News Scan for May 11, 2015

Avian flu in Burkina, Turkey, Taiwan
Drug-resistant typhoid
More chikungunya
Plague drug approved
Washington state E coli
Measles in France

Burkina Faso, Turkey, and Taiwan report high-path avian flu

Veterinary officials in Burkina Faso and Turkey reported more highly pathogenic H5N1 avian flu outbreaks, as their counterparts in Taiwan reported that highly pathogenic H5N2 has struck 10 more locations, according to separate reports to the World Organization for Animal Health (OIE).

In Burkina Faso, H5N1 caused four recent outbreaks, two in Kadiogo province and one each in Boulkiemde and Nahouri provinces, according to a May 9 OIE report. Nahouri is in the south-central part of the country, and the three other locations are in central Burkina Faso. The H5N1 virus started hitting the country's poultry in April after a 9-year absence.

Two of the latest outbreaks were at farms, and two were in backyard poultry, with a total of 2,054 susceptible birds. The events were reported from Mar 1 to Apr 15. The H5N1 virus killed 555 birds, and the rest were to be stamped out.
May 9 OIE report on Burkina Faso outbreaks

Meanwhile, Turkish officials reported another H5N1 outbreak at a poultry farm in Balikesir province in the far western part of the country, which killed 150 of 4,141 susceptible birds and led to the culling of 3,991 others, according to report today to the OIE.

The outbreak began on Apr 28 and appears to be related to an outbreak noted in a May 2 listing from the EMPRES Global Animal Disease Information System of the United Nations Food and Agriculture Organization that didn't specify an outbreak subtype. The virus was recently found in Turkey again after about a 7-year hiatus.
May 11 OIE report on Turkey outbreak

Elsewhere, Taiwan reported 10 more H5N2 outbreaks in four different counties, Yunlin (4), Kaohsiung (3), Pingtung (2), and Changhua (1), all on the western side of the island, according to a separate report today to the OIE.

Most were on poultry farms, affecting geese, chickens, and ducks. The outbreak in Changhua County, however, involved two wild sparrows.

Of 62,780 susceptible birds the outbreaks killed 22,552, with the remaining ones culled to curb the spread of the virus. Most of the events began in January or February.
May 11 OIE report on Taiwan outbreaks


Study notes ongoing spread of drug-resistant typhoid

Drug-resistant typhoid fever is creating a previously unnoticed but ongoing epidemic in eastern and southern Africa and has spread across Asia and Africa in the past 30 years, according to the results of a comprehensive genomic study published today in Nature Genetics.

Seventy-four scientists from more than 24 countries conducted a whole-genome sequence analysis of 1,832 isolates of Salmonella enterica serotype Typhi, the bacterium that causes typhoid. They noted that the H58 lineage, which is resistant to multiple drugs, has replaced antibiotic-sensitive isolates in many locations, "transforming the global population structure of this pathogen," the authors write.

"Multidrug resistant typhoid has been coming and going since the 1970s and is caused by the bacteria picking up novel antimicrobial resistance genes, which are usually lost when we switch to a new drug," said Dr. Kathryn Holt, senior author from the University of Melbourne, in a Wellcome Trust Sanger Institute news release.

"In H58, these genes are becoming a stable part of the genome, which means multiply antibiotic resistant typhoid is here to stay."

Typhoid causes about 21 million cases worldwide each year and 200,000 deaths, according to data from the US Centers for Disease Control and Prevention (CDC).
May 11 Nat Genet abstract
May 11 Wellcome Trust press release


PAHO reports 12,000 new chikungunya cases

Chikungunya cases in the Americas continued their steady increase last week, with 12,064 new cases reported, bringing the outbreak total to 1,426,515, the Pan American Health Organization (PAHO) said in its weekly update.

The previous weeks saw increases of almost 13,000 and 30,000, respectively.

As has been the case in most weeks of late, the vast majority of new infections were reported in Colombia, which saw a 10,120-case increase, to 297,061. Other nations reporting new cases included Brazil, with 553 new cases, and Mexico, with 156.

As noted before, however, very few countries have reported cases in recent weeks. The outbreak began in December 2013, with the first locally acquired chikungunya case ever reported in the Americas, on St. Martin in the Caribbean.
May 8 PAHO update


FDA approves new drug to treat, prevent plague

Late last week the US Food and Drug Administration (FDA) approved the drug Avelox (moxifloxacin) to treat and prevent plague.

The drug, made by Bayer, is approved to treat pneumonic plague (plague of the lungs) and septicemic plague (infection of the blood) in all patients and to prevent plague in adults. It is not approved to treat the third common form, bubonic plague, which involves the lymph nodes.

The FDA approved Avelox for plague under the agency's Animal Efficacy Rule, which allows efficacy findings from adequate and well-controlled animal studies to be used when it is not feasible or ethical to conduct trials in humans. Because plague is so uncommon, it would not be possible to conduct adequate efficacy trials in people.

FDA approval was based on an efficacy study conducted in African green monkeys that were experimentally infected with Yersinia pestis, the bacterium that causes plague. All 10 monkeys treated with Avelox survived, compared with none of 10 monkeys treated with a placebo.

Plague can be spread to people through flea bites, contact with infected animals or people, or lab exposure. From 1,000 to 2,000 cases occur worldwide each year.
May 8 FDA news release


CDC team to help probe Washington state E coli outbreak

CDC experts are slated to arrive today in Whatcom County in northwestern Washington to help investigate on Escherichia coli outbreak linked to a dairy festival, the Bellingham Herald reported on May 8.

At least 47 people have fallen ill and 8 have been hospitalized in the outbreak, according to county officials. Most are among a group of more than 1,300 first-graders who attended the annual Milk Makers Fest in Lynden Apr 21 through 23. The festival introduces students to farming and gives them an opportunity to pet farm animals.

Workers who helped set up and take down the event are also among the ill.

State epidemiologist for communicable diseases, Scott Lindquist, MD, MPH, said he invited the CDC team. He said, "I could use extra hands on this."
May 8 Bellingham Herald report


France reports 67-case measles outbreak

French officials have reported a measles outbreak involving at least 67 cases in the Alsace region in northeastern France, which borders Germany and Switzerland, according to a report late last week from the European Centre for Disease Prevention and Control (ECDC).

"The French index case had most probably been infected during a school trip to Berlin, following contact with a confirmed case in the German host family," the ECDC said.

An increase in cases in the region was first noted in early April. As of May 3, 67 cases were reported to regional health authorities. Of them, 11 have been lab confirmed, 51 are epidemiologically linked, and 5 were "clinically compatible." Four patients had received only one dose of measles vaccine, with the rest unvaccinated. Fewer than 30 cases have been reported outside the Alsace region in France this year.

All reported case-patients attended a music school in Colmar, France, or had direct contact with patients who had. Fifty-nine are students at one of three schools in the region, while eight cases involve family members of people with a possible social link.

Germany has been experiencing a measles outbreak since October 2014 that involves 1,134 cases reported as of Apr 22, the ECDC said.

Alsace officials are encouraging vaccination and conducting contact tracing.
May 7 ECDC report

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