PRO/EDR> Cholera, diarrhea & dysentery update (16): Africa

Cholera -- Somalia
The Ministry of Health of Somalia has announced 55 new suspected cases of cholera, with no deaths, for epidemiological week 20 (13-19 May) in 2019. No suspected cholera cases were reported between epidemiological weeks 1 and 7 due to closure of main cholera treatment center, from which the data are collected. The cumulative total number of suspected cholera cases since the beginning of this outbreak in December 2017 is 7290, including 46 associated deaths. During this reporting period, all of

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PRO/ALL> New in IJID (06): June 2019

Diarrhea -- Bangladesh
Molecular characterization and analysis of _Mycoplasma pneumoniae_ among patients of all ages with community-acquired pneumonia during an epidemic in China.
Jiuxin Qu, Shuyan Chen, Fang Bao, Li Gu, Bin Cao.
Int J Infect Dis. 2019; 83(June): 26-31.

Exploring bacterial resistance in Northern Oman, a foundation for implementing evidence-based antimicrobial stewardship program.
Diaa Al Rahmany, Adel Albeloushi, Iman Alreesi, Ahmed Alzaabi, Mohammed Alreesi, Laura Pontiggia, et al.
Int J

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PRO/AH/EDR> Tularemia - USA: (NM)

Tularemia -- United States
New Mexico state health officials are reporting 2 confirmed cases of tularemia in 2019 among 2 residents of Santa Fe County: a 57 year old man and a 72 year old woman.
"Tularemia can cause serious illness in both people and pets, so I would encourage people in Santa Fe County to follow precautions to avoid getting infected," said Department of Health cabinet secretary, Kathy Kunkel. "People can get tularemia if they handle infected animals such as rabbits or rodents or are bitten by

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PRO/AH/EDR> E. coli EHEC - France (02): O26, unpasteurized cheese

E. coli -- France
Outbreak detection
------------------
From 25 Mar to 27 Apr 2019, 19 suspected Shiga toxin-producing _Escherichia coli_ (STEC) [also called enterohemorrhagic _E coli or EHEC. - Mod.LL) associated pediatric haemolytic uraemic syndrome (HUS) cases were notified by French hospital paediatric departments to Sante publique France, compared with 5-10 cases during the same period in previous years [1]. 13 cases were confirmed as serogroup O26, with whole genome sequencing (WGS) underway for strain

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PRO/EDR> Syphilis, gonococcal disease, chlamydia - UK: (Scotland) increase, MSM

Chlamydia, Gonorrhea, Syphilis -- United Kingdom
Reports from Health Protection Scotland (HPS) show that the sexually transmitted infections (STI), chlamydia, gonorrhea, and syphilis have all increased from 2017 to 2018.
Gonorrhea cases increased the most. In 2018, 3233 episodes of gonorrhea were reported, a 24% increase compared to 2017 and the largest number recorded in the last decade. In fact, since 2013, gonorrhea diagnoses have increased by 103% (from 1595 in 2013 to 3233 in 2018). The increase is largely due to a 121% increase in

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PRO/AH/EDR> Ebola update (49): Congo DR (NK,IT) cases, WHO, response

Ebola -- DR Congo
- Swedish ambassador to the DRC, Maria Hakansson, and British foreign minister, Harriett Baldwin, visited the Ebola response teams in Butembo on Mon 27 May 2019. After the courtesy of the mayor of the city, the 2 guests visited different sites of the Ebola response starting with a vaccination site. They also visited the ETC and the ETC nursery in Butembo. After all these visits, the Swedish ambassador and the British foreign minister visited the Auberge, the Butembo coordination center, and

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PRO/EDR> Pertussis update (06): Canada, USA, New Zealand

Whooping Cough -- Canada
There are now 22 confirmed cases of whooping cough in the greater Fredericton area, including 19 school-aged children from several schools, says the regional medical officer of health. That's nearly double the number of cases from last month [April 2019], when Dr Na-Koshie Lamptey declared a whooping cough outbreak for the capital region.
Public health will be offering immunization clinics over the next week for those most at risk of the bacterial respiratory infection easily spread through

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PRO/EDR> Poliomyelitis update (41): Afghanistan, Pakistan, global

Polio -- Afghanistan
New wild poliovirus reported this week:
AFP cases: 2
Environment: 8
New cVDPV poliovirus reported this week:
AFP cases: 1
Environment: 3
Headlines
- Following the group's meeting earlier this month, the latest report of the International Health Regulations (IHR) Emergency Committee is available online. The committee evaluated the latest global poliovirus epidemiology and concluded that the effort to eradicate polio remained a Public Health Emergency of International Concern (PHEIC).

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PRO/AH/EDR> African swine fever - Asia (48): North Korea (CH) domestic, 1st rep, OIE

African Swine Fever -- North Korea
Information received on [and dated] 30 May 2019 from Mr Ri Kyong Gun, director of the Veterinary and, Ministry of Agriculture, Anti-Epizootic Department, Pyongyang, Korea (Dem People's Rep.)
Summary
Report type: immediate notification
Date of start of the event: 23 May 2019
Date of confirmation of the event: 25 May 2019
Reason for notification: 1st occurrence of a listed disease in the country
Causal agent: African swine fever virus
Nature of diagnosis: clinical, laboratory

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PRO/AH> Nipah virus - Bangladesh (03): treatment

Nipah/Hendra Virus -- Bangladesh
Lo MK, Feldmann F, Gary JM, et al. Remdesivir (GS-5734) protects African green monkeys from Nipah virus challenge. Science Translational Medicine 2019: 11; 494, eaau9242, DOI: 10.1126/scitranslmed.aau9242
Abstract
--------
Nipah virus is an emerging pathogen in the _Paramyxoviridae_ family. Upon transmission of Nipah virus from its natural reservoir, _Pteropus_ spp. fruit bats, to humans, it causes respiratory and neurological disease with a case fatality rate about 70%. Human-to-human

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PRO/AH> Equine influenza - UK (09): horse, EIV H3N8 Florida clade 1

Equine Influenza -- United Kingdom
Experts are urging owners to continue to be vigilant over equine flu as 32 cases have been confirmed in less than 2 months. The latest update from the Animal Health Trust shows 20 outbreaks in May [2019], including 9 in a week. This follows 12 cases confirmed in April [2019].
Of the outbreaks reported at the beginning of May, 8 involved horses who had recently been imported from Ireland, and one a horse who had recently arrived from Europe.
Two of the affected horses were vaccinated

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PRO/AH> African swine fever - Europe (19): Moldova (BR) wild boar, OIE

African Swine Fever -- Moldova
Information received on [and dated] 28 May 2019 from Dr Vitalie Caraus, head of the Sanitary Veterinary Surveillance Department, Sanitary and Veterinary Surveillance Division, National Food Safety Agency, National Food Safety Agency of the Republic of Moldova, Chisinau, Moldova
Summary
Report type: immediate notification
Date of start of the event: 27 May 2019
Date of confirmation of the event: 28 May 2019
Reason for notification: 1st occurrence of a listed disease
Manifestation of

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PRO/AH/EDR> Yellow fever - Africa (09): Uganda (OK,MQ)

Yellow Fever -- Uganda
The Ugandan Ministry of Health declared a yellow fever outbreak earlier this month [May 2019] after laboratory confirmed cases were reported from Koboko [Northern region] and Masaka [Central region] districts (in the region of 600km [375 miles] apart). The patients are an 80 year old woman and a 10 year old girl. Neither had a history of yellow fever vaccination, nor exhibited symptoms of jaundice, however the older woman had hemorrhagic signs.
A district rapid response team was sent to the

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PRO/AH/EDR> Alongshan virus - China (NM)

Other Human Disease -- China
Researchers in north eastern China discovered a new segmented RNA virus associated with febrile illness in dozens of patients, and they suspect that the virus is transmitted by ticks, according to a study published in the New England Journal of Medicine. They named the previously unknown pathogen the Alongshan virus (ALSV).
"ALSV infection can cause clinical disease, and, therefore, it should be differentiated from other tickborne diseases, such as severe fever with thrombocytopenia

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PRO/AH/EDR> Rabies (31): Americas, USA (WV,FL,NH) raccoon, dog, cat, bat, human exp

Rabies -- United States
Another raccoon tested positive for rabies in Monongalia County after getting into a fight with a family's dog, according to a press release from the Health Department. It's the 4th reported encounter with dogs and rabid raccoons in the county this year [2019], health officials said.
The dog involved in the most recent incident was up to date on its rabies shots and has been revaccinated, according to Jon W Welch, program manager of the Monongalia County Health Department Environmental

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PRO/EDR> Cholera, diarrhea & dysentery update (15): Asia (Yemen)

Cholera -- Yemen
The Ministry of Public Health and Population of Yemen reported 16 827 suspected cases and 18 associated deaths during epidemiological week 20 (13-19 May 2019). 15 per cent of cases were severe. The cumulative total number of suspected cholera cases from 1 Jan 2018 to 28 Apr 2019 is 704 986, with 1114 associated deaths (case fatality rate [CFR] 0.16%). Children under 5 represent 22.6% of total suspected cases during 2019. The outbreak has affected 22 of 23 governorates and 295 of 333 districts

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PRO/EDR> Poliomyelitis update (40): Central African Republic (MP,UK) cVDPV, WHO, RFI

Polio -- Central African Republic
Two cases of vaccine-derived poliovirus have been reported from Bambari health district. The index case presented with acute flaccid paralysis [AFP], while the 2nd case was an asymptomatic contact of the index case. There is a high risk of transmission of the virus, as both cases were among internally displaced person with an estimated population of 8000. The 2 cases had no previous history of vaccination for polio. Vaccination coverage in the affected district is 50%, with insecurity being

