News Scan for Nov 02, 2018

Polio in 4 countries
Avian flu in Minnesota, Vietnam
Testing for very resistant TB
New CWD type in moose?

Four nations report total of 9 new polio cases

Afghanistan officials have reported 3 new cases of wild poliovirus 1 (WPV1), while Papua New Guinea (3 cases), Nigeria (2 cases), and the Democratic Republic of the Congo (DRC, 1 case) have all reported cases involving circulating vaccine-derived poliovirus (cVDPV), according to a weekly update today from the Global Polio Eradication Initiative (GPEI).

The WPV1 cases in Afghanistan were in Nuristan province in the east and Kandahar and Helmand provinces in the south. Onset of paralysis ranged from Sep 24 to Oct 2. The country has now logged 19 WPV1 cases this year, compared with 8 at this point last year and 14 for all of 2017. The only other country that has reported WPV1 cases this year is Pakistan, which has had 6.

The three cVDPV cases in Papua New Guinea involved the cVDPV1 strain and were also in separate provinces: Jiwaka, Gulf, and Southern Highlands, with dates of paralysis onset varying from Aug 20 to Sep 8. The country has now had 21 cVDPV cases, compared with none in 2017.

Nigeria's and the DRC's cases involved the type 2 circulating strain, cVDPV2.

In Nigeria, one cVDPV2 patient, in Katsina state, first experienced paralysis on Sep 18. The other, in Borno state, had paralysis begin on Sep 25. The country has now reported 19 cVDPV cases so far this year, after having none cases last year. The cVDPV2 case in the DRC was in Mongala province, with a paralysis-onset date of Aug 9. The DRC has had 16 cVDPV cases in 2018, compared with 10 at this point last year and 22 by the end of the year.

The GPEI also said that officials have confirmed 4 WPV1-positive environmental samples in Afghanistan and 7 in Pakistan. In addition, 3 environmental samples tested positive for cVDPV1 in Papua New Guinea, and 4 in Somalia tested positive for cVDPV2.
Nov 2 GPEI update


Low-path H5N2 avian flu found in Minnesota, high-path H5N6 in Vietnam

Minnesota has reported a second detection of low-pathogenic H5N2 avian flu this fall in turkeys, while officials in Vietnam have confirmed highly pathogenic H5N6 in a village flock.

H5N2 was found by routine surveillance testing in a turkey flock in Stearns County, the Minnesota Board of Animal Health (MBAH) said in a news release yesterday. "All flocks are tested for influenza before they are moved to market, and this finding was part of the everyday process of ensuring a safe food supply and protecting Minnesota’s poultry industry from the spread of influenza.”

The flock of 13-week-old hens has been quarantined and will be tested until MBAH officials determine it is free of avian flu and can be sold. "This is not the same strain of virus that impacted Minnesota and other states in 2015, and thus the Board's response is different," the MBAH said. "This strain of influenza in poultry does not pose a public health risk or food safety concern." The 2015 H5N2 strain was of the highly pathogenic variety and decimated many Minnesota turkey farms.

On Oct 22 Minnesota officials detected low-pathogenic H5N2 on a turkey farm in neighboring Kandiyohi County.
Nov 1 MBAH news release
Oct 23 CIDRAP News scan on previous Minnesota detection

In Vietnam, H5N6 struck village poultry in Phu Yen province in the southern half of the country, according to a report today from the World Organization for Animal Health (OIE). The virus killed 1,000 of 2,900 susceptible birds, and authorities culled the remainder of the flock to prevent further disease spread. The country's most recent previous report involving the strain was on Oct 18.
Nov 2 OIE report on Vietnam

Study finds pyrosequencing tied to much earlier treatment for MDR-TB

California Department of Public Health (CDPH) investigators found that patients with multidrug-resistant tuberculosis (MDR-TB) had effective treatment begun 5 weeks earlier when pyrosequencing (PSQ) was used to detect resistance mutations than when it was not, according to a study yesterday in Clinical Infectious Diseases.

The CDPH began using PSQ in 2012 to detect mutations associated with resistance to isoniazid, rifampin, quinolones, and injectable drugs in Mycobacterium tuberculosis bacteria. For the study, the researchers used PSQ to test 1,957 specimens collected from Aug 1, 2012, through Dec 31, 2016.

Among 36 patients with MDR-TB who had a sediment specimen submitted for PSQ, the median time from specimen collection to MDR-TB treatment initiation was 12 days—versus 51 days when PSQ was not used. In addition, among 303 TB patients who completed a survey, 126 clinicians (42%) reported PSQ as a reason for treatment change.

The authors conclude, "Survey data suggest clinicians use PSQ to devise effective TB drug regimens. To maximize the benefit of PSQ, earlier submission of specimens should be prioritized."
Nov 1 Clin Infect Dis abstract


Chronic wasting disease found in three moose in Norway may be novel

Chronic wasting disease (CWD) has been identified in three wild moose in Norway, and tests suggest that the cases may involve a novel form of the disease, according to a report published yesterday in Emerging Infectious Diseases.

CWD afflicts cervids (deer, elk, and moose) in North America, but no European cases were found until 2016, when the disease was identified in a reindeer in Norway, notes the report by an international team of researchers. The disease is one of the transmissible spongiform encephalopathies, which are fatal brain diseases characterized by misfolded prion proteins.

The cases were detected in central Norway through a surveillance program in which more than 10,000 moose were tested. All three animals were older—13- and 14-year-old females. Two of them showed abnormal behavior with reduced fear of humans; one of these was emaciated, and the other had a dislocated hip. The third moose was found dead of trauma, but necropsy showed its body was otherwise in normal condition.

The researchers said they detected abnormal prion protein in brain tissue from all three moose but not in lymphoid tissue. Immunohistochemistry studies showed that the moose all had the same neuropathologic phenotype, involving intraneuronal deposition of the prion protein. "This pattern differed from that observed in reindeer and has not been previously reported in CWD-infected cervids," the team reported.

In addition, Western blot tests revealed a type of prion protein that differed from those in previous CWD cases and known ruminant prion diseases in Europe, with the possible exception of one strain found in sheep. "These findings suggest that these cases in moose represent a novel type of CWD," the report says.

Although CWD has been found in several captive and wild cervid species in North America, fewer than 10 cases have been reported in moose, the researchers said. They also noted that a case was recently detected in a moose in Finland. CWD transmission studies now under way in rodents should help to clarify whether the disease found in the Norway moose reflects the presence of a new cervid prion strain, they added.
Nov 1 Emerg Infect Dis report

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