Avian Flu Scan for Dec 31, 2014

News brief

Human H5N1 uptick continues in Egypt with 1 case, 1 death

Egypt's ministry of health (MOH) today announced a case of H5N1 avian influenza in a 3-year-old boy in Giza governorate, bringing the country's 2014 total to 27 cases, according to a machine-translated statement posted by FluTrackers.

The MOH also reported the death from H5N1 of a 30-year-old woman from Ashmun, Monofia governorate, raising Egypt's H5N1 death toll this year to 11.

The child experienced fever and cough, said MOH. Chest films showed he had pneumonia on Dec 26, and H5N1 was confirmed Dec 29.

The MOH is calling on Egyptians who work with poultry to go immediately to a hospital if they experience symptoms and to exercise caution in working with birds, particularly any showing signs of illness. It also cautions people to wash their hands after handling birds, to keep children away from bird breeding or slaughter areas, and to separate birds from living quarters.

The past 6 weeks have seen a major uptick in H5N1 cases in Egypt, notes a post today in Avian Flu Diary. The country went nearly 2 years with only 8 human cases of H5N1 but has reported 23 cases just since mid-November, it notes.
Dec 31 FluTrackers notice
Dec 31 Avian Flu Diary article

Tests confirm H7N9 in Hong Kong poultry imports

Follow-up tests by Hong Kong's agriculture department on a shipment of live chickens from China's mainland that were shown on serologic tests to have been exposed to H7 avian influenza revealed that the birds are infected with the H7N9 virus, the government said today in a statement.

The initial 120 swabs taken from the birds were negative on polymerase chain reaction (PCR) tests, but officials collected 120 more swabs from the same birds, and PCR results were positive for H7N9 in a number of them.

The findings triggered a 21-day closure of the wholesale poultry market where the birds were kept and the temporary suspension of live poultry imports from the mainland, Hong Kong's government said. Authorities started culling the 15,000 birds at the wholesale market today.

Officials will ensure that biosecurity measures are in place before the farm that raised the infected birds is allowed to resume supplying birds to Hong Kong, and they will inspect all 29 registered farms in Hong Kong to make sure their flocks are not infected with H7N9.

A handful of Chinese provinces have reported recent human H7N9 infections, and most of the patients had been exposed to poultry markets or live poultry. Hong Kong officials had detected H7N9 in poultry imported from the mainland in previous waves of infection. However, at a media briefing today, Ko Wing-man, MBBS, Hong Kong's secretary of food and health, said this is the first time authorities have used serology to detect H7 in live poultry.

In a related development, Hong Kong's Centre for Health Protection (CHP) said it is monitoring the health of workers who were exposed to the poultry. A worker at the wholesale market is considered a close contact, and among 77 other contacts identified were the truck driver who transported the chickens, animal inspectors, and cullers.
Dec 31 Hong Kong government statement
Dec 31 CHP statement

News Scan for Dec 31, 2014

News brief

Listeriosis cases linked to caramel apples reach 32 in 11 states

Three more Listeria monocytogenes infections have been identified in an outbreak linked to commercially produced caramel apples, raising the count to 32 cases in 11 states, the Centers for Disease Control and Prevention (CDC) announced in an update today.

Thirty-one of the 32 patients have been hospitalized, and the number of deaths increased by 1, to 6, the CDC said. Listeria contributed to three of the deaths, one death was unrelated to the illness, and the role of the illness in the other two is unclear.

The agency said 10 cases involved pregnant women or newborn babies, up by 1 since the previous update on Dec 22. One fetal loss was reported.

The CDC said 23 of 26 patients who were interviewed reported eating commercial caramel apples before they got sick.

Three companies—Happy Apples, California Snack Foods, and Merb's Candies—have recalled caramel applies after hearing from Bidart Brothers, an apple supplier, that the outbreak may be related to its apples, the CDC noted. Merb's Candies, based in St. Louis, issued the latest recall, on Dec 29.

The CDC is continuing to recommend that consumers refrain from eating any commercially produced, prepackaged caramel apples until more specific guidance can be provided.

Nevada is the latest state affected by the outbreak, reporting one case. Other affected states are Arizona (4 cases), California (2), Minnesota (4), Missouri (5), New Mexico (6), North Carolina (1), Texas (4), Utah (1), Washington (1), and Wisconsin (3).

In Canada, authorities have identified two Listeria monocytogenes infections with the same DNA fingerprint as seen in the US outbreak, according to the CDC.
Dec 31 CDC update
Related Dec 23 CIDRAP News item

Aseptic meningitis in California football players caused by echovirus 30

The first known outbreak of aseptic meningitis associated with echovirus type 30 struck 10 young people in California in late summer, 8 of them members of a football team, according to an article today in Morbidity Mortality Weekly Report (MMWR).

Echovirus types 5, 9, 16, and 24 have previously been associated with aseptic meningitis outbreaks in football teams, the article notes. It states that type 30 accounted for 4.5% of nonpolio enterovirus serotypes in the United States from 2006 to 2008.

All 10 of the individuals infected with echovirus 30 sought care in an emergency department, and 5 were hospitalized. All have recovered. Eight of the case-patients were football players at a Los Angeles County high school; the remaining two were siblings of players.

With 7 of 57 players on one team affected, the attack rate was 12.3%. The relative risk (RR) of illness was higher for linemen than for other players (RR = 5.4 [P = 0.03]).

Likely factors in transmission were thought to be shared water bottles, inadequate washing of the bottles, and poor hand hygiene.
Jan 2, 2015 MMWR article (released Dec 31, 2014)

South Dakota has first measles case in 17 years

South Dakota has identified its first measles case since 1997, the South Dakota Department of Health reported yesterday, as a busy year for measles in the United States neared its end.

The South Dakota case involved an unvaccinated child under age 5 in Davison County, the health department said in a press release.

"South Dakota has good immunization coverage rates but measles is on the rise nationally which means unvaccinated individuals are at risk for exposure when they travel to areas with cases," said State Epidemiologist Lon Kightlinger, PhD, in the release. He said the department is working to identify contacts of the case-patient.

In related news, a measles case has been identified in North Carolina in an unvaccinated resident who recently traveled to India, according to an ABC News Radio report yesterday. The case was reported in Mooresville, the story said.

The North Carolina Department of Health and Human Services' Web site did not show any information about the case today.

For this year, the nation as a whole had 610 measles cases in 24 states through Nov 29, making it the worst year for measles since the disease was officially eliminated in 2000, according to the CDC. By comparison, fewer than 200 cases were reported in 2013.

The CDC said 20 outbreaks accounted for 89% of the cases this year.
Dec 30 South Dakota press release
Dec 30 ABC News Radio report
CDC count of measles cases