News Scan for Mar 03, 2017

Zika cases, birth defects
H7N9 spike
Nut butter E coli outbreak
Yellow fever ebbing

Florida confirms 3 more local Zika cases; CDC reports more birth defects

The Florida Department of Health (Florida Health) yesterday reported three more locally acquired Zika cases, all involving samples collected a few months ago.

Two involve people who were sampled in October as part of an ongoing investigation, and Florida Health recently received confirmation test results back from the US Centers for Disease Control and Prevention (CDC).

The third case involves an individual who didn't have symptoms but whose blood samples tested positive for Zika virus in connection with donating blood in January. An investigation suggested the person has multiple exposures in Miami-Dade County and probably contracted the virus in 2016, though the case is considered the first local Zika case of 2017. Overall, the state has reported 277 local Zika infections.
Mar 2 Florida Health statement

In other US developments, the CDC yesterday said four more babies have been born with Zika-related defects, raising the total to 47. The number of Zika-related pregnancy losses remained at 5. The CDC has been monitoring 1,534 pregnant women who are infected with Zika virus, and so far 1,143 have completed their pregnancies.
Mar 2 CDC updates on Zika birth defects and pregnant women with Zika

Meanwhile, researchers from France today reported that Zika RNA persists much longer in whole blood than in plasma, a finding that may have implications for testing and diagnosis. They published their findings, based on serial tests on five asymptomatic patients returning from the Caribbean or the Americas, in a letter to Emerging Infectious Diseases.

The median duration of Zika virus was 22 days (range, 14 to 100) for whole-blood samples and 10 days (range 7 to 37) in plasma samples.
Mar 3 Emerg Infect Dis letter


H7N9 sickens 21 more in China over past week

Hong Kong's Center for Health Protection (CHP) said today that from Feb 24 to Mar 2 the mainland reported 21 more H7N9 avian influenza cases. Earlier this week Chinese health officials said the cases in the fifth and biggest wave of H7N9 have peaked and are declining.

In its statement today, the CHP said illness onsets for the most recent cases range from Feb 10 to Feb 27. It added that the patients are in nine provinces, though most were in Guangdong, Anhui, and Jiangsu. Eighteen of the patients have a history of exposure to poultry or poultry markets.

Poultry market surveillance from Guangdong province from Feb 22 to 28 shows that, based on environmental sampling, about 30% of the markets were positive for H7 viruses, the CHP said, urging travelers to avoid poultry and live-market settings.

China has now reported at least 472 cases in the fifth wave, and imported cases were reported in Hong Kong, Taiwan, and Macao.
Mar 3 CHP statement

In other H7N9 developments, CDC scientists and their counterparts in China today published an overview of China's fifth wave of H7N9 activity in an early release report in Morbidity and Mortality Weekly Report (MMWR).

The authors also provide an update on recent genetic findings and cover yesterday's World Health Organization advisory group recommendation to add two more candidate vaccine viruses for pandemic preparedness. One would target the recently emerged highly pathogenic virus from Yangtze River Delta lineage and the other the low-pathogenic virus from the lineage.

The report notes that the CDC is preparing the latter candidate vaccine using reverse genetics.

Though the current public health risk from H7N9 is considered low, the group points out that, of 12 novel influenza A viruses that the CDC evaluates with its Influenza Risk Assessment Tool, H7N9 viruses have the highest risk score and are listed as a moderate-high potential pandemic risk.
Mar 3 MMWR report


CDC says multistate E coli outbreak tied to nut butter has hit kids hard

At least 12 people—11 of them children—in five states have been sickened by Escherichia coli infections tied to I.M. Healthy brand SoyNut Butter products, and 4 have developed potentially life-threatening kidney complications, the CDC said today.

The culprit is Shiga toxin–producing E coli O157:H7, a common foodborne outbreak strain. Six of the 12 patients have required hospitalization.

"Epidemiologic evidence available at this time indicates that I.M. Healthy brand SoyNut Butter is a likely source of this outbreak," the CDC said. "I.M. Healthy brand SoyNut Butter may be contaminated with E. coli O157:H7 and could make people sick."

"CDC recommends that consumers do not eat, and childcare centers, schools, and other institutions do not serve, any I.M. Healthy brand SoyNut Butter varieties and sizes, or I.M. Healthy brand granola coated with SoyNut Butter." The company, located in Glenview, Ill., today issued a voluntary recall of its Original Creamy SoyNut Butter with "best by" dates of Aug 30 or Aug 31, 2018, but the recall does not involve other I.M. Healthy products.

The patients first fell ill from Jan 6 to Feb 15, and their ages range from 2 to 48 years, with a median age of 8. Seven are male. Four people developed hemolytic uremic syndrome, a type of kidney failure, but no deaths have been reported. Arizona and California have each confirmed four cases, while Maryland, New Jersey, and Oregon have each reported one.

Investigators interviewed 9 of the patients, and all reported exposure to I.M. Healthy nut butter; 5 ate the company's SoyNut Butter at home before getting sick and 4 attended a childcare center that served I.M. Healthy SoyNut Butter or I.M. Healthy brand granola coated with SoyNut Butter.
Mar 3 CDC outbreak notice
Mar 3 I.M. Healthy recall statement


PAHO's weekly report says yellow fever cases on decline

Despite reporting cases in Brazil, Colombia, Peru, and Bolivia so far this year, the Pan American Health Organization (PAHO) said in its weekly report yesterday that the current yellow fever outbreak in South America is waning.

Since PAHO's last update on Feb 23, there have been only 32 new suspected human cases and 5 more deaths in Brazil, raising the total of suspected cases to 1,368 and lifting the total number of deaths to 220. The case-fatality rate in that country is 33% among confirmed cases and 11% among suspected cases.

Since last week, one more Brazilian state has reported suspected or confirmed cases of the mosquito-borne disease, making the current tallies as follows: Minas Gerais (1,209), Espirito Santo (185), Sao Paulo (10), Bahia (9), Tocantins (2), Goias (1) and Rio Grande do Norte (1). So far the states reporting confirmed cases remain at three: Espirito Santo, Minas Gerais, and Sao Paulo.

Like last week, PAHO is reporting more cases in non-human primates. A total of 76 new infections were reported in nonhuman primates (NHP) and are under investigation, bringing the total number of epizootic cases to 959.

There is still no evidence that the Aedes aegypti mosquito is playing a role in transmission, PAHO said.
Mar 2 PAHO report

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