- 16 Jul 2017 Typhoid fever - Pakistan: (SD) multidrug resistance, RFI
- 16 Jul 2017 Botulism - Canada (02): (QC) whale meat
- 16 Jul 2017 Cholera, diarrhea & dysentery update (71): Yemen
- 16 Jul 2017 Rabies (32): Malaysia (SK) human, 5th case
- 16 Jul 2017 Brucellosis - India: (AP) bovine
- 16 Jul 2017 Cyclosporiasis - Canada (02): (ON, BC)
- 16 Jul 2017 Avian influenza (123): South Africa, H5N8, China, poultry, H7N9, vaccination
- 16 Jul 2017 Glanders, equine - India (03): (MH)
- 15 Jul 2017 African swine fever - Europe (12): Lithuania, Estonia (SA) domestic swine, RFI
- 15 Jul 2017 Lymphocryptovirus 1 - Africa: Rwanda, Uganda, 1st report
- 15 Jul 2017 La Crosse encephalitis - USA: (OH)
- 15 Jul 2017 Monkeypox - Africa (05): Central African Republic
- 15 Jul 2017 Kyasanur Forest disease - India (13): (MH) update
- 15 Jul 2017 Meningococcal disease, eculizumab: complement deficiency, increased risk
- 15 Jul 2017 Hendra virus - Australia (06): (NS)
- 14 Jul 2017 Hantavirus - Americas (41): USA (NM)
- 14 Jul 2017 Cyclosporiasis - France ex Mexico: (QR)
- 14 Jul 2017 Anthrax - Bangladesh (04): (KH) bovine, human
- 14 Jul 2017 Chronic wasting disease, cervid - USA (09): (PA) free ranging deer
- 14 Jul 2017 Salt poisoning - Canada: (SK) bovine
- 14 Jul 2017 Cytauxzoonosis, feline - USA (02): (TN)
- 14 Jul 2017 Powassan virus encephalitis - USA (06): (NY)
- 14 Jul 2017 Lassa fever - West Africa (26): Nigeria
- 13 Jul 2017 Undiagnosed illness - Bangladesh: (CG) fatal, children, RFI
- 13 Jul 2017 Jamestown Canyon virus - USA (ME)
- 13 Jul 2017 Botulism - Canada: (QC) whale meat
- 13 Jul 2017 Powassan virus encephalitis - USA (05)
- 13 Jul 2017 Infectious salmon anemia - Norway (02): (MR) ser. HPR-deleted, OIE
- 13 Jul 2017 Hepatitis A - USA (13): (CA) fatal
- 13 Jul 2017 Hantavirus - Americas (40): Panama (LS), Chile (LG)
- 13 Jul 2017 Yellow fever - Americas (50): dissemination risk
- 13 Jul 2017 Poliomyelitis update (18): global (Pakistan, Syria)
- 13 Jul 2017 Conjunctivitis - Panama: (CL)
- 13 Jul 2017 Japanese encephalitis & other - India (09): (BR)
- 13 Jul 2017 Downy mildew, cucurbits - USA (multistate) Canada (ON)
- 13 Jul 2017 Meningitis, meningococcal - Fiji: (LM) college
- 13 Jul 2017 Newcastle disease - Portugal: (CO) pigeon, OIE
- 13 Jul 2017 Coconut wilt-related phytoplasma, cassava - Cote d'Ivoire: 1st rep (LN)
- 13 Jul 2017 Avian influenza (122): Viet Nam (HM) backyard, HPAI H5N1, OIE
- 12 Jul 2017 Tick-borne encephalitis - Japan
- 12 Jul 2017 Equine infectious anemia - Switzerland (02): (AG) OIE
- 12 Jul 2017 Measles update (35): Europe, USA
- 12 Jul 2017 Rabies (31): Malaysia (SK) canine, feline, OIE
- 12 Jul 2017 Poliomyelitis update (17): Syria (DY, RA), cVDPV update
- 12 Jul 2017 Leishmaniasis, visceral - Kenya: (MB, WJ)
- 12 Jul 2017 Fibropapillomatosis, turtle - USA: (FL)
- 12 Jul 2017 Hepatitis E - Nigeria (02): (BO) WHO
- 11 Jul 2017 E. coli EHEC - USA (15): (UT) O157, fatalities
- 11 Jul 2017 Varroa mite, apis - USA: (NY)
- 11 Jul 2017 MERS-CoV (47): Saudi Arabia (MK)
- 11 Jul 2017 Vibrio parahaemolyticus - Nepal: (Kathmandu)
- 11 Jul 2017 Gonococcal disease - antibiotic resistance, WHO
- 11 Jul 2017 Avian influenza, human (62): China, H7N9, cases, research
- 11 Jul 2017 Chikungunya (23): Asia (Bangladesh), case numbers
- 11 Jul 2017 Cholera, diarrhea & dysentery update (70): Asia (Yemen)
- 10 Jul 2017 Equine infectious anemia - Switzerland: (AG) 1st case
- 10 Jul 2017 Lassa fever - West Africa (26): Nigeria
- 10 Jul 2017 Tilapia syncytial hepatitis - Taiwan (03): (Taoyuan) update
- 10 Jul 2017 Dickeya blackleg, potato - Australia: 1st rep (WA), alert
- 10 Jul 2017 Strangles, equine - USA (02): (FL) equine
