News Scan for Nov 01, 2019

New DRC Ebola infection
Another Saudi MERS case
Polio in 5 countries
Romaine-linked E coli outbreak
US flu remains low

DRC confirms 1 more Ebola case, raising total to 3,273

One new case was reported in the Democratic Republic of the Congo (DRC) Ebola outbreak today, nudging the outbreak total to 3,273, according to numbers reflected on the World Health Organization (WHO) online Ebola dashboard. Health officials are still investigating 500 suspected cases, and the number of deaths held steady at 2,183.

The DRC's Ebola technical committee (CMRE) yesterday had locations for three cases reported yesterday; all were from Mandima health zone. Over the past few weeks, one of the outbreak's last remaining hot spots is the Biakato Mines area in Mandima health zone.

In its weekly snapshot of the outbreak, the WHO yesterday said activity over the past week stabilized, with 19 cases reported for the week ending on Oct 29, similar to the previous week. Most of the recent cases link back to Biakato Mines area, including three detected outside of Mandima health zone in people who had recently traveled from Biakato.

Onward transmission is occurring in a limited number of towns and villages, including seven cases in Mabalako, two of which are linked to Biakato. Butembo—after going 21 days with no new cases—had two cases this week, both of them residents of Kalunguta where they were likely exposed to the virus. So far, there is no evidence of onward Ebola transmission in Butembo, a former Ebola hot spot. But the WHO said the cases highlight the risk of reintroduction and resurgence in areas that have cleared the virus.
WHO online Ebola dashboard
Oct 31 CRME report
Oct 31 WHO update


Saudi Arabia tracks new MERS case in Riyadh

Saudi Arabia today reported another new MERS-CoV case, this time in a man from Riyadh.

According to a Ministry of Health (MOH) statement, the patient is a 58-year-old man from Riyadh with unknown camel contact, a risk factor for Middle East respiratory syndrome coronavirus (MERS-CoV). The MOH classified the man's case as a primary exposure, meaning its unlikely he contracted the disease from another person.

This is the first case recorded in November; Saudi Arabia reported 14 MERS-CoV cases in October, up sharply from 4 reported in September.

The WHO recently reported that, as of Oct 8, it has received reports of 2,470 MERS-CoV cases since 2012, at least 851 of them fatal.
Nov 1 MOH report


Five countries report more polio cases

In the latest polio developments, Afghanistan and Pakistan each reported a new wild poliovirus type 1 (WPV1) case, and three countries reported new vaccine-derived polio cases, according to the latest update from the Global Polio Eradication Initiative (GPEI).

Afghanistan's latest WPV1 case involves a patient from Kandahar province who had an Aug 17 paralysis onset, lifting the country's total for the year to 19 cases — quickly approaching the 21 cases reported for 2018.

In Pakistan, health officials reported another case from Khyber Pakhtunkhwa province whose paralysis symptoms began on Oct 13, lifting the nation's number of cases this year to 77, far exceeding the 12 it reported in 2018.

Elsewhere, the Central African Republic (CAR) reported three vaccine-derived poliovirus type 2 (cVDPV2) cases from three different provinces with paralysis onsets ranging from Aug 20 to Oct 1. The CAR has now had 13 cases this year that are part of five different outbreaks. Angola reported 11 new cVDPV2 cases from four different provinces, and patients' paralysis onsets ranged from Aug 19 to Sep 25. The new illnesses lift the country's total for the year to 29 cases, which are part of seven different outbreaks.

In the Philippines, one new cVDPV2 case was reported, which involves a patient from Mindanao province who had a Sep 12 paralysis onset. The country has now had two such cases this year. Also, health officials reported new detections of both cVDPV2 and cVDPV1 from environmental samples in Manila.
Nov 1 GPEI weekly report


FDA details 23-case multistate E coli outbreak linked to romaine lettuce

The US Food and Drug Administration (FDA) announced yesterday that it and the Centers for Disease Control and Prevention (CDC) have wrapped up an investigation into an Escherichia coli O157:H7 outbreak likely linked to romaine lettuce that sickened 23 people from 12 states.

In a statement, the FDA said the CDC notified the agency of an illness cluster in the middle of September. Affected states include Arizona (3), California (8), Florida (1), Georgia (1), Illinois (2), Maryland (1), North Carolina (1), Nevada (1), New York (1), Oregon (1), Pennsylvania (2) and South Carolina (1). Eleven people were hospitalized, and no deaths were reported. Illness onsets ranged from Jul 12 to Sep 8.

When romaine lettuce was identified as the likely source, data suggested that the outbreak was not ongoing and that the romaine eaten by sick patients was past its shelf life and no longer available for sale, the FDA said. "The FDA is communicating details about the outbreak at this time to help ensure full awareness by the public and to highlight the ongoing importance of industry actions to help ensure the safety of leafy greens," the agency said in the statement.

The FDA's trace-back investigation identified farms in California's Central coast region as the probable source, but the outbreak strain was not found in the many environmental samples that were collected and tested. Though romaine lettuce is the likely source, the probe didn't find a common source or point contamination. Given that no new cases have been reported since Sep 8, the outbreak appears to be over, the FDA added.
Oct 31 FDA statement


Flu activity still low throughout much of US

In its weekly flu update today, the CDC reported that the nation's flu activity rose in the last week but is still at low levels.

As reported last week, the percentage of respiratory specimens that tested positive for flu at clinical labs was 2.4%. Of those specimens, 32.9% were influenza A, and 67.1% were influenza B.

No new pediatric deaths were recorded in the past week. The total number of pediatric deaths this season remains at two. Clinic visits for flulike illness were 1.9%, still below the national baseline of 2.4%.

The low level of flu activity so far is similar to recent seasons, but the CDC said there are a few hot spots, including Louisiana and Puerto Rico. Seven states—Alabama, Connecticut, Georgia, Missouri, South Carolina, Texas, and Virginia—are reporting low levels of flu activity, with the remaining states reporting minimal activity.

"It's too early to characterize the timing of the season, what viruses will predominate, or how severe the season will be," the CDC said. "Flu vaccination is always the best way to prevent flu and its potentially serious complications."
Nov 1 CDC FluView update

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