U.S. measles cases in 2019 highest since 1992

FILE PHOTO: Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia September 30, 2014. REUTERS/Tami Chappell/File Photo/File Photo

By Alex Dobuzinskis

(Reuters) – The United States recorded 971 cases of measles in the first five months of 2019, surpassing the total for any year since 1992, which was before the disease was declared eradicated in the country, federal officials said on Thursday.

The United States declared measles eradicated from the country in 2000, but officials with the U.S. Centers for Disease Control and Prevention warned on Thursday that the country risks losing its measles elimination status.

There were a total of 2,126 U.S. cases of measles in 1992, the CDC said in a statement.

The disease has spread mostly among school-age children whose parents declined to get them vaccinated.

Public health officials blame the resurgence on the spread of misinformation about vaccines. A vocal fringe of parents opposes vaccines, believing, contrary to scientific studies, that ingredients in them can cause autism.

“Measles is preventable and the way to end this outbreak is to ensure that all children and adults who can get vaccinated, do get vaccinated,” CDC Director Robert Redfield said in a statement.

“Again, I want to reassure parents that vaccines are safe, they do not cause autism,” Redfield said.

When measles was declared eradicated in the United States in 2000, it meant the virus was no longer continually present year-round although outbreaks have still happened via travelers coming from countries where measles is common.

Communities in New York City’s Brooklyn borough and Rockland County, an area of New York state about 30 miles (50 km) north of Manhattan, are dealing with measles outbreaks that have lasted nearly eight months.

Other measles cases have occurred in Oklahoma and Washington state.

Decades ago, before widespread use of the measles vaccine, about 3 million to 4 million people a year became sick with the disease in the United States with 400 to 500 deaths a year.

(Reporting by Rama Venkat in Bengaluru; Editing by Richard Chang and Diane Craft)

As Ebola threatens mega-cities, vaccine stockpile needs grow

FILE PHOTO: Healthcare workers carry the coffin of a baby believed to have died of Ebola, in Beni, North Kivu Province of Democratic Republic of Congo, December 15, 2018. REUTERS/Goran Tomasevic/File Photo

By Kate Kelland

LONDON, Dec 20 (Reuters) – Doubts are growing about whether the world’s emergency stockpile of 300,000 Ebola vaccine doses is enough to control future epidemics as the deadly disease moves out of rural forest areas and into urban mega-cities.

Outbreak response experts at the World Health Organization (WHO) and at the vaccines alliance GAVI are already talking to the leading Ebola vaccine manufacturer, Merck, to reassess just how much larger global stocks need to be.

“We’re actively engaged with the World Health Organization and with groups like GAVI, the U.S. government and others to try to understand what will be an appropriate sized stockpile in the future,” Merck’s head of vaccines clinical research, Beth-Ann Coller, said in a telephone interview.

Supply of the Merck shot, which is currently being used to fight a large and spreading outbreak of Ebola in the eastern Democratic Republic of Congo, is not a problem right now, according to the WHO’s deputy director-general of emergency preparedness and response, Peter Salama.

But the nature of Ebola outbreaks is changing, he told Reuters. As the virus finds its way out of rural villages into populous urban settings, plans for how to contain it in future must change too.

“What I’m concerned about is the medium- to long-term stockpile. The figure of 300,000 was very much based on previous Ebola outbreaks where you never really had huge numbers of cases because they were in isolated, rural, populations. But now, we increasingly see Ebola in mega-cities and towns.”

“We need to view it now as an urban disease as well as a rural one – and therefore one requiring a different order of magnitude of preparations, including vaccines,” he said.

Merck’s experimental Ebola vaccine, known as rVSV-ZEBOV, is the furthest ahead in development. Another potential vaccine being developed by Johnson & Johnson could also eventually become part of the stockpile, global health officials say.

Congo’s two Ebola outbreaks this year illustrate the shifting nature of the threat.

The first was relatively contained, infecting up to 54 people and killing 33 of them in an area of DRC’s Equateur Province that is remote and sparsely populated.

Several of the eight outbreaks before this one in Congo – including one in 2014 and another in 2017 both also in Equateur – were also quickly contained and limited in size.

But this year’s second outbreak in Congo – and the country’s tenth since the virus was first identified there in 1976 – is concentrated not in rural villages but in urban areas of the North Kivu and Ituri provinces.

It has already infected more than 450 people, killed more than 270, and last month spread to Butembo, a densely populated city of about one million.

This kind of prospect means global health emergency responders must “review our assumptions around Ebola”, Salama said. “If it were to take off in Butembo, or Goma, or, even worse, Kinshasa, we’d be talking about a totally different issue in terms of … vaccine supplies required.”

Seth Berkley, chief executive of the GAVI vaccines alliance which has an agreement with Merck to ensure a current stockpile of 300,000 rVSV-ZEBOV doses, told Reuters that around 40,000 doses had been used so far in the Congo outbreak.

The emergency response is based on “ring vaccination” which aims to control an outbreak by identifying and offering the vaccine to contacts of anyone likely to be infected. This method uses relatively small numbers of vaccine doses and forms a human buffer of immunity to try to prevent spread of the disease.