- 10 Jul 2017 Japanese encephalitis & other - India (08): (AS)
- 09 Jul 2017 Hendra virus, equine - Australia (05): (NS)
- 09 Jul 2017 Chlamydia, livestock - Australia
- 09 Jul 2017 Rabies (30): Malaysia (SK)
- 09 Jul 2017 Scrub typhus - Nepal (06): (GU, NU)
- 09 Jul 2017 Anaplasmosis - USA: (NY)
- 09 Jul 2017 Novel pestivirus, swine - Austria: (ST)
- 09 Jul 2017 Bourbon virus - USA (02): (MO)
- 09 Jul 2017 Heartland virus - USA: (AR)
- 09 Jul 2017 Hantavirus - Americas (39): Panama (LS)
- 09 Jul 2017 Cholera, diarrhea & dysentery update (69): Asia (Yemen)
- 09 Jul 2017 Ebola update (31): news, vaccines, research, funding
- 09 Jul 2017 Salmonellosis, st. Enteritidis - USA (02): (MI) raw eggs
- 08 Jul 2017 Anthrax - France (02): (Moselle) bovine
- 08 Jul 2017 Rabies (29): Asia (Philippines, Malaysia-Borneo) human, animal
- 08 Jul 2017 Mumps update (22): New Zealand, USA
- 08 Jul 2017 Anthrax - Ukraine: (SM) porcine, OIE, corr. ovine
- 08 Jul 2017 Cholera, diarrhea & dysentery update (68): Asia (Philippines) cholera confirmed
- 08 Jul 2017 Cyclosporiasis - Mexico: (GJ) RFI
- 08 Jul 2017 Undiagnosed illness - Liberia (09): WHO, fatal, N. meningitidis sg C diagnosed
- 08 Jul 2017 Legionellosis - Europe (03): 2011-2015
- 08 Jul 2017 Hantavirus - Americas (38): USA (WA)
- 08 Jul 2017 Japanese encephalitis - Malaysia (SK)
- 07 Jul 2017 Hepatitis A - USA (12): (MI) fatal, RFI
- 07 Jul 2017 Cholera, diarrhea & dysentery update (67): Africa, Asia
- 07 Jul 2017 MERS-CoV (46): Saudi Arabia, WHO
- 07 Jul 2017 Babesiosis - United States: (WI) 2001 - 2015
- 07 Jul 2017 Anthrax - Ukraine: (SM) ovine, OIE
- 07 Jul 2017 Amebic meningoencephalitis, primary - Pakistan (03) : (SD), fatal
- 07 Jul 2017 Avian influenza (121): Belgium (LG) captive birds, HPAI H5N8, spread
- 07 Jul 2017 Tick paralysis, canine - USA (03): (CO) correction
- 07 Jul 2017 Rabies (28): Americas, USA (OR), bat, human exp.
- 07 Jul 2017 Vibrio vulnificus - USA (05): (AL)
- 07 Jul 2017 Asian greening, citrus - Panama: 1st rep (BC)
- 06 Jul 2017 Poliomyelitis update (16): Pakistan (BA), global
- 06 Jul 2017 Legionellosis - Europe (02): ex United Arab Emirates (DU)
- 06 Jul 2017 E. coli EHEC - Canada (11): O121, flour
- 06 Jul 2017 Equine infectious anemia - Canada (03): (MB) comment
- 06 Jul 2017 Trichinellosis - United States: (AK) walrus meat
- 06 Jul 2017 Influenza: Bats as potential hosts of human and avian influenza
- 06 Jul 2017 Burkholderia thailandensis - China: (CQ) fatal, increased virulence
- 06 Jul 2017 Botulism - Ukraine (02): fatalities, current antitoxin availability
- 06 Jul 2017 Cholera, diarrhea & dysentery update (66): Asia (Yemen)
- 06 Jul 2017 Meloidogyne enterolobii root knot, yam - Nigeria: 1st rep
- 06 Jul 2017 Blueberry rust - China: 1st rep (SC)
- 06 Jul 2017 Crimean-Congo hem. fever - Pakistan (07): Balochistan
- 06 Jul 2017 Yellow fever update - Africa (02): Angola vaccination
- 06 Jul 2017 Kyasanur Forest disease - India (12): (KA), preventive measures
- 05 Jul 2017 Poliomyelitis update (15): Syria (RA) new case, Pakistan, violence
- 05 Jul 2017 MERS-CoV (45): Saudi Arabia (HA), Lebanon ex Saudi Arabia, WHO
- 05 Jul 2017 Hepatitis A - France: (CN)
- 05 Jul 2017 E. coli EHEC - UK (02): (Scotland) O157, race participants, alert
- 05 Jul 2017 Hepatitis B - Australia: (NS)
- 05 Jul 2017 Salmonellosis, serotype Enteritidis - EU/EEA: Polish eggs
- 05 Jul 2017 Hepatitis C - USA (08): (VA) unlicensed tattooing, RFI
- 05 Jul 2017 E. coli EHEC - USA (14): (UT) O157, fatalities
- 05 Jul 2017 Monkeypox - Africa (04): Congo DR, Central African Republic
- 05 Jul 2017 Hepatitis A - EU (03): MSM, ECDC report
- 05 Jul 2017 Japanese encephalitis & other - India (07): (JH) susp.
