WHO

Chikungunya reported in Pakistan

WHO

CIDRAP

The World Health Organization was requested by Member States to develop a global priority pathogens list (global PPL) of antibiotic-resistant bacteria to help in prioritizing the research and development (R&D) of new and effective antibiotic treatments.

WHO PRIORITY PATHOGENS LIST  FOR R&D OF NEW ANTIBIOTICS

Priority 1: CRITICAL
Acinetobacter baumannii, carbapenem-resistant
Pseudomonas aeruginosa, carbapenem-resistant
Enterobacteriaceae, carbapenem-resistant, 3rd generation cephalosporin-resistant

Priority 2: HIGH
Enterococcus faecium, vancomycin-resistant
Staphylococcus aureus, methicillin-resistant, vancomycin intermediate and resistant
Helicobacter pylori, clarithromycin-resistant
Campylobacter, fluoroquinolone-resistant
Salmonella spp., fluoroquinolone-resistant
Neisseria gonorrhoeae, 3rd generation cephalosporin-resistant, fluoroquinolone-resistant

Priority 3: MEDIUM
Streptococcus pneumoniae, penicillin-non-susceptible
Haemophilus influenzae, ampicillin-resistant
Shigella spp., fluoroquinolone-resistant

Clinical Infectious Diseases

“…..A prospective case series of 87 infants with laboratory-confirmed congenital Zika syndrome (CZS) at the epicenter of the Brazilian Zika epidemic in Pernambuco state is presented. Mothers were interviewed for symptoms of possible Zika virus (ZIKV) infection during pregnancy and fetal ultrasounds were obtained. Infant cerebrospinal fluid (CSF) samples were tested for ZIKV specific antibodies and sera were screened for other congenital infections. Neuroimaging and ophthalmologic evaluations were also performed. Sixty six mothers (76%) reported symptoms of ZIKV infection during gestation. Fetal ultrasounds were available from 90% of the mothers and all demonstrated brain structural abnormalities. All the CSF samples tested positive for ZIKV IgM. The majority of infants (89%) were term, the mean birth weight was 2577±260g and the mean head circumference was 28.1±1.8 cm. Severe microcephaly, defined as head circumference below 3 SD for sex and gestational age, was found in 72 (82%) infants. All infants had an abnormal neurological exam and 18 (20.7%) had arthrogryposis. The main abnormalities detected in CT scans were calcifications (99%), followed by ventricular enlargement (94%), cortical hypogyration (81%), and less commonly, cerebellar hypoplasia (52%). Unilateral diaphragm paralysis was identified in three infants. Maternal young age, term infant, small for gestational age and the presence of ophthalmologic abnormalities were significantly associated with a smaller head circumference Z score. Our findings, based on laboratory-confirmed ZIKV infection, add valuable evidence for the understanding of CZS.”

USDA

USDA Office of Communications sent this bulletin at 02/22/2017 03:11 PM EST

ABC

• 21 were transported by ambulance to seven area hospitals:  University Medical Center, Tulane Medical Center, Tulane Lakeside, Touro Hospital, East Jefferson General Hospital, Ochsner Main Hospital, and Ochsner Baptist Hospital.
• Seven people declined treatment
• The victims range in age from 3 or 4-years-old to adults in their 30s and 40s
• New Orleans Police Department Chief Michael Harrison said one person is in custody and he is being investigated for driving while intoxicated.
• Police do not  suspect terrorism.

WHO

Meningococcal disease – Togo

Since 1 January 2017, 201 suspected cases of meningitis with 17 deaths were reported by 19 health districts. In week 2, the district of Akebou which is part of the Plateau Region issued an alert after four cases of meningitis were reported. In week 4, the epidemic threshold was reached with nine cases and an attack rate of 12.4 per 100 000 inhabitants. From 2 January to 12 February 2017, 48 suspected meningitis cases with three deaths were reported (case fatality rate of 6.3%). Of these, 14 specimens were confirmed as Neisseria meningitidis serogroup W by PCR.

The Plateau Region, together with the other three regions in the country benefited from the mass vaccination campaign with MenAfriVac in December 2014.

Togo is part of the African meningitis belt and documents cases and deaths due to meningitis every year. In 2016, the country recorded an epidemic in the northern part caused by Neisseria meningitidis serogroup W. A total of 1975 cases and 127 deaths were reported in 2016.

Public health response

In response to the outbreak, the following measures are being implemented:

• 56 000 doses of meningitis vaccines have been requested from the International Coordinating Group (ICG) for the planned vaccination campaign.
• WHO Field Mission was deployed in the field to strengthen outbreak management.
• Strengthening of meningitis surveillance at the district level.
• Training of clinicians at the district level on case management.
• Conducting cross-border meetings with Ghana and Benin.

WHO risk assessment

The largest burden of meningococcal disease occurs in the African meningitis belt. Although the successful roll-out of MenA conjugate vaccine has resulted in the decreasing trend of meningitis A, other meningococcal serogroups are shown to have caused epidemics. This report of the Neisseria meningitidis W outbreak in Togo calls for a close monitoring of the changing epidemiology of meningococcal disease. There is a need to ensure that global stocks of vaccines are available, laboratory and epidemiologic surveillance systems are strengthened and outbreak response strategies in the countries are on hand.

WHO advice

The epidemic response consists of prompt, appropriate case management involving reactive mass vaccination of populations, and strengthening of meningitis surveillance.

CDC

All data are preliminary and may change as more reports are received.

Synopsis:

During week 7 (February 12-18 2017), influenza activity decreased slightly but remained elevated in the United States.

• Viral Surveillance: The most frequently identified influenza virus subtype reported by public health laboratories during week 7 was influenza A (H3). The percentage of respiratory specimens testing positive for influenza in clinical laboratories decreased slightly but remained elevated.
• Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was above the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.
• Influenza-associated Pediatric Deaths: Five influenza-associated pediatric deaths were reported.
• Influenza-associated Hospitalizations: A cumulative rate for the season of 33.7 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
• Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 4.8%, which is above the national baseline of 2.2%. Nine regions reported ILI at or above their region-specific baseline levels. 27 states experienced high ILI activity; New York City and five states experienced moderate ILI activity; Puerto Rico and 10 states experienced low ILI activity; eight states experienced minimal ILI activity; and the District of Columbia had insufficient data.
• Geographic Spread of Influenza: The geographic spread of influenza in Puerto Rico and 44 states was reported as widespread; Guam and four states reported regional activity; the District of Columbia and one state reported local activity; one state reported sporadic activity; and the U.S. Virgin Islands reported no activity.

NY Times