News Scan for Apr 01, 2014

News brief

WHO reports fatal MERS case in UAE man

The World Health Organization (WHO) today confirmed a new fatal case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in a 64-year-old man from the United Arab Emirates (UAE).

According to information supplied to the WHO on Mar 30 by UAE health officials, the man, from Abu Dhabi, became ill Mar 21 and was admitted to a hospital on Mar 25. His condition deteriorated, he was placed in intensive care, and he died in the facility on Mar 30. He had underlying medical conditions, the WHO said in a statement.

The man had contact with animals, including camels, before becoming ill but had no contact with lab-confirmed case-patients, the agency said. He recently traveled to Oman and Saudi Arabia, which has confirmed by far the most MERS cases. The WHO recently said that camels are likely the primary source of MERS-CoV.

The agency said the man's case raises its official global MERS tally to 207 lab-confirmed cases, of which 87 have proved fatal.
WHO landing page for Apr 1 MERS update

In related news, a study published yesterday in the International Journal of Infectious Disease found additional evidence of possible MERS-CoV transmission from camels in two case clusters in the Hafr Al-Batin district of Saudi Arabia.

The district houses the country's largest camel market and holds an annual camel festival, Saudi and British scientists reported. They noted 12 cases from June through August of 2013 for which they conducted a detailed epidemiologic investigation. They said that genetic data indicate that at least two of the case-patients could not have been infected by the index patient, indicating another source.

"Camels appear as the likely source but other animals have not been ruled out," they conclude, adding that more detailed case-control studies are being conducted to delineate the missing pieces in the outbreak.
Mar 31 Int J Infect Dis abstract

Chikungunya cases in the Caribbean top 18,000

Caribbean islands have reported 2,580 new confirmed, probable, or suspected cases of chikungunya in the past week, the European Centre for Disease Prevention and Control (ECDC) said in an update yesterday. The numbers raise the region's total to 18,493 cases, up from 15,913 a week ago.

Martinique continues to lead the case total, with 9,340 suspected and 1,207 confirmed or probable cases, the ECDC said. The French side of St. Martin is next, with 2,750 suspected and 784 confirmed or probable cases, but the pace of new cases appears to be slowing there. Guadeloupe is third with 2,270 suspected and 734 confirmed or probable cases.

The next hardest-hit areas are St. Barthelemy, 435 suspected and 134 confirmed or probable cases; Dominica, 487 suspected and 72 confirmed cases; the Dutch side of St. Martin, 224 confirmed cases; French Guiana, 22 confirmed locally acquired and 11 imported cases; Anguilla, 14 confirmed cases; British Virgin Islands, 7 confirmed cases; and Aruba and St. Kitts/Nevis, each with 1 confirmed case.

The ECDC also reported 3 chikingunya-related deaths on the French side of St. Martin and 2 on Martinique. The outbreak is the first known in the Americas and began in December 2013 on the French side of St. Martin.

The ECDC also cited a Mar 25 report from ProMED, the reporting service of the International Society for Infectious Diseases, that said the Dominican Republic's health minister has reported a large suspected outbreak of chikungunya. The country has sent specimens to the US Centers for Disease Control and Prevention for confirmation, according to ProMED.
Mar 31 ECDC update
Mar 25 ProMED report

Flu Scan for Apr 01, 2014

News brief

Sea otters test positive for H1N1 antibodies

Federal researchers have found antibodies to the 2009 H1N1 (pH1N1) flu virus in almost three fourths of sea otters they tested that were from off the coast of Washington state, according to a letter today in Emerging Infectious Diseases.

Researchers from the Centers for Disease Control and Prevention and US Geological Survey collected samples from 30 sea otters captured in 2011 and found that 22 (73%) had hemagglutination inhibition antibody titers of 40 or higher against the pH1N1 virus. They also found that the serum from 21 otters (70%) had detectable Immunoglobulin G (higher than 200) for recombinant hemagglutinin (HA) of the A/Texas/05/2009 pH1N1 strain.

The authors write, "Although we cannot exclude the possibility that sea otters were infected with classical swine influenza A(H1N1) virus, which shares high HA genetic and antigenic similarity with pH1N1 virus, our serologic evidence is consistent with isolation of pH1N1 virus from northern elephant seals [off the California coast in 2010]. Therefore, we conclude that these sea otters were infected with pH1N1 virus."

They add, "Our results show that sea otters are susceptible to infection with influenza A virus and highlight the complex nature of interspecies transmission of influenza viruses in the marine environment."

They said the source of the virus remains unknown.
Mar 31 Emerg Infect Dis letter

Study: 'Universal' vaccine protects mice against H7N9, other strains

A "universal" influenza vaccine containing H5N1 proteins but designed to combat diverse flu strains protected mice against H7N9, H3N2, pH1N1, and H7N7, according to a study by Hong Kong researchers published yesterday in the Proceedings of the National Academy of Sciences.

The vaccine, made by Wyeth, uses a live vaccinia (cowpox) virus that expresses multiple H5N1 viral proteins (HA, neuraminidase, matrix protein 1 [M1], M2, and nucleoprotein) as well as an immune-boosting adjuvant called IL-15. It has already proved to be protective for mice against various H5 strains, the authors write.

In the current study, the vaccine increased survival in the animals compared with those who didn't receive it and significantly reduced viral loads in the mice's lungs against the most recent human H7N9 strain, seasonal H3N2, pH1N1, and a highly pathogenic H7N7 avian flu virus. The vaccine induced T-cell immune responses that recognized different flu viruses, and those responses were augmented in the presence of a challenge virus, the researchers said.

They conclude, "This study illustrates the potential utility of our multivalent Wyeth/IL-15/5Flu as a universal influenza vaccine with a correlate of protective immunity that is independent of neutralizing antibodies."
Mar 31 Proc Natl Acad Sci abstract