News Scan for Jul 14, 2017

Minnesota measles case
Jamestown Canyon virus
UN funds for Haiti cholera support
Zika and chikungunya coinfection
USDA animal disease response plan

New case of measles in Minnesota reported

The Minnesota Department of Health (MDH) said there was a new case of measles in an adult who visited several public places while infectious. The new case brings the total to 79 for Minnesota's ongoing measles outbreak.

The patient, who is described as white and from Hennepin County, was unvaccinated and in proximity to several unvaccinated people, according to a news story in the Star Tribune. The MDH said the individual was "likely exposed to measles at locations frequented by the last identified case." The patient visited several public locations in Hennepin, Ramsey and Carver counties before being diagnosed with measles.

"While there's been some recent speculation that the outbreak was nearing its end, we've been cautious about making any predictions," said Kristen Ehresmann, RN, MPH, director of infectious disease for MDH, said in a press release. "When you're dealing with a disease that can spread as easily as measles, you need to keep your guard up until the very end of the possible timeframe when people could get sick."

Most (90%) Minnesotans are vaccinated against measles, but pockets of unvaccinated communities, including Somali-Americans, have caused outbreaks in recent years. The MDH said 42 days must pass with no new cases reported before they can say the current outbreak is over.
Jul 13 MDH press release
Jul 13 Star Tribune story


Adult diagnosed with Jamestown Canyon virus in Maine

An older adult from Kennebec County, Maine, was diagnosed with Jamestown Canyon virus, a rare mosquito-borne disease, after his symptoms began in early June. The patient was hospitalized but recovered at home.

Initial statements from state officials said this may be the first documented case of Jamestown Canyon virus in Maine. Symptoms include fever, neck stiffness and body aches, and in rare cases the illness can develop into meningitis and encephalitis. Mosquitoes become infected after feeding off of deer, and most human infections occur in late summer and early fall.

According to a post on ProMED Mail, an message board of the International Society for Infectious Diseases, there were only 31 cases of the disease documented nationally over a 14-year period.
Jul 13 State of Maine press release
Jul 13 ProMED Mail post


UN general assembly approves funds for Haiti cholera trust fund

The United Nations (UN) General Assembly approved a resolution yesterday to transfer $40.5 million in unspent funds to help Haiti recover from a cholera outbreak, according to an Associated Press (AP) report.

The outbreak in 2010 occurred in the wake of a massive earthquake, and investigations have said the virus was brought into the country by UN peacekeepers from Nepal. The outbreak sickened about 800,000 and led to about 9,000 deaths.  The UN has accepted some blame for the outbreak and had vowed to raise about $400 million to help affected communities. However, as of late May, only $2.67 million had been contributed to an earmarked trust fund.

The funding approved yesterday comes from unspent money from the UN Haiti peacekeeping mission, which will end in October after 13 years. The UN's goals for reducing the cholera burden in Haiti is aimed at improving water, sanitation, and health systems, as well as expanding access to care and supporting communities.
Jul 13 AP story


Zika and chikungunya led to neuro complications in patient

A 74-year-old man who suffered simultaneous Zika and chikungunya infections developed severe meningoencephalitis and neurological injury as a patient in a northeastern Brazilian hospital. A new case history published in PLoS Neglected Tropical Diseases describes the man's illness, offering one of the first accounts of severe brain damage due to Zika and chikungunya co-infection.

The patient presented at a hospital in Recife, Brazil, in April of 2016, complaining of fever and edema. Three days later the patient's condition worsened considerably, and he went into shock and experienced hypoxia, eventually requiring mechanical ventilation. MRIs showed inflammation in the brain, and blood tests confirmed Zika and chikungunya. The patient was treated for 5 days with intravenous human immunoglobulin. Six months after infection, he made almost a full recovery, but still complained of strength deficiency in the lower limbs.

"Although data on literature is still scarce, we cannot exclude the possibility that coinfections could lead to more severe neurological damage," the authors concluded. "In fact, the case here presented reinforces the need of arboviruses effective surveillance programs in recently affected areas, especially in those that are now epidemic for Zika."
Jul 13 PLoS Neg Trop Disstudy


APHIS releases response and preparedness plan for emerging animal diseases

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) today unveiled an emerging animal disease preparedness and response plan, which sets out a strategy for detecting and responding to disease events and defines the process for identifying, evaluating, and responding to emerging diseases in animal populations.

In a statement today, APHIS said it developed a framework for the plan in 2014 and sought input from federal and state agencies, veterinary labs, livestock groups, and individuals.  Feedback from the stakeholders is included in the plan, which APHIS said is a living document that can be updated as infrastructure and policies change.

One theme of the document is that rather than offering a single process to fit all emerging diseases, it spells out roles and responsibilities across business units for evaluating animal health information and determining response options. It also details the need for collaboration among all the different stakeholder groups.
Jul 14 APHIS press release
Jul 14 APHIS
emerging animal diseases preparedness and response plan

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