News Scan for Apr 30, 2019

Final turkey Salmonella update
Global measles outbreaks
Korean flu resurgence
Combo flu infections
HPV vaccine gaps
Pakistan polio vaccination pause

CDC: 79 more illnesses in multistate outbreak linked to raw turkey

The US Centers for Disease Control and Prevention (CDC) today posted a final investigation update for a Salmonella Reading outbreak that it first announced in July 2018, which reflects 79 new cases since its last report in February, lifting total cases to 358 in 42 states.

The latest illness onset was Mar 31, and though the number of illnesses has declined, cases still continue to be reported, the CDC said. Investigations over the past months have found that the multidrug-resistant Salmonella strain is present in live turkeys and many types of raw turkey products. Several products, including raw ground turkey and raw turkey pet food, were recalled, but health officials have said they don't account for all of the illnesses, and a single common supplier has not been identified. Federal health officials have shared the information with turkey industry representatives.

Of the 302 people with available information, 133 (44%) were hospitalized and 1 death was reported. Of patients interviewed, 130 (65%) got sick after eating turkey products that were purchased raw, and 4 became ill after pets in their homes ate raw ground turkey pet food. Five worked in facilities that raise or process turkeys. In February, 47 people in Iowa got sick after eating turkey that wasn't prepared properly at an event, the agency said.

The CDC said it continues to monitor for more cases, interview sick people, and analyze Salmonella isolates for antibiotic resistance patterns. It added that it will provide future updates if there is an increase in new cases. The agency urges consumers to treat raw turkey properly, such as washing hands before and after handling the products and cooking the products thoroughly.
Apr 30 CDC final outbreak update


Philippines, Nigeria report growing measles outbreaks

The Philippines will launch a measles vaccination campaign when school starts the first week of June, to target millions of elementary age children, the nation's department of health announced today, according to GMA News.

Of 8.5 million elementary school children, only around 944,000 have been immunized from measles since February. In January, the country saw the beginning of a large-scale measles outbreak, with more than 31,000 cases recorded from Jan 1 to Apr 13.

Although 93% of children under age 5 years and 42% of those 12 and older, have been vaccinated in the last several months, national campaigns missed elementary school children because the campaign was launched at the end of the school year, then students went on break.

The Philippines, Ukraine, Israel, and other nations are experiencing measles outbreaks that have resulted in imported cases in the United States.

Also, the World Health Organization's (WHO's) African regional office said Nigeria is still facing a growing measles outbreak, concentrated in Borno state. Since Jan 1, a total of 20,127 cases and 50 deaths (case-fatality rate, 0.25%) have been recorded in the country. Borno state accounts for 48.4% of cases.

Borno, Katsina, and Yobe states have launched or will soon launch extensive vaccination campaigns, the WHO said.

"The measles outbreak in Nigeria is occurring at a time when there is a global rise in measles cases. The high incidence and recurrent outbreaks of measles are linked to sub-optimal immunization coverage," the WHO said.
Apr 30 GMA News
Apr 28 WHO African Regional


WHO: Second wave of flu seen in South Korea

According to the latest global flu update from the WHO, flu activity is decreasing in most regions in the Northern Hemisphere, but hot spots remain.

Countries in North America, Europe, North Africa, and most of West Asia are recording fewer flu cases, the WHO said. In those regions, H3N2, an influenza A strain, was predominant in the 2018-19 flu season. An exception in the WHO West Asian region is Saudi Arabia, which is still reporting high levels of influenza and respiratory illness.

In East Asia, influenza activity was reported in some countries, with influenza B viruses most frequently detected, followed by H3N2.

"In the Republic of Korea, influenza activity continued to increase with influenza B most frequently detected followed by influenza A(H3N2) viruses, after a first wave of influenza activity predominated by influenza A(H1N1)pdm09 virus," the WHO said.

Of global flu specimens tested in the first half of April, 83.9% were typed as influenza A and 16.1% as influenza B. Of the influenza A viruses, 32.8% were H1N1 and 67.2% were influenza H3N2.
Apr 29 WHO


Study: Coinfection with multiple flu viruses linked to cardiopathy, death

Coinfections with multiple influenza subtypes at the same time is linked to more severe outcomes, according to a study yesterday in The Journal of Infectious Diseases.

The study was based on specimens collected from 34,459 patients with respiratory infection from 2009 to 2018 in Rio Grande do Sul, Brazil, of which 8,011 were positive for influenza A or B viruses. Eighteen of the cases showed dual infections with two influenza strains, and one case showed a triple influenza strain infection.

The 19 coinfection cases were compared with 76 mono-infected controls. No difference was seen in flu vaccine uptake in either group. And although hospitalization rates were similar for both groups, co-infected individuals were more likely to be admitted to an intensive care unit (33.3% vs 13.6%).

"Conjunctivitis (21.0% vs. 7.3%) and low oxygen saturation (26.3% vs. 14.5%) were more frequent among coinfected than mono-infected patients," the authors concluded. "Cardiopathy was more common among coinfected than mono-infected patients (35.3% vs.13.3%, p=0.035). In total, 21.1% of the coinfected and only 5.3% of mono-infected patients deceased."
Apr 29 J Infect Dis study


HPV vaccine coverage rates lag behind 2020 goal

During the Pediatric Academic Societies (PAS) 2019 meeting last week and this week, researchers presented data showing that, despite increasing uptake trends, human papillomavirus (HPV) vaccination rates in the United States fall far below the Healthy People 2020 goal of 80% coverage.

Researchers used data from a cohort study of 7.5 million children and adolescents to compare vaccine rates in 2011 to 2016. Children were enrolled at age 9 and followed through their first dose of HPV vaccine, death, end of insurance coverage, or the end of the year when they turned 17.

HPV vaccine coverage among girls and boys by age 15 increased from 38% and 5%, respectively, in 2011, to 54% and 45%, respectively, in 2016. 

"The HPV vaccine uptake varied substantially across states and, by 2016, it was above 60% for 15-year-old girls and boys only in 13 and three states, respectively," according to a PAS press release.
Apr 27 PAS
press release


Attacks prompt pause in Pakistan polio vaccination

A dramatic spike in deadly attacks on Pakistan's polio workers and police officers who protect them has led the country to suspend a polio vaccination campaign that had a goal of immunizing 40 million children under age 5, according to media reports.

Pakistan is one of three countries in which wild poliovirus is still endemic, and the attacks and the halt in vaccination activities mark the latest setback in eradicating the disease. The country has reported six wild poliovirus type 1 (WPV 1) cases so far this year.

Two police officers accompanying polio teams were killed in separate attacks in different locations this month, and over the past several days, polio workers have been attacked in four different locations, with a 35-year-old woman shot and killed in one of the incidents, The Guardian, a UK newspaper, reported today.

According to the report, the violence was preceded by rumors and a viral video that circulated on Facebook of a man claiming that children were getting sick after the polio vaccinations, which prompted thousands of children to be taken unnecessarily to hospitals by worried parents.
Apr 30 Guardian story

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