News Scan for Jan 11, 2016

High global melioidosis burden
New chikungunya cases
H5 in Scotland, Vietnam, Nigeria
Lassa fever in Nigeria

Study estimates 89,000 global melioidosis deaths a year

According to the first-ever global burden estimates for melioidosis, the disease is sharply underreported in 45 endemic countries, it's probably endemic in 34 more, and conditions are suitable for the disease in parts of the United States and Japan.

The study, published today in Nature Microbiology, has practical implications for the United States, given the 2014 outbreak linked to the Tulane Primate Research Center in Louisiana.

The findings are based on reports of human and animal cases, reports of Burkholderia pseudomallei—the bacterium that causes the disease—in the environment, and modeling that takes into account factors such as environmental suitability.

Researchers estimate that there are about 165,000 cases each year worldwide, 89,000 of them fatal, a level that calls for new policy and public health steps to battle the disease, they write.

The report includes a map of highest-risk zones, which include Southeast and South Asia, tropical Australia, west sub-Saharan Africa, and South America.

The researchers also said the United States and Japan are among 44 countries where the disease is absent but soil and other conditions are suitable for the disease. The US risk area is in the southern parts of Florida, Louisiana, and Texas. For Japan, risk areas are Okinawa and Kagoshima prefectures.

When the investigators looked specifically at the area around the Tulane lab, they noted that the risk is very low for the facility, but moderately high for New Orleans, leading to the estimation that B pseudomallei could become established in the state if it were released widely.
Jan 11 Nature Microbiol abstract
Mar 13, 2015, CIDRAP News scan "CDC notes safety lapses at melioidosis-linked Tulane lab"


PAHO reports almost 42,000 new chikungunya cases

The Pan American Health Organization (PAHO) reported 41,815 new chikungunya cases in the Americas and Caribbean late last week in an update that covered 3 weeks' worth of data.

The new infections, which average about 14,000 per week, bring the outbreak total to 1,832,496, PAHO said in the Jan 8 update.

The agency's previous two weekly updates included only 1,432 and 1,191 new cases, respectively. The new illnesses bring the total for 2015 and 2016 to 685,727 suspected and confirmed cases. PAHO also reported 5 new deaths, bringing that total to 82.

Guatemala accounted for more than half of the new cases, but it reported 27 weeks' of data. The country had 21,893 new cases, or 29,757 since Jan 1, 2015. Nicaragua, reporting 10 weeks' of data, had the second largest jump, with 17,158 new cases, or 74,062 through late December 2015. Colombia, which typically notches the most cases but reliably reports them each week, had 2,113 new cases, bringing it to 358,367 infections through late December.

The vast majority of countries in the region, however, have not provided updates to PAHO for many weeks. The epidemic began in December 2013 with the first locally acquired chikungunya case ever reported in the Americas, on St. Martin in the Caribbean.
Jan 8 PAHO update


Avian flu outbreaks reported in Scotland, Vietnam, Nigeria

Agriculture officials in Scotland announced yesterday that initial tests have identified H5 influenza in an outbreak at a poultry farm in Fife, located in the east central part of the country.

In a statement, the government warned poultry producers to remain vigilant and that so far the clinical profile suggests that it a low-pathogenic avian flu strain. It added the further tests are under way to identify the exact strain.

Response steps include culling, establishing a control zone around the farm, restricting poultry movements, and limiting bird exhibits.

Over the past few months several European countries have reported avian flu outbreaks. France has been especially hard it, with 67 outbreaks involving three different strains: a new Eurasian H5N1 type, H5N2, and H5N9.
Jan 10 Scottish government statement

In related developments, Vietnam today reported two more highly pathogenic H5N6 outbreaks, while Nigeria reported 11 more high-path H5N1 detections.

In Vietnam, H5N6 hit backyard flocks last week in Quang Ngai province, in the south central region, and Kon Tum province in the central highlands, according to a report to the World Organization for Animal Health (OIE). Of 1,824 susceptible birds between the two locations, the virus killed 1,054, with the remaining poultry were culled to curb the spread of the disease. The country is one of four in Asia that have reported H5N6 in birds; the others are China, Laos, and Hong Kong.

Meanwhile, Nigeria in two separate OIE reports today, confirmed 11 more H5N1 outbreaks that occurred earlier this month, affecting 6 of the country's 36 states. Nine occurred at farms, while two were in backyard birds. Most of the affected flocks were egg-laying hens. Affected states include Kano (5 outbreaks), Federal Capital Territory (2), and 1 each in Nasarawa, Plateau, Enugu, and Edo.

All told, the virus killed 23,373 of 11,6390 susceptible birds. Nigeria and a handful of other African nations have reported several avian flu outbreaks in the past year.
Jan 11 OIE report on H5N6 in Vietnam
Jan 11 OIE report on nine H5N1 outbreaks in Nigeria
Jan 11 OIE report on two H5N1 outbreaks in Nigeria


Nigerian Lassa fever outbreak spreads to 10 states

Nigeria's health ministry said a Lassa fever outbreak over the past 6 weeks has so far totaled 86 cases, 40 of them fatal,, an Internet news portal based in Lagos, reported on Jan 9.

At a media briefing, health minister Isaac Adewole, MD, said the Lassa infections have been reported in 10 of the country's 36 states. Seven are in the north, and three are in the south. He said most of the cases didn't involve person-to-person contact and that the number of deaths—with the case-fatality rate at 43.2%—was unusual, according to the report.

Lassa fever is a viral hemorrhagic disease similar to Ebola and is common in West Africa. Though it can cause severe disease, it is less likely to be fatal and spread between people.
Jan 9 story

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