News Scan for Mar 29, 2017

MERS case
Brazil yellow fever vaccination
Avian flu outbreaks
Flu vaccine uptake
Hepatitis elimination
E coli in flour

Another camel-related MERS case confirmed in Saudi Arabia

The Saudi Arabia Ministry of Health (MOH) reported one new case of MERS-CoV today in a woman who had indirect contact with camels.

The MOH said a 93-year-old Saudi woman from Buraydah was diagnosed with Middle East respiratory syndrome coronavirus (MERS-CoV). She was symptomatic and is currently in stable condition.  Health officials said the woman had indirect contact with camels, a known risk factor for the disease.

The new case lifts Saudi Arabia's total to 1,582 MERS-CoV cases, 659 of them fatal, since the virus was first detected in humans in 2012. Nine people are still being treated for their infections, the MOH said.
Mar 29 MOH report


More than 18.8 million doses of yellow fever vaccine distributed in Brazil

According to an update yesterday from the Pan American Health Organization (PAHO), more than 18.8 million doses of yellow fever vaccine have been distributed in Brazil since January, in addition to routine immunization efforts. The massive campaign aims to quell the current yellow fever outbreak before it reaches the country's largest cities.

The 18.8 million vaccine doses include 3.5 million dose that Brazil requested from the emergency stockpile held by the International Coordinating Group (ICG) on Vaccine Provisions. Those vaccines have already been delivered to Brazil.

One dose of yellow fever vaccine is enough to confer lifelong immunity, and the World Health Organization recommends that everyone over the age of 1 year be vaccinated against the mosquito-borne disease. All travelers to yellow fever–endemic regions should also receive a vaccine 10 days prior to visiting.

The PAHO update also said that only two mosquito species, Haemagogus and Sabethes, found in Brazil's jungle, have been linked to the current outbreak. Experts fear if the outbreak becomes urbanized, the disease could be spread by Aedes aegypti mosquitoes.

As of Mar 24, Brazil's Ministry of Health has reported 492 confirmed cases of yellow fever, with 162 confirmed deaths. Another 1,101 suspected cases are under investigation.
Mar 28 PAHO update


High-path avian flu strikes poultry in Nigeria, France, Taiwan

Nigeria, France, and Taiwan reported more highly pathogenic avian flu outbreaks, according to the latest updates from the World Organization for Animal Health (OIE).

Nigeria, which has been battling a resurgence of H5N1 since 2015, reported two new outbreaks, both on layer farms in Bauchi state in the central part of the country. The events began on Mar 24, killing 315 of 4,715 susceptible poultry between the two locations.

Meanwhile, France reported 23 more H5N8 outbreaks, 1 more highly pathogenic H5N1 outbreak, and 1 more low-pathogenic H5N1 event, all on poultry farms in the country's already hard-hit southwest, which is home to foie gras production.

The latest round of H5N8 outbreaks had start dates from Jan 25 to Mar 21 and led to the culling of 21,256 poultry. The detection of high-path H5N1—not the same as the strain infecting birds in Asia or Africa—was found on Mar 10 in samples taken for movement of poultry out of a zone. Also, low-path H5N1 was detected in a flock of ducks that were already slated for depopulation.

In Taiwan, officials reported eight more highly pathogenic H5N2 outbreaks on poultry farms, which began from Mar 13 to Mar 21, affecting more than 62,000 birds at locations on the southwestern side of the island. Also, officials reported one more H5N8 event, which began Mar 23 on a farm in Tainan City.
Mar 29 OIE report on H5N1 in Nigeria
Mar 28 OIE report on H5N8 in France
Mar 28 OIE report on high-path H5N1 in France
Mar 28 OIE report on low-path H5N1 in France
Mar 29 OIE report on H5N2 in Taiwan
Mar 29 OIE report on H5N8 in Taiwan


Recommendation, positive attitude boost flu vaccine use in kids

Only about half (47% to 62%) of US children ages 9 to 17 get the flu vaccine, but a strong recommendation from a health care provider (HCP), and annual check-ups result in more vaccine uptake, according to a new study from researchers at Indiana University. The results were published recently in Vaccine.

