News Scan for Jan 30, 2017

H7N9 cases in China
More Saudi MERS
New chikungunya cases
High Listeria burden

Two more H7N9 cases reported in China

Signaling an ongoing rise in H7N9 avian flu activity in China, the country's Liaoning province in the northeast today reported two cases, according to a local health department statement translated and posted today by FluTrackers, an infectious disease news message board.

No details were available about the two patients, other than that they are from different cities and that both are in stable condition. Provincial officials said they have designated a hospital for treating the patients. The cases appear to be the first from Liaoning province in the current H7N9 wave, which is the country's fifth.

China, which celebrated Lunar New Year over the weekend, reported an early large spike in H7N9 cases in December, and cases in January have already topped that level. An analysis of China's recent surge said one reason may be an increase in viral levels in poultry and their environments. Most cases occur in people who have contact with poultry.

Though a few small clusters have been reported, the virus doesn't spread easily among people, and no sustained human-to-human transmission has been reported.
Jan 30 FluTrackers thread


New MERS cases linked to camel exposure

The Saudi Arabian Ministry of Health (MOH)  confirmed two new MERS-CoV cases over the weekend and said that a previously reported patient died from the respiratory illness.

On Jan 28 the MOH reported that two Saudis were in critical condition with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus). A 75-year-old man from Taif reportedly had direct contact with camels, while a 74-year-old woman in Al Khurma is listed as having indirect contact with camels. Exposure to camels, including drinking raw camel milk, has been cited as a risk factor for contracting MERS.

Yesterday the MOH reported the death of a 48 year-old foreign man in Jeddah. The patient had a preexisting illness.

The new cases raises Saudi Arabia's MERS-CoV total to 1,549 infections, including 642 deaths. Ten people are still in treatment or monitoring.
Jan 28 MOH report
Jan 29 MOH report


PAHO reports 1,400 new chikungunya cases in the Americas

As it begins a new year of tabulating chikungunya cases while continuing to update 2016 numbers, the Pan American Health Organization (PAHO) late last week added 1,439 new cases, 980 from 2016 and 459 from the first few weeks of this year.

The 980 cases from last year were in Bolivia, which has now reported a full 52 weeks' worth of 2016 data, according to a Jan 27 update e-mailed to CIDRAP News. The country closed the year with 21,977 confirmed, suspected, and imported cases, bringing the total number of 2016 cases in the Americas to 504,373.

So far in 2017, five countries have reported cases, led by Venezuela with 254, Colombia with 65, and Peru with 49. Of the 459 cases documented in 2017, 426 were noted in an updated posted on Jan 27 and 33 the week before.

The vast majority of countries, however, have not reported to the PAHO yet this year. And most countries are lacking full 2016 data, as well. Most notable among them is Brazil, which accounted for 82% of 2016 cases. It has not reported on the final 2 weeks of last year or on the first 4 weeks of this year.

The outbreak began in late 2013 on the Caribbean island of St. Martin and has now sickened at least 2,387,177 people.
Jan 27 PAHO update for 2017


Largest study of listeriosis shows high burden of disease

The largest prospective study of listeriosis, a foodborne pathogen, showed that infection with the bacterium can cause a high burden of disease, especially among pregnant women. The results were published today in The Lancet Infectious Diseases.

The MONALISA study took place in France, where listeriosis is a notable disease. The authors enrolled 818 eligible patients, who provided samples to the National Reference Center for Listeria from November 2009 to July of 2013. The cases included 107 maternal–neonatal infections, 427 cases of bacteremia, and 252 cases of neurolisteriosis.

One quarter (24%) of pregnant women experienced fetal loss if Listeria infection happened before 29 weeks of pregnancy, 45% experienced premature delivery, and 21% delivered a baby diagnosed with acute fetal distress (including fever, meconium contamination, or elevated heart rate). Only 5% of the documented pregnancies were unaffected by listeriosis.

Eighty-four percent of patients who had neurolisteriosis presented with meningoencephalitis. The authors found that only 39% of patients with neurolisteriosis survived and fully recovered, a higher percentage than reported in other studies.

In a comment on the study, Dutch experts said the data paint a grim picture of listeriosis. "Early diagnosis and treatment and standardised antibiotic regimens are needed to improve prognosis, but equally important is a better understanding of bacterial virulence and the pathophysiology of listerial disease."
Jan 30 Lancet Infect Dis study
Jan 30 Lancet Infect Dis commentary

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