News Scan for Mar 20, 2020

Uptick in US visits for flulike illness
E coli sproutbreak
Ebola in DRC
3 Saudi MERS cases
Polio in 5 countries

CDC: Uptick in visits for flulike illness likely linked to COVID-19

There was a sharp uptick last week in US clinic visits for influenza-like illness (ILI), according to the latest FluView report today from the Centers for Disease Control and Prevention (CDC), but CDC officials say that could reflect more people seeking care for respiratory illness as COVID-19 spreads across the country.

While the percentage of respiratory specimens testing positive for influenza at clinical laboratories decreased from 21.1% to 15.3% last week, visits to healthcare providers for ILI jumped from 5.2% to 5.8%, with all regions of the country above their baselines.

"Due to the ongoing COVID-19 pandemic, more people may be seeking care for respiratory illness than usual at this time," the CDC said.

High ILI activity was reported in 40 jurisdictions, down from 43 the previous week. On a regional level, the percentage of outpatient visits for ILI ranged from 4.6% to 7.9%. The number of regions reporting widespread or regional flu activity fell to 49 from 50 the previous week.

The 2019-20 flu season also continued to be hard on children, as five more pediatric deaths were reported during the week ending Mar 14. Except for the 2009 pandemic flu season, the 149 pediatric deaths recorded are the most at this point for any season since reporting began in 2004-05. In addition, hospitalization rates for children 0 to 4 are the highest the CDC has on record for that age-group, and hospitalization rates for school-aged children (5 to 17) are higher than any recent season other than 2009.

The overall cumulative hospitalization rate for flu increased to 65.1 per 100,000 population, up from 61.6 the previous week.

Testing by public laboratories shows that 55.9% of the circulating viruses tested since Sep 29, 2019, are influenza A, and 44.1% are influenza B. The most common influenza A viruses are 2009 H1N1 (92.4%), while 98.4% of influenza B samples belong to the Victoria lineage.

The CDC estimates there have been at least 38 million flu illnesses so far this season, and 23,000 deaths.
Mar 20 CDC FluView report


Multistate E coli outbreak tied to sprouts grows to 39 illnesses

In an update yesterday, the CDC said 25 additional people from two states have been infected in a foodborne outbreak of Shiga toxin-producing Escherichia coli since Feb 26, bringing the total to 39 cases in six states. Two people have been hospitalized.

Information gathered by the agency indicates that clover sprouts are the likely source of the E coli O103 outbreak strain, which has infected people in Iowa, Illinois, Missouri, Texas, Florida, and Utah. After identifying the outbreak strain in samples of products from Chicago Indoor Gardens containing sprouts, the CDC is advising consumers, restaurants, and retailers not to eat, serve, or sell products containing sprouts from the company.

Chicago Indoor Gardens recalled all products containing red clover sprouts on Mar 16.

Illness started on dates ranging from Jan 6 to Mar 2. Ill people range in age from 1 to 79 years, and 16 (59%) of 27 people interviewed reported eating sprouts.

The CDC said a trace-back investigation has shown that a common seed lot was used to grow the recalled sprouts, and that investigation into where the sprouts and seeds have been distributed is ongoing.
Mar 19 CDC food safety alert


WHO: $20 million still needed to fund Ebola response in DRC

Yesterday in their weekly update, the World Health Organization (WHO) said there have been no new cases of Ebola reported in the Democratic Republic of the Congo (DRC) since Feb 17.

"However, because there is still a risk of re-emergence of EVD [Ebola virus disease], it is critical to maintain surveillance and response operations until and after the end of outbreak declaration," the WHO said.

In order to do so, the WHO said it needs $20 million US dollars to fund response efforts through May, and said no new funding for Ebola has been received since December of 2019. "If no new resources are received, WHO risks running out of funds for the Ebola response before the end of the outbreak," the WHO said.

During the outbreak, which began in August of 2018, a total of 3,444 people were infected with the virus, and 2,264 cases died (overall case fatality ratio 66%). Twenty-eight percent of cases were seen in children under the age of 18, and 5% in healthcare workers.
Mar 19 WHO update


Saudi Arabia reports 3 more MERS cases

Saudi Arabia's Ministry of Health (MOH) today reported three more MERS-CoV cases, one from Riyadh and two from Najran.

The patient from Riyadh is a 50-year-old woman whose exposure is listed as primary, meaning she didn't likely contract Middle East respiratory syndrome coronavirus (MERS-CoV) from another known patient. The other two from Najran include two men, ages 59 and 70, both of whom are listed as having primary exposure.

Today's 3 new reports bring Saudi Arabia's case total for March to 11.

In its update at the end of January, the WHO said since 2012, when the first human illness was detected, it has received reports of 2,519 MERS-CoV cases, at least 866 of them fatal. Saudi Arabia has been the hardest-hit country.
Mar 20 Saudi MOH statement


Pakistan, Malaysia, African countries report more polio cases

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

Pakistan reported five wild poliovirus type 1 (WPV1) cases, two in Khyber Pakhtunkhwa and one each in the Federally Administered Tribal Area, Balochistan province, and Sindh province. So far this year, the country has reported 30 WPV1 cases.

In Africa, three countries reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases. Angola reported one more case, from Cuando Cubango province, marking the second case of the year. Chad has two more cases, one from Ouaddai and Ndjamena, and Ivory Coast has one case, its first, which was reported from Sud Comoe province. That case is linked to the Savanes outbreak in Togo.

Meanwhile, Malaysia reported one more circulating vaccine-derived poliovirus type 1 (cVDPV1) case, its first of 2020. The case was reported from Sabah province.
Mar 19 GPEI weekly report

In other developments, GPEI said earlier this week that the COVID-19 pandemic requires global solidarity and that it and thousands of polio workers have a moral imperative to ensure that its extensive lab and surveillance network are used to support countries with their preparedness and response efforts.

GPEI and its partners have a significant footprint in Nigeria, Pakistan, and Afghanistan, and workers will pitch in with tasks such as surveillance, health worker training, contact tracing, and risk communication. It said the US Centers for Disease Control and Prevention has deployed the Stop Transmission of Polio volunteer program to work on COVID-19 in 13 countries.
Mar 18 GPEI statement

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