News Scan for Dec 17, 2013

WHO confirms MERS cases
Anthrax vaccine on hold
Polio in Syria, Nepal
Pertussis exposures
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Two new WHO-confirmed MERS cases bring global count to 165

The World Health Organization (WHO) today confirmed the two most recent cases of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia, in 51- and 26-year-old women.

The agency offered a few new details in the cases, which were first reported by Saudi officials on Dec 5.

The 51-year-old, from Jawf province, got sick Nov 20 and had no reported contact with animals. She has an unspecified underlying chronic disease and was transferred to Riyadh for intensive care treatment.

The 26-year-old is a non-Saudi healthcare worker in Riyadh and has not had symptoms. She had contact with a 37-year-old patient who died of lab-confirmed MERS. The WHO reported his case on Nov 26.

The two cases bring the WHO's official MERS-CoV case count to 165, including 71 deaths. Of those cases, 132 have been in Saudi Arabia, including 55 fatalities.
Dec 17 WHO update


FDA puts anthrax vaccine SparVax on hold again; reasons unclear

PharmAthene, Inc., the developer of SparVax anthrax vaccine, has been notified by the US Food and Drug Administration (FDA) that the program has been placed on clinical hold, according to a press release yesterday from the company.

A Phase 2 clinical trial of SparVax, a next-generation recombinant protective (rPA) anthrax vaccine, was expected to begin by the end of the year. No subjects have been enrolled in this trial to date, meaning no adverse events have been reported. The FDA told PharmAthene that it would detail reasons for the hold within 30 days, says the release

The FDA earlier put a hold on the trial, in August 2012, when it asked for additional stability data, says a story yesterday in the Wall Street Journal (WSJ); that hold was lifted in May. SparVax has undergone three earlier Phase 1 and Phase 2 clinical trials that involved 770 human subjects, says the WSJ story.

PharmAthene, of Annapolis, Md., is a biodefense company focused on developing medical countermeasures biological and chemical threats. Its markets include civilian, military, and non-US populations.
Dec 16 PharmAthene press release
Dec 16 WSJ article


Syrian province excluded from polio vaccinations, Nepal nears polio-free status

A province in war-torn Syria, a country that has seen polio cases this year for the first time since 1999, was purposely excluded by the country's government from a vaccination campaign launched in December 2012 that the WHO, the UN Children's Fund (UNICEF), and the Syrian Ministry of Health said at the time was intended to reach all children under 5 years of age, an investigation by Reuters has found.

The province, Deir al-Zor, is largely held by rebels and was left out of the vaccination program because the government claimed most its 1.2 million residents had moved elsewhere. Hundreds of thousands of people were still there, however, Reuters reported today.

The WHO reported 13 polio cases in the province in November, and at least 2 more have occurred since then. The virus has been found in Aleppo city and near Damascus as well.

"With the breakdown of the health system, sanitation and nutrition, the exclusion of Deir al-Zor from the vaccination campaign provided the ideal conditions for an outbreak to occur," said WHO official Chris Maher. He noted that 67,000 young children in the province were reportedly vaccinated in January of this year, and public health sources say the coverage rate is about 50% there. However, repeated vaccinations and higher coverage rates are needed to interrupt polio transmission.
Dec 17 Reuters story on Syria

Meanwhile, Nepal has not seen a polio case in 3 years, says a story today on a Nepali news portal. The last case there was in August of 2010.

Two 1-day "polio vaccination camps" are scheduled in the country for children under 5 in December and January in an effort to keep Syria polio-free. More than 80,000 health workers are expected to administer polio vaccine drops to more than 4 million children.
Dec 17 story

Study: Health workers often exposed to pertussis in peds units

A study of healthcare workers (HCWs) in a large US pediatric care network revealed more than 100 exposures a year to pertussis, with more than three-fourths occurring in emergency departments or ambulatory sites.

Researchers analyzed data from a quaternary pediatric care network from Jan 1, 2002, through Jul 18, 2011. They noted 1,193 confirmed HCW pertussis (whooping cough) exposures, 38.8% involving exposure to infants younger than 6 months. Seven exposures were to fellow HCWs.

Fully 77.5% of exposures happened in the emergency department or ambulatory site, and 27.0% occurred after documented infection prevention and control (IPC) precautions were initiated.

The authors conclude, "Occupational exposures to pertussis occur frequently in pediatric health care settings despite appropriate IPC guidelines."
Dec 16 Pediatrics abstract

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