News Scan for May 25, 2018

Nipah virus in India
Salmonella and kratom
New US pediatric flu death
MCR-1, MCR-3 in Korea
Polio in Nigeria

Tests rule out Nipah in 2 cases; samples from another state sent for testing

Tests on two earlier reported suspected Nipah virus cases from India's Karnataka state were negative for the virus, as another, previously unaffected state—Telangana—identified two possible cases and sent samples for testing, according to the latest media reports from India.

So far, cases have been confirmed only in Kerala state. Yesterday in a statement the health ministry said the event isn't a major outbreak, is localized, and hasn't spread to new areas. It added that all confirmed and suspected cases have direct or indirect links to the index patient and his family. As of May 24, 34 cases have been reported, 14 of them confirmed and 20 suspected. So far 12 deaths have been reported in two Kerala districts, Kozhikode and Malappuram.

In announcing the negative test results for the patients in Karnataka state, a health official said one of the patients was an employee of the medical college in Kozhikode who was visiting the area, according to The Hindu, an English-language newspaper based in India, yesterday.

Meanwhile, health officials in Telangana state said one of two suspected patients had recently visited Kerala state, but not the outbreak area, Press Trust of India (PTI) reported today. The official said the tests were being done as a precaution, and the samples are also being tested for influenza.
May 24 Indian health ministry statement
May 24 Hindu story
May 25 PTI story


CDC calls kratom-linked Salmonella outbreak probe over after 199 cases

An investigation into the Salmonella outbreak linked to the herbal supplement and stimulant kratom is over after cases reached 199 in 41 states, the Centers for Disease Control and Prevention (CDC) said yesterday as it reported 67 new cases since its last update on Apr 5.

Of 132 people with available information, 50 (38%) were hospitalized, but no deaths have been reported, the CDC said. Nine states reported cases for the first time linked to the supplement, which is an opioid substitute. Kratom is also known as Thang, Kakuam, Thom, Ketom, and Biak.

Illness-onset dates range from Jan 11, 2017, to May 8, 2018. Patients vary in age from less than 1 year to 75 years, with a median age of 38. Several companies have recalled products because of the outbreak. Washington was the most affected state, with 16 cases, but illnesses were widely scattered across the country.

The CDC said, "People should be aware that kratom could be contaminated with Salmonella and could make people sick. Contaminated products may still be available for purchase because the investigation was not able to identify a single, common source of contaminated kratom."
May 24 CDC update


US flu levels continue to decline as 1 new pediatric death confirmed

As spring winds down, US flu levels continued to drop or remain at low levels again last week, but the CDC recorded one new influenza-related death in a child, according to a CDC update today.

Flu was reported as widespread in only Massachusetts, compared with that state plus New York the week before. All 50 states reported minimal influenza-like illness (ILI) activity.

Clinic visits for ILI remained steady, at 1.2%, well below the national baseline of 2.2%. The CDC said flu has now been below the national baseline for the seventh consecutive week. The overall hospitalization rate last week also held steady, at 106.6 per 100,000 population. The highest level, in seniors, ticked up a bit, from 460.3 to 460.8 per 100,000 population.

The pediatric death was caused by influenza B and occurred in mid-April, the CDC said. So far this season the agency has confirmed 169 pediatric flu deaths. The 2012-13 season saw 171 pediatric flu deaths, according to CDC data, which was the highest since the 2009-10 pandemic.

Of respiratory specimens tested at clinical labs last week, only 2.2% were positive for flu, and influenza B made up about 54% of the positive detections.
May 25 CDC FluView report


Korean researchers report MCR-1, MCR-3 in E coli from food animals

South Korean researchers have confirmed the colistin-resistance genes MCR-1 and MCR-3 in Escherichia coli isolates from food animals, according to a study yesterday in the International Journal of Infectious Diseases.

The scientists analyzed 636 E coli isolates collected from 2014 through 2017, 9 of which proved to be resistant to colistin, an antibiotic of last resort used to treat drug-resistant infections, as well as resistant to other antimicrobials. Of the 9 isolates, 3 harbored MCR-1 genes and 2 harbored MCR-3. All of the MCR-1 and MCR-3 genes proved to be transferable to another E coli strain, the authors said.

This is the first known report of MCR-3 in healthy animals in South Korea, the authors say.

Since MCR-1 was first discovered in E coli isolates in China in 2015, the gene has been detected in animals, humans, and the environment in more than 30 countries. Scientists have identified MCR-1 through MCR-7 in E coli and other bacterial species, including Klebsiella and Enterobacter.
May 24 Int J Infect Dis abstract


New polio case reported in Nigeria

Health officials in Nigeria confirmed a new case of vaccine-derived poliovirus type 2, the first such case reported this year.

Healthcare workers detected the case in Jigawa state and reported that the patient had symptom onset on Apr 15, according to the latest weekly update from the Global Polio Eradication Initiative (GPEI).

GPEI said environmental isolates of vaccine-derived polio type 2 were found in Nigeria in January and February, prompting an injected polio virus vaccine campaign in 13 high-risk areas. The campaign reached approximately 55,000 children.

In other polio news, Somalia reported three more environmental samples of vaccine-derived polio types 2 and 3 in Bandar province, GPEI noted, while Pakistan confirmed three new wild poliovirus environmental samples in Sindh and Balochistan provinces.
May 25 GPEI report

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