Using data collected from an online survey of 2,363 mothers of kids 9 to 13 years old, the researchers identified the key predictors of flu vaccine use. Of the mothers questioned, 59% obtained flu vaccine for their children in the previous year, citing two main reasons: "preventing their child from getting the flu" (40%) followed by "It's routine, I always have my child vaccinated against the seasonal flu"(13.2%). Nearly 30% of mothers who did not get the flu shot for their child said it was because they did not think the vaccine worked, and 23.3% said they believed the vaccine could harm their child.

A strong recommendation from a HCP, seeing a HCP in the past year, positive attitude about the vaccine, and being of a minority race were all good indicators that a mother would choose to vaccinate her child against the flu.

"These data highlight potential areas for intervention (i.e., strong provider recommendations and addressing parents' beliefs about the influenza vaccine) to improve delivery of influenza vaccination in early adolescents," the authors concluded.
Mar 27 Vaccine study


National Academies spells out strategy for eliminating hepatitis B and C

An expert task force yesterday unveiled a strategy for eliminating hepatitis B and C in the United States by 2030, which could prevent nearly 90,000 deaths by then and remove the diseases from the list of serious public health problems. A report from the group, convened by the National Academies of Sciences, Engineering, and Medicine to review the evidence and come up with a game plan, was posted yesterday on the National Academies Web site.

Brian Strom, MD, MPH, the committee's chair and professor at Rutgers University, said in a National Academies press release that viral hepatitis isn't a high enough priority in the United States, despite being the world's seventh leading cause of death. He said efforts to address the diseases account for less than 1% of the National Institutes of Health research budget.

About 1.3 million Americans have chronic hepatitis B, and 2.7 million have chronic hepatitis C—infections known to increase the risk of liver cancer, for which incidence rose 38% between 2003 and 2012. The group emphasized that the world has the tools to prevent deaths from both diseases, including a vaccine for hepatitis B and treatments for hepatitis C.

The committee projected that diagnosing 90% of chronic hepatitis B patients and treating 80% of those who warrant treatment could halve deaths by 2030. For hepatitis C, the experts said treating all infected people could cut new infections by 90% by 2030 and reduce deaths by 65% over the same period.

Shooting for those goals would require a significant departure from the status quo, they said, such as aggressive testing, diagnosis, and treatment, and preventions steps like needle exchange. The group called for a coordinated federal effort to tackle hepatitis elimination, covering syringe exchanges for those who use injectable drugs, free hepatitis B vaccine in pharmacies, outreach to underserved populations, and unrestricted treatment for everyone with hepatitis C, covered by novel payment methods and drug licensing agreements.
Mar 28 National Academies press release
Mar 28 National Academies hepatitis B and C elimination strategy report


Canada's 25-case E coli outbreak linked to Robin Hood flour

A four-province outbreak that has now expanded to 25 Escherichia coli infections has been tied to Robin Hood flour, which has been recalled, the Public Health Agency of Canada (PHAC) said in an update yesterday.

The Canadian Food Inspection Agency (CFIA) has issued a food recall of original Robin Hood All Purpose Flour, which has been distributed in British Columbia, Alberta, Saskatchewan, and Manitoba. The product is sold in 10-kilogram bags, with a code containing "BB/MA 2018 AL 17" and "6 291 548." It is produced by Smucker Foods of Canada Corp of Markham, Ont.

"The investigation is ongoing and it is possible that additional products linked to the outbreak investigation may be identified," PHAC said. "This outbreak is a reminder that it is not safe to taste or eat raw dough or batter, regardless of the type of flour used as raw flour can be contaminated with harmful bacteria such as E. coli."

PHAC also noted 25 E coli O121 cases in four provinces: British Columbia (12 cases), Saskatchewan (4), Alberta (4), and Newfoundland and Labrador (5). The number reflects a new case in Alberta since the agency's previous update on Mar 13.
Mar 28 PHAC update
Mar 28 CFIA recall notice

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