News Scan for Mar 15, 2017

News brief

New polio case reported in Pakistan, its second this year

Pakistan has a new case of paralysis and infection with wild poliovirus type 1 (WPV1), its second of the year and the world's fourth in 2017, according to a post yesterday by ProMED-mail, the infectious disease news service of the International Society for Infectious Diseases.

The EpiCore Surveillance Project confirmed the infection after the case in Gilgit-Baltistan in the far north was reported in the media, according to ProMED-mail. The virus isolated from the patient is genetically related to isolates from environmental samples in Lahore collected last year, suggesting significant "silent" circulation of WPV1 near Lahore and possibly Gilgit-Baltistan. Such circulation would be an indication of suboptimal vaccination coverage in areas believed to be polio free, according to a ProMED moderator.

Pakistan's first reported WPV1 patient of 2017 had onset of paralysis in late January, according to an update last week by the Global Polio Eradication Initiative (GPEI). Afghanistan has also reported two cases this year. The global WPV1 total in 2016 was 37 cases, GPEI noted, all in Afghanistan, Pakistan, and Nigeria, the only countries in the world that still have endemic polio.
Mar 14 ProMED-mail post
Mar 8 GPEI update

High prevalence of drug-resistant bacterial eye infections noted in Ethiopia

A study yesterday in BMC Infectious Diseases found a high prevalence of bacteria in Ethiopian patients with eye infections, with a significant amount of multidrug resistance.

In the study, which was conducted at a hospital in Ethiopia in 2015, researchers cultured ocular specimens from 270 patients who presented with suspected ocular infections, including conjunctivitis, keratitis, periorbital cellulitis, and blepharitis. The investigators also conducted antimicrobial susceptibility testing and collected data on sociodemographic and risk factors.

Of the 270 patients, 180 (66.7%) were culture-positive for bacterial isolates, with 113 (60.7%) bacterial isolates identified as gram-positive and 87 (39.3%) as gram-negative. The dominant bacterial isolates were Staphylococcus aureus (21.5%), coagulase-negative staphylococci (16.7%), Pseudomonas aeruginosa (11.3%), and Escherichia coli (8%).

Antimicrobial susceptibility testing showed that a strong majority of isolates were susceptible to amikacin (93.2%), ciprofloxacin (89.2%), gentamicin (131, 89.1%), and doxycycline (71.9%). But 22.5% of bacterial isolates were resistant to at least one antimicrobial agent, 53.9% were resistant to two or more antimicrobials, and 34.8% were resistant three or more.

Ocular surface disease, ocular trauma, hospitalization, and cosmetic application practices were significantly associated with the occurrence of bacterial infection.

"Identification of the specific etiologic agent and antimicrobial susceptibility testing should be practiced during the management of ocular infections to reduce the further emergence of multidrug-resistant bacteria," the authors conclude.
Mar 14 BMC Infect Dis study

Flu Scan for Mar 15, 2017

News brief

China, Russia report more high-path H5 outbreaks

China today reported another highly pathogenic H5N6 avian influenza outbreak in poultry, this time in backyard ducks in Hubei province, officials said in a report to the World Organization for Animal Health (OIE). The outbreak began on Mar 3, and, of 767 susceptible birds, the virus sickened 134 and killed 86. Authorities culled the surviving ducks.

China has reported several H5N6 outbreaks in poultry since 2014, as well as 17 illnesses in humans, 6 of them fatal.

In other avian flu developments, Russia reported two more H5N8 outbreaks in backyard poultry in two cities in Moscow oblast in the western part of the country, according to a report today to the OIE. The events began on Mar 4 and Mar 10, killing 18 of 28 susceptible birds. Authorities destroyed the remaining ones and have ordered controls on poultry movement and have increased screening.

Last week Russia reported six other H5N8 outbreak in backyard and farm poultry, all of them in Moscow oblast.
Mar 15 OIE report on H5N6 in China
Mar 15 OIE report on H5N8 in Russia

Legislators warn of cuts to pandemic flu readiness in letter to HHS's Price

Two US senators and three members of Congress penned a letter this week to Tom Price, the secretary of Health and Human Services (HHS), voicing their concern over President Trump's proposed cuts to government agencies whose work enables pandemic preparedness.

The legislators, including Sen. Elizabeth Warren (D-Mass.), said that recent reports of human cases of avian influenza in China have raised the threat of a global pandemic, and that since taking office, President Trump has issued at least seven threats of budget cuts to HHS and the Centers for Disease Control and Prevention (CDC), the main agencies that would handle a flu pandemic.

The president has said he would propose a $54 billion budget cut on non-defense discretionary spending, which could include CDC and HHS. Moreover, in repealing the Affordable Care Act, the president proposes to cut the Prevention and Public Health Fund (PPHF) which makes up more than 12 % of the CDC's total budget.

In addition to budget cuts, the president has left several key public health administration roles empty, including a CDC director.

The letter concludes with several questions to Secretary Price about the president's understanding of public health preparedness, beliefs concerning vaccines, and executive orders. The legislators request a written response to their questions by Mar 27.
Mar 13 letter