Weekly Update: Hepatitis A outbreak in Minnesota; Legionnaires’ disease outbreak in Georgia; African Swine Fever in Asia
CAHFS News

LOCAL

Hepatitis A outbreak in Minnesota

Hepatitis A outbreaks have been occurring nationwide since 2016 affecting 23,000 people and causing 233 deaths. Since May, Minnesota has had an increased number of cases and, now, an official outbreak has been declared affecting nine counties. About 57% (13/23) of the reported cases have required hospitalization. No deaths have been reported.

Disease transmission primarily occurs through ingestion of infected fecal material, often the result of inadequate handwashing. At-risk populations include those residing in potentially unsanitary or close-confined areas such as homeless shelters or prisons. Additionally, those using injectable or injectible illicit drugs are vulnerable and may be the cause for an increasing number of cases reported nationwide. Hepatitis A is usually a mild self-limiting disease with flu-like symptoms, but fatal liver failure can occur.

An effective vaccine is available. As a result of the outbreak declaration, federal resources are now available to help curb this problem - including increased access to the vaccine normally in limited supply. Most adults are not currently vaccinated against the disease: only children born during 2006 and thereafter are vaccinated. State officials have been advocating for increased vaccination in high risk areas. Since last year, nine homeless shelters in Minneapolis have offered vaccination and have also made the vaccine available at outreach events. Currently, many area jails are waiting on the vaccine to be delivered to administer to agreeing inmates

Star Tribune

MDH

NATIONAL

Legionnaires’ disease outbreak in Georgia

Georgia is experiencing its largest ever outbreak of Legionnaires' disease. Cases have been identified in people who stayed in the Sheraton Atlanta Hotel between June 12 and July 15. To date, 12 cases have been confirmed with one death. Additionally, 63 people are considered “probable” cases with samples awaiting laboratory confirmation.

The Atlanta-based hotel has been closed since July 16 and may open August 14. The hotel has been working closely with area public health departments and environmental experts conducting testing to determine the source of the outbreak. The hotel’s entire water distribution system, including all water features, have been thoroughly cleaned and chlorinated out of an abundance of caution.

Legionnaires’ disease is caused by the Legionella bacteria which is found in freshwater water environments. The bacteria becomes problematic when it multiplies in large, complex man-made water systems in hotels and hospitals such as shower heads, faucets, hot tubs, hot water tanks, and fountains. Pneumonia may develop when a susceptible individual inhales water droplets laden with the bacteria. Most people exposed do not get sick. Risk factors for illness include being over 50 years of age, a smoker, having chronic lung disease, and having an immunocompromised immune system. While treatable with antibiotics, the Centers for Disease Control and Prevention estimates the disease is fatal in one out of ten people.

NY Times

CDC (PDF)

INTERNATIONAL

African Swine Fever in Asia

One year has passed since African Swine Fever (ASF) was identified in Asia. To date, almost five million pigs have died or have been culled in Asia. ASF has also been identified in six other countries including Cambodia, China, DPR Korea, Lao PDR, Mongolia, and Vietnam. In Europe, an ASF epidemic is affecting the wild pig population.

ASF causes infection only in pigs, not humans, and is spread through contact with a sick pig or the ingestion of raw, undercooked contaminated swill or pork products. Additionally, the ASF virus can survive for long time periods on dried, frozen, and cured pork products. Fomites such as contaminated footwear, clothes, or equipment can also spread disease. ASF has up to a 100% fatality rate in pigs, causing severe economic loss, particularly in small scale farms. China has around 26 million pig farmers with 50% of pork production coming from small scale farmers. Nearly 2 million pigs have been culled in China. In Vietnam, the pork industry comprises nearly 10% of the country’s agriculture: nearly 300 million pigs have been culled.

There is no effective vaccine to protect pigs from ASF. As such, the Chief Veterinary Officer of the Food and Agricultural Organization of the United Nations (FAO), Dr. Juan Lubroth insists emphasis must be placed on other disease transmission control efforts to prevent disease spread, “Countries must be vigilant at borders – land, sea or air – in preventing the disease’s entrance and spread through the introduction of infected pigs or contaminated pork products. Outbreaks need to be reported immediately.” ASF affected farms are urged to practice biosecurity measures, halt pig movement and their products, practice effective and humane culling of pigs, and have official oversight for carcass disposal. In collaboration with the World Organization for Animal Health, the FAO’s Emergency Management Centre for Animal Health have deployed response teams to assist affecting countries control the disease.

FAO

FAO: Update

ASF Resources

To stay up to date on swine disease news, check out the CAHFS swine disease global surveillance project at z.umn.edu/SwineDiseaseSurveillance

ASFWatch was CAHFS's fall 2018 Emerging Issues feature, including video and audio podcasts, timelines, maps, fact sheets, infographics, and other timely information. View the resources at z.umn.edu/ASFWatch 

Questions, comments, feedback about today's Weekly Update? Please email Dr. Jan Mladonicky, [email protected].

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CAHFS News

CAHFS News is a compilation of current topics and news updates in animal health, food safety, and veterinary public health.