News Scan for Aug 24, 2015

More chikungunya cases
Tuna salmonellosis outbreak over
Ebola IHR review

Chikungunya outbreak in Americas grows by more than 34,000 cases

The Pan American Health Organization (PAHO) on Aug 21 reported 34,866 new cases of chikungunya in the Caribbean and Americas. The outbreak total, adjusted for ongoing case confirmation, is 1,679,223.

The new total includes 514,534 suspected, 17,118 confirmed locally acquired cases, and 802 imported cases reported in 2015, or 532,454 total for the year.

Nicaragua, reporting cases for the first time in 19 weeks, had the largest increase with 20,953 new cases, bringing its 2015 outbreak total to 41,134. El Salvador, reporting for the first time in 4 weeks, had 10,349 new cases, for an outbreak total this year of 10,349.

Colombia, which has reported thousands of cases per week for the past several months, reported 3,046 new cases last week, bringing its 2015 outbreak total to 319,608.

Nicaragua reported its first death this year, bringing the year's outbreak fatality total to 63. Previously reported fatalities and cases in the non-Latin Caribbean decreased in the most recent PAHO update, likely due to ongoing laboratory testing and case confirmation.

The chikungunya epidemic began in December 2013 with the first locally acquired chikungunya case ever reported in the Americas, on St. Martin in the Caribbean.
Aug 21 PAHO update

In related news, the European Centre for Disease Prevention and Control (ECDC) late last week released a rapid risk assessment on Spain's first case of chikungunya, which was reported on Aug 10 in a man with no travel history to an area where the virus is endemic.

The assessment said that the case was not unexpected, due to presence of the mosquito vector, a climate conducive to mosquito population growth in coastal Spain, and the recent increase in imported chikungunya cases in Europe.

From 2008 to 2013, 541 imported cases of chikungunya were reported in Europe. Imported cases in 2014 alone were 1,450, and 81% of the 1,178 cases with test data available in 2014 were imported from the Caribbean.
Aug 21 ECDC rapid risk assessment
Aug 10 CIDRAP News story on chikungunya case in Spain


Salmonella outbreak investigation tied to frozen tuna declared over

The Centers for Disease Control and Prevention (CDC) on Aug 19 released its final report on a multistate Salmonella outbreak linked to frozen yellowfin tuna imported by the United States from Indonesia.

The outbreak sickened 65 people, 18% of whom were hospitalized, in 11 states between Mar 5 and Jul 20. Illnesses were attributed to two strains: Salmonella Paratyphi B variant L(+) tartrate(+) in 64 people and Salmonella Weltevreden in one person.

Investigators identified the source of the outbreak as frozen yellowfin tuna imported by Osamu Corporation in Gardena, Calif., from one Indonesian processing plant.

Because of the frozen tuna's long shelf life, recalled fish may still be in freezers. CDC cautioned restaurants and consumers to not eat recalled products, saying "When in doubt, don't sell or serve it."
Aug 19 CDC final report


Committee launches review of IHRs in Ebola response

A 16-member committee to review how well the International Health Regulations (IHRs) performed during the Ebola response met at World Health Organization (WHO) headquarters in Geneva today, the first day of a 2-day meeting. In May, the World Health Assembly asked for a committee to assess the IHRs during the epidemic. In 2010 a similar group reviewed IHR performance during the 2009 H1N1 pandemic.

In opening comments, WHO Director-General Margaret Chan, MD, MPH, said the review is taking place against the backdrop of nearly universal agreement that the global response to the outbreak was inadequate, according to remarks released by the WHO. She said the IHRs are an instrument for helping the WHO control the international spread of diseases, and a review is needed to help pinpoint response shortcomings.

She emphasized that the IHRs are the only international agreed-on rules governing emergency response. "If its legally-binding obligations on state parties are not being met, change is urgently needed," Chan said. "Your job is not an easy one. Emerging and re-emerging infectious diseases have become a much larger menace under the unique conditions of the 21st century."

Chan alluded to current IHR weaknesses, such as lack of an enforcement mechanism and lack of an intermediate alert level short of declaring a full public health emergency of international concern (PHEIC)

The WHO said last week that the committee chair will hold a press conference tomorrow after the meeting concludes.
WHO IHR review background
Aug 24 Margaret Chan opening remarks

In other Ebola developments, Sierra Leone's last known Ebola patient was released from treatment today, which signals the start of a 42-day countdown to Ebola-free status, provided no other cases are reported, the Associated Press (AP) reported today. The patient is a 40-year-old woman who contracted the virus from her 23-year-old son upon his return from Freetown. The man died from his infection.

Last week the WHO reported that Sierra Leone had gone a full week without reporting a new case, the first time since the outbreak began.
Aug 24 AP story

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