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Health Alerts

David Trump, MD, MPH, MPAActing Chief Deputy Commissioner for Public

Health and Preparedness & State Epidemiologist

Health and Medical SubpanelApril 28, 2014

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Ebola Virus

A viral hemorrhagic fever caused by exposure to animal sources in the environment (fruit bats, monkeys) or blood or body fluids of ill persons

Outbreak in Africa (as of Apr 16):• Guinea – 197 cases with 122 deaths (24 HCW, 13

deaths)• Liberia – 27 cases with 13 deaths• Sierra Leone – 12 suspected cases, all tested

negativePatient isolation, contact tracing in effect; PPE in

healthcare and burial practicesNo travel restrictionsVirginia hospitals and local health departments on alert for

incoming ill travelers

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Influenza A(H7N9)

375 cases with 115 (31%) deaths – China (98% of cases), Taiwan, Hong Kong, one Chinese traveler in Malaysia

Severe illness, disproportionately affecting middle-aged men

1st wave Feb-May 2013; 2nd wave began Oct 2013 & continues

80% exposed to birds or live poultry marketsSmall clusters; not easily spread between peopleSurveillance, usual precautionsNo travel restrictions

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Influenza A(H5N1)

649 cases and 385 (59%) deaths since 2003Jan 2014 case in Canada in a person who traveled

to ChinaProper precautions; surveillance of contacts; search

for exposure history (e.g., poultry) No travel restrictionsWHO now reporting on this monthly unless risk

situation changes

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MERS-CoV*

Since September 2012 – 243 cases with 93 (38%) deaths

Associated with travel to Middle East, contact with animals or ill persons where disease is occurring

Surveillance for severe acute respiratory infections (SARI)

Healthcare precautions importantNo travel restrictions

* MERS-CoV: Middle Eastern Respiratory Syndrome coronavirus

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Chikungunya Virus

Mosquito-borne illness, mostly seen in Africa, Asia, Europe

In Dec 2013, 1st case in the Americas – St. Martin Island

By Apr 4, 2014, >3,290 confirmed cases in multiple Caribbean island nations and in French Guiana

Symptoms: high fever (>102ºF), headache, nausea, muscle and joint pain, and rashes

Commissioner sent letter to clinicians on Apr 18 Recommended awareness of the illness and assessment of travel history in those with compatible symptoms

Potential for cases to be imported and lead to local spread in the US primarily by the Aedes albopictus “Tiger” mosquito

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Virginia’s 2013-14 Flu Season is Concluding

Recent uptick in Flu B