News Scan for Jul 28, 2014

Fist bump for hygiene
H5N8 in Korea
Oral drugs for hepatitis C
Saudi MERS update

Study: Replace handshake with fist bump for hygiene

Significantly fewer infectious organisms are transferred through a fist bump than through a handshake or even a "high five," so fist bumps would be a more hygienic way of greeting others, says a study from the United Kingdom released today in the American Journal of Infection Control, the journal of the Association for Professionals in Infection Control and Epidemiology (APIC).

The researchers had "greeters" don a sterile glove, immerse the gloved hand in a container of germs, allow the glove to dry, and then shake hands with, high-five, or fist-bump a recipient who wore a sterile glove. The recipients' gloves were immersed in a buffer solution and the bacteria washed into the buffer for counting.

The gloves that received the handshake had nearly twice as many bacteria on them as the ones receiving high fives, and the fist-bump gloves had significantly fewer than the high-five ones. Longer periods of contact and stronger grips were associated with more transmission of bacteria.

"Adoption of the fist bump as a greeting could substantially reduce the transfer of infectious diseases between individuals," said one of the authors in an APIC press release. This would be particularly important in the hospital setting, says the study.
Jul 28 J Am Infect Control article
Jul 28 APIC press release


H5N8 avian flu resurfaces in South Korea

Highly pathogenic H5N8 avian influenza was confirmed Jul 25 on a duck farm in South Korea, according to a Korea Joongang Daily story today, resulting in the culling of more than 40,000 birds on the farm and others in surrounding areas.

The farm is in Hampyeong county, which is in the southwestern province of South Jeolla. The virus was detected when sanitation officials conducted tests on the farm for approval of its products for sale, says the story. H5N8 was confirmed the same day.

In addition to destroying some 42,000 birds on the farm, about 2,000 chickens on another farm within a 500-meter radius were also killed, and transport of animals from farms within 10 kilometers of the infected farm were restricted.

The avian flu outbreak comes shortly before the Chuseok holidays in early September, when consumer demand for meat increases, and on top of discovery of foot-and-mouth disease in hogs at a farm in Uiseong County, South Gyeongsang.

South Korea had a series of H5N8 outbreaks in January and February, prompting the culling of millions of poultry, and at least one outbreak was reported in June.
Jul 28 Joongang Daily article
Related Jun 20 CIDRAP News item


Two regimens of oral hepatitis C treatment found effective

A pair of studies published today in The Lancet is adding to expectations that it may be possible to cure hepatitis C with oral-only drug regimens, which could replace the current standard treatment that involves months of injections along with an oral drug.

All-oral treatment of hepatitis C (HCV) genotype 1b infection with two direct-acting antiviral agents was effective in 90% of treatment-naive patients and only a slightly lower proportion of other hepatitis C patients, including those previously not responding to treatment, according to one of the studies.

The phase 3, multicohort study, called HALLMARK-DUAL, took place at 116 sites in 18 countries from May 2012 to October 2013. Volunteers included 307 treatment-naive subjects, 205 nonresponders, and 235 patients who were ineligible for and/or intolerant of other hepatitis treatments. The oral treatment comprised daclatasvir, 60 mg once daily, plus asunaprevir, 100 mg twice daily, for 6 months.

A sustained virologic response was seen in 80% of the treatment-naive cohort, in 82% of the previous nonresponders, and in 82% of the ineligible and/or intolerant group. Serious adverse events occurred in 6%, 5%, and 7% of the groups, respectively. No difference in efficacy was seen in patients with characteristics typically recognized as predicting a poor response, including cirrhosis.
Jul 28 Lancet study abstract
Jul 27 Lancet press release

In the other study, regimens consisting of 150 mg of simeprevir and 400 mg of sofosbuvir daily for 3 or 6 months with or without ribavirin were given to patients with chronic HCV who were treatment-naive or unresponsive to standard treatment.

A sustained virologic response 3 months after stopping treatment was apparent in 90% of patients receiving only the oral agents and in 94% of those receiving the agents plus ribavirin. Serious adverse effects were seen in only 2% of patients.
Jul 28 Lancet study abstract
Jul 27 Lancet press release
Nov 6, 2013, CIDRAP News article on oral HCV treatment


Saudi Arabia reports MERS-CoV death but no new cases

A female health worker in Saudi Arabia with MERS-CoV died over the weekend, according to a Saudi Ministry of Health (MOH) update yesterday, but the country has gone 18 days with no new cases.

The woman was 42 years old and an expatriate from the city of Jeddah.

A further update today shows that one patient under treatment, a 42-year-old man from Hofuf who is not a health worker, has recovered, bringing the MERS-CoV (Middle East respiratory syndrome coronavirus) totals for Saudi Arabia to 721 total cases. The number includes 395 recovered patients, 28 active cases, and 298 deaths.

The last new case in the country was reported Jul 10.
Jul 28 MOH update
Jul 27 MOH update
MOH MERS-CoV page with case count

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