- 04 Jul 2017 European foulbrood, apis - Europe (04): Norway (AA) OIE
- 04 Jul 2017 Equine infectious anemia - Canada (02): (MB)
- 04 Jul 2017 Legionellosis - USA (11): (FL) fitness gyms
- 04 Jul 2017 Conjunctivitis - Bonaire
- 04 Jul 2017 Amebic meningoencephalitis, primary - Pakistan (02): (SD) fatal
- 04 Jul 2017 Plague, animal - USA (09): (TX) prairie dog, alert
- 04 Jul 2017 Hand, foot & mouth disease update (07) - Mexico
- 04 Jul 2017 Chikungunya (22) - Americas, Asia
- 04 Jul 2017 Equine infectious anemia - Netherlands: (UT) 1st report, OIE
- 04 Jul 2017 Trypanosomiasis, Argentina: (SF) bovine, first report, OIE
- 04 Jul 2017 Avian influenza (120): France (NC) HPAI H5N8, poultry, spread
- 04 Jul 2017 Dengue/DHF update (08): Americas
- 04 Jul 2017 Avian influenza (119): Togo (MA) poultry, HPAI H5N1, OIE
- 03 Jul 2017 Salmonellosis, serotype Paratyphi B - Bhutan: (TM)
- 03 Jul 2017 Bourbon virus - USA: (MO) tick-borne case
- 03 Jul 2017 Dolphin die-off - Russia: (Black sea)
- 03 Jul 2017 Vibrio vulnificus - USA (04): (TX)
- 03 Jul 2017 Meningitis - Romania (02): (BV) fatal, N. meningitidis identified
- 03 Jul 2017 E. coli, EHEC - USA (13): (UT) fatalities, susp EHEC, RFI
- 03 Jul 2017 Cyclosporiasis - Canada: (ON, BC)
- 03 Jul 2017 Avian influenza, human (61): CHINA, H7N9
- 02 Jul 2017 Legionellosis - USA (10): (OH) nosocomial
- 02 Jul 2017 Measles update (34): Europe, Africa, USA
- 02 Jul 2017 Rabies (27): Americas, USA (MD) feline
- 01 Jul 2017 Bovine tuberculosis - USA (09): (SD) wildlife not
- 01 Jul 2017 Tick paralysis, canine - USA (02): (CO) comments
- 01 Jul 2017 MERS-CoV (44): Lebanon ex Saudi Arabia, Saudi Arabia, exp. antiviral, RFI
- 01 Jul 2017 Cholera, diarrhea & dysentery update (65): Asia (Yemen)
- 01 Jul 2017 Zika virus (15): Americas, research, observations
- 01 Jul 2017 Hand, foot & mouth disease update (06): Thailand
- 01 Jul 2017 Foot & mouth disease - India (02): (MN) bovine, caprine, suspected, RFI
- 01 Jul 2017 Legionellosis - USA (09): (TN) hotel, hot tub/pool susp.
- 01 Jul 2017 Japanese encephalitis - China (HK)
- 30 Jun 2017 Tick paralysis, canine - USA: (CO)
- 30 Jun 2017 Porcine epidemic diarrhea - North America (04): Canada (MB) human cost
- 30 Jun 2017 Chronic wasting disease, macaque - Canada: susceptible
- 30 Jun 2017 Crayfish plague - Ireland (02): white-clawed crayfish, conf, OIE
- 30 Jun 2017 White nose syndrome, bats - North America (08): (AL) bat population decline
- 30 Jun 2017 Tetanus - Italy (02): commentary
- 30 Jun 2017 Anthrax - India (11): (AD) livestock vaccination
- 30 Jun 2017 Gastroenteritis - Brazil (02): (RS, ES)
- 30 Jun 2017 Strep. Group B - USA: (OR) neonatal infection, maternal placenta ingestion
- 30 Jun 2017 Cholera, diarrhea & dysentery update (64): Asia (Yemen)
- 30 Jun 2017 Legionellosis - USA (08): (FL) gym
- 30 Jun 2017 Tick-borne encephalitis - France
- 29 Jun 2017 Poliomyelitis update (14): Syria (DY), new cases, cVDPV, global
- 29 Jun 2017 Ebola update (30): news, research, non-governmental organization, vaccines
- 29 Jun 2017 Chronic wasting disease, cervid - USA (08): comment
- 29 Jun 2017 Hepatitis A - USA (11): (CA)
- 29 Jun 2017 Lassa fever - West Africa (25): Nigeria
- 29 Jun 2017 Hepatitis B & C - USA (02): (VA) injection drug use
- 29 Jun 2017 Salmonellosis, serotype anatum - USA: imported hot peppers, 2016
- 29 Jun 2017 Hepatitis E - Europe (02): 2005-2015
- 29 Jun 2017 Anthrax - India (10): (AD) caprine, more human cases
- 29 Jun 2017 Gastroenteritis - Brazil: (RS, ES) RFI
- 29 Jun 2017 Rabbit hemorrhagic disease - Guernsey: wild rabbit
- 29 Jun 2017 Rocky Mountain spotted fever (03) - USA: (TN, NE, LA) fatal
- 29 Jun 2017 Cholera, diarrhea & dysentery update (63): Africa, Asia
- 29 Jun 2017 Tetanus - Italy: (SD) unimmunized child
- 29 Jun 2017 Malaria - India: New Delhi
- 29 Jun 2017 Avian influenza, human (60): WHO, human-animal interface
- 29 Jun 2017 Scrub typhus - India (02): (HP)
- 29 Jun 2017 Viral hemorrhagic septicemia, fish - Slovakia: (BL), OIE
- 29 Jun 2017 Equine infectious anemia - Germany (03): (HH, BY) spread
- 28 Jun 2017 Hantavirus - Americas (37): Panama (LS)
- 28 Jun 2017 Anthrax - India (09): (AD) caprine, human conf.
