NEWS SCAN: Biodefense research, cholera vaccination, early H1N1 in Taiwan, avian flu in Myanmar, IV zanamivir

Jan 19, 2011

DoD biodefense research changes focus from treatment to detection
The US Department of Defense (DoD) is cutting back on the hunt for new treatments for victims of biological attacks while stepping up efforts to find better ways to detect mutant forms of deadly viruses such as Ebola and Marburg, the Boston Globe reported this week. A 5-year, $1 billion quest by the DoD Transformational Medical Technologies program for new medicines for deadly viruses was not very successful, yielding only two drugs that look promising, the story said. As a result, the next $1 billion for the program will be used mainly to develop better ways to identify mutant versions of lethal viruses, in view of the concern that bioterrorists may try to tinker with such viruses to make them more virulent. Alan S. Rudolph, director of science and technology at the Defense Threat Reduction Agency, said that research could pave the way for the development of antidotes that could eventually win Food and Drug Administration (FDA) approval, according to the story. He said the ultimate goal still is to develop drugs that are effective against multiple viruses. Biodefense specialists said it has become clear that it is easier to modify a pathogen for an offensive threat than it is to develop an effective defense.
Jan 17 Boston Globe story

Global experts, Haitian officials at odds on cholera vaccination plans
International health experts and the Haitian government disagree on how to use cholera vaccination to fight Haiti's cholera epidemic, which has claimed about 3,800 lives and caused 189,000 illnesses, according to a report in the Jan 20 issue of Nature. Earlier in the epidemic, which began in October, vaccination was dismissed as impractical in the face of a very limited vaccine supply and the rapid spread of the disease. But most international experts now favor a limited pilot project that would help determine whether a broader effort is worthwhile and how to use cholera vaccines in future outbreaks elsewhere, the story said. An expert committee convened by the World Health Organization is recommending a pilot campaign that would use the 250,000 to 300,000 available doses of Dukoral, a vaccine made by Crucell. But the Haitian government, fearing that those denied vaccination would be resentful, is demanding a much larger campaign. Jean Ronald Cadet, vaccination program manager in Haiti's health ministry, said the government wants at least 1 million doses as the prerequisite for launching an immunization drive and ultimately wants to vaccinate 6 million people, according to the story. Such an effort would require major increases in vaccine production.
Jan 20 Nature report
Dec 20 CIDRAP News story on vaccination issue

Serology shows Taiwan was hit with novel H1N1 earlier than thought
As much as 14% of Taiwan's population may have been infected with pandemic flu from April to June of 2009, before the first clinical cases were detected by surveillance in June, according to a new serologic study. Starting in the fall of 2009, researchers tracked 306 people from households with schoolchildren in central Taiwan. They took three separate samples from each patient over time for hemagglutination inhibition (HI) assay and defined seroconversion to 2009 H1N1 influenza as an HI titer of 1:40 or higher and a fourfold increase in neutralization titer. They found novel H1N1 antibody incidence to be 14.1% from April to June 2009 and 29.7% from July to October 2009, with the earliest instance of seroconversion occurring from Apr 26 to May 3. They found no age-specific pattern in their data, which they say may highlight "the importance of children as asymptomatic transmitters of influenza in households."
Jan 18 PloS One study

Avian flu outbreak kills 500 poultry in Myanmar
Highly pathogenic avian flu has been confirmed in Myanmar poultry for the first time in almost a year, according to a World Organization for Animal Health (OIE) report filed yesterday. The farm, in Bumay village in Sittwe township, housed 800 3-month-old layer chickens. Starting Jan 6, 500 of the 800 birds died, and a highly pathogenic H5 avian flu strain was confirmed. The other 300 chickens were culled to prevent disease spread. The village is home to eight farms that house a total of about 5,000 chickens, according to the report. Workers on the affected farm have tested negative for the virus, according to a story today in the Myanmar newspaper Mizzima. The last outbreak in the country was in March 2010, according to the OIE.
Jan 18 OIE report
Jan 19 Mizzima story

Glaxo launches phase 3 trial of IV zanamivir
GlaxoSmithKline today announced that it has launched a phase 3 clinical trial to compare intravenous (IV) zanamivir (Relenza), a drug licensed through Biota, with oral oseltamivir in patients hospitalized with influenza. The study's endpoint is time to clinical response, and the company hopes to enroll 462 patients in more than 20 countries. IV zanamivir isn't approved for sale in any country, but during the 2009 H1N1 pandemic the FDA allowed physicians to request to use it on an emergency basis. The approved zanamivir formulation is an inhaled drug, which can be difficult to administer to severely ill flu patients who have impaired lung function and can't use a nebulizer. Zanamivir has served as a key treatment for managing oseltamivir-resistant flu infections.
Jan 19 Glaxo press release

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