Ivory Coast launches Ebola vaccination, is monitoring 9 contacts

The Ivory Coast yesterday launched an Ebola vaccination campaign aimed at frontline health workers and other high-risk groups, part of the response into an imported Ebola case involving a woman who had just arrived from Guinea.

In a statement today, the World Health Organization (WHO) African regional office said following the confirmation of the initial case, investigators have identified one suspected case and nine contacts who are being monitored.

The country is using Merck's VSV-EBOV vaccine for the vaccine campaign, using supplies quickly sent from Guinea to Ivory Coast. The 2,000 doses will be used in a ring vaccination strategy, as well as to immunize healthcare workers. Guinea also sent 3,000 doses of the Johnson & Johnson Ebola vaccine, which it will use in areas that aren't experiencing active transmission.

In addition, Guinea deployed five vaccination experts and made monoclonal antibody treatments available. The patient, an 18-year-old woman who had traveled from Labe in northwestern Guinea to the major urban center of Abidjan in Ivory Coast last week is receiving treatment at a hospital in Abidjan.

The patient's infection does not appear to be linked to Guinea's earlier outbreak, which was declared over in the middle of June. The woman's Ebola infection is the Ivory Coast's first since 1994.
Aug 17 WHO African regional office statement

Indian report notes gaps in guidance on antibiotic use in food animals

A new report by an Indian public interest research and advocacy organization highlights gaps in global recommendations on antibiotic use in food-producing animals and calls for more uniform guidance from the Tripartite United Nations (UN) organizations.

The report from the Centre for Science and Environment notes that while the WHO, the UN Food and Agriculture Organization (FAO), and the World Organization for Animal Health (OIE) all have their own guidance on the use of antibiotics in food-producing animals, there is significant overlap in the antibiotics considered critical for human medicine and veterinary medicine. For example, 47 of the antimicrobials listed by the OIE as being important for veterinary medicine are also on the WHO's list of critically important antibiotics for human medicine.

The report also points out a lack of coherence among the organizations on how antibiotics should be used in food-producing animals. Although there is uniform agreement that critically important antibiotics for human medicine should not be used for growth promotion in livestock, there is less agreement on whether they should be used for disease prevention and control in herds and flocks, or whether critically important antibiotics should be used to treat sick animals.

"Clearly, there is need for more clarity, coherence and, most importantly, a uniform message from the Tripartite organizations," the authors write. "In the absence of this, chances of consensus among national-level animal- and human-health stakeholders are low and the possibility for misinterpretation remains high. This can result in limited action, leading to misuse and overuse of critically important antimicrobials in the food-producing animal sector."

The authors say the organizations should develop uniform guidance that contains a clear message about which critically important antibiotics can be used across the food-animal sector, how they should be used, and which should be prohibited immediately or phased out. They also call for the Tripartite organizations to develop a better understanding of how countries are using critically important antibiotics in food-producing animals, and the levels of resistance to those antibiotics.

The report also contains recommendations for the Indian government to develop a roadmap and policy framework for conserving the use of these antibiotics in the food-animal sector.
Aug 16 Centre for Science and Environment report

CDC: More Salmonella illnesses linked to frozen shrimp

Yesterday the Centers for Disease Control and Prevention (CDC) announced three new cases of Salmonella Weltevreden illnesses linked to frozen cooked shrimp in a multistate outbreak, raising the number of confirmed cases to nine. Two more states are affected, and the recall of shrimp products has been expanded.

Three people have required hospitalization, but no deaths have been reported in this outbreak. Cases have been detected in Nevada (4 cases), Arizona (2), Michigan (2), and Rhode Island (1). At least five of the patients report eating shrimp in the week prior to symptom onset. Illness-onset dates range from Feb 26 to Jul 17. Patients range in age from 30 to 80, with a median of 60.

The outbreak was detected by the Food and Drug Administration (FDA) when a sample of Avanti Frozen Foods shrimp that was collected for testing at import was found to be contaminated with Salmonella Weltevreden.

The CDC said the shrimp in question were sold under multiple brands and distributed from November 2020 to May 2021.

"On August 13, 2021, Avanti Frozen Foods expanded their initial recall to include additional brands and expiration dates," the agency wrote. "CDC urges consumers and retailers with frozen cooked shrimp in their freezers to carefully review the product tables in both recall notices and throw away or return any recalled products."
Aug 16 CDC update
Aug 13 FDA notice of expanded recall

WHO details India's first H5N1 avian flu case, fatal with flu B coinfection

The WHO yesterday fleshed out more details about a human H5N1  avian flu case recently reported by the media. The patient is a boy younger than 18 years old from Haryana state in the north who had been receiving immunosuppressive therapy for an underlying health condition before he got sick.

His symptoms began on Jun 12, and his condition worsened, requiring mechanical ventilation. He died on Jul 12.

Respiratory samples collected on two dates in July while he was sick were positive for influenza A and influenza B. After he died, the samples were sent to the country's National Institute of Virology for further testing, which revealed H5N1 and influenza B (Victoria lineage). Whole-genome sequencing and virus isolation are under way.

The investigation revealed that, over the past year, the boy lived with a family member who owns a butchery, but no reports of poultry illnesses or deaths had been reported in the area. So far, the source of the infection isn't known, and none of the boy's family members have shown similar symptoms.

The WHO said the risk of human-to-human infection appears low, but sporadic H5 infections may be reported in India because of occasional detections in poultry. India has reported H5N1 on poultry farms every year since 2016, and earlier this year, Haryana state reported H5N8 outbreaks in poultry.
Aug 16 WHO statement