ProMED-mail 情報: 2024年10月26日

腸管出血性大腸菌 EHEC　アイスランド

マラリア　ルワンダ

●　腸管出血性大腸菌 EHEC　アイスランド

PRO/AH/EDR> E. coli EHEC - Iceland: (CR) kindergarten children

Archive Number: 20241026.8719626

　情報源 Food Safety News 2024年10月25日

_E. coli_ outbreak sickens kids in Iceland

アイスランドで小児10人が大腸菌 a type of Shiga toxin-producing _E. coli_ (or enterohemorrhagic _E coli_, EHEC) に感染した。感染したのは，100人以上が通園する幼稚園 the Mánagarð kindergarten in the Vesturbær district of Reykjavík. の子どもらで，検便の PCR tests 検査で確認され培養の結果が待たれている。保健当局者 Landlaeknir (The Directorate of Health) は結果判明まであと数日かかかるとしている。感染源は特定されていないが，食品関連とみられている。様々な症状がみられているが，主に下痢と赤痢である。1人は症状が重く集中治療室に収容されている。4人ga　Barnaspítali Hringins, a children's hospital に入院となり，他の4人は救急室で診察を受けた。

●　サルモネラ感染症，カンピロバクター症　世界

PRO/AH/EDR> Salmonellosis, campylobacteriosis: global, climate change, increased incidence

Archive Number: 20241026.8719622

　情報源 Food Safety News 2024年10月24日

Review supports temperature-infection increase link

気温の上昇 higher temperatures がサルモネラ感染症とカンピロバクター症の増加 more _Salmonella_ and _Campylobacter_ infections につながるとの証拠が示されている。

疫学研究のレビュー peer-reviewed epidemiological studies published between January 1990 and March 2024で，3472 results のうち44 studies のシステマティックレビュー the systematic review, covering more than 1 million cases each of _Salmonella_ and _Campylobacter_ infections が得られた。

Overall, 22 studies examined _Salmonella_ infection, 15 investigated _Campylobacter_, and 7 assessed both infections. Studies covered 27 countries across 5 continents, but most were from high-income nations（高所得国）。

気温が1℃上昇するごとに，感染リスク the risk of _Salmonella_ and _Campylobacter_ infections が5% 増加した。The Lancet journal eBioMedicine に掲載されたこの論文で，気温と感染症の発生との関連 the relationship between temperature and the incidence of _Salmonella_ and _Campylobacter_ infections が強調されている。

気温の上昇は直接病原体の増殖 pathogen growth and replication に影響するとともに，間接的には食品の保存，生や不十分に加熱された食品の摂取，高温環境での調理などにも影響を与えていた。

[Mod.LL－ The citation and abstract of the article discussed follow:

Damtewa YT, Tong M, Varghesea BM, et al: The impact of temperature on non-typhoidal _Salmonella_ and _Campylobacter_ infections: an updated systematic review and meta-analysis of epidemiological evidence. eBioMedicine. 2024;109:10539.]

●　マラリア　ルワンダ

PRO/EDR> Malaria - Rwanda: case increase

Archive Number: 20241026.8719623

　情報源 Daijiworld 2024年10月24日

この9か月間にルワンダのマラリア感染 Malaria cases が著しく増加したと，the latest data from the Rwanda Biomedical Centre (RBC) で示されている。

2024年1月から9月までの間に全国で約51万８千人がマラリアに感染し，昨年同時期の37万人からの増加であると，23日に報告された。感染例のうち合計6万1千人が死亡した。およそ1900例の重症マラリアが確認されている。

参考項目

Malaria - Africa: Anopheles stephensi, expanded range 20240123.8714387

●　マールブルグ病　ルワンダ

PRO/AH/EDR> Marburg virus disease - Rwanda (10): additional case

Archive Number: 20241026.8719613

　情報源 WHO DON 2024年10月25日

Situation at a glance

As of 24 Oct 2024, a total of 64 Marburg virus disease cases, including 15 deaths (case fatality ratio (CFR) 23.4%), have been reported in Rwanda. Among the initial 62 confirmed cases with available data, 70% were males, and 48% were aged between 30 to 39 years. The highest number of new confirmed cases were reported in the first 2 epidemiological weeks of the outbreak with 26 cases reported in epidemiological week 39 (23 to 29 Sep 2024) and 23 cases in week 40 (30 Sep 2024 to 6 Oct 2024). This was followed by a sharp decline in weeks 41 and 42, with 12 and one case reported, respectively. Contact tracing is ongoing, with 1146 contacts under follow-up as of 20 Oct 2024. Based on available updates from the outbreak investigation, the index case was a male between 20 and 30 years old with a history of exposure to bats in a cave.

