News Scan for Jul 26, 2018

Next Ebola steps in the DRC
Campus mumps outbreak response
Melon Salmonella probe ends

WHO details next steps in wake of Ebola outbreak end in DRC

In an update yesterday that came a day after the Democratic Republic of Congo's (DRC's) Ebola outbreak was declared over, the World Health Organization (WHO) said it now considers the risk to the region and the rest of the world as low.

As of Jul 24, the outbreak's total is 54 cases, 38 confirmed by lab tests and 16 classified as probable. Thirty-three deaths were reported in the outbreak that began with the first illness onset in early April.

Earlier this month the DRC's health ministry met with the WHO and its partners to assess the current epidemiologic situation, evaluate progress, and prioritize activities going forward. The group came up with a government-led plan to transition and strengthen emergency response capacities, with steps to take place between August and October. The steps include maintaining lab capacity to detect new cases and provide medical and psychosocial care for survivors and their families.

The WHO said as part of the next phase it will help the health ministry conduct an after-action review to highlight lessons learned and how to leverage resources and knowledge from the outbreak's earlier stages.

Also, the agency recommended three measures to reduce the risk of Ebola transmission in the outbreak area, including using gloves or protective clothing while handling fruit bats, monkeys, or apes, and cooking animal products thoroughly. The other steps include wearing gloves while caring for sick patients at home and male survivors practicing safe sex and hygiene for 12 months after illness onset or until their semen tests negative twice for Ebola virus.
Jul 25 WHO


Report details lessons learned in mumps outbreaks at Indiana universities

Public health officials who were involved in responding to four mumps outbreaks at universities in Indiana in 2016 described the need for schools to standardize immunization and immunity documentation, according to a report today in Morbidity and Mortality Weekly Report (MMWR).

Through September of that year, the four colleges reported 281 cases, 179 of them in students or staff members and the rest in community members. The cases occurred during a year when 6,366 cases were reported to the US Centers for Disease Control and Prevention (CDC), the highest number of cases in a decade.

At some universities, documentation of two doses of measles, mumps, and rubella vaccination wasn't available, requiring substantial staff time to verify. The authors also reported difficulty implementing policies for excluding susceptible people from classes and other group settings.

Receipt of two doses was documented for nearly 85% of the infected students or staff, and policies on contact exclusion based on vaccination status might not be enough for outbreak control, the team wrote.

Waning immunity after the second dose is thought to be a contributing factor in mumps outbreaks at colleges, and in 2017 the CDC's vaccine advisory group recommended a third dose for people at increased risk in outbreak settings.

Seven vaccination clinics were held at three of the schools, at which 5,273 doses were administered, and the authors said many of the doses were likely third doses. The group noted that that that availability of an outbreak-specific lab testing protocol possibly increased the overall positivity rate of specimens tested at the state lab, which improved case detection.
Jul 26 MMWR report


CDC wraps up probe into Salmonella outbreak linked to precut melon

The investigation into a Salmonella Adelaide outbreak linked to precut melon has ended with 77 cases reported from nine states, the CDC said today.

Since the last update on Jun 19, seven more cases were confirmed, with two more states reporting cases. The latest illness onset was Jul 2. Thirty-six people were hospitalized, but no deaths were reported.

Epidemiologic and trace-back investigations suggest that precut melon supplies by Caito Foods, based in Indianapolis, is the likely source of the outbreak. Before getting sick, most of the outbreak patients interviewed had eaten cantaloupe, watermelon, or a fruit salad mix bought from grocery stores. The company recalled its products, which were distributed in 22 states, on Jun 8.

The Food and Drug Administration (FDA) said in an update today that an investigation with the CDC and state health officials didn't identify a common source of contamination.
Jul 26 CDC final outbreak update
Jul 26 FDA

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