News Scan for Nov 04, 2019

New Saudi MERS case
Severe Salmonella outbreak
Measles in the Americas
HPV vaccine effectiveness

Secondary MERS case reported in Saudi Arabia

Saudi Arabia yesterday reported another lab-confirmed MERS-CoV infection, the second so far for November.

The patient is a 49-year-old woman from the city of Wadi ad-Dawasir in Riyadh region, located in the central part of the country. Her exposure to MERS-CoV (Middle East respiratory syndrome coronavirus) is listed as secondary, meaning she probably contracted the virus from another patient, according to a statement from Saudi Arabia's Ministry of Health (MOH).

The suspected transmission route hints at possible healthcare or household spread. The woman's illness is the second to be reported in Wadi ad-Dawasir in the past few days. On Oct 31, the MOH reported a MERS case involving a 32-year-old man from the city.

In a recent update on MERS-CoV, the World Health Organization said that, as of Oct 8 it has received reports of 2,470 cases since the virus was first detected in humans in 2012. At least 851 related deaths have occurred. Saudi Arabia has been the hardest-hit country.
Nov 3 Saudi MOH statement


Severe ground beef-linked Salmonella outbreak sickens 10, kills 1

Federal and state health officials are investigating a multistate Salmonella outbreak linked to ground beef that involves the Dublin subtype known to cause severe infections, the US Centers for Disease Control and Prevention (CDC) said in a Nov 1 statement.

So far, 10 cases from six states have been reported: Colorado (3 cases), California (2), Kansas (2), Iowa (1), Oklahoma (1), and Texas (1). Eight people have been hospitalized, and a patient from California has died from his or her infection.

Illness-onset dates range from Aug 8 to Sep 22. Patient ages range from 48 to 74 years old. Eight of the patients are men.

The CDC said the percentage of people hospitalized is much higher than expected for Salmonella infections. For five patients, Salmonella was found in blood samples, a sign of severe disease that often requires hospitalization.

A comparison of surveys among patients who were and weren't sickened in the outbreak suggests ground beef as a potential source. The outbreak strain has been found in leftover ground beef from one of the California patients' homes. Also, routine testing has identified the outbreak strain in six samples from slaughter and processing establishments. However, the investigators haven't identified a single, common ground beef supplier.

Whole-genome sequencing hasn't identified any antibiotic resistance in 16 isolates from 10 sick people or from 6 food samples. Testing of clinical isolates for antibiotic susceptibility is under way as part of the CDC's National Antimicrobial Resistance Monitoring System (NARMS).
Nov 1 CDC investigation notice


Measles up 76% in Americas, PAHO reports

In a recent update on measles activity in the Americas since the end of September, the Pan American Health Organization (PAHO) said the number of confirmed illnesses has increased 76%, with eight countries reporting new cases.

The overwhelming majority were in Brazil, which has reported 4,828 new cases. Other countries reporting additional cases include Venezuela (71), Argentina (26), Colombia (9), the United States (9), Chile (2), the Bahamas (1), and Canada (1).

From the first of the year to Oct 31, the region has reported a total of 11,487 cases in 14 countries, including 15 deaths. The hardest-hit countries are Brazil, the United States, and Venezuela.

Brazil so far this year has reported 14 measles deaths, 1 in Pernambuco state and 13 in Sao Paulo state. Nearly half were in babies younger than 1 year old.
Nov 1 PAHO update


Study: Even 1 HPV vaccine dose protects against worst cervical lesions

Even one dose of human papillomavirus (HPV) vaccine provides almost 50% protection against high-grade cervical lesions—those most likely to turn cancerous—while three doses provided 74% protection, according to a study today in the American Journal of Epidemiology.

When first introduced to female patients 9 to 26 years old in 2006, the HPV vaccine was administered in three doses over 6 months. From 2006 to 2015, thousands of US women received three or fewer doses of the vaccine.

Researchers from the CDC and elsewhere in the Unites States used data from the Human Papillomavirus Vaccine Impact Monitoring Project (HPV-IMPACT) to determine real-world effectiveness of 1, 2, and 3 vaccine doses against cervical lesions involving two strains in the vaccine: 16 and 18 (HPV-16/18).

The researchers compared data from 2008 to 2014 of women who tested HPV-16/18 positive with precancerous lesions (cervical intraepithelial neoplasia grades 2 and 3 and adenocarcinoma in situ (CIN2+) and compared them with HPV-16/18–negative controls. They found the vaccine efficacy of 1, 2, and 3 compared with 0 doses was 47%, 55%, and 74%, respectively.

"Direct comparisons by number of doses among vaccinated women indicated little difference between 1 and 2 doses and nearly 40% greater effectiveness for 3 doses than for 1 or 2 doses," the authors said. "These data provide encouraging evidence that some women who were vaccinated older than the recommended ages of 11-12 years can still receive protection against HPV-16/18associated CIN2+."
Nov 4 Am J Epidemiol study

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