News Scan for Oct 19, 2016

E coli in beef
Avian flu outbreaks
Cholera funding
Healthcare-related infections
5-strain kids' vaccine

CDC calls E coli outbreak tied to Adams Farm meat over after 11 cases

A multistate outbreak of Escherichia coli infections tied to Adams Farm beef, veal, and bison products appears to be over after 11 cases, which is 4 more than when the outbreak was first reported last month, the Centers for Disease Control and Prevention (CDC) said today.

Seven of the patients required hospitalization, and one had hemolytic uremic syndrome, a serious kidney complication. Illness-onset dates range from Jun 27 to Sep 10, with patients ranging in age from 1 year to 74, with a median of 32.

Cases have been confirmed in five states, which is one more than on Sep 24, when the CDC first announced the outbreak. Virginia reported its first case. Other states reporting cases are Massachusetts with 5, Connecticut and Pennsylvania with 2 each, and West Virginia with 1.

The outbreak investigation traced the likely source to Adams Farm Slaughterhouse in Athol, Mass. The company recalled various cuts of beef, veal, and bison on Sep 24. The products were shipped to farmers' markets, retail stores, and restaurants in Massachusetts, Connecticut, and eastern New York and may have been shipped elsewhere.

"This outbreak appears to be over," the CDC said in today's update. "However, the recalled beef, veal, and bison products may still be in freezers. Consumers who don't know about the outbreak could continue to eat recalled products and may get sick."
Oct 19 CDC update


$22.35 million needed to fight cholera in Yemen, more cholera reported in Haiti

The World Health Organization (WHO) said today it required more than $22 million U.S. dollars to fight an ongoing cholera epidemic in Yemen, with $16.6 million needed immediately to address the outbreak.

As of Oct. 17, there have been 340 cases of cholera and no deaths.  Cases come from the Taiz, Al-Hudaydah, Aden, Al Bayda, Lahj, and Sana’a governorates. Without a sustained intervention, the WHO said there could be as many as 76,000 cases in Yemen, where only 45% of health facilities are functional due to medical and staff shortages.

The WHO said there's an urgent need for chlorine tablets, an improved surveillance system, and support for public health laboratories.

In other cholera news, the Pan American Health Organization (PAHO) released its epidemiological update on cholera in the Americas, and said Hurricane Matthew caused wider spread of the disease in both Haiti and the Dominican Republic.

Haiti is seeing more cases at this point than last year, with a total of 28,559 suspected cases thus far in 2016. The country is also seeing a higher case-fatality rate (0.9%) in 2016 than it did in 2014 or 2015. The Dominican Republic is reporting twice the number of cholera cases this year as it did in 2014, with a total so far of 1,069 suspected cases.
Oct 19 WHO statement
Oct 19 PAHO update


New reports of avian flu in Taipei, India, and Germany

Three countries are reporting avian flu outbreaks today in a farm, park, and zoo.

In Taipei, the World Organization for Animal Health (OIE) reported a commercial farm destroyed 23,008 native chickens after 5,192 birds died from H5N2, highly pathogenic avian influenza. The mortality rate was 18.41% for this strain. The farm was located in the Zhutang Township.

A zoo in New Delhi is temporarily closed after nine birds died from H5N1 on Oct 14 and 15, according to the Associated Press (AP). The AP reports that autopsies conducted on two of the dead birds (ducks and pelicans) showed signs of H5N1 infection. The zoo is one of the largest in India, with more than 1,400 animals and 2.2 million visitors annually. At this point, zoo officials say there's no threat to human visitors.

Finally, Reuters reports that two pheasants in a Mannheim, Germany park died from low-pathogenic avian flu. While officials are testing more birds, six pheasants, 26 ducks, and two peacocks were culled as a precautionary measure.
Oct 19 OIE report
Oct 19 AP story
Oct 19 Reuters story


Europe reports high burden of healthcare-related infections

European patients develop an estimated 2.6 million cases of healthcare-associated infections each year, according to a study yesterday in PLoS Medicine led by researchers from the European Centre for Disease Prevention and Control (ECDC) and Germany's Robert Koch Institute.

The investigators estimated the burden of six common HAIs in 2011 through 2012: healthcare-associated pneumonia (HAP), healthcare-associated urinary tract infection (HA UTI), surgical site infection (SSI), healthcare-associated Clostridium difficile infection (HA CDI), healthcare-associated neonatal sepsis, and healthcare-associated primary bloodstream infection (HA primary BSI). For disease burden they calculated disability-adjusted life years (DALYs), a commonly used metric for measuring the impact of diseases on population health.

The team estimated that 2,609,911 new cases of HAI occur every year in Europe. The cumulative annual burden of the six HAIs was estimated at 501 DALYs per 100,000 population, or 2.5 million DALYs per year. They note that the cumulative burden of the six HAIs was higher than the total burden of all other 32 common communicable diseases tracked in Europe.

The authors wrote that, even though many of the reported HAIS can be prevented, "they still represent a significant burden among communicable diseases in Europe." They call for intensified prevention and control efforts in hospitals.
Oct 18 PLoS Med study
Oct 18 ECDC press release


UNICEF reaches deal on low-cost 5-strain vaccine for children

Six vaccine suppliers have agreed to cut the cost of a five-strain childhood vaccine in half, to 84 cents a dose, according to a press release today from UNICEF, the United Nations' children's organization.

The new pricing allows UNICEF to buy 450 million doses to send to 80 countries at a savings of $366 million for donors and governments, the agency said. Of those doses, 400 million will be allocated to nations supported by Gavi, the Vaccine Alliance and those transitioning to become so. The pentavalent vaccine protects against diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b.

"Ninety percent of the world's children under five who die from vaccine-preventable diseases live in countries whose vaccine supply is no longer fully funded by donors," said Shanelle Hall, director of UNICEF's supply and procurement headquarters. "For the most vulnerable children in the world, pricing can make a difference between life and death," Hall added.

"Gavi estimates that 5.7 million deaths will be averted thanks to pentavalent vaccination in Gavi-supported countries between 2011 and 2020," said Gavi CEO Seth Berkley, MD.
Oct 19 UNICEF news release

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