News Scan for Apr 13, 2020

More Ebola in DRC
Heartland virus cases
Yellow fever in South Sudan

DRC reports another new Ebola death

The Democratic Republic of the Congo (DRC) reported a second new Ebola case, which involves an 11-month-old girl who was treated at the same Beni hospital as a man whose illness was announced on Apr 10.

The girl died from her infection, as did the 26-year-old man whose illness was announced a few days ago, dashing hopes that the country would soon be declared free of the viral disease, Reuters reported, citing Boubacar Diallo, deputy incident manager for the World Health Organization (WHO) Ebola response.

So far, it's not clear how the man contracted the virus. He wasn't a known contact of an earlier case and was not a survivor who experienced an illness relapse.

The WHO had identified 215 of the man's contacts, including 53 healthcare workers from three facilities. Diallo said a group of men threw stones at a WHO team and Beni's deputy mayor who arrived to decontaminate the man's home. The girl's illness raises the outbreak total to 3,456 cases, 2,266 of them fatal, according to the WHO's online Ebola dashboard.
Apr 13 Reuters story
Apr 10 CIDRAP News scan "WHO confirms new Ebola case in DRC, prolonging outbreak"
WHO online Ebola dashboard


Study finds tickborne Heartland virus infection in 19% of people tested

Researchers with the US Centers for Disease Control and Prevention (CDC) reported a 19% rate of tickborne Heartland virus infection among 85 people tested in seven states in a study published late last week in Open Forum Infectious Diseases.  

The first known US Heartland virus infection occurred in 2012. The disease spreads via lone star ticks, found in the eastern and central United States. Because it is caused by a virus, it will not respond to antibiotics, as opposed to other tickborne diseases like Lyme.

From June 2013 to December 2017, the CDC instituted national procedures to test subjects for the virus; determine its geographic distribution, epidemiology, and clinical findings; and formulate diagnostic tests. The investigators collected data on patients 12 years and older whose clinicians had suspected possible Heartland infection.

They also screened the patients for recent fever with leukopenia (low white blood cell count) or thrombocytopenia (low platelet count), which are common signs of the disease, and tested their blood for viral RNA and neutralizing antibodies.

Of the 85 people tested, 16 (19%) had evidence of current Heartland infection, while 1 (1%) was previously infected. Of the infected patients, 12 (75%) were male, and the median age was 71 years (range, 43 to 80). All had thrombocytopenia and leukopenia.

Illness onset ranged from April to September, with 8 cases (50%) occurring in June. Most infected participants reported fatigue, loss of appetite, nausea, headache, confusion, joint pain, and muscle aches. Fourteen (88%) were hospitalized, and 2 (13%) died.

Fourteen of the patients said that they had found an attached tick in the 2 weeks before symptom onset. Infected subjects were significantly older (P < 0.001) and more likely to say they had an attached tick (P = 0.03) than uninfected participants.

The authors urged clinicians to consider testing for Heartland in patients with fever and leukopenia or thrombocytopenia unexplained by another condition or who were thought to have a tickborne illness but did not recover after appropriate antibiotic therapy. "Future research is needed to understand the clinical spectrum and further geographic distribution of Heartland disease, including determination of whether asymptomatic infections can occur," they wrote.
Apr 11 Open Forum Infect Dis study
Jul 22, 2013, CIDRAP News story "Researchers trace novel Heartland virus to Missouri ticks"


WHO confirms yellow fever outbreak in South Sudan

South Sudan has two lab-confirmed yellow fever cases in a new outbreak, according to the WHO. The cases were reported in Kajo Keni County in Central Equatoria state.

Officials detected the cases during cross-border surveillance, and they are linked to an outbreak in the bordering Moyo district of Uganda. Neither patient has died.

"To respond to the outbreak, a targeted reactive vaccination campaign was mounted in the affected area," the WHO said.

Yellow fever is a viral hemorrhagic disease transmitted by mosquitoes. The last yellow fever outbreak confirmed in South Sudan was in November of 2018, and the last deadly outbreak took place in 2003.
Apr 10 WHO update

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