NEWS SCAN: Ebola in south Asian bats, no Ebola in Uganda, fecal infusion for C diff , Lyme-like disease

Jan 17, 2013

Ebola antibodies found in Bangladesh bats
Fruit bats in Bangladesh carry antibodies against two Ebola virus strains, suggesting that the geographic range of the virus extends to south Asia and adding to evidence that bats may be the natural reservoirs. The study, led by researchers from the nonprofit global organization EcoHealth Alliance, appeared yesterday in Emerging Infectious Diseases. The team sampled a variety of bat species in four Bangladesh districts from April 2010 to March 2011. Blood tests revealed that 5 (3.5%) of the 276 bats were positive for antibodies to Ebola Zaire and Reston viruses. All five were healthy male fruit bats. Earlier studies have found evidence of Ebola antibodies in bats from Africa, the Philippines, and Spain, and in October 2012 researchers reported similar findings in bats from China. Lead author Kevin Olival, PhD, said in an EcoAlliance press release, "This study has been vital to better understand the wildlife reservoirs and potential transmission routes for Ebola virus in Bangladesh and the region."
Jan 16 Emerg Infect Dis study
Jan 16 EcoHealth Alliance press release
Oct 23, 2012, CIDRAP News scan "Ebola antibodies found in Chinese bats"

Uganda declared Ebola-free
Uganda's health ministry yesterday declared an end to an Ebola outbreak in Luweero district that began last November, according to AllAfrica News yesterday. The statement means the area has gone 42 days without detecting any cases, after seven cases were reported, with six of them in relatives living in the same sub-county. It follows by a month an Ebola-free declaration in Kibaale district.
Jan 16 AllAfrica article

Study: Fecal infusion boosted drug treatment for recurrent C diff infection
In a small Dutch trial, fecal infusion worked significantly better than a standard antibiotic regimen for ridding patients of recurrent Clostridium difficile infections, according to a report in the New England Journal of Medicine yesterday. The researchers say antibiotic treatment for a first C difficile infection fails to effect a lasting cure in 15% to 26% of patients. In the study, patients were randomly assigned to receive one of three treatments: (1) 500 mg of oral vancomycin four times a day for 4 days, followed by bowel lavage and subsequent infusion of a solution of donor feces through a nasoduodenal tube; (2) a standard vancomycin regimen (500 mg four times a day for 14 days); or (3) a standard vancomycin regimen followed by bowel lavage. Thirteen of 16 (81%) patients in the infusion group were free of C difficile–related diarrhea after the first infusion, the report says. The other three patients were given a second infusion with feces from a different donor, after which symptoms cleared in two of them. The C difficile infection resolved in 4 of 13 (31%) patients who received vancomycin alone and in 3 of 13 (23%) who received vancomycin and bowel lavage. Both outcomes were significantly poorer than that in the infusion group (P < .001). There were no significant differences in adverse events, except that the infusion group had mild diarrhea and cramping on the infusion day. After the infusions, the recipients had greater fecal bacterial diversity, similar to that observed in the donors.
Jan 16 N Engl J Med article

Evidence of Lyme-like disease found in US patients
A disease closely related to Lyme and also transmitted by deer ticks has been detected in an 80-year-old New Jersey woman, and 18 other patients in the Northeast have developed antibodies to the disease, according to a case report and letter in today's New England Journal of Medicine. The woman, who had been treated for Lyme disease in 2006 and 2007, was assessed after 4 months of symptoms. She had been found to have cancer in 2005 and was immunocompromised. During her workup, physicians detected Borrelia miyamotoi in her cerebrospinal fluid via microscopy and polymerase chain reaction. The B miyamotoi spirochete is closely related to B burgdorferi, the cause of Lyme disease, and both are transmitted by Ixodes ticks, according to the case report. In the letter, scientists from Yale and other US institutions reported analyzing serum samples taken from patients from New England and New York from 1990 through 2010. They found that 18 of the 875 patients (2%) had antibodies to B miyamotoi, with 3 of them having seroconversion associated with symptoms, suggesting recent infection. None of these 3 was immunocompromised. The authors say their findings suggest that "B miyamotoi infection may be prevalent in areas where Lyme disease is endemic in the United States."
Jan 17 N Engl J Med case report
Jan 17 N Engl J Med letter

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