News Scan for Oct 02, 2017

Saudi MERS cases
More H3N2v flu
Plague outbreak response
Zika center closes
Chikungunya in Italy

New MERS cases confirmed in Saudi Arabia  

After a lag in reporting last week, the Saudi Arabian Ministry of Health (MOH) updated it information on MERS-CoV cases over the weekend, noting three new cases since the agency last reported on Sep 25.

On Sep 26, the MOH said a 52-year-old Saudi man from Taif had been diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus). He was reported to be in critical condition. The man had direct contact with camels, a known risk factor for MERS transmission.

The following day a 76-year-old Saudi man from Nifi was diagnosed as having the disease. He was also symptomatic and is in stable condition. The man's source of infection is listed as "primary," meaning it's unlikely he contracted the disease from another person.

Finally, on Sep 30, the MOH said a 31-year-old Saudi man from Bishah was in critical condition with a MERS-CoV infection. That man also had direct contact with camels.

None of the newly reported patients are healthcare workers. The new cases raise Saudi Arabia's MERS count to 1,726 since 2012, including 699 deaths. Four people are currently being treated for the disease.
Sep 26 MOH report

Sep 27 MOH report
Sep 30 MOH


Maryland reports 5 more H3N2v flu infections

In its latest update on variant H3N2 (H3N2v) flu cases linked to contact with pigs at county fairs, the Maryland Department of Health (MDH) reported 5 more presumed positive, raising the state's overall total to 37.

One more patient was hospitalized, raising that number to two. Since Sep 20, Maryland has reported infections in people who had close contact with pigs at fairs in three counties: Charles, Anne Arundel, and Frederick. Most are in children, and two were reported to be in adults older than 30.

On Sep 29 the US Centers for Disease Control and Prevention (CDC), in reporting 31 cases in Maryland, said 50 cases have been reported in six states, most of them from Maryland and Pennsylvania. CDC testing is still under way on 18 viruses identified as presumed H3v-positive by Maryland's public health laboratory.

Led by Maryland's surge of H3N2v cases, the number of illnesses in the United States is the highest since the record year in 2012, when 309 cases were reported.
Sep 29 MDH case count


WHO steps up Madagascar plague outbreak response as cases top 130

The World Health Organization (WHO) announced yesterday that it is scaling up its response to a plague outbreak in Madagascar that has spread to the capital and port cities in recent weeks over the past few weeks, resulting in more than 100 infections.

In an update today, the WHO said that, as of Sep 30, Madagascar has reported 73 suspected, probable, and confirmed cases of pneumonic plague, 17 of them fatal.  Besides the pneumonic cases, Madagascar has reported 58 cases of bubonic plague, 7 of them fatal. The latest totals reflect increases of 22 pneumonic and 5 bubonic plague cases since the WHO's first outbreak announcement on Sep 29.

A case of septicemic plague has also been reported, for a total of 132, which is 27 more cases than the WHO reported just 3 days ago. The event is Madagascar's second plague outbreak this year.

Ten cities have reported pneumonic plague cases, including the capital city of Antananarivo and its suburbs, Toamasina and Faratsiho.

On Sep 27, a basketball player from the Seychelles who was in Madagascar participating in championship games died in a Madagascar hospital from pneumonic plague, triggering an investigation into his close contacts, who have received prophylactic treatment.

Dr Charlotte Ndiaye, the WHO's representative in Madagascar, said yesterday that the WHO is worried that the plague could spread farther, because it is already present in several cities at the start of the country's epidemic season. "Our teams are on the ground in Madagascar providing technical guidance, conducting assessments, supporting disease surveillance, and engaging with communities," she said. "We are doing everything we can to support the Government's efforts, including by coordinating health actors."

The WHO said it has released $300,000 in emergency funds plus critical supplies and is appealing for $1.5 million to support the response.

Plague is endemic in Madagascar, and 400 cases are usually reported each year, but most of them are the bubonic type. The WHO said the latest event is unusual because it is affecting large urban areas. Plague is caused by Yersinia pestis, a bacterium spread by infected rats via flea bites. Human-to-human transmission fuels the spread of pneumonic plague.
Oct 1 WHO press release
Oct 2 WHO outbreak update


CDC closing Zika Emergency Operations Center

The CDC announced the closing of its Zika Emergency Operations Center (EOC) on Sep 29. The EOC opened on Jan 22, 2016, to monitor and assess the outbreak of the mosquito-borne disease in US states and territories.

"Deactivation does not mean that the threat of Zika has lessened in importance or that people are no longer at risk of infection. Zika continues to be a public health threat in the United States and internationally," the CDC's announcement said. "CDC remains committed to protecting the health of Americans and will continue working to protect the nation from the threat of Zika."

During natural disasters and disease outbreaks, including the 2009-10 H1N1 flu pandemic and the 2014-16 Ebola outbreak, the CDC creates EOCs to coordinate emergency response efforts. Now, a group of experts, called the Zika Coordination and Operations Transition Team (ZCOTT), will transition from EOC activation to "routine, long-term activities" concerning Zika virus.
Sep 29 CDC press release


Chikungunya in Italy nears 200 cases as PAHO reports more infections

Italian officials have reported at least 183 locally acquired chikungunya cases through Sep 26, the WHO said in a Sep 29 statement, while the large outbreak in the Americas has grown by 223 cases.

The outbreak in Italy has ballooned from just 14 cases 2 weeks ago. It is centered in the country's Lazio Region, which includes the coastal areas of Anzio and Latina as well as Rome. Of the 183 cases, 109 are confirmed and the rest are being investigated. Three cases elsewhere in Italy have been linked to travel to Anzio, which would be bring the total to 186 cases. The earliest onset of symptoms was Jun 26.

The WHO said a risk of further transmission exists, in part because the Aedes albopictus mosquito that spreads the disease is established throughout the Mediterranean basin. And researchers writing in Eurosurveillance last week reported detecting live chikungunya virus in Ae albopictus in the region. The report also noted that the virus isolated from patients is closely related to a strain causing an ongoing epidemic in Pakistan.

A separate report in Eurosurveillance last week detailed findings in a nine-case outbreak in France. In that report, scientists describe a mutation in the virus that might facilitate transmission.
Sep 29 WHO statement
Sep 28 Eurosurveill
report on Italy
Sep 28 Eurosurveill
report on France

In the Western Hemisphere, meanwhile, the Pan American Health Organization (PAHO) on Sep 29 reported 223 new chikungunya infections, bringing the yearly total to 182,950 confirmed, suspected, and imported cases. In the previous week PAHO reported 37,254 new cases, almost all of them in Brazil.

French Guiana reported the highest increase last week, with 89 new cases but only 261 total for the year. Several other nations reported small increases, including the United States, which has now reported 52 imported cases to PAHO.

Since the outbreak began in 2013 on the Caribbean island of St. Martin, the Americas region has reported 2,569,661 cases.
Sep 29 PAHO update

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