News Scan for Mar 07, 2019

Saudi MERS cases
Yellow fever in South America
Absenteeism and illness
Flu vaccine and heart attack

Two more MERS cases recorded in Saudi Arabia

Saudi Arabia's Ministry of Health (MOH) recorded two cases of MERS-CoV in young women from Khamis Mushait in an update to its epidemiologic week 10 report.

The first patient is a 33-year-old woman who is listed as a secondary case, meaning she likely contracted MERS-CoV (Middle East respiratory syndrome coronavirus) from another sick person. She did not report recent camel contact, the MOH said.

A 42-year-old woman is also a secondary case with no camel contact. The cases may represent a healthcare-associated outbreak or could have contracted the disease from another patient at home. Khamis Mushait is in far southwestern Saudi Arabia and hasn't seen a MERS case in more than a year.

The newly reported illnesses raise Saudi Arabia's MERS-CoV total this year to 94, including 53 in Wadi ad-Dawasir, which has reported cases linked to healthcare and camel exposure.
Mar 7 MOH report


PAHO: Brazil, in midseason, reporting only 50 yellow fever cases

In the its latest update on yellow fever in the Americas, the Pan American Health Organization (PAHO) said three South American countries have reported cases since December 2018: Bolivia, Brazil, and Peru.

Brazil, which is in the middle of yellow fever season, has recorded 50 cases in humans, including 12 deaths. That number is dwarfed by the previous two yellow fever seasons; in 2016-17, officials confirmed 778 confirmed human cases, including 262 deaths, and 2017-18 saw 1,376 confirmed human cases, including 483 deaths.

The large outbreaks—or waves — were caused by the virus spreading to parts of Brazil with unvaccinated populations, and PAHO said the cases in the current season still represent a geographic shift.

"The occurrence of cases and epizootics in the southern part of the state of Sao Paulo and in the state of Parana indicates the progression of transmission towards the Southeast and South regions of the country, with the possibility of reaching bordering countries such as Argentina and Paraguay," PAHO said.

Bolivia has recorded one yellow fever case so far this year, and Peru has recorded nine, with eight probable cases under investigation.
Mar 6 PAHO update


Gastrointestinal, respiratory illness more common in low-income US families

A study today in Morbidity and Mortality Weekly Report (MMWR) involving national data from 2000 through 2016 found gaps among household incomes, illness, and school absenteeism in American families.

Using data collected from the National Health Interview Survey (NHIS), the researchers found that low-income families (households that made $35,000 annually or less) were more likely to report children having gastrointestinal or respiratory illnesses in the 2 weeks prior to the survey, but those children had a lower likelihood of missing school during the previous year.

"Adjusting for age, sex, and year of survey, children in the lowest income bracket were 4%–12% less likely to miss school (95% confidence interval [CI] = 1%–16%), but 12%–28% more likely to have had a recent gastrointestinal illness (95% CI = 2%–35%)," the study found. "Children in the lowest income bracket were also 6%–11% more likely to have had a respiratory illness, although comparisons with each of the next two highest income brackets ($35,000–$49,999 and $50,000–$74,999) were not statistically different."

The authors suggest that low-income families may send sick children to school more frequently because parents lack jobs with paid sick leave, among other factors.
Mar 8 MMWR study


Study suggests flu shots in hospitalized patients may cut heart attack risk

A large study based on hospital records found an association between getting vaccinated against flu during hospitalization and a 10% lower risk of heart attack in the following year. Researchers are slated to present the findings on Mar 16 at the American College of Cardiology (ACC) annual meeting in New Orleans, according to an ACC news release today.

For the study, the scientists analyzed data from the National Inpatient Sample, which includes records for nearly 30 million adults who were hospitalized in the United States in 2014. First they divided patients into two groups: those who had been immunized against flu during their hospital stay and those who had not. Then they looked at the proportion who were hospitalized for a heart attack or unstable chest pain at any time during 2014.

About 2% of patients had received a flu shot during their hospital stay. Of those who didn't, 4% had a heart attack or unstable angina, compared with 3% of those who had been immunized. The researchers found that the difference was statistically significant, given the large size of the data set, amounting to about 5,000 fewer heart attacks than expected without the vaccine. After adjusting for confounders, the team found that flu vaccination was associated with a 10% reduction in heart attack risk.

Mariam Khandaker, MD, study coauthor and internal medicine resident at Icahn School of Medicine at Mount Sinai St. Luke's in New York City, said in the press release that, as a very low-cost intervention, the flu vaccine is still underused. "It is important for physicians to educate patients about the benefits of vaccination in order to help them make informed decisions. Hospitals are a good venue to do this, in addition to other places such as the primary care clinic," she said.
Mar 7 ACC press release

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