News Scan for Oct 16, 2013

News brief

Survey shows gaps in first-responder anthrax knowledge

More than half of 70 first responders surveyed did not know that occupants of an entire building need decontamination following an indoor release of Bacillus anthracis, the bacterium that causes anthrax, according to a study in the Journal of Homeland Security and Emergency Management.

The researchers recruited survey respondents from throughout the United States by a variety of means. They found that 57 of 69 (83%) who provided such information had some bioterrorism training, but most were trained on-site by a colleague.

When asked about decontamination after an indoor B anthracis release from an envelope, 97% correctly said room occupants needed decontamination, while 80% correctly said the entire floor required the procedure and only 42% correctly applied the measure to the entire building.

Also, 15% said they would don personal protective equipment inside the affected building, which could result in contamination.

For an outdoor release, only 30 of the 70 participants coded a map in a way that could be analyzed. Of those 30, 20 (67%) showed correct awareness of a spore-dispersing plume by drawing various zones downwind from the agent release.

The authors said online training might be one way to address these knowledge gaps.
October J Homeland Secur Emerg Manage abstract

 

Poliovirus still detected in some Israeli towns

Poliovirus is still being found in several communities in Israel, but no new sites of contamination have been detected since a vaccination campaign was launched in August, the European Centre for Disease Prevention and Control (ECDC) reported yesterday.

Citing information from the Israeli Ministry of Health, the ECDC statement listed six towns in which, as of Oct 3, wild-type poliovirus 1 (WPV1) was still being found in wastewater but was showing a mild decline.

In another four towns, WPV1 activity in wastewater has been inconsistent and testing must continue, the ECDC said. The virus has disappeared from sewage in three other cities, including Jerusalem, but testing will continue.

The virus first turned up in southern Israel in February. It was later found in stool samples from 42 people, nearly all of them young children, and all of whom had been reported to be fully vaccinated, the agency said.

As a result, an immunization campaign involving bivalent oral vaccine was launched in August. According to the latest estimates, 890,000 children under age 10 have been vaccinated out of about 1.2 million eligible, the ECDC said. No clinical cases of paralytic polio have been reported.

The ECDC said the latest information does not change the recommendations the agency issued in late September. At that point the ECDC cited a risk of polio reintroduction in Europe and called for a thorough assessment of polio vaccination uptake and strengthening of surveillance and laboratory capacity.
Oct 15 ECDC update

Avian Flu Scan for Oct 16, 2013

News brief

WHO confirms new H7N9 case in China

The World Health Organization (WHO) today confirmed an H7N9 avian flu case in a 35-year-old man from Zhejian province that was reported yesterday by Chinese health officials and also confirmed a death in a previously reported H7N9 patient.

In addition, the organization said that three patients remain hospitalized with the disease. Its global H7N9 count now stands at 136 cases and 45 deaths.

The WHO statement afforded no new details on the recent case. The Zhejian man was hospitalized on Oct 8 and is in critical condition. His is the first H7N9 case since Aug 11.

The patient who died was from Hebei province, the WHO said. The only H7N9 case-patient confirmed in that province was a 61-year-old woman whose case was announced by the WHO on Jul 20. At that time she was listed in critical condition.

Today on Twitter, Gregory Hartl, WHO head of public relations, said that new H7N9 cases are to be expected as the weather turns colder. "Don't be surprised if we see more," he tweeted.
Oct 16 WHO update
Jul 22 CIDRAP News story "Chinese woman critical with H7N9 infection"
Gregory Hartl Twitter account

 

Study reports possible human-to-human H7N9 spread

An analysis of a six-patient cluster of H7N9 avian flu in Shanghai likely linked to live-bird markets revealed that two cases may have involved human-to-human spread, according to a report in PLoS One yesterday.

Shanghai researchers examined the epidemiologic and clinical data from patients in the Minhang District of Shanghai who were referred to the same hospital during 2 weeks in February and March. All the patients were men.

Their ages were 27, 41, 63, 67, 74, and 87. Only the 41-year-old had no underlying conditions. The 27-year-old, a pork butcher, had hepatitis B, and the four oldest all had hypertension. Three of those with hypertension also had two or more additional conditions.

Three of the patients had a history of contact with poultry, but all six lived near two food markets where H7N9 was later detected in chickens and pigeons. All patients were treated with oseltamivir (Tamiflu) 3 to 8 days after symptom onset, and four died of acute respiratory distress.

The 87-year-old and 67-year-old were a father and son who lived in the same house. The father died from his infection, while the son was discharged after 15 days. The father's other son had similar symptoms and died from severe pneumonia without H7N9 confirmation.

The authors said the two cases "indicated that human transmission may be involved in the spread of this infection" and added that the two markets were the likely source of the virus.
Oct 15 PLoS One report

 

H7N2 avian flu kills 18,000 chickens in New South Wales

Highly pathogenic H7N2 avian influenza has been confirmed in free-range and caged layer hens on a poultry farm in southeastern Australia, reports a World Organization for Animal Health (OIE) notification today. An investigation is under way to find the source of the infection.

H7N2 cases, all of them fatal, number 18,000 to date. The number of susceptible birds is listed as 435,000. The infection manifested as clinical disease, and diagnosis was by polymerase chain reaction and gene sequencing over the past few days.

The property, in New South Wales, has been put under quarantine, with a 10-km-diameter control area surrounding it. All movements of birds, people, vehicles, and eggs at the farm are being traced. Stamping out and disinfection of the premises are planned as further control measures.
Oct 16 OIE notification

This week's top reads