News Scan for Aug 16, 2019

Polio in 5 countries
PAHO's dengue warning
Invasive pneumococcal disease
Heartland virus in Illinois

Five countries report polio, including first vaccine-derived case in Benin

In new polio developments, Pakistan reported five more wild poliovirus type 1 (WPV1) cases and four African countries reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases, including the first in Benin, according to the latest weekly update today from the Global Polio Eradication Initiative (GPEI).

Pakistan's five cases are all in Khyber Pakhtunkhwa province—three in Bannu district and one each in Charsadda and South Waziristan districts. All of the patients had paralysis onsets in July. The country has now reported 53 WPV1 cases this year, up sharply from the 12 reported in all of 2018.

In Africa, the four countries reporting new cVDPV2 cases are Nigeria, the Democratic Republic of Congo (DRC), Angola, and Benin.

The case in Benin is the country's first and was reported in a patient from Borgou state who had a Jul 7 paralysis onset. The GPEI said a response team is working with country officials to conduct a full field investigation and to assess the risk of local spread and need for a response. It added that the risk of further spread across West Africa remains high.

Nigeria reported two cases in different districts in Kogi state in patients who had Jul 13 and Jul 20 paralysis onsets. The country now has 15 cases for the year.

The DRC has 2 new cases, which involve patients from separate districts of Haut Lomami state, bringing its total for the year to 17. The DRC is experiencing nine separate cVDPV2 outbreaks, two of them in Haut Lomami state.

Elsewhere, Angola reported two more illnesses from different parts of Lunda Norte state, with Jul 1 and Jul 21 paralysis onsets. The country has now reported five cVDPV2 cases this year after recording none in 2018.
Aug 16 GPEI weekly update


PAHO warns of complex dengue situation in Latin America, Caribbean

Yesterday the Pan American Health Organization (PAHO) warned of a complex dengue situation in Latin America and the Caribbean, stating the region is now experiencing a new epidemic cycle of the disease after 2 years of low incidence.

As of Aug 9, more than 2 million people contracted the disease and 723 died in the region since Jan 1. While this number is higher than numbers reported in 2017 and 2018, the case count remains lower than it was in 2015 and 2016.

Experts from PAHO warned that a characteristic of this epidemic is cases prevalent among children under the age of 15 years.

"In Guatemala, they represent 52% of total cases of severe dengue, while in Honduras, they constitute 66% of all confirmed deaths," PAHO said in a press release. "This may be due to the fact that their age means they have been less exposed to the virus in the past and may therefore lack immunity."

PAHO said Nicaragua, Brazil, Honduras, Belize, Colombia, El Salvador, Paraguay, Guatemala, Mexico, and Venezuela have the most dengue activity. Honduras and Nicaragua have both issued national-level epidemiologic alerts.

PAHO said it was encouraging communities to eliminate mosquito breeding grounds in and around homes by removing containers that could hold standing water.
Aug 15 PAHO
press release


Study: A fourth of pneumococcal disease in kids caused by vaccine strains

A study today in Pediatrics shows that 4 to 7 years after the introduction of the 13-valent (13-strain) pneumococcal conjugate vaccine (PCV13) in the United States in 2010, 23.9% of invasive pneumococcal disease (IPD) cases were caused by strains contained in the vaccine.

Overall, however, IPD rates among US children have declined, the study's authors noted.

The research was conducted in eight US children's hospitals by the Pediatric Multicenter Pneumococcal Surveillance Study Group and included 495 pediatric patients with IPD in 2014 to 2017. On average, each hospital saw 120 cases of IPD per year.

"Almost 30% had not received any doses of PCV13 before the IPD episode, although >70% of these children were at an age at the time of the IPD at which they should have received ≥2 doses," the authors said. "Thus, additional cases of IPD might be prevented if PCV13 and PPSV23 [the 23-valent vaccine] are administered to all eligible children according to the recommended schedule."

The authors also said that more than 50% of children sickened with IPD from a non-PCV13 strain had an underlying condition.
Aug 16 Pediatrics


Illinois confirms Heartland virus in Kankakee County ticks

This week the Illinois Department of Health (IDPH) confirmed that ticks collected in Kankakee County tested positive for Heartland virus. The department tested the ticks after a resident from that county became the first person in the state to contract Heartland virus last summer.

"Bites from ticks can result in multiple types of infections, which can cause serious illness in some people," said IDPH Director Ngozi Ezike, MD, in a press release. "It is important to take precautions and protect yourself from tick bites by using insect repellent and checking regularly for ticks when in wooded areas or high grass."

Heartland virus is spread via the bites of lone star ticks. It was first identified in Missouri farmers in 2009. While rare, the virus can be severe, and usually results in hospitalization. Most patients recover, but deaths from the virus have been noted. Treatment is supportive, and there are no current vaccines against the virus.

According to the IDPH, Heartland virus symptoms mimic other tickborne diseases, and include fever, headaches, fatigue, muscle aches, and diarrhea. Symptom onset is usually 2 weeks after a tick bite.
Aug 14 IDPH press release

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