News Scan for Oct 10, 2018

More polio-like illnesses
Technology against public health threats
Lyme disease in Ontario

Colorado, Pittsburgh, Chicago officials report AFM cases in children

After 6 children in Minnesota were reported to be afflicted with enterovirus-linked cases of acute flaccid myelitis (AFM), officials in Colorado, Pittsburgh, and Chicago are reporting cases. Colorado has had 14 AFM cases since the beginning of the year, while Pittsburgh authorities are reporting 3 recent cases and Chicago 2.

According to the Colorado Department of Public Health and Environment (CDPHE), the state has had 41 cases of enterovirus A71 (EV-A71) infections tied to neurologic illness in children. Of those cases, 14 have involved AFM, a rare polio-like condition. And 11 of those 14 children tested positive for EV-A71, 1 tested positive for EV-D68, and 2 tested EV-negative. The hallmark of AFM is a sudden onset of limb weakness associated with spinal cord inflammation.

"The state health department has been monitoring this situation closely since early spring," the CDPHE said in a news release yesterday. "In addition to investigating the outbreak, the department has issued alerts to health care providers on how to test for the viruses and enhanced guidance to child care centers on infection prevention."

Meanwhile, Children's Hospital of Pittsburgh confirmed three AFM cases yesterday and Chicago officials have reported two cases, Yahoo News reported today. The two Chicago-area children are being treated at Lurie Children's Hospital.

The US Centers for Disease Control and Prevention said on Oct 8 that it has confirmed 38 AFM cases in 16 states through September. In 2014 and 2016 the condition spiked, affecting 120 and 149 children, respectively.
Oct 9 CDPHE news release
Oct 10 Yahoo News report
Oct 8 CIDRAP News story "States and CDC probe reports of rare poliolike symptoms in kids"


Experts recommend 15 cutting-edge tools to combat public health threats

Investing in 15 promising technologies—from ubiquitous genomic sequencing to self-spreading vaccines—could make the world better equipped to prevent future infectious disease outbreaks from snowballing, the Johns Hopkins Center for Health Security said in a new report yesterday.

A team of researchers sought to pinpoint areas in need of technological solutions to address severe pandemics and other global catastrophic biological risk (GCBR) areas. They then detailed technologies that have "significant potential to reduce GCBRs," whether they be "naturally emerging or reemerging, deliberately created and released, or laboratory-engineered and escaped."

"Properties of the technologies needed to prevent or respond to these events are likely to be qualitatively and quantitatively different from those used in routine public health and medical practice," the report authors wrote. "Through this research, we focused on properties that transformative technologies in GCBR reduction might possess." Such devices would have better sensitivity, demonstrate improved capacity, would be rugged and easy to use, and could be developed and deployed fairly quickly.

The experts highlighted promising technology in five groups: (1) disease detection, surveillance, and situational awareness; (2) infectious disease diagnostics; (3) distributed medical countermeasure (MCM) manufacturing; (4) MCM distribution and administration; and (5) medical care and surge capacity.

Under disease detection, the group recommended prioritizing ubiquitous genomic sequencing and sensing, drone networks for environmental detection, and remote sensing of agricultural pathogens. MCM technology included microarray vaccine patches, self-spreading vaccines, ingestible bacteria for vaccination, self-amplifying mRNA vaccines, and drone delivery to remote locations.
Oct 9 Center for Health Security news release
Oct 9 Center for Health Security full report


Lyme disease triples from 2012 to 2017 in Ontario

According to new studies published in the Canadian Communicable Diseases Report (CCDR) 30% of ticks sampled near Ottawa, Ontario, carried the bacterium that causes Lyme disease, and the number of human cases tripled from 2012 through 2017.

The new surveillance data aims to provide more context to the marked rise of Lyme disease in Ontario. Case counts in Canada have increased by a factor of six from 2009 through 2015, mainly in central and eastern regions. In this study, researchers looked at all Lyme disease cases with episode dates from Jan 1, 2012, through Dec 31, 2017, in Ontario and calculated the number and proportion of cases by residence, month of occurrence, age, and sex.

In 2012, there were only 173 confirmed and probable cases in Ontario; by 2017, that number was 959—three times higher than the 5-year (2012-2016) average of 313. Most cases in 2017 were reported in the eastern part of the province, and 59.8% of cases were in men.

"Lyme disease incidence is increasing in Ontario. This trend is likely to continue as climate change progresses and enables blacklegged ticks to survive and propagate in new areas," the authors said.

In another study, researchers collected and sampled black-legged (deer) ticks (Ixodes scapularis) collected from June to October of 2017 at 23 sites in Ottawa municipal parks, recreational trails, and forests. Ticks were found at 16 of the 23 sites (70%).

Thirty percent of the ticks carried Borrelia burgdorferi, the bacterium that causes Lyme disease. Oct 4 CCDR Lyme study
Oct 4 CCDR tick study

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