News Scan for Apr 22, 2014

News brief

Guinea, Liberia probe new Ebola cases

Three new Ebola virus disease (EVD) cases, along with five deaths in previously announced infections, have been reported in Guinea, the World Health Organization (WHO) Regional Office for Africa reported today. The new cases raise the country's overall number of cases to 208 and number of deaths to 136; 112 illnesses have been lab confirmed. So far 25 EVD infections, 16 of them fatal, have been reported in Guinea's healthcare workers.

Liberian health officials reported 6 more EVD cases, raising that country's total to 34, according to the WHO report. The number of deaths has been adjusted downward from 13 to 11, because 1 was included with Guinea's case count and 1 occurred in a discarded case. So far lab tests have been conducted on 32 clinical samples, and the number of positive samples remains at 6. The WHO said some of Liberia's suspected cases will likely be removed from the case count. The latest illness-onset date for a confirmed case is Apr 6.
Apr 22 WHO update

Chikungunya cases still increasing in some Caribbean areas

Although the ongoing Caribbean outbreak of chikungunya has slowed or stayed steady in some areas, it is increasing in others, the European Centre for Disease Prevention and Control (ECDC) reported in its latest Communicable Disease Threats Report, released today.

In the French West Indies, where the outbreak began last December on the French side of St. Martin, the number of new cases has generally leveled off or decreased, says the ECDC. However, an increasing number of autochthonous cases is reported in French Guiana, Dominica, and Anguilla. The Dominican Republic as of Apr 17 reported 17 confirmed and 767 suspected cases in its San Cristobal province.

A total of 29,761 suspected, probable, and confirmed cases have occurred, with 6 deaths. Most territories in the French West Indies have stopped seeking laboratory confirmation for all suspected cases because of the large caseload.
Apr 22 ECDC report
Last (Apr 15) CIDRAP News item on outbreak

Wide variety of antibiotic-resistance genes found in manure

Cow manure harbors a "remarkable" diversity of antibiotic-resistance genes and could be a reservoir for new types of antibiotic resistance (AR) as the genes transfer to soil when manure is used as crop fertilizer, according to a study released today in mBio, published by the American Society of Microbiology (ASM).

The researchers, from Yale University and the University of Connecticut, extracted DNA from five manure samples from four cows at a dairy farm in Connecticut, says a story from Agence France-Presse (AFP). Using a screening-plus-sequencing method, they identified 80 unique AR genes. When applied to a laboratory strain of Escherichia coli, the genes rendered the bacteria resistant to beta-lactams, aminoglycosides, tetracycline, or chloramphenicol.

About three fourths of the genes were unfamiliar, although genetic sequencing showed they were distantly related to already-known AR genes. In addition, a new family of genes that confer resistance to chloramphenicol was identified.

More study is needed to determine whether the genes could move into the human population. Said senior author Jo Handelsman in an ASM press release, "This is just the first in a sequence of studies—starting in the barn, moving to the soil and food on the table and then ending up in the clinic—to find out whether these genes have the potential to move in that direction."
Apr 22 mBio article abstract
Apr 22 ASM press release
Apr 22 AFP story

Flu Scan for Apr 22, 2014

News brief

Declining global flu activity marked by uptick in B-positives

Flu activity in Northern Hemisphere countries is headed toward interseasonal levels despite a late-season rise in influenza B activity in many areas, including Asia, the Middle East, and North America, the World Health Organization (WHO) said today in its latest global flu update. Though each flu season is different, flu experts say it's not unusual to see a late-season rise in influenza B activity.

In Europe, most flu markers declined, but the percentage of samples positive for flu was up a bit, with Eastern Europe seeing a late flu season compared with the rest of the region, says the report.

China's flu activity is approaching interseasonal levels, and though influenza B detections have increased, especially in the north and south, influenza A remains the dominant strain this season, according to the WHO.

In Canada, Mexico, and the United States, an increasing proportion of influenza B detections was reported against a backdrop of declining flu activity overall.

In the Southern Hemisphere, flu activity was still low, with only sporadic detections. The region's flu season typically runs from May through October.

Globally, influenza A is the dominant strain and accounted for 62% of detections. Of the subtyped influenza A viruses, 52.8% were H3N2 and 47.2% were the 2009 H1N1 virus.
Apr 22 WHO global flu update

Taiwan detects imported H7N9 infection

Taiwanese health officials today reported an H7N9 influenza infection in a traveler from the mainland's Jiangsu province, the region's third such imported case, according to a report from China News Agency (CNA), which cited Taiwan's Centers for Disease Control.

The patient is a 44-year-old woman who came to Taiwan on Apr 17 with a tour group. She had a dry cough and muscle aches the day she arrived and immediately sought care at a clinic. The next day her condition worsened, and the woman went to a hospital where tests showed she had pneumonia and pleural effusion. She was hospitalized and treated with oseltamivir (Tamiflu) on Apr 20. She is listed in serious condition and is in the intensive care unit, according to the CNA report.

An official from Taiwan's Centers for Disease Control told CNA that the woman had bought slaughtered chicken at a poultry market in Nanjing before she traveled to Taiwan. So far no signs of illness have been seen in other members of the woman's tour group.

Her infection lifts the overall H7N9 outbreak total to 429, according to a running list of cases kept by FluTrackers, an infectious disease news message board. So far 293 illnesses have been confirmed during the second wave of H7N9 activity, which began in October, compared with 136 in the first wave.
Apr 22 CNA story