News Scan for Oct 17, 2013

MERS case in Qatar
;
Limited flu vaccine impact in seniors
;
Potential flu drug
;
Feces odor as flu marker in ducks

Qatar reports another MERS case

A 61-year-old man in Qatar is being treated for a Middle East respiratory syndrome coronavirus (MERS-CoV) infection, according to a Qatar News Agency report today. The report marks the country's sixth case.

Qatar's Supreme Council of Health said the man, who has chronic illnesses, is being treated and is in stable condition, according to the story.

Investigators have learned that the man has not traveled outside Qatar recently and has not had contact with other MERS-CoV case-patients, the story said. His family members and other contacts have been tested for the virus, all with negative results.

The story did not mention the patient's home town or whether he had any recent contact with animals.

The last previous MERS-CoV case reported in Qatar involved a 56-year-old woman who died of her infection on Aug 31. Two other cases also were reported in August, and two were reported in the fall of 2012. One of the latter cases involved a man who got sick in Qatar in September 2012 and was treated in London but died there in June of this year.

The World Health Organization, which has not yet acknowledged the new case, listed a total of 138 MERS-CoV cases and 60 deaths in its latest update on Oct 14. Other groups have reported slightly higher numbers. FluTrackers, an online infectious disease message board, maintains a case list that currently shows 144 cases, including the new Qatari one.
Oct 17 Qatar News Agency story
Sep 4 CIDRAP News item on previous Qatari case
FluTrackers novel coronavirus case list

 

Study: Flu vaccine has limited impact on serious outcomes in seniors

A study designed to gauge the effectiveness of flu vaccine in older people, along with its ability to prevent serious outcomes, estimated that it reduced deaths by 22%when flu activity was moderate-to-high.

The study focused on adults age 65 and older in Ontario and covered 15 flu seasons, from September 1993 through September 2008. A research team from Ontario, the United Kingdom, and the US Centers for Disease Control and Prevention (CDC) published the findings yesterday in PLoS One.

The retrospective cohort study was designed to reduce confounders, such as frailty and dementia, and prevent biases such as the "healthy vaccinee effect."

The team analyzed weekly vaccination, hospitalization, and death records for 1.4 million seniors. They estimated vaccine effectiveness using models that took into account flu surveillance and temperature data. Goals were to determine the impact of the vaccine on three outcomes: all-cause deaths, deaths within 30 days of pneumonia or flu hospitalization, and pneumonia and flu hospitalizations.

During weeks when 5% of respiratory specimens tested positive for influenza A, estimated vaccine effectiveness was 22% for flu-linked deaths, 25% for deaths that occurred within 30 days of flu or pneumonia hospitalization, and 19% for flu- or pneumonia-related hospitalizations. Because only small proportions of these three outcomes were associated with flu, the authors estimated that the vaccine prevented 1.6%, 4.8%, and 4.1% of the outcomes, respectively.

Based on the findings and other studies that pointed to shortcomings in the flu vaccine for seniors, the researchers concluded that more effective flu vaccines are needed to prevent serious outcomes, especially in older people.
Oct 16 PLoS One study

 

Flu drug favipiravir to move into phase 3 trials

The investigational anti-influenza drug T-705A (favipiravir) will go into phase 3 clinical trials in November, according to a press release yesterday from the US Department of Defense (DoD). The drug is being developed by MediVector, Inc., under a contract with the DoD's BioDefense Therapeutics (BD-Tx).

Further testing of the drug follows successful completion of a phase 2, double-blind, placebo-controlled clinical trial in which twice-daily dosing resulted in significant decreases in the time to alleviation of six flu symptoms, the release said. The drug appeared to be safe and well tolerated, with no serious adverse effects, and subjects were able to clear it significantly faster than a placebo.

Army Lt. Col. Eric G. Midboe, joint product manager for BD-Tx, said in the release, "We are encouraged by this important achievement; it means BD-Tx is one step closer to providing the military and our nation with safe therapeutics to counter biological threats."

The drug is being developed to enhance the nation's biodefense response to a potential flu pandemic. It has been shown in vitro to be effective against a number of flu viruses, including H1N1, H5N1, H7N9, and drug-resistant strains.

Officials said favipiravir has a unique mechanism of action that involves blocking viral RNA replication within infected cells, giving it the potential to be a broad-spectrum drug.
Oct 16 DoD Medical Countermeasure Systems press release

 

Flu-infected ducks have distinct fecal odor, finds study

Avian influenza infection in ducks results in a distinct fecal odor, a finding that someday might lead to a surveillance tool to track the disease, which is often asymptomatic in animals but can have serious human health consequences.

The discovery came from experiments on mallards by researchers from the Monell Chemical Senses Center and the US Department of Agriculture, who published their findings yesterday in PLoS One.

The team used chemical and behavioral methods to detect the odor changes in infected birds. Chemical analysis found that chemical compounds linked to infection are acetoin and 1-octen-3-ol, which have also been identified as possible markers for gastrointestinal diseases in humans. Researchers also trained lab mice to tell the difference between the feces of infected and uninfected birds, which also indicates a change in odor.

Bruce Kimball, PhD, a study coauthor and USDA research chemist working at Monell, said in a press release that the distinctive odor change might "advertise" avian flu infection to other birds, warning them to stay away from sick ducks. However, he noted that the odor might benefit the pathogen by attracting other ducks.

The researchers said they will conduct further studies to assess if the odor changes can be used for surveillance, if the change is specific to avian flu or is a more generalized response to infection, and how such odors might influence social behavior in wildlife populations.
Oct 16 PLoS One study
Oct 16 Monell Chemical Senses Center press release

 

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