News Scan for Oct 28, 2014

Another Saudi MERS case, 2 deaths
More EV-D68 cases, genome study
EU antimicrobial initiative

MERS cases in Saudi Arabia reach 780 with 333 deaths

One new case of MERS-CoV and two deaths since yesterday bring Saudi Arabia's totals to 780 and 333, respectively, the nation's Ministry of Health (MOH) announced today in another of what have become nearly daily updates.

The new case-patient is a 53-year-old man in Riyadh who is being treated in an intensive care unit. He is not a healthcare worker and has had no animal exposures or contact with infected people, although he does have preexisting disease.

The MERS-CoV (Middle East respiratory syndrome coronavirus) patients who died in the past 24 hours were a 70-year-old man in Riyadh and a 90-year-old woman in Jeddah. Both had preexisting diseases, and neither was a healthcare worker.

Two Saudi patients who had active disease have recovered, according to today's update, bringing the total recoveries to 435 and leaving 12 active cases in the country. The patients are a 46-year old man from Medina and a 37-year-old man from Taif.

An MOH news release today says 38 confirmed cases have been reported since Sep 5, with 17 in Taif. The Taif cluster began with people who had unprotected contact with camels or drank camel milk and then came in contact with others, including healthcare workers, says the agency. The recent uptick in cases follows a summer slowdown, and the MOH "expects to see more cases in the coming days and weeks," according to Dr. Anees Sindi, deputy commander of MOH's Command & Control Center.

Strict protocols for treating MERS-CoV patients have been developed by the MOH in collaboration with the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC). In addition, the ministry has set up a comprehensive disease surveillance system that gives real-time information on new cases and available hospital facilities.

Sindi said the MOH is taking aggressive action that "includes educating the public about the importance of avoiding close contact with camels and providing additional training for hospital workers on proper infection-control procedures."
Oct 28 MOH update
Oct 28 MOH news release


US EV-D68 cases top 1,100 as group publishes genetic analysis

The number of confirmed cases of enterovirus 68 (EV-D68) in the United States has reached 1,105 with 70 new cases, the CDC reported today, up from 1,035 yesterday.

Almost all the cases, which involve severe respiratory illness, have been in children, many of whom have asthma, the CDC said. The illnesses have occurred in 47 states and Washington, DC. The CDC expects numbers to decline by late fall.

Of the more than 2,000 specimens the CDC has assayed, about 40% have tested positive for EV-D68, and about a third have tested positive for a different enterovirus or a rhinovirus.
CDC EV-D68 outbreak page
CDC EV-D68 activity by state

In related news, a team from the Washington University School of Medicine in St. Louis sequenced EV-D68 viruses from St. Louis patients and found them similar to other viruses sequenced by the CDC this year, according to a letter yesterday in Emerging Infectious Diseases.

The researchers determined the complete coding sequence of one strain by using high-throughput sequencing of nucleic acid and generated partial-genome sequences from eight more samples. They found the viruses genetically very similar to isolates sequenced recently by the CDC that were from Missouri patients, as well as one from Thailand from a previous season.

Overall, the St. Louis viruses shared 97% to 99% sequence identity with other sequenced strains, and there was little genetic diversity among the nine viruses sequence.
Oct 27 Emerg Infect Dis letter


European consortium forms to tackle antimicrobial use and development

Eleven European countries will participate in a three-year initiative to define appropriate use for existing antibiotics and promote investment in research and development (R&D) for new ones, according to an Oct 27 press release from the University of Geneva.

The initiative, known as DRIVE-AB (Driving Reinvestment in R&D and Responsible Antibiotic Use), received €9.4 million (approximately $12 million US) in funding from the European Union Innovative Medicines Initiative, the alert said. DRIVE-AB brings together an international body of pharmaceutical experts from the academic, research, pharmaceutical, and biotechnology fields to define how the world's remaining effective antibiotics should be used.

The group will also create and test new economic models for pharmaceutical industry investment in developing new antibiotics, an area of R&D that has traditionally come with high risks and little benefit to pharmaceutical companies, according to the press release.

The WHO has declared antimicrobial resistance to be one of the three greatest threats to human health, yet only two new classes of antibiotics have entered the market in the last 30 years, the release said.
Oct 27 press release

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