News Scan for Apr 19, 2017

Saudi MERS case
Wolbachia trial launch
Federal interagency preparedness drill
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MERS hospitalizes another in Saudi Arabia

Saudi Arabia's Ministry of Health (MOH) today announced a new MERS-CoV case, involving a 55-year-old expat man from Wadi Aldwasir who is hospitalized in critical condition. It's not clear if his illness is part of a recent hospital cluster reported from Wadi Aldwasir; he is not a healthcare worker and his infection source is listed as primary, meaning he didn't likely contract the virus from another person.

Ten MERS-CoV (Middle East respiratory syndrome coronavirus) cases were recently linked to a dialysis unit at a hospital in Wadi Aldwasir, located in Riyadh province, about 420 miles south of the city of Riyadh.

The man's MERS-CoV infection lifts Saudi Arabia's overall total to 1,592 cases, 659 of them fatal. Six people are still being treated for their illnesses.
Apr 19 Saudi MOH statement

In MERS-CoV research developments, a team from South Korea yesterday described patterns they observed with outbreaks reported from two hospitals in Daejeon that occurred in May through July of 2015. One is a 300-bed general hospital and the other is an 800-bed university hospital. The group published its findings in Emerging Infectious Diseases.

The index patient in Daejeon was a 41-year-old man who had undergone surgery and then a follow-up colonoscopy at the hospital in Pyeongtaek, the facility where South Korea's outbreaks originated. He got sick with fever and chills in Daejeon, where he was treated at the general hospital then sent to the emergency department of the university hospitals when his symptoms didn't improve.

Those around him didn't use protective equipment during his first 10 days of illness. A total of 26 cases were confirmed at the two hospitals, and 11 of them died. Incubation period was about 6.1 days, similar to 2013 outbreaks in Saudi Arabia.

Officials ordered cohort quarantine at the two hospitals to prevent spread the local community, which the team said had its advantages and disadvantages. It prevented transmission to the community but may have increased transmission within the hospital, they wrote.
Apr 18 Emerg Infect Dis report


Wolbachia mosquito trial launches in Florida Keys

The Florida Keys Mosquito Control District (FKMCD) yesterday launched a field trial of Wolbachia-infected male Aedes aegypti mosquitoes on Stock Island near Key West, which it is conducting with MosquitoMate, the Lexington, Ky., company that produces the mosquitoes.

Males infected with the naturally-occurring Wolbachia bacteria do not bite and when they mate with female Aedes aegypti mosquitoes, the eggs do not hatch. The strategy is part of the battle against mosquitoes that spread Zika virus and other related diseases.

The initial release involved 20,000 mosquitoes that were freed from cardboard tube carriers at 20 locations, and additional releases will take place twice a week for about the next 12 weeks, according to the FKMCD, which said it is always looking for and evaluating new ways to prevent mosquito-borne diseases from entering the island communities.

The Florida Keys release is MosquitoMate's second field trial in the United States; the first one took place last year in Clovis, Calif., according to a report on the release yesterday in the Orlando Sentinel. The company's Web site said it expects to receive US Environmental Protection Agency (EPA) approval this spring.

A World Health Organization expert group that met last year to discuss what new methods might be useful in battling mosquitoes to curb the spread of Zika virus recommended Wolbachia as one of only two methods for careful pilot testing.
FKMCD Wolbachia field trial information
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Feds conduct interagency large-scale biocontainment evacuation drill

The US State Department and the Department of Health and Human Services (HHS) last week conducted an unprecedented inter-agency drill to test the ability to airlift clusters of infected patients to hospitals with special biocontainment units, the Associated Press (AP) reported yesterday.

The drill involved flying 11 patients in specially designed biocontainment containers on two 747 airliners and three smaller Gulfstream jets from Sierra Leone, to Dulles International Airport in Washington, D.C., and to five medical facilities. They included Bellevue Hospital in New York City, Johns Hopkins University in Baltimore, the University of Minnesota Medical Center in Minneapolis, the Denver Health Medical Center in Denver, and the University of Nebraska Medical Center in Omaha.

At a telebriefing yesterday, State Department and HHS officials said the State Department maintains all-hazard biohazard containment transport capability through a contract with Phoenix Air Group in Cartersville, Ga., which they said performed flawlessly during dozens of evacuations during the Ebola outbreak, but it became clear that a larger transport capability was needed.

The Containerized BioContainment System tested last week, the third such exercise since last August, is the result of a $5 million public-private partnership between the State Department and the Paul G. Allen Foundation. The system is designed as a first-responder to manage clusters of patients during the first days of an outbreak, allowing international responders to focus immediately on containment. It is a 40-foot container that can be loaded onto a number of different aircraft, containing three chambers: a patient-care area, a space for donning and doffing personal protective equipment, and a space where medical workers can rest and prepare for crew rotation.

According to a briefing transcript, William Walters, MD, managing director for operational medicine with the State Department's bureau of medical services, said, "Tranquil Shift prepares us today for what we were largely unprepared for in 2014. This is not about Ebola. This is about the Middle East respiratory syndrome coronavirus, MERS-CoV, in Qatar, with outbreaks every month for the past several months; Lassa fever in Benin, Togo, and Burkina Faso from February of this year; plague in Madagascar in December of last year." He said infectious disease outbreaks happen all the time and that the US has a responsibility globally and to American citizens to continue to support ongoing efforts to prevent future catastrophes.

During the Ebola outbreak, Donald Trump criticized the Obama Administration for bringing Ebola patients to the United States, and when pressed by reporters, Walters said he couldn't speak for the Trump White House on whether it supported the exercise, but added that what officials have learned going forward is that transport can be done safely as long as exercises take place, that stakeholders are identified early, and that there's careful coordination.
Apr 18 AP story
Apr 18 State Department/HHS
telebriefing transcript

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