News Scan for Aug 02, 2018

Ebola species in DRC
Gaps in school crisis plans
Rat lungworm infection
Longhorned tick in Pennsylvania
Latent TB treatment
Trump's science adviser

DRC confirms Ebola species as Zaire in latest outbreak

The Democratic Republic of the Congo's (DRC's) ministry of health confirmed that the new Ebola outbreak in the eastern reaches of the country is caused by the Zaire Ebola virus species, according to Science magazine.

The Zaire species was also the cause of the recent outbreak 2,500 kilometers (1,550 miles) away, in Mbandaka, DRC. Officials declared that outbreak over 1 week ago. A total of 54 cases of Ebola were confirmed in the earlier outbreak, including 33 fatalities.

So far four people have been confirmed as having Ebola in the latest outbreak, with as many as 20 more suspected illnesses near the village of Mangina, which is about 30 kilometers (19 miles) from the city of Beni. The area is near the Uganda border, and home to nearly 1 million displaced people.

"Ebola is a constant threat in the DRC," said World Health Organization Director-General Tedros Adhanom Ghebreyesus, PhD, on Twitter yesterday. "What adds to our confidence in the country's ability to respond is the transparency they have displayed once again."

This is the DRC's tenth Ebola outbreak since 1976. So far DRC officials have not said if Merck’s experimental Ebola vaccine, which targets the Zaire strain, will be deployed in this outbreak.  More than 3,000 people received the vaccine during the earlier DRC outbreak.
Aug 2 Science article
Tedros Adhanom Ghebreyesus Twitter account


Survey finds gaps, regional differences in school district crisis plans

A review of how well school districts are prepared to manage disasters, including pandemic influenza, found gaps in achieving goals set by the federal Healthy People 2020 plan, scientists from the US Centers for Disease Control and Prevention (CDC) reported today in Morbidity and Mortality Weekly Report (MMWR).

The researchers looked data from 2006, 2012, and 2016 from the School Health Policies and Practices Study, a national survey periodically conducted by the CDC to assess school health policies. Across the three intervals, the number of school districts samples ranged from 461 to 697, with response rates from 64% to 66.5%.

The investigators found that district requirements for crisis plans varied by urbanicity. In 2016, large districts were significantly more likely than small districts to provide funding or offer crisis training preparedness for faculty, staff, and students' families. The number of districts requiring schools to include family reunification procedures in their plans rose in suburban areas from 2006 to 2016, but the percentage of districts that requires schools to include pandemic influenza or other disease outbreaks in their plans decreased in rural areas and in the South.

For crisis training funding for faculty and staff, researchers saw regional differences, with districts in the South less likely to allocate support for the efforts compared with schools in the Midwest. And schools in the Midwest were less likely to offer crisis training for students' families than their counterparts in the Northeast, South, and West.

Though most districts have plans to address mental health needs and family reunification after an emergency, one in four fall short, and one in three don't have policies in place to prepare for infectious disease outbreaks, according to the repot. "Because schools often function as community hubs, these gaps in preparedness planning leave communities potentially vulnerable to critical public health threats," the authors wrote.

They concluded that the report's findings highlight the need for wider adoption of policies on family reunification, pandemic influenza and other infectious diseases, and provisions for students and staff with special needs, especially in rural areas.
Aug 3 MMWR report


Study details locally acquired rat lungworm infections in US patients

Health providers, especially in the southern United States, should consider angiostrongyliasis, a brain infection caused by larvae from the rat lungworm (Angiostrongylus cantonensis) parasite, in patients with eosinophilic meningitis, especially those have a history of eating snails or slugs or fresh produce contaminated with their larvae, according to a separate MMWR report today.

A team from the CDC and its partners in Alabama, California, Colorado, Georgia, Tennessee, Texas, and Utah described 12 angiostrongyliasis cases that occurred in the continental United States from January 2011 through January 2017.

