News Scan for Jul 23, 2015

MERS in Saudi Arabia
;
H5N2 vaccine in chickens
;
Experimental Marburg drug
;
Klebsiella in retail meat
;
Epidemic threat poll
;
EV-D68 rapid test

Saudi MERS total grows by four

Middle East respiratory syndrome coronavirus (MERS-CoV) has sickened four more people in Saudi Arabia in the past 2 days, one of them fatally, according to reports from the country's Ministry of Health (MOH).

Three of the patients are from Riyadh, and one is a 60-year-old woman from Rania-Altaif in the southwestern part of Saudi Arabia. Patients in Riyadh include a 52-year-old Saudi woman who died from her illness. The others are a 54-year-old foreign man and a 56-year-old Saudi man.

None are healthcare workers, and three of them had no known contact with a suspected or confirmed case in the community in the hospital. Possible links to contacts for the foreign man are still under investigation.

Saudi health officials also announced three deaths in previously reported cases, all of whom had preexisting medical conditions. One more patient has recovered from his MERS-CoV illness, a 93-year-old man.

The new developments lift Saudi Arabia's overall disease totals to 1,053 cases, 465 deaths, and 581 recoveries. Seven people are still being treated for their infections.
Jul 22 Saudi MOH update
Jul 23 Saudi MOH update

 

USDA chief says new H5N2 vaccine works well in chickens

The head of the US Department of Agriculture (USDA) said yesterday that a vaccine his department developed for H5N2 avian influenza has tested "100% effective" in chickens and is now being tested in turkeys, according to the Associated Press (AP).

If the vaccine also works well in turkeys, the USDA plans to quickly license it for production, and the agency is seeking funding from the Office of Management and Budget to stockpile it, Agriculture Secretary Tom Vilsack told the House Agriculture Committee.

The H5N2 virus and resulting culling of flocks killed 48 million poultry during the spring and early summer, mostly in Iowa and Minnesota. No more outbreaks have been reported since mid-June, but experts are concerned that the virus may return in the fall, when migratory birds, which can carry it without getting visibly sick, head south.

"Hopefully we'll be able to get a lot of folks working collaboratively together and we stockpile enough [vaccine] so that if this does hit and hits us hard we're in a position to respond quickly," Vilsack said, according to the AP.

If the virus does return, use of the vaccine isn't a given, because it could badly hurt US poultry exports. As noted in the story, many countries refuse to accept poultry from nations using an avian flu vaccine because it can be difficult to discern through testing whether birds were infected or vaccinated. Sometimes vaccinated birds can become infected without getting sick, and thus can spread the virus silently.

The AP story noted that poultry farmers don't all agree on whether to use a vaccine. Turkey producers tend to favor vaccination to protect flocks because turkeys appear more vulnerable to viruses, but egg producers and farmers who raise broiler chickens often resist vaccination programs because of the possible impact on export markets.

Vilsack said any vaccination program would not begin until the USDA, consulting with affected states, decided it was necessary to control an outbreak, according to the AP.
Jul 22 AP story
Related Jul 8
CIDRAP News story

 

Study finds experimental Marburg drug protective in monkeys

An experimental antiviral drug protected monkeys against Marburg virus—a close relative of Ebola—and was shown safe in a phase 1 human trial, according to a study today in the New England Journal of Medicine.

The research was conducted by the US Army Medical Research Institute of Infectious Diseases (USAMRIID) and the biotechnology firm Sarepta Therapeutics, Inc., using a compound known as AVI-7288.

Researchers exposed cynomolgus macaques to Marburg virus and then administered one of three treatments: AVI-7288 in varying doses, an inactive placebo, or a saline control.

Survival was 0%, 30%, 59%, 87%, 100%, and 100% at AVI-7288 doses of 0 milligram (mg), 3.75 mg, 7.5 mg, 15 mg, 20 mg, and 30 mg per kilogram of body weight, respectively. None of the monkeys treated with a placebo or the saline control survived.

In addition, a dose of 15 mg per kilogram per day for 14 days starting at 24, 48, and 96 hours after viral challenge provided 83%, 100%, and 83% protection, respectively. Those findings demonstrated effectiveness even if drug administration was delayed.