For now, in Congo, Berkley said, there is no immediate need to boost the stockpile. But looking towards future inevitable outbreaks, the numbers would likely need to change.

“The challenge we would have – and this has been under discussion – is if we started to do community-based vaccination in urban and semi-urban areas. That’s when the numbers would start to get quite big quite quickly,” he told Reuters.

Merck’s shot has proven safe and effective in trials in West Africa but has yet to be approved for a license by U.S. and European regulators, so is being used in the Congo outbreak under special emergency rules for experimental products.

When it gets approval, which Coller hopes would be in 2019, it will be made at a newly built manufacturing plant in Germany.

Coller said Merck is not yet clear how many doses a year, or a month, the German facility could churn out once it is in production, but she stressed the company would “work collaboratively with the public health agencies to do our best to support their needs”.

(Reporting by Kate Kelland; Editing by Giles Elgood)

Yemen’s cholera epidemic likely to intensify in coming months: WHO

FILE PHOTO: A nurse walks by women being treated at a cholera treatment center in the Red Sea port city of Hodeidah, Yemen October 8, 2017. REUTERS/Abduljabbar Zeyad

RIYADH (Reuters) – The World Health Organization warned on Monday that a cholera epidemic in Yemen that killed more than 2,000 people could flare up again in the rainy season.

WHO Deputy Director General for Emergency Preparedness and Response Peter Salama said the number of cholera infections had been in decline in Yemen over the past 20 weeks after it hit the 1 million mark of suspected cases.

“However, the real problem is we’re entering another phase of rainy seasons,” Salama told Reuters on the sidelines of an international aid conference in Riyadh.

“Usually cholera cases increase corresponding to those rainy seasons. So we expect one surge in April, and another potential surge in August.”

A proxy war between Iran-aligned Houthis and the internationally recognized government of President Abd-Rabbu Mansour Hadi, which is backed by a Saudi-led alliance, has killed more than 10,000 people since 2015, displaced more than 2 million and destroyed much of the country’s infrastructure, including the health system.

Yemen relies heavily on food imports and is on the brink of famine. The United Nations says more than 22 million of Yemen’s 25 million population need humanitarian assistance, including 11.3 million who are in acute need.

Salama said the country had also had an outbreak of diphtheria, a vaccine-preventable disease that usually affects children and which has largely been eliminated in developed countries.

Both cholera and diphtheria outbreaks are a product of the damage to the health system in the country, he said, adding that less than half of Yemen’s health facilities are fully functioning.

“We’re very concerned we’re going to go from a failing health system to a failed one that’s going to spawn more infectious diseases and more suffering,” Salama said.

However, Salama said that despite more than 2,000 deaths from cholera, the fatality rate has been low, at around 0.2 to 0.3 percent.

The WHO has approval from the government for vaccination campaigns and is working on ensuring all parties to the conflict implement the plan, he added.

(Reporting by Sarah Dadouch; Editing by Alison Williams)

Chipotle E. Coli outbreaks appear to be over, CDC says

Two E. Coli outbreaks linked to Chipotle restaurants appear to be over, officials said Monday.

The Centers for Disease Control and Prevention (CDC) said it still doesn’t know what specific ingredient was behind the outbreaks, though it hasn’t received word of any illnesses since Dec. 1.

The CDC said 60 people in 14 states fell ill last October and November, and 22 were hospitalized. The organization interviewed 59 of those people, and 52 of them said they had eaten at Chipotle.

The CDC collected food from several Chipotle restaurants, though none of its tests showed signs of the bacteria. The organization said a food source is only identified in 46 percent of outbreaks, and it can be hard to determine the exact item responsible for the illnesses in cases where restaurants cook several ingredients together and serve them in different menu items.

According to the CDC, the first E. Coli outbreak affected 55 people in Washington, Oregon, California, Delaware, Illinois, Kentucky, Maryland, Minnesota, New York Ohio and Pennsylvania. The second outbreak, which featured a different strain of the bacteria, sickened five people in Kansas, Oklahoma and North Dakota. None of the 60 people died or developed hemolytic uremic syndrome, a type of kidney failure that sometimes occurs following E. Coli infections.

Chipotle has said it has since implemented new food safety protocols, and announced earlier this month that it will close all of its restaurants for four hours on Feb. 8 for a food safety meeting.

The outbreaks were just a part of the recent struggles for Chipotle.

The restaurant also told investors earlier this month that it was subpoenaed by a federal grand jury in connection with an “isolated norovirus incident” in August at a California restaurant. The same message indicated a norovirus outbreak in December at a Boston restaurant “worsened the adverse financial and operating impacts” Chipotle experienced from the E. Coli outbreaks.

Norovirus and E. Coli are both foodborne illnesses that can cause vomiting, diarrhea and stomach cramps, according to the CDC.

Chipotle’s stock was trading at $750.42 on Oct. 13, near an all-time high, but tumbled to $404.26 on Jan. 12 amid the E. Coli and norovirus concerns. That was a 54 percent drop.

The stock has rebounded slightly and was trading at $472.64 on Monday afternoon.