Description of the situation

Since the last Disease Outbreak News on this event was published on 18 Oct 2024, 2 additional laboratory-confirmed cases of Marburg virus disease (MVD) were reported in Rwanda on 23 and 24 Oct 2024. The new cases include a healthcare worker who had been treating MVD cases since the start of the outbreak and a case linked to the site where the index case was exposed. Both cases are currently in isolation and receiving treatment. As of 24 Oct 2024, a total of 64 confirmed cases, including 15 deaths (CFR: 23.4%), have been reported. Excluding the recently confirmed cases, 70% of the 62 initially confirmed cases were among males, and 48% were among adults between 30 and 39 years of age. Health workers from 2 health facilities in Kigali account for over 82% of confirmed cases. Most of the cases have been reported from the 3 districts in Kigali city.

The highest number of new confirmed cases were reported in the first 2 epidemiological weeks of the outbreak with 26 cases reported in epidemiological week 39 (23 to 29 Sep 2024) and 23 cases in week 40 (30 Sep to 6 Oct 2024). This was followed by a sharp decline in epi weeks 41 (7 to 13 Oct 2024) and 42 (14 to 20 Oct 2024), with 12 and 1 cases reported, respectively.

Since the declaration of the outbreak by the Government of Rwanda on 27 Sep 2024 and as of 23 Oct 2024, 46 confirmed cases have recovered, and 3 cases are under care at the designated Marburg treatment center. The 62 confirmed cases reported since the start of the outbreak have been part of one major cluster with 3 branches. As of 24 Oct 2024, a total of 5074 tests for Marburg virus have been conducted, with approximately 100-300 samples being tested daily at the Rwanda Biomedical Center.

Contact tracing is ongoing, with 1146 contacts under follow-up as of 20 Oct 2024.

WHO continues to support the Government of Rwanda. Enhanced surveillance, contact tracing and infection prevention and control measures must be maintained until the outbreak is declared over.

Based on available updates from the outbreak investigation, the index case was a male between 20 and 30 years old with a history of exposure to bats in a cave. Preliminary phylogenetic analyses indicate a close evolutionary relationship to a viral sequence from _Orthomarburgvirus marburgense_ (Marburg virus, MARV) that was observed in the MVD outbreak in East Africa in 2014.1

Figure 1. MVD cases by week of reporting in Rwanda, as of 24 Oct 2024, (n=64)

MVD Epi curve

-------------

[see above URL]

* Epidemiological week 43 is not complete as it will end on 27 Oct 2024.

Epidemiology

------------

MVD is a highly virulent disease that can cause haemorrhagic fever and is clinically similar to Ebola virus disease. Marburg and Ebola viruses are both members of the Filoviridae family (filovirus). People are infected with Marburg virus when they come into close contact with Rousettus bats, a type of fruit bat, that can carry the Marburg virus and are often found in mines or caves. Marburg virus then spreads between people via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids. Health workers have previously been infected while treating patients with suspected or confirmed MVD. Burial ceremonies that involve direct contact with the body of the deceased can also contribute to the transmission of Marburg virus.

The incubation period varies from 2 to 21 days. Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the 3rd day. Although not all cases present with haemorrhagic signs, severe haemorrhagic manifestations may appear between 5 and 7 days from symptoms onset, and fatal cases usually have some form of bleeding, often from multiple areas. In fatal cases, death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock. There is currently no approved treatment or vaccine for MVD. Some candidate vaccines and therapeutics are currently under investigation.

Seventeen outbreaks of MVD have previously been reported globally. The most recent outbreaks were reported in Equatorial Guinea and the United Republic of Tanzania between February and June 2023. Additional countries that previously reported outbreaks of MVD in the African Region include Angola, the Democratic Republic of the Congo, Ghana, Guinea, Kenya, South Africa, and Uganda. ...

