News Scan for Apr 15, 2014

News brief

Pasteur Institute loses 2,300 vials containing pieces of SARS virus

Officials at the Pasteur Institute in Paris say the laboratory's loss of 2,349 "tubes" containing fragments of the SARS (severe acute respiratory syndrome) virus does not pose an infection risk, but they call the lapse an "unacceptable mistake," according to media reports.

The institute revealed on Apr 13 that the vials have been missing since January, according to a report today from Euronews, a French-based television news network. A routine inventory led to the discovery of the samples' disappearance.

"We knew from the beginning that the samples were not infectious, as the MSNA's independent experts confirmed," Christian Brechot, president of the institute, was quoted as saying. The MSNA is the National Agency for the Safety of Medicine and Health Products.

The story said experts dismissed any possibility of misuse of the samples because none of the tubes contained a complete virus. But Brechot commented, "Losing the samples is an unacceptable mistake. . . . It is the first time that the institute has lost samples in this manner and it is entirely inadmissible."

The institute has asked French authorities to investigate the loss of the samples, the story said.

The tubes were stored in a high-security laboratory with limited access, according to an International Business Times story. It said Brechot suggested that the vials, which were moved from one freezer to another in March 2013, might have been destroyed by a staff member who forgot to document the procedure.

The SARS virus, a coronavirus, sickened about 8,000 people and killed around 800 when it spread internationally from China in 2003.
Apr 15 Euronews story
Apr 15 Business Times story


Chikungunya cases in the Caribbean approach 25,000

The Caribbean chikungunya outbreak grew by 5,149 cases in the past week, reaching 24,831 cases, according to an update yesterday from the European Centre for Disease Prevention and Control (ECDC). That's up from 19,682 cases a week ago.

Martinique continues to report the largest numbers, with 13,500 suspected (up from 11,400) and 1,284 confirmed or probable cases, the ECDC said. Guadeloupe for the first time reported the second-most cases, with 3,690 suspected and 942 confirmed or probable cases. The French side of St. Martin is third, with 2,910 suspected and 791 confirmed or probable cases.

Also reporting cases are Dominica, 764 suspected and 81 confirmed cases; St. Barthelemy, 444 suspected and 135 confirmed or probable cases; the Dutch side of St. Martin, 224 confirmed cases; French Guiana, 25 confirmed locally acquired and 15 imported cases; Anguilla, 14 confirmed cases; British Virgin Islands, 7 confirmed cases; and Aruba, St. Lucia, and St. Kitts/Nevis, each with 1 confirmed case. Of those areas, Dominica reported the heftiest increase, up from 487 cases last week.

The chikungunya outbreak is the first known in the Americas and began in December 2013 on the French side of St. Martin. So far 6 related deaths have been confirmed, 3 on the French side of St. Martin, 2 on Martinique, and 1 on Guadeloupe.

The ECDC also said that the Dominican Republic has reported confirmed cases but has not given exact numbers.
Apr 14 ECDC update


Study finds diarrhea treatment gap in African kids

In the first large study of childhood diarrhea treatment practices in sub-Saharan Africa, researchers reported that kids are less likely to receive vital oral rehydration treatment if they receive care at a private, for-profit clinic, compared with a public clinic.

California researchers published their findings yesterday in the American Journal of Tropical Medicine and Hygiene (AJTMH).

According to the study, children younger than age 5 who were treated in private facilities were 22% less likely to receive oral rehydration, considered an effective and inexpensive treatment. They were, however, 61% more likely to receive other treatments in those settings, such as herbal remedies or other medications, some of which are not recommended and can be harmful.

Zachary Wagner, study coauthor who is a public health doctoral student at the University of California at Berkeley, said in a press release from AJTMH that the findings are worrisome, because private healthcare providers are increasingly filling gaps in underserved parts of sub-Saharan Africa. The team found that private providers ranged from mobile clinics to small pharmacies to clinics that are sometimes located in substandard facilities, where regulations aren't often enforced.

When the researchers looked at patterns in rural areas, they found that poor children with diarrhea were less likely to receive rehydration treatment at both private and public clinics, though the effect was most pronounced at private clinics.

They calculated that closing the gap between private and public care for the youngsters could save the lives of 20,000 children under age 5 in the region each year.
Apr 14 AJTMH abstract
Apr 14 AJTMH press release

Flu Scan for Apr 15, 2014

News brief

H7N9 sickens man in China's Hunan province

China reported one new H7N9 influenza infection, in a 30-year-old man from Hunan province, according to a Chinese media report that quoted the province's health department.

The report was translated and posted by FluTrackers, an infectious disease news message board. The patient is hospitalized, and the report didn't list his condition.

The man's infection pushes the outbreak's overall total to 422 infections, according to FluTrackers' updated case list. So far 286 of the cases have been reported in the outbreak's current second wave, compared with 136 during the first wave last spring.

In related developments, the World Health Organization (WHO) said it has received notifications of two more H7N9 cases, one reported by Hong Kong on Apr 13 and one reported by China on Apr 14.

Hong Kong's case involves an 85-year-old woman who got sick on Apr 11, which was 6 days after returning from a trip to visit family in Guangdong province, where she had contact with poultry. She was hospitalized on Apr 13 and is in critical condition.

The mainland's case involves a 52-year-old man from Jiangsu province who got sick on Apr 10 and was hospitalized on Apr 13, where he is listed in severe condition.
Apr 15 FluTrackers thread
FluTrackers human H7N9 case list
Apr 15 WHO statement


Study: Only 45% of adults, 57% of kids seek care for ILI

Only 45% of adults and 57% of children who had influenza-like illness (ILI) reported seeking healthcare, according to a large study by researchers from the Centers for Disease Control and Prevention (CDC) in the Journal of Infectious Diseases.

The CDC team interviewed, via phone, 75,088 adults in 31 states and the District of Columbia (D.C.) and the parents of 14,649 children in 25 states and D.C. from January through April 2011. Of those groups, 8.9% of adults and 33.9% of kids reported recent ILI.

Among those who reported ILI, 45% of adults reported said they sought healthcare. Seeking medical care was highest in those 65 or older (60%) or who reported chronic obstructive pulmonary disease (62%), heart disease (59%), kidney disease (69%), disability (50%), being obese (52%), or having current (57%) or past (58%) asthma. Those with the lowest levels of healthcare seeking were Native American (34%), the unemployed (35%), and those with no insurance (27%) or no personal doctor (38%).

Among children with ILI, 57% sought healthcare, led by those 0 to 4 years old (68%), 5 to 11 years old (56%), African-American (67%), or Hispanic (64%).

Of adults with ILI who sought medical care, 35% sought care within 3 days and 47% within 3 to 7 days of the start of symptoms. Jobless adults and those with no insurance were especially likely to delay care, with only 23% to 27% seeking care within 2 days.

In addition, 34% of those who were diagnosed as having influenza were given antiviral drugs, the investigators reported, similar to the 36% antiviral prescribing rate during the 2009 H1N1 pandemic.

The authors conclude, "Further efforts are needed to educate persons at high risk to seek healthcare early and to identify reasons why persons at high risk are not receiving influenza antivirals."
Apr 13 J Infect Dis study

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