News Scan for Feb 21, 2014

News brief

ECDC reports spike of Caribbean chikungunya, spread in South America

Martinique and neighboring Caribbean islands have seen a major surge of suspected chikungunya cases this week, and two locally acquired cases in French Guiana mark the first indigenous cases in South America, the European Centre for Disease Prevention and Control (ECDC) reported today.

The ECDC said the suspected cases total more than 5,900, but it gave an island-by-island breakdown that totaled 6,540. Both numbers are far above the roughly 2,000 confirmed cases the ECDC reported on Feb 17. It was not clear if the 6,540 suspected cases included any confirmed or previously reported cases.

Martinique has 3,030 suspected cases, the ECDC said. The suspected-case counts for other locations include the French side of St. Martin, 1,780; St. Barthelemy, 350; and Guadaloupe, 1,380. In addition, the agency listed the following numbers of confirmed cases: the Dutch side of St. Martin, 65; the British Virgin Islands, 5; Dominica, 45 (1 imported case); Anguilla, 5 (1 imported); Aruba, 1; and St. Kitts and Nevis, 1.

For French Guiana, the ECDC listed seven confirmed or probable cases, including 5 imported ones and 2 autochthonous (locally acquired) cases.

A translated Feb 19 media report from French Guiana, posted by ProMED-mail yesterday, said the two cases involved two Kourou residents who live in the same neighborhood. It said they were the first people to contract the virus locally.

The case reported in St. Kitts and Nevis is the first confirmed case there, according to a Feb 20 story from the West Indies News Network (WINN). It said the case involved a 30-year-old man who was hospitalized and discharged 2 weeks ago.

The Caribbean outbreak is the first known chikungunya epidemic in the Americas. It began on St. Martin in December.
Feb 21 ECDC statement
Feb 20 ProMED-mail post
Feb 20 WINN story

Settlement extends deadlines for FSMA final rules into 2016

The US Food and Drug Administration (FDA) yesterday reached a settlement with the Center for Food Safety (CFS) and the Center for Environmental Health that will push back deadlines for the finalization of several rules related to the FDA Food Safety Modernization Act (FSMA), some into the spring of 2016.

The agreement, reached in the US District Court of Northern California, extends deadlines for four final rules beyond the June 2015 deadline set by the same court last year, Food Safety News reported today. In return, the FDA will drop its Ninth Circuit Court appeal in a dispute with the two consumer groups. The settlement also marks the end of CFS's 2012 lawsuit against the FDA for failing to meet deadlines for the FSMA-mandates rules.

The settlement also removes any prior deadlines for public comment periods. The new deadlines for the various rules are as follows:

Aug 30, 2015, for preventive controls for human and animal food
Oct 31, 2015, for produce safety, foreign supplier verification program, and third-party accreditation
Mar 31, 2016, for sanitary transport
May 31, 2016, for intentional adulteration

"The agency is working as quickly and expeditiously as possible to meet our deadlines for the final rules, while also ensuring that we get these rules right," an FDA spokesperson told Food Safety News.
Feb 20 District Court settlement
Feb 21 Food Safety News story

Study: Malaria parasite may have come from Africa, not Asia

Plasmodium vivax, the second-worst malaria parasite, may have its origins in Africa and not Asia as has been believed, according to a study today in Nature Communications.

Researchers from the University of Pennsylvania School of Medicine and elsewhere around the world found that wild chimpanzees and gorillas in central Africa are widely infected with parasites that are nearly genetically identical to human P vivax. (The ape precursor of P falciparum, the deadliest human malaria parasite, infects gorillas only.)

To examine the evolutionary relationships between ape and human parasites, the investigators generated parasite DNA sequences from wild and sanctuary apes, as well as from a global sampling of human P vivax infections, according to a University of Pennsylvania press release. They constructed a family tree of the sequences and found that ape and human parasites were very closely related.

The team's sequence analyses revealed that the ape P vivax parasites lack host specificity and are much more diverse than human P vivax. They conclude, "All extant human P vivax parasites are derived from a single ancestor that escaped out of Africa."

"Our finding that wild-living apes in central Africa show widespread infection with diverse strains of P vivax provides new insight into the evolutionary history of human P vivax and resolves the paradox that a mutation conferring resistance to P vivax occurs with high frequency in the very region where this parasite is absent in humans," said U Penn researcher Beatrice Hahn, MD, in the release.
Feb 21 Nat Commun abstract
Feb 21 U Penn School of Medicine news release

Fordham reports 13 suspected mumps cases

Fordham University in Bronx, N.Y., has reported a mumps outbreak, with 13 suspected cases on two campuses, the New York Post reported today. Twelve of the cases were reported in the past 4 days.

"All the students with suspected mumps infections have either returned home or have been isolated from other residents during the infectious phase of the illness," Fordham officials told the Post. "Typically mumps patients are contagious for 2 days prior to the outbreak of symptoms and 5 days after."

All of the affected students had been vaccinated, the university said in a statement, adding, "Vaccinations do not offer 100% protection." It said that mumps in college students typically runs its course without long-term effects.
Feb 21 New York Post report

Flu Scan for Feb 21, 2014

News brief

1,500 chickens culled for H5N1 in Nepal

After about 300 chickens on a farm in Nepal died mysteriously, H5N1 avian flu was confirmed and 1,552 chickens on that and a neighboring farm as well as 30 crates of eggs were destroyed yesterday by a rapid response team, according to a story in Republica, a Nepalese newspaper.

The farms are in Itahari in the southeast district of Sunsari. Dr. Bodh Raj Parajuli, director of the Regional Veterinary Directorate at Biratnagar, said chickens and other domestic birds within a 500-meter radius of the two farms would be destroyed, says the article. Poultry farmers are being urged to report any symptoms of illness in their flocks.

Large outbreaks of H5N1 in Nepal were reported late last year.
Feb 20 Republica story
Most recent (Nov 13, 2013) CIDRAP News item on H5N1 in Nepal

WHO holds mission in Egypt to lend support surrounding H1N1 flu

Egypt's Ministry of Health and Population (MoHP) has received help from the World Health Organization (WHO) in the midst of a rash of 2009 pandemic H1N1 influenza cases, according to a WHO statement yesterday.

According to the WHO, the large number of H1N1 cases is not unexpected, as the strain is hitting many areas of the world hard this flu season. The number of cases this season is similar to the number last flu season, but many areas are reporting an increase in severe cases. The 2009 H1N1 type of flu tends to affect young adults in larger numbers than typical seasonal influenza strains.

The H1N1 cases appear to have peaked about 2 weeks ago, said Anthony Mounts, MD, leader of the epidemiologic portion of WHO's Egyptian mission, and numbers are likely to decline going forward.

The WHO gave recommendations to MoHP for improving early detection and notification of influenza-like illness and severe respiratory events. The organization also worked with MoHP on educating critical care doctors in Egypt on specimen collection, care of critically ill patients, and infection control, and it worked with MoHP staff on appropriate risk communications.

Henk Bekedam, WHO's representative in Egypt, said that "On the whole, Egypt has a well-established and -functioning surveillance system."
Feb 20 WHO statement