News Scan for Apr 15, 2019

Saudi MERS case
Salmonella melon outbreak
H5 avian flu in 3 countries
Vectorborne disease and climate

Two new MERS cases reported in Saudi Arabia

Saudi Arabia's Ministry of Health (MOH) reported a new MERS-CoV case over the weekend in an update to its epidemiologic week 15 report.

On Apr 13, the MOH noted that a 75-year-old woman from Khafji had contracted MERS-CoV (Middle East respiratory syndrome coronavirus) as a secondary case, meaning likely not from another MERS patient. It's unknown if she had camel contact.

This is the 11th case reported from that city since Mar 29. Her illness lifts Saudi Arabia's total since the first of the year to 130 cases, including 57 linked to a large outbreak in Wadi ad-Dawasir.
Apr 13 MOH update


CDC ties pre-cut melon to 93-case multistate Salmonella outbreak

The Centers for Disease Control and Prevention (CDC) announced late last week a Salmonella outbreak tied to pre-cut watermelon, honeydew melon, cantaloupe, and fruit medley products sold by Caito Foods LLC of Indianapolis.

So far 93 people in nine states have been sickened in the outbreak, caused by Salmonella Carrau. There have been no deaths, but 23 patients have required hospitalization. Illnesses started on dates ranging from Mar 4 to Mar 31, and most of the patients are over the age of 50—the median age is 53, with patients' ages ranging from less than 1 to 93 years.

According to an Apr 12 CDC notice, 30 of 39 people interviewed reported eating pre-cut melons bought from grocery stores in the week prior to illness. Four additional people reported eating pre-cut melon outside the home.

Ohio has reported the most cases, with 27, followed by Michigan (19), Indiana (18), Kentucky (16), and Illinois (5). Both Minnesota and Missouri have three cases, and Alaska and Wisconsin have one case each.

On Apr 12 Caito recalled products produced at an Indianapolis facility. According to the Food and Drug Administration (FDA), "The products were packaged in clear, plastic clamshell containers and distributed in Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Missouri, Nebraska, New York, North Carolina, Ohio, Pennsylvania, Tennessee, West Virginia, and Wisconsin."

Both retailers and consumers are urged to toss the fruit, and Caito has halted production on these types of fruit products until further notice.
Apr 12 CDC
Apr 12 FDA


H5 avian flu poultry outbreaks strike Iran, Nigeria, and Nepal

Three countries reported more highly pathogenic avian flu outbreaks in poultry, with Iran and Nigeria grappling with H5N8 and Nepal with H5N1, according to the latest notifications from the World Organization for Animal Health (OIE).

In Iran, the country's veterinary ministry reported two H5N8 outbreaks, one involving a large flock of village birds in Tehran province and the other affecting a layer farm in East Azarbayejan province. Between the two events, the virus killed 4,278 of 75,000 susceptible birds. Authorities culled the remaining ones to curb the spread of the virus. The outbreaks began on Apr 8 and are now considered resolved.

So far, the source of the virus isn't known. Iran reported its last H5N8 outbreak about a month ago.

Nigeria reported an H5N8 outbreak at a farm housing cockerels and layers in Edo state in the country's southwest. The event began on Apr 5, killing 250 of 1,500 birds. The surviving ones were destroyed as part of the outbreak response. Nigeria's last H5N8 detection in poultry occurred in late January.

And Nepal's agriculture ministry reported another H5N1 outbreak, part of sporadic detections since March. The latest outbreak began on Apr 12 at a layer farm in Bagmati zone, killing 123 of 1,000 birds.
Apr 14 OIE report on H5N8 in Iran
Apr 15 OIE report on H5N8 in Nigeria
Apr 13 OIE report on H5N1 in Nepal


Experts warn of climate-related vectorborne disease spread in Europe

Speakers at a symposium on climate change at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in Amsterdam yesterday warned that the geographic range of mosquito and tickborne diseases is expanding quickly, fueled by multiple factors, including climate change.

The experts predicted that vectorborne disease outbreaks will increase across many parts of Europe over the next few decades, even at previously unaffected higher latitudes and altitudes in Northern Europe, according to an ECCMID news release. They warned that actions are needed to improve surveillance and data sharing and to monitor environmental and climate precursors to outbreaks.

Climate change is only one of many factors, which include globalization, socioeconomic development, urbanization, and changes in land use, said Jan Semenza, PhD, MPH, with the European Centre for Disease Prevention and Control.

Giovanni Rezza, MD, PhD, who directs the department of infectious diseases at the Instituto Superiore di Sanita in Rome, said the stark reality is that longer hot seasons will enlarge the seasonal window for the potential spread of vector-borne outbreak, favoring larger events. "We must be prepared to deal with these tropical infections. Lessons from recent outbreaks of West Nile virus in North America and chikungunya in the Caribbean and Italy highlight the importance of assessing future vector-borne disease risks and preparing contingencies for future outbreaks."

The experts noted that the interplay between multiple drivers makes projecting disease burden challenging, but they said climate change has allowed mosquitoes and ticks to adapt, proliferate, and broach new areas, with examples including dengue outbreaks in France and Croatia, malaria in Greece, West Nile fever in southeast Europe, and chikungunya in Italy and France.
Apr 13 ECCMID press release

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