News Scan for May 06, 2016

News brief

Yellow fever transmission continues in southern Africa

Yellow fever case totals in Angola and the Democratic Republic of Congo (DRC) continue to climb, with Namibia now reporting its first suspected case, according to a World Health Organization (WHO) situation report yesterday.

Though nearly 6 million people have been vaccinated, yellow fever transmission is ongoing in six Angolan provinces, including Luanda, where the outbreak began in December 2015. As of May 4, totals in that country reached 2,149 suspected and 661 confirmed cases and 277 fatalities, the WHO said.

Angola's outbreak has been tied to 37 cases of yellow fever in the DRC, 11 cases in China, and 2 in Kenya. On Apr 28, Namibia, which shares a porous border with Angola, reported its first suspected yellow fever case in a 27-year-old woman who was initially hospitalized in Angola's Benguela province, the WHO said.

The DRC government, which declared a yellow fever outbreak on Apr 23, has linked 44 cases to Angola's outbreak, 37 of which were imported. Two cases, one each in Kinshasa and Kongo provinces, were locally acquired, and an additional 10 possible locally acquired cases in DRC are under investigation.

Elsewhere, seven lab-confirmed yellow fever cases in Uganda don't appear to be linked to Angola's outbreak, the WHO said.

The agency said that insufficient vaccination coverage in Angola's hardest-hit provinces of Luanda, Benguela, and Huambo continues to spur transmission within the country and across its borders. More than 1.5 million vaccines are scheduled to be sent to Angola, and 2.2 million vaccines will arrive in the DRC by mid-May.
May 5 WHO situation report
May 2 CIDRAP News item on the outbreak

MCR-1 gene detected in British pig farm samples

Bacterial sampling as part of investigation into fatal diarrheal illnesses at a pig farm in Great Britain found multidrug resistance, including to the drug colistin, in three isolates, and two harbored the MCR-1 gene, researchers reported in the Journal of Antimicrobial Chemotherapy.

Two Escherichia coli samples and one Salmonella Copenhagen isolate were resistant to colistin, an antibiotic often used in raising animals that is considered a last-line treatment for multidrug-resistant infections in humans. Whole-genome sequencing revealed that one E coli and the Salmonella isolate contained the MCR-1 gene, first described by Chinese scientists toward the end of 2015.

The team also found that the two E coli samples harbored beta-lactamase resistance but did not specify when the samples were collected.

The farm had a history of post-weaning diarrhea, and the pigs that were sampled in the study had zinc oxide and florfenicol in feed and colistin in water and had shown poor response to treatment.

The authors concluded that colistin use probably created selective pressure at the farm and that multidrug-resistance contributed to poor treatment outcomes alongside rotavirus enteritis. Also, they said their findings support the concept of global distribution within a variety of MCR-1 plasmids.
May 4 J Antimicrob Chemother abstract

Flu Scan for May 06, 2016

News brief

Four more flu-related children's deaths reported as cases ebb

Influenza activity around the United States continued its retreat toward summertime levels last week, but four more flu-related children's deaths were reported, according to today's weekly update from the Centers for Disease Control and Prevention (CDC).

For the first time in months, no states reported high influenza-like illness (ILI) activity, the CDC said. For the previous 2 weeks, New Jersey was the only state in that category. But New Jersey, Minnesota, and Puerto Rico still reported moderate ILI activity, as had Arkansas, Arizona, and Puerto Rico a week earlier.

Reports from sentinel clinics showed that 1.8% of patient visits last week were for ILI, down from 2.0% a week earlier and below the national baseline of 2.1%. Three of 10 CDC regions were at or above their own baselines for this marker.

In addition, the count of states with geographically widespread flu cases dropped to 7 plus Puerto Rico, from 13 and Puerto Rico the previous week.

The four flu-related deaths in children equaled the toll the previous week and raised the season's total to 64. Two of the deaths were due to influenza A/H1N1 viruses, one to a type B virus, and one to a type A virus that was not subtyped.

As for overall mortality, 6.8% of deaths reported in the 122 Cities Morality Reporting system were attributed to pneumonia and flu last week. That was up a hair from 6.7% a week earlier but below the week's designated epidemic threshold of 6.9%.

The share of respiratory samples testing positive for flu ebbed again last week, at 11.2% of 12,818 specimens, versus 12.5% of 14,806 the previous week. And the dominance of type B over type A viruses continued to increase, reaching 61.9%, up from 52.6% a week earlier.

The cumulative incidence of flu-related hospitalizations reached 30.6 per 100,000 population, compared with 29.8 the week before.
May 6 CDC FluView update

Taiwan reports H5N8 and H5N2 outbreaks

In separate reports to the World Organization for Animal Health (OIE) yesterday, Taiwan noted two outbreak of highly pathogenic H5N8 avian flu in Tainan and Kaohsiung City and one outbreak of H5N2 in Tainan.

The H5N8 outbreak in Tainan began Apr 19 on a farm in Guiren District. Of 1,936 geese on the farm, 104 died, and 1,832 birds were culled to prevent the spread of disease. Elsewhere in Taiwan, officials reported an H5N8 outbreak in a slaughterhouse in Kaohsiung City's Daliao District after observing suspicious postmortem signs in 5 chickens. The remaining 1,080 chickens at the slaughterhouse were destroyed.

An outbreak of high-path H5N2 began on Apr 29 and involved a farm in Tainan's Guanmiao District. Of the 8,470 chickens, 3,583 died, and the remainder of the flock was destroyed. As in the H5N8 outbreak in Tainan, abnormal mortality on the farm prompted avian flu testing.

Taiwan has been battling avian flu outbreaks, mainly H5N2 and H5N8, since January 2015.
May 5 OIE report on H5N8 outbreaks
May 5 OIE report on H5N2 outbreaks