- 28 Jun 2017 MERS-CoV (43): Saudi Arabia, WHO
- 28 Jun 2017 Chronic wasting disease, cervid - USA (07): control hypothesis
- 28 Jun 2017 Panleukopenia virus, feline - USA: (GA) cat shelter
- 28 Jun 2017 Sepsis - Venezuela: (Caracas) fatal, pediatric hemodialysis unit
- 28 Jun 2017 Influenza, canine - USA (05): (GA) increasing incidence
- 28 Jun 2017 Porcine reprod. & resp. syndrome - Israel: (HZ) first report, OIE
- 28 Jun 2017 Melioidosis - Belgium: ex Southeast Asia
- 28 Jun 2017 MERS-CoV (42): Saudi Arabia (RI, SH, MD), WHO
- 28 Jun 2017 Hepatitis E - Nigeria (BO)
- 28 Jun 2017 African swine fever - Europe (11): Czech Republic (ZK) wild boar, 1st rep. OIE
- 28 Jun 2017 Avian influenza (118): South Korea, wild birds, HPAI H5N8, OIE
- 28 Jun 2017 Hantavirus - Americas (36): USA (WA)
- 27 Jun 2017 Scrub typhus - Nepal (05): (CT, NP)
- 27 Jun 2017 Cholera, diarrhea & dysentery update (62): Asia (Yemen)
- 27 Jun 2017 Salmonellosis, st Enteritidis - Canada: frozen chicken products
- 27 Jun 2017 Non-TB mycobacteria, nosocomial: Background
- 26 Jun 2017 Plague - USA (08): (NM)
- 26 Jun 2017 Chikungunya (21) - Americas, Asia, observations, research
- 26 Jun 2017 Recombinant bacillus anthracis - USA: new avirulent strain
- 26 Jun 2017 Anthrax - India (08): (AD) human, suspected
- 26 Jun 2017 Dengue/DHF update (07): Americas, Pacific
- 26 Jun 2017 Foot and mouth disease - Colombia: (AR) bovine, serotype O, OIE
- 26 Jun 2017 Vibrio vulnificus - China: (HK) necrotizing fasciitis
- 26 Jun 2017 Ciguatera fish poisoning - EU (03): possible local fish source
- 26 Jun 2017 Cholera, diarrhea & dysentery update (61): Africa, Asia
- 26 Jun 2017 Shigellosis - USA (02): (PA, CA, FL)
- 26 Jun 2017 Legionellosis - Australia (03): (VI) gym spa susp.
- 26 Jun 2017 Lassa fever - West Africa (24): Nigeria
- 26 Jun 2017 Die-off, bees - USA: (GA) pesticides
- 25 Jun 2017 Adenovirus hemorrhagic disease, cervids - USA: (OR)
- 25 Jun 2017 Sarin, laboratory errors: DOD investigation report
- 25 Jun 2017 Non-TB mycobacteria - USA: ex Dominican Rep, M. abscessus/chelonae, post-surgery
- 25 Jun 2017 Norovirus (06): France (AR), Fiji (WE), Canada (QC)
- 25 Jun 2017 Undiagnosed deaths, canine - USA (03): (CA) poisoning susp, RFI
- 25 Jun 2017 Sarcocystosis, animals - Ireland: (DG) ovine
- 25 Jun 2017 Japanese encephalitis - Taiwan (03): (NT)
- 24 Jun 2017 Cholera, diarrhea & dysentery update (60): Asia (Yemen)
- 24 Jun 2017 Hepatitis E - Nepal: (DO, KT)
- 24 Jun 2017 Toxic spider bite - Venezuela: (ZU) black widow spider
- 24 Jun 2017 Clostridium perfringens foodborne illness - USA (02): (CO)
- 24 Jun 2017 Avian influenza (117): South Korea (TG) poultry, HPAI, spread, serotyping pending
- 24 Jun 2017 Avian influenza, human (59): China, H7N9
- 23 Jun 2017 Zika virus (14): Americas, Asia, research, observations
- 23 Jun 2017 Mumps update (21): USA (OR,HI,CA) Europe (UK)
- 23 Jun 2017 Chikungunya (20): Asia (Pakistan)
- 23 Jun 2017 Tularemia - USA (06): (CO) wild rabbit
- 23 Jun 2017 Avian influenza (116): South Africa, Finland, H5N8, H5, poultry, wild, OIE
- 23 Jun 2017 Haff disease - Brazil (03): clinical evidence
- 23 Jun 2017 Diphtheria - Venezuela (02): (ZU)
- 23 Jun 2017 Hand, foot, & mouth disease update (05): Thailand (SK)
- 22 Jun 2017 Foot & mouth disease - Uganda: (QM) bovine, suspected, vaccination RFI
- 22 Jun 2017 Poliomyelitis update (13): Syria (DY, RA), global
- 22 Jun 2017 Cholera, diarrhea & dysentery update (59): Africa, Oceania
- 22 Jun 2017 Bornavirus - Austria: equine, clinical disease, shrew
- 22 Jun 2017 E. coli EHEC - UK: (England) O157
- 22 Jun 2017 Measles update (33): USA, Europe, Africa
- 22 Jun 2017 Cholera, diarrhea & dysentery update (58): Asia (Yemen)
- 22 Jun 2017 Japanese encephalitis & other - India (06): (MH)
- 22 Jun 2017 Lassa fever - West Africa (23): Nigeria (ON)
