News Scan for Mar 30, 2015

Lack of good filovirus PPE data
Flu vaccine and disease severity
Novel tickborne parasite

Experts call for better filovirus PPE data

Filovirus experts who met a year ago say that evidence is lacking for recommending personal protective equipment (PPE) for health workers treating patients for diseases like Ebola and Marburg, and they outline several priorities for research, according to a report late last week in the Journal of Infectious Diseases.

The experts, who met Apr 3, 2014, at the Galveston National Laboratory in Galveston, Tex., included experts in filovirus virology, worker protection and protective equipment, epidemiologists, and outbreak response agencies. The group included scientists from industry as well as national and international public health agencies, and from Doctors without Borders (MSF), which convened the meeting.

Noting, "The limited evidence for the effectiveness of PPE used in filovirus outbreaks has led to choices being made with little empiric support," the group recommends as a high priority (1) testing gown, coverall, and hood materials in a biosafety level 4 lab; (2) conducting a non-human primate study to assess whether skin is an effective barrier; and (3) testing current PPE configurations in an environment simulating the typical outbreak setting.

"These three investigations would establish an improved evidence base for selecting PPE for use in filovirus epidemics that would provide sufficient protection from the virus while minimizing the risk of heat illness in the wearer," the authors write.
Mar 27 J Infect Dis report


Flu vaccine not strongly linked to less severe symptoms

Public health officials have suggested this year that the flu vaccine, while not providing much protection against influenza, might at least reduce the severity of symptoms. But a new study showed that might not be the case in older adults

The study in the Journal of Infectious Diseases showed that flu vaccine at best might reduce disease severity in a subset of the patients studied.

US researchers, including some from the Centers for Disease Control and Prevention, analyzed data on vaccination and flu severity from the Hospitalization Surveillance Network (FluSurv-NET) data for the 2012-13 flu season. The found no differences in severity between unvaccinated and vaccinated persons when they used a multivariable logistic regression model to compare the two groups.

When the used propensity score matching, however, they noted that vaccinated adults aged 50 to 64 had a shorter length of stay in the intensive care unit compared with their unvaccinated counterparts. That difference did not hold, though, for other age-groups.

A study early last year in Vaccine found flu vaccine over eight seasons in adults 20 and older was not associated with reduced odds of hospital admission.
Mar 27 J Infect Dis abstract
Jan 16, 2014, Vaccine


Chinese team reports novel tickborne Anaplasma species

Chinese researchers have identified a new strain of tickborne Anaplasma species that infects humans and goats in China, according to a report yesterday in The Lancet Infectious Diseases.

The team collected blood samples from patients who had a history of tick bite in the preceding 2 months at a hospital in Heilongjiang province from May 1 to Jun 10, 2014. They found that 28 of 477 patients (6%) were infected with a novel strain of Anaplasma that differed from the A phagocytophilum and A ovis species known to infect people.

Because the parasite also infects goats, the investigators dubbed it Anaplasma capra.

All 28 patients developed non-specific febrile manifestations, including fever in 23, headache in 14, malaise in 13, dizziness in 9, myalgia in 4, and chills in 4. Ten had rash or eschar, 8 had lymphadenopathy, 8 had gastrointestinal symptoms, and 3 had stiff neck. Five patients were hospitalized because of severe disease.
Mar 29 Lancet Infect Dis abstract

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