News Scan for Jan 26, 2016

News brief

Cucumber-linked Salmonella outbreak grows to 888 cases, 6 deaths

In the more than 2 months since a previous update, the toll of a cucumber-linked Salmonella outbreak has risen by 50 cases and 2 deaths, and Tennessee has joined the list of affected states. Cases have reached 888, deaths 6, and states 39, the Centers for Disease Control and Prevention (CDC) said today.

The two new deaths are in California, but health officials in that state said Salmonella infection was not a contributing factor, the CDC said. California had one of the other deaths, as have Arizona, Oklahoma, and Texas. Also, 191 cases required hospitalization.

Illness-onset dates range from Jul 3, 2015, to Jan 6, 2016, though the outbreak appears to be slowing, the CDC said. Patients range in age from 1 to 99, with a median age of 18, meaning about half of them are children.

"The number of reported illnesses has declined substantially since the peak of illnesses in August and September; however, it has not returned to the number of reported illnesses that we would expect to see (about 1 every month during this time of year)," the CDC said.

The agency said, "The investigation into the source of these recent illnesses is ongoing," but it added, "Whole genome sequencing (WGS) of Salmonella Poona isolates from ill people and from contaminated cucumbers distributed by Andrew & Williamson Fresh Produce showed that the strains are closely related genetically."

Andrew & Williamson, of San Diego, as well as Custom Produce Sales of Parlier, Calif., recalled cucumbers in September.

Texas has confirmed the most outbreak cases, 241, followed by Arizona, 134, and Texas, 52. The previous CDC update was on Nov 19, 2015.
Jan 26 CDC update

Diarrhea, rotavirus cases drop after vaccine introduction in Rwanda

Introduction of the pentavalent (five-strain) rotavirus vaccine into Rwanda in 2012 was associated with less diarrheal disease and fewer detections of the virus in hospitalized preschoolers, according to a time-series study published today in The Lancet Global Health.

An international team studied hospital data on kids younger than 5 from 2009 through 2014. Rwanda became the first low-income African nation to introduce the vaccine into its routine national immunization program in May 2012.

The researchers found that admissions for non-bloody diarrhea dropped by 17% to 29% from the pre-vaccine to post-vaccine eras. They also found that admissions for rotavirus captured by active surveillance fell 61% to 70%, and admissions for acute gastroenteritis fell 48% to 49%.

The authors conclude, "These data highlight the benefits of routine vaccination against rotavirus in low-income settings."
Jan 26 Lancet Glob Health study

Avian Flu Scan for Jan 26, 2016

News brief

WHO reports earlier H5N1, H9N2 cases in Bangladesh

In its monthly report on influenza at the animal-human interface, the World Health Organization (WHO) today confirmed human H5N1 and H9N2 avian flu cases in Bangladesh. Both were from October.

The H5N1 patient is a 60-year-old man from Mymensing district in the north. He was hospitalized Oct 12 with a severe acute respiratory infection. He had contact with live backyard poultry before becoming ill. Nasopharyngeal and throat swabs tested positive for the virus. He has since recovered.

The H9N2 patient is a 46-year-old male poultry worker in a market in Dhaka City, which is in central Bangladesh. He handled sick poultry on Oct 26 and developed a fever, runny nose, headache, and muscle aches on Oct 27. Throat and nasal swabs tested positive for H9N2. The man has fully recovered, the WHO said.

The agency also noted in the report five H5N6 avian flu cases in Guangdong province, China, and 10 H7N9 cases in four Chinese provinces, all of which had earlier been confirmed by Chinese authorities.

The report is dated Jan 20 but was posted today.
Jan 20 WHO report

Study shows repeat introductions of H5N8 into South Korea

US and Korean researchers studying H5N8 avian flu viruses in migratory waterfowl have determined that they differ from those in isolates from poultry farms in South Korea, indicating a new introduction after the winter of 2013-14.

Writing in Emerging Infectious Diseases yesterday, the investigators characterize 11 highly pathogenic avian influenza (HPAI) H5N8 viruses isolated from 9 fecal samples and 2 swab samples isolated from 980 wild bird fecal samples and 102 wild bird swabs collected in December 2014 and February 2015. They write that phylogenetic analysis showed the wild bird viruses were different from poultry samples collected after farm outbreaks caused by a novel reassortant H5N8 virus in January 2014 and into the summer of 2014.

They conclude, "HPAI (H5N8) viruses thus independently evolved in wild bird populations and poultry farms in South Korea until late 2014."
Jan 25 Emerg Infect Dis study