News Scan for Nov 12, 2015

News brief

CDC notes growing concern of meningococcal disease in MSM

Three US outbreaks of meningococcal disease in men who have sex with men (MSM) in recent years prompted the Centers for Disease Control and Prevention (CDC) to request reports from states on the disease in this population, and they noted at least 74 cases since 2012 concentrated in large cities, according to a report today in Morbidity and Mortality Weekly Report (MMWR).

In May 2013 and again in August this year, CDC asked health departments to review all meningococcal disease cases in men from January 2012 through June 2015, reporting MSM status, if possible. The request came after clusters of 13, 4, and 7 cases were reported among MSM in New York City, Los Angeles, and Chicago, respectively in 2012, 2013, and 2015.

Officials reported 527 cases in working-age men. Although MSM status is not routinely collected for the disease and might be underreported, 74 cases involved MSM, the CDC said. Of those, 23 were in New York City, 14 in Los Angeles County, and 11 in Chicago, while 26 sporadic cases occurred elsewhere, with no more than 3 in any one area during any 3-month period.

The median age of MSM patients was 31 years (range, 20 to 59). Neisseria meningitidis serogroup C accounted for 62 cases (84%), while serogroups B, W, and Y accounted for 5, 2, and 3 cases, respectively. Serogroup was unknown for 2 patients. A full 24 cases (32%) proved fatal. Of the 41 patients for whom vaccination status was known, 6 (15%) had received a quadrivalent meningococcal vaccine, which does not contain serogroup B.

The authors conclude, "Health departments are encouraged to attempt to determine MSM and HIV status during investigations of meningococcal disease cases caused by any serogroup occurring among males aged ≥16 years."
Nov 13 MMWR report

US cases of congenital syphilis up sharply

After dropping substantially from 2008 to 2012, the rate of congenital syphilis (CS) rose sharply in 2014, CDC researchers noted in a separate MMWR report today.

Previously, the CDC said that CS decreased from 1991 through 2005 before rising a bit from 2005 to 2008. In today's report, the agency said the rate of CS per 100,000 births decreased from 10.5 to 8.4 cases from 2008 to 2012. But the rate climbed to 11.6 cases per 100,000 births in 2014.

Increases in CS rates occurred in all regions but were greatest in the West, where the rate more than doubled, from 5.5 to 12.8 cases per 100,000 live births. The decline of CS from 2008 to 2012 reflects syphilis rates in women during that time, which dropped from 1.5 to 0.9 cases per 100,000 women, the CDC said.

Racial disparities in CS rates increased from 2008 to 2012, because relative decreases in rates were greater among whites (21%) than African Americans (11%). In 2012, 57% of CS cases were in African American infants, the report said.

The authors conclude, "To reduce CS, the timely identification of and response to increases in syphilis among women of reproductive age and men who have sex with women are essential. All women should have access to quality prenatal care, including syphilis screening and adequate treatment, during pregnancy."
Nov 13 MMWR report

Flu Scan for Nov 12, 2015

News brief

Study: Flu vaccine might help mitigate H3N2 flu symptoms

Flu vaccination might alleviate symptoms of the H3N2 influenza strain, according to a small study in Vaccine.

US military researchers studied 155 patients with lab-confirmed flu from five military hospitals from 2009 through 2014. Of them, 66 had H3N2 flu, while 69 had 2009 H1N1, 3 had influenza A that wasn't subtyped, and 17 had influenza B. The vaccination rate was 72% (111 patients).

Multivariate analyses showed that vaccinated patients were significantly less likely to report a fever of 101°F or higher but more likely to report muscle pain than unvaccinated patients.

In addition, vaccinated patients infected with H3N2 infections reported significantly lower severity scores for upper respiratory and total symptoms during the first 2 days of illness, and the differences in total symptom severity persisted for 7 days. Bivariate analyses also revealed severity-score differences for lower respiratory and systemic symptoms throughout 7 days of H3N2 illness.

No differences in symptom severity were reported in patients with H1N1 infections.
Nov 10 Vaccine study

Iowa declares commercial farms ready for restocking after avian flu

All 72 Iowa farms affected by highly pathogenic H5N2 avian flu earlier this year have had the quarantines on their facilities lifted and are eligible to restock poultry, the Iowa Department of Agriculture and Land Stewardship (IDALS) said in a news release late last week.

"All sites have completed the cleaning and disinfection process and had negative environmental tests," the agency said. The farms also had to undergo a 21-day fallow period following disinfection. They include 35 commercial turkey flocks, 22 egg-producing flocks, 13 pullet flocks, a chicken breeding flock, and a mail order hatchery.

"Five backyard operations remain under quarantine," IDALS said. "Backyard facilities must undergo a 180 day fallow period following depopulation before the quarantines can be lifted and birds brought back to the farm. It is anticipated that these sites will be able to come off of quarantine in the next month."

The agency also said that bird owners must employ effective biosecurity measures to prevent a return of avian flu now that the fall migration of wild birds, which can spread the disease, has begun. IDALS also pointed to the US Department of Agriculture's fall plan, which focuses on preventing or reducing outbreaks, enhancing preparedness, improving response capabilities, and preparing for potential use of avian flu vaccines.
Nov 6 IDALS news release