ECDC has published Summary of Public health threats, CDTR week 24/2016. Click or tap through for many related links.
The ECDC Communicable Disease Threats Report (CDTR) is a weekly bulletin for epidemiologists and health professionals about active public health threats. This issue covers the period 12 – 18 June 2016, and includes updates on the Enterovirus A-71 outbreak, Measles, Zika virus infection, the yellow fever outbreak in Africa and Plasmid-mediated colistin resistance mechanism MCR-1 in Gram-negative.
Enterovirus A-71 – Catalonia, Spain
An outbreak of enterovirus with neurological complications has been ongoing in Catalonia since mid-April 2016, mostly affecting children. The causative agent has been identified as enterovirus A71.
As of 14 June, 91 probable cases have been detected and most have recovered. The cases are widespread in Catalonia. No cases have been reported from other regions in Spain.
Measles – multistate
Measles, a highly transmissible vaccine-preventable disease, is still endemic in some EU countries where vaccination uptake remains below the level required to interrupt the transmission cycle. Elimination of measles requires consistent vaccination uptake above 95% with two doses of measles vaccine in all population groups, strong surveillance and effective outbreak control measures.
In 2014, 16 EU/EEA countries were above the measles vaccination coverage target of 95% for the first dose, and six countries for the second dose. Fourteen countries in the EU have coverage rates of <95% for the first dose and 20 countries for the second dose.
During the past month, ongoing measles outbreaks were detected in Ireland, Germany, Russia, New Zealand, the United States of America, Mali and the Democratic Republic of Congo.
Zika virus infection
As of 15 June 2016, WHO reports 60 countries and territories with continuing mosquito-borne transmission. Of these, 52 countries and territories have reported autochthonous cases of Zika virus infection during the past nine months. Ten countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route.
An article on the Zika outbreak in Colombia was published in NEJM on 16 June 2016. Preliminary findings included:
• Overall Zika incidence in women was twice that of men, which reflects factors such as increased testing in reproductive-age women because of the microcephaly threat or the role of sexual transmission.
• More than 90% of mothers who were infected during their third trimesters had given birth, and no infants with microcephaly or brain abnormalities were found.
• Four infants with laboratory evidence of congenital Zika virus disease were born to asymptomatic mothers.
Yellow fever outbreak – Africa
An outbreak of yellow fever in Angola started in December 2015 in the municipality of Viana, Luanda province and spread to all the 18 provinces of Angola.
The neighbouring Democratic Republic of Congo (DRC) reports both imported and autochthonous cases of yellow fever. An outbreak of yellow fever, not linked to the outbreak in Angola, has been reported in several districts in Uganda.
Another unrelated outbreak of yellow fever is reported in Peru.
Plasmid-mediated colistin resistance mechanism MCR-1 in Gram-negative bacteria - Multistate (world)
The recent discovery of the mcr-1 gene, which encodes the first transferable resistance mechanism to colistin (a last-resort antimicrobial agent for infections caused by multidrug-resistant (MDR) gram-negative bacteria) raised widespread concern that its dissemination within the human microbiome could lead to nosocomial outbreaks of virtually untreatable infections.
Follow-up reports have revealed worldwide spread of the mcr-1 gene by plasmid transfer to diverse species and strains of Enterobacteriaceae, including MDR strains. In May 2016, the US CDC reported the first human mcr-1 positive E. coli isolate detected in the United States.