News Scan for Dec 08, 2017

Texas Zika cases
H7N9 survivor study
Avian flu in Europe, South Africa
Marburg outbreak over
Malaria in Mekong

Texas reports more Zika cases, 1 infected locally

Health officials in Hildago County on Dec 7 reported three recent Zika cases, one of which appears to have been transmitted locally by mosquitoes, the Texas Department of State Health Services (TDSHS) said yesterday in a statement.

The cases are a reminder that Zika is still a threat in the Rio Grande valley, the TDSHS said, adding that city and county authorities are investigating the cases and have stepped up mosquito surveillance and control efforts in the surrounding areas. In July, Hildago County reported a probable local Zika case, and in early October, Cameron County reported a local infection in a Laguna Heights woman who contracted the virus 2 to 3 months earlier.

Hildago and Cameron counties are both located on the southern tip of Texas near the border with Mexico, where Zika activity continues. Both are among nine counties for which the TDSHS earlier this year expanded testing recommendations, including testing pregnant women for the virus once each trimester. According to the TDSHS, enhanced testing has identified Zika infections that would have otherwise gone undetected.

"Residents of the Rio Grande Valley should remain on alert for Zika and take precautions even during the winter months because it often stays warm enough there for mosquito activity to continue through much of the winter, and there are reports of Zika activity in communities on the Mexican side of the border," the TDSHS said.
Dec 7 TDSHS statement


Study finds lingering effects in H7N9 survivors

The first study to track long-term outcome of patients after hospitalization with H7N9 avian flu infection in China found that lung problems and psychological issues persisted as long as 2 years after discharge. The study, which involved 56 patients from a single hospital in Zhejiang province who were sick during the country's first wave of H7N9 activity, was published today in Scientific Reports.

The team followed the patients with chest radiographs, lung function tests, and quality of life surveys. Pulmonary function and imaging findings improved during the first 6 months after hospitalization, especially in patients who had experienced acute respiratory distress syndrome (ARDS).

By the 2-year mark, most patients had returned to work, but more than half of the survivors still had problems with ventilation and blood-gas diffusion. H7N9 survivors had lower quality-of-life survey scores when compared to controls, and a history of ARDS seemed to have a big impact. Researchers noted that survivors not only experienced fear of death in the hospital, they also faced isolation at home after discharge from relatives and friends who feared the disease.
Dec 8 Sci Rep abstract


H5 poultry outbreaks reported in Italy, Netherlands, South Africa

In the latest avian influenza developments, Italy reported another highly pathogenic H5N8 outbreak in poultry, Dutch officials are investigating an H5 event at a duck farm, and South Africa said H5N8 struck another commercial ostrich farm.

The outbreak in Italy began on Nov 30 at a commercial farm housing ducks, broiler chickens, and breeding poultry in Veneto region, according to a report yesterday from the World Organization for Animal Health (OIE). The virus killed 117 of 7,421 birds and culling of the survivors was completed yesterday. Many countries in Europe were hit hard by H5N8 outbreaks last season, and Italy was one of the few to experience detections throughout the summer and into the fall.

In the Netherlands, tests have detected H5 avian influenza, likely a highly pathogenic strain, at a duck farm near the city of Dronten in the central part of the country, according to a government statement today translated and posted by Avian Flu Diary (AFD), an infectious disease news blog. The facility houses 16,000 ducks, which are slated for culling.

Elsewhere, South Africa reported an H5N8 outbreak at a commercial ostrich farm in Western Cape province that began on Oct 10, killing 2 of 1,878 birds, the OIE said today in a notification.
Dec 7 OIE report on H5N8 in Italy
Dec 8 AFD
Dec 8 OIE report on
H5N8 in South Africa


Uganda declares Marburg outbreak over

The Ugandan Ministry of Health (MOH) declared an end to the country's Marburg outbreak today. There have been no confirmed cases for 42 days, which covers two 21-day transmission cycles. During the outbreak, which began on Oct 19, 3 people died, and 316 known contacts were followed for signs of the severe virus.

The outbreak occurred in the eastern districts of Kween and Kapchorwa, near the border with Kenya. Marburg, which is related to the Ebola virus, has a high case-fatality rate. The disease causes a sudden fever, severe headache, and other symptoms.

Ugandan officials said the virus likely began when a 35-year-old herdsman from Kween returned from a hunting mission that involved visits to caves that harbored large fruit bat populations. He died, as did his 50-year-old sister who took care of him, the MOH said. Another sibling, a brother, also died from Marburg.

The World Health Organization (WHO) today commended Uganda for its swift containment of the virus.

"Uganda has led an exemplary response. Health authorities and partners, with the support of WHO, were able to detect and control the spread of Marburg virus disease within a matter of weeks," said Matshidiso Moeti, MD, WHO regional director for Africa, in a WHO news release.
Dec 8 Uganda MOH statement
Dec 8 WHO press release


Mekong countries accelerate malaria eradication

Several Southeast Asian countries have announced they are speeding up efforts to end malaria by 2030 amid increasing concern over rising rates of antimalarial resistance.

Representatives from Cambodia, China, Laos, Myanmar, Thailand, and Vietnam, known as the Greater Mekong Subregion (GMS), announced their efforts during a meeting in Myanmar today.

The Mekong region is home to some of the highest rates of resistance to antimalarials, including artemisinin.

"Malaria is a disease that we can—and must—eliminate from the Greater Mekong Subregion. The drive to achieve this goal by 2030 demonstrates the joint commitment of health leaders from across the subregion to secure the health and well-being of vulnerable populations and ensure no one is left behind," said Dr Poonam Khetrapal Singh, WHO regional Director for Southeast Asia, in a WHO announcement.

The GMS already has made strides in reducing malaria in recent years. According to the WHO, malaria cases in the six countries fell by an estimated 74% between 2012 and 2016. Deaths due to malaria fell 91% during the same period.

Progress has been attributed to greater access to artemisinin-based combination therapies for malaria treatment, rapid diagnostic tests, and insecticide-treated nets, the WHO said.
Dec 8 WHO announcement

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