News Scan for Aug 31, 2018

DRC Ebola total at 116
MERS in Saudi Arabia
More polio in 4 nations
H1N2v case in Ohio
Intercontinental avian flu duck travel

DRC confirms 1 more Ebola case as vaccination level passes 5,000

One more case has been confirmed in the Democratic Republic of the Congo's (DRC's) latest Ebola outbreak, in a patient from Beni, the health ministry said yesterday in its latest update.

The development raises the outbreak total to 116, which includes 86 confirmed and 30 probable cases. Health officials are still investigating 8 suspected cases, including those involving 3 people who died in community settings, a factor known to increase the risk of virus transmission in Ebola outbreaks.

In Beni, Health Minister Oly Ilunga, MD, led city and district officials, as well as other community leaders, on tours of the outbreak response center and the town's Ebola treatment center to give them a better understanding of case management and to respond to community concerns about the epidemic and patient care.

Meanwhile, the World Health Organization (WHO) said in an update today that over the past week contact follow-up has improved, most patients admitted for treatment have received therapeutics within hours of case confirmation, and ring vaccination has reached most contacts of confirmed cases.

The agency urged caution, however, in light of the promising trends, noting that 13 confirmed and probable cases have been reported since its last update on Aug 24, 8 of them in Beni. The WHO also said substantial risks remain from possible undocumented transmission chains; of the 13 most recent cases, 4 were among unknown contacts.

Also, it said sporadic high-risk behaviors in some communities have been reported, such as unsafe burials and reluctance to cooperate with contact tracing, vaccination efforts, and admission to Ebola treatment centers. The WHO added that gaps in infection prevention and control in some community health centers and delays in some patients reaching treatment centers also have the potential to fuel the outbreak.

As of Aug 30, 5,130 contacts and their contacts have been vaccinated. The WHO said 20 patients have now received investigational treatments: 13 mAB114, 5 remdisivir, and 2 zMapp.
Aug 30 DRC update
Aug 31 WHO
outbreak update


Saudi Arabia reports more MERS-CoV cases

Saudi Arabia's health ministry has reported five MERS-CoV cases so far for the month of August, three involving camel contact, according to posts covering epidemiologic weeks 31, 32, 33, and 35.

During the first week of the month, the ministry reported two MERS-CoV (Middle East respiratory syndrome coronavirus) case-patients, a 55-year-old man from Hufoof in the eastern part of the country who recovered and an 82-year-old woman from Tabuk in the far northwest who died from her infection. Both had contact with camels before they got sick.

The following week, officials reported an illness in a 41-year-old man living in Dammam in Saudi Arabia's Eastern province. An investigation also revealed that he had contact with camels before his symptoms began. He has recovered.

In reports for epidemiologic week 33 and 35, the ministry reported infections in an 80-year-old man from the city of Buljorshy in the southwest who died and a 77-year-old man from Alzulfi in in the centrally located Riyadh province who is hospitalized. Investigators found that neither of the men had contact with camels.

The latest illnesses from Saudi Arabia, combined with a travel-related case reported last week from the United Kingdom, appear to lift the global MERS-CoV total to 2,243 cases and the number of deaths from the disease to 795.
Saudi MOH report for week 31
Saudi MOH report for
week 32
Saudi MOH report for
week 33
Saudi MOH report for
week 35
Aug 23 CIDRAP News story "
Traveler from Mideast diagnosed with MERS in UK"


Four countries from 3 parts of the world report more polio cases

In its latest weekly update, the Global Polio Eradication Initiative (GPEI) reported new polio cases in four countries: Afghanistan, Nigeria, the DRC, and Papua New Guinea.

In Afghanistan, one more wild poliovirus type 1 (WPV1) case was reported, involving a patient from Nangahar province who had a Jul 17 paralysis onset. The country has now had 12 WPV1 cases in 2018.

Meanwhile, Nigeria, which is experiencing two separate circulating vaccine-derived poliovirus (cVDPV2) outbreaks, reported three new cases, two from different locations in Jigwa state that had Jun 27 and Jul 24 symptom onsets and one in Katsina state with a Jul 27 illness onset. Nigeria's cVDPV2 total for the year now stands at eight.

The DRC, which is affected by three separate cVDPV2 strains, said two patients who were contacts of negative acute flaccid paralysis case-patients from Mongala province have been classified as case-patients. The country has now reported 13 such cases in 2018.

Elsewhere, Papua New Guinea, which is experiencing a circulating vaccine-derived poliovirus type 1 (cVDPV1) outbreak, reported two new cases, one in Madang province with a symptom onset of Jul 11 and one in Eastern Highland province with a Jul 26 illness onset. The country has now reported six 2018 cVDPV1 cases from four provinces.
Aug 31 GPEI update


CDC confirms new H1N2v flu case, raising season total to 13

For the fourth straight week the US Centers for Disease Control and Prevention (CDC) has confirmed variant H1N2 (H1N2v) flu, this time in a case in Ohio.

The new case involves a child who contracted the disease after exposure to swine at an agricultural fair, which is a common risk factor for variant flu strains. The child is still recovering from the illness but did not require hospitalization, the CDC said in a FluView update today.

The new H1N2v cases bring the total this year to 13, with the most in California (6), followed by Ohio (4) and Michigan (3). Since 2011, the CDC has confirmed only 25 H1N2v cases. The only other variant flu case reported so far this year in the United States was caused by the much more common H3N2v strain, in a patient in Indiana.

"Early identification and investigation of human infections with novel influenza A viruses are critical so that the risk of infection can be more fully understood and appropriate public health measures can be taken," the CDC said.
Aug 31 CDC FluView report


Scientists report international avian flu travel involving wild duck in Alaska

For the fourth time in 7 years scientists have reported international spread of influenza A viruses via migratory birds, this time involving a Eurasian-origin H8N4 virus identified in a northern pintail duck in Alaska, according to a study yesterday in Emerging Infectious Diseases.

The isolate was among 541 samples collected by US Geological Survey scientists from hunter-harvested waterfowl taken in the fall of 2016 in western Alaska. It shared more than 99% of its genetic material with isolates recovered from wild and domestic birds in East Asia from 2006 through 2016. It also shared that genetic closeness with avian flu isolates collected in western Alaska in 2012 through 2015 but not with an H8N4 isolate collected in the state from a northern pintail in 1997.

Those data indicate that the new H8N4 isolate "might represent a previously unidentified or unreported genome constellation," the authors wrote. They added, "Phylogenetic analyses provided support for Eurasian ancestry of this genomic constellation."

The other three reports of intercontinental travel of avian flu viruses involved H16N3, H9N2, and highly pathogenic H5N8.

The researchers conclude, "Evidence for repeated introductions of influenza A viruses into North America by migratory birds suggests that intercontinental dispersal might not be exceedingly rare and that our understanding of viral establishment is incomplete."
Aug 30 Emerg Infect Dis study

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