NEWS SCAN: Injection-related anthrax, drug-resistant gonorrhea, post-pandemic illness, imported rubella, polio vaccine deal

Mar 28, 2013

Analysis of European anthrax cases tied to heroin points to common source
Anthrax cases tied to injection drug use in Europe since 2000 appear to be caused by the same strain of Bacillus anthracis and point to a common source, says a report in today's Eurosurveillance. German and Norwegian scientists write that injection-drug-related anthrax was first identified in a heroin user in Norway in 2000. In 2009 and 2010, 52 new anthrax cases among heroin users were reported in the United Kingdom and 3 in Germany. Ten additional cases in this outbreak were reported in 2011 and 2012 from Germany, Denmark, France and the United Kingdom. The researchers analyzed isolates from 2009-10 and 2012 as well as from the 2000 case using comparative molecular typing. "Our results show that all cases may be traced back to the same outbreak strain. They also indicate the probability of a single source contaminating heroin and that the outbreak could have lasted for at least a decade," the authors write. They also mention that a German serologic pilot study in 2011 failed to uncover additional anthrax cases among 388 heroin users.
Mar 28 Eurosurveillance report

ECDC sees worrying drug-resistant gonorrhea patterns
New Neisseria gonorrhoeae susceptibility surveillance data released by European health officials yesterday shows worrying patterns, despite a slight drop in specimens showing drug resistance. The report released by the European Centre for Disease Prevention and Control (ECDC) covers testing in 2011 by 21 countries. The proportion of isolates that showed decreased susceptibility to cefixime in 2011 was still high, at 7.6%, but was down from 8.7% in 2010. The ECDC said four countries reported reduced susceptibility to cefixime for the first time, and for the first time 10 isolates showed resistance to ceftriaxone, another recommended treatment for gonorrhea. Although overall resistance to ciprofloxacin and azithromycin has continued to decrease since 2009, testing identified two isolated that were highly resistant to azithromycin. In 2012 concerns about drug-resistant gonorrhea prompted the ECDC to release a response plan that includes improvements in surveillance, lab capacity and training, detection of treatment failures, and awareness.
Mar 27 ECDC press release
Mar 27 ECDC surveillance report

German study finds 2009 H1N1 more severe in second season
A German analysis of patients hospitalized with 2009 H1N1 (pH1N1) flu during the pandemic year and the first post-pandemic year found that severe illnesses and deaths jumped dramatically the year after the pandemic. Researchers who conducted a retrospective study on patients hospitalized with lab-confirmed flu at University Hospital Heidelberg during the two seasons published their findings yesterday in Emerging Infectious Diseases. They identified 102 patients with pH1N1 infections during the 2009-10 season and 76 in the first post-pandemic season. The proportion of severe illnesses rose from 14% the first year to 46% the second year, and the mortality rate rose from 5% to 12%. Patients hospitalized during the post-pandemic season were older, at an average age of 38 compared with age 18 during the pandemic year. Those hospitalized during the second year were also more likely to have an underlying medical condition. Researchers noted that there weren't any virus changes that were known to account for the change in clinical pattern and that it's not unusual for trends to change from a pandemic season to the following one. They suggested that the increase in severity could reflect the effects of pH1N1 on remaining susceptible adults and risk groups.
Mar 27 Emerg Infect Dis report

CDC reports three imported rubella syndrome births for 2012
Though rubella and congenital rubella syndrome (CRS) have been eliminated from the Unites States since 2004, rare cases of CRS are occasionally reported. Researchers from the US Centers for Disease Control and Prevention (CDC) and their state health partners today described the three most recent cases in the latest issue of Morbidity and Mortality Weekly Report (MMWR). The three babies were all born in 2012, in Maryland, Alabama, and Illinois. All had severe defects, and one of the babies died about a month after birth. Testing and maternal histories all suggested that the cases were linked to the mothers who weren't vaccinated and were pregnant when they were likely exposed to the virus in African countries in which the disease still circulates. Researchers noted that CRS cases are a public health concern, because infants with CRS can shed the virus for several months. They also wrote that the cases underscore the importance of considering CRS when a baby is born with birth defects compatible with the condition to mothers who were in rubella-endemic countries while pregnant. Providers should also be vigilant about the vaccination status of women of childbearing age who plan to travel overseas.
Mar 28 MMWR report

HPA, GSK sign next-generation polio vaccine deal
The UK Health Protection Agency (HPA) announced today that it has signed an agreement with GlaxoSmithKline (GSK) to develop a new polio vaccine, according to an HPA statement. Polio eradication plans include transitioning from the current oral polio vaccine to a new inactivated version, and the HPA said its researchers have developed genetically stable strains that allow a simpler production process that would enable the inactivated vaccine to be produced in developing countries, making the vaccines cheaper and more accessible. The agreement allows the HPA to contribute to polio eradication while securing a commitment from a major company to develop the new technology, according to the statement.
Mar 28 HPA statement

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