less than a year, Mike Coston noted on his Avian Flu Diary blog.

And yesterday the MOH said that its Command and Control Center has enhanced its capability of responding to MERS-CoV and other infectious disease threats by forming three rapid response teams comprising 120 health specialists.

"Team A" is assigned to discovering MERS cases and ensuring that all healthcare centers in the country are prepared to handle the disease. Team B, according to the MOH, "is tasked with supporting the infection control team in the facility to curb spread of the disease and to make sure of the environmental cleaning measures, provided that the facility receives two suspected corona cases on weekly bases."

Team C responds when there are more than two suspected MERS-CoV cases in the same facility within a month. It will examine the facility for 5 days and provide "intensive training" for health workers in addition to sterilizing the building and preparing workers to conduct epidemiologic surveillance, including investigating the source of the outbreak.
Apr 11 SPA notice
Apr 11 Avian Flu Diary
Apr 12 MOH


Americas chikungunya cases rise by 14,000

The number of chikungunya cases reported in the Americas grew by 14,788 cases last week, putting the total at 1,371,399 cases, according to an Apr 10 update from the Pan American Health Organization (PAHO).

The rise was similar to the 13,239 cases reported the previous week, with both weeks down from increases in the 20,000 to 30,000 range reported in past weeks. PAHO's tally reflects 1,338,026 suspected cases and 29,755 confirmed cases, which is 554 fewer than the week before. Nine more imported cases—all from the United States—were reported, edging that total to 3,618 cases. Most of the imported cases, which are also included in the total, are from the United States.

The US Centers for Disease Control and Prevention (CDC) said in an Apr 7 update that so far 77 chikungunya infections have been reported in the United States, all of them in travelers returning from affected areas. So far no locally transmitted US cases have been reported this year.

Colombia, as in past weeks, reported the biggest increase, accounting for 13,710 of the new cases. Other areas reporting new cases include Costa Rica, El Salvador, and Puerto Rico.
Apr 10 PAHO update


FDA: Medically important drugs make up 62% of those used in food animals

Domestic sales and distribution of medically important antimicrobials approved for food-producing animals increased by 3% in 2013—to 62% of all antimicrobials used in such animals—and they increased 20% from 2009 through 2013, the US Food and Drug Administration (FDA) said in its annual update on drug use in domestic animals.

In December, the FDA announced Guidance for Industry #213, which calls for animal pharmaceutical companies to remove growth-promotion claims from medically important antimicrobial drugs in food-producing animals. At that time the FDA also implemented the Veterinary Feed Directive for ensuring that the drugs can no longer be used without veterinary oversight.

Of 2013 sales of medically important antimicrobials in food animals, tetracyclines accounted for 71%, penicillins for 9%, macrolides for 6%, sulfonamides for 4%, aminoglycosides for 3%, lincosamides for 3%, and cephalosporins for less than 1%.

The FDA report also noted that domestic sales and distribution of all antimicrobials approved for use in food-producing animals increased by 17% from 2009 through 2013. They decreased from 72% to 68% from 2009 through 2012, but then increased from 68% to 72% from 2012 through 2013.
Apr 10 FDA news release
Apr 10 FDA


Review: Invasive Salmonella causes 3.4 million global cases a year

Each year bloodstream Salmonella infections cause an estimated 3.4 million cases and 680,000 deaths worldwide, with an especially high incidence in Africa, according to a meta-analysis published in Emerging Infectious Diseases late last week.

An international team of researchers, including scientists from the CDC, analyzed data from 10 major studies that involved the global incidence of invasive nontyphoidal Salmonella infections. They estimated that 3.4 million cases occur annually (range, 2.1 million to 6.5 million) and 681,316 deaths (range, 415,164 to 1.3 million).

The researchers also determined a global incidence of 49 cases per 100,000 population. That number, however, surged to 227 cases per 100,00 population in Africa. They called for a better understanding of the epidemiology of the disease.
Apr 10 Emerg Infect Dis study

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