- 22 Jun 2017 Recall, pet treat - USA: chemical contamination
- 22 Jun 2017 Pertussis (06): USA, Canada
- 21 Jun 2017 Poliomyelitis update (12): Syria (DY, RA), susp. cases
- 21 Jun 2017 Japanese encephalitis - Australia ex Thailand (02): fatal
- 21 Jun 2017 E. coli EHEC - USA (12): (TX)
- 21 Jun 2017 Invasive mosquito - USA (03): (CA)
- 21 Jun 2017 Snake fungal disease - Europe: (UK, Czech Republic) 1st report
- 21 Jun 2017 Cholera, diarrhea & dysentery update (57): Africa, Asia, Americas
- 21 Jun 2017 Japanese encephalitis - Taiwan (02): (PT)
- 21 Jun 2017 Meningitis - Romania: (BV) bacterial, RFI
- 20 Jun 2017 Japanese encephalitis & other - India (05): (OR)
- 20 Jun 2017 Conjunctivitis - Americas: update
- 20 Jun 2017 Yellow fever - Americas (49): Bolivia (CB), Canada (SK)
- 20 Jun 2017 Influenza (13): WHO global update
- 20 Jun 2017 Tilapia syncytial hepatitis - Taiwan (02): (Taoyuan City) emerging disease, spread
- 20 Jun 2017 Foot & mouth disease - Myanmar: (RA) st Asia 1, bovine, OIE
- 20 Jun 2017 Lassa fever - West Africa (22): Nigeria (AN)
- 20 Jun 2017 Hepatitis E - Niger (06): (DF) fatal, pregnant women
- 20 Jun 2017 Botulism - Morocco (02): (DT) fatal
- 20 Jun 2017 Ciguatera fish poisoning - EU (02): possible local fish source
- 20 Jun 2017 Cholera, diarrhea & dysentery update (56): Asia (Yemen)
- 20 Jun 2017 Streptococcus, group A - USA (02): (AZ) pharyngitis, fire fighters
- 20 Jun 2017 MERS-CoV (41): Saudi Arabia (RI, SH)
- 20 Jun 2017 Crimean-Congo hem. fever - Iran (03): update
- 19 Jun 2017 Anthrax - Romania (03): (BT) bovine, human, OIE
- 19 Jun 2017 Obituary: Martin S. Wolfe
- 19 Jun 2017 Avian influenza (115): Belgium (WV) poultry, HPAI H5N8, OIE
- 19 Jun 2017 Foodborne illness - Iraq (03): (NI) IDP camp, NOT fatal
- 19 Jun 2017 Campylobacteriosis - Mexico: (SO) Guillain-Barre syndrome
- 19 Jun 2017 MERS-CoV (40): animal reservoir, camels, review, FAO
- 19 Jun 2017 Foodborne illness - Turkey: (MN) military base, RFI
- 19 Jun 2017 Hepatitis B & C - USA: (NC) injection drug use
- 19 Jun 2017 Ciguatera fish poisoning - EU: possible local fish source, RFI
- 19 Jun 2017 Late blight, potato - Bhutan: (CK)
- 19 Jun 2017 Cyst nematode, potato - Kenya
- 18 Jun 2017 Leptospirosis - Philippines: (CAR) flooding
- 18 Jun 2017 Cholera, diarrhea & dysentery update (55): Asia (Yemen)
- 18 Jun 2017 Severe fever w/ thrombocytopenia synd. - South Korea (KW)
- 18 Jun 2017 Malaria - Venezuela (02): (BO) autochthonous, natl. epidemic extension
- 18 Jun 2017 Yellow fever - Americas (48): Brazil
- 18 Jun 2017 Announcements (04): WHO video courses on health emergencies for responders
- 18 Jun 2017 Ebola update (29): news, vaccine, research, funding
- 18 Jun 2017 Conjunctivitis - Turks & Caicos Islands
- 18 Jun 2017 Avian influenza, human (58): China, H7N9
- 17 Jun 2017 Lassa fever - West Africa (21): Nigeria
- 17 Jun 2017 Hepatitis A - Chile: (AN) street food
- 17 Jun 2017 Botulism - Ukraine: fatalities, lack of antitoxin availability
- 17 Jun 2017 Legionellosis - USA (07): (NYC)
- 17 Jun 2017 Zika virus (13): Americas, research, observations
- 16 Jun 2017 Porcine epidemic diarrhea - North America (03): Canada (MB) vaccination
- 16 Jun 2017 Foodborne illness - Japan (05): (IB) school students, milk
- 16 Jun 2017 Scabies - France: (Paris) migrants
- 16 Jun 2017 Rabies (26): Asia (India, Nepal, Pakistan) Africa (Algeria) animal, human
Published Date: 2017-07-16 12:03:46
Subject: PRO/EDR> Typhoid fever - Pakistan: (SD) multidrug resistance, RFI
Archive Number: 20170716.5178355
TYPHOID FEVER - PAKISTAN: (SINDH) MULTIDRUG RESISTANCE, REQUEST FOR INFORMATION
*******************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Sun 16 Jul 2017
Source: Geo television [edited]
https://www.geo.tv/latest/149448-multi-drug-resistance-typhoid-experts-warn-about-worlds-biggest-outbreak