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PRO/EDR> Diphtheria - India: (KL)

Diphtheria -- India
Diphtheria has surfaced again in the district, with a 10 year old boy from Parassala who was admitted to SAT Hospital with suspected diphtheria or tonsillitis and tested positive for diphtheria. This is the 2nd case of diphtheria in the district this year [2019], after a 21 year old college student from Kattakada tested positive for the disease in January [2019]. The boy, who was admitted to SAT on 22 May [2019], has recovered well without any complications and is due for discharge in a day or

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PRO/EDR> Measles update (38)

Measles -- United States
Health officials in 5 states, including New York, have contacted CDC about travelers who have been exposed to measles for their potential inclusion on the list, according to the Washington Post.
A total of 880 cases of measles in 24 states [see above -- the most current CDC case count is 940 cases in 26 states] have been reported this year [2019], which is a 25-year high, CDC recently reported. That's the highest annual total since more than 950 cases were reported in 1994. A representative

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PRO/AH/EDR> Yersiniosis - Denmark, Sweden: spinach, ex Italy

Not Yet Classified -- Denmark
An outbreak of yersiniosis in Denmark and Sweden with more than 50 cases has been linked to fresh spinach. Statens Serum Institut, a public health research institute in Denmark, reports 20 people have been infected in the country. One person needed hospital treatment. The Public Health Agency of Sweden has recorded 37 confirmed cases.
In March 2019, 20 cases of _Yersinia enterocolitica_ [infection] were found in Denmark. There were 11 women and 9 men aged 2 to 74 years old, with most cases

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PRO/PL> Undiagnosed virus, pumpkin - Bangladesh: (RP)

Undiagnosed -- Bangladesh
Thakurgaon [district] pumpkins have been infected with a viral disease known as mosaic. The virus is at risk of invading other nearby yields [and] has adversely affected cultivation this year. This alarming for the farmers.
A pumpkin farmer said although his yield was significant, it all started to fade in colour, including roots and leaves. [Another] farmer says the seeds they got from distributors this [2019] season might have caused this viral outbreak. Many farmers said they had not

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PRO/AH/EDR> Tick fever - Australia (02): (NS) cattle

Tick-borne disease -- Australia
Five cows have died from tick fever in recent weeks in the Northern Rivers region, leaving veterinarians pleading with producers to practise good farming biosecurity. District veterinarian Dr Phillip Kemsley confirmed that 3 cows have died from the disease on a property in the Tweed and 2 on a holding in the Lismore area.
If the disease spreads, Dr Kemsley said tick fever and cattle tick can cause the biggest economic impact on cattle production in northern Australia, because it can create

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PRO/AH/EDR> Phosphine gas poisoning - United Arab Emirates: fatal

Poisoning -- United Arab Emirates
A banned pesticide used in a neighbouring apartment caused the death of a 10 year old boy in Al Nahda, the Sharjah police have said. The family of Pakistani boy, who died on Friday [24 May 2019], is struggling through legal clearance to get his body released. His father said they would bury the boy in the UAE since they could not leave his twin sister alone at the hospital. "It's been 4 days, and we want to bury our boy. We have to do it here since his sister is still in serious

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PRO/AH/EDR> Anthrax - Guinea: (KB) goat, human

Anthrax -- Guinea
On [9 May 2019], the Prefectural Health Directorate of Koubia, Guinea was informed of the admission of 4 suspected anthrax cases at the Prefectural Hospital located in Labé region in the northern part of the country. Three of the case-patients presented to the hospital with skin lesions typical of a cutaneous anthrax infection (black crusts on either face, hands, head, or neck with swelling around the affected parts). The 4th case-patient, a 2 year old boy, son to one of the 3 case-patients

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PRO/AH> African swine fever - global control initiative, OIE, FAO

African Swine Fever -- Worldwide/Unknown
The recent upsurge in the spread of African swine fever (ASF) throughout several regions of the world poses a direct threat to the majority of pig populations worldwide. The 87th General Assembly of OIE National Delegates ['OIE General Session'] has called for the establishment of a global initiative to control the disease, in hope of eradicating it entirely, and to reduce its devastating economic impacts on the pig industry. This initiative will be coordinated by the OIE (World Organisation

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PRO/AH/EDR> MERS-CoV (51): Saudi Arabia (RI,NJ,QS)

MERS -- Saudi Arabia
In the 2 days since the last update (see MERS-CoV (50): Saudi Arabia (RI, MD) http://bit.ly/2Wb3wxE) there have been 4 newly confirmed cases of MERS-CoV infection including 1 death reported from Saudi Arabia.
Information on newly confirmed cases (4) [includes 1 fatality reported at time of initial confirmation report]

[1]
Date of confirmation: 27 May 2019
Case No: 19-1923
MERS from Riyadh city: 23 year old female from Riyadh city, Riyadh region
Contact with

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PRO/AH/EDR> Die-off, bird - USA: (CA) murre

Animal Die-off -- United States
Starting on [Wed 22 May 2019], hundreds of common murres, an ocean-going bird native to the Pacific Coast from the Channel Islands to the tip of the Aleutians in Alaska, have been reported washed up dead or dying on beaches along a 10-mile [16 km] stretch of coastline in Mendocino county between Noyo Bay and Seaside Beach. Local wildlife observers say it's too early to tell what is causing the die-off.
The common murre looks a little like a penguin, but is more closely related to terns or

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PRO/PL> Ramu stunt, sugar cane - Papua New Guinea: new virus

Other Plant Disease -- Papua New Guinea
Ramu stunt is a serious disease of sugarcane, currently reported only from Papua New Guinea (PNG). It is found in both commercial sugarcane grown on the Ramu Agri Industries Limited (RAIL) estate, and in chewing canes (_Saccharum officinarum) grown in village gardens across the country.
The vector of Ramu stunt disease is the island sugarcane planthopper, _Eumetopina flavipes_. Here we report on the successful transmission of Ramu stunt using _E. flavipes_ and verify that the disease is

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PRO/AH/EDR> Yellow fever vaccine shortage

Yellow Fever -- Worldwide/Unknown
[Concern about yellow fever (YF) vaccine availability has been increasing following the large outbreak in Angola and the Democratic Republic of the Congo and more recently in Brazil. Because YF vaccine supplies were not adequate to provide full 0.5 ml doses during those outbreaks, a 1/5th fractional dose was used. The abridged report below reviews the situation and proposes measures to be taken. - Mod.TY]
Daniel R Lucey, Kristen R Kent. Boosting global yellow fever vaccine supply for

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PRO/AH/EDR> Rift Valley fever - Mayotte (12): human, cattle

Rift Valley Fever -- Région d'outre-mer de Mayotte, France
To limit the spread of cases [of Rift Valley fever (RVF)], the prefecture of Mayotte, in collaboration with the ARS Indian Ocean and the Directorate of Food, Agriculture and Forestry of Mayotte (DAAF) reminds all of the importance of prevention measures for protect from the disease [figure: Map of households as of 22 May 2019. New geographic areas affected.]
Epidemiological situation as of 24 May 2019:
In total, since the beginning of the epidemic (end of November [2018]):
- samples taken

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PRO/AH/EDR> Hantavirus - Americas (25): USA (CA)

Hantavirus -- United States
A deer mouse trapped in routine monitoring in the Fallbrook area has tested positive for the potentially deadly hantavirus, prompting [San Diego] County officials to remind people to never sweep or vacuum up after rodents if they find them in homes, garages, sheds or cabins. County environmental health officials said hantavirus is not uncommon in San Diego, but people are unlikely to be exposed to it if they keep wild rodents out of their living spaces.
However, especially with the

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PRO/AH/EDR> Anthrax - Lesotho (02): (MS) cattle, human

Anthrax -- Lesotho
Over 50 people were taken ill this week after they ate meat from cattle that died of anthrax in Qeme last Saturday [18 May 2019]. About 55 were rushed to nearby clinics while 18 of them were given prophylaxis and treated as outpatients. Most of the victims developed blisters and had swollen limbs while others suffered from severe stomach-aches and diarrhea. So far more than 20 cattle have died from anthrax.
The Ministry of Agriculture and Food Security this week declared that there had been

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PRO/EDR> Varicella update (04): USA (CA) student

Chicken Pox -- United States
In January of 2016, Governor Jerry Brown passed a bill titled "SB 277", which banned the "personal or religious belief" vaccination exemption for schools. Currently, students can be exempt from immunization if forms are submitted by a physician stating that it would be medically unsafe for the individual to be immunized. After Brown's bill passed, the rate of medical exemptions nearly quadrupled, according to a study by the Journal of Pediatrics.
Currently, the CSU-wide immunization policy

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PRO/AH/EDR> African swine fever - Asia (47): Viet Nam, China, domestic, spread, control

African Swine Fever -- Vietnam
Viet Nam culled a further 500 000 pigs over the past 2 weeks to tackle an outbreak of African swine fever, taking the total killed so far to 1.7 million, or 5 per cent of the country's herd, the agriculture ministry said on [Mon 27 May 2019]. Pork accounts for three quarters of the total meat consumption in Viet Nam, a country of 95 million people where most of its 30 million farm-raised pigs are consumed [by the] domestic [market].
The virus, first detected in the South East Asian country

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PRO/AH> Peste des petits ruminants - Iran: (GI) deer, susp

