NEWS SCAN: West Nile challenges, possible cholera in Cuba, dismissed vaccine suit

Sep 26, 2012

Difficulties in West Nile countermeasures detailed as US cases top 3,500
Because of its sporadic nature and relatively low number of symptomatic cases each year, West Nile disease presents unique obstacles to developing vaccines or effective therapy, but doing so is important as the disease will likely cycle for years in the United States, two West Nile experts wrote today in the New England Journal of Medicine. Lyle R. Petersen, MD, MPH, and Marc Fischer, MD, MPH, of the Division of Vector-Borne Diseases (DVBD) of the Centers for Disease Control and Prevention, in Fort Collins, Colo., write that West Nile, which was first detected in the country in 1999, is now entering its "adolescence" but, judging by the 80-year pattern seen with St. Louis encephalitis, will likely circulate for years. They write that the sporadic incidence and geographic dispersal of cases make clinical trials for drugs and vaccines difficult. "New paradigms are needed for bringing novel therapeutics and vaccines for emerging diseases such as West Nile virus to market in a timely and cost-efficient manner," they conclude. They also point out the efficacy of aerial spraying, as was demonstrated this year in the Dallas area.
Sep 26 N Engl J Med perspective
In related news, the DVBD said yesterday that US West Nile cases have risen to 3,545, including 147 deaths and 1,816 cases of neuroinvasive disease. Those numbers represent increases of 403, 13, and 186, respectively, over last week's totals, demonstrating a further slowing of the outbreak. Last week's numbers rose 506, 16, and 225, respectively, over the previous week's. The case total is the nation's highest at this time of year since 2003, the DVBD said. About 38% of the cases are from Texas, and 70% are from eight states: Texas, Mississippi, South Dakota, Michigan, California, Louisiana, Oklahoma, and Illinois.
Sep 25 DVBD update

More cholera cases in Cuba?
Cholera cases in Cuba, though unconfirmed at this point, have been reported to the media in San Luis, in the eastern province of Santiago de Cuba, and in Bahia Honda, 35 miles west of Havana, according to a story in the Miami Herald. The Cuban government has remained silent on the situation since Aug 28, when it said the recent outbreak, which was focused in the eastern city of Manzanillo and involved 471 confirmed cases with three deaths, was over. A member of the dissident Cuban Patriotic Union informed the Herald that he had been told of 102 suspected cases and 27 confirmed cases in San Luis, that he had seen police keeping nonresidents out of the town and trucks delivering water, and that part of a hospital in the town had been made into an isolation facility. An independent journalist reporting 19 cases in Bahia Honda, including one death, said public health workers had been instructed how to recognize cholera symptoms but had been told not to use the word "cholera" and that water purification tablets were being distributed.
Sep 25 Miami Herald article

Parent suit against vaccine maker dismissed
Parents who believe their child was harmed or killed by vaccine cannot sue manufacturers in state court but rather must use the federal "vaccine court" set up by a 1986 federal law on vaccine injuries and accept no-fault compensation, according to a story in the San Francisco Chronicle. This decision was reached by a federal appeals court in California in regard to the suit of a Las Vegas couple whose 1-year-old son seized 9 days after administration of a Merck vaccine for measles, mumps, and rubella and died 6 months later. The federal law states that if a vaccine court officer decides harm is consistent with known side effects of a vaccine, compensation can be awarded without proving that the manufacturer caused harm or acted negligently. The child's estate received $250,000, the maximum award for a vaccine-related death but far less than the typical award in a wrongful-death suit, the Chronicle article says. The parents' lawyers say they are asking for a rehearing and will take their case to the Supreme Court if necessary.
Sep 25 San Francisco Chronicle story

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