News Scan for Mar 11, 2016

Saudi MERS cases
Avian flu in China and France
Wisconsin bloodstream infections

Saudi Arabia reports 2 asymptomatic MERS cases in healthcare workers

Saudi Arabia's Ministry of Health (MOH) reported two asymptomatic MERS-CoV cases today related to a healthcare cluster in Buraydah that now includes 19 cases. The agency also noted that three previously reported patients died from their infections, including two in Buraydah.

The asymptomatic MERS-CoV (Middle East respiratory syndrome coronavirus) cases involve 25- and 29-year-old women, both of whom are foreign healthcare workers living in Buraydah. Both women are under home isolation, and the MOH said that their infections were contracted in a healthcare setting. Neither woman had contact with camels.

The MOH also reported today that two previously reported patients from Buraydah, neither of whom were healthcare workers, have died. They were a 24-year-old foreign man who had no underlying medical conditions and a 50-year-old Saudi man with preexisting disease.

The MOH also reported the death of a 75-year-old Saudi man from Taif who had an underlying medical condition and was not likewise a healthcare worker.

Today's update brings Saudi Arabia's MERS-CoV total since 2012 to 1,335 cases and 567 deaths. Twenty cases remain active, the MOH confirmed.
Mar 11 MOH update
Mar 10 CIDRAP News story on Buraydah cluster


China and France report ongoing high-path avian flu outbreaks

France and China are responding to outbreaks of highly pathogenic avian flu, according to reports their agricultural officials filed with the World Organization for Animal Health (OIE) yesterday and today.

On Mar 6, China detected an H5N6 outbreak on a farm housing 34,233 birds in Jiangxi province, according to an OIE report today. The virus sickened 34,233 birds, causing 14,705 deaths and prompting destruction of the rest to prevent the spread of infection.

On Mar 4, French officials discovered the H5N9 virus in two holdings of water birds located in the commune of Arsagues in France's southwestern Landes region. The 14,370 birds on the two farms are scheduled to be culled. The most recent previous H5N9 outbreak in France was a month ago.

Officials in both countries are implementing disease control procedures, including movement control and disinfection of affected facilities.
Mar 11 OIE report on outbreak in China
Mar 10 OIE report on outbreak in France


Wisconsin notes more bloodstream infections in Elizabethkingia outbreak

Wisconsin health officials have identified 4 more bloodstream infections caused by the bacterium Elizabethkingia anophelis, bringing the state's outbreak total to 48, the Wisconsin Department of Health Services (WDHS) said yesterday. Eighteen deaths have been reported since the beginning of the outbreak.

The source of the outbreak is currently unknown, the WDHS said, and most patients are over the age of 65. All patients have a history of an underlying serious illness, though the agency did not specify how many patients contracted the infection in healthcare settings.

Cases occurred between Nov 1, 2015, and Mar 9, 2016, and have involved residents of Columbia, Dane, Dodge, Fond du Lac, Jefferson, Milwaukee, Ozaukee, Racine, Sauk, Sheboygan, Washington, and Waukesha counties.

E anophelis is an opportunistic pathogen that typically affects people how are immune-compromised or have serious underlying medical conditions. The WDHS has notified healthcare providers and laboratories about the outbreak and has provided treatment guidance to Wisconsin clinicians. Untreated infections are associated with a high mortality rate, the WDHS said.

Though E anophelis is a multidrug-resistant bacterium, the WDHS said that isolates from outbreak patients reveal it is susceptible to fluoroquinolones, rifampin, and trimethoprim/sufamethoxazole. Testing performed by the Centers for Disease Control and Prevention on nine Wisconsin isolates found similar results, with the addition of detecting susceptibility to minocycline.

Combination treatment is more effective than monotherapy in treating bloodstream infections caused by E anophelis, the WDHS said.
Mar 10 WDHS update
Mar 3 CIDRAP News item on outbreak

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