News Scan for Dec 04, 2013

News brief

Fourth UCSB student sickened in meningitis outbreak

Testing has confirmed that a fourth undergraduate student has been infected in a meningococcal disease outbreak involving the less common serogroup B at the University of California at Santa Barbara (UCSB), according to a Dec 2 statement from the Santa Barbara County Public Health Department (SBCPHD). All four students were sickened within 3 weeks in November.

The health department said one of the cases resulted in a permanent disability. That student is an 18-year-old freshman lacrosse player who is hospitalized in San Diego after his feet were amputated due to severe sepsis, the Associated Press (AP) reported yesterday.

Outbreak response steps have so far included providing antibiotics to more than 500 close contacts of the four students, distributing information on the disease to UCSB students and staff, raising awareness among the state's health providers, and staying in close contact with the US Centers for Disease Control and Prevention.

The SBCPHD also said it is making more intensive efforts this week to identify people in the students' social networks for supervised antibiotic prophylaxis, and it said campus social events, such as parties sponsored by Greek organizations, are being suspended to curb disease transmission.

A similar outbreak from serogroup B meningococcal disease has sickened eight students at Princeton University, which will host an immunization campaign targeted to the strain starting Dec 9. The outbreak strain is not covered in US meningococcal vaccines, and federal health officials have approved the use of an imported vaccine and the plan to vaccinate those in certain risk groups at Princeton. Officials don't believe the two outbreaks are related.
Dec 2 SBCPHD press release
Dec 3 AP story
Nov 27 CIDRAP News story "CDC clears Princeton's meningococcal vaccine campaign"

 

UN: $12 billion in pledges to Global Fund reflect worldwide solidarity

Pledges to the Global Fund to Fight AIDS, Tuberculosis, and Malaria for the next 3 years have increased sharply, to $12 billion, over the last 3-year commitment period, says a news item from the United Nations. The previous funding period, covering 2010 to 2013, saw funding commitments of $9.2 billion.

The new pledges "are a demonstration of global solidarity and trust to move towards ending the three diseases," said Michel Sidibe, executive director of the Joint United Nations Programme on HIV/AIDS, speaking on behalf of UN Secretary-General Ban Ki-moon at the fourth replenishment meeting for the Global Fund, held in Washington, DC.

Sidibe noted that the impressive results against AIDS, tuberculosis (TB), and malaria to date remain fragile because of such factors as the increase in drug-resistant TB but that the work financed by the Global Fund "remains a lifeline for millions." The UN story says that shared responsibility worldwide has grown, as illustrated by the fact that domestic spending on HIV in 2012 amounted to about 53% of total HIV resources.

The United States has made a commitment to the Global Fund of up to $5 billion for the 2013-16 period.
Dec 3 UN News Service story
Dec 3 CIDRAP News scan on US commitment

In related news, a partnership was announced today between the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) and the Global Fund to aid in preventing harm from fake medicines worldwide.

A news release from IFPMA says that although such medicines likely account for only 1% of medication market value in high-income countries, that figure rises to 10% globally, and up to a third of malaria medicines in Africa may be counterfeit.

The partnership will build on Fight the Fakes, a public service campaign launched last month to encourage organizations and individuals to spread the word about these drugs. IFPMA Director General Eduardo Pisani said that sale of counterfeit drugs "poses a public health risk that can lead to treatment failure, antibiotic resistance, extended illness, disability, and even death."
Dec 4 IPFMA press release
Fight the Fakes Web site

Flu Scan for Dec 04, 2013

News brief

Hong Kong initiates border monitoring, quarantine over H7N9 case

Authorities are monitoring incoming travelers for disease and have quarantined 17 close contacts of the first H7N9 avian flu patient identified in Hong Kong, its Centre for Health Protection (CHP) said today in a statement.

"All border control points (BCPs) have implemented disease prevention and control measures. Thermal imaging systems are well in place at BCPs for body temperature checks of inbound travellers," a spokesman for Hong Kong's Department of Health said in the statement.

