News Scan for May 25, 2017

Ebola in DRC
Saudi MERS cases
Yellow fever in Brazil
Zika and fetal outcome
WHO budget OK'd

WHO: DRC Ebola outbreak smaller than previously reported

The World Health Organization's  (WHO's) regional office for Africa released a new Ebola situation report today, noting fewer cases than previously reported in the Democratic Republic of the Congo (DRC).

The report said there were no new cases as of May 23, and currently there are only 2 confirmed, 3 probable, and 30 suspected cases of the deadly hemorrhagic virus. The last patient with suspected Ebola was admitted to a treatment center on May 20.

It is unclear if the smaller number of reflects suspected or probable cases that have been ruled out after testing. According to the report, no healthcare workers have been infected, and the outbreak is still contained to the Likati Health Zone, in northern DRC.

On May 23, 177 contacts had completed the 3-week follow-up period, leaving 294 contacts still being closely monitored by health officials for signs of the virus.

While the DRC with other groups are preparing to offer the experimental Ebola vaccine to contacts and healthcare workers, the country is still waiting for approval from the national regulatory authority and the ethics review committee. Today, Stat reported that said the limited outbreak may not warrant the use of the vaccine, based on comments from a WHO official.

In other outbreak developments, an influx of refugees fleeing militia attacks the Central African Republic (CAR), crossing the DRC border not far from the outbreak area, is raising worries of the virus spreading to the CAR, Reuters reported today, citing another WHO official. The attacks in the CAR have displaced about 2,750 people to Bas Uele province.
May 23 WHO AFRO report
May 25 Stat story
May 25 Reuters story


New MERS case linked to camel contact

The Saudi Arabian Ministry of Health (MOH) today reported another case of MERS-CoV in that country, in a man who had direct contact with camels.

A 52-year-old man from Jeddah was diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus) after presenting with symptoms. He is in critical condition.

In addition, on May 21 the MOH announced an earlier case. A 64-year-old Saudi man from Hail was diagnosed as having MERS-CoV after presenting with symptoms. He is in stable condition, and the source of his infection was listed as "primary," meaning it is unlikely he contracted the virus from another person.

The new cases raise Saudi Arabia's number of MERS cases since the disease was first detected in humans in 2012 to 1,614, which includes 668 deaths. Five people are still being treated for their infections.
May 25 MOH report
May 21 MOH report


Yellow fever now found in 7 Brazil states

The Pan American Health Organization (PAHO) said yesterday that seven Brazilian states now report suspected cases of yellow fever, but the virus is still not being transmitted by Aedes aegypti mosquitoes.

PAHO warned, however, that "confirmed epizootics in large cities, such as Vitoria in Espirito Santo and Salvador in Bahia, represent a high risk for a change in the transmission cycle."

So far Brazil has had 758 confirmed cases of yellow fever and 622 under investigation from December of 2016 to May 18. There have been 426 deaths.

The case-fatality rate remains at 34% for confirmed cases of yellow fever. Goias state reported its first case. Minas Gerais and Espirito Santo, which have had the most outbreak cases, have reported none in the past 2 weeks.
May 24 PAHO situation report


Zika severity not linked to defects, prior dengue infection

A new study in Clinical Infectious Diseases showed that Zika severity, prior dengue infection, and viral load did not affect pregnancy outcomes in mothers who contracted the disease.

Researchers have posited that congenital Zika syndrome, a constellation of defects and deformities—with microcephaly being the most severe—is connected the severity of maternal disease, or to the presence of previous flavivirus antibodies, which enhance Zika virus in a pregnant woman.

To test this theory, researchers followed 131 Zika-positive pregnant women. Fifty-eight of them (46.4%) experienced abnormal outcomes, including 9 fetal losses (7.2%). But they found no associations between disease severity and abnormal outcomes, disease severity and viral load, viral load and adverse outcomes, or existence of prior dengue antibodies (88% of the women had previously had dengue infections).
May 23 Clin Infect Dis

In other Zika news, researchers have used elevation as a proxy to predict the likelihood of Ae aegypti–transmitted diseases, concluding that there's a low potential for mosquito Zika transmission above 2,000 meters in the Americas. The study was published yesterday in PLoS One.

The researchers looked at 16 countries in the Americans with local Zika transmission, finding that above 1,600 meters, less than 1% of each country's total land area could host Ae aegypti mosquitoes. The findings align with US Centers for Disease Control and Prevention travel guidance.
May 24 PLoS One study


WHA approves more funds for emergencies, antimicrobial resistance

The World Health Assembly (WHA), meeting in Geneva this week, yesterday approved a proposed budget for the WHO for the next biennium totaling $4.42 billion, which factors in a 3% increase in member state contributions.

In a press release, the WHO said the budget includes Sustainable Development Goal priorities and reflects increased investments for the new health emergencies program ($69.1 million) and combating antimicrobial resistance ($23.2 million).

About 3,500 delegates from the WHO's 194 member states, many of them health ministers, are at the WHA, the decision-making body of the WHO. The meeting runs through May 31.
May 24 WHO statement

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