News Scan for Jul 07, 2017

Zika birth defects in US
H7N9 in China
Hantavirus cases rise
Meningitis alert for Soliris treatment

More babies born in the US with Zika-related birth defects

According to the latest numbers from the Centers for Disease Control and Prevention (CDC), there are now 88 babies born in the United States with Zika-related birth defects, an increase of 8 since the last report. The number of pregnancy losses showing Zika-related birth defects remains at 8.

The numbers are updated through Jun 27. A total of 1,687 Zika-affected pregnancies with or without birth defects have been documented in the United States since 2016. In the US territories, including Puerto Rico, the corresponding number is 2,830; this includes 122 infants with birth defects and 6 pregnancy losses.

The numbers reflect only laboratory-confirmed Zika infections in pregnancies registered with the US Zika Pregnancy Registry.
Jul 6 CDC update


China's weekly H7N9 total declines to single case

China reported just one H7N9 avian influenza case this week, down sharply from six reported the previous week, Hong Kong's Center for Health Protection (CHP) said today in its weekly update.

The patient is a 35-year-old man from Xinjiang Uygur Autonomous Region in the far northwest of the country who began having symptoms on Jun 23 and died on Jun 30. An investigation into the source of his exposure to the virus found that he had sold and slaughtered chickens at a market.

Xinjiang has reported a few H7N9 cases in the past, but not in the recent wave of activity, which has been marked by a wide geographic spread of detections in poultry and in people.

China has had more than 750 cases in the fifth and largest wave of infections, at least 209 of them fatal.
Jul 7 CHP update

In other H7N9 developments, Chinese researchers who compared recent human infections with highly and low-pathogenic H7N9 in Guangdong province found that clinical outcomes were similar, though people sickened by the highly pathogenic form had longer hospitalizations. The team reported their findings yesterday in the latest issue of Eurosurveillance.

Their analysis included 9 patients infected with highly pathogenic H7N9 and 51 who had been sickened by the low-pathogenic strain.

Researchers also assessed poultry market environmental surveillance, finding that the touching of sick or dead poultry was the most important risk factor for contracting highly pathogenic H7N9, hinting that because that form of the virus disseminates to multiple organs, including muscle, handling sick birds could be more risky. Raising backyard poultry and touching live poultry were also risk factors.

They concluded that it's still not possible to tell if highly pathogenic H7N9 causes more severe disease in humans, but detailed investigations about shedding, virus dissemination, and inflammation levels are needed to shed more light. They also noted that investigation of the impact of the virus on chickens is urgently needed.
Jul 6 Eurosurveill report


Washington state hantavirus cases rise to five

Washington state reported another hantavirus infection, raising the season's total to five, the most since 1999, the Washington State Department of Health (WSDH) said yesterday in a press release.

The illnesses are from four counties, Franklin, King, Spokane, and Skagit, and three deaths occurred among the cases.

Deer mice are known to carry hantavirus, which can spread to humans through contaminated air or direct contact with the animals or their saliva, urine, droppings, or nesting material, the WSDH said.

In its background materials on the disease, the department said 1 to 5 cases are typically reported each year, and about 1 in 3 people who have hantavirus pulmonary syndrome die.
Jul 6 WSDH press release
hantavirus background
Jun 28 CIDRAP News scan "
Washington state reports fourth hantavirus case of the year"


CDC warns of meningitis risk in vaccinated patients on Soliris

The CDC today issued a Health Alert Network (HAN) advisory warning about a high risk of meningococcal disease despite vaccination in patients who are being treated with Soliris (eculizumab), a monoclonal antibody used to treat rare blood diseases including atypical hemolytic uremic syndrome and paroxysmal nocturnal hemoglobinuria.

Patients taking the drug are known to be at 1,000- to 2,000-fold greater risk of meningococcal disease, and Soliris comes with a warning that those on the medication should be vaccinated.

The CDC said that between 2008 and 2016 it has identified 16 cases of meningitis in eculizumab recipients, 11 of whom had nongroupable Neisseria meningitidis, which isn't covered by the MenA conjugate vaccine. The newly approved meningococcal B vaccine protects only against that strain. The CDC detailed the findings and concerns today in an early release report in Morbidity and Mortality Weekly Report (MMWR). They said researchers haven't assessed the extent of any cross-protection for nongroupable N meningitidis strains.

In today's HAN, the CDC urged health providers to consider antimicrobial prophylaxis for the duration of eculizumab treatment and to continue to vaccinate patients who are on the medication, administering the first dose at least 2 weeks before starting treatment when possible. They also recommended that clinicians keep a high index of suspicion for meningococcal disease in patients who are taking eculizumab.
Jul 7 CDC HAN notice
Jul 7 MMWR


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