More Ebola cases suspected in remote DRC health zones

The Democratic Republic of the Congo (DRC) yesterday noted four new suspected cases of Ebola virus, two each in Bikoro and Iboko health zones, yet the number of cases overall remained steady. Four previously suspected cases tested negative for the virus, so the current total now stands at 61 cases, including 38 confirmed, 14 probable, and 9 suspected.

The death toll remains at 28, and the number of cured patients holds at 24.

Bikoro and Iboko are both remote health zones in the DRC, accessible only by motorcycle in some parts. Officials from the DRC and the World Health Organization (WHO) have said it may take several more weeks to track all known contacts of Ebola cases in these areas.

Also yesterday, the WHO released information concerning a May 26 panel of experts who met to discuss clinical trial design for testing Ebola therapeutics in an outbreak setting. To meet standards of both safety and efficacy, the experts recommended "a three-arm, open-label, randomized trial to evaluate simultaneously two candidate therapeutics."

Jun 21 DRC update

Jun 21 WHO document

Advance notice of polio cases in Papua New Guinea, DRC

Both Papua New Guinea and the DRC announced advanced notice of new polio cases, according to the weekly update from the Global Polio Eradication Initiative (GPEI).

Last month officials in Papua New Guinea identified a patient with acute placid paralysis (AFP), which will now be classified as a circulating vaccine-derived poliovirus type 1 (cVDPV1) case, GPEI said.

In the DRC, a circulating vaccine-derived poliovirus type 2 case was recorded in Ituri province, in the northeast part of the country near the Ugandan border. The patient is a child who suffered onset of paralysis on May 5, and recently traveled to Haut Katanga. According to GPEI, genetic sequencing indicates the case is linked to the Haut Lomami/Tanganika/Haut Katanga outbreak.

So far this year officials have reported five vaccine-derived polio cases globally, four in the DRC.

Jun 22 GPEI report

Trump proposes single federal food safety agency

Under President Trump's executive government reorganization plan, "Delivering Government Solutions in the 21st Century," all federal food safety issues would be handled by a single agency housed in the US Department of Agriculture (USDA).

Citing several Government Accountability Office (GAO) reports and calling the current system "irrational," the reorganization plan would consolidate the USDA's Food Safety and Inspection Service (FSIS) and the Food and Drug Administration's (FDA's) food inspection functions into one group called the Federal Food Safety Agency.

"There are many examples of how illogical our fragmented and sometimes duplicative food safety system can be," the proposal says. "For example: while FSIS has regulatory responsibility for the safety of liquid eggs, FDA has regulatory responsibility for the safety of eggs while they are inside of their shells; FDA regulates cheese pizza, but if there is pepperoni on top, it falls under the jurisdiction of FSIS; FDA regulates closed-faced meat sandwiches, while FSIS regulates open-faced meat sandwiches."

Increased food safety, better communications, and money saving, are all listed as benefits to moving towards consolidation. The new agency would have an annual operation budget of approximately $2.3 billion.

Jun 22 White House document

Cyclospora outbreak linked to veggie trays sickens 66 more

In an update yesterday on a multistate Cyclospora outbreak linked to Del Monte vegetable trays, the US Centers for Disease Control and Prevention (CDC) said 66 more cases have been reported, raising the outbreak total to 144.

The number of affected states remained at four: Iowa, Michigan, Minnesota, and Wisconsin. The patients in Michigan are linked to vegetable trays bought in Wisconsin. So far, six people have been hospitalized and no deaths have been reported. The most recent illness onset is Jun 6.

Federal and state investigations are still under way, but so far the exact source isn't known. The vegetable trays were sold at convenience stores and markets and contained broccoli, cauliflower, carrots, and dill dip.

The Minnesota Department of Health is also investigating a separate Cyclospora outbreak tied to Minneapolis restaurant Sonora Grill that has sickened 17 people. Foodborne illness outbreaks from Cyclospora cayetanensis, a parasite, have been reported the past several summers and when a cause is identified, the culprit has been imported produce such as basil, cilantro, mesclun lettuce, raspberries, and snow peas.

Jun 21 CDC outbreak update

Jun 18 CIDRAP News scan "Veggie tray Cyclospora outbreak sickens people in 2 more states"

China, Russia, Denmark report more high-path avian flu outbreaks

China's agriculture ministry has reported a highly pathogenic H5N1 avian flu outbreak at a broiler chicken farm in Qinghai province in the country's northwest, according to a government statement translated and posted today by Avian Flu Diary (AFD), an infectious disease news blog.

The outbreak began on Jun 12, killing 1,050 birds. The remaining 565 poultry were destroyed to curb the spread of the virus. The country's last known H5N1 outbreak was reported in August 2017 affecting poultry in Inner Mongolia province.

In related news, Russian officials reported two more highly pathogenic H5 outbreaks in poultry, both in Saratov oblast in the west, according to a separate AFD post today. The country has reported several recent similar outbreaks in the same general area.

And finally, Denmark today reported another H5N6 detection in a wild bird, this time a white-tailed eagle found sick on Mar 27 in Zealand region in the south of the country, according to a notification from the World Organization for Animal Health (OIE).

Jun 22 AFD post on H5N1 in China

Jun 22 AFD post on avian flu in Russia

Jun 22 OIE report on H5N6 in Denmark

Study: California Aedes mosquitoes capable of spreading Zika

Researchers reporting in PLoS Neglected Tropical Diseases provide evidence that Aedes aegypti mosquitoes from California are capable of transmitting the Zika virus (ZIKV).

Though it's well known that Ae aegypti mosquitoes are vectors of the flavivirus, competency varies between geographical regions.

To survey mosquitoes in California, researchers allowed Californian Ae aegypti, Culex tarsalis, and Cx quinquefasciatus to feed on mice infected with three different strains of ZIKV collected from Puerto Rico and Brazil in 2015 and Malaysia in 1966.

Neither Culex species showed signs of Zika in saliva at days 14 and 21 after infection. But 85% to 90% of the Aedes mosquitoes had ZIKV RNA in their saliva. All strains of the virus were found in the Aedes, with the Malaysian strain producing the highest levels of viral RNA.

"This laboratory vector competence study confirmed that Ae. aegypti from Los Angeles, California, USA, can transmit Asian lineage ZIKV and that Cx. tarsalis and Cx. quinquefasciatus are inefficient ZIKV vectors," the authors concluded. "Given that Culex mosquitoes are poor ZIKV vectors and seek primarily non-human hosts, they are unlikely to facilitate a ZIKV outbreak. Thus, vector control efforts targeting ZIKV should remain focused on reducing urban Aedes populations."

Jun 21 PLoS Negl Trop Dis study