News Scan for Apr 27, 2018

Yellow fever in Brazil
US flu continues decline
Ebola lab exposure update
New polio case in DRC
Bat immunity and Marburg virus

Brazil confirms 61 new yellow fever cases, 22 deaths

The Brazilian Ministry of Health (MOH) updated yellow fever counts for the country, noting 61 newly confirmed cases including 22 more deaths from the virus.

Between Jul 1, 2017 and Apr 24, 2018 the MOH has confirmed 1,218 cases of yellow fever and 364 deaths. During the same period in 2016-2017, 779 human cases and 262 deaths were registered, according to the MOH.

The majority of new cases occurred in Rio de Janeiro (36), Minas Gerais (14), and Sao Paulo (11). Also last week, officials confirmed yellow fever cases in non-human primates in the same three states.

Yellow fever is a sometimes fatal flavivirus spread primarily by the Aedes aegypti mosquito. The current outbreak in Brazil is the country's biggest in decades, and has spurred a nationwide immunization program with full and fractioned doses of the yellow fever vaccine.
Apr 24 Brazilian Ministry of Health update


CDC: Four pediatric deaths recorded despite low flu activity

Despite low levels of flu activity, the US Centers for Disease Control and Prevention (CDC) noted 4 new pediatrics deaths last week, bringing the season's total to 160. The information is published in this week's FluView surveillance report.

For the third week in a row, the rate of outpatient visits for influenza-like illnesses (ILI) was below the national average of 2.2%, at 1.7%. According to the CDC, ILI was at or above the national baseline for 19 weeks this season. Over the past five seasons, ILI has remained at or above baseline for an average of 16 weeks.

Only 4 states are reporting widespread flu activity, down from the previous week's 5. The states are Connecticut, Delaware, Massachusetts, and New York. No states reported high or moderate ILI, and only 3 states reported low ILI (Arizona, Kentucky, and Massachusetts).

Influenza B was the dominant strain last week, following the trend seen at the end of flu seasons. Of positive flu specimens gathered at clinical labs, 70.4% were influenza B.

Overall hospitalizations are still high, at 105.3 lab-confirmed cases per 100,000 population. In patients 65 and older the number reached 454.3 per 100,000 population, up from 446.4 the week before. The vast majority of hospitalizations (73.1%) were due to infections with influenza A viruses.
Apr 27 CDC FluView


Hungarian scientist exposed to Ebola was in BSL-4 lab

The weekly communicable disease threat report from the European Center for Disease Prevention and Control today had new details about the Hungarian lab worker who was placed in isolation after accidental exposure to Ebola virus.

The scientist was exposed on Apr 13 while working in a biosafety level 4 (BSL-4) lab at the National Public Health Institute (OKI) National Security Laboratory and was wearing appropriate personal protective equipment. The worker was immediately isolated in the South Pest Centrum Hospital at Szent Laszlo. Hungarian officials sought assistance from the World Health Organization, which sent the experimental VSV-EBOV vaccine within 24 hours and two experimental treatments and their protocols: Remdesevir and ZMapp.

So far the lab worker has shown no symptoms, other than a reaction to the vaccine, according to the ECDC report.
Apr 23 CIDRAP News scan "Hungarian lab worker isolated after exposure to Ebola"
Apr 27 ECDC
weekly communicable disease threat report


Officials record new vaccine-derived polio case in DRC

According to the latest report from the Global Polio Eradication Initiative (GPEI), officials confirmed one new case of vaccine-derived polio in the Democratic Republic of the Congo (DRC). This is the fourth case of circulating vaccine-derived poliovirus type 2 (cVDPV2) reported this year.

Health workers identified the case in Kikula district, Haut Katanga province, with the patient experiencing symptoms on Feb 19. The DRC, working with GPEI, will continue to use monovalent oral polio vaccine type 2 (mOPV2) across the country to prevent further cases.

Elsewhere in Africa, both Nigeria and Somalia reported positive environmental samples for vaccine-derived polio types 2 and 3. In Pakistan, officials confirmed the environmental detection of a positive wild poliovirus type 1 in Khyber Pakhtunkhwa province.
Apr 27 GPEI report


Bat genome study suggests natural immunity to Marburg virus

A genetic analysis of samples of Egyptian fruit bats from a colony linked to a human Marburg virus death in Uganda yielded new clues about how their immune systems differ from primates and other species and how they harbor the viruses. A team based at the US Army Medical Research Institute of Infectious Diseases (USAMRIID) reported their findings yesterday in the journal Cell.

The bat DNA was provided by a US Centers for Disease Control and Prevention (CDC) scientist who had traveled to Uganda to investigate the bats following the fatal human Marburg case. In generating the most contiguous bat genome to date, the team identified an expanded and diversified family of natural killer (NK) cell receptors, MHC class 1 genes, and type 1 interferons that dramatically differ from those in mammals, including mice and monkeys. Researchers suspect that the genetic function and differences lead to a higher threshold of activation of part of the bat immune system.

For NK cells, which play a key role in fighting viral infections, the authors found genetic evidence of a bias toward an inhibitory signal.

In a USAMRIID press release, Mariano Sanchez-Lockhart, PhD, said further evaluation hints that other key components may have evolved toward a state of immune tolerance. The group said their next stop is to compare antiviral responses between bats and nonhuman primates.
Apr 26 USAMRIID press release
Apr 26 Cell

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