News Scan for Sep 19, 2016

Saudi MERS case
;
Ebola death rate in kids
;
More chikungunya
;
Global Fund raises billions
;
Meningitis booster

New Camel-linked MERS case in Saudi Arabia

On Sep 17 the Saudi Arabia Ministry of Health (MOH) reported one new MERS-CoV case, involving a Saudi man from Riyadh who had contact with camels.

The 50-year-old man is in stable condition after presenting with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus). The MOH said the patient had direct contact with camels, a known risk factor for contracting the respiratory virus.

Late last week, meanwhile, the World Health Organization (WHO) released details of 8 cases of MERS-CoV reported by Saudi Arabia between Jul 20 and Aug 18. Direct or indirect contact with camels is cited in 3 cases, contact with a sick patient is noted in 1 case, and sources are still unknown for the remaining 4 cases. One of the patients died, on Jul 20.

Two cases were from Jubail city, in a 58-year-old man who had a history of drinking camel's milk and in his 52-year-old female caregiver. The man is on mechanical ventilation, while the woman remains in stable condition in home isolation.

Saudi Arabia's MERS case count since 2012 has now reached 1,453, including 610 deaths. Four patients are still being treated, according to the MOH.
Sep 17 MOH report
Sep 16 WHO report

 

Report: 57% case-fatality rate in children with Ebola

A new study in Emerging Infectious Diseases shows children infected with Ebola virus disease (EVD) aged 2 to 12 years old suffered a 57% case-fatality rate. The numbers come from a retrospective cohort study of 282 children infected with the hemorrhagic fever in Sierra Leone.

Researchers said more than half (55%) the deaths took place while the children were being treated in 1 of 11 Ebola holding units. Fever was the most common symptom present in the children (99%), followed by fatigue and loss of appetite (80%; 79%). Unexplained bleeding occurred in only 1% of patients.

Forty-four percent of children presented with diarrhea, which was associated with death. Younger children were also more likely to die, and the median time until death was only 3 days after admission.

The vast majority of children (78%) had household contact with someone infected with Ebola virus.

This is the largest cohort study completed on children with Ebola. But the authors warned that there was an "apparent lack of association between death and potentially modifiable factors that could alter outcome after infection," the authors said.  "This lack of association calls for urgent prioritization of interventions targeted to prevent EVD in children. Children have been neglected thus far in EVD vaccine development, and this knowledge gap should be addressed."
Sep 15 Emerg Infect Dis study

 

PAHO reports about 2,000 new chikungunya cases

The Pan American Health Organization (PAHO) late last week reported 1,989 new chikungunya cases in the Americas, after 2 weeks of reporting cases below 1,000. The new cases raise the 2016 total to 255,009.

Almost all the new cases are from Panama, which had 1,788 new cases in the past month after reporting only 10 before, to bring its total this year to 1,798 cases.

The previous weekly PAHO updates included 290 and 510 new cases, respectively. PAHO lowered the chikungunya-related death count by 1, to 53. Many countries have not reported on the disease for weeks.

The outbreak began in December 2013 on St. Martin in the Caribbean, with the first-ever cases in the Americas. Since then the region has logged 2,134,976 suspected, confirmed, and imported cases, according to PAHO statistics.
Sep 16 PAHO update

 

Global Fund raises billions to battle malaria, AIDS, and TB

The Global Fund announced that donors had pledged $12.9 billion in an effort to end epidemics of malaria, AIDS, and tuberculosis (TB) by 2030. The announcement of the donations came at the launch of the Global Fund's fifth replenishment conference on Sep 17.

The event was held in Montreal and hosted by Canadian Prime Minister Justin Trudeau, who called on the world's youth to help eradicate international disease. "We can end these epidemics for good, if we accelerate our efforts and continue to bring in new partners," said Prime Minister Trudeau.

The conference raised $1 billion more than the last replenishment conference, held in 2013.  The United States was the biggest donor, pledging $4.3 billion, or one third of the total funding. In addition to nations, private citizens donated $250 million, meant to be used in the next 3 years to fight malaria, AIDS, and TB.

The Global Fund began in 2002, and, as of Sep 1 the organization said its efforts have led to 20 million saved lives around the world. The new donations are projected to save 8 million lives and prevent 300 million infections.
Sep 17 Global Fund press release

 

Booster for meningococcal vaccines proves safe, effective

A new study in Vaccine suggests that a booster dose of the quadrivalent meningococcal conjugate vaccines (MenACWY, or Menactra) helps lift the vaccine's antibody activity in people 4 to 6 years post-vaccination. The study, which was conducted by Menactra manufacturer Sanofi Pasteur, also demonstrated the booster's safety.

MenACWY is a common and effective vaccine, but reduced bactericidal antibody titers to types C and Y of the disease have been described 5 years after initial vaccination. In this study, participants who'd completed vaccination 4 to 6 years earlier received a single 0.5-mL booster dose of MenACWY-D (the four strains plus diphtheria.

Researchers measured antibody titers at day 6 and day 28 post-booster. Titers greater than 1:4 have been ruled to confer immunity against meningococcal disease.

On day 0, 38.7% to 68.5% of participants had a titer of 1:8. By day 6 post-booster, 98.2% to 99.1% of participants had a titer greater than 1:8. By day 28, 99% of participants reached this threshold.

There were no serious adverse events associated with the booster. Injection-site pain was described by about 60% of patients. The pain usually resolved in 1 to 3 days.
Sep 15 Vaccine study

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