News Scan for Dec 20, 2013

MERS treatment options, new cases
Chikungunya outbreak grows
Gain-of-function pushback

Experts say convalescent serum may be useful against MERS

A meeting of world experts last week concluded that convalescent serum—antibody-rich blood from survivors—may be a promising tool for treating Middle East respiratory syndrome coronavirus (MERS-CoV) infections.

A systematic review by Nottingham University researchers on the use of convalescent plasma in flu and SARS coronavirus cases "supported the conclusion that convalescent plasma is a particularly promising intervention that warrants careful clinical study in MERS-CoV infections," said a workshop summary report today from the World Health Organization (WHO).

The workshop, held Dec 10-12 in Geneva, involved clinicians experienced in caring for MERS patients and experts in various fields from affected countries: France, Jordan, Qatar, Saudi Arabia, Tunisia, the United Arab Emirates (UAE), and the United Kingdom. It was sponsored by the WHO and the International Severe Acute Respiratory and Emerging Infection Consortium.

The experts also noted that highly neutralizing antibody preparations against MERS-CoV, such as monoclonals and transgenic cow-derived human polyclonal antibodies, may offer additional therapeutic options. Also, tests are under way to determine what antiviral drugs may be effective against the virus.

The participants also agreed to work toward developing a regional clinical research network and agreed on conducting a feasibility survey, developing a multi-center retrospective case series and prospective clinical study, and other steps.
Dec 20 WHO workshop summary

In other MERS news, a 68-year-old man in Dubai, UAE, has contracted the disease, according to a report today from the UAE-based newspaper The National. The man, who has diabetes and chronic kidney failure, is hospitalized in intensive care, the story said.

In addition, Saudi Arabia today reported four more MERS-CoV cases, according to a machine-translated Saudi health ministry statement posted on the Avian Flu Diary blog by Michael Coston.

The brief, vague statement indicated that two of the patients are health workers, a third is a 53-year-old who has chronic diseases and is in intensive care, and the fourth was a 73-year-old who died of the illness.

The WHO's official MERS-CoV count, which does not include these new cases, is 165 cases, including 71 deaths.
Dec 20 The National story
Dec 20 Avian Flu Diary post


St. Martin chikungunya outbreak grows to 26 cases

Chikungunya cases on the French part of the island of St. Martin in the Caribbean have grown from 10 to 26 confirmed cases, according to a press release today from the European Centre for Disease Prevention and Control (ECDC).

The outbreak represents the first known indigenous transmission of chikungunya fever in the Americas. Twelve additional cases are listed as probable.

In addition, cases have been reported on the Dutch part of the island (3) and nearby Martinique (2), and 1 case that was imported from Martinique has been reported from Guyane, the ECDC said. Three foci of infection have been noted on St. Martin—Oyster Pound, Sandy Ground, and quartier d'Orleans—and more appear to be emerging.

The ECDC said in a Dec 11 risk assessment on chikungunya in the Caribbean that with increased travel over the holiday season, the risk of transmission would be high. St. Martin is a popular travel destination for Europeans. The organization stresses that clinicians and travel medicine clinics should be vigilant in assessing patients with suggestive symptoms who live in or have traveled to the Caribbean.

Chikungunya, a viral disease caused by an alphavirus from the Togaviridae family, is spread mainly by Aedes aegypti and A albopictus mosquitoes. When symptomatic, the disease typically causes fever and arthralgia, similar to dengue.
Dec 20 ECDC press release
Dec 11 ECDC risk assessment


Scientists call for meeting over gain-of-function research

In a Dec 18 letter to the European Commission, 56 scientists from the Washington, DC–based Foundation for Vaccine Research (FVR) and elsewhere around the world voiced concern over gain-of-function (GOF) research on avian flu and other viruses and called for the commission to hold a scientific briefing on the topic. The group also called on the commission to formally examine the risks and benefits of such research.

The letter was in response to an October letter from the European Society for Virology (ESV) that supported such research and voiced concern that the Dutch government had used European export regulations to regulate the dissemination of research results from a group of Dutch scientists. The FVR letter said its group took no stand on export licenses, "although we do understand the Dutch government's concern."

The FVR group took exception to several claims in the ESV letter, including a claim that GOF research has been used to "reproduce what nature already selected." Scientists wrote in the FVR letter that research by a group led by Ron Fouchier, PhD, in the Netherlands has produced H5N1 strains not seen in nature.

They also wrote that there is no compelling evidence that GOF studies can help predict natural viral evolution, lead to more effective vaccines, or help evaluate candidate drugs.

"Gain-of-function research into highly pathogenic microbes with pandemic potential has global implications for public health," said Ian Lipkin, of New York's Columbia University, in a Nature news story today. "We are not seeking to shut down all gain-of-function research, but asking that stakeholders meet to establish guidelines for doing it."

Lipkin is one of the signers of the letter.
Dec 18 FVR letter
Dec 20 Nature News story


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