News Scan for Jun 15, 2018

Ebola count at 66
No polio in Venezuela
2nd Midwest Cyclospora outbreak
Legionnaires' and the VA
Avian flu outbreaks

DRC Ebola total rises to 66 with 11 new suspected cases

The Democratic Republic of the Congo's (DRC's) ministry of health said 66 cases of Ebola have been reported, after 11 previously suspected case samples tested negative for the virus and 11 new suspected cases were added to the total.

The totals for the outbreak now stand at 38 confirmed, 14 probable, and 14 suspected cases. The new suspected cases include 1 in Bikoro, 4 in Iboko, 1 in Wangata, and 5 in Ingende. The death toll remains at 28.

At this time, 24 people have recovered from Ebola virus infection in the country, officials said.

The ministry of health also updated vaccine statistics, confirming that 2,730 people have been vaccinated, including 813 in Mbandaka, 660 in Bikoro, 1,222 in Iboko, 30 in Ingende, and 5 in Kinshasa. A ring vaccination campaign of case contacts began on May 21 in Mbandaka.

All case contacts are being observed for 21 days, per Ebola's transmission cycle. More than 800 contacts in Bikoro health zone reached that milestone this week.
Jun 15 DRC


GPEI: Paralysis case in Venezuela is not polio, but Pakistan has new case

The Global Polio Eradication Initiative (GPEI) today confirmed that a case of paralysis recently reported in Venezuela was not caused by poliovirus.

Last week Venezuela recorded what was reputedly its first case of the virus in 30 years in a 2-year-old child. Though stool samples collected from the child contained a Sabin type 3 poliovirus, the virus did not cause the paralysis, GPEI said in a news release.

"Isolation of Sabin type 3 poliovirus can be expected in children and communities immunized with bivalent oral polio vaccine, which contains attenuated (weakened) type 1 and type 3 Sabin strains. Final laboratory analysis received today has confirmed that the AFP symptoms are not associated with wild or vaccine-derived poliovirus," the organization said.

In its weekly report, GPEI said Pakistan recorded a new case of wild poliovirus type 1, its third this year. The patient is from Dukki, Balochistan, and experienced paralysis on May 18.
Jun 15 GPEI news release
Jun 15 GPEI update


Minnesota and Wisconsin Cyclospora outbreaks sicken nearly 100

In ongoing Cyclospora outbreak developments in two states, Minnesota health officials reported a second outbreak and more cases with apparent links to contaminated vegetable trays, as their counterparts in Wisconsin reported more cases, some of which they say don't appear to be related to Del Monte vegetable trays.

The Minnesota Department of Health (MDH) said today that increasing Cyclospora infections within the last month are related to two outbreaks that have sickened at least 37 people. One outbreak involved people who ate at a Minneapolis restaurant named Sonora Grill in the middle of May, which has so far resulted in 17 infections. The MDH is hoping to interview people who ate at the restaurant—those who did and didn't get sick—the weekend of May 18.

The MDH said the second outbreak linked to Del Monte vegetable trays sold at Kwik Trip locations has resulted in 20 illnesses in Minnesota residents. Trisha Robinson, MPH, an epidemiologist supervisor at MDH, said so far there's no indication that the two outbreaks are related.

Meanwhile, the Wisconsin Department of Health Services (WDHS) said that, as of Jun 13, 60 Cyclospora cases have been reported, many of them linked to the already implicated Del Monte vegetable trays. It added, however, that there are other cyclosporiasis cases that don't appear to be linked and that the investigation is ongoing.

Spikes in Cyclospora illnesses have been reported over the past several summers, some of them linked to international travel to areas in which the Cyclospora cayetanensis parasite is endemic. Past outbreaks have involved a variety of imported produce, but sometimes the source of foodborne outbreaks hasn't been clearly identified.
Jun 15 MDH press release
Jun 13 WDHS update
Jun 11 CIDRAP News scan "Wisconsin and Minnesota Cyclospora illnesses linked to veggie trays"


Legionnaires' increasing among VA enrollees, but not from VA visits

Legionnaires' disease is on the rise in the United States, with several outbreaks in healthcare settings. According to the latest information from the Centers for Disease Control and Prevention, as many as 20% of Legionnaires' cases could be healthcare-associated.

A study today in JAMA Network Open assessed the risk of contracting Legionnaires' in Veterans Affairs (VA) hospitals, and found that while more VA enrollees are suffering from Legionnaires', the infection rate for patients with a VA overnight stay decreased on a population level (5.0 to 2.3 per 100,000 enrollees) from 2014 to 2016.

The researchers reviewed 491 Legionnaires' cases reported within the VA system from Jan 1, 2014, to Dec 31, 2016. While total Legionnaires rates for users of VA healthcare increased from 2.3 to 3.0 per 100,000 enrollees during the study period, 91% of patients had no VA exposure before contracting the disease.

"The decrease in the [Legionnaires'] rate in patients and/or residents with an overnight stay may be a result of intense efforts at VA facilities after publication of the most recent policy in 2014 to prevent Legionella growth in building water distributions systems," the authors conclude.

Legionnaires' disease is a type of pneumonia caused by bacteria that can proliferate in engineered water systems such as cooling towers.
Jun 15 JAMA Network Open study


Four countries report more H5 avian flu detections

Sporadic highly pathogenic avian flu detections continued this week in different countries, with Bulgaria, Northern Ireland, Russia, and Taiwan reporting events involving H5 subtypes.

Bulgaria's outbreak occurred at a poultry farm in Dobrich in the northeast, according to a government food safety announcement translated and posted by Avian Flu Diary (AFD), an infectious disease news blog. A local news report said the outbreak involved two barns at a layer farm that houses about 550,000 birds. The reports didn't say what strain was involved, but on Jun 10 the country reported five H5N8 outbreak on poultry farms that occurred in April and May.

In Northern Ireland, agriculture officials said a greylag goose found in a park in Argamh county in the south tested positive H5N6, marking the second detection in a wild bird since March.

Elsewhere in Europe, Russia's agriculture ministry reported an H5 outbreak at a backyard holding in Kursk Oblast in the far west, according to a Jun 13 report to the World Organization for Animal Health (OIE). The outbreak began Jun 7, killing 6 of 99 birds.

And finally, Taiwan reported another outbreak involving H5N2. The latest detection occurred in meat ducks at a farm in Tainan City and led to the culling of 5,590 poultry, the OIE said in a Jun 12 notification.
Jun 15 AFD post on more avian flu in Bulgaria
Jun 15 AFD post on H5N6 in Northern Ireland
Jun 13 OIE report on H5 in Russia
Jun 12 OIE report on H5N2 in Taiwan

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