From Polio to Plague: Don't Forget Other Bugs

In Madagascar, 119 cases of plague -- caused by the bacterium Yersinia pestis and spread by infected fleas -- have claimed 40 lives since early September, the agency reported at the weekend. Most have been bubonic, but 2% of the cases are the highly dangerous pneumonic form, in which the bacteria reach the lungs and can then be spread in droplets through coughing. Meanwhile, after a quiet summer, cases of Middle East coronavirus infection have increased in Saudi Arabia, which has been the center of that outbreak. The Saudi Ministry of Health reported 18 lab-confirmed cases of the virus so far this month, after 31 in October and 12 in September. All told, the ministry reported a total of 810 cases and 346 deaths since 2012, when the virus was first identified. Thirteen patients are currently being treated and 451 have recovered. Several dozen cases of the virus have also been reported outside the country, and the WHO said it has been formally notified of 909 laboratory-confirmed cases of infection. The early symptoms of MERS are nonspecific, the agency noted and healthcare workers need to apply standard precautions consistently, adding droplet precautions when patients have acute symptoms and contact precautions and eye protection when MERS infection is probable or confirmed. In China, the H7N9 avian flu continues to cause illness, although not at the alarming pace seen in 2013 and early 2014. In the past 3 months, China reported seven cases and two deaths from the virus. The novel avian flu strain was first identified in February 2013 and caused some 135 cases that spring. A second wave, starting in September, included another 220 cases to mid-February. The case-fatality rate over the two waves was about 31%. The virus is the first H7 strain to cause serious illness in humans; previous outbreaks of flu with a similar hemagglutinin gene -- the 'H' in H7N9 -- have mostly caused mild disease, such as conjunctivitis. H7N9 is regarded as a low-pathogenic avian strain -- it doesn't cause sickness and death in birds, making it difficult to track in poultry, which appear to be the reservoir for the virus. http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/48809?xid=nl_mpt_DHE_2014-11-25&utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=ST&eun=g721819d0r&userid=721819&email=amydugan2%40gmail.com&mu_id=5883165&utm_term=Daily