News Scan for Nov 02, 2015

News brief

Saudi Arabia reports 1 new MERS case, 1 death

After a weekend with no MERS-CoV cases, Saudi Arabia's Ministry of Health (MOH) reported a new case today away from recent hot spots and yesterday reported the death of a previously confirmed patient.

The new MERS-CoV (Middle East respiratory syndrome coronavirus) case is in Afif, a city of about 40,000 roughly halfway between Riyadh, which has seen many recent cases, and Mecca. It involves a 50-year-old Saudi woman who is hospitalized in critical condition and is not a healthcare worker (HCW). She did not contract the disease from a known case, the MOH said.

The agency also said today that a 24-year-old female HCW in Riyadh has recovered from MERS. She had no preexisting disease.

Yesterday the MOH confirmed that a 37-year-old Saudi man in Hofuf with preexisting illness died from MERS-CoV. He was not an HCW. That city has also reported multiple recent cases.

The country has now confirmed 1,274 MERS cases since the outbreak began in 2012, including 544 deaths.
Nov 2 MOH update
Nov 1 MOH update

Chipotle-linked E coli outbreak sickens 22 in 2 states

State health officials in Washington and Oregon are investigating an Escherichia coli outbreak linked to eating at Chipotle restaurants that has sickened 22 people so far, 19 in Washington and 3 in Oregon. The company has voluntarily closed its 43 restaurants in the two states during the investigation, the Seattle Times reported yesterday.

The Washington State Department of Health (WSDOH) said in an Oct 31 statement that 8 patients have been hospitalized, 7 in Washington and 1 in Oregon. Washington's cases are from four different counties in the western third of the state: King, Clark, Cowlitz, and Skagit.

Oregon's affected counties are Clackamas and Washington, both in the far northwestern part of the state, according to an Oct 31 statement from the Oregon Health Authority (OHA). Patient ages range from 11 to 64 years old, the OHA said.

The WSDOH is asking people who got sick after eating at a Chipotle restaurant in the past 3 weeks to contact their health providers, and OHA asked people who got sick between Oct 14 and Oct 23 after eating at the restaurants to see their doctors and mention the outbreak.

Though the event appears to be linked to food served at Chipotle restaurants, so far the food or other contamination source hasn't been identified. The WSDOH said local and state health officials are investigating the outbreak, along with the US Centers for Disease Control and Prevention and the Food and Drug Administration.

The event is the second recent foodborne illness outbreak linked to Chipotle restaurants. In September the Minnesota Department of Health (MDH) linked 64 Salmonella Newport infections to 22 restaurants. Tomatoes were identified as the outbreak source.
Nov 1 Times story
Oct 31 WSDOH statement
Oct 31 OHA statement
Sep 16 MDH news release

Cholera cases top 2,000 in Iraq as WHO mobilizes vaccine efforts

Cholera cases in Iraq have topped 2,000 as the World Health Organization (WHO) ramps up an immunization campaign, the agency said in a news release yesterday.

About 250,000 displaced people in 62 refugee camps will be targeted during the oral cholera vaccine campaign. The WHO has mobilized 510,000 doses of the vaccine, which will start to be administered this week. People need to receive two doses each for optimal effect.

The outbreak has now reached 2,173 lab-confirmed cases have been reported in 15 of the country's 19 governorates, up from 1,811 on Oct 20, the WHO said. Two people have died from the disease. Cases are dwindling, though, the agency said, especially in the north.
Nov 1 WHO news release

Flu Scan for Nov 02, 2015

News brief

Study finds shedding pattern differences between flu A and flu B

A 7-year study of naturally acquired flu infections revealed that viral shedding mirrors the clinical profile for influenza A infections, but not influenza B. A research group based in Hong Kong—where the study took place—published its findings Oct 30 in an early online issue Clinical Infectious Diseases.

The team followed initially healthy people from 2008 through 2014, identifying 224 influenza infections. For 127 of the patients they recorded clinical symptoms and monitored viral shedding with reverse-transcription polymerase chain reaction testing and viral culture.

In patients with influenza A infections, viral shedding peaked on the first 2 days of clinical illness, dropping to undetectable levels by day 6 or 7, a pattern that closely matched the illness trajectory. For influenza B, howeer, viral shedding peaked as soon as 2 days before symptom onset and lasted for 6 or 7 days after onset, with a bimodal pattern.

Researchers concluded that although clinical illness might serve as a proxy for influenza A, for influenza B, patients can be infectious before symptoms set in or after they improve.

The same team reported initial shedding findings for just 1 year, 2008. They noted that other shedding experiments involved high challenge doses and that studying naturally acquired infections may shed better light on the infectiousness period.
Oct 30 Clin Infect Dis abstract

Flu vaccine found 52% effective against hospitalization in Australia

Flu vaccination last year cut hospitalization for influenza by more than half in Australia, according to data released Oct 31 in Vaccine.

Researchers analyzed data from adult patients hospitalized with influenza from April to November 2014, which is Australia's flu season. They estimated vaccine effectiveness using data from 1,283 patients with flu and 1,116 patients who tested negative.

They found flu effectiveness at reducing the risk of hospitalization for flu to be 51.5% (95% confidence interval [CI], 41.6%-59.7%, P < 0.001) for all patients and 50.7% (95% CI, 40.1%-59.3%) in the target population.
Oct 31 Vaccine abstract