[With an additional case now tied back to the same site from which the index case originated, answering the question I posed in our last update as to whether or not those miners and others at the site of origin were vaccinated/are being vaccinated becomes all the more important. - Mod.JH

関連項目

Pertussis - USA (07): (CO, NJ, ID, WA) 20241025.8719588

●　エーリキア　米国，ダニ

PRO/AH/EDR> Ehrlichia muris ssp eauclairensis - USA: (IL) 1st isolation in ticks in the state

Archive Number: 20241026.8719624

　情報源 Newsweek 2024年10月24日

A rare tickborne disease has been spotted in Illinois for the first time, health officials have said. The bacterium, identified in Lake County, can cause serious disease in humans if not treated quickly, and can sometimes be fatal.

_Ehrlichia muris_ [subspecies] _eauclairensis_ (EME) is an emerging disease-causing bacterium spread through the bite of infected deer [_Ixodes_] ticks, known as blacklegged ticks. These same [arachnids] are known to spread Lyme disease, anaplasmosis and babesiosis, among other things. The bacterium was first isolated from a resident in Wisconsin in 2009, and all known human cases of the disease have occurred in that state and Minnesota, or individuals who have traveled from these areas.

EME is one of several bacteria species found across the United States that can cause a condition called ehrlichiosis. Symptoms of the disease usually start within 1 to 2 weeks of being bitten and include fever, chills, headaches, muscle aches, rashes, and an upset stomach. Without early antibiotic treatment, the disease can result in damage to the brain and nervous system, respiratory failure, uncontrolled bleeding, organ failure, and even death, the CDC says. Children under 5, adults over 65, and those with a weakened immune system are the most likely to experience severe symptoms, although anyone who delays antimicrobial treatment may be at risk.

In Illinois, ehrlichiosis is primarily seen in southern parts of the state and spread through the bites of infected Lone Star ticks. However, with this latest discovery in Lake County, blacklegged ticks can also carry ehrlichiosis-causing bacteria. However, no deaths from EME have so far been reported in the United States, according to the Wisconsin Department of Health Services.

Blacklegged ticks are most commonly found in areas with woods, brush, leaf litter, and tall grass and are most active between October and December, or any winter days above freezing, the Illinois Department of Public Health reports.

"The discovery of the first tick in Illinois carrying EME, a rare and serious disease, is a great reminder of the importance of our active tick surveillance program in Illinois," Illinois Department of Public Health Director, Dr. Sameer Vohra, said in a statement. "Anyone who spends time in wooded areas or brush, including hunters, should be sure to check for ticks every few hours and remove any that you find."

Vohra continued: "If you experience common symptoms of tickborne illnesses -- such as fever, sweats, chills, muscle aches, nausea or vomiting -- see your healthcare provider immediately and let them know about tick exposure so that you can obtain testing and treatment that can prevent serious illness."

To avoid EME in the first place, the health department issued the following advice:

- Walk in the center of trails and avoid wooded, bushy areas with high grass.

- Wear light-colored clothing to make ticks easier to find and tuck long pants into socks.

- Apply EPA-registered insect repellent.

- Treat outdoor clothing and gear with insect repellent.

- Put your clothes in the dryer on a higher heat for 10 minutes to kill ticks.

- Shower within 2 hours of coming indoors.

[Initially referred to as the _Ehrlichia muris_-like agent (EML) or Ehrlichia type strain WisconsinT, this tickborne human pathogen was initially found to be geographically restricted to Wisconsin and Minnesota based on human testing performed to date (1). Pritt et al's article, however, noted another study (2) after their article was submitted that reported findings of an _E. muris_-like bacterium in Wisconsin _I. scapularis_ ticks collected during the 1990s. Prior to these descriptions, ehrlichioses were recognized as human diseases mostly limited to the Southeast and central regions of the USA, transmitted solely by the _A. americanum_ tick. In 2023, the organism was isolated from its tick vector in the eastern state of Massachusetts (3) and now in Illinois. Illinois is in the upper Midwest of the USA, close to Wisconsin and Minnesota.

References Mod.LL]

●　アフリカ豚熱　フィリピン

PRO/AH/EDR> African swine fever - Asia (64): Philippines (Western Visayas) domestic, spread, red zones

Archive Number: 20241026.8719614

　情報源 The Panay News 2024年10月25日

6 towns in Aklan still under ASF

Six towns in this province are still marked as red zones for African Swine Fever (ASF) in the latest zoning status of the Department of Agriculture (DA).

The municipalities of Lezo, Ibajay, Libacao, Kalibo, Tangalan, and Altavas were categorized as red zones due to confirmed cases of ASF.

ProMED-mail 情報

ページ

2024年10月26日

Disclaimer

記事分類（以前の記事のみ）