News Scan for Mar 22, 2016

News brief

Saudi Arabia reports 2 MERS cases in Buraydah, 1 fatal

A MERS-CoV cluster in Buraydah, Saudi Arabia, has grown by 2 cases, 1 of which was fatal, to 28 since Mar 3, the Saudi Ministry of Health (MOH) reported today. The agency also noted that a previously reported patient in Buraydah died from his infection.

The two cases in Buraydah involve Saudi women who acquired their MERS-CoV (Middle East respiratory syndrome coronavirus) infections in a healthcare setting, the MOH said. Neither had contact with camels. One patient is a 78-year-old woman who is not a healthcare worker and is hospitalized in stable condition. The woman who died was 29, had preexisting disease, and was not a healthcare worker.

Most of the 28 cases in the north-central city have been tied to healthcare settings, and the World Health Organization has confirmed that many infections occurred in a single hospital.

In addition, the MOH said today that a 66-year-old man in Buraydah whose cases was confirmed earlier died from MERS in the past 24 hours. He was not a healthcare worker and had an underlying medical condition.

Two men in Riyadh have also recovered from their infections. Recoveries involved a 45-year-old foreign healthcare worker who had no preexisting disease and a 49-year-old Saudi man who was not a healthcare worker and had an underlying medical condition.

Today's update brings the country's MERS-CoV total since 2012 to 1,353 cases, 17 of which remain active, and 577 deaths.
Mar 22 MOH update
Mar 21 CIDRAP News story on Buraydah cluster

PAHO reports 1,700 new chikungunya cases in the Americas

The Pan American Health Organization (PAHO) late last week reported 1,693 new cases of chikungunya in the Americas, bringing the 2016 outbreak total to 32,535 confirmed and suspected cases.

The agency did not report any new 2015 cases since its previous update on Mar 4, leaving that number at 731,920 cases. Therefore, the outbreak total since its 2012 onset has now reached 1,912,081 cases, according to PAHO's total.

Colombia had the largest increase, with 782 new cases, to bring its total for the year to 8,701. Honduras was next, with 463 new cases and 6,194 total. Ecuador had 187 new cases and 570 for the year, and Venezuela had 116 new cases, raising its 2016 total to 1,866.

Of note, PAHO did not add to its 2015 or 2016 totals any of the more than 2,300 cases reported by Argentina and noted in a World Health Organization (WHO) news release on Mar 14. Those cases included the first-ever locally transmitted infections in the country. Also, many countries have not reported in many weeks.

PAHO did report in its Mar 18 update, however, the first two chikungunya-related deaths of the year, in Ecuador. The outbreak was first reported in December 2013 on St. Martin in the Caribbean with the first recorded cases of the disease in the Americas.
Mar 18 PAHO update
Latest PAHO 2015 cumulative case numbers
Mar 14 WHO news release

FAO reports human H5N1 case in northern Egypt

Egypt has reported a new human case of highly pathogenic H5N1 avian flu, according to the United Nations Food and Agriculture Organization (FAO).

The infection occurred in a child, now hospitalized, according to translated accounts posted on FluTrackers, an infectious disease news message board. The case was confirmed Mar 20 in the Bulaq Al-Dakrour district of Giza governorate, said the FAO's EMPRES (Global Animal Disease Information System) database, which lists cases reported by national authorities.

The new illness marks the country's fourth H5N1 case over the past 2 weeks. Egypt had a surge of at least 134 human H5N1 cases in the first half of 2015.
Mar 20 FAO report
Mar 20 FluTrackers post

Yellow fever outbreak grows in Angola as China reports imported case

The World Health Organization (WHO) reported today that yellow fever transmission is still occurring in Angola despite successful vaccination campaigns, while Chinese authorities yesterday reported the country's fourth case imported from Angola.

Sixteen of Angola's 18 provinces have reported suspected yellow fever cases, with evidence of both locally acquired and imported cases from Luanda province, where the outbreak began on Dec 5, 2015.

