DRC reports six new Ebola cases in known contacts
The Democratic Republic of Congo (DRC) reported six more suspected cases of Ebola, including five in Bikoro and one in Wangata in its latest outbreak update. All of the new cases are known contacts of previously recorded cases.
The new cases bring the total number of suspected or confirmed Ebola cases to 56 (37 confirmed, 13 probable, and 6 suspected), including 25 deaths. No new deaths have been reported since late last week. Also, testing conducted on Jun 2 ruled out three previously suspected cases, the ministry of health said.
The DRC also said a total of 1,199 people have been vaccinated with Merck's unlicensed VSV-EBOV vaccine, including 577 in Mbandaka, 299 in Bikoro and 323 in Iboko.
Earlier today, Peter Salama, MD, the World Health Organization's deputy director-general of emergency response, tweeted that the WHO was working with the DRC's ministry of health and Doctors without Borders (MSF) to administer five therapeutics approved for compassionate use under WHO's MEURI (Monitored Emergency Use of Unregistered and Investigational Interventions) by DRC authorities. Salama said four were "currently available in-country and in place for access if Ebola patients need them today."
This is the first time during early stages of an Ebola outbreak a global evidence-based framework is in place to guide the review and prioritization of investigational drugs, Salama said. The therapies include ZMapp and mAb 114, both monoclonal antibody treatments.
Jun 4 DRC update
May 17 WHO Ebola treatment page
Peter Salama Twitter feed
More suspected monkeypox cases reported in Cameroon
Health officials in Cameroon announced 9 more suspected monkeypox cases, bringing the total number of cases to 16 (15 suspected, 1 confirmed), the World Health Organization (WHO) said in an update today.
Patients range from 1 month to 58 years of age, with a median age of 13. Nine patients are male. So far there have been no deaths, but all cases have involved a fever and body rash.
The outbreak began on Apr 30. The incubation period for monkeypox can be up to 10 days, with lesions lasting 2 to 5 weeks. The disease, a relative of smallpox, can be fatal but is much milder than smallpox, which has been eradicated.
Monkeypox, caused by an orthopoxvirus, is most likely transmitted through the consumption of contaminated bushmeat, a common practice in Western and central Africa.
"The detection of monkeypox in Cameroon underscores the need to maintain high level of vigilance and raise awareness of the disease among the local population," the WHO said. "Communication and education for people on how to prevent infection by avoiding contact with wild animals particularly rodents and primates are important."
Jun 5 WHO update
Chinese poultry workers have higher levels of avian flu antibodies in blood
A 3-year study of avian flu viruses such as H7N9, H9N2, H5N1, and H5N6 in poultry workers, swine workers, and members of the public in China's Jiangsu province who didn't have contact with the animals found low levels of exposure overall, but poultry workers had a higher risk than the other two groups, Chinese researchers reported the findings yesterday in Emerging Infectious Diseases.
They focused on live-poultry markets in the city of Wuxi, where they also obtained swab samples from chickens, ducks, and geese to assess the diversity and genetic variation of avian flu viruses at the locations.
The survey began in July 2013, and the team made follow-up visits at 1, 2, and 3 years, enrolling about 2,000 new participants each year to address the challenge of tracking often-temporary animal workers. The control group was made up of residents from community service centers who had not been exposed to poultry, pigs, or animal manure as part of their everyday activities. For the animal sampling, they visited nine markets each month and collected about 54 cloacal samples, plus additional environmental samples, at each visit.
Seroprevalence varied by group and over time, with overall levels of H7N9, H9N2, and H5N1 significantly higher in poultry workers than in swine workers and controls. Of 964 poultry workers, 9 showed evidence of H7N9 exposure, 18 for H9N2, and 18 for H5N1 over the study period. Seroprevalence in swine workers and controls was similar. No poultry workers were seropositive for H7N9 in 2016 or for H5N1 in 2014 and 2015. The team saw a significant increase in H5N1 seroprevalence in poultry workers in 2016 compared with 2015. None of the participants of any of the three groups were seropositive for H5N6 in the 3 study years.
When the researchers looked at incidence of seroconversion in poultry workers, 2 seroconverted for H7N9, 12 for H9N2, and 7 for H5N1. Of the other two groups, 1 control seroconverted for H7N9, and 3 swine workers and 4 controls seroconverted for H9N2. Poultry workers were more likely than controls to be infected with H9N2 and H5N1, but the rates weren't significantly different for H7N9.
Poultry sampling found high diversity of avian flu viruses, with H9N2 as the dominant subtype, making up 31.5% of the viruses. All H5 subtypes had genetic features that suggested high pathogenicity in poultry. There weren't any H5 outbreaks in Wuxi during the study period, but there were some events in several nearby cities in Jiangsu province.
The team concluded that surveillance for new flu viruses at live-poultry markets, especially at large facilities, and monitoring poultry and poultry workers is critical.
Jun 4 Emerg Infect Dis study