News Scan for Jun 12, 2014

Chickungunya vaccine
vCJD blood test
Sepsis and latent viruses

Early results from chikungunya vaccine trial called promising

An Austrian pharmaceutical company today reported promising findings from a phase 1 study of its candidate chikungunya vaccine. The vaccine, which uses a standard measles vaccine vector, induced a significant neutralizing immune response and appeared to be safe, according to a press release from the Vienna-based company, Themis Bioscience.

The results are based on a study of 42 people that was conducted at Vienna General Hospital. Themis said the vaccine prompted the required immune response, even at the lowest dose, and that increasing dosages led to even stronger immune responses.

Currently, there are no vaccines to protect against chikungunya illness, a mosquito-borne disease that has been triggering outbreaks for the first time in Caribbean nations and territories.
Jun 12 Themis Bioscience press release

In other developments, the US Virgin Islands yesterday reported its first locally acquired chikungunya case and North Carolina reported its first imported infection, according to media reports.

Public health officials in the US Virgin Islands have confirmed the first locally transmitted case but did not detail any information about the patient, the Associated Press (AP) reported yesterday. Earlier this month the territory reported its first imported case, a traveler who returned to St Thomas after a Caribbean cruise.

Elsewhere, the North Carolina Department of Health and Humans Services said today that the first imported case has been detected in the state, in a resident who had recently traveled to the Caribbean, according to report today from the AP.

An increasing number of US states have reported imported chikungunya cases, with many of them in Florida. The US Centers for Disease Control and Prevention (CDC) has warned that more cases are likely to be reported in the wake of the Caribbean outbreak. The nation's number of imported cases so far this year appears to have passed the average number of cases reported in a typical year, which is about 27.
Jun 11 AP story
Jun 4 US Virgin Islands health department press release
Jun 12 AP story


Encouraging results for another prion blood assay

French researchers today described a test that can detect prions in humans infected with variant Creutzfeldt-Jakob disease (vCJD) and in animals that are in the early asymptomatic phase of the disease. The team reports its findings in PLoS Pathogens.

They developed their assay after optimizing a method that mimics the method that misfolded toxic prions use to propagate.

In exposed sheep and macaques, the test accurately identified the infections and detected vCJD prions in infected macaques shortly after initial infection. In blinded testing of the blood of four infected humans and 141 noninfected controls, the assay identified vCJD in three of the four infected patients and had no false-positives in the controls.

The team said the findings show progress toward a vCJD blood test that might someday be used to identify infected asymptomatic people or for screening donated blood.

Earlier this year, another research team reported results from a large trial of another test to detect abnormal prion protein associated with vCJD. The group said the test performed well enough for use in screening populations for the disease. Their findings appeared in the Mar 3 issue of the Journal of the American Medical Association (JAMA) Neurology.
Jun 12 PLoS Pathog abstract
Jun 12 Ecole Nationale Veterinaire de Toulouse press release
Mar 5 CIDRAP News scan "Study: vCJD blood test accurate enough for large-scale screening"


Surprising number of viruses found in critically ill septic patients

Reactivation of latent viruses is extremely common in patients with prolonged late-stage sepsis and may justify the use of immune-adjuvant drugs along with antibiotics, according to the results of a study published yesterday in PLoS One.

The researchers used polymerase chain reaction to test for viruses in the blood and urine of 560 critically ill hospitalized patients with sepsis and compared results with those from 101 critically ill hospitalized patients without sepsis and 164 healthy controls who were having outpatient surgery.

They found more viruses than expected in the septic patients: Overall, 42.7% had two or more viruses detected. The authors note that this number may underestimate viruses because not all patients were tested for all viruses. In a subgroup of 209 patients tested for all viruses, 54% showed two or more.

The virus detection rate increased with the duration of stay in the intensive care unit (ICU). In addition, the number of viruses detected correlated with the severity of illness, the frequency of secondary fungal and bacterial infections, and longer stays in the ICU.

Research has suggested that when sepsis is prolonged, the initial, hyperinflammatory phase may progress to a predominantly immunosuppressive phase. The present authors note that their research does not answer "whether the increased viral reactivation with sepsis is merely a marker of impaired immunity or contributes to sepsis morbidity/mortality" and encourage further research into this question.
Jun 11 PLoS One study
Jun 11 PLoS press release

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