News Scan for Apr 29, 2015

WHO MERS update
Regional C diff rates
Meningitis in Niger

WHO notes 4 previous Saudi MERS-CoV cases and 1 death

Four cases of MERS-CoV in Saudi Arabia, one of them fatal, were officially reported to the World Health Organization (WHO) for the period Apr 14 to 20, according to an update today.

The new cases, all previously reported by the Saudi Ministry of Health (MOH) and noted by CIDRAP News, are in adult men, and tracing of household and healthcare contacts is ongoing.

Three of the case-patients had preexisting disease, including the man who died. Three, including the fatality and the one with no comorbidities, had a history of frequent contact with camels and/or sheep as well as consumption of raw camel milk.

The WHO's official global count of MERS-CoV (Middle East respiratory syndrome coronavirus) cases stands at 1,110, with "at least 422 related deaths," says the update.

MERS-CoV case numbers reported by the MOH stand at 981 confirmed cases since June 2012, with 428 deaths, 551 recoveries, and 2 in treatment. The MOH has reported no new cases since Apr 20 and just 8 cases so far in April, compared with 53 in March and 75 in February.
Apr 29 WHO update
Apr 20 CIDRAP News item on MERS
Apr 17 CIDRAP News item on MERS

In related news out of Saudi Arabia today, a new minister of health, Kahlid Al Falih, has been appointed in "a wave of reappointments" across King Salman bin Abdulaziz al-Saud's cabinet, reports a story in Al Arabiya News.

Al Falih replaces Mohammed bin Abdulmalik bin Abdullah Al Al-Sheikh, who was appointed acting minister of health on Apr 11. The country has had five health ministers in about a year. Al Falih is CEO of Saudi oil company Aramco.
Apr 29 Al Arabiya News story


10-year study notes C diff incidence highest in Northeast

The incidence of hospitalization for Clostridium difficile infection (CDI) was highest in the Northeast and in the spring season, whereas C diff mortality rates were highest in the Midwest and in the wintertime, according to a large 10-year study of the disease across US regions published today in the American Journal of Infection Control.

University of Texas researchers analyzed 2.3 million cases of CDI from 2001 through 2010 and found the highest incidence in the Northeast, with 8.0 CDI hospital discharges out of 1,000 total discharges, followed by the Midwest (6.4), South (5.0), and West (4.8).

Seasonally, spring brought the highest incidence (6.2 /1,000), followed by winter at 5.9, summer at 5.9, and fall at 5.6. Adults and older adults followed overall trends, whereas pediatric CDI was highest in winter.

CDI mortality was highest in the Midwest, at 7.3%, compared with 6.9% in the Northeast and South and 6.2% in the West. The death rate was highest among seniors, at 8.8%, compared with 6.9% in working-age adults and 3.1% in children. Mortality peaked at 7.9% in the winter, compared with 6.8% in the summer, 6.6% in the fall, and 6.2% in the spring.

"The peak incidence in the spring could be attributed to increased utilization of antibiotics in winter months for respiratory infections," the authors wrote. "Prior studies have found a 1-2 month lag time between antibiotic exposure and the development of CDI."
Apr 29 Am J Infect Control abstract


Meningitis outbreak hits Niger, with serogroup C predominant

More than 1,500 cases of suspected meningococcal disease with nearly 150 deaths have been reported in Niger, the largest country in West Africa, since the beginning of the year, according to a notice today from the WHO. An international team from the WHO and the US Centers for Disease Control and Prevention is assisting in investigation and surveillance.

Seven of the country's eight regions have cited suspected meningitis, and cases have been confirmed in Dosso region and in Niamey, the capital and largest city. Neisseria meningitides serogroup C has been shown through laboratory testing as predominant in samples from affected areas, with serogroup W also present.

The notice gives the total suspected cases through Apr 25 as 1,543 and the number of deaths as 147. Just last week the WHO reported only 461 cases and 62 deaths in Niger through Apr 5. Mass vaccination campaigns, case management, and social mobilization actions are under way.

Meningitis has been reported recently in Nigeria, just south of Niger, and in nearby Ghana as well.
Apr 29 WHO notice
Apr 21 CIDRAP News item

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