News Scan for Oct 24, 2013

News brief

WHO confirms H7N9 case in China

The World Health Organization (WHO) today confirmed China's latest H7N9 influenza case, in a 67-year-old farmer from Zhejiang province, and said the man is in critical condition.

The WHO said the patient, whose case was reported by the media yesterday, had contact with poultry. He got sick on Oct 16, was admitted to local hospital 2 days later, and was transferred to another hospital on Oct 21 as his condition worsened.

The case raises the WHO's H7N9 count to 137 cases with 45 deaths. Four patients remain hospitalized with the illness, and 88 have been discharged, the agency said.

The latest case was preceded last week by another one in the same province, involving a 35-year-old man.
Oct 24 WHO statement


Histoplasmosis cases suggest fungus is endemic in Montana

Since November 2012 four Montanans have been diagnosed as having histoplasmosis, a signal that the risk of the disease is further west than previously thought, according to a report today in Morbidity and Mortality Weekly Report (MMWR).

The Histoplasma capsulatum fungus, found in soil containing bird droppings and bat guano, is known to be endemic in the Ohio River and Mississippi River valleys, though recent studies have suggested that the risk could extend into Montana and other western states.

The patients were all treated by different physicians, and no epidemiologic links were found, according to the report authors, who included Montana health providers and officials from the US Centers for Disease Control and Prevention (CDC).

Three of the patients were adults, and one was a 17-year -old boy. Only one patient had recent travel outside of Montana, a 59-year-old woman who had been exposed to potting soil that contained bat guano in California.

All patients had immunocompromising conditions before their Histoplasma infections were found, which may have increased their risk. Unusual clinical presentations were seen in three of the patients, which—in addition to the lack of travel history—may have delayed the diagnosis for some of the cases.

Environmental studies are needed to assess if H capsulatum is endemic in Montana, the authors conclude, and the cases serve as a reminder for health providers to consider the possibility of histoplasmosis alongside similar possibilities, even if patients haven't traveled outside Montana.
Oct 25 MMWR report


WHO warns of drug-resistant malaria, asks for funds

The WHO said today that it needs $450 million over the next 3 years to stop a worrisome drug-resistant strain of malaria from spreading from Southeast Asia to the rest of the world.

The agency said in a press release that resistance to the front-line drug artemisinin was first confirmed on the Cambodia-Thailand border in 2008 and has now spread to Myanmar and Vietnam.

"The emergence of artemisinin resistance could undo the enormous progress made towards malaria control and elimination—and potentially pose a serious global health threat," said WHO Regional Director for the Western Pacific Shin Young-soo, MD, PhD, in a WHO press release.

"We are taking the situation very seriously," said Shin. "If resistance to artemisinin emerges elsewhere, the consequences for global health could be grave." He was speaking at an international malaria meeting in Manila, where the WHO is urging immediate action from member states.

"We still face a funding gap of at least US$450 million over the next 3 years," Shin said. He added that the Global Fund to Fight AIDS, Tuberculosis and Malaria has pledged $100 million toward the effort.
Oct 24 WHO press release

WHO, ECDC take precautions over suspected polio in Syria

On World Polio Day today, the WHO's Regional Office for Europe (WHO/Europe) announced it is ramping up polio surveillance after suspected cases were reported this week in Syria, and yesterday the European Centre for Disease Prevention and Control (ECDC) issued a risk assessment on the Syrian situation.

WHO/Europe said it has established a new center of operations in Gaziantep, Turkey, near the Syrian border. More than 500,000 Syrian refugees displaced by civil war now live in 21 camps in Turkey and in private homes in 10 provinces.

Turkish health officials plan two rounds of polio vaccination by the end of the year for all children under 5 years old in selected provinces and for refugee children.

"Along with improved surveillance, an active search is being conducted to provide additional doses of vaccine to un- and under immunized resident children nationwide," WHO/Europe said in a news release.
Oct 24 WHO/Europe news release

In its assessment, the ECDC said the cases of acute flaccid paralysis in Syria raise the risk of importation of wild poliovirus to Europe, of further re-establishment, and of transmission among member states.

It recommends that countries test for polio transmission in Syrian refugees, assess vaccine status when refugees arrive, and provide vaccine as needed. It encourages support for regional and international control efforts, consideration of ECDC recommendations made in its risk assessment of polio in Israel, and review of preparedness plans.
Oct 23 ECDC risk assessment regarding Syria
Sep 25 ECDC risk assessment on Israel

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