News Scan for Dec 01, 2015

Saudi MERS case
Hawaii dengue outbreak
Invasive pneumonia risk
MRSA carriers

Saudi Arabia reports Riyadh MERS case

Saudi Arabia's Ministry of Health (MOH) reported a new MERS-CoV case today in the capital city of Riyadh.

The case involves a 21-year-old Saudi woman who is in critical condition with a MERS-CoV (Middle East respiratory syndrome coronavirus) infection. She is not a healthcare worker and was not exposed to other MERS patients, the agency said. No other risk factors were noted.

Saudi Arabia has now has 1,278 MERS cases since the outbreak began in 2012, the MOH said. Of the total number, 728 (57%) have recovered, 549 (42.8%) have died, and two people remain under treatment.
Dec 1 MOH update


Hawaii dengue fever cluster tops 100 cases

The Hawaii Department of Health (HDOH) said yesterday that the number of locally acquired dengue fever cases has risen by 20 within the last week, for a total of 112 cases.

Of the confirmed cases of dengue fever, 98 are in Hawaii residents, and 14 are in visitors. Most of the total cases (77%, or 86) have occurred in adults, while 26 cases (23%) involve children. Illness onset occurred between Sep 11 and Nov 20.

The HDOH has excluded 262 potential cases due to negative test results or failure to meet case criteria.

High- and moderate-risk areas for dengue fever currently lie along the western and eastern coasts of the Big Island. State health officials continue to conduct vector control activities and monitor for imported cases.
Nov 30 HDOH update


Young immunocompromised have 18-fold risk of invasive pneumonia

Young people with immunocompromised or chronic health conditions have the highest risk of invasive pneumococcal disease (IPD) due to Streptococcus pneumoniae, according to findings published Nov 29 in Vaccine.

A team of Dutch researchers analyzed national IPD surveillance data and primary care data on chronic conditions in The Netherlands between 2008 and 2012. The high-risk group included people with an immunocompromised state due to HIV/AIDS, chronic renal disease, lymphoma, and other conditions. Medium-risk people included those with chronic lung disease, cardiovascular disease, and diabetes; normal-risk people had no comorbidities.

Of the 960 IPD cases that occurred in people ages18-64, 149 (16%) occurred in high-risk people, and 363 (38%) occurred in medium-risk people. Those with a high-risk condition had an 18-fold higher risk (95% confidence interval [CI], 15.6-21.2) for IPD, with a rate of 89 per 100,000 population compared to 5 per 100,000 in the normal-risk group. Those with a medium-risk condition had a 5-fold higher risk (95% CI, 4.3-5.7) of IPD, with a rate of 25 per 100,000.

People ages 18-64 with HIV/AIDS had a 61-fold higher risk (95% CI, 40.7-92.3) for IPD, with a rate of 308 per 100,000.

Of the 1,264 IPD cases that occurred in people 65 years and older, 175 (14%) occurred in high-risk people, and 888 (70%) occurred in medium-risk people. Older people with a high-risk condition had a 3-fold higher risk (95% CI, 2.6-3.9) of IPD, with a rate of 82 per 100,000 population compared to 25 per 100,000 in the normal-risk elderly age group. Those with a medium risk condition had a 2-fold higher risk (95% CI, 1.9-2.6), with a rate of 57 per 100,000.

High- and medium-risk people in all age groups had higher case fatality rates. High-risk people experienced a 2-fold higher risk of death from IPD (95% CI, 1.5-3.5), while medium-risk people had a 1.4 fold higher risk (95% CI, 1.0-2.1).

Researchers also found that four serotypes (6A, 6B, 23A, and 23B) caused a greater likelihood of IPD in high-risk people, indicating that these serotypes may have relevance for pneumococcal vaccine manufacturing.
Nov 29 Vaccine study


MRSA carriage associated with livestock, healthcare exposure

Carriage of MRSA strains among Dutch and German outpatients was significantly associated with proximity to livestock in a primary care population and with healthcare exposure in a urology population, according to a study yesterday in PLoS One.

A team of Dutch and German researchers evaluated carriage of methicillin-resistant Staphylococcus aureus (MRSA) between Nov 2011 and Jun 2012 among outpatients who had been prescribed antibiotics within the previous 3 months and lived in livestock farming regions along the Dutch-German border. Included were 513 patients from 12 Dutch general practitioners (GPs), 261 patients from 7 German GPs, and 200 patients from 2 German outpatient urology clinics.

Prevalence of MRSA carriage in the Dutch and German GP outpatients was 0.8% and 1.1%, respectively. Testing revealed that all S aureus protein A (spa) types were livestock-associated MRSA, and MRSA in Dutch and German outpatients was associated with proximity to a livestock farm. Of Dutch GP outpatients, 11.5% (3 of 26) of MRSA carriers lived on or near a farm; 10% (2 of 20) of German GP outpatients lived on or near a farm.

German urology patients had a higher prevalence (2%) of MRSA carriage. All spa types in the urology population were associated with healthcare exposure, and 30% of the urology outpatients had been hospitalized in the previous 6 months.

Though MRSA carriage rates on the Dutch-German border are within expected ranges, the researchers recommended that greater attention be paid to MRSA strain similarities and prevalence among people living near livestock.
Nov 30 PLoS One study

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