Six of the cases were likely contracted in the United States, and six of the patients had eaten raw vegetables, three from local gardens. Two had consumed raw snails, and two others had potential environmental exposure to snails. One had eaten slugs, and one had possible exposure to slugs. Some of the patients had eaten shrimp or crab, mainly cooked.

Eleven of the patients received systemic steroids, as recommended, and seven got an antiparasitic drug. All but one of the patients was alive 11 months after the initial exam. Symptoms improved for all 11, but 4 had lingering neurologic symptoms.
Aug 3 MMWR report


Longhorned tick found in 7th state: Pennsylvania

The invasive longhorned tick has now been found in seven US states, after the Pennsylvania Department of Agriculture (PDA) reported the tick on a wild deer in Centre County this week.

Tests by the National Veterinary Services Laboratory in Ames, Iowa, have confirmed the presence of Haemaphysalis longicornis, the PDA said in a news release. The tick, originally from Asia, is known to carry several diseases in hogs and cattle in indigenous regions, but so far ticks examined in the United States don't carry any infectious pathogens, the PDA said. The longhorned tick can also transmit human disease but has not been associated with any in this country.

"Even experts have difficulty distinguishing among tick species, so it is important to take precautions to protect pets, livestock and family members from becoming a host for ticks of any kind," Pennsylvania State Veterinarian David Wolfgang, DVM, said in the release. "Scientists don't yet know how this species will adapt to the North American climate and animal hosts, but we know it survived New Jersey's winter and has infested sheep and cattle in this region."

The tick can reproduce without male fertilization—essentially clone itself—and a single blood-fed female tick can create an entire localized population. After initially being identified in New Jersey last September, it has since been confirmed in Arkansas, Virginia, West Virginia, North Carolina, and New York state.
Jul 31 PDA news release


Short-term treatment yields better outcomes for latent TB, study says

A study today in the New England Journal of Medicine suggests that a 4-month course of rifampin is more effective in treating latent tuberculosis (TB) than the standard 9-month treatment with isoniazid (INH), because patients are more likely to adhere to the treatment.

Latent TB does not cause symptoms but can be dormant inside a person for years before causing serious health problems. The study followed more than 6,800 adults and 850 children diagnosed as having latent TB.

More than 85% of children who received rifampin completed treatment without developing an active TB infection, compared with 76% of children treated with INH. The difference in completion rates between the rifampin and INH groups in adults was 15.1 percentage points.

According to the study, among the 3,443 adult patients in the rifampin group, active TB developed in 4 patients and clinically diagnosed active TB developed in 4 during 7,732 person-years of follow-up, as compared with 4 and 5 patients, respectively, among 3,416 patients in the INH group during 7,652 person-years of follow-up.

Rates of adverse events were similar in treatment groups, seen in fewer than 5% of participants.

"The four month treatment was as effective in preventing TB, safer and more acceptable," said study leader Dick Menzies, MD, in a McGill University press release. "We believe this four month rifampin treatment should replace the nine months on INH for most people who need therapy for latent TB." Menzies is a researcher at the McGill International TB Centre.
Aug 2 N Engl J Med
Aug 1 McGill University press release


Trump names meteorologist as science adviser

President Donald Trump named Kelvin Droegemeier, PhD, to be director of the federal Office of Science and Technology Policy. Trump had delayed naming a science adviser since his inauguration in January of 2017.

According to the White House, Droegemeier currently serves as the vice president for research and the regent's professor of meteorology at the University of Oklahoma. He previously served two terms on the National Science Board under presidents George W. Bush and Barack Obama. He is a fellow of the American Meteorological Society and American Association for the Advancement of Science.

According to The New York Times, Droegemeier is well-respected among fellow meteorologists and scientists, and has conducted pivotal research on short-term storm systems. 

His views on climate change, however, are not well known. Scientists have routinely criticized the Trump administration as being anti-science and have objected to the president's withdrawal of the United States from the Paris climate agreement.
Jul 31 White House
Aug 1 New York Times article

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