News Scan for Apr 03, 2019

Ebola Bombali in Kenyan bats
Universal flu vaccine trial
E coli O103 in 4 states
Lassa fever in Nigeria
Waterborne hospital infections

Recently identified Ebola Bombali species detected in Kenyan bats

A new Ebola species first identified in bats last year in Sierra Leone—named Bombali virus— has now been found in bats in Kenya, pointing to wide distribution, given that the two countries are on opposite coasts of Africa. Researchers from Finland, Kenya, and Sweden reported their findings in Emerging Infectious Diseases.

The discovery of Bombali ebolavirus last year marked the sixth known species, three of which have been proven to trigger large outbreaks in humans. In Sierra Leone, Bombali ebolavirus was found in the saliva and feces of Angolan free-tailed bats, an insect-eating species, but so far there's no evidence that it can be transmitted to people.

As noted in the new report, the researchers found the virus in the same bat species captured in the Taita Hills in southeast Kenya. No Ebola viruses had ever been found before in wildlife from Kenya or any other east African country. The team found high levels of Bombali ebolavirus in bat tissues, including the virus's full genome, suggesting that active infection occurs. The bats also had antibodies to the virus.

To look for any signs of infection in people, the researchers screened febrile patients who had contact with bats and were seen in Taita Hills clinics. No evidence of Bombali ebolavirus infection or past infection was found.

Bombali ebolavirus is likely to be transmitted across much of sub-Saharan Africa, though Angolan free-tailed bats aren't thought to travel large distances, the group wrote. Tarja Sironen, PhD, study coauthor who is from the University of Helsinki, said in a press release from the school, "This finding increases our understanding about ebolavirus diversity and geography, and highlights the role that insectivorous bat species may play, in addition to fruit bats, for ebolavirus maintenance in nature."
Mar 28 Emerg Infect Dis study
Apr 2 University of Helsinki
press release
Jul 27, 2018, CIDRAP News story "
New Ebola species identified in Sierra Leone"


NIH launches first human trial of universal flu vaccine candidate

Scientists at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), launched the first human trial of H1ssF_3928, an experimental universal flu vaccine.

The trial will test the vaccine's safety and tolerability, as well as its success in eliciting an immune response.

"Seasonal influenza is a perpetual public health challenge, and we continually face the possibility of an influenza pandemic resulting from the emergence and spread of novel influenza viruses," said NIAID Director Anthony S. Fauci, MD. "This Phase 1 clinical trial is a step forward in our efforts to develop a durable and broadly protective universal influenza vaccine."

The trial will include 53 healthy adults ages 18 to 70. A group of 5 participants will receive a single 20-microgram (mcg) intramuscular injection of the experimental vaccine, while the remaining 48 will receive two 60-mcg vaccinations spaced 16 weeks apart.

The vaccine was developed to include the stem of hemagglutinin (HA), an influenza protein. The head of HA is subject to change each year depending on circulating viruses, but the stem remains the same. H1ssF_3928 was created using the stem of the H1N1 virus.
Apr 3 NIH press release


E coli O103 tied to 44 cases in Kentucky, spread to 3 other states

Escherichia coli O103 has infected at least 44 people in Kentucky—24 more than were reported on Mar 29—and has also spread to Tennessee, Ohio, and Georgia, Kentucky officials said today, according to an NPR story.

The possible culprits are beef, chicken, and sliced American cheese, said Mel Bennett, MD, MPH, the manager of the Infectious Disease Branch of the Kentucky Department for Public Health. Six of the 44 patients have required hospitalization. E coli O103 is much less common that the O157:H7 strain, which causes the most foodborne disease illnesses. The 44 Kentucky cases would make it the largest O103 US outbreak since 2000, NPR reported.

Bennett also said the outbreak has spread to the three other states and that Kentucky health officials have been in daily contact with the Centers for Disease Control and Prevention (CDC).

Doug Hogan, spokesperson for the Kentucky Cabinet for Health and Family Services, said cases are spread across several counties, with five confirmed in Fayette County. Some sort of food distribution service may be the root cause, he said. Bennett said some early reports indicated fast food as a primary source of concern.
Apr 3 NPR story


Lassa fever outbreak reaches 500-case milestone in Nigeria

In its latest update on the ongoing Lassa fever outbreak, officials from the Nigerian Centre for Disease Control (NCDC) said today that 15 newly recorded cases raise the outbreak total to 510 cases.

The outbreak began on Jan 1, and so far 119 people have died, resulting in a case-fatality rate of 22.9%. Twenty-one states have at least one confirmed case, with the majority of sicknesses occurring in Edo and Ondo states.

Nigeria has traced case contacts extensively, as some human-to-human transmission has been described in the outbreak.

"A total of 6,320 contacts have been identified from 20 States," the NCDC said. "Of these 1,567 (24.8%) are currently being followed up, 4,690 (74.2%) have completed 21 days follow up, while 8 (0.1%) were lost to follow up. 110 (1.7%) symptomatic contacts have been identified, of which 55 (1.0%) have tested positive," the NCDC said.

Lassa fever is endemic in Nigeria. Most case-patients contract the virus after coming into contact with rodent excreta.
Apr 3 NCDC update


Study: 20% of healthcare-acquired infections are waterborne  

A study today in Infection Control & Hospital Epidemiology examined CDC healthcare infection consultations from 2014 to 2017 and found that 21.6% involved potentially waterborne pathogens.

A total of 1,380 patients (in 134 investigations), with an average of 10.3 affected patients per investigation, were involved in possible water-related healthcare-acquired infections (HAIs).

Nontuberculous mycobacteria were involved in the greatest number of investigations (29.9%). Investigations usually involved medical products (35.8%), and most of these products were medical devices (83.3%), the authors said.

Inpatient facilities represented 70.1% of requested HAI consultations, followed by outpatient (19.4%) and long-term care (14.9%) facilities.

"A large proportion of water-related HAI investigations involved surgery (17.9%) or a medical device (29.9%). In the presence of surgical incisions, injections, and invasive devices, normal surface and mucosal host defenses are breached, potentially leading to invasive infections," the authors concluded.

"As more invasive medical procedures are transitioned from the inpatient to the outpatient setting, patients at risk for becoming infected with water-related organisms are increasingly being exposed in ambulatory settings."
Apr 3 Infect Control Hosp Epidemiol study

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