News Scan for Sep 29, 2016

Flour E coli outbreak over
Saudi MERS case
Rift Valley fever in Niger
Novel H1N1 in China

CDC calls flour-linked E coli outbreak over after 63 official cases

A multistate Escherichia coli outbreak linked to consumption of uncooked General Mills flour is over after 63 cases, 17 more than reported in the previous update on Jul 25, the Centers for Disease Control and Prevention (CDC) said today.

Illnesses were reported in 3 new states—Nebraska, Oregon, and Tennessee—bringing the total number of affected states to 24. Of the 63 patients infected with the outbreak strains of Shiga toxin–producing E coli O121 or O26, 17 were hospitalized. One patient developed hemolytic uremic syndrome, a type of kidney failure. Illness-onset dates ranged from Dec 21, 2015, to Sep 5.

Public health investigations found that flour produced at a General Mills plant in Kansas City, Mo., is the likely source of this outbreak.

"Although the outbreak investigation is over, illnesses are expected to continue for some time. The recalled flour and flour products have long shelf lives and may still be in people's homes," the CDC said.

"This outbreak is a reminder that is it not safe to taste or eat raw dough or batter, whether made from recalled flour or any other flour."

Of 37 people interviewed, 28 (76%) reported that they or someone in their household used flour in the week before they became ill. Nineteen of 38 people (50%) reported eating raw homemade dough or batter, and 21 of 37 people (57%) reported using Gold Medal brand flour. Three children in the outbreak reported eating or playing with raw dough at restaurants.

After the initial announcement of the outbreak, General Mills on May 31 announced a flour recall. It expanded the recall on Jul 1 and Jul 25.
Sep 29 CDC statement


Saudi Arabia: New MERS case tied to camel exposure

The Saudi Arabia Ministry of Health (MOH) announced another case of MERS-CoV today, in a woman who had indirect contact with camels. Though there's been a slowdown of MERS cases this summer, most have been tied to direct or indirect contact with camels, a known reservoir for the virus.

The 51-year-old Saudi woman from Al-Kharj is in stable condition after displaying symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus). Her indirect camel contact could include drinking camel milk or eating camel meat.

The case raises Saudi Arabia's overall MERS total to 1,455 cases, of which 611 have proved fatal.
Sep 29 MOH report


WHO reports Rift Valley fever outbreak in Niger

As many as 64 people in Niger have fallen ill and 23 have died in an outbreak tied to Rift Valley fever, a viral hemorrhagic fever disease caused by a bunyavirus, the World Health Organization (WHO) reported today.

The agency first started receiving reports of unexplained deaths in people as well as livestock and fetal livestock deaths in the northwestern parts of Niger, including areas bordering Mali. From Aug 2 to Sep 22, officials reported 64 human cases, including 23 deaths in the northern part of Tahoua region, which is mainly populated by nomadic herdsmen.

"As of 16 September 2016, 6 of the 13 human specimens tested at Institute Pasteur (IP), Dakar, were positive for Rift Valley Fever (RVF)," the WHO said in today's statement. "Among the 6 animal specimens tested, 3 were positive for RVF. Sequencing and further laboratory testing is ongoing."

WHO and local health authorities have begun a field investigation, developed a response plan, and taken other steps in response to the outbreak.
Sep 29 WHO statement


Researchers note virulent novel H1N1 flu strain in young boy

Chinese researchers yesterday reported identifying a novel strain of H1N1 flu in a 2-year-old boy in Hunan province that showed high infectivity and virulence in mice.

Writing in Emerging Infectious Diseases, the investigators noted that the boy had severe pneumonia with his H1N1 infection. They said the isolate was a genetic reassortant of Eurasian avian-like influenza H1N1 (EA-H1N1) that contained two surface genes from an EA-H1N1 virus and four internal genes from 2009 H1N1, the virus that caused the 2009-10 pandemic. It also had a nonstructural protein gene derived from classical swine influenza H1N1.

When the researchers inoculated mice with the novel variant, it showed higher infectivity, virulence, and rate of respiratory replication than a similar EA-H1N1 virus.

The authors conclude that, even though human-to-human spread of the new virus has not been shown, "given the circulation of novel EA-H1N1 viruses in pigs, enhanced surveillance should be instituted among swine and humans."

In March the WHO reported three cases of variant H1N1 in young children.
Sep 28 Emerg Infect Dis report
Mar 16 CIDRAP News Scan on previous cases

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