An ongoing immunization campaign has vaccinated 90% or more of the population in half of Luanda's 12 municipalities and has reached especially high immunization rates in the cities of Viana and Pela, the WHO said.

So far 757 suspected and 375 confirmed cases (1,132 total) have been reported in Angola, including 168 deaths. That's up from 878 total cases (813 suspected, 65 confirmed) and 138 deaths reported by the WHO on Mar 9. In the outbreak's epicenter of Luanda province, 818 cases, 281 of which were confirmed, and 129 deaths have occurred.

The WHO said that barriers to stopping transmission include non-optimal surveillance tactics in border areas and potential for international spread. No travel restrictions to or from Angola are recommended for vaccinated people.

In related news, China yesterday reported its fourth imported case of yellow fever since Mar 13, according to China's official news agency, Xinhua. All four imported cases occurred in travelers from Angola. The new case involves a 50-year-old man from Fujian province with no history of yellow fever vaccination. He experienced a fever in Angola on Mar 6 and returned to Beijing on Mar 18, where he is hospitalized in serious condition.
Mar 22 WHO update
Mar 21 Xinhua story
Mar 10 CIDRAP News item on Angola outbreak

Ebola Scan for Mar 22, 2016

News brief

Guinea reports 5th Ebola death as Liberia closes border

A fifth person has died from Ebola virus infection in southeast Guinea in recent days—raising fears of geographic spread—as the country monitors more than 800 possible contacts and Liberia closed its border with Guinea, Reuters reported in separate stories.

The latest case was detected in Macenta prefecture, about 125 miles from the village of Koropara where the four other recent Ebola-related deaths occurred, said Fode Sylla Tass, a spokesman for the country's Ebola response efforts, Reuters reported today.

The man had recently visited Koropara and had been in direct contact with the first patients, Tass said. He was buried in the village of Makoidou without proper disease-control measures.

After the first four deaths in Koropara, the Ebola coordination team in the country has traced an estimated 816 people in 107 families who may have come in contact with the newest victims or their corpses, Reuters reported yesterday.

These people have been quarantined in their homes for 21 days, and apparently they have been cooperating. If they have no symptoms by the end of the quarantine period, they will be released.

In response to the deaths, Liberia closed its borders, Reuters said today in a separate story. "The border will remain closed until the situation in Guinea improves. . . . We are not taking any chance at all," said Guinea's information minister, Eugene Nangbe.

Guinea was declared free of Ebola last December, and the recent flare-up brought to an end a World Health Organization declaration earlier in the day that West Africa was free of the disease.
Mar 22 Reuters report on latest death
Mar 21 Reuters story on contact follow-up
Mar 22 Reuters story on border closing
Mar 21 CIDRAP News scan on Guinea cases

Study confirms need for early follow-up of Ebola survivors

In other Ebola news, findings of a study published yesterday in Clinical Infectious Diseases added more weight to the importance of early follow-up of Ebola survivors for common sequelae that could lead to long-term disabilities if not treated.

The authors, from Geneva, followed 166 Ebola patients in a survivor clinic in Freetown, Sierra Leone, from Feb 3 through Jun 21, 2015; 1,001 medical consultations were done among the subjects.

The most frequent complaints and diagnoses were arthralgia in 129 (77.7%), fatigue in 116 (69.8%), ocular complications in 94 (56.7%), abdominal pain in 90 (54.2%), headache in 87 (52.4%), anemia in 83 (50%), skin disorders in 81 (48.8%), back pain in 54 (32.5%), and alopecia in 53 (31.9).

Among the ocular complications, uveitis was most common, occurring in 57 (34%). Those who presented with red or infected eyes during the acute phase of their illness were 10 times for likely to have uveitis as survivors, said the authors, indicating the importance of early treatment after discharge to minimize such sequelae as blindness.
Mar 21 Clin Infect Dis abstract