Peste des petits ruminants -- Iran
According to the United Nations' Food and Agriculture Organization (FAO) ovine rinderpest, commonly known as peste des petits ruminants (PPR) or sheep and goat plague, is a highly contagious animal disease affecting small ruminants. Once introduced, the virus can infect up to 90 per cent of an animal herd, and the disease kills anywhere from 30 to 70 per cent of infected animals. The PPR virus does not infect humans.
Following the spread of the infection in a forest park in province of

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PRO/AH/EDR> Hantavirus - Europe (02): Germany, comment

Hantavirus -- Germany
As the moderator indicates, the hantavirus most likely involved in these German cases is probably Puumala virus (PUUV), with the bank vole (_Myodes glareolus_) as the rodent reservoir host, although surprisingly enough not stated in this [original press] report. The illness caused by PUUV is the so-called hemorrhagic fever with renal syndrome (HFRS), with extremely variable fatality rates, depending not only from the infecting hantavirus species, but also for a big part from the immune

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PRO/AH/EDR> E. coli EHEC - USA (08): flour, alert, recall

E. coli -- United States
CDC, public health and regulatory officials in several states, and the US Food and Drug Administration (FDA) are investigating a multistate outbreak of _Escherichia coli_ O26 infections.
Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on _E. coli_ bacteria isolated from ill

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PRO/AH/EDR> Undiagnosed hemorrhagic fever - Uganda (Kagadi) RFI

Hemorrhagic Fever -- Uganda
On Thursday [23 May 2019], 2 children died of a strange disease which presented symptoms similar to those of the Ebola virus [infection].
The victims of the strange disease are a 10-year-old girl and a boy who was 9 months old. They were children of a man, a resident of Kikonda village in Kiryanga Sub-county, Kagadi District.
They were passing blood from the mouth and the nose, which symptoms are similar to those caused by the Ebola virus [infection].
Their death has caused fear among

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PRO/AH/EDR> West Nile virus (12): Americas (Canada) horses

West Nile Virus -- Canada
West Nile virus is becoming a more serious issue in horses; rates are rising in Alberta, and 1/3rd of the horses which become infected will die.
But there is a way to protect your horses, said veterinarian Melissa Smith of West Wind Veterinary Hospital in Sherwood Park.
"There are vaccines available for West Nile," she said. "It is one we consider a core vaccination for horses. We know any horse can be exposed, and it is a disease seen in our area, and it can have severe consequences

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PRO/AH/EDR> Rabies (30): Americas, USA (FL, NC) cat, fox, dog, human exposure

Rabies -- United States
Health department officials are urging Escambia County residents and visitors to protect themselves from rabies exposure by avoiding contact with wild and stray animals after a rabid cat attacked 2 people.
A stray cat recently attacked 2 individuals in Escambia County, and tissue samples from the animal tested at the state laboratory confirmed the presence of the rabies virus, according to a news release from the Florida Department of Health (FDOH) in Escambia County.
Rabies is a viral

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PRO/AH/EDR> Anthrax - India (05): (TG) ovine, human exposure

Anthrax -- India
Three sheep died in Kattangoor mandal headquarters on Saturday [25 May 2019]. On receiving the information, animal husbandry officials rushed to spot and confirmed that the sheep died of anthrax disease.
District Animal Husbandry joint director Ch Ramesh told the Express that the department has sent 4 special teams to vaccinate livestock within a radius of 5 km from Kattangoor mandal headquarters. It would take 3 days for the vaccination, he said.
It also came to light that some people

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PRO/AH/EDR> MERS-CoV (50): Saudi Arabia (RI, MD)

MERS -- Saudi Arabia
In the past 4 days since the last update, there have been a total of 3 newly confirmed cases of MERS-CoV infection including 2 deaths reported from Saudi Arabia.
Information on newly confirmed cases (3) [includes 2 fatalities reported at time of initial confirmation report]
[1]
Date of confirmation report: 23 May 2019
Case No: 19-1920
MERS from Riyadh city: 69-year-old male from Riyadh city, Riyadh region
Contact with camels: Yes
Case classification: Primary
Current status:

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PRO/EDR> Legionellosis - USA (08): (NJ) fatal

Legionnaires' -- United States
Health officials have identified a cluster of Legionnaires' disease cases in Union County, [New Jersey] authorities said Friday [24 May 2019]. There are 22 confirmed cases. [The people became ill between 8 Mar-13 May 2019 (). A "vast majority" of those who fell ill live in Union County (.)] The disease is being blamed for 5 deaths, although officials said they were "older adults who had significant medical conditions."
"This is a continuing investigation. The risk to any resident of or

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PRO/EDR> Syphilis - Thailand (02): incr. cases, teenagers/young adults, lack of education

Syphilis -- Thailand
Syphilis has become a serious public health concern in Thailand. An alarming rise in syphilis cases in the country underscores the need for a public health education campaign. But it's a topic rarely discussed freely in Thailand, where sexual dialogue is received with embarrassment, mockery or laughter in sex education classes.
According to the Thai Health Ministry, the average age of the 1st sexual encounter of Thais has fallen to 13-15 years old. Fifty percent report to have not used a

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PRO/EDR> Influenza (16): India, Australia, seasonal activity

Influenza -- Australia
The city has witnessed 200 cases of swine flu (H1N1) in the 1st 5 months of the year [2019], the highest since 2016. There have been 2 deaths owing to the virus in March 2019.
While there were no cases reported between January and May in 2018, 70 cases (3 deaths) were reported in 2017, and 2 cases in 2016. Doctors, however, claimed the outbreak is "under control."
The number of cases has dropped from 85 in March to 47 in April and 29 in May [2019], according to the epidemiology cell of

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PRO/EDR> West Nile virus (12): Europe (Italy) Usutu immunity

West Nile Virus -- Italy
Abstract
"In 2018, there was a large West Nile virus (WNV) outbreak in northern Italy. We observed 5 atypical cases of WNV infection that were characterised by the presence of WNV RNA and WNV IgG at the time of diagnosis, but no IgM response during follow-up. Neutralisation assays demonstrated pre-existing Usutu virus immunity in all patients. Besides challenging diagnosis, the immunological crosstalk between the 2 viruses warrants further investigation on possible cross-protection or

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PRO/AH/EDR> Angiostrongylus cantonensis - USA (03): (HI)

Other Human Disease -- United States
The Hawaii Department of Health has received notification from the Centers for Disease Control and Prevention that its laboratory confirmed 3 unrelated cases of angiostrongyliasis, or rat lungworm disease, in visitors to Hawaii island.
All 3 individuals are adult residents of the US mainland and were traveling in Hawaii when they were infected with the parasite causing the disease.
One of the individuals visited East Hawaii in December 2018 and became infected by purposely eating a slug

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PRO/AH/EDR> Hantavirus - Americas (24): USA (NM)

Hantavirus -- United States
The New Mexico Department of Health confirms the state's 1st hantavirus [infection] case of 2019. A 50-year old woman from McKinley County was hospitalized and is now resting at home.
Hantavirus pulmonary syndrome (HPS) is a severe respiratory illness caused by the Sin Nombre virus and can be deadly. HPS results in flu-like symptoms such as fever and muscle aches, which may be accompanied by chills, headache, nausea, vomiting, diarrhea, abdominal pain, and cough. HPS can be transmitted by

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PRO/EDR> Mumps update (08): USA (CO, TX), Asia (Malaysia)

Mumps -- United States
Summit County Public Health investigators are looking into a cluster of 6 confirmed mumps virus cases. The cases are all associated with people at Arapahoe Basin Ski Area.
Investigators are broadening their surveillance area for the possibility of more mumps cases. The confirmed cases are all employees or people associated with those employees. There are no known skiers or boarders confirmed in the mumps cases.
[Byline: Matt Kroschel]
--
Communicated by:
ProMED-mail from HealthMap

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PRO/AH/EDR> Anthrax - Kenya (10): (NK) buffalo

Anthrax -- Kenya
An anthrax outbreak that affected Kenya's Lake Nakuru National Park is over, and the last buffalo death was recorded on 10 May [2019], the country's wildlife conservation agency said on Saturday [25 May 2019]. John Waweru, director general of Kenya Wildlife Service (KWS), said in a statement that the total mortalities to date are 145 buffaloes representing 3.54% of the estimated population of 4100 buffaloes in Lake Nakuru National Park.
"Our partnership with the local administration and

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PRO/AH/EDR> Anthrax fears - UK: (England) tannery concerns

Anthrax -- United Kingdom
A burial site underneath land earmarked for development in Yeovil could bring the risk of deadly disease contamination, according to local councils. A housing estate featuring 765 homes is planned to be built on land at the outskirts of the town. The redevelopment plans, to the north of Yeovil at Upper Mudford, also include a 65-bed care home, shops, a health centre, and a new primary school.
A decision is expected to be made on the applications "in the coming months," according to a South

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PRO/AH/EDR> Mycobacterium bovis - UK (02): (Scotland) cat, pet food origin

Bovine TB -- United Kingdom
A Scottish family had to be tested for tuberculosis (TB) after their cats contracted a strain of the infection that can be passed to humans. [NT], 43, from Kirkintilloch, had been feeding her cats the wild venison flavour of Natural Instinct pet food, which is being investigated by Food Standards Scotland over a possible link to TB in cats. Her beloved tabby, Jax, was ill for 9 months before he was diagnosed with the bovine strain of TB, and sadly he passed away in March [2019]. Her older cat,

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PRO/AH/EDR> Ebola update (48): Congo DR (NK, IT) cases, summary, WHO, response

