News Scan for Aug 18, 2016

Saudi MERS case
Burden of bloodstream infections
UN Haiti cholera shift
Contact lens infections

New Saudi MERS case linked to camel exposure

After 9 days of no new cases, the Saudi Arabia Ministry of Health (MOH) today reported a new case of MERS-CoV infection.

A 39 year-old Saudi man from Al Kharj was diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus) after he presented with symptoms. The MOH said he is in stable condition, and was described as having contact with camels, a known risk factor for MERS-CoV. Camels can pass the disease to humans, but the route of transmission is still unknown. 

The case brings the total in the country since the outbreak began in 2012 to 1,446, including 608 fatalities.

In a few weeks, millions of Muslims will travel to Saudi Arabia for the Hajj, an annual Islamic pilgrimage to Mecca. In years past, the Saudi MOH has taken measures to avoid a MERS-CoV outbreak during the 3-day religious event.
Aug 18 Saudi MOH report


Study profiles impact of antimicrobial-resistant bloodstream infections within Europe

A new study of European hospitals is providing some perspective on the health and economic burden of bloodstream infections caused by antimicrobial-resistant bacteria.

The study, published today in Eurosurveillance, looked at data on more than 600,000 patients who experienced acute care episodes at 10 European hospitals in 2010 and 2011. The researchers sought to estimate the impact of bloodstream infections caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), third-generation cephalosporin-susceptible Enterobacteriaceae (3GCSE), methicillin-resistant Staphylococcus aureus (MRSA), and methicillin-susceptible S aureus (MSSA) on hospital mortality, length of stay, and hospital costs. The hospitals were in Switzerland, France, Spain, Italy, Germany, and the United Kingdom.

Compared with non-infected patients, patients with bloodstream infections caused by 3GCRE, MRSA, and MSSA were significantly more likely to die in a hospital (with adjusted hazard ratios of 1.80, 2.42, and 1.81, respectively) and have prolonged hospital stays (9.3 days, 13.3 days, and 11.5 days). Bloodstream infections caused by 3GCSE significantly lengthened hospital stays, but not the risk of death.

Overall, bloodstream infections caused by S aureus had a greater effect on mortality, length of stay, and hospital costs per infection than infections caused by Enterobacteriaceae. But when the researchers compared the impact of resistant Enterobacteriaceae and S aureus bloodstream infections with those caused by susceptible strains, they found that third-generation cephalosporin resistance had a greater impact than methicillin resistance; 3GCRE infections significantly increased both the risk of death and the length of hospital stays compared with 3GCSE infections, while MRSA infections did not significantly increase the risk of death or length of hospitals stays compared with MSSA infections.

"Our data demonstrate the substantial health and economic burden imposed by BSI in European hospitals," the authors wrote.
Aug 18 Eurosurveill study


UN closer to admitting fault in Haiti’s cholera outbreak

The New York Times reported yesterday that the United Nations (UN) was taking some blame for the cholera outbreak that swept through Haiti after the 2010 earthquake, taking 10,000 lives and making thousands of others sick. 

The Times quoted an email from Farhan Haq, deputy spokesman for UN Secretary General Ban Ki-moon, that said, "over the past year, the UN has become convinced that it needs to do much more regarding its own involvement in the initial outbreak and the suffering of those affected by cholera."  The UN had previously denied any responsibility for the outbreak.

The email statement is a reaction to a document released Aug 8 by a UN advisor, claiming UN personnel from Nepal were likely to blame for importing cholera to Haiti after they arrived after the Jan 12, 2010 earthquake. According to the Associated Press, "Researchers say there is ample evidence that cholera was introduced to Haiti’s biggest river in October 2010 by inadequately treated sewage from a U.N. peacekeeping base."

Thousands of cholera victims have sued the UN, with human rights lawyers in Haiti and abroad calling for reparations.
Aug 17 New York Times story
Aug 18 Associated Press story


CDC: Contact lens infection trends serve as safety reminder

Analysis of a decade's worth of adverse events from wearing contact lenses reported to the US Food and Drug Administration (FDA) found eye damage in 20% of the reports, along with actions in 25% of the cases that could have prevented corneal infections.

Researchers from the US Centers for Disease Control and Prevention (CDC) reported the findings today in Morbidity and Mortality Weekly Report (MMWR). The team released the new findings, which looks at FDA reports spanning 2005 to 2015, a few days ahead of national Contact Lens Health Week, designed to boost awareness of health contact use practices.

Of 1,075 reports researchers reviewed, 925 were reported by manufacturers and 150 were reported by eye care providers or patients. Nearly 20% described a patient with a central corneal eye scar, decreased vision, or a corneal transplant. A quarter of the reports noted practices known to increase the risk of corneal infections, such as sleeping in contact lenses or poor contact lens hygiene.

The CDC said more efforts are needed to educate consumers about preventing eye infections related to the use of contact lenses.

Jennifer Cope, MD, MPH, study coauthor who is with the CDC's waterborne disease prevention branch, said in a CDC press release today that about 41 million contact lens users benefit from improved vision and comfort. "While people who get serious eye infections represent a small percentage of those who wear contacts, they serve as a reminder for all contact lens wearers to take simple steps to prevent infections."
Aug 18 MMWR report
Aug 18 CDC press release

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