News Scan for Sep 06, 2017

Two MERS cases
Newer rapid flu tests
Zika-GBS link
More Cyclospora

Two new Saudi MERS cases announced as WHO details household cluster

The Saudi Arabian Ministry of Health (MOH) reported two new cases of MERS-CoV yesterday and today.

Yesterday, a 37-year-old Saudi man from Al Hofuf was diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus). He is in critical condition. The MOH said the source of his infection was primary, meaning he likely did not contract the disease from another person.

Today a 78-year-old Saudi man in Riyadh is in stable condition after being diagnosed as having MERS. He had direct contact with camels, a known risk factor for the virus.

The new cases raise Saudi Arabia's MERS-CoV case count since 2012 to 1,719, including 693 deaths. Eight patients are still being treated, according to the MOH.
Sep 5 MOH report
Sep 6 MOH report

Also today, the World Health Organization (WHO) described 12 MERS cases reported by the MOH between Aug 13 and 30. Included in these cases are 6 patients from Dumah Al Jandal, who were household contacts of previous cases in that city.  They did not contract MERS during an early-August healthcare outbreak in that city, the WHO said.

According to the WHO, officials have reported 2,079 laboratory-confirmed cases of MERS-CoV worldwide, including at least 722 related deaths, since 2012.
Sep 6 WHO report


Meta-analysis shows better performance for newer rapid flu tests

Newer commercially available rapid tests for diagnosing influenza A and B are much more sensitive than traditional rapid tests and are just as specific, a Canadian-led research team reported yesterday in Annals of Internal Medicine.

The group's meta-analysis of 162 studies provides an update of a similar study in 2012 that found traditional rapid influenza diagnostic tests (RIDTs) were highly specific but poorly sensitive when compared to reverse-transcriptase polymerase chain reaction as the reference test. Since then, two other novel rapid tests have come on the market, digital immunoassays (DIAs) and rapid nucleic amplification tests (NAATs).

The scientists noted that rapid and accurate flu diagnosis paves the way for promptly starting antiviral treatment, leads to fewer other tests and hospitalizations, supports hospital infection control measures, and results in less unnecessary antibiotic use.

Based on their analysis, pooled sensitivities for DIAs and NAATs were markedly higher than RIDTs, and the use of DIAs and NAATs improved the detection of true cases of flu by 25 and 40 percentage points, respectively, compared with RIDTs.

Similar to the group's earlier findings, the researchers found that traditional RIDTs have sensitivities (54.4% for influenza A and 53.2% for influenza B) well below new US Food and Drug Administration (FDA) performance requirements that were released in February 2017. The authors added that regulatory agencies will likely phase out traditional RIDTs because of their poor sensitivity, especially in adults.

In a related editorial in the same issue, Michael Ison, MD, MS, an infectious disease specialist at the Northwestern University Feinberg School of Medicine in Chicago, wrote that the next-generations tests are simple, fast, and approved for point-of-case use by nonlaboratory staff, adding that their sensitivity approaches that of reverse transcriptase polymerase chain reaction testing. He added that the newer tests could improve care. "Increased availability and use of such assays likely will drive more appropriate early use of antivirals, may decrease unnecessary antibacterial therapy, and may improve patient outcomes."
Sep 5 Ann Intern Med study
Sep 5 Ann Intern Med editorial


Colombian case-control study builds support for Zika-GBS link

On the heels of similar findings from Brazil last week, a case-control study from Colombia found more evidence of a link between Zika illness and Guillain-Barre syndrome (GBS) and a much higher incidence of the condition in older people.

Researchers from Colombia and their collaborators at the US Centers for Disease Control and Prevention (CDC) reported their findings Sep 4 in the Journal of the Neurological Sciences.

They interviewed and tested 47 patients with GBS who were reported to health officials in Barranquilla, Colombia, from Oct 1, 2015, to Apr 2, 2016. The team compared the findings and incidence with two age-range matched controls from the same neighborhood as each GBS patient.

Incidence of GBS was 10 times higher in people age 60 and older compared with those younger than 20. Last week's Brazilian study also found that the incidence was 10 times higher in the oldest group than in the youngest group.

The Colombian study also found that those with suspected or probable Zika disease also had higher odds of developing GBS. In addition, the researchers found that, similar to reports from other regions, peaks in Zika disease and GBS coincided.
Sep 4 J Neurol Sci abstract
Aug 31 CIDRAP News story "Case-control study finds more evidence of Zika-GBS link"


CDC reports more Cyclospora cases in multistate outbreak

In its latest update, the CDC late last week reported 48 more cases of Cyclospora since its previous weekly report. Alongside a normal summer rise in travel-related Cyclospora cases, the CDC on Aug 7 notified health providers that it was investigating several locally acquired cases in several states, but so far a food source for the illnesses hasn't been found.

As of Aug 30, the CDC has received reports of 930 lab-confirmed cyclosporiasis cases this year, and at least 514 (55%) of the patients didn't report international travel and were sick on or before May 1, when health officials normally see a rise in illnesses. Of the 48 new cases, 36 involved no history of international travel. The latest illness onset is Aug 15.

Two more states reported locally acquired cases, raising the total to 36, the CDC said. Texas, the hardest-hit state by far, has been investigating a rise in cases that began in the middle of June. As of Aug 22, the Texas Department of State Health Services (TDSHS) reported 259 infections.
Sep 1 CDC update
Aug 22 TDSHS update

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