More than 250 children have been affected by multi-drug resistant typhoid (MDR) typhoid in Hyderabad, said Dr Farah Qamar, the Assistant Professor of Pediatric at the Aga Khan University Hospital.
Qamar, who conducted a survey in different areas of Hyderabad and Karachi, warns that it is "typhoid at its worst," adding that the 2 cities are seeing the biggest outbreak of MDR typhoid.
In Karachi, 15 children have been affected by the outbreak, Dr Qamar added. The worst affected areas of Karachi, where an antimicrobial-resistant strain of typhoid is circulating, were found to be Lyari, North Karachi, Gulshan-e-Hadeed, Gulistan-e-Jauhar, Malir and Ibrahim Haydri.
Areas in Hyderabad affected by the outbreak include Bhittai Colony, Qasimabad, and Wehdat colony, where the affected include children under the age of 2 to 5 years.
According to Dr Qamar, the primary reason for the outbreak is un-chlorinated water, contaminated water, and poor sanitation and sewerage conditions, which have contributed to an increase in MDR germs in the environment. Another issue highlighted during her survey is the condition of all 4 water treatment plants in Hyderabad district, which are non-functional and are supplying contaminated water to the residents.
As the cases are hard to treat, Dr Qamar stressed the importance of managing the cases to prevent outbreaks. The situation has worsened since November 2016, but no concrete actions have been taken by the authorities. Dr Mohammad Taufeeq, Director Health of Karachi, confirmed the presence of MDR typhoid and said that vaccinations with the help of Child Survival Program have been started in Lyari, Ibrahim Hyderi and Gadap town.
Dr M.N Lal, Program Director of Child Survival in Sindh, suggested that for MDR typhoid prevention, people need to ensure avoiding unhygienic food and water, ensuring tap water is chlorinated, ensuring personal hygiene, and drinking boiled water.
Prevention can be done by vaccination with the Typbar vaccine, which can be given to children aged more than 2 years, adds Dr Qamar.
In addition, awareness about the overuse of drugs is being discussed with local physicians. "We need to limit the inappropriate use of antimicrobials or face more outbreaks," says Dr Qamar. "Globally, drug-resistant typhoid is spreading across Africa and Asia, and we need to work together to develop methods to identify new cases, clinically evaluate and treat those who are affected, and find prevention and control measures."
Lack of chlorination of water in Karachi is also a major culprit. According to Deputy Secretary Health Dr Zafar Mehdi, the primary responsibility for chlorination of water lies with Karachi Water and Sewerage Board (KWSB). Health experts say Pakistan is signatory to the UN sustainable development goals and must carry out a mandatory effort to control typhoid disease.
Typhoid is one of the common causes of death in children in South Asia, and a lack of awareness and the abysmal situation of basic utilities affect millions of children every year. Health experts urge the government to take concrete steps to save future generations from contracting the disease by providing clean and safe water and repairing and separating the sewerage lines from water lines.
--
Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka
[ProMED thanks Kunihiko Iizuka for this posting.
This outbreak may well be caused by _S._ Typhi, H58, defined based on single nucleotide polymorphisms frequently referred to as SNPs (pronounced "snips"), which has been accounting for a significant amount of morbidity and mortality, which may be based on its increasingly antimicrobial resistance. ProMED would appreciate more information regarding the outbreak strain and its antimicrobial sensitivity pattern(s).
