News Scan for Feb 09, 2016

Global leishmaniasis burden
More H5N1 in Nigeria
Eye problems and Zika-linked microcephaly

Report calls leishmaniasis neglected disease of marginalized people

Leishmaniasis, a growing parasitic disease that causes an estimated 1.6 million new cases and 40,000 deaths each year across nearly 100 countries, is largely ignored by the international community, states a 22-page report titled Leishmaniasis Gap Analysis Report and Action Plan, released today by CORDS (Connecting Organisations for Regional Disease), one of the disease surveillance networks involved in the study.

Research for the report, funded by the Bill & Melinda Gates Foundation, was carried out in Albania, Jordan, and Pakistan in 2015. Key findings included:

  • Leishmaniasis is highly correlated with poverty, malnutrition, crowded living conditions, and poor sanitation.
  • The real health burden it causes is largely unknown because those most affected are from marginalized communities (eg, rural areas, slums) and unable to seek or afford care.
  • The disease has been largely ignored "because of its association with poverty and the limited capacity of governments and aid agencies to deal with its complex epidemiology" and because pharmaceutical companies have considered it a low priority for research and vaccine/treatment investments.

Leishmaniasis, spread by female sandflies, causes disfiguring skin ulcers and can also cause fatal damage to the liver and spleen, a CORDS press release noted.

The authors say that coordinated efforts in the form of a “one health” framework are critical to correct the gaps in treatment and prevention they identified. One crucial need, they say, is for affected countries to change their regulations to allow registration and importation of anti-leishmaniasis drugs.

"Our goal is to raise awareness about the millions of people suffering from leishmaniasis, and address barriers to its treatment and prevention. We need more action and a stronger political commitment to end the needless suffering of millions," stated Nigel Lightfoot, executive director of CORDS.
Full report (dated Dec 30, 2015)
Summary of report
press release


Nigeria reports more H5N1 outbreaks; Indiana’s H7N8 event may be over

Nigeria has logged 19 more H5N1 avian influenza outbreaks in chicken flocks in recent days, national officials told the World Organization for Animal Health (OIE), adding to scores of H5N1 events since the virus reappeared in the country last year,

The outbreaks struck poultry farms and backyard flocks between Feb 1 and 4. Eight of the events involved flocks in Kano state in north-central Nigeria and three were in the Federal Capital Territory in the center of the country, with the rest scattered among several other states. The involved flocks included broilers, layers, and pullets and ranged in size from a few hundred to 9,475.

Of 45,813 birds on the affected holdings, 4,708 were sickened and died, according to the report. All the rest—41,105—were destroyed to prevent further cases. The report cites "poor farm biosecurity" as a factor in the outbreaks.
Feb 8 OIE report

In other avian flu news, Indiana officials recently announced that on Feb 22 they will lift a quarantine on uninfected farms near a turkey farm that was hit by a novel highly pathogenic H7N8 virus in mid-January.

Quarantines on uninfected farms within 20 kilometers of the outbreak sites will be lifted if no further outbreaks are reported, the Indiana State Board of Animal Health (ISBAH) said in a Feb 4 update.

The initial outbreak on a farm in southern Indiana's Dubois County was announced Jan 15 and prompted the culling of 60,000 turkeys. Another nine H7 virus detections were announced Jan 16, but officials determined that eight of those involved low-pathogenic viruses, and additional testing did not confirm the ninth finding, according to the ISBAH.

More than 414,000 turkeys and chickens on the 10 affected farms have been euthanized to stop the virus, the Associated Press (AP) reported yesterday. Quarantines will remain on those farms while the dead birds are composted.

An ISBAH spokeswoman, Denise Derrer, said the board is cautiously optimistic that the outbreak is contained.
Feb 4 ISBAH update
Feb 8
AP story


Ocular problems unfold in Zika-suspected microcephaly

Brazilian clinicians are seeing an increase in eye problems in babies born with suspected Zika-related microcephaly, according to a case series published today in JAMA Ophthalmology. The study was conducted in December to look for ocular abnormalities and includes 29 infants with microcephaly who were identified during an active search of hospitals and clinics.

The team conducted physical and ocular exams on all of the infants and their mothers. Of the 29 mothers, 23 had reported Zika infection symptoms during pregnancy. Among the 29 babies, researchers found ocular abnormalities in 17 (29.3%) eyes of 10 children. The most common conditions were focal pigment mottling of the retina, chorioretinal atrophy, and optic nerve abnormalities.

Investigators concluded that presumed congenital infection with Zika virus is associated with problems that threaten vision.

In the middle of January the Pan American Health Organization (PAHO) described ocular problems in three microcephalic babies from Brazil. Shortly after that the US Centers for Disease Control and Prevention (CDC) issued interim guidance to help clinicians assess and manage babies born with possible Zika infections; among the recommendations were ophthalmologic testing before hospital discharge or within 1 month after birth.
Feb 9 JAMA Ophthalmol abstract
Jan 26 CIDRAP News story "CDC unveils Zika guidance for infants, expands travel advisory"

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