Ebola -- DR Congo
- 123 526 vaccinated persons;
- 831 people vaccinated on 23 May 2019;
- Of those vaccinated, 34 048 are high-risk contacts (CHR), 60 522 are contacts of contacts (CC), and 28 956 are front-line providers (PPL);
- Persons vaccinated by health zone: 32 412 in Katwa, 25 048 in Beni, 15 798 in Butembo [total numbers can be seen at the source URL above];
- The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval

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PRO/EDR> Poliomyelitis update (39): Pakistan, Nigeria, politics of health

Polio -- Pakistan
Paralysis cases spiked after a vaccination drive was derailed by false rumors that dozens of children had collapsed and died.
After serious setbacks in April [2019] led to a cluster of new polio cases, Pakistan is revamping its vaccination strategy in a renewed effort to wipe out the virus. The country is one of just 3 -- along with Afghanistan and perhaps Nigeria -- in which polio is still endemic. Eradication of the virus in Pakistan is crucial to the drive to rid the world of polio, once

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PRO/AH/EDR> Newcastle disease - Russia (02): (PR) poultry, OIE

Newcastle Disease -- Russia
Information received on [and dated] 24 May 2019 from Dr. Nikolay Vlasov, Deputy Head, Federal Service for Veterinary and Phytosanitary Surveillance, Ministry of Agriculture, Moscow, Russia
Summary
Report type: Immediate notification
Date of start of the event: 30 Apr 2019
Date of confirmation of the event: 7 May 2019
Report date: 24 May 2019
Date submitted to OIE: 24 May 2019
Reason for notification: Recurrence of a listed disease
Date of previous occurrence: 7 Jan

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PRO/AH/EDR> Infectious hematopoietic necrosis, trout - Austria: (KA) OIE

Other Animal Disease -- Austria
Information received on [and dated] 20 May 2019 from Dr. Ulrich Herzog, Chief Veterinary Officer, Consumer Health, Federal Ministry of Health, Vienna, Austria
Summary
Report type: Immediate notification (final report)
Date of start of the event: 1 Apr 2019
Date of confirmation of the event: 8 Apr 2019
Report date: 20 May 2019
Date submitted to OIE: 20 May 2019
Date event resolved: 7 May 2019
Reason for notification: Recurrence of a listed disease
Date of previous occurrence: 2 Feb

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PRO/EDR> Legionellosis - Europe (03): Belgium (OV) L. pneumophila, cooling towers pos.

Legionnaires' -- Belgium
The Flemish Agency for Health and Safety reported (computer translated) that 5 of the 17 company cooling towers tested were positive for the bacterium _Legionella_. Two companies reported high values of the organism. Officials remind us that this does not mean that the source of the infection is known. The samples will now be genetically tested. In the remaining 12 company cooling towers tested, 10 were negative and 2 had different kind than the _Legionella pneumophila_ that made the people

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PRO/AH/EDR> Red sea bream iridoviral disease - India: (KA) sea bass, 1st report, OIE

Other Animal Disease -- India
Information received on [and dated] 23 May 2019 from Mr. Tarun Shridhar, Secretary, Department of Animal Husbandry, Dairying & Fisheries, Ministry of Agriculture and Farmers Welfare, New Delhi, India
Summary
Report type: Immediate notification (final report)
Date of start of the event: 18 Jan 2018
Date of confirmation of the event: 15 May 2019
Report date: 23 May 2019
Date submitted to OIE: 23 May 2019
Date event resolved: 3 Feb 2019
Reason for notification: 1st occurrence of a

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PRO/AH/EDR> Schistosomiasis - Myanmar (02): (RA)

Schistosomiasis -- Myanmar
Arakan state [now Rakhine state] has the largest outbreak of schistosomiasis cases among 14 states and regions in Myanmar, said Dr. Kyi Lwin, head of the Department of Public Health in Arakan State. "The outbreaks of schistosomiasis are still discovered here. Diarrhea is also prevalent here. Arakan has the most rampant cases of schistosomiasis in Myanmar," Dr. Kyi Lwin told the media in a campaign held on [21 May 2019] at U Ottama Hall in Sittwe to prevent schistosomiasis disease caused by

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PRO/AH/EDR> Babesiosis - USA: blood transfusion

Babesiosis -- United States
The Food and Drug Administration (FDA) just came out with strict new recommendations on screening for the parasite causing the tick-borne infection babesiosis. Medical screening has always been part of the blood donation process, but this month [May 2019] a new recommendation from the FDA includes wholesale testing of donor samples in certain areas of the country for the tick-borne infection babesiosis.
Dr. Steven Sloan is the medical director of the blood bank at Boston Children's

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PRO/AH/EDR> Strangles - North America (06): USA (WA) horses

Strangles -- United States
In January of this year [2019], there were confirmed cases of equine strangles in Snohomish County, Washington. The Washington Department of Agriculture has confirmed on 15 May 2019, 2 horses on a property in the county were positive for strangles. Eight other horses were exposed on the property.
A 4-year-old Arab gelding and a 4-year-old Arab mare on that property began showing clinical signs of strangles on 11 May 2019. Those signs included fever, nasal discharge and swollen lymph nodes.

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PRO/AH/EDR> Chronic wasting disease - Sweden (02): (NB) moose

Chronic Wasting Disease -- Sweden


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PRO/AH/EDR> Ficus toxicity - India: (KA) cattle

Other Animal Disease -- India
Even though the drought has not affected cattle in Thirthahalli taluk [administrative district], as is the case in other drought-affected taluks of Shivamogga district, the death of 2 heads of cattle at Araga village recently has set off alarms in the district. However, a thorough investigation conducted by the Obscure Disease Research Center, Shivamogga, has revealed they [the cattle] died after consuming the toxic _Ficus tsjahela_ leaves.
This is not the 1st such incident reported in the

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PRO/AH/EDR> Leishmaniasis - Armenia (02): (LO) dog, OIE

Leishmaniasis -- Armenia
Information received on [and dated] 21 May 2019 from Dr. Hovhannes Mkrtchyan, head, Veterinary Inspectorate of the State Service for Food Safety, Ministry of Agriculture, Yerevan, Armenia
Summary
Report type: Immediate notification (final report)
Date of start of the event: 8 May 2019
Date of confirmation of the event: 21 May 2019
Date event resolved: 9 May 2019
Reason for notification: 1st occurrence of a listed disease
Manifestation of disease: Clinical disease
Causal agent:

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PRO/AH/EDR> Tick-borne encephalitis - Czech Republic

Tick-borne Encephalitis -- Czech Republic
The Czech Republic recorded the highest number of tick-borne encephalitis (TBE) cases in the EU last year [2018]. In the whole of Europe, only Russia recorded more cases of the potentially deadly disease.
There were 712 recorded TBE cases in the country last year [2018], the highest number since 2011, a Czech member of the International Scientific Working Group on TBE (ISW-TBE) said in a press release on Thursday [23 May 2019].
Only about one-quarter of inhabitants of the Czech Republic

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PRO/AH/EDR> Foot & mouth disease - Israel (03): (HA) cattle, gt O/ME-SA/PanAsia-2(QOM-15)

Foot and Mouth -- Israel
The VP1 sequencing results of the recent foot-and-mouth disease (FMD) virus isolate from Daliyat Al-Karmel presents a higher than 99% similarity to the isolate from cattle in Tamra. The causative agent is O/ME-SA/PanAsia-2(QOM-15).
Dr. Avi Vaserman
Field Veterinary Services Director, IVSAH
Ministry of Agriculture and Rural Development
--
Communicated by:
ProMED-mail

[The above information, which addresses ProMED-mail's RFI in http://bit.ly/2HVS3I1, was

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PRO/EDR> Poliomyelitis update (38): Iran, overview, WHO

Polio -- Iran
On 9 May 2019, the Global Polio Laboratory Network (GPLN) notified WHO of the detection of wild poliovirus type 1 (WPV1) from an environmental sewage sample collected on [20 Apr 2019] in Konarak district, Sistan-Baluchistan province, Islamic Republic of Iran. The virus was detected in an environmental sample only, and to date, no associated cases of paralysis have been detected.
The subsequent scheduled sewage sample collected from the same site on 4 May 2019 (2 weeks after the positive

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PRO/AH/EDR> Rift Valley fever - Chad: (BA) antelope, OIE

Rift Valley Fever -- Chad
Information received [and dated] 20 May 2019 from Dr. Nodjimadji Rirabe, Director of Veterinary Services, Veterinary Services, Ministry of Livestock and Animal Production, N'djamena, Chad
Summary
Report type: Immediate notification (final report)
Date of start of the event: 3 Sep 2018
Date of confirmation of the event: 30 Jan 2019
Report date: 20 May 2019
Date submitted to OIE: 20 May 2019
Date event resolved: 20 May 2019
Reason for notification: 1st occurrence of a listed

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PRO/AH/EDR> Avian influenza (35): Viet Nam (HU) backyard, HPAI H5N1, OIE

Avian Influenza H5N1 -- Worldwide/Unknown
Information received on [and dated] 20 May 2019 from Dr. Dong Pham Van, Director General, Chief Veterinary Officer, Department of Animal Health, Ministry of Agriculture and Rural Development, Hanoi, Viet Nam
Summary
Report type: immediate notification
Date of start of the event: 4 May 2019
Date of confirmation of the event: 13 May 2019
Reason for notification: reoccurrence of a listed disease
Date of previous occurrence: 11 Mar 2019
Manifestation of disease: clinical disease
Causal

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PRO/AH/EDR> Anthrax - Lesotho: (MS) cattle, OIE

Anthrax -- Lesotho
Information received on [and dated] 21 May 2019 from Dr Gerard Relebohile Mahloane, Director General of Veterinary Services, Livestock Services, Ministry of Agriculture and Food Security, Maseru, Lesotho
Summary
Report type: immediate notification
Date of start of the event: 12 May 2019
Date of confirmation of the event: 18 May 2019
Report date: 21 May 2019
Date submitted to OIE: 21 May 2019
Reason for notification: reoccurrence of a listed disease
Date of previous occurrence: 10 May

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PRO/AH/EDR> Anthrax - Zimbabwe (06): (MN) wildlife, comment

Anthrax -- Zimbabwe
There is confusion in media sources regarding the location of the current anthrax outbreak in Zimbabwe, with some media sources mistakenly reporting the location of the outbreak as "Hwange National Park".