The phase 1 clinical trial involved 40 healthy people who received AVI-7288 at up to 16 mg per kilogram per day. The researchers noted no significant safety concerns or dose-dependent side effects.

"These results have allowed for detailed modeling to predict a human dose of AVI-7288 that could reasonably be expected to protect humans exposed to Marburg virus," said senior author and USAMRIID Science Director Sina Bavari, PhD, in a USAMRIID press release.
Jul 23 N Engl J Med study
Jul 22 USAMRIID press release

 

Study indicates Klebsiella may be significant foodborne pathogen

Almost half of retail chicken, turkey, and pork products tested positive for Klebsiella pneumoniae, a common cause of gastrointestinal illness, the first indication that the bacterium may be a significant foodborne pathogen, according to a study yesterday in Clinical Infectious Diseases.

US researchers sampled products sold in nine major grocery stores in Flagstaff, Ariz., in 2012 and also analyzed urine and blood samples taken from Flagstaff-area patients in 2011 and 2012. They found that 47% of the 508 meat products harbored Klebsiella—and many of the strains were resistant to antibiotics. They also determined that 10% of the 1,728 positive cultures from patients were Klebsiella, including drug-resistant strains.

Whole-genome sequencing revealed that isolate pairs from the meat and from patients were nearly identical.

"This study is the first to suggest that consumers can be exposed to potentially dangerous Klebsiella from contaminated meat," Lance B. Price, PhD, lead author of the study, said in a George Washington University news release.

He added, "Now we have another drug-resistant pathogen in the food supply, underscoring the public health concern regarding antibiotic use in food animal production," referring to the problem of overuse of such drugs in animals causing resistant strains of bacteria.
Jul 22 Clin Infect Dis abstract
Jul 23 George Washington University
news release

 

Poll reveals epidemic, preparedness concerns

A survey commissioned by the World Bank of people in five developed countries found that many believe the world isn't prepared for another global epidemic like Ebola and strongly support investments in developing countries to curb future threats.

The poll included 4,000 people in France, Germany, Japan, the United Kingdom, and the United States. The online survey was conducted from Jun 14 to Jun 24 and included 600 people from each country and an oversampling in each nation of 172 to 200 opinion elites—people who hold a college degree or higher and follow global news events closely.

Twice as many people thought another global epidemic will occur in the next decade—40% versus 19%, with 40% being neutral on the topic. And less than half (45%) thought their own country was prepared.

Almost 80% responded that investing in healthcare workers and clinics in developing countries can help prevent epidemics from spreading to other countries. The poll also revealed strong support for policy changes that will protect the world from global epidemics and that related investments will help save the world money.

Jim Yong Kim, MD, PhD, World Bank president, said in a press release that the survey shows that the public sees global infectious disease outbreaks as a serious threat and that they want their leaders to take steps to become better prepared. "This heightened concern also translates into strong support for investments to strengthen health systems in vulnerable countries, as any country with a weak health system puts both its own citizens and the entire world at risk."
Jul 23 World Bank press release
Jul 23 World Bank brief, with links to full results

 

Test accurately, quickly identifies EV-D68

Researchers at Washington University in St. Louis have developed a diagnostic test to quickly identify enterovirus D-68 (EV-D68) that outperforms other tests, according to a study in the August issue of the Journal of Clinical Microbiology.

The researchers isolated segments of viral DNA sequences that are common to every D68 subtype but to no other virus and developed a computer program that compares many sequences simultaneously. This technique led to a test that identifies every known subtype of enterovirus D68 while excluding all other known viruses.

The new test is more effective than others for EV-D68, including one developed by the US Centers for Disease Control in October 2014 that was deployed quickly in response to the EV-D68 outbreak last year that involved more than 1,000 cases in children and 14 deaths, according to a Washington University press release.

To validate the new test, the investigators examined panels of rhinoviruses and enteroviruses. The test did not miss any known samples of EV-D68, and it did not falsely identify EV-D68 in samples that were known to be other viruses. The test retained its accuracy even with tiny amounts of the virus, according to the authors.

"These kinds of tests help treatment decisions because it is important to know that the patient doesn't have influenza or another disease that might require a specific treatment," said senior author Gregory A. Storch, MD.
August J Clin Microbiol abstract
Jul 22 Washington University
press release

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