TB Scan for Mar 17, 2015

News brief

Europe reports declining TB rates, but MDR-TB at high levels

The incidence of tuberculosis (TB) is declining in Europe, but the continent still sees 1,000 new cases a day and drug-resistant TB remains at high levels, the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization's Regional Office for Europe (WHO Europe) said in a joint surveillance report today.

An estimated 360,000 Europeans developed TB in 2013, a drop of 6% compared with 2012, the agencies reported. But rates of multidrug-resistant TB (MDR-TB) remain at very high levels, particularly in the 18 high-priority nations, which see 85% of all new TB cases in the WHO's European Region. These countries accounted for most of the 38,000 TB-related deaths in 2013.

"MDR-TB is still ravaging the European Region, making it the most affected area of the entire world," said Zsuzsanna Jakab, PhD, WHO Regional Director for Europe, in a WHO Europe press release. "Only 50% of MDR-TB patients are found and half of them successfully cured. This calls for a considerable scaling up of access to safe, rational and efficient new TB drugs."

"At the current pace of an annual 6% decline, the [European Union/European Economic Area] will only be free of TB in the next century," said ECDC Director Marc Sprenger, MD, PhD. "In order to achieve elimination by 2050, for example, we would have to cut down cases at least twice as fast."
Mar 17 WHO Europe press release
Mar 17 ECDC/WHO Europe TB report

CDC study says new screening has aided immigrant TB detection

In related news, the US Centers for Disease Control and Prevention (CDC) today published a report in the Annals of Internal Medicine that said, because of screening guidelines issued in 2007, physicians overseas diagnosed 629 additional TB cases in immigrants in 2012 that otherwise might have been missed.

Before 2007, immigrants and refugees were screened for TB using a smear-based algorithm that could not diagnose smear-negative/culture-positive TB.

CDC researchers analyzed data from 1,650,961 immigrants who were screened by the smear-based algorithm and 1,561,460 who were screened by the newer culture-based algorithm. Although the annual number of TB cases detected from 2007 to 2012 decreased from 1,511 to 940, the annual number of smear-negative/culture-positive TB cases diagnosed increased from 4 to 629.

"The results of this study showed that the updated overseas screening guidelines led to a roughly one-third decrease in the number of TB cases among foreign-born persons within their first year in the United States," the CDC said in a news release yesterday.
Mar 17 Ann Intern Med study
Mar 16 CDC news release

News Scan for Mar 17, 2015

News brief

Saudi Arabia reports another MERS case

Saudi Arabia's Ministry of Health (MOH) today reported a new MERS-CoV case, continuing the steady stream that began early this year.

The MERS-CoV (Middle East respiratory syndrome coronavirus) case involves a 73-year-old male Saudi national in Riyadh who is hospitalized in critical condition. He had no recent animal exposure or contact with MERS cases in the community, but possible contact with MERS cases in the healthcare setting is under investigation.

He is not a healthcare worker and had preexisting disease, the MOH said.

The agency also reported that a 51-year-old male expatriate in Khobar has recovered from the disease. He also is not a health worker and had preexisting disease.

The new cases bring the total for March to 38 so far, compared with 75 in all of February. Since 2012 the country has confirmed 958 MERS-CoV cases with 416 deaths. Twenty-five patients are still being treated or are in home isolation, and 517 have recovered.
Mar 17 MOH update

Feds seek public comment on impact of select agent rule

As part of a federal review of select agent regulations that began last August, the National Security Council and the White House's Office of Science Technology and Policy yesterday invited the public to comment on the impact that the current rules have on science, technology, and national security.

According to a Federal Register notice, a fast-track committee is reviewing the impacts of the select agent regulations and will weigh options to address challenges and gaps that come out of the feedback. Public comments must be received by 5 pm Eastern time on Mar 30 to be considered.

Federal officials are also holding a series of stakeholder listening sessions, the first of which was held on Feb 17.

The select agent review comes in the wake of several lab biosafety incidents, and in the federal memo last August announcing a review of policies, federal official asked federal agencies and departments that conduct life sciences research to take immediate and long-term steps to address the underlying causes of recent incidents and to strengthen overall biosafety.
Mar 16 White House press release
Mar 16 Federal Register notice
Aug 29, 2014, CIDRAP News scan on biosecurity review