As noted in the [ProMED post referenced above], the outbreak is actually occurring in 2 sections of the Matetsi Safari Area (Matetsi Unit 6 and Matetsi Unit 7).
These areas are situated some 100 km [62 mi] northwest of the northern border of Hwange National Park, in the area to the

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PRO/AH/EDR> Foot & mouth disease - Libya (02): (ZW) sheep, st pending, OIE

Foot and Mouth -- Libya
Information received on 23 May 2019 from Dr Zakaria Mohamed Mustafa Elkhatal, Director General, National Centre for Animal Health (NCAH), Ministry of Agriculture, Animal & Marine Wealth, Tripoli, Libya
Summary
Report type: follow-up report no. 1
Date of start of the event: 25 Apr 2019
Date of confirmation of the event: 3 May 2019
Report date: 22 May 2019
Date submitted to OIE: 23 May 2019
Reason for notification: recurrence of a listed disease
Date of previous occurrence: 30 Dec

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PRO/EDR> Typhoid fever - Denmark: ex Pakistan, multidrug resistance

Typhoid -- Pakistan
In Denmark, typhoid fever is a rare infection in returning travelers with fewer than 100 cases in our laboratory during the past 20 years. On a global level, the WHO estimates between 11 and 22 million cases with 128 000 to 161 000 deaths annually [1]. Since November 2016, an outbreak of _Salmonella enterica_ serotype Typhi resistant to ampicillin, trimethoprim/sulfamethoxazole, chloramphenicol, fluoroquinolones and ceftriaxone has been ongoing in the Sindh Province in Pakistan, especially in

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PRO/AH/EDR> Crimean-Congo hem. fever - Africa (09): Namibia, update

Crimean-Congo Hemorrhagic Fever -- Namibia
The Ministry of Health and Social Services of Namibia officially declared an outbreak of Crimean-Congo hemorrhagic fever (CCHF) on [6 May 2019] after reporting a number of cases from different regions of the country.
As of 15 May 2019, 7 suspected cases of CCHF were reported from 5 regions, including one laboratory confirmed case out of 7 samples tested and one death (case fatality ratio 14 percent).
The Ministry of Health and Social Services detail the cases/locations in the following

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PRO/AH/EDR> Leishmaniasis - Lebanon: ex Syria, refugees, cutaneous

Leishmaniasis -- Lebanon


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PRO/AH/EDR> African swine fever - Asia (46): China (GZ) domestic, spread, OIE

African Swine Fever -- China
Information received on [and dated] 21 May 2019 from Dr Zhang Zhongqui, director general, China Animal Disease Control Centre, Veterinary Bureau, Ministry of Agriculture, Beijing, China (People's Rep of)
Summary
Report type: immediate notification
Date of start of the event: 17 May 2019
Date of confirmation of the event: 18 May 2019
Reason for notification: recurrence of a listed disease
Date of previous occurrence: 3 Feb 2019
Manifestation of disease: clinical disease
Causal agent:

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PRO/EDR> Poliomyelitis update (37): Pakistan, Nigeria

Polio -- Niger
New wild poliovirus reported this week:
AFP cases: 2
Environment: 7 [8?]
New cVDPV poliovirus reported this week:
AFP cases: 1
Environment: 3
Officially reported wild poliovirus cases as of 21 May 2019
--------------------------
Total global cases in 2019: 24 (compared with 8 for the same period in 2018)
- Total in endemic countries in 2019: 24 (compared with 8 for the same period in 2018)
- Total in non-endemic countries in 2019: 0 (compared with 0 for the same period in

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PRO/EDR> Measles update (37)

Measles -- United States
Measles continues to spread across the United States, with 41 new cases confirmed in the past week, according to an update today from the Centers for Disease Control and Prevention (CDC).
From 1 Jan through 17 May [2019], the CDC has recorded 880 measles cases in 24 states, the most since 1994 and easily the most since the disease was declared eliminated in the country in 2000. Many of the cases are part of 10 outbreaks (3 or more cases) ongoing across the country, including large outbreaks

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PRO/AH/EDR> Anthrax - Myanmar: (ML) bovine, OIE

Anthrax -- Myanmar
Information received on 25 May 2018 from Dr. Ye Tun Win, Chief Veterinary Officer Director General, Livestock Breeding and Veterinary Department, Ministry of Livestock and Fisheries, Nay Pyi Taw, Myanmar
Summary
Report type: Immediate notification
Date of start of the event: 4 May 2018
Date of confirmation of the event: 24 May 2018
Report date: 25 May 2018
Date submitted to OIE: 25 May 2018
Date event resolved: 14 May 2018
Reason for notification: Recurrence of a listed disease
Date

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PRO/AH/EDR> Scrub typhus - India (03): (KL)

Scrub Typhus -- India
Staff of the Health Department distributed preventive medicines among residents of a tribal colony at Karassery grama panchayat in Kozhikode district on [Wed 22 May 2019] after lab results confirmed that the death of one of the residents there was due to scrub typhus, a disease caused by the bacterium _Orientia tsutsugamushi_.
According to sources, the patient, 65 [years of age], of Mayangal colony in the panchayat [village] had died on [4 May 2019] after undergoing treatment for fever for

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PRO/AH/EDR> Hantavirus - Europe: Germany

Hantavirus -- Germany
More and more people are catching the harmful hantavirus. There have already been more than 200 registered cases in Baden-Wurttemberg in 2019, compared with only a dozen or so in the same period last year. Those infected experience flu-like symptoms, which in more severe cases can lead to kidney failure and lung disease.
The number of cases in Stuttgart has risen particularly sharply. The regional council announced on 15 May [2019] that so far this year 211 cases have already been reported.

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PRO/EDR> Legionellosis - Europe (02): Belgium (OV)

Legionnaires' -- Belgium
An additional patient, the 19th, was admitted to the hospital in Flanders, [East Flanders province] suffering from legionellosis.
This case comes in addition to the 18 others who have been exposed to _Legionella_ bacteria in the Evergem area [East Flanders], right next to Ghent, and who developed legionnaires' disease, a lung disease that is not transmitted from human to human.
Of the total of 19 patients, 2 men died: one Monday night [20 May 2019] and the other [Wed 22 May 2019], in 2

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PRO/PL> Southern tomato virus - UK: 1st rep

Other Plant Disease -- United Kingdom
A new and previously unrecorded outbreak of '_Southern tomato virus_' (STV) has been reported in the UK. The virus has been previously reported around mainland Europe for some years.
The virus (which displays symptoms akin to ToBRFV [_Tomato brown rugose fruit virus_]/PepMV [_Pepino mosaic virus_]) does not seem to be very damaging to tomato plants and is thought to be seed borne. Where outbreaks occur the virus is not easily mechanically moved so removal of affected plants is thought to be

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PRO/AH/EDR> Malaria - Algeria, Argentina: WHO certified malaria-free

Malaria -- Algeria
Algeria and Argentina have been officially recognized by WHO as malaria-free.
The certification is granted when a country proves that it has interrupted indigenous transmission of the disease for at least 3 consecutive years.
Contracted through the bite of an infected mosquito, malaria remains one of the world's leading killers, with an estimated 219 million cases and over 400 000 malaria-related deaths in 2017.
Approximately 60% of fatalities are among children aged under 5 years.

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PRO/EDR> Amebic meningoencephalitis, primary - India: (KL) fatal

Amoeba -- India
1. Sood A, Chauhan S, Chandel L, Jaryal SC. Prompt diagnosis and extraordinary survival from _Naegleria fowleri_ meningitis: A rare case report. Indian J Med Microbiol 2014; 32(2):193-6; .
2. Jain R, Prabhakar S, Modi M, Bhatia R, Sehgal R. _Naegleria_ meningitis: a rare survival. Neurol India 2002; 50(4): 470-2; .
There have been 5 well-documented survivors in North America: one in the US in 1978, one in Mexico in 2003, 2 additional survivors from the US in 2013, and one from the US in

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PRO/AH/EDR> Hantavirus - Americas (23): USA (CO)

Hantavirus -- United States
The 1st confirmed Colorado case of hantavirus in 2019 has recently been reported, according to Northeast Colorado Health Department Public Information Officer Alicea Einspahr.
Einspahr said in a press release this serves as a good reminder that the virus is found throughout the state, including in Northeast Colorado.
Human cases infrequently occur however, the illness is severe and potentially life-threatening if not identified early.
Hantavirus is a respiratory disease carried by

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PRO/AH/EDR> MERS-CoV (49): Saudi Arabia (RI) secondary case

