News Scan for Jan 15, 2016

Avian flu in Vietnam, Taiwan
Scope-linked outbreak probe

Vietnam reports new H5N6 avian flu outbreak; Taiwan details H5N2 events

Vietnam has reported a new H5N6 avian flu outbreak, and Taiwan officials have confirmed seven separate H5N2 events, according to reports posted today by the World Organization for Animal Health (OIE).

The Vietnamese outbreak involves a flock of 220 backyard poultry in Lang Son province in the far north. The H5N6 virus killed 155 of the birds, and the remaining 65 were culled to prevent disease spread. The event began on Jan 2.

Vietnam has battled a slew of H5N6 poultry outbreaks beginning last summer, the most recent two being confirmed just yesterday and involving more than 4,500 birds total. China, Laos, and Hong Kong are the only other countries to report the virus in birds.

In Taiwan, H5N2 avian flu struck six flocks in four counties on the western side of the island as well as a thrush in Taipei city, according to a separate OIE report.

Two of the outbreaks began in late December, and the other four began the first week of this month. Affected counties are Yunlin and Chiayi, each with two outbreaks, and Kaohsiung and Changhua, each with one outbreak. The outbreak in Kaohsiung involved a chicken abattoir, while the other five involved farm birds.

Flocks ranged in size from 1,000 to 18,000 chickens, turkeys, ducks, and geese. All told 11,122 of 32,310 poultry died from their infections, while the surviving birds were euthanized to contain the outbreaks.

The H5N2 finding in Taipei city involved a dead pale thrush that was discovered on Dec 15.
Jan 15 OIE report on Vietnam
Jan 15 OIE report on Taiwan


Duodenoscope outbreaks exacerbated by lack of response, report says

Drug-resistant infections linked to inadequately cleaned duodenoscopes sickened at least 250 patients in 25 outbreaks from 2013 to 2015 because of repeated failures by manufacturers, hospitals, and the Food and Drug Administration (FDA) to adequately report and respond to the problem, according to a US Senate report released this week.

The 301-page report, initiated by Sen Patty Murray (D-Wash.), the Ranking Member of the Senate Health, Education, Labor, and Pensions Committee, found that, by early 2013, Olympus, the Japanese manufacturer of 85% of the nation's duodenoscopes, knew of lab confirmation that its closed-channel model could harbor bacteria even after cleaning according to manufacturer's instructions. Yet it did not inform the FDA of this finding and only relayed the information to hospitals and physicians in February 2015.

The probe also found that Olympus, Pentax, and Fujifilm, which also produce duodenoscopes used in the United States, as well as Custom Ultrasonics, which makes the cleaning machine for the scopes, failed to meet regulatory obligations. As well, 16 US hospitals traced antibiotic-resistant infections to the scopes but failed to send the required adverse event forms to the device manufacturers.

The report also said, "While FDA started investigating how closed-channel duodenoscopes cleaned according to manufacturers' instructions spread infection in September of 2013, the agency took no action to alert hospitals, doctors and the public to the risk posed by closed-channel duodenoscopes for 17 months. At least 68 patients in seven different hospitals in the United States were infected with antibiotic-resistant bacteria linked to duodenoscopes during this period."

Recommendations listed in the report focus on Senate regulatory action and changes necessary at the FDA.

Reuters reported today that the FDA cleared Olympus's duodenoscope with changes to the device's design and labeling that are designed to reduce the risk of bacterial infections. Olympus, the world's leading maker of duodenoscopes, will voluntarily recall its original model, the story said.
Jan 13 US Senate report
Jan 15 Reuters story

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