News Scan for Mar 13, 2020

US flu levels rise a bit
Ebola milestone in DRC
MERS case in Qatar
Polio cases in 4 nations
San Fran meat antibiotics ordinance

US flu activity ticks upward, and 8 more pediatric deaths reported

US levels of clinic visits for influenza-like illness (ILI), after falling for 3 straight weeks, rose slightly last week, but the increase might be related to concerns over COVID-19, according to the latest FluView report from the Centers for Disease Control and Prevention (CDC), and the flu season continues to take a toll on children.

The CDC confirmed eight new flu-associated pediatric deaths during the week ending Mar 7.

"Pneumonia and influenza mortality has been low, but 144 influenza-associated deaths in children have been reported so far this season," the CDC said. "This number is higher for the same time period than in every season since reporting began in 2004-05, except for the 2009 pandemic."

The overall cumulative flu-associated hospitalization rate increased to 61.6 per 100,000 population, which is higher than all recent seasons at this time of year except for 2017-18. Hospitalization rates in children 0 to 4 years (88.9 per 100,000 population) and adults 18 to 49 years (32.8 per 100,000 population) are now the highest the CDC has on record.

All regions reported a percentage of outpatient visits for ILI above their region-specific baselines. Nationally, the rate of outpatient visits for ILI increased from 5.1% to 5.2%—still well above the national baseline of 2.4%.

High ILI activity was reported in New York City, Puerto Rico, and 41 states, up from 40 the previous week. The number of regions reporting widespread or regional flu activity fell from 51 to 50. The CDC also noted that the largest increases in ILI activity occurred in areas of the country where the pandemic coronavirus disease COVID-19 is most prevalent.

"More people may be seeking care for respiratory illness than usual at this time," the CDC said.

Testing by public health laboratories shows that 55.2% of the circulating viruses tested since Sep 29, 2019, are influenza A, and 44.8% are influenza B. The most common influenza A viruses are 2009 H1N1 (92.2%), while 98.4% of influenza B samples belong to the Victoria lineage.
Mar 13 CDC FluView report


DRC reaches Ebola milestone: 21 days with no new cases

The Democratic Republic of the Congo (DRC) has reached 21 days with no new cases of Ebola virus disease (EVD), a promising milestone in the nation's longest outbreak, which began in August of 2018.

"On 9 March, the last 46 contacts finished their follow-up," the World Health Organization (WHO) wrote in an update. "These are important milestones in the outbreak as over one maximum incubation period has passed without any confirmed cases of EVD. However, there is still a high risk of re-emergence of EVD, and a critical need to maintain response operations."

According to the WHO, the outbreak total stands at 3,444 cases in 29 health zones in northeastern DRC. The outbreak includes 2,264 fatalities (overall case fatality rate. 66%). Of the total confirmed and probable case-patients, 56% (1,931) were female, 28% (975) were children, and 5% (171) were healthcare workers, the WHO said.

The next milestone will be when the DRC completes 42 days with no new cases, or two Ebola transmission cycles, and the country can officially be called Ebola-free. Though two effective vaccines were deployed during this outbreak, the disease spread in part because the outbreak region is home to a mobile population and thousands of militia who targeted medical responders in violent attacks that halted response work for weeks at a time.
Mar 12 WHO update


New case of MERS recorded in Qatar

The WHO yesterday said Qatar has a new confirmed case of MERS-CoV (Middle East respiratory syndrome coronavirus) infection.

The patient is a 65-year-old man from Doha who developed symptoms on Feb 9 and was hospitalized the same day. He tested positive on Feb 17, but the WHO does not say why his case was not reported earlier. The man had a history of close camel contact in the 2 weeks before falling ill, a known risk factor for MERS transmission.

He has underlying medical conditions, including diabetes, high blood pressure, obesity, and heart disease. He is in critical condition in an intensive care unit.

Since 2012, Qatar has reported 23 human cases of MERS-CoV, the WHO said. From October 2012 through Mar 5, the total number of laboratory-confirmed MERS-CoV infection cases reported globally to WHO is 2,521, including 866 associated deaths. The vast majority of cases have been in Saudi Arabia.
Mar 12 WHO update


Pakistan, African countries report more polio cases

Four countries—Pakistan and three African nations—reported new polio cases over the past week, according to the latest update from the Global Polio Eradication Initiative (GPEI).

Pakistan reported 4 wild poliovirus type 1 (WPV1) cases, 1 each in Khyber Pakhtunkhwa and Balochistan provinces, and 2 in Sindh province. The country has now reported 25 cases in 2020.

In Africa, Angola, the DRC, and Ghana all reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases. Angola reported 1 case in Cuando Cubango province, marking its first of 2020. The DRC reported 3 cVDPV2 cases, 2 in Kwango and 1 in Kongo province. One case is added to the 2019 total, for which 87 are now reported. The other 2 are the first recorded in 2020.

Meanwhile, Ghana reported 1 more cVDPV2 case, its third of 2020.
Mar 12 GPEI weekly update


Report: San Francisco food antibiotic ordinance hampered by lack of data

A new report from the San Francisco Department of the Environment on a 2017 ordinance that required chain grocers to report on antibiotic use by producers of the raw meat and poultry they sell says the ordinance has been hampered by producers being unable or unwilling to provide the information.

Under the ordinance, 10 grocery chains, representing more than 100 individual retail stores in San Francisco, were required to report antibiotic use policies and practices for almost 350 meat and poultry products sold in the study starting in 2018. The report found that, while grocers sought to comply with the ordinance, and many producers provided policy-level information about antibiotic use, few producers provide full data on antibiotic use. In addition, much of the data that were reported were incomplete and/or contained many errors.

The report also found the poultry industry provided far higher levels of transparency than the beef, pork, and lamb sectors, with data from conventional chicken producers showing significantly lower levels of antibiotic use than conventional turkey producers. Of 115 beef providers, only 1—which produced two products—provided antibiotic use date. No pork producers provided antibiotic use data.

"Ultimately, this first report reveals that antibiotic use in meat and poultry production is shrouded behind an industry-created veil, making it difficult for not only the public but grocers themselves to understand the practices behind the food they purchase," the report states. "San Francisco's Ordinance is a first step toward bringing these practices to light; more jurisdictions passing similar transparency requirements could provide additional market pressure necessary to transform the livestock industry into one that is fully transparent about its use of antibiotics."
March 2020 SF Environment report

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