News Scan for Mar 02, 2017

Birth defects and Zika
MERS case in teen
More H5N8 avian flu
MRSA, VRE in infants
Multistate E coli outbreak

US study shows Zika-type birth defects rise 20-fold

The incidence type of birth defects seen with congenital Zika infections in the United States rose 20 times higher than it was before the virus started circulating in the Americas region, researchers reported today in the latest issue of Morbidity and Mortality Weekly Report (MMWR).

In their attempt to better define the baseline for Zika-related birth defects, the team based its findings on birth defect surveillance data for 2013 in Massachusetts and North Carolina and for 2013-14 in Atlanta, before Zika started triggering outbreaks in the Americas. They focused on the birth defects that have been linked to Zika virus by using a case definition that was developed for Zika in 2016, meaning they were looking for brain abnormalities and microcephaly, neural tube defects, eye abnormalities, and other central nervous system problems. Then they compared the findings with data from the US Zika Pregnancy Registry from Jan 15, 2016, to Sep 22, 2016.

The proportion of birth defects that researchers saw in the pregnancy registry was 58.8 per 1,000 live births, about 20 times higher than the 2.86 per 1,000 prevalence seen in the three birth-defect surveillance systems in the pre-Zika years.

Researchers concluded that the higher proportion of birth defects seen in pregnancies in the US Zika registry supports the relationship between congenital Zika infection and the birth defects.
Mar 2 MMWR report


Saudi Arabia reports MERS in teen girl

After several days' trouble with its Web site, Saudi Arabia's Ministry of Health (MOH) today posted a Feb 28 update that detailed a MERS-CoV case involving a teenager in Az Zulfi in the center of the country.

The MERS-CoV (Middle East respiratory syndrome coronavirus) patient, a 17-year-old Saudi girl, is listed in stable condition. Her source of infection is noted as "primary," which means she likely did not contract the disease from another person. The MOH, though, lists no potential risk factors for exposure.

Her infection brings Saudi Arabia's total since the outbreak began in 2012 to 1,568 MERS cases, including 651 deaths. Twelve patients are still recovering from the disease.
Feb 28 Saudi MOH update


H5N8 strikes more birds in 3 European countries

Three European countries—Belgium, Bosnia and Herzegovina, and Poland—reported more highly pathogenic H5N8 avian influenza outbreaks in wild birds and poultry, according to the latest reports to the World Organization for Animal Health (OIE).

Belgium's outbreak involves a mallard found dead on Feb 27 in Flemish Brabant province in the central part of the country, and Bosnia and Herzegovina's detection involved two mute swans found dead on Feb 28 at a zoo in Sarajevo, the country's capital.

Elsewhere, Poland's agriculture ministry reported an outbreak in backyard poultry, which began on Feb 22, killing 24 of 41 birds at a holding in Lubuskie province in the west.
Mar 2 OIE report on H5N8 in Belgium
Mar 2 OIE report on H5N8 in Bosnia and Herzegovina
Mar 1 OIE report on H5N8 in Poland


Study identifies risk factors for MRSA, VRE in NICU patients

Surgery and prolonged antimicrobial treatment can increase the risk of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) colonization in infants prior to neonatal intensive care unit (NICU) discharge, according to a study yesterday in the Journal of the Pediatric Infectious Diseases Society.

For the study, New York researchers identified 1,320 infants younger than 7 days of age who had been hospitalized for more than 2 weeks at four children's hospitals from 2009 to 2012 and had been swabbed for surveillance cultures for MRSA and VRE within 7 days of NICU discharge. Although it's known that infants hospitalized in the NICU can be at risk of infection with one of these pathogens and can serve as a reservoir for them, MRSA and VRE colonization rates preceding NICU discharge have not been well studied.

The results of the surveillance cultures showed that, among the 1,320 infants, 58 (4%) were colonized with MRSA and 17 (1%) were colonized with VRE within 7 days of NICU discharge. Final multivariable models revealed that surgical procedures were a statistically significant predictor of MRSA colonization (OR, 2.83, P = .01), while 10 days or more of treatment with oxacillin (OR, 23.40, P  < .01) or penicillin/ampicillin (OR, 6.26, P < .01) was a statistically significant predictor of VRE colonization.

The authors conclude that while the study found only a small percent of infants harbor MRSA and VRE prior to NICU discharge, the findings "have potential implications for dissemination of these potential pathogens, particularly MRSA, into long-term care facilities, other hospital units, and the communities."
Mar 1 J Pediatric Infect Dis study


CDC investigating 4-state E coli outbreak from unknown source

The Centers for Disease Control and Prevention (CDC) is investigating a four-state outbreak of Escherichia coli infections that involves at least 10 people, Food Safety News reported yesterday.

Officials are interviewing patients about possible foodborne sources, the story said. "This investigation is ongoing, and we will update the public when more information becomes available," a CDC spokeswoman said. "CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill people and to interview those people about foods they ate before they got sick."

The Food and Drug Administration is testing isolates to identify patterns. The cluster of infections involves Shiga toxin–producing E coli, a common foodborne disease pathogen.
Mar 1 Food Safety News story

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