News Scan for Aug 12, 2015

Polio milestone in Africa
More Cyclospora cases
More global AI outbreaks
Cleaning healthcare surfaces

WHO says African continent has gone a year without polio

The World Health Organization (WHO) issued a statement yesterday confirming that a wild poliovirus case has not been detected in Africa for 1 year.

The last wild polio case was reported on Aug 11, 2014, in central Somalia, where officials continue to monitor for the possibility of undetected wild poliovirus transmission. Nigeria, the last remaining African country where polio is endemic, marked a year without a polio case on Jul 24.

Africa will be certified as polio-free if the continent goes two more years without a case, leaving Pakistan and Afghanistan as the only two countries in the world where polio transmission is ongoing. Polio-free certification of the African continent will represent a significant step toward eradication of the disease.
Aug 11 WHO statement


CDC reports more cyclosporiasis cases in ongoing outbreak

The Centers for Disease Control and Prevention (CDC) yesterday reported 73 new cases of cyclosporiasis in an outbreak that has now sickened 457 people in 29 states.

More than half (275, or 60%) of people became ill with the intestinal parasite Cyclospora cayetanensis after May 1 and did not have a history of international travel in the 2 weeks preceding their illness. No deaths have been reported, and 16 people have been hospitalized.

The CDC continues to investigate case clusters related to restaurants and events in Texas, Wisconsin, and Georgia. Officials have preliminarily identified cilantro as the source of Cyclospora in the Wisconsin and Texas clusters, though recalls have not been issued. At the end of July the Food and Drug Administration announced an import ban on cilantro from Mexico's Puebla region, after investigations turned up several problems, including human feces in growing fields.

An Aug 11 update from the Texas Department of State Health Services (TDSHS) lists 237 cases of cyclosporiasis in the state this year.
Aug 11 CDC update
Aug 11 TDSHS update


Four countries report new high path AI outbreaks

Four countries reported new highly pathogenic avian influenza detections yesterday, involving H5N1 in Nigeria, Russia, and Vietnam and both H5N2 and H5N8 in Taiwan, according to separate reports to the World Organization for Animal Health (OIE).

Nigeria reported three new outbreaks, one at an egg farm in Lagos state and two in backyard birds in Oyo state, just north of Lagos. The outbreaks began on Jul 30, but the two in Oyo state are reported to be resolved. Of 5,447 susceptible birds at the three locations, the virus killed 1,596, and the remaining ones were culled to control the spread of the virus.

The country's latest outbreaks are part of an H5N1 resurgence that began at the end of 2014, after about a 7-year hiatus.

Russia's H5N1 detection involves a whooper swan found dead at a lake in May at a nature park in Zabaykalsky Krai, located in the south central part of the country not far from the border with Mongolia. According to the OIE report, the swan was tested as part of avian influenza monitoring, and genetic sequencing showed that the H5N1 virus is similar to other isolates detected in Russia in 2014 and 2015 and in China and Vietnam from 2012 through 2014.

Vietnam's H5N1 outbreak occurred in backyard birds in a village in Tra Vinh province, on the country's southern tip. The event began on Aug 7. Of 1,036 susceptible birds, the virus struck 852, and the remaining poultry were destroyed.
Aug 11 OIE report on H5N1 in Nigeria
Aug 11 OIE report on
H5N1 in Russia
Aug 11 OIE report on
H5N1 in Vietnam

In other avian influenza developments, Taiwan reported more outbreaks from H5N2 and H5N8 related to ongoing activity that began earlier this year. Officials reported four more H5N2 outbreaks from three different counties located on the west central part of the island: Yunlin, Nantou, and Changhua. All of the events began in late July, striking commercial farms that housed geese, ducks, and native chickens.

Of 57,888 susceptible birds at the four locations, the virus killed 10,627, and the rest were destroyed to curb the virus.

Taiwanese veterinary officials also reported one new H5N8 outbreak, which occurred at a commercial duck farm in Yunlin County, also on the west central side of the island. The event started on Jul 28 and killed 1,333 of 11,653 susceptible birds. The remaining ones were slaughtered as a control measure.
Aug 11 OIE report on H5N2 in Taiwan
Aug 11 OIE report on H5N8 in Taiwan


Study: More evidence needed for preventing healthcare-associated infections

Hospital practices to prevent healthcare-associated infections (HAIs) have produced encouraging results, yet still lack a focus on patient outcomes, according to a study yesterday in Annals of Internal Medicine.

Researchers affiliated with the Agency for Healthcare Research and Quality (AHRQ) conducted 12 key informant interviews and reviewed 80 studies published since 1990 to evaluate the effects of cleaning and disinfecting high-touch surfaces in patient rooms. The study also assessed how hospitals monitored effectiveness of cleaning strategies and educated healthcare workers in HAI prevention.

The most common high-touch surfaces included bed rails, call buttons, light switches, side or tray tables, and toilets. Researchers only looked at practices that addressed contamination, colonization, or infection with Clostridium difficile (C diff), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE).

Of the 49 studies that evaluated cleaning and disinfecting strategies, four found that bleach-based disinfectants reduced surface C diff, 17 found that no-touch strategies (ultraviolet light, hydrogen peroxide vapor) reduced infection rates from all three pathogens, and 7 found that copper coatings were effective in preventing microbe colonization and infection.

Of the 14 studies that looked at cleaning program effectiveness, six reported that fluorescent and ultraviolet surface markers helped improve cleaning and disinfection. Among the 17 studies of hospital program implementation, three found that multicomponent programs (including education, checklists, and color-coded cleaning supplies) reduced C diff infection rates.

While many of the results were encouraging, researchers noted that studies comparing various cleaning, disinfection, and program administration methods are sorely needed, along with studies that focus on patient-centered outcomes. Most of the studies (65%) identified in this assessment used surface contamination, rather than patient infection rate, as their primary outcome.

The study noted that 60% of the cleaning and disinfection studies had been published in the last 3 years, indicating intense interest in the area of HAI prevention. HAIs sicken more than 700,000 and kill approximately 75,000 people in the United States every year.
Aug 11 Ann Intern Med study

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