NEWS SCAN: ECDC flu assessment, BSE update from Brazil, leishmaniasis treatment

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Feb 7, 2013

ECDC: No flu strain dominating to date
Flu cases in Europe began earlier this season than last, but no specific strain is dominating to date, the European Centre for Disease Prevention and Control (ECDC) said today in its annual flu risk assessment. Influenza cases have been fairly evenly divided between types A and B. Cases first appeared in Western Europe and the Scandinavian countries, with southwestern countries less affected so far. Flu vaccination is being encouraged, although early estimates show only modest vaccine effectiveness at best. The main uncertainties in Europe are the impact among young people that the widespread circulation of 2009 H1N1 influenza will have in terms of disease severity as well as how circulating flu B Victoria-lineage viruses might affect vaccine effectiveness, according to the report. It is too early to draw conclusions from certain trends in Europe, such as indications of increased mortality from all causes in the elderly in some areas temporally associated with flu outbreaks and an apparent rise in severe pneumonia in the United Kingdom. The early onset of cases in Europe is similar to what occurred in the United States this season, but US cases have predominantly involved H3N2 strains.
Feb 7 ECDC press release
Full report

Final report on Brazil BSE cow suggests atypical disease
Brazilian veterinary officials yesterday submitted a final report to the World Organization for Animal Health (OIE) on the country's first case of bovine spongiform encephalopathy (BSE, or mad cow disease). The epidemiologic investigation found that the cow was born in 1997, a year after Brazil put a feed ban on ruminant protein in ruminant feed. The animal received only fodder and mineral supplement and lived in a rearing system that wasn't favorable to the development of classical BSE. The cow's infection was unusual, because it had only acute symptoms less then 24 hours before it died and was older, about 13 years of age. Authorities identified, monitored, and limited the movements of cohort animals born a year before and after the affected cow. Those cattle were about 15 years old and in good health. They were humanely euthanized and buried in a deep pit in appropriate locations. Samples from all of the animals were negative for BSE. Though there were some problems with quality of the sick cow's samples, lab testing suggested that it appears to have characteristics of H-type rather than L- or C-type BSE, which could indicate an atypical BSE case that is rare and spontaneous, according to the report. The animal did not enter the meat processing chain and was buried on the farm where it lived. The OIE noted that it does not recognize atypical BSE as a distinct entity. The cow died in 2010, and initial tests ruled out suspected rabies and BSE. Lab problems delayed further BSE testing, which in December yielded a positive result.
Feb 6 OIE report
Dec 7, 2012, CIDRAP News scan on the case

Antibiotic cream for cutaneous leishmaniasis looks promising
An antibiotic cream for treating cutaneous leishmaniasis, a parasitic disease found in about 90 countries, produced a high cure rate with few side effects in a phase 3 trial, according to a report published today in the New England Journal of Medicine. The Leishmania parasite, spread by sand flies, causes skin sores that take months or years to heal and can leave ugly scars, according to the Centers for Disease Control and Prevention. The current standard treatment requires a 20-day regimen of "toxic and painful" treatments with drugs called antimonials, according to a press release from the US Army Medical Research and Materiel Command (USAMRMC), which collaborated on the trial with French and Tunisian researchers. In the study, 375 patients were randomly assigned to receive a cream containing 15% paromomycin, with or without 0.5% gentamicin, or a similar cream with no active ingredients. Treatment was given once daily for 20 days. The rates of complete cure after 98 days were 81% for paramomycin alone, 82% for paramomycin with gentamicin, and 58% for the control group. Mild or moderate application-site reactions were more common in the antibiotic groups but occurred in fewer than 5% of participants, say the report and release. The release says more than 3,000 cutaneous leishmaniasis cases have been reported in US military members since 2003, many of whom have had to leave their duty posts for treatment.
Feb 7 N Eng J Med abstract
Feb 6 USAMRMC press release

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