News Scan for Nov 09, 2018

Polio in Pakistan, Africa
More adenovirus cases in NJ
Zika and congenital brain defects
Slight US flu rise

Pakistan, 3 African countries report more polio cases

In the latest global polio developments, Pakistan reported two new wild poliovirus type 1 cases and three African countries reported seven more vaccine-derived polio cases in their outbreaks, according to today's weekly update from the Global Polio Eradication Initiative (GPEI).

Pakistan's two patients are from Federally Administered Tribal Areas (FATA) province and had paralysis onsets on Sep 1 and Oct 7, respectively. The country has now reported eight polio cases in 2018.

In the Democratic Republic of the Congo (DRC), two new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported, both in Mongala province. One patient is from Yambuku district and had paralysis onset on Sep 5, and the other is from Yamaluka district and had a paralysis onset on Sep 13. The DRC is experiencing circulation of three different cVDPV2 strains in different parts of the country, and so far officials have reported 18 cases this year.

Meanwhile, Niger reported one new cVDPV2 case in Zinder province involving a patient who experienced paralysis onset on Sep 9. The country has now reported seven cases for 2018, and the outbreak strain is genetically linked to a cVDPV2 case from Nigeria. The second of two vaccine campaigns in response to the outbreak is expected to wrap up on Nov 11.

Elsewhere, Nigeria reported four more cVDPV2 cases, all from Katsina state with paralysis onset dates ranging from Sep 26 to Oct 7. The country is experiencing two separate cVDPV2 outbreaks and has now reported 23 cases in 2018.
Nov 9 GPEI update


More adenovirus cases noted in New Jersey—39 total in 2 outbreaks

An adenovirus outbreak recently announced at a second pediatric health facility in New Jersey has been identified as involving type 3, which usually results in milder illnesses than the type 7 strain linked to illnesses in the first outbreak, according to an update today from the New Jersey Department of Health (NJDH).

Since the last update, three more cases in an adenovirus type 3 outbreak at Voorhees Pediatric Facility in Vorhees, N.J., have been confirmed, raising the total to seven. No deaths have been reported.

Meanwhile, 5 more illnesses have been reported in the first and more serious adenovirus type 7 outbreak at Wanaque Center for Nursing and Rehabilitation in Haskell, N.J., raising the total to 32, which includes 31 residents and 1 staff member. The number of deaths remains at 10.

The NJDH continues to investigate the two outbreaks, which appear to be unrelated. It said adenoviruses are common and cause cold-like symptoms, but illness can be serious in those with weakened immune systems or underlying respiratory or cardiac disease.
Nov 9 NJDH update


Brain abnormalities found in almost half of babies during Zika screening

A brain imaging study of babies born with suspected congenital Zika infections in Salvador, Brazil's fourth-largest city, found that, of 365 investigated cases between Apr 2015 and Jul 2016, 166 (45.5%) had congenital brain abnormalities, researchers from Brazil and the United States reported yesterday in Eurosurveillance.

Among 166 babies with positive imaging findings, 143 (86.1%) had intracranial calcifications and 111 (66.9%) had ventriculomegaly. The prevalence of brain abnormalities peaked in December 2015, and babies with confirmed brain abnormalities were more likely to have been born prematurely and to mothers who had Zika symptoms during pregnancy.

When the group looked at how well head circumference screening criteria predicted the presence of brain abnormalities, they found that none of them did an optimal job.

The authors concluded that novel screening methods for congenital Zika syndrome that consider other factors than just head circumference are urgently needed and that prenatal and postnatal ultrasound screening by experienced ultrasonographers may be an efficient option during outbreaks, especially among women who had Zika symptoms during pregnancy. Also, they emphasized that clinical exam and follow-up of newborns are crucial and that better serologic and molecular tests are needed.
Nov 8 Eurosurveill report


CDC sees small rises in US flu activity

The US Centers for Disease Control and Prevention (CDC) today in its weekly flu update reported small increases in activity, with one of the country's regions—the one that covers Iowa, Kansas, Missouri, and Nebraska—rising above its baseline, a first for the new season.

Also, the agency said Maryland and Texas are the first two states to report regional geographic spread of flu. Local activity was reported by Guam and six states: Connecticut, Kentucky, Massachusetts, New Hampshire, North Dakota, and Oregon. The CDC added, however, that 40 states, plus the District of Columbia, Puerto Rico, and the US Virgin Islands are reporting only sporadic flu activity.

All three flu subtypes are circulating, but the 2009 H1N1 virus has been the most commonly detected virus since the end of September.

No new pediatric flu deaths were reported last week, keeping the total at two for the new season.

The CDC urges everyone age 6 months and older to be vaccinated against flu, preferably by the end of October before illness levels start rising—but as soon as possible. According to the latest flu vaccine distribution information, vaccine makers expect to make between 163 million and 168 million doses for the US market, and companies have sent out 151.7 million doses.
Nov 9 CDC FluView report
Nov 9 CDC weekly flu
situation update
CDC flu vaccine distribution

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