News Scan for Jun 11, 2018

MERS household cluster
US flu deaths in kids
Polio in Venezuela
Cyclospora infections in 2 states
Measles in Brazil
H5N1, H5N8 poultry outbreaks

WHO notes 1 more MERS case in Saudi household cluster

Health officials reported a total of 12 MERS-CoV cases in May, according to an overview published today by the World Health Organization's (WHO's) Eastern Mediterranean office. Eleven cases are from Saudi Arabia, and the United Arab Emirates recorded one.

The Saudi Arabian Ministry of Health has released only sporadic updates on cases of MERS-CoV (Middle East respiratory syndrome coronavirus) in recent weeks, but on May 30 and 31, ProMED Mail, the online reporting system of the International Society for Infectious Diseases, said there were seven new MERS cases in a household cluster in Najran.

The WHO's summary raises the household cluster number to eight. The initial patient in that cluster drank raw camel milk before becoming symptomatic in the middle of May, but the other seven patients reported no contact with camels, and are thus listed as secondary cases.

The WHO notes that hospital-acquired cases have decreased since 2015, but there are no major differences in the demographic and epidemiologic characteristics of reported cases from 2013 to 2018.

Since 2012, the WHO has recorded 2,220 cases of MERS, including 790 associated deaths (case-fatality rate of 35.6%). The vast majority of these cases were reported from Saudi Arabia (1,844 cases, including 716 deaths, for a case-fatality rate of 38.8%).
Jun 11 WHO update
May 31 CIDRAP News Story "Cluster of MERS illnesses reported in Saudi family"


Latest US pediatric flu death means 2017-18 deadliest season for kids

The Centers for Disease Control and Prevention (CDC) announced a flu-related pediatric death late last week, bringing the total for the 2017-18 flu season to 172. That total exceeds the 2012-2013 season, making last year's flu season the deadliest for kids in a non-pandemic year.

"Approximately 80% of these deaths occurred in children who had not received a flu vaccination this season. CDC recommends an annual flu vaccine for everyone 6 months and older. These deaths are a somber reminder of the importance of flu vaccination and the potential seriousness of flu," the CDC said in a news release.

The CDC has tracked flu-related pediatric deaths since 2004. In 2011-12, only 37 pediatric deaths from flu complications were reported to the CDC. During the 2009 H1N1 pandemic, 358 pediatric deaths were recorded.

Of the 172 cases from this season, about 60% of patients died after hospitalization, and 40% at home or in emergency departments. Patients were divided evenly among girls and boys, and most children died within 7 days of symptom onset. About half of the deaths occurred in otherwise healthy children.
Jun 8 CDC
news release


Venezuela confirms first polio case in nearly 30 years

For the first time since 1989, Venezuela has reported a case of vaccine-derived Sabin-type 3 poliovirus in the eastern state of Delta Amacuro, according to Newsweek.

The case comes after other diseases, including measles, tuberculosis, and diphtheria, have made a stark return in Venezuela amidst a collapsing national healthcare system.

According to a Pan American Health Organization (PAHO) update, the case involves a 2-year-old unvaccinated child who suffered paralysis onset on Apr 29. An ongoing investigation has also revealed that an 8-year-old girl in the same community reported flaccidity in her legs.
Jun 11 Newsweek story
Jun 8 PAHO


Wisconsin and Minnesota Cyclospora illnesses linked to veggie trays

Health officials in Wisconsin and Minnesota are investigating an increase in Cyclospora illnesses that appear to be linked to Del Monte fresh vegetable trays sold at convenience stores, the Wisconsin Department of Health Services (WDHS) said in a Jun 8 press release.

So far 11 sick patients in Wisconsin and 3 in Minnesota reported buying the vegetable trays from a Kwik Trip location before they became ill. The 6- and 12-oz trays contained broccoli, cauliflower, carrots, and dill dip and may have been sold at other retail locations, and the WDHS said more details are pending about the distribution of the products, which Kwik Trip has voluntarily removed from its stores.

Cyclospora infection is caused by the Cyclospora cayetanensis parasite. Symptom onset can range from 2 days to 2 weeks after exposure and can include watery diarrhea, appetite loss, cramping, bloating, and fatigue.

The US Centers for Disease Control and Prevention (CDC) has said that many cases are linked to international travel to places where the parasite is endemic, but illness spikes from foodborne illnesses have been reported over the past several summers. Investigations don't always identify the food source, but past outbreaks have been linked to a variety of imported produce items, including basil, cilantro, mesclun lettuce, raspberries, and snow peas.
Jun 8 WDHS press release
CDC Cyclospora page


Growing Brazilian measles outbreak likely imported from Venezuela

Since Jan 1 through May 23, Brazil has recorded 995 measles cases, including 2 deaths. This is the country's largest measles outbreak in recent decades.

"The Region of the Americas was declared free of measles in September 2016, nevertheless, outbreaks caused by imported cases from other regions may occur sporadically," the WHO said in an outbreak update today. Cases have been recorded in Amazonas and Roraima states, both in the northern part of the country.

According to the WHO, among 84 confirmed cases, 58 involve Venezuelans (69%), 24 involve Brazilians (28.6%), and 1 case each has been confirmed in a Guyaneseand Argentinian. Of all confirmed case-patients, 34 are indigenous. The 2 deaths were in Venezuelans.

The Brazilian Oswaldo Cruz Foundation conducted testing and analysis on case samples and found the current strain is identical to one that caused a 2017 measles outbreak in Venezuela. The WHO and PAHO warned of South American measles outbreaks from imported cases in late 2017.

A vaccination campaign targeting all unvaccinated residents of Amazonas and Roraima over 6 months of age is under way.
Jun 11 WHO notice  


High-path avian flu strikes poultry in Bangladesh, Nepal, and South Africa

Bangladesh and Nepal reported new highly pathogenic H5N1 avian influenza outbreaks in poultry, as South Africa detected H5N8 again at a commercial farm, according to recent notifications from the World Organization for Animal Health (OIE).

In Bangladesh, the H5N1 outbreak occurred in pheasants at a farm in Dhaka Division in the northeastern part of the country. The outbreak began on May 26, killing all 600 susceptible birds and is now considered resolved. Bangladesh reported its last H5N1 outbreak in April, which struck a farm in the southeast.

Meanwhile, Nepal reported its third recent outbreak involving H5N1. The latest detection occurred at a broiler farm in Bagmati zone. The event began on Jun 4 killing 1,340 of 6,000 susceptible birds. Authorities culled the surviving poultry as part of the outbreak response. The outbreak is Nepal's third involving H5N1 since the middle of May.

South Africa, meanwhile, reported another H5N8 detection, this time at a farm in Gauteng province in the north central part of the country. The outbreak began on Jun 6, killing 95 of 30,241 birds. The remaining ones are slated for culling to curb the spread of the virus.
Jun 11 OIE report on H5N1 in Bangladesh
Jun 8 OIE report on H5N1 in Nepal
Jun 8 OIE report on H5N8 in South Africa

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