News Scan for Jul 31, 2015

Cyclospora goes nationwide
Avian flu in Nigeria, UK
Flu in live-animal markets
CSL-Novartis deal

CDC reports 358 Cyclospora cases in 26 states

Cyclospora illness—which previously this summer had been almost exclusively reported in Texas—has now affected 358 people in 26 states, the Centers for Disease Control and Prevention (CDC) said in an update today.

More than half (199, or 56%) had symptoms that began after May 1 and reported no international travel before becoming sick, the agency said.

The CDC is investigating clusters of cases linked to restaurants or to specific events in Texas, Wisconsin, and Georgia. It is also probing additional clusters in Texas and Georgia. The agency said that investigations in Texas and Wisconsin "have preliminarily identified cilantro as a suspect vehicle," echoing an import alert from the Food and Drug Administration (FDA) earlier this week regarding cilantro from Mexico's Puebla region.

The CDC said investigations are ongoing to pinpoint the food culprit in other cases. The agency did not give a breakdown of the number of cases in affected states or specifics about patients. A Jul 29 update from the Texas Department of State Health Services (TDSHS) lists 212 cases in that state.
Jul 31 CDC statement
Jul 28 CIDRAP News scan on FDA alert
Jul 29 TDSHS update


Nigeria notes 4 H5N1 outbreaks; UK reports LPAI-to-HPAI mutation

Nigerian officials have reported four new H5N1 avian flu outbreaks involving more than 6,000 poultry, and UK authorities are saying that a highly pathogenic avian influenza (HPAI) H7N7 outbreak in that country earlier this month was the result of a mutation from a low-pathogenic (LPAI) H7N7 virus.

In Nigeria, the H5N1 outbreaks, in the southern part of the country, involved a total of 6,747 birds, according to a report posted by the World Organization for Animal Health (OIE). One was a backyard flock of 178 laying chickens, and the others housed poultry flocks ranging from 620 to 3,269 birds. All told, 3,879 birds were sickened by the virus, and 3,417 of them died. The rest were euthanized to prevent disease spread.

The outbreaks began from Jul 12 to Jul 20. The country has confirmed 168 H5N1 outbreaks since January. Before that, it hadn't reported an outbreak since 2008.
Jul 29 OIE report

In the United Kingdom, the country's Department for Environment, Food and Rural Affairs (DEFRA) released a preliminary outbreak assessment for an HPAI H7N7 avian flu outbreak in Germany earlier this week affecting a farm of more than 10,000 laying hens. In the report, the agency mentions several recent LPAI H7N7 outbreaks in Europe, noting that one occurred within 1 kilometer of the German HPAI H7N7 outbreak.

It then cites the other recently reported HPAI H7N7 outbreak, which occurred on a UK farm on Jul 6. DEFRA says in its report, "Investigations into this outbreak have revealed a mutation event occurred within the poultry premises, following an incursion of LPAI. The most likely source of infection was contact with wild birds, given the presence on the farm of nesting wild waterfowl and two ponds. The full epidemiology report will be available soon at"

It adds, "The mutation of LPAI to HPAI viruses is a rare event."
Jul 29 UK DEFRA report


Flu viruses found in workers, animals at fairs

Live-animal fairs produced substantial levels of influenza in employees, animals, and their environs, and sequencing indicated transmission involving humans and animals in one case, according to a new study in Clinical Infectious Diseases.

Researchers from the CDC and Minnesota obtained samples from two markets that were epidemiologically linked to people with infections of variant swine-origin flu. Nasal swabs from 11 of 17 employees (65%) tested positive for influenza A, and 7 tested positive multiple times. Also, 11 of 15 workers (73%) had baseline hemagglutination-inhibition antibody titers of 40 or higher to swine-origin flu, and 1 had a fourfold titer increase to both swine-origin and 2009 H1N1 flu.

In addition, influenza A viruses were isolated from 72 of 84 swine (86%), from 30 of 45 air samples (67%), and from 5 of 21 railings (24%). Whole-genome sequencing of viruses isolated from swine and environmental specimens revealed multiple strains and subtype co-detections, with multiple gene segment exchanges.

Finally, genetic sequencing of viruses from a market customer and from swine indicated pig-to-human transmission or vice versa. The authors conclude that live-animal markets may provide conditions for novel flu viruses to emerge.
Jul 29 Clin Infect Dis abstract


CSL's acquisition of Novartis flu vaccine business cleared

CSL Ltd., of Melbourne, Australia, has received the necessary approvals to acquire Novartis's influenza vaccine business, and both companies hope to finalize the deal in the next few days, according to a Melbourne Herald Sun story today.

The $275 million acquisition will be combined with bioCSL's flu vaccine operations to create a new subsidiary called Seqirus, the story said. The new subsidiary will make CSL the second-largest player in the $4 billion influenza vaccine industry.

"This is a significant acquisition for CSL as a leading global biotherapeutics company which has long been at the forefront of protecting people's health," CSL Chief Executive Paul Perreault said.

Earlier this month CSL won European approval for the purchase.
Jul 31 Herald Sun story
Jul 21 CIDRAP News scan on European approval

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