News Scan for Oct 10, 2016

CRE in LA hospitals
Yellow fever in Angola
Chikungunya slows
Polio in Pakistan, Afghanistan

Los Angeles hospitals will have to start reporting CRE infections

Hospitals in Los Angeles County will soon be required to report when patients are infected with carbapenem-resistant Enterobacteriaceae (CRE), according to the Los Angeles Times.

The deputy director of the county's acute communicable disease control program told the paper that health officials will use the data to look for clusters of infections and prevent outbreaks but will not report the names of the hospitals reporting the infections and won't require hospitals to report whether CRE patients die or survive. Nursing homes and clinics will be exempt from the new reporting rule.

The Times reports that the county had stopped requiring hospitals to report CRE infections in 2012 because of limited resources. But the highly drug-resistant bacteria have caused three outbreaks in Los Angeles hospitals since 2014. The outbreaks have been linked to a medical scope that is hard to disinfect, even when the manufacturers' cleaning instructions are followed.

The story suggests that the policy change is in response to the death of a Manhattan Beach resident who developed a CRE infection after surgery at Torrance Medical Center in 2014. The patient reportedly had two scope procedures before the surgery.

According to the Centers for Disease Control and Prevention (CDC), more than 9,000 healthcare-associated infections are caused by CRE each year. Because CRE have become resistant to nearly all antibiotics used to treat them, more than half of all bloodstream infections caused by the bacteria result in death.
Oct 6 Los Angeles Times story
April 2013 CDC antibiotic resistance threats report

Mar 5, 2013, CIDRAP News story "CDC warns of drug-resistant Enterobacteriaceae"


32 probable new cases of yellow fever in Angola

The World Health Organization (WHO), in its yellow fever situation report late last week, said there were 32 probable cases of yellow fever in Angola. The WHO also announced that phase 2 of the vaccination campaign in that country has been postponed until next week because of logistical challenges.

The yellow fever outbreak, which began in Luanda, Angola, in January of this year, has had no confirmed cases since Jun 23, but the 32 probable cases reported in September means active surveillance is still necessary, the WHO said. As of Sep 29, there have been 4,188 suspected cases, with 373 deaths, representing a case-fatality rate of 8.9%.

The Democratic Republic of the Congo (DRC) reported 7 probable cases and also announced that phase 2 of its vaccination campaign began on Oct 2. The campaign focuses on Feshi and Mushenge Health Zones in Kwango province. As of Oct 5, the DRC reported 2,870 suspected or confirmed cases of yellow fever and 16 deaths, for a case-fatality rate of 21%.

The WHO said there have been 20 million yellow fever vaccine doses approved for Angola and 9.4 million doses for the DRC. The global stockpile has also been replenished to 8.8 million doses as of Oct 7.
Oct 7 WHO yellow fever situation report


PAHO: 627 more chikungunya cases

The Pan American Health Organization (PAHO) said in its Oct 7 chikungunya update that there were 627 more suspected cases reported than the previous week. The vast majority of those cases came from Bolivia, Costa Rica, and Colombia.

Two weeks ago, the PAHO reported 47,931 new confirmed, suspected, and imported cases. Last week's numbers means the downward trend of new cases of the mosquito-borne disease is continuing. Many countries, however, haven't updated their case counts in several weeks.

Bolivia had 359 new cases, bringing its total to 19,327 cases this year. Costa Rica had 188 more suspected cases than last week, raising its cases to 2,809, and Colombia reported 47 more cases this week, lifting its 2016 total to 18,844.

The Americas' outbreak began in December on St. Martin in the Caribbean. Since then the region has recorded 2,182,588 chikungunya cases.
Oct 6 PAHO update


Afghanistan, Pakistan each report a new polio case

Despite increased efforts to eradicate wild polio virus (WPV) within the next 2 years, the weekend brought news of at least one new case of WPV in both Pakistan and Afghanistan. So far there have been 5 cases of polio recorded in Pakistan this year and 8 in Afghanistan.

An 8-year-old in the Sujawal district of Pakistan was diagnosed as having the virus despite receiving three doses of the oral polio vaccine (OPV), according to the country's Express Tribune newspaper yesterday.

In Afghanistan, the ministry of health confirmed a new case of polio today in the eastern Paktika province, which borders Pakistan, according to Xinhua, China's state news agency. The case triggered the ministry of health to launch a National Immunization Day on Oct 17 to deliver oral polio vaccines.

Afghanistan, Pakistan, and Nigeria are the only three countries in the world where polio is endemic. The mountainous and war-torn regions have been reservoirs for the virus, and vaccination campaigns have failed in light of political turbulence in the area and violence against immunization teams.
Oct 9 Express Tribune story
Oct 10 Xinhua story

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