News Scan for May 31, 2019

Salmonella and hedgehogs
More pediatric flu deaths
Novel H1N2 flu in Denmark
Polio in Pakistan, Somalia
Honduras dengue

CDC: 10 more people infected with Salmonella linked to hedgehogs

The Centers of Disease Control and Prevention (CDC) yesterday announced 10 more cases of Salmonella Typhimurium illness linked to pet hedgehogs, and 6 more states are affected. The new cases raise the outbreak total to 27 cases in 17 states.

Two people have been hospitalized in this outbreak, but there have been no reported deaths. Forty-two percent of cases involve children aged 12 or younger, the CDC said. In interviews, 90% of patients said they had contact with a hedgehog prior to symptom onset. Illnesses were reported from Oct 22, 2018, to Apr 8, 2019.

"The outbreak strain of Salmonella Typhimurium was identified in samples collected from 10 hedgehogs in Minnesota, including 5 hedgehogs from the homes of five ill patients. A common source of hedgehogs has not been identified," the CDC said.

Minnesota has the most recorded cases, with 5, followed by Missouri (3), and California, Indiana, Virginia, and Wyoming with 2 each. Eleven states have reported 1 case.

The CDC recommends good hygiene when handling pet hedgehogs and says to avoid kissing or snuggling the animals.
May 30 CDC update


CDC records 2 new pediatric flu deaths, 1 variant H1N1 case

Today the CDC recorded 2 new pediatric deaths from influenza in its weekly FluView report, raising the 2018-2019 total to 113. The agency also notes an infection with a variant strain.

The rate of influenza-like-illness (ILI) remained at 1.5%, well before the national baseline of 2.2%, signaling flu is circulating at low levels typically seen in summer months. All 10 regions reported ILI activity below their region-specific baseline levels.

"CDC continues to recommend vaccination as long as flu viruses are circulating until all vaccine expires at the end of June and prompt antiviral treatment in people with flu symptoms who are very sick or who are at high risk of developing serious flu illness," the CDC said in a summary statement last week.

The CDC said the variant influenza A strain, H1N1v, was recorded in a patient in Michigan. The patient is older than 65, has no history of swine exposure, and has fully recovered. This is the first H1N1v case recorded in the United States in 2019.
May 31 CDC FluView report
May 24 CDC FluView


H1N2 seasonal flu reassortant infects Danish woman

European health officials recently reported a novel H1N2 infection in Denmark, a reassortment involving two seasonal flu strains: the 2009 H1N1 virus and H3N2. The original source of the report was the European Union Early Warning and Response System (EWRS), according to a post yesterday on Avian Flu Diary (AFD), an infectious disease news blog.

The latest novel H1N2 case marks Europe's third in just over a year; earlier cases were detected in March 2018 in the Netherlands and in February 2019 in Sweden.

In the Danish case, the sample was collected on Apr 11 as part of routine surveillance. The patient is a 74-year-old unvaccinated woman who had traveled by plane to Croatia, then returned home after also visiting Bosnia and Herzegovina. Her symptoms began after returning to Denmark on Apr 7, and she was hospitalized on Apr 11. She was discharged on Apr 13. It's not clear where she contracted the virus. No other cases have been detected in other contacts or fellow travelers.

A genetic analysis of the novel H1N2 virus found that has a hemagglutinin gene from the 2009 H1N1 virus and a neuraminidase gene from H3N2. No evidence of coinfection was found.

Last year, the US Centers for Disease Control and Prevention (CDC) said in a risk assessment that the reassortant H1N2 virus is similar to other seasonal flu viruses and that current seasonal flu vaccines are likely to offer some protection. It also said the virus doesn't show any markers to suggest resistance to neuraminidase inhibitors.
May 30 AFD post
Feb 6 CIDRAP News scan "Rare H1N2 flu reassortant reported in Swedish adult"
Mar 23, 2018, CIDRAP News scan "Dutch officials report reassortant seasonal flu H1N2 infection"


Polio cases confirmed in Pakistan, Somalia

Pakistan has two more wild poliovirus type 1 (WPV1) cases, and Somalia has one vaccine-derived polio case, according to the Global Polio Eradication Initiative's (GPEI) latest weekly situation report today.

Pakistan has now recorded 19 WPV1 case in 2019, an increase from 2018's total of 12. The two most recent case-patients, from North Waziristan and Khyber Pakhtunkhwa, experienced symptom onset on May 3 and 5, respectively.

In Somalia, the vaccine-derived case of circulating poliovirus type 2 (cVDPV2) was recorded in Togdher, with an onset of paralysis on Apr 22. This is the second cVDPV2 case recorded in Somalia this year.

In addition to the three new cases, the GPEI also reported new positive environmental samples collected in Cameroon and Iran, but no associated cases of paralysis in those countries.
May 31 GPEI report


Almost 7,000 sickened with dengue in Honduran outbreak

Doctors without Borders (MSF) is ramping up its efforts in Honduras, as the country has tallied 6,883 cases of dengue fever since the first of the year.

Sixty-one percent of cases have been recorded in Honduras's Cortes department, and the nearly 7,000 cases include 2,111 cases of severe dengue, MSF said in a press release.

"The behaviour of this epidemic is unusual compared to previous dengue outbreaks," says Deysi Fernandez, MD, MSF's medical activity manager for the dengue response in Honduras. "This epidemic fluctuates, with a high number of cases some weeks and a decrease in other weeks."

MSF said it is engaging in community education and extensive mosquito control.
May 29 MSF press release

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