DRC reports new Ebola case in earlier outbreak hot spot

The Democratic Republic of the Congo (DRC) yesterday announced a new Ebola case, its first since September, which involves a woman who died from her infection in Butembo, one of the main hot spots in the country’s 10th outbreak that was centered in North Kivu and Ituri provinces.

In a statement yesterday, the World Health Organization (WHO) said the woman is the wife of an Ebola survivor who sought care at a local health center in Butembo, one of the biggest cities in North Kivu.

The previous North Kivu–centered outbreak—the world’s second largest and the DCR’s biggest—went on for 2 years before it was declared over in June 2020. The WHO said samples from the woman have been sent to Kinshasa for genetic sequence to see if the virus is linked to the earlier outbreak. Survivors can harbor the virus for long periods in “immune-protected” sites such as the testes and eyes, and similar sporadic cases in the wake of Ebola outbreaks have sometimes triggered resurgences.

So far, 70 of the woman’s contacts have been identified, and disinfection of the sites that she visited is under way. The earlier North Kivu outbreak resulted in 3,481 cases, 2,299 of them fatal. A smaller outbreak that occurred in the western DRC soon after led to 150 cases and 55 deaths before it was declared over in the middle of November 2020.

At a media briefing, WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said the WHO expects more cases to be reported, given that the woman had contact with several people while she was symptomatic. He added that vaccines have been sent to the country, along with a rapid response team.
Feb 7 WHO update

PAHO issues epidemiologic alert on Candida auris

The Pan American Health Organization (PAHO) late last week issued an alert on outbreaks of Candida auris in the Americas, noting an increase in cases of the multidrug-resistant yeast during the COVID-19 pandemic.

While several countries in the region have reported isolated cases or small outbreaks of C auris since 2012, four countries with no previous history of the pathogen (Brazil, Guatemala, Mexico, and Peru) reported cases during the last 6 months of 2020, with a hospital in Mexico reporting an outbreak involving 10 patients in an intensive care unit. In addition, Panama and Colombia reported 124 and 340 C auris cases, respectively, in 2020. Most cases have been reported in patients with COVID-19.

First identified in Japan in 2009, C auris spreads easily in healthcare settings, can cause serious invasive infections in immunocompromised patients, and has shown resistance to three major antifungal drug classes. Recent case reports, including an investigation of a C auris outbreak at a Florida hospital in July 2020, have linked COVID-related breakdowns in infection prevention and control to the spread of the pathogen in hospitals.

To prevent hospital outbreaks, the PAHO alert recommends that health services build capacity for early detection of patients with suspected C auris infections or colonization, isolate cases in single rooms when recommended, screen all patients on the same hospital ward, clean and disinfect the patient area and surfaces with disinfectant effective against C auris on a daily basis, and reinforce hand hygiene among healthcare workers.

PAHO also recommends that hospitals notify health authorities of any positive C auris isolates identified by validated methods.
Feb 6 PAHO epidemiologic alert

H5N8 avian flu strikes more poultry in Russia and the UK

Two countries in Europe—Russia and the United Kingdom—reported more highly pathogenic H5N8 avian flu outbreaks in poultry, according to the latest official notifications, including from the World Organization for Animal Health (OIE).

Russia’s outbreak began on Jan 27 at a turkey farm in Rostov oblast in the country’s southwest, killing 99473 of 213,881 susceptible birds, according to an OIE notification. Elsewhere, the UK Department for Environment, Food, and Rural Affairs (DEFRA) today reported H5N8 at a layer farm at a small farm near Redcar in North Yorkshire in the country’s northeast. The UK has now reported 13 outbreaks in poultry this winter.

Meanwhile, several European countries reported more avian flu outbreaks in wild birds, mostly involving the H5N8 strain, but Switzerland reported an event involving H5N4, the second country in Europe behind Germany to report the strain in wild birds. Elsewhere, China reported another H5N8 detection in wild birds, which involved mandarin ducks found dead on Jan 29 at a nature park in Jiangsu province in the country’s east.
Feb 5 OIE report on H5N8 in Russia
Feb 8 DEFRA report
Feb 5 OIE report on H5N4 in Swiss wild birds
Feb 8 OIE report on H5N8 in Chinese wild birds