News Scan for Apr 26, 2018

Modified FMD virus
MERS in Saudi Arabia
Midwest measles
Rotavirus patterns
Listeria and soft cheese
CWD not spread to monkeys

USDA clears way for work on modified FMD on US mainland

The US Department of Agriculture (USDA) today announced that Secretary Sonny Perdue has authorized the movement of a modified, noninfectious version of the foot and mouth disease (FMD) virus from the Plum Island Animal Disease Center, off the coast of New York, to the US mainland for vaccine development and research purposes.

Though the modified FMD virus can't cause disease and doesn't pose a transmission risk, it is still a live virus, and federal law requires USDA approval for its movement, the USDA's Animal and Plant Health Inspection Service (APHIS) said today in a statement.

Because the disease could devastate the livestock industry, developing a vaccine using a modified virus will help the USDA more quickly order and acquire an FMD vaccine in the event of an outbreak. The USDA added that the move allows vaccine companies to apply for USDA permits to continue their work with the modified virus in the United States, which when granted requires appropriate biocontainment and use restrictions.

Handling unmodified live FMD viruses has been illegal in the United States, except for at the USDA's Plum Island research facility, where work has been done on the virus under very strict biocontainment procedures. The United States has not had an FMD outbreak since 1929.
Apr 26 APHIS press release


New Saudi MERS case linked to direct camel contact

The Saudi Arabian Ministry of Health (MOH) confirmed one new case of MERS-CoV related to camel contact. This is the MOH's first update in 10 days.

Officials said in an Apr 22 report posted yesterday that a 72-year-old Saudi man from Al Qunfudhah has been diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus). The man is in critical condition, and the source of his infection is primary direct contact with camels, a known risk factor for the virus.

On Apr 15 the Saudi MOH reported a MERS-CoV case in a 93-year-old man in Al Qunfudhah, and it had confirmed one earlier in that city, in late January. The new case brings Saudi Arabia's MERS totals since 2012 to 1,836, including 742 deaths. Five people are still being treated for their infections.
Apr 22 MOH


Second measles outbreak reported in KC area; alerts issued elsewhere

Ten illnesses have been reported in a second measles outbreak in the Kansas City, Mo., area, and an infected traveler from Missouri has prompted warnings about possible exposure in Iowa, Minnesota, and Wisconsin.

The latest measles activity in the Kansas City area mainly involves people infected in the Missouri side of the metro area, including three students who attend Liberty Public Schools, the Kansas City Star reported yesterday, citing a spokesman with the Kansas City Health Department. The Missouri Department of Health & Senior Services (MDHSS) today detailed possible exposure locations and times.

A separate outbreak that began in March at a Johnson County daycare center in the Kansas part of the metro has grown to 18 cases, according to an Apr 20 update from the Kansas Department of Health and Environment (KDHE). That total includes 14 Johnson County residents, plus 3 from Linn County, and 1 from Miami County. According to the Star, that outbreak is Kansas's largest involving measles since 1990.

Meanwhile, the same infected Missouri traveler has triggered warnings in Iowa, Minnesota, and Wisconsin, Kerri Tesreau, with the MDHSS, told the Star. On Apr 23, the Iowa Department of Public Health (IDPH) warned of exposure at a fast food outlet in Des Moines on Apr 13 and at a restaurant in Ankeny on Apr 16. The Minnesota Department of Health (MDH) yesterday warned of exposures at a fast food restaurant in Winona on Apr 13 and a gas station in Albert Lea on Apr 16. In western Wisconsin, the La Crosse and Trempealeau county health departments on Apr 23 warned of exposures at seven locations, mainly hotels and restaurants, between Apr 13 and Apr 16.
Apr 25 Star story
Apr 26 MDHSS press release
Apr 20 KDHE news release
Apr 23 IDPH news release
Apr 25 MDH news release
Apr 23 La Crosse County Health Department
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Report profiles rotavirus outbreaks following vaccine introduction

Though the rollout of rotavirus vaccination in 2006 has substantially cut severe diarrhea infections in US kids, seasonal outbreaks causing mainly mild-to-moderate illness continue to occur, and researchers today described three 2017 outbreaks in California that illustrate current patterns in the postvaccine era.