MERS -- Saudi Arabia
In the 4 days since the last update (see MERS-CoV (48): Saudi Arabia (RI) WHO http://bit.ly/2VGcxJH), there have been 2 newly confirmed cases of MERS-CoV infection reported and one newly reported fatality in a previously confirmed case.
Information on newly confirmed cases (2)
[1]
Date of confirmation report: 19 May 2019
Case No: 19-1918
MERS from Alkharj city: 22-year-old female from Alkharj city, Riyadh region
Contact with camels: No
Case classification:

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PRO/AH/EDR> Yellow fever - Africa (08): Nigeria

Yellow Fever -- Nigeria
In this reporting month of April 2019:
- 332 suspected cases were recorded
- 3 new presumptive positive cases were recorded
- NCDC Central Public Health Laboratory (CPHL) reported 1 new presumptive positive case from Imo State - (Orsu LGA)
- Yusuf Danshoho Memorial Hospital (YDMH) Kaduna reported 1 presumptive case - case from Kebbi - (Arewa Dandi LGA)
- Gombe Specialist Hospital (GSH) Gombe reported 1 presumptive case from Gombe LGA
- 3 new confirmed cases from the Institute

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PRO/AH> African swine fever - Asia (45): China, global economic impact

African Swine Fever -- China
The outbreak of African swine fever (ASF) in East Asia is likely to have a noticeable impact on meat and feed markets worldwide. The extent and speed of the spread and the number of countries affected are still uncertain. FAO monitors the outbreak, providing regular updates through its Emergency Prevention System for Animal Health (EMPRES-AH). It also provides detailed recommendations on how to curb the outbreak and assists governments in their implementation.
The FAO-EMPRES-AH update of 2

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PRO/EDR> Pertussis update (05): USA

Whooping Cough -- United States
A baby in California has died after contracting whooping cough, officials said, marking the 1st such death in Orange county in more than a decade. A news release posted on [Thu 18 Apr 2019] by the county's health officials did not identify the child or list the baby's age. "We are deeply saddened by this loss of life and send our condolences to the family," Dr Nichole Quick, interim county health officer, said in the news release.
The health department counted 171 cases of whooping cough,

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PRO/AH/EDR> Salmonellosis - USA (03): (WI, MN) vegetable tray

Salmonella -- United States
Public health officials are investigating an ongoing multi-state outbreak of salmonellosis linked to consumption of certain Del Monte vegetable trays. To date, 3 people in Wisconsin and one in Minnesota, have reported becoming sick after consuming a Del Monte vegetable tray purchased from a Wisconsin or Minnesota Kwik Trip, according to a news release.
Patients reported becoming ill between 13 and 27 Apr 2019. It is possible additional illnesses will be reported due to the several week

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PRO/EDR> Typhoid fever - USA (02): (MA) food worker, imported

Fever -- United States
A cook at Kelly's Roast Beef in Saugus, Massachusetts is sick with _Salmonella_ Typhi, a bacteria which causes typhoid fever. The restaurant confirmed the information Tue 21 May 2019. The illness is rare in the United States, but more common in some developing nations. Kelly's says the employee had just returned from out of the country.
"We were coming to have clams, roast beef, the usual," said a customer, one of the many regulars showing up unaware that the restaurant temporarily closed

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PRO/AH/EDR> Diphyllobothrium latum - France: (BT)

Other Human Disease -- France
Lovers of sushi, maki, sashimi, and other raw fish, beware of your stomach! 7 cases of fish tapeworm, better known as tapeworm [ProMED presumes it is _Diphyllobothrium latum_], have been reported in 2 years by the Rennes hospital in Ille-et-Vilaine [Brittany].
An exceptional number of cases was counted between July 2016 and September 2018, especially since no case had been detected for at least 20 years.
The infection is acquired by "eating raw or marinated fish which contains larvae of

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PRO/AH/EDR> Equine piroplasmosis - USA: (TN) horses

Other Animal Disease -- United States
The state veterinarian's office is investigating an outbreak of equine piroplasmosis [EP] in a group of racing quarter horses in the midstate [Tennessee, USA].
22 horses have tested positive for EP in 5 locations within Bedford, Rutherford, and Williamson counties. The horses are all under quarantine and being treated.
EP is a blood parasite affecting equines. The disease is not contagious to humans. Although it can be transmitted through infected ticks, it is more commonly spread by

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PRO/AH/EDR> Hantavirus - Americas (22): Bolivia (TR)

Hantavirus -- Bolivia
Tarija Departmental Health Services (SEDES) reported a new case of hantavirus [infection] in Padcaya municipality. The number of patients with this illness is within what is expected, because this season is when more people acquire the disease. Epidemiological surveillance is continuing in Arce province. The person who acquired this illness is male and is under medical care until his recuperation.
The head of the Epidemiological Unit of SEDES, Claudia Montenegro, stated that the patient is

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PRO/AH/EDR> Anthrax - Zimbabwe (05): (MN) wildlife, under control

Anthrax -- Zimbabwe
Anthrax - Zimbabwe (07): (MN) human, wildlife, contained http://bit.ly/2VGOdYi
Anthrax - Zimbabwe (06): (MN) human, wildlife http://bit.ly/30BgLWX
Anthrax - Zimbabwe (05): (MN) wildlife http://bit.ly/2VHTPl8
Anthrax - Zimbabwe (04): (MN) wildlife http://bit.ly/30yoHIn
Anthrax - Zimbabwe (03): (MN) wildlife, human death http://bit.ly/2VF1JMa
Anthrax - Zimbabwe (02): (MN) wildlife,

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PRO/EDR> Hepatitis A - USA (20): (PA)

Hepatitis A -- United States
Pennsylvania's Secretary of Health, Dr. Rachel Levine has announced that the state has declared a hepatitis A outbreak with 171 cases in 36 counties. According to the map provided by the Department of Health, Allegheny and Philadelphia counties are hit the hardest with anywhere between 31-50 cases.
The counties hit hardest by this outbreak are Philadelphia and Allegheny, but we have seen an increase of cases throughout much of the state," Dr. Levine said. "We are taking this action now to

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PRO/EDR> Botulism - USA (04): (NM) wound, injection drug related

Botulism -- United States
The New Mexico Department of Health is investigating a case of apparent wound botulism. A 30-year-old male resident of Santa Fe County is hospitalized with suspected wound botulism. This is the 1st case of wound botulism that NMDOH has been notified of in 2019. The last in-state case of wound botulism occurred in 2018 in Dona Ana County. The suspected source of infection is contaminated black tar heroin.
Botulism is a rare but serious paralytic illness caused by a nerve toxin that is

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PRO/AH/EDR> Lassa fever - West Africa (26): Nigeria

Lassa Fever -- Nigeria
- In the reporting week 19 (6-12 May 2019) 4 new confirmed cases were reported from 3 states -- Edo (2), Ebonyi (1), and Taraba (1) states with no new deaths;
- From 1 Jan-12 May 2019, a total of 2426 suspected cases have been reported from 21 states. Of these, 569 were confirmed positive, 15 probable and 1842 negative (not a case);
- Since the onset of the 2019 outbreak, there have been 128 deaths in confirmed cases. Case fatality ratio in confirmed cases is 22.5%;
- 21 states (Edo, Ondo,

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PRO/EDR> Measles update (36)

Measles -- Ukraine
"When universal routine immunisation in childhood improves and the virus is still in circulation, the disease will naturally move to the older age group who may be unimmunised or whose vaccine-derived immunity has begun to wane. At a time when the state is moving towards measles elimination, adult measles is a major concern," a senior health official said.
Historically, measles has been a childhood disease. The epidemiological shift to older population presents new public health challenges

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PRO/EDR> Amebic meningoencephalitis, primary - Pakistan (02): (SD)

Amoeba -- Pakistan
People in Karachi are in the grip of deadly infectious diseases at the moment as officials in Karachi said [Fri 17 May 2019] that a 34-year old man was infected with the lethal _Naegleria fowleri_ amoeba or the brain-eating bug and was struggling for life at a private hospital in the city.
_N. fowleri_ is a single-celled organism that can cause a rare infection of the brain called "primary amoebic meningoencephalitis", also known as PAM, which is usually fatal, officials said adding that it

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PRO/EDR> Syphilis - Thailand: increased incidence, congenital

Syphilis -- Thailand
As many as 249 babies were born with syphilis in Thailand this year [2019], according to the Public Health Ministry. "The babies were affected because their mothers were infected," the ministry's permanent secretary, Dr Sukhum Karnchanapimai, said yesterday [18 May 2019].
Sukhum said that between 1 Jan and 13 May 2019, 3080 people of all ages were diagnosed with syphilis. Of them, 40.42 per cent are between 15 and 24 years old. Some 24.48 per cent of others are between 25 and 34 years old.

