News Scan for Jul 09, 2015

News brief

Oral killed cholera vaccine shown 53% effective in real-life use

A large study in Bangladesh of oral killed whole-cell cholera vaccine found that it cut disease rates in half, even with moderate coverage, according to a report yesterday in The Lancet.

Bangladeshi and US researchers analyzed data on 267,270 participants; 94,675 received two doses of Shanchol vaccine (made by Shantha Biotechnics-Sanofi), 92,539 received the vaccine and made cholera-avoiding behavioral changes, and 80,056 received no intervention. Vaccine coverage was 65% in the vaccination-only group and 66% in the vaccination-plus-behavioral-change group.

For those who received two doses of the vaccine, total effectiveness was 53% in the vaccination-only group and 58% in the vaccination-plus-behavioral-change group at 2-year follow-up. The team also noted 37% overall protection against severely dehydrating cholera in the vaccine group and 45% overall protection against that form in the vaccine-plus-behavior-change group.

The authors conclude, "Our results show that even with moderate coverage, the incidence of severely dehydrating cholera was reduced by oral cholera vaccination in the study population, irrespective of vaccination status, when vaccine was administered via routine government services in a densely populated urban setting."

UK experts in an accompanying commentary wrote that although oral cholera vaccination has been shown effective in previous trials, the new study "showing its feasibility and effectiveness under real-life conditions, is a welcome step towards vaccine deployment in endemic settings."

The study was funded by the Bill & Melinda Gates Foundation.
Jul 9 Lancet abstract
Jul 9 Lancet commentary
May 29, 2014, CIDRAP News story "Study: Cholera vaccine worked well during outbreak"
Oct 18, 2013, CIDRAP News story "Cholera vaccine yields 5-year protection, finds acceptance"

 

Review of West Nile virus studies finds long-term effects common

Studies of West Nile virus cases suggest that muscle weakness, fatigue, pain, and cognitive effects persist in many patients for months or years, according to a systematic review published this week in The Lancet Infectious Diseases.

Researchers from Toronto found 67 studies that met their criteria, including 30 that looked at West Nile neuroinvasive disease (WNND) only, 4 that examined only West Nile fever (WNF), 30 that covered both forms of the disease, and 3 in which the diagnosis was unknown or not reported.

The most common lingering physical effects, reported in 24 studies, were muscle weakness, fatigue, and myalgia, the report says. For example, muscle weakness persisted in 7% to 73% of patients with WNND for 3 to 18 months, 12% to 24% of those with WNF for 1 to 6 months, and 7% to 73% of those in combined studies for 1 month to 8 years.

Similarly, fatigue was reported in 48% to 75% of WNND patients for 8 to 18 months, in 48% of WNF patients for 30 days, and in 20% to 84% of patients in combined studies for 1 month to 8 years. The percentages were somewhat lower for lingering myalgia, for example, 19% to 49% of WNND patients (6 to 12 months).

The most common cognitive or psychological sequelae, reported in 19 studies, were memory loss (in up to 59% of patients), depression (up to 41%), and difficulty concentrating (up to 48%). Problems with activities of daily living were common.

The authors said the studies involved a wide variety of methods, and more than half of those that reported sequelae relied exclusively on subjective assessments. "Therefore, opportunities exist for more robust primary studies," they concluded.
Jul 7 Lancet Infect Dis abstract

 

White House denies Iowa request for avian flu disaster declaration

The Obama administration has turned down Iowa Gov. Terry Branstad's request for a federal disaster declaration in response to the avian influenza outbreaks in the state, the Associated Press (AP) reported yesterday.

Branstad had asked for a major disaster declaration for the four counties hit hardest by the virus, the story said. The request was rejected in a letter dated Jul 7, which said the damage was "not of such severity and magnitude" that the state couldn't handle it.

Branstad spokesman Jimmy Centers told the AP that the administration was gathering information to assess whether an appeal of the decision would be effective. The state has lost more than 31.5 million birds to the virus and precautionary culling of flocks.
Jul 8 AP story

 

Beef slaughterhouse kill steps reduce Salmonella, E coli, FSIS says

Food safety measures at beef slaughter plants seem to be reducing levels of Salmonella and Escherichia coli on carcasses, Food Safety News reported today, citing federal data.

The US Department of Agriculture's Food Safety and Inspection Service (FSIS) last week released data from the first 6 months of surveys meant to establish baseline levels of the two pathogens on beef and veal carcasses. They showed drops in both Salmonella and E coli levels after interventions.

The FSIS found 24.5% of beef carcasses were contaminated with Salmonella immediately after slaughter and hide removal, but this dropped to 3.9% after a kill step such as a hot water or lactic acid wash. E coli O157:H7 prevalence dropped from 1.6% to 1.1% after the kill step, and non-O157:H7 E coli rates dropped from 8.4% to 1.8%, according to FSIS data.

"These results suggest that the interventions are reducing the pathogens on the beef and veal carcasses," the FSIS said. It plans to release an official report in 6 months, after a year of surveying.
Jul 9 Food Safety News story
Jul 2 FSIS update

Biosecurity Scan for Jul 09, 2015

News brief

GAO says US has been slow to implement biosurveillance strategy

The Obama administration has been slow to take recommended and promised steps toward a coordinated national biosurveillance strategy, the Government Accountability Office (GAO) said in a report released yesterday.

Following an earlier GAO recommendation, the administration released its National Strategy for Biosurveillance in July 2012, the report notes. The White House was to issue an implementation plan within 120 days of that, but it still had not done so as of last month, the GAO said.

The GAO, Congress's investigative arm, also faulted the administration's efforts on food and agriculture disease surveillance.

The report noted that in 2011 the GAO said the administration lacked coordination of efforts to implement the national food and agriculture defense policy, spelled out in Homeland Security Presidential Directive 9 (HSPD-9), which includes food and agriculture disease surveillance. In addition, the GAO said the US Department of Agriculture (USDA) had no overall strategy for handling its HSPD-9 responsibilities

Since then, the National Security Council has begun holding interagency meetings on HSPD-9 measures, and a report on the activities is expected this summer, the GAO reported. It said that by February of this year the USDA had analyzed its HSPD-9 efforts but had not developed an overall strategy.

The GAO also said the USDA's Animal and Plant Health inspection Service (APHIS) has broadened its disease surveillance program but has made only limited progress on aligning the program with overall national biosurveillance efforts.
Jul 8 GAO report on biosurveillance

 

Anthrax lab snafu update: 85 US labs now involved, Italy joins list

The number of US labs that were mistakenly sent live samples of Bacillus anthracis—the bacterium that causes anthrax—has increased by 7, to 85, and Italy has been added to the list of foreign countries affected, the Department of Defense (DoD) said in an update today.

The commercial, academic, and federal labs are in 20 states and the District of Columbia. They received live samples from the Dugway Proving Ground's Life Science Test Facility in Utah after insufficient methods were used to inactivate the bacteria. The DoD on Jun 29 had listed 78 labs.

In addition, labs in Japan, the United Kingdom, South Korea, Australia, Canada, and now Italy have received live B anthracis from the Utah facility. The biosafety lapse was first reported on May 28.

The DoD also said that 22 lab personnel are receiving post-exposure drugs as a precaution against anthrax, 15 of whom work for the DoD. Those numbers are down from 31 and 23, respectively.
Jul 9 DoD update
Jun 30 CIDRAP News scan on previous update

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