A team from California and the US Centers for Disease Control and Prevention (CDC) profiled the events, two of which were first thought to involve norovirus, in the latest issue of Morbidity and Mortality Weekly Report (MMWR).

One of the outbreaks, first suspected as norovirus, struck a child care center in Long Beach in April, which led to 27 cases of acute gastroenteritis in children and 4 in staff members. Five secondary infections in household members were also reported. No hospitalizations or deaths were reported, and 6 of the 27 children had been vaccinated.

The same month another outbreak occurred at an adult assisted living and memory care facility in San Mateo, sickening 4 residents and 5 staff members. Health officials initially suspected norovirus, but tests on two ill people confirmed rotavirus as the cause. No hospitalizations or deaths were reported, and none of the patients were vaccinated, with the authors noting that the patients weren't eligible to be immunized.

A third outbreak struck a subacute care facility for children in Santa Clara County in May, sickening 24 of 25 patients, along with 3 of 115 staff members. A 22-month-old child who had preexisting respiratory failure died from rotavirus-related dehydration. That child and 16 others had not been vaccinated for various reasons, including being on a delayed vaccination schedule that may have made them ineligible to be immunized.

The authors said the outbreaks show that rotavirus disease continues to occur, even in vaccinated people, and that outbreaks can affect adults, especially those in congregate living situations. They also said the outbreaks are a reminder that although the vaccine is highly effective against severe disease, it doesn't always prevent infection and mild disease. "Thus, rotavirus disease and outbreaks can occur even in populations where vaccination coverage is high," they wrote.
Apr 27 MMWR report


Report: Listeria outbreaks associated with soft cheese on the rise in the US

Listeriosis infections connected to eating soft cheeses are on the rise in the United States, according to a report today in Emerging Infectious Diseases. The report tracked illnesses caused by Listeria monocytogenes from 1998 to 2014 in the United States, noting a rise in cases since 2006.

Using data from the Foodborne Disease Outbreak Surveillance System, CDC scientists recorded 58 listeriosis outbreaks, 30% of which were related to soft cheeses (most were "Latin-style" soft cheeses like queso fresco). The outbreaks linked to soft cheese included 180 illnesses, 14 fetal losses, and 17 deaths. The vast majority of patients (88%) were hospitalized for their infections.  Of 116 patients with known ethnicity, 38 (33%) were Hispanic.

According to the report, the proportion of listeriosis outbreaks linked to soft cheese made from pasteurized milk was significantly higher from 2007 to 2014 (12 outbreaks, 33%) than from 1998 to 2006 (1 outbreak, 5%). The authors said the increase could be due to a number of factors, including "the growing US Hispanic population (which increased from 11% in 1998 to 17% in 2014 ); a 2.5-fold increase in per capita consumption of cheese from 1980–2013; consumer demand for certain types of cheeses; and an increase in the number of small producers, some of which had sanitary deficiencies."

Listeriosis outbreaks are most commonly associated with refrigerated ready-to-eat foods, including deli meats, hot dogs, soft cheeses, and other dairy products, the authors note.
Apr 26 Emerg Infect Dis study


Chronic wasting disease not transferred to monkeys in NIH-led study

Chronic wasting disease (CWD), a prion disease affecting cervids such as deer, did not cross the species barrier to infect monkeys in a National Institutes of Health–funded study published yesterday in the Journal of Virology.

Since the late 1960s, scientists have tracked CWD in elk, deer, and moose, but the risk to humans who consume infected animal meat remains unknown. Though prion diseases do not normally cross species, the "mad cow" (bovine spongiform encephalopathy) outbreak of the 1980s demonstrated the possibility.

In the study, seven monkeys were inoculated with CWD via intracerebral or oral routes and followed for 11 to 13 years to see if prion disease developed. In humans, prion diseases usually develop over the course of a decade. Scientists used RT-QuIC (real-time quaking-induced conversion) tests on the monkeys and found no clinical or pathological signs of CWD in the animals.
Apr 25 J Virol

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