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PRO/AH/EDR> Anthrax - Zimbabwe (04): (MN) wildlife

Anthrax -- Zimbabwe
A suspected outbreak of anthrax has been reported in the Zambezi Valley following the death of 8 elephants, 2 buffaloes, and other animals last week.
The latest outbreak comes barely a year after 20 hippos were found dead in the Zambezi River in Mlibizi, Binga district [Matabeleland North province] after being infected by anthrax.
In an interview on the sidelines of a District Civil Protection Committee meeting in Hwange last week, Hwange District Veterinary Officer Dr Lovemore Dube said

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PRO/AH/EDR> Population declines, apis - Australia: native bees

Other Animal Disease -- Australia
The world's honey bees have been in steep decline for over a decade, with extraordinary losses in population witnessed across the globe resulting in a 30 percent loss of some honey bee colonies every year.
Beekeepers across the US and Europe have reported these mass bee deaths, known as 'colony collapse' since 2006 and in the absence of any singular explanation, the disturbing decline was dubbed 'colony collapse disorder' or CCD.
This was a shocking and frightening prospect for

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PRO/AH/EDR> Ebola update (47): Congo DR (NK, IT) cases, summary, situation, research

Ebola -- DR Congo
- Investigations continue around the 1st confirmed patient in the Alimbongo health zone. According to the initial results, the patient was contaminated after participating in an unsecured burial of a family member who died in Katwa.
Figures of the response
-----------------------
- 119 652 vaccinated persons
- 792 people vaccinated on 18 May 2019;
- of those vaccinated, 32 577 are high-risk contacts, 58 347 are contacts of contacts, and 28 728 are front-line providers;
- persons

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PRO/PL> Black spot, citrus - Italy: ex Tunisia, intercept

Other Plant Disease -- Italy
Citrus black spot was detected in some shipments of citrus fruit imported by the European Union from Tunisia. "[This] confirms all our worries about the spread of this devastating disease in the Mediterranean and we require the immediate block of imports from Africa. Over the past few years, we have asked the authorities to implement stricter checks," explains Giovanni Selvaggi, Consorzio Arancia Rossa di Sicilia IGP [Sicilian blood orange growers' association].
"We require the activation

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PRO/EDR> Influenza (15): WHO global update, Australia, seasonal activity

Influenza -- Australia
Information in this report is categorized by influenza transmission zones, which are geographical groups of countries, areas, or territories with similar influenza transmission patterns.
Summary
In the temperate zone of the northern hemisphere, influenza activity decreased overall.
- In North America and Europe, influenza activity was low overall.
- In North Africa, influenza detections were low across reporting countries.
- In western Asia, influenza activity decreased overall,

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PRO/AH/EDR> Japanese encephalitis - Taiwan

Japanese Encephalitis -- China
The Centers for Disease Control (CDC) on Friday [17 May 2019] confirmed this year's [2019] 1st Japanese encephalitis case, urging people to take precautionary measures against mosquito bites as the disease's peak season approaches.
A man in his 60s from Kaohsiung on 1 May [2019] started showing symptoms of fever, headache, convulsions and loss of consciousness, and was immediately hospitalized, the centers said.
He was reported as a suspected case and transferred to another hospital for

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PRO/AH/EDR> Texas cattle fever tick - USA (02): (TX) cattle

Tick-borne disease -- United States
Texas Animal Health Commission (TAHC) livestock inspectors discovered fever ticks on cattle originating from a Webb County premises during a routine voluntary inspection at a program dipping vat on 23 Apr 2019. The premises where the cattle originated has been placed under quarantine, and all cattle on the premises have started treatment.
"We are thankful for cattle producers' support in voluntarily inspecting their animals for fever ticks," said Dr. Andy Schwartz, TAHC Executive Director.

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PRO/AH/EDR> MERS-CoV (48): Saudi Arabia (RI) WHO

MERS -- Saudi Arabia
From [9 through 30 Apr 2019], the National International Health Regulations (IHR) Focal Point of Saudi Arabia reported 9 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 3 deaths. Of the 9 cases reported, 5 were associated with ongoing clusters in 3 cities: 3 cases (including 1 death) in Alkhafji city in the Eastern region of Saudi Arabia, 1 case in Alderb city in Jazan region, and 1 case in Alkharji city in Riyadh region of Saudi

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PRO/AH/EDR> Crimean-Congo hem. fever - Africa (08): Namibia, update

Crimean-Congo Hemorrhagic Fever -- Namibia
Health minister Kalumbi Shangula announced at a press conference in Windhoek yesterday [Wed 15 May 2019] that of the 6 reported cases of Crimean-Congo haemorrhagic fever (CCHF), only one had tested positive for the fever, while 3 were found to be negative. The results of the remaining 2 cases are still pending.
Shangula said a 54-year-old woman from Onethika B Village in the Olukonda constituency, who had since recovered and was discharged on 11 May [2019], had tested positive for the

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PRO/AH> African swine fever - Asia (44): China, Viet Nam, domestic, spread

African Swine Fever -- China
A man in a white protective suit parked a dump truck at the edge of a dusty pit and unloaded a pile of pink carcasses. They tumbled to the ground just as a 2nd truck arrived with another batch.
The scene at a Hong Kong landfill this week was part of a government effort to kill and dispose of 6000 pigs from a slaughterhouse where one of them had been found to have African swine fever [ASF].
It was the latest turn in an outbreak that has decimated pig herds in the Chinese mainland and

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PRO/EDR> Botulism - Argentina: commercial hummus, homemade preserves

Botulism -- Argentina
A case of foodborne botulism occurred in Slovakia in 2015. _Clostridium botulinum_ type A was isolated from 3 nearly empty commercial hummus tubes. The product, which was sold in Slovakia and the Czech Republic, was withdrawn from the market, and a warning was issued immediately through the European Commission's Rapid Alert System for Food and Feed (RASFF). Further investigation revealed the presence of botulinum neurotoxin (BoNT) subtype BoNT/A3, a very rare subtype implicated in only one

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PRO/AH/EDR> Mycobacterium bovis - UK: (England) cats, pet food origin

Bovine TB -- United Kingdom
A batch of raw pet food produced by the British company Natural Instinct has been identified as the probable cause of a rare outbreak of feline tuberculosis (TB) that infected 13 cats last year [2018] in the United Kingdom [see commentary regarding additional cases].
The Camberley-based company confirmed to the VIN News Service today [15 May 2019] that it is working with Britain's Food Standards Agency as part of a related investigation into its now-discontinued "Wild Venison"

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PRO/AH/EDR> Mayaro virus - Americas (02): Brazil (RJ)

Other Human Disease -- Brazil
A new threat to public health haunts the state of Rio de Janeiro: Scientists at the Federal University of Rio de Janeiro (UFRJ) have discovered that a virus with symptoms similar to those of the chikungunya virus [infection] may precipitate an epidemic in the Southeast.
Both have similar characteristics, such as disabling intense joint pains that last for months. There is no vaccine or any specific treatment.
Laboratory tests have shown that the Mayaro virus can be transmitted by both

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PRO/AH/EDR> African swine fever - USA (03): proactive surveillance

African Swine Fever -- United States
The US Department of Agriculture (USDA) within weeks will begin testing sick and dead pigs for a hog virus that has killed herds across Asia in an effort to minimize devastation if the disease enters the USA, the agency said on Thursday [16 May 2019].
Increased testing aims to help US officials detect cases of African swine fever quickly so they can contain the disease. African swine fever kills almost all pigs infected, though it is not harmful to people. There is no vaccine or cure. The

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PRO/AH/EDR> Newcastle disease - USA (10): (CA) biosecurity

Newcastle Disease -- United States
As agriculture officials ramp up the battle against the poultry-killing Newcastle disease outbreak in Southern California, state Veterinarian Annette Jones has issued a directive that state, county and city workers avoid poultry areas in an effort reduce spread of the highly contagious virus. When such visits are unavoidable because of a public-health threat, a strict protocol -- including biosecurity clothing -- is detailed in the guidelines issued by Jones last week.
Friday [17 May 2019]

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PRO/AH/EDR> Salmonellosis, st Braenderup & Montevideo - USA: live poultry

Salmonella -- United States
CDC and public health officials in several states are investigating multistate outbreaks of _Salmonella_ Braenderup and _Salmonella_ Montevideo infections linked to contact with backyard poultry.
Public health investigators are using the PulseNet system to identify illnesses that may be part of these outbreaks. PulseNet is the national subtyping network of public health laboratories coordinated by CDC. DNA fingerprinting is performed on _Salmonella_ bacteria isolated from ill people by

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PRO/AH/EDR> Hantavirus - Americas (21): USA (WA)

Hantavirus -- United States
A Grant County resident is recovering from hantavirus pulmonary syndrome [HPS], the 1st case of hantavirus [infection] in the state this year [2019]. The hantavirus illness was confirmed by laboratory testing on Friday [10 May 2019] at the state Public Health Laboratory. The individual is expected to survive and is recovering at home.
Hantavirus [causes] a rare illness caused by a virus found in the urine, droppings, and saliva of infected rodents. Deer mice are the only carriers of the

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PRO/EDR> Hepatitis A - USA (19): (KY)

Hepatitis A -- United States
The death toll has risen to 57 in Kentucky's hepatitis A outbreak, which has fallen from its peak but still hasn't been wrestled under control, according to the state's latest weekly report. Kentucky's deaths account for one-third of what the Centers for Disease Control and Prevention said are at least 170 deaths nationally from hepatitis A outbreaks, which since 2016 have spread to 22 states, largely among the homeless population and drug users. The contagious liver disease has sickened 4621

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PRO/AH/EDR> Anthrax (02): global, model map

Anthrax -- Worldwide/Unknown
_Bacillus anthracis_ is a spore-forming, Gram-positive bacterium responsible for anthrax, an acute infection that most significantly affects grazing livestock and wild ungulates, but also poses a threat to human health. The geographic extent of _B. anthracis_ is poorly understood, despite multi-decade research on anthrax epizootic and epidemic dynamics; many countries have limited or inadequate surveillance systems, even within known endemic regions. Here, we compile a global occurrence

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PRO/PL> Black sigatoka, banana - Reunion Island: 1st rep

Other Plant Disease -- Région d'outre-mer de Réunion, France
_Pseudocercospora fijiensis_, the causal agent of black Sigatoka disease of banana (Musa spp.) (BLSD), is considered to be the major economic threat for banana cultivated for export. The disease has a worldwide distribution throughout the humid tropical regions and has been previously reported in the southwest Indian Ocean area: in 1993 in Mayotte and Comoros islands, in Mauritius in 1996 and in Madagascar in 2000.
In December 2017, typical BLSD symptoms were observed in a Cavendish cv.

