Top Infectious Disease News of the Week—January 12, 2020

#5: Three Pan-Resistant Candida auris Cases Identified in New York

Candida auris was first identified in the United States and has been particularly prevalent in New York. As of June 28, 2019, a total of 801 patients with C auris were identified in New York. Closer analysis found that 3 of these cases were pan-resistant infections that developed following treatment with antifungals, including echinocandins.

Details of the 3 cases were presented in an article in the US Center for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

“The occurrence of these cases underscores the public health importance of surveillance for C auris, the need for prudent antifungal prescribing, and the importance of conducting susceptibility testing on all clinical isolates, including serial isolates from individual patients, especially those treated with echinocandin medications,” the authors wrote.

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#4: A Novel Coronavirus Challenges China

Since news broke of a pneumonia outbreak with unknown origin in Wuhan, China, there has been increased concern and speculation in the media. Several individuals quickly drew comparisons to the SARS-CoV outbreak in 2003. As there have been several rapid developments, there is a lot to catch up on regarding this new outbreak.

Late last week, investigators identified the causative agent of the outbreak as a new coronavirus. Coronaviruses have also been responsible for the emergence of both SARS-CoV and MERS-CoV.

Recently, the Chinese public health authorities announced that the previously announced 59 cases have been scaled back to 41 cases. The first death has been labeled as a result of the novel Coronavirus (nCoV), for which a name has not been established yet. Health officials have also released more information, including the genetic data, on nCoV. The release of the genome can be found here, which was provided by the Shanghai Public Health Clinical Center & School of Public Health.

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#3: CDC Offers STD Recommendations as Care Shifts to Primary Care Setting

The US Centers for Disease Control and Prevention (CDC) has issued new guidelines to help primary care providers treat patients with sexually transmitted diseases (STDs).

The recommendations are a response to a shift in how Americans access health care for STDs.

They come amid increasing rates of STDs across the country.

“During the 1980s and 1990s, most specialized STD care was provided in STD clinics and HIV programs,” notes the report, which was published January 3 in the CDC’s Morbidity and Mortality Weekly Report. “For patients, STD clinics were unique because they provided confidential, walk-in, low-cost specialty care, and offered the expertise necessary to manage STDs.”

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#2: Early 2020 Flu Season Statistics and Other Influenza News

The US Centers for Disease Control and Prevention (CDC) said that for the first week of 2020, influenza virus remains high, but indicators for severity—such as hospitalizations and deaths—are not high at this point in the flu season, which can run into the springtime.

The CDC also said that visits to health care providers for influenza-like illness decreased from 7.0% during the holiday week (between Christmas and New Year’s) to 5.8% the first week of January. That number is considered below the “epidemic” threshold. However, all regions remain above their baselines, and there are 46 states plus Puerto Rico that report “widespread” flu activity.

The agency estimates that so far this flu season there have been 9.7 million flu illnesses, 87,000 hospitalizations and 4800 deaths from flu, including 32 pediatric deaths. More than 170 million doses of the flu vaccine have been administered, they added.

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#1: Influenza B/Victoria Strain Predominating 2019-20 US Flu Season Thus Far

For the first time since the 1992-93 influenza season, influenza B viruses are the predominant circulating flu virus in the United States. Typically, influenza B viruses circulate near the end of the flu season. In fact. in the previous 3 flu seasons B/Victoria viruses accounted for <10% of influenza isolates.

This year appears to be quite the contrast. Between September 29 through December 28, 2019, influenza B viruses accounted for 59.2% of influenza-positive results reported nationwide. Of these isolates, 97.9% belonged to the B/Victoria lineage.

According to a report in the US Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, B/Victoria viruses appear to be the most common strain affecting individuals under the age of 25 years, while influenza A(H1N!)pdm09 viruses are most commonly reported among individuals 25 years and older.

Authors of the article also report that 70% of influenza-associated hospitalization among children and 18 of 27 influenza-associated deaths among pediatric populations were associated with influenza B viruses.

The report also discusses the severe nature of the 2019-20 influenza season in the state of Louisiana. The state’s flu season has been “usually early and intense” and health officials have noted a high number of illnesses of the B/Victoria lineage.

In one particular pediatric health care facility a total of 1268 laboratory-confirmed influenza B virus infections, including 23 hospitalizations, were documented between July 31 through November 21, 2019.

An investigation was conducted using data from medical and vaccine records from 198 patients. In total, 158 individuals were treated at the aforementioned facility and 17 were from other facilities in the state. The research found that none of the patients had received the seasonal influenza vaccine, which is likely attributable to the fact that flu activity began before annual flu vaccination is recommended.

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