Source: http://www.cidrap.umn.edu/news-persp...an-may-07-2019

News Scan for May 07, 2019
Plague cases in Mongolia; Foodborne tularemia cluster; PCV13 pneumonia illness
Filed Under:
Plague; Tularemia; Pneumonia

Mongolian town quarantined after couples dies from plague

A 38-year-old man and his pregnant wife, 37, died in Mongolia from bubonic plague after eating tainted marmot meat, according to a report in The Siberian Times.
The Mongolian Ministry of Health confirmed the cause of death, and issued a quarantine for Ulgii, the town where the couple lived, leaving several dozen tourists stranded. The quarantine lifted yesterday, the BBC reported.
Mongolian folk tradition dictates that eating raw marmot can bring good health. The couple reportedly ate raw marmot kidneys.
Buponic plague is caused by the bacterium Yersinia pestis. Fleas infected with the bacteria typically bite animals, including rodents like marmots.
The BBC said 118 people who had contact with the couple were isolated and treated with antibiotics for prophylaxis.
May 4 Siberian Times story
May 7 BBC story

Report details tularemia cluster linked to contaminated wine grape juice

An investigation into a cluster of tularemia cases in Germany found that the patients had drunk contaminated pressed grape juice at a wine tasting in Rhineland-Palatinate, according to a report published yesterday in the International Journal of Infectious Diseases.
One of the patients was a 46-year-old man who was hospitalized after prolonged symptoms that included pharyngitis and swollen cervical lymph nodes, which was complicated by septicemia. An ear, nose, and throat physician who consulted on the case sent serum samples to the Robert Koch Institute, where they tested positive for antibodies to Francisella tularensis, the bacterium that caused tularemia.
Ciprofloxacin treatment was initially helpful, but the symptoms got worse and the man was hospitalized again on day 60. Six days later, blood samples tested positive for F tularensis, and a sample from a lymph node aspirate was positive for F tularensis holarctica, the most common subtype in the Northern Hemisphere that typically causes a milder form of tularemia.
The patient was diagnosed as having the oropharyngeal form of the disease, suggesting that he had consumed the infectious agent. Clinicians drained the man's abscess, and he was discharged with oral antibiotics treatment that included ciprofloxacin and rifampicin.
An investigation found that five other patients were infected at the same wine tasting, three of them children. The beverage they sampled was grape must, which is nonalcoholic pressed unfiltered juice. The grape must had evidence of F tularensis DNA, and a mechanical harvester was identified as the source. Though the illnesses are rare, infections from contaminated drinking water and food have been reported before. The authors said the automatic harvest machines could have contaminated the grape must via an infected rodent or rabbit.
May 6 Int J Infect Dis abstract

Study: PCV13 serotypes detected in about 5% of adult pneumonia patients

Despite the high uptake of the 13-valent pneumococcal conjugate vaccine (PCV13) in the United States, 3.8% to 5.3% of community acquired pneumonia (CAP) cases in working-age adults are still caused by strains contained in the vaccine, according to a study published yesterday in Vaccine.
The study collected respiratory samples from 12,055 CAP patients seen at 21 acute care hospitals in 10 US cities between 2013 and September 2016. The mean patient age was 64.1 years, and 52.7% were 65 years or older.
PCV13 serotypes were detected in 4.6% of all patients and 4.2% of those 65 years or older; for patients ages 18 to 64, PCV13 serotypes were detected in 3.8% to 5.3% of patients.
In 2010, PCV13 was introduced into US childhood vaccine schedules, and in 2012, the vaccine was recommended for all adults over the age of 65.
"Despite pediatric herd effects, PCV13 serotypes continue to cause CAP in adults in the United States," the authors concluded. "Given this remaining vaccine-type disease identified in adults, direct vaccination with PCV13 is likely beneficial in all older adults and younger adults with underlying chronic conditions."
May 6 Vaccine study