Vector-borne Disease Scan for Dec 04, 2017

News brief

PAHO reports 1,100 new chikungunya cases in recent weeks

In the past month the Pan American Health Organization (PAHO) has reported 1,106 new chikungunya infections, bringing the yearly total to 184,636 confirmed, suspected, and imported cases.

Because of the low numbers, CIDRAP News has not reported on the outbreak since PAHO's Nov 3 update. During the most recent weeks, Peru reported by far the highest increase, with 782 new cases and 2,450 total for the year, according PAHO's Dec 1 update. Colombia was next, with 52 new cases, for a total of 1,047 so far in 2017, and Bolivia reported 45 new cases and 3,326 total.

Several other nations reported small increases, including the United States, which has now confirmed 93 imported cases this year. A host of nations, however, including Brazil, which has reported more than 90% of this year's total, have not reported on their chikungunya situation for many weeks. Brazil has not reported its numbers to PAHO for 3 months.

Since the outbreak began in 2013 on the Caribbean island of St. Martin, the Americas region has reported 2,570,767 cases.

In related news, a Dec 1 study in Travel Medicine and Infectious Disease reports that chronic inflammatory rheumatism is common in patients even a full year after infection. Colombian scientists reported that 38 of 65 lab-confirmed patients (58.5%) had at least one persistent rheumatologic symptom in the year after infection, and 28 (43.1%) had chronic polyarthralgia—arthritis pain in more than one joint.
Dec 1 PAHO update
Dec 1 Travel Med Infect Dis study

 

FDA advisers recommend paring back on Zika blood donor screening

An expert advisory panel has recommended that the US Food and Drug Administration (FDA) relax its recommendations on screening blood for Zika virus because of few new cases, Thomson Reuters reported Dec 1.

The advisors recommended testing small groups of donated blood samples in lieu of testing every individual blood donor sample. In 2016, at the height of the Zika outbreak in the America's the FDA advised all blood centers to screen all blood for Zika virus.

Cases since then have tumbled. In the Miami area, for example, a hotbed of Zika activity last year, only two local cases have been confirmed this year.
Dec 1 Thomson Reuters story

China reports infections from H7N9, H9N2 avian flu viruses

China has detected two new human avian influenza cases, one involving an adult sickened by H7N9 and the other a young child infected with H9N2, according to government reports in the region.

The H7N9 illness, China's first since September, involves a 64-year-old man in the Yunnan province city of Kunming. His symptoms began on Nov 21, Hong Kong's Centre for Health Protection (CHP) said in a Dec 2 statement, based in information from mainland health officials. The man is hospitalized in serious condition.

An investigation into the source of his illness found that the man had contact with dead poultry.

The case might mark the beginning of China's sixth wave of H7N9 activity, though the country is known to report sporadic cases throughout the year. The case appears to lift the global number of H7N9 cases to 1,565, according to numbers in a regular summary report from the CHP.

Meanwhile, Macao's health bureau said yesterday in a report on China's new H7N9 case that the mainland has also reported a new H9N2 infection, involving a 20-month-old girl from Changsha City in Hunan province, according to a government statement translated and posted by Avian Flu Diary, an infectious disease news blog. The girl's symptoms began on Nov 27, her infection is not severe, and she apparently had exposure to a live-poultry market.

So far, five H9N2 infections have been reported this year. The virus is endemic in Chinese poultry, and infections involving the strain are more common in children than in adults.
Dec 2 CHP statement
Nov 28 CHP weekly avian influenza report
Dec 4 Avian Flu Diary post

 

New MERS case, death reported in Saudi Arabia

Over the weekend the Saudi Arabian Ministry of Health (MOH) reported one new MERS cases and one death in a previously announced patient.

On Dec 2 the MOH said a 71-year-old Saudi man from Buraydah was in stable condition after presenting with symptoms of MERS-CoV (Middle East respiratory syndrome) illness. The man's source of infection is listed as "primary," meaning it's unlikely he contracted the virus from another person.

Yesterday the MOH reported the death of a 15-year-old Saudi boy in Riyadh. The MOH said he had preexisting illnesses in addition to MERS.

As of yesterday, Saudi Arabia's MERS-CoV total cases since 2012 is 1,752, including 709 deaths. Four people are still being treated for their infections.
Dec 2 MOH report
Dec 3 MOH report

 

Salmonella outbreak in Pacific Northwest linked to precut melon

Precut cantaloupe and watermelon slices sold in Pacific Northwest grocery stores have been linked to at least 20 cases of Salmonella illness in Washington and Oregon, according to a Dec 1 Food Safety News story.

The melon slices were sold separately and in fruit mixes at Kroger brand grocery stores. Genetic testing has linked the illness outbreak to a Salmonella Newport strain found on the fruit.

Washington state health officials urged consumers to toss any precut melon products bought from about Oct 25 to Dec 1 from QFC, Fred Mey, Rosauers, and Central Market, according to a state health department news release. KTVZ, a central Oregon television station, said patients reported symptoms between Oct 29 and Nov 15.

So far, there have been no reported hospitalizations or deaths. Most salmonellosis symptoms, including vomiting and diarrhea, resolve within 3 to 7 days.
Dec 1 Food Safety News story
Dec 1 Washington State Department of Health news release
Dec 1 KTVZ story

 

Filovirus signs in fruit bats indicate circulation in Southeast Asia

A new study published in Emerging Infectious Diseases documents the presence of antibodies to several filoviruses, including Ebola, in populations of Southeast Asian fruit bats.

From 2011 to 2016, researchers collected and sampled specimens from three bat species in Singapore, including Cynopterus brachyotis, Eonycteris spelaea, and Penthetor lucasi. From 4.3% to 9.1% of all bats tested harbored antibodies toward filoviruses, including Ebola Zaire, Bundibugyo, and Sudan strains. Marburg virus and Ebola Reston, however, were not detected in the animals.

Bats have been identified as reservoirs for Ebola virus in Africa, and though interspecies spillover is unlikely, the authors said continued bat surveillance is useful to understand the potential threats of filoviruses.

"Comprehensive surveillance including serology and detection of viral nucleic acid, along with virus isolation, will help elucidate the characteristics of filoviruses endemic to Asia and identify bat species that function as maintenance populations and reservoirs," the authors concluded.
Dec 1 Emerg Infect Dis study

 

Sanofi ends development of experimental C difficile vaccine

Drugmaker Sanofi Pasteur says it's discontinuing clinical development of an experimental vaccine for Clostridium difficile infection (CDI).

In a Dec 1 press release, the company announced that, following a planned interim analysis of early results from the phase 3 Cdiffense clinical trial, an independent data monitoring committee concluded that the study was unlikely to meet its primary objective. The trial was designed to test the efficacy and safety of a toxoid vaccine in a subpopulation at risk of CDI. The vaccine stimulates the immune system to fight toxins generated by C difficile bacteria.

The company said data from all vaccinated volunteers in the trial will continue to be analyzed for more information and shared with the scientific community.

CDI is a leading cause of diarrhea in hospital patients and one of the most common healthcare-associated infections. According to the US Centers for Disease Control and Prevention's most recent estimates, C difficile is responsible for nearly half a million infections among US hospital patients annually, with approximately 29,000 patients dying within 30 days of infection.
Dec 1 Sanofi press release     

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