A non-systematic mention of outbreaks that have caught my attention this week. For a more comprehensive search, there is ProMED Mail. One can also skim through the MOH’s weekly infectious diseases bulletin, which is only about local notifiable diseases (where one can quickly see that we have had more dengue and HFMD cases compared to last year, although the spike of dengue cases has since reverted to baseline relative to 2015; polyclinic attendances for “influenza-like illness” has also gone up this week past the threshold for concern).

Zika, USA

The big news is that CDC Atlanta has reported local transmission of Zika in Miami, Florida, specifically in the gentrifying neighbourhood of Wynwood. There were four cases reported, which were believed to be spread by local mosquitoes. As of 27th July, there has been 1,658 cases of Zika reported in the US (which does not include these 4 new local transmission cases).

Colistin Resistance, Germany

The Germans completed a systematic testing of >10,000 Escherichia coli (a Gram-negative bacteria that is common in humans, animals, and the environment, and which is the most common cause of urinary tract infections in humans) and found that 3.8% were positive for the new mcr-1 gene that conveys resistance to polymyxins. The gene is important for a couple of reasons – colistin is now considered a last-line antibiotic for extremely drug-resistant Gram-negative bacterial infections, and hence the spread of this gene may result in untreatable infections; also, this gene is on a plasmid, and therefore will spread more easily between bacteria.

ST283 Group B Streptococcus, Singapore (2015)

The outbreak is technically over, but the publications are starting to appear. Here is a local work describing a subset of 14 patients with GBS brain infections, showing a unique pattern of imaging appearances, just published in the Journal of Magnetic Resonance Imaging (alas behind a paywall). I had previously shown the MRI images of a man with ST283 GBS meningo-encephalitis as a clinical vignette.

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