The following is abstracted from the introduction of the article, Wong VK, Baker S, Pickard DJ, et al: Phylogeographical analysis of the dominant multidrug-resistant H58 clade of _Salmonella_ Typhi identifies inter- and intracontinental transmission events. Nature Genetics. 2015;47:632-639 with the citations removed:
"_S._ Typhi, the primary global cause of human typhoid (enteric fever), is a monophyletic serovar of _S. enterica_. Unlike many Salmonella, _S. Typhi_ are highly restricted to infection of humans and are associated with systemic infection, prolonged fever and an asymptomatic carrier state. Typhoid is still a common disease in many regions of the world with poor infrastructure and limited economic development and is also a risk for travelers who visit such regions. It is estimated that 20-30 million cases of typhoid occur annually, although deaths are less frequently reported than before the availability of effective antimicrobials.
In addition to improvements in access to clean water and sanitation, typhoid can potentially be controlled by other interventions such as vaccination and antimicrobial therapy. Chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole were traditional 1st-line drugs commonly used to treat acute typhoid, and these agents continue to be used in areas of the world where _S._ Typhi are deemed susceptible. However, since the 1970s, _S._ Typhi have emerged that display multidrug resistance, defined as resistance to the above antimicrobials, compromising treatment. Since the 1990s, alternative treatment options have included fluoroquinolones, 3rd-generation cephalosporins (such as ceftriaxone) and the azalide azithromycin. The early emergence of MDR _S._ Typhi was driven in large part by the acquisition of IncHI1 plasmids carrying antibiotic resistance genes and, more recently, by chromosomal mutations associated with resistance to fluoroquinolones, and MDR strains have been reported across Asia and Africa.
Phylogenetic analysis, initially based on subgenomic DNA sequences but later on whole-genome DNA sequences, showed that the global _S._ Typhi population is highly clonal and likely originated from a common ancestor that moved into the human population several thousand years ago. It also indicated that the population is relatively small and that recombination between _S._ Typhi and other salmonellae is rare. Simple SNP-based typing schemes have been developed that stratify the _S._ Typhi population into haplotypes, and these schemes are now used to unequivocally map new isolates to the phylogeny. Notably, this approach identified a single emerging, highly clonal MDR haplotype of _S._ Typhi, H58, which is being reported with increasing frequency from many countries in Africa and Asia. Within the H58 lineage, IncHI1 MDR plasmids of the restricted subtype PST6 and chromosomal point mutations conferring quinolone resistance are common." - Mod.LL
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/707.]
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Typhoid fever - Nepal: (SP) post-earthquake 20150726.3528925
Typhoid fever - Africa, Asia: multidrug resistant 20150512.3357675
Typhoid fever - Fiji (02): (NO) commentary 20150123.3114013
Typhoid fever - Fiji: (NO) 20150122.3111081
.................................................sb/ll/msp/mpp
Subject: PRO/EDR> Typhoid fever - Pakistan: (SD) multidrug resistance, RFI
Archive Number: 20170716.5178355
TYPHOID FEVER - PAKISTAN: (SINDH) MULTIDRUG RESISTANCE, REQUEST FOR INFORMATION
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Sun 16 Jul 2017
Source: Geo television [edited]
https://www.geo.tv/latest/149448-multi-drug-resistance-typhoid-experts-warn-about-worlds-biggest-outbreak
More than 250 children have been affected by multi-drug resistant typhoid (MDR) typhoid in Hyderabad, said Dr Farah Qamar, the Assistant Professor of Pediatric at the Aga Khan University Hospital.
Qamar, who conducted a survey in different areas of Hyderabad and Karachi, warns that it is "typhoid at its worst," adding that the 2 cities are seeing the biggest outbreak of MDR typhoid.
In Karachi, 15 children have been affected by the outbreak, Dr Qamar added. The worst affected areas of Karachi, where an antimicrobial-resistant strain of typhoid is circulating, were found to be Lyari, North Karachi, Gulshan-e-Hadeed, Gulistan-e-Jauhar, Malir and Ibrahim Haydri.
Areas in Hyderabad affected by the outbreak include Bhittai Colony, Qasimabad, and Wehdat colony, where the affected include children under the age of 2 to 5 years.
According to Dr Qamar, the primary reason for the outbreak is un-chlorinated water, contaminated water, and poor sanitation and sewerage conditions, which have contributed to an increase in MDR germs in the environment. Another issue highlighted during her survey is the condition of all 4 water treatment plants in Hyderabad district, which are non-functional and are supplying contaminated water to the residents.
As the cases are hard to treat, Dr Qamar stressed the importance of managing the cases to prevent outbreaks. The situation has worsened since November 2016, but no concrete actions have been taken by the authorities. Dr Mohammad Taufeeq, Director Health of Karachi, confirmed the presence of MDR typhoid and said that vaccinations with the help of Child Survival Program have been started in Lyari, Ibrahim Hyderi and Gadap town.
Dr M.N Lal, Program Director of Child Survival in Sindh, suggested that for MDR typhoid prevention, people need to ensure avoiding unhygienic food and water, ensuring tap water is chlorinated, ensuring personal hygiene, and drinking boiled water.
Prevention can be done by vaccination with the Typbar vaccine, which can be given to children aged more than 2 years, adds Dr Qamar.
In addition, awareness about the overuse of drugs is being discussed with local physicians. "We need to limit the inappropriate use of antimicrobials or face more outbreaks," says Dr Qamar. "Globally, drug-resistant typhoid is spreading across Africa and Asia, and we need to work together to develop methods to identify new cases, clinically evaluate and treat those who are affected, and find prevention and control measures."
