News Scan for Feb 17, 2017

Zika birth defects
More yellow fever
Limiting dengue
Malaria in the Americas
H5N8 outbreaks

Officials confirm 5 more cases of Zika-related birth defects in US

Five more babies have been born in the United States with Zika-related birth defects, according to updated data from the Centers for Disease Control and Prevention (CDC). There are now 43 babies in the country with documented defects from the mosquito-borne illness.

The CDC had not updated its Zika numbers since Feb 2. Since then, there have been 61 Zika-affected pregnancies added to the national registry, bringing the total to 1,455 in US states.  In US territories (mostly Puerto Rico) 3,156 pregnant women have been diagnosed as having a Zika infection.

As of Jan 15, there are 5,040 cases of Zika in the United States, 220 of them acquired locally (6 in Texas, 214 in Florida). US territories have reported 37,023 cases, almost all transmitted locally.

Also yesterday, Reuters reported that a Washington, D.C., lab public health lab had to repeat 300 Zika tests for pregnant women after a routine check of lab practices performed in December showed that all test results were coming back negative. At least two women were mistakenly told they did not have the mosquito-borne disease when, in fact, they had. The CDC will be retesting 294 specimens from the lab.
Feb 16 CDC Zika update
Feb 16 Reuters story


Brazil's yellow fever outbreak shows signs of slowing but tops 1,200 cases

Yellow fever activity in Brazil seems to be decreasing, but monitoring in the weeks ahead will tell if the downward trend continues, the Pan American Health Organization (PAHO) said yesterday in an update.

As of Feb 15, PAHO reported 1,236 suspected cases, 243 of them confirmed, 108 discarded, and 885 still under investigation. So far 197 deaths have been reported, 82 of them confirmed as caused by yellow fever. The totals include 176 new cases and 31 new deaths since Brazil's health ministry updated the situation a week earlier.

Three states have reported confirmed cases: Minas Gerais (208), Espirito Santo (31), and Sao Paulo (4). Three other states have reported suspected cases: Bahia, Rio Grande do Norte, and Tocantins.

So far no yellow fever cases outside of Brazil have been linked to the country's outbreak, but health officials are investigating outbreaks in monkeys in parts of Brazil that border Bolivia, Paraguay, Argentina, and Uruguay, posing a risk of spread, especially in areas with similar ecosystems.

Response activities have included distributing 12.5 million yellow fever vaccine doses to five states. PAHO said though the transmission pattern in the outbreak could still change, so far there is no evidence that Aedes aegypti mosquitoes are playing a role.
Feb 16 PAHO yellow fever update


Study: Contract tracing, spraying limit dengue

A paper published today in Science Advances showed that spraying insecticides indoors can reduce dengue transition by up to 96%. The data comes from an outbreak in Cairns, Australia, where local health officials targeted indoor spraying on viral "hot spots."

In 2008-2009, Cairns experienced a dengue outbreak, and Queensland Health launched an intensive contact tracing program paired with indoor residual spraying of possible exposure sites as listed by patients.

According to the authors, workers applied insecticides in households within 100 meters of many of the 902 confirmed dengue cases. The insecticide was sprayed once and lasted for 2 to 3 months. By the end of the outbreak, targeted indoor residual spraying reached 5,428 locations in 31 weeks. Some exposure areas were not sprayed, and an analysis comparing targeted areas versus non-targeted areas saw dengue transmission reduced by 86% to 96%.

Though the method is costly and time consuming, the authors suggest it could be useful for Zika, another vector-borne disease that is transmitted by the Aedes aegypti mosquito, a species that likes to live indoors.
Feb 17 Science Advances study


PAHO: Some nations report rise in malaria, P falciparum proportion 

In its latest update on malaria, PAHO said some countries in the region are seeing significant increases in transmission, with some reporting growing rates of cases caused by Plasmodium falciparum.

The number of cases reached a four-decade low in 2014, but cases rose 16% in 2015, and increases continued in 2016 for some countries, PAHO said in a Feb 15 epidemiologic update. In 2016, Colombia, Ecuador, and Venezuela reported increased malaria infections, along with an increased proportion of illnesses from P falciparum, compared with P vivax, and carrying with it an increased risk of complications. Also, the main transmission areas in Honduras and Peru reported similar tilts toward P falciparum cases.

Increases in malaria transmission may reflect environmental conditions driven by cyclical patterns, but in 2015 and 2016, social and economic factors, such as migration flow into endemic areas or mining activity, might have contributed to transmission. PAHO said poor diagnostic capacity could also play a role, highlighting the importance of maintaining strong early-warning and response systems at the local level.

PAHO urged countries to be vigilant about the risk of reintroduction of P falciparum strains from South America into areas of Central America and the Caribbean that have favorable ecosystems.
Feb 15 PAHO update


Five European countries report more H5N8 mainly in wild birds

Five European countries reported more highly pathogenic H5N8 avian influenza outbreaks in wild birds, as Greece and Romania reported a few more detections in backyard poultry, according to the latest updates from the World Organization for Animal Health (OIE).

Two Czech Republic outbreaks occurred in different regions, involving a wild goose found dead on Feb 10 in Pardubice region in the central part of the country and a grey heron found dead on Feb 11 in Liberec region in the north.

Greece's backyard poultry outbreaks occurred in Western Macedonia region in the northwest and Peloponnese region in the south, with the events beginning on Feb 6 and Feb 7, respectively, killing 62 of 64 birds. A separate report noted three more H5N8 detections in mute swans found dead in two different regions from Feb 1 to Feb 6.

In the Netherlands, the H5N8 strain was detected in a mute swan found dead on Feb 6 in a village in South Holland province and in a Eurasian buzzard found dead on Feb 9 in a village in Utrecht province. Romania reported 14 outbreaks in wild birds plus 3 in backyard poultry from six different regions, with start dates ranging from Feb 3 to Feb 11. Five different wild bird species were involved, but most were swans.

Slovakia reported five more detections, two of them in wild geese found dead in Bratislava, the country's capital. Among the outbreaks, five birds that were tested were collected between Feb 8 and Feb 13.
Feb 17 OIE report on H5N8 in the Czech Republic
Feb 16 OIE reports on H5N8 in Greek backyard birds and wild birds
Feb 17 OIE report on H5N8 in the Netherlands
Feb 16 OIE report on H5N8 in Romania
Feb 16 OIE report on H5N8 in Slovakia

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