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PRO/AH/EDR> Salmonellosis, st Concord - USA: tahini, alert, recall request

Salmonella -- United States
The United States Food and Drug Administration, along with the Centers for Disease Control and Prevention (CDC), and state and local partners, are investigating a multistate outbreak of _Salmonella_ Concord illnesses linked to "Karawan Tahini and Halva" brand tahini imported from Israel.
The FDA has been working with the state of New York and New York City. The New York City Department of Health and Mental Hygiene tested samples of Karawan tahini and found that the product contained

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PRO/AH/EDR> Equine herpesvirus - North America (16): USA (AZ) horse

Equine Herpes Virus -- United States
Herpesvirus is highly contagious among horses and can cause a variety of ailments in equids, including rhinopneumonitis (a respiratory disease usually found in young horses), abortion in broodmares, and equine herpesvirus myeloencephalopathy (the neurologic form).
In many horses, the 1st or only sign of EHV-1 infection is fever, which can go undetected. In addition to fever, other common signs of EHV-1 infection in young horses include cough, decreased appetite, depression, and a nasal

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PRO/EDR> Poliomyelitis update (36): global, Iran environmental, Pakistan

Environmental -- Iran
New wild poliovirus reported this week:
AFP cases: 4
Environment: 5
New cVDPV poliovirus reported this week:
AFP cases: 0
Environment: 0
Headlines
- On 9 May 2019, the WHO received notification of the detection of wild poliovirus type 1 (WPV1) from an environmental sample collected on [20 Apr 2019], in Seestan and Balochistan province, Iran. The virus collected is an environmental sample only, and no associated cases of paralysis have been detected. Genetic sequencing confirmed it

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PRO/EDR> Measles update (35)

Measles -- Philippines
6 Feb 2019: The DOH declared a measles outbreak in the National Capital Region (NCR) and Region 3 (Central Luzon). The PRC [Professional Regulation Commission] escalated preparations at chapter and national HQ levels and started to mobilize community health volunteers for rapid assessment and disease surveillance.
7 Feb 2019: DOH announced that the measles outbreak had spread to more areas in Luzon and Visayas in Calabarzon, Region 6 (Western Visayas) and Region 7 (Central Visayas).
12

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PRO/AH> Influenza A, poultry: Belgium (WV), A(H3), low pathogenicity

Influenza -- Belgium
A total of 35 farms in Belgium have been affected by a [strain] of avian influenza that is harmless to humans, the country's agriculture department says. Since the beginning of April [2019], several poultry farms, mainly located in West Flanders, have been affected by a bird flu virus.
The Federal Minister for Agriculture Denis Ducarme emphasises that the virus in question is 'completely harmless to human health'. Moreover, the virus in question - bird flu virus of the H3 type - is not on

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PRO/AH/EDR> Rabies (29): Europe, Asia (Norway ex Philippines) human, dog

Rabies -- Norway
The family and relatives of Birgitte Kallestad wanted to say goodbye to the young woman under sheltered and private frames.
At 1:00 p.m. today [Wed 15 May 2019], the 24-year-old was buried in the upbringing municipality of Fjell in Hordaland.
"Intangible to all of us, her goodness became her path. Nevertheless, according to Birgitte's heart, it is now possible to give a gift to the Animal Protection. It's a great way to honor her memory," priest Maria Tveiten said in the memorial in the

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PRO/ALL> New in IJID (05): May 2019

Other Human Disease -- Worldwide/Unknown
Neurosyphilis: Concordance between cerebrospinal fluid analysis and subsequent antibiotic strategy for patients undergoing evaluation of a diagnosis of neurosyphilis
O.C. Smibert, S. Abbinga, D.W. Spelman, A.W.J. Jenney
Int J Infect Dis., Volume 82, May 2019, Pages 73-76

The need for an antibiotic stewardship program in a hospital using a computerized pre-authorization system
Buket Erturk Sengel, Huseyin Bilgin, Beyza Oren Bilgin, Tolga Gidener, Simge Saydam, Aslıhan Pekmezci, Onder

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PRO/AH/EDR> Herpesvirus, zoo elephant - USA: (IN)

Herpes -- United States
The Indianapolis Zoo says their 13-year-old male African elephant, Kedar, has tested positive for elephant endotheliotropic herpesvirus (EEHV).
The Zoo started testing the blood of each elephant twice a week after 2 elephants, Nyah and Kalina, died in March [2019]. Lab and pathology tests confirmed both elephants had EEHV, which is a virus that causes fatal hemorrhagic disease in elephants, mainly Asian elephants.
The Zoo says they are bringing the full force of knowledge and support

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PRO/AH/EDR> Anthrax - Kenya (09): (NK) wildlife, discussion

Anthrax -- Kenya
There's been an anthrax outbreak in Kenya's Nakuru county. But it's not the 1st time. Nakuru seems to be a hotspot for these outbreaks. The Conversation Africa's Moina Spooner asked Bernard Bett and John Gachohi to shed light on the reasons for this.
Why does Nakuru county have recurring outbreaks?
Last month [April 2019] an anthrax outbreak killed more than 10 buffaloes in Lake Nakuru National Park, which is in Kenya's Rift Valley. This area is no stranger to outbreaks. In our research,

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PRO/AH/EDR> Ebola update (46): Congo DR (NK, IT) cases, summary, response

Ebola -- DR Congo
114 553 Vaccinated persons:
- 486 people vaccinated on 12 May 2019.
- Of those vaccinated, 30 816 are high-risk contacts (CHR), 55 294 are contacts of contacts (CC), and 28 443 are front-line providers (PPL).
- Persons vaccinated by health zone: 30 886 in Katwa, 24 064 in Beni, 14 006 in Butembo.
- The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May

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PRO/AH/EDR> Anthrax - Botswana: (CH) elephant, OIE

Anthrax -- Botswana
Information received on [and dated] 15 May 2019 from Dr. Letlhogile Modisa, Director, Veterinary Services, Ministry of Agriculture, Gaborone, Botswana
Summary:
Report type: Immediate notification
Date of start of the event: 9 May 2019
Date of confirmation of the event: 15 May 2019
Report date: 15 May 2019
Date submitted to OIE: 15 May 2019
Reason for notification: Recurrence of a listed disease
Date of previous occurrence: 30 Sep 2015
Manifestation of disease: Clinical

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PRO/EDR> Cholera, diarrhea & dysentery update (14): Africa

Waterborne Illness -- Kenya
The outbreak of acute watery diarrhea (AWD) has killed 3 people in the North Gondar Tselemt area in the Amhara region of Ethiopia. The 3 people who were getting medical treatment after acquiring AWD have passed away, according to the state broadcaster ETV. The report indicated that currently 151 people affected by AWD are also identified in 3 locations of Amhara region. Currently in North Gondar, Tselemt area, 90 people infected with AWD have been identified and are being treated. While in

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PRO/AH/EDR> Hepatitis E - China: (HK) human, rat virus

Hepatitis E -- China
"Hepatitis E virus (HEV) is a major public health concern in developing countries where the primary transmission is via contaminated water. Zoonotic HEV cases have been increasingly described in Europe, Japan and the United States with pigs representing the main animal reservoir of infection. We report an unusual acute hepatitis infection in a previously healthy man caused by a rat hepatitis E virus with a considerably divergent genomic sequence compared to other rat HEV strains. It is

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PRO/AH/EDR> Yellow fever - Africa (07): Nigeria fake cards

Yellow Fever -- Nigeria
In the departure hall of Nigeria's busiest airport, Murtala Muhammed International in Lagos, passengers get their travel documents ready for check-in. In addition to a passport, ticket, and visa, travelers to many destinations need a yellow fever vaccination card, as Nigeria struggles with an ongoing outbreak. The cards are automatically issued following immunization at a government hospital and are validated with a signature and stamp from the port health authority.
But although 1 in 5

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PRO/AH/EDR> MERS-CoV (47): Saudi Arabia (RI, MK) EMRO April SitRep

MERS -- Saudi Arabia
At the end of April 2019, a total of 2428 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 838 associated deaths (case-fatality rate: 34.5%), were reported globally; the majority of these cases were reported from Saudi Arabia (2037 cases, including 760 related deaths with a case-fatality rate of 37.3%). During the month of April [2019], a total of 29 laboratory-confirmed cases of MERS were reported globally. All the 29 cases were reported from Saudi Arabia with

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PRO/AH/EDR> Squirrel pox, red squirrel - UK: (England)

Other Animal Disease -- United Kingdom
Squirrel pox is spreading fast along the Solway coast, affecting the population of red squirrels in the area. The virus is carried by grey squirrels - they are not affected by the disease but are capable of contaminating native reds that are not immune.
In recent weeks a number of red squirrels have died as a result of the disease. Those with pox [squirrel pox] resemble rabbits with Myxomatosis. A list of symptoms include skin ulcers, lesions, scabs, swelling and discharge from the

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PRO/EDR> Legionellosis - Europe (01): Belgium (OV)

Legionnaires' -- Belgium
One person has died from [legionellosis] in Evergem, [a municipality] near Ghent, after health authorities declared an outbreak of the bacteria in the region, which accelerated at the weekend. The patient died in Ghent's University Hospital on [Mon 13 May 2019] evening, The Flanders Agency for Care and Health announced in a statement.
The agency has currently identified at least 16 cases after it was reported that 11 infected people had been admitted to the hospital late last week.
The

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