Lack of chlorination of water in Karachi is also a major culprit. According to Deputy Secretary Health Dr Zafar Mehdi, the primary responsibility for chlorination of water lies with Karachi Water and Sewerage Board (KWSB). Health experts say Pakistan is signatory to the UN sustainable development goals and must carry out a mandatory effort to control typhoid disease.
Typhoid is one of the common causes of death in children in South Asia, and a lack of awareness and the abysmal situation of basic utilities affect millions of children every year. Health experts urge the government to take concrete steps to save future generations from contracting the disease by providing clean and safe water and repairing and separating the sewerage lines from water lines.
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Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka
[ProMED thanks Kunihiko Iizuka for this posting.
This outbreak may well be caused by _S._ Typhi, H58, defined based on single nucleotide polymorphisms frequently referred to as SNPs (pronounced "snips"), which has been accounting for a significant amount of morbidity and mortality, which may be based on its increasingly antimicrobial resistance. ProMED would appreciate more information regarding the outbreak strain and its antimicrobial sensitivity pattern(s).
The following is abstracted from the introduction of the article, Wong VK, Baker S, Pickard DJ, et al: Phylogeographical analysis of the dominant multidrug-resistant H58 clade of _Salmonella_ Typhi identifies inter- and intracontinental transmission events. Nature Genetics. 2015;47:632-639 with the citations removed:
"_S._ Typhi, the primary global cause of human typhoid (enteric fever), is a monophyletic serovar of _S. enterica_. Unlike many Salmonella, _S. Typhi_ are highly restricted to infection of humans and are associated with systemic infection, prolonged fever and an asymptomatic carrier state. Typhoid is still a common disease in many regions of the world with poor infrastructure and limited economic development and is also a risk for travelers who visit such regions. It is estimated that 20-30 million cases of typhoid occur annually, although deaths are less frequently reported than before the availability of effective antimicrobials.
In addition to improvements in access to clean water and sanitation, typhoid can potentially be controlled by other interventions such as vaccination and antimicrobial therapy. Chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole were traditional 1st-line drugs commonly used to treat acute typhoid, and these agents continue to be used in areas of the world where _S._ Typhi are deemed susceptible. However, since the 1970s, _S._ Typhi have emerged that display multidrug resistance, defined as resistance to the above antimicrobials, compromising treatment. Since the 1990s, alternative treatment options have included fluoroquinolones, 3rd-generation cephalosporins (such as ceftriaxone) and the azalide azithromycin. The early emergence of MDR _S._ Typhi was driven in large part by the acquisition of IncHI1 plasmids carrying antibiotic resistance genes and, more recently, by chromosomal mutations associated with resistance to fluoroquinolones, and MDR strains have been reported across Asia and Africa.
Phylogenetic analysis, initially based on subgenomic DNA sequences but later on whole-genome DNA sequences, showed that the global _S._ Typhi population is highly clonal and likely originated from a common ancestor that moved into the human population several thousand years ago. It also indicated that the population is relatively small and that recombination between _S._ Typhi and other salmonellae is rare. Simple SNP-based typing schemes have been developed that stratify the _S._ Typhi population into haplotypes, and these schemes are now used to unequivocally map new isolates to the phylogeny. Notably, this approach identified a single emerging, highly clonal MDR haplotype of _S._ Typhi, H58, which is being reported with increasing frequency from many countries in Africa and Asia. Within the H58 lineage, IncHI1 MDR plasmids of the restricted subtype PST6 and chromosomal point mutations conferring quinolone resistance are common." - Mod.LL
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/707.]
See Also
Typhoid fever - Zambia: (LS) 20170524.5059531Typhoid fever - New Zealand (04): (MW) 20170524.5058851
Typhoid fever - Syria: (HL) 20170523.5057372
Typhoid fever - Kenya: H58 haplotype, antimicrobial resistance 20170430.5005152
Typhoid fever - Tonga 20170414.4971570
Typhoid fever - New Zealand (03): (AU) church community 20170413.4969569
Typhoid fever - New Zealand (02): (AU) church community 20170405.4947714
Typhoid fever - New Zealand: (AU) RFI 20170403.4943251
Typhoid fever - Zimbabwe (02): (HA) 20170402.4942851
Typhoid fever - Zimbabwe: (Harare) 20170107.4749025
2016
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Typhoid fever - USA: (CO) restaurant cluster, 2015 20160624.4307017
Typhoid fever - Zimbabwe: (Harare) 20160318.4103720
2015
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Typhoid fever - USA: (CO) restaurant cluster 20151107.3774978
Typhoid fever - Syria (03): (DI) refugee camp 20150928.3670433
Typhoid fever - Syria (02): (DI) susp., refugee camp 20150903.3622700
Typhoid - Syria: (DI) refugee camp 20150821.3591694
Typhoid fever - Nepal: (SP) post-earthquake 20150726.3528925
Typhoid fever - Africa, Asia: multidrug resistant 20150512.3357675
Typhoid fever - Fiji (02): (NO) commentary 20150123.3114013
Typhoid fever - Fiji: (NO) 20150122.3111081
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