Wrap-up of May MERS cases notes household cluster in Saudi Arabia

The World Health Organization (WHO) Eastern Mediterranean regional office (EMRO) recently published its monthly snapshot of MERS-CoV activity, which covers 14 cases reported for May and one cluster, all in Saudi Arabia.

Of the 14 patients, 4 died from their MERS-CoV Middle East respiratory syndrome coronavirus) infections, all of them men who had underlying health conditions.

A household cluster in Al Kharj included two symptomatic Saudi women ages 22 and 44. Also in May, a 23-year-old Saudi woman who worked as a healthcare worker in Riyadh contracted the virus.

The WHO said the demographic and epidemiologic characteristics of recent cases haven't changed. The new cases push the global MERS-CoV total through the end of May to 2,442 cases, at least 842 of them fatal.

WHO EMRO MERS-CoV May situation update

WHO: 1 in 3 people globally cannot access safe drinking water

One third of the world's population does not have access to clean drinking water, while more than half cannot access safe sanitation services, according to a report today by UNICEF and the World Health Organization (WHO).

"Mere access is not enough. If the water isn't clean, isn't safe to drink or is far away, and if toilet access is unsafe or limited, then we're not delivering for the world's children," said Kelly Ann Naylor, UNICEF's associate director of Water, Sanitation and Hygiene, in a WHO press release. "Children and their families in poor and rural communities are most at risk of being left behind. Governments must invest in their communities if we are going to bridge these economic and geographic divides and deliver this essential human right."

The report assessed water access and sanitation globally from 2000 to 2017, and it found that 1.8 billion people have gained access to basic drinking water services since 2000. But an estimated 144 million people still regularly drink untreated water.

Also highlighted in the report are the economic and geographic disparities between urban and rural populations, and those in wealthy versus low-income countries. Seven out of 10 of the 2 billion people in the world who lack basic sanitation live in rural areas, and one-third live in the least economically developed countries.

The authors of the report emphasize that poor sanitation and contaminated water are linked to the transmission of cholera, dysentery, hepatitis A, and typhoid, among other diseases.

Jun 18 WHO news release

Jun 18 full report

Experimental botulism antitoxin safe, effective in adults, study finds

The new botulism antitoxin heptavalent (BAT) therapy was safe and effective in treating exposure to botulinum neurotoxins in adults and pediatric patients, according to a new post-licensure study published in Clinical Infectious Diseases.

The study followed 162 patients, median age 51, treated with BAT for suspected botulism poisoning in the United States from 2014 through 2017.

Of the 162 patients, 113 received a final diagnosis of botulism. Those treated within 2 days of symptom onset with BAT spent far less time in the hospital (5 vs 15.5 days) than those treated more than 2 days after symptom onset. They also spent less time in intensive care (4 vs 12 days) and on mechanical ventilation (6 vs 14.5 days).

Only seven patients reported serious side effects from the treatment. Thirty-one patients (19.1%) had 41 BAT product-related adverse events, the authors said.

Botulism is a neuroparalytic illness spread by Clostridium botulinum bacteria and, if left untreated, can cause death. Cases can arise sporadically or from known exposures. BAT was licensed for use in the United States in 2013 based on efficacy studies in animal models. The treatment is a mixture of immune globulin fragments derived from horses.

Jun 15 Clin Infect Dis study