News Scan for Apr 26, 2016

Ebola vaccine funding
;
Yellow fever vaccination for travelers
;
C diff hospital intervention

NewLink receives more funding to keep testing VSV-EBOV Ebola vaccine

NewLink Genetics Corporation announced yesterday that it had received $21.6 million in federal funding to continue developing its vesicular stomatitis virus–Ebola virus (VSV-EBOV) vaccine candidate.

The new funding was awarded by the United States Biomedical Advanced Research and Development Authority (BARDA), which has now contributed a total of $74.6 million for testing of NewLink's rVSV-ZEBOV-GP Ebola vaccine since 2014. The $21.6 million will extend the research period to Oct 11, 2017, and allow NewLink to evaluate the vaccine's safety, immunogenicity, and efficacy populations outside of West Africa's outbreak regions.

The vaccine candidate was originally developed by the Public Health Agency of Canada and was licensed by NewLink, along with Merck, which manufactures the drug, in 2014. It has recently shown good effectiveness in a phase 3 trial and has been used for ring vaccination in West Africa.
Apr 25 NewLink press release
Jan 20 CIDRAP News story on VSV-EBOV vaccine

 

WHO reminds travelers to Angola that yellow fever vaccination is required

The World Health Organization (WHO) said today that certification of yellow fever vaccination is required in all travelers to Angola, where an outbreak of the disease continues to spread.

Angola's outbreak began in December 2015, and most of the 1,975 suspected cases have occurred in the the country's capital, Luanda. To date, 618 yellow fever cases have been confirmed, along with 258 deaths in the country. Imported cases in recent travelers to Angola have been reported in other regions of Africa and in Asia.

"We are particularly concerned that large urban areas are at risk and we strongly urge all travellers to Angola to ensure they are vaccinated against yellow fever and carry a valid certificate," said WHO Director-General Margaret Chan, MD, MPH.

A single dose of yellow fever vaccine protects against infection for life and is effective 10 days after immunization. No specific treatment exists for the disease, which is spread by mosquitoes and is deadly in approximately half of people who develop severe symptoms, the WHO said.

Because vaccination is effective in preventing infection, the WHO has imposed no travel restrictions to Angola.
Apr 26 WHO press release

 

Study: Isolation of asymptomatic C diff carriers lowers hospital infections

Screening patients at hospital admission for asymptomatic Clostridium difficile (C diff) and isolating those found to be carriers lowered the incidence of healthcare-associated C diff infection by more than 60% and may be a promising strategy for prevention, according to a study published yesterday in JAMA Internal Medicine.

Researchers from Canadian and Israeli institutions screened patients for asymptomatic C diff from Nov 19, 2013, to Mar 7, 2015, at admission to the emergency department of Quebec Heart and Lung Institute (QHLI). Hospital C diff infection case numbers over the period were then compared with QHLI C diff incidence from 2004 to 2013.

During the intervention, 368 of 7,599 patients (4.8%) were identified as asymptomatic C diff carriers and were isolated during their hospital stay. C diff infection occurred in 38 QHLI patients (3 cases per 10,000 patient days) during the intervention, compared with a total of 416 cases (6.9 per 10,000 patient days) in prior years.

Researchers observed a 7% decrease in C diff infections in each of 17 4-week periods after the screening program began, and modeling found a progressive decrease of 7.2 C diff infections per 10,000 patient days over the study period.

Proportions of C diff infection attributable to the NAP1 strain, which can cause severe disease, dropped from 59.2% to 20% during the study; no changes in NAP1 rates were observed in other Quebec hospitals. Researchers estimate that screening and isolation prevented 63 of 101 (62.4%) expected C diff cases.

In a related commentary in the same issue of JAMA Internal Medicine, Alice Y. Guh, MD, MPH, and Clifford McDonald, MD, of the US Centers for Disease Control and Prevention address the study's limitations, including observations that isolation was not stringently enforced, testing methods likely failed to detect carriers with low C diff burdens, and patients transferred from other healthcare facilities may have been excluded from screening, noting that the latter factor likely led to the low estimated prevalence of C diff carriage at QHLI.

Despite these limitations, Guh and McDonald said the intervention's results were strong and call for additional studies to evaluate evidence for C diff transmission from asymptomatic carriers in hospitals. The feasibility of screening and isolating carriers, however, will likely require a focus on patients in high-risk wards and the development of effective testing methods, the authors said.
Apr 25 JAMA Intern Med study
Apr 25 JAMA Intern Med commentary

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