* Nipah virus. An outbreak of Nipah virus infection began in May in Kerala, India; it is the first time the virus has been identified in the southeastern area of the country. As of June 2, 19 patients had been diagnosed and 17 of those had died. Nipah virus is an emerging zoonotic infection first identified in Malaysia in the late 1990s, and has an estimated fatality rate of 40% to 75%. Death usually occurs from acute respiratory infection or encephalitis. Its natural host is the fruit bat; however, pigs may be intermediate hosts. The disease can be spread by direct contact with animals, infected humans, or contaminated food. No drugs or vaccines are available; thus treatment is supportive. For more details and a fact sheet, go to http://www.searo.who.int/entity/emerging_diseases/links/nipah_virus/en.
* Ebola virus. A May outbreak of Ebola virus in the northwestern region of the Democratic Republic of the Congo has resulted in 54 cases of the disease and 33 deaths, according to the World Health Organization. That outbreak was contained in slightly over two months. Success was attributed to the rapid mobilization of teams to trace contacts, arrange vaccine supplies, and set up the specialized cold chain needed to store the vaccine. In late July, new cases of Ebola were identified on the other side of the country near the village of Mangina, which is 60 miles from the Ugandan border. The new outbreak is in an active conflict zone in a region that hosts over 1 million displaced people fleeing the violence. The presence of armed groups and the extensive cross-border trade in the area are likely to make containment of the new outbreak more difficult. As we went to press, at least 20 people had died there from Ebola.
* Hepatitis A. In June, the Ohio Department of Health (ODH) declared a statewide outbreak of hepatitis A after an increased number of cases were reported since the beginning of the year. As of July 30, 176 cases had been identified, mostly in men (63%). As we went to press, the ODH and local health departments were investigating the uptick in this vaccine-preventable disease, which is spread by objects, food, and drinks contaminated with fecal matter or by sexual contact. Outbreaks of the virus have also occurred in Indiana, Kentucky, Michigan, and West Virginia. For updates on the situation in Ohio, visit http://www.odh.ohio.gov/hepa. Other state-specific information about current outbreaks can be found at http://www.cdc.gov/hepatitis/outbreaks/2017March-HepatitisA.htm. A June health advisory from the Centers for Disease Control and Prevention is at https://emergency.cdc.gov/han/han00412.asp.