News Scan for Jan 03, 2019

Federal shutdown impact
Flaccid myelitis in Argentina
New Trump science adviser
Surprises about Yemen cholera

Shutdown having limited impact on federal public health activities

The partial government shutdown that began on Dec 22 will have limited impact on most federal public health activities, including flu surveillance and food safety actions, according to official statements and media reports.

Funding for the US Department of Health and Human Services (HHS) continues through September, because it was covered when Congress passed 5 of 12 major appropriations bills, NBC News reported today.

A Food and Drug Administration (FDA) overview on the government funding lapse said agency operations continue to the extent permitted by law, such as those needed to address threats to human life and activities funded by user fees. It said mission-critical actions include monitoring for and quickly responding to foodborne illness and flu outbreaks, recalling high-risk foods and medical products, and screening imported food and medical products.

At the Department of Agriculture (USDA), activities that will continue despite the shutdown include meat, poultry, and processed egg inspections.

Meanwhile, plans at the Department of Homeland Security (DHS) Office of Health Affairs, which monitors infectious-disease, pandemic, and biological threats, specify a scale-back, Kaiser Health News (KHN) reported today. Some DHS professionals are likely to work without pay, including border health inspectors.
Jan 3 NBC News report
Dec 29, 2018, FDA update
Jan 3 KHN story


Acute flaccid paralysis in Argentina in 2016 linked to enterovirus D68

A study yesterday in Emerging Infectious Diseases describes a cluster of 14 suspected cases of acute flaccid myelitis/paralysis (AFM) reported in Buenos Aires from April to August of 2016 and finds a connection between the mysterious disease and enterovirus D68 (EV-D68).

The prospective study analyzed fecal, serum, nasal, and cerebrospinal fluid samples taken from the 14 patients. Six of the 14 were confirmed to have AFP, and 4 of those 6 also tested positive for EV-D68.

The median age of patients with AFM was 3.9 years, and 50% had asthma. All had symptoms of an upper respiratory tract infection in the days prior to AFM symptom onset, which appeared 1 to 11 days after the respiratory symptoms. All confirmed AFM cases showed gray matter lesions on spinal cord imaging.

"Our findings contribute to global evidence of EV-D68 as a possible cause of localized polio-like illness," the authors concluded.
Jan 2 Emerg Infect Dis


Senate confirms Droegemeier as Trump's top science adviser

The US Senate confirmed University of Oklahoma meteorologist Kelvin Droegemeier as the president's top science adviser in a vote on last night, according to media reports.

Droegemeier, an expert on extreme weather patterns, is the first meteorologist to serve as the director of the White House Office of Science and Technology Policy (OSTP). All previous directors have been physicists.

President Donald Trump has not had a formal science adviser thus far in his presidency; Droegemeier was first nominated for the role this summer. Previously, the meteorologist served for 12 years on the National Science Board under Presidents George W. Bush and Barack Obama.

The OSTP is affected by the current government shutdown, with only a handful of essential employees still working. It is not known when Droegemeier will officially begin his new role.
Jan 2 The Oklahoman story
Jan 3 Science


Genetic probe finds surprises in Yemen's cholera outbreak

Genetic analysis of Vibrio cholerae samples from Yemen's cholera outbreak, which has sickened more than 1 million people and is the largest in recent history, suggests the strain came from eastern Africa and entered the country by migration in and out of the region, researchers from the Wellcome Sanger Institute and Pasteur Institute reported yesterday in Nature.

Yemen had two waves in its cholera outbreak: one between September 2016 and April 2017 and another that began later in April 2017. The outbreaks have been linked to at least 2,500 deaths.

The team sequenced 42 samples collected in Yemen and a refugee center at the Saudi Arabia border and compared them with a global collection of more than 1,000 samples from a current and ongoing pandemic, which has been under way since the 1960s and is caused by a single V cholerae lineage, 7PET.

The strain fueling Yemen's outbreak is similar to one first seen in South Asia in 2012 that has spread globally, but it didn't arrive directly from South Asia or the Middle East. Before arriving in Yemen, the strain was circulating and triggering outbreaks in eastern Africa in 2013 and 2014.

Experts had thought that Yemen's outbreaks were caused by two different strains, but the study found they were caused by the same one that entered Yemen in 2016. Another unexpected finding was that Yemen's cholera strain is susceptible to many antibiotics—most that trigger epidemics are resistant to several antibiotics.

Marie-Laure Quilici, PhD, with the Pasteur Institute, said in a Wellcome Trust press release, "This study illustrates again the key role of genomic microbial surveillance and cross-border collaborations in understanding global cholera spread."
Jan 2 Nature abstract
Jan 2 Wellcome Trust press release

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