Officials have identified 17 close contacts and more than 220 other contacts, the CHP statement said. The close contacts include 10 home contacts, including 4 with nonspecific symptoms, a friend who traveled to Shenzhen with the case-patient, and 6 patients who stayed in the same cubicle with the female 36-year-old H7N9 patient in Tuen Mun Hospital.

The close contacts were prescribed the antiviral drug oseltamivir (Tamiflu) as a precaution, and all tested negative for H7N9 on preliminary lab tests. Asymptomatic close contacts will live in a designated quarantine village for 10 days since their last contact with the index patient, who is a domestic helper from Indonesia.

The other contacts are being monitored and have been offered oseltamivir, the CHP said.

The agency said travelers who return to Hong Kong with a fever or respiratory symptoms, especially from H7N9-affected areas, should seek medical attention.

In a separate government statement today, Ko Wing-man, MBBS, secretary for food and health, said the risk of a community H7N9 outbreak in Hong Kong was low.
Dec 4 CHP statement
Dec 4 Hong Kong government statement


Tests weigh threat from former H2N2 pandemic flu virus

Experiments involving an avian H2N2 flu virus that caused a pandemic in the late 1950s and still circulates in birds found that it can infect mammalian cells and spread in ferrets, though it lacks the genetic markers for human adaptation, according to a study in the Journal of Virology. The goal was to assess the risk of the H2N2 virus, which hasn't been seen in humans since 1968.

Researchers from St. Jude Children's Research Hospital in Memphis analyzed 22 H2N2 viruses obtained from domestic and wild poultry from 1961 to 2008, the most comprehensive analysis so far of the virus. They found that the viruses haven't changed much since when H2N2 circulated as a pandemic strain. Most of the isolates they looked at replicated in mouse and human bronchial epithelial cells but showed little ability to replicate in swine tissues.

Several isolates replicated well in ferrets, and three spread through direct contact in the animals. Researchers classified one of the three strains, which was isolated in 1979 from a duck in Hong Kong, as having high pandemic potential. But no ferret-transmissible H2N2 strains spread by the airborne route.

Isolates still had a preference for cells in avian respiratory tracts, the team wrote, and the team's antiviral susceptibility tests found that all of the viruses were susceptible to neuraminidase inhibitors and adamantanes.

Co-author Jeremy Jones, PhD, said in a St. Jude press release that although the viruses appear avian, the study found that they can behave like mammalian flu strains. "That is troubling, because some of the H2N2 pandemic viruses looked avian when the pandemic began in 1957, but in a few short months, all of the isolated viruses had picked up the genetic signatures of adaptation to humans," he said. Jones added that the pattern could recur if the viruses jump from birds to humans again.

The group concluded that the greatest threat would be to people under age 50 who have no previous exposure to the virus. They also observed that isolates' close similarity to an H2N2 pandemic vaccine candidate could suggest that another outbreak in humans might be mitigated by a vaccine, though the changes in the virus warrant close surveillance.
Dec 2 St Jude press release
Nov 13 J Virol abstract

 

Low-path avian flu outbreaks reported in Taiwan, Germany, Portugal

Three outbreaks of low-pathogenic avian flu have affected poultry in Taiwan, Germany, and Portugal, according to reports filed with the World Organization for Animal Health (OIE).

In Taiwan, "third round surveillance" detected low-pathogenic H5N3 avian flu viruses in 20 ducks yesterday at a meat-type farm of 10,000 birds in Yuli township of Hualien County. Surveillance was being conducted after an August H5N3 outbreak in the vicinity.

The ducks showed no signs of clinical illness, and no culling was done to prevent disease spread.

In Germany, 20 laying hens tested positive for H5N3 on a farm of 130 birds in Baden-Wurttemberg state. The hens were culled yesterday, and ostriches on the farm will also be destroyed, according to the OIE report.

In Portugal, a low-pathogenic H7 strain was detected in Baixo Alentejo province during routine surveillance in a backyard flock of 63 birds—36 broilers, 18 chickens, 6 guinea fowl, and 3 ducks. All birds were destroyed, and a 1-kilometer restriction zone has been established.
Dec 3 OIE report on Taiwan
Dec 3 OIE report on German outbreak
Dec 2 OIE report on Portugal

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