News Scan for Jul 28, 2017

Avian flu outbreaks
Zika vaccine deal
US pneumonia burden
NICU stewardship
Cholera in Somalia

Avian flu outbreaks hit farms in Italy, Taiwan

In sign of low but ongoing highly pathogenic H5N8 activity in Europe, Italy today reported three more outbreaks in poultry, according to a notification from the World Organization for Animal Health (OIE).

The virus struck a layer farm in the Lombardy region and two turkey farms in neighboring Veneto region. Both regions are in northern Italy. The events began between Jun 20 and Jun 26 and killed 5,220 of 489,924 susceptible birds. The surviving poultry were slated for culling. So far an investigation into the outbreaks hasn't identified a source.
Jul 28 OIE report on H5N8 in Italy

Elsewhere, Taiwan reported one more highly pathogenic H5N2 outbreak, which affected a commercial poultry farm housing native chickens in Changhua County on the west side of the island, according to a recent OIE report. The outbreak started on Jul 17, killing 1,680 of 18,722 birds at the farm.
Jul 25 OIE report on H5N2 in Taiwan


Emergent, Valneva to co-develop Zika vaccine

Emergent BioSolutions announced this week that it has licensed Zika vaccine technology from Valneva, a biotechnology company based in France.

In a Jun 26 press release, Emergent said it will co-develop ZIKV-VLA1601, an inactivated vaccine from preclinical development through the end of a phase 1 clinical trial. The vaccine is based on Valneva's manufacturing platform for an inactivated whole-virus vaccine against Japanese encephalitis.

Adam Harvey, Emergent's executive vice president of business operations, said the company is focused on providing preparedness solutions to public health threats and emerging infectious diseases. "This commitment extend beyond acquiring revenue-generating products and advancing our own products to aligning with partners such as Valneva to develop innovative products that could potentially serve the needs of both government customers and the commercial market."

In addition to the product development agreement, the companies expect to sign a technology transfer agreement at a later time to allow Valneva's candidate vaccine to be made at Emergent's Bayview manufacturing facility in Baltimore, Md.

A phase 1 trial of the vaccine is planned for late 2017 or early 2018.
Jul 26 Emergent BioSolutions press release


New adult pneumonia estimate details substantial burden

In a new estimate of the community-associated pneumonia (CAP) burden in US adults, researchers said today that more than 1.5 million are hospitalized with the disease each year, with 100,000 of the patients dying during their hospital stays and one in three of them dying in the year following hospitalization.

A research team from the University of Louisville used adult population and hospitalization data from Jun 2014 through May 2016 for the city of Louisville to estimate the national burden of CAP among adults. Using geospatial analysis, they also looked at CAP patterns by income level, race, and age. They also evaluated timing of pneumonia deaths, extending from the time of hospital stay to 1 year post-discharge.

Over the 2 years, 7,449 adults were hospitalized in Louisville for CAP. The age-adjusted incidence was 649 patients per 100,000 adults, which extrapolates to 1,591,825 adult pneumonia hospitalizations in the wider US population.

The team identified clusters of patients in low-income and African-American populations.

About 6.5% of Louisville adults hospitalized with pneumonia died from their disease, corresponding to 102,821 deaths a year in the United States.

The authors concluded that the nation's burden from CAP is substantial.
Jul 28 Clin Infect Dis abstract


NICU program associated with lower sepsis, better antibiotic prescribing

The neonatal intensive care unit (NICU) at Yale University School of Medicine significantly reduced its cases of late-onset sepsis, a leading cause of death among preterm infants, by implementing guidelines designed to eliminate antibiotic overuse, according to a new study in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA).

A team of experts developed the antibiotic stewardship program, which consists of clinical guidelines published to the hospital intranet to curtail provider-to-provider variability in prescriptions and to educate NICU staff. The NICU antibiotic stewardship guidelines reduced variability in treating common infections, improving clinical adherence to best practices.

Using electronic medical records, the stewardship team reviewed a daily report of all prescribed antimicrobials and provided timely prescriber oversight and feedback.

The researchers found that healthcare-associated infections decreased after program implementation, including evaluations for late-onset sepsis, with an average reduction of 2.65 late-onset sepsis evaluations per year per provider. Overall, the rate of late-onset evaluations per 100 days dropped from 21.2 to 8.4. The data also showed that physicians followed antibiotic prescribing guidelines 98.75% of the time, and no infants with clinical infections developed a recurrent infection after 7 days of discontinuing antibiotic treatment.

"So few antimicrobial stewardship programs provide NICU-specific guidelines to cut down on unnecessary prescription practices," said study author Matthew Bizzarro, MD, in a SHEA news release. "Our use of an electronic medical record-generated daily report, with additional information on the rationale behind each prescription event was somewhat novel and incredibly useful in providing timely feedback and review of prescriber practices."
Jul 26 Infect Control Hosp Epidemiol abstract
Jul 27 SHEA news release


Somalia has 3 new cholera deaths, more than 1,000 new cases

The World Health Organization (WHO) yesterday confirmed 1,068 new cases of cholera in Somalia this week, and an additional 3 deaths from the disease, which causes severe, watery diarrhea. Despite the cases, however, the WHO said the country's outbreak is on the decline.

Since January, Somalia has reported 58,524 cases, including 812 deaths, in 15 regions across the nation. The overall case-fatality rate is 1.4%, which is above the emergency threshold of 1%.

"Cholera response and prevention efforts are being continued throughout the country," the WHO said. "With improvements to the surveillance systems in the country, a total of 265 sentinel health facilities are now able to report on health alerts, in addition to existing reporting mechanisms."

Somalia is suffering a severe drought, which has displaced millions of people and left them without easy access to food and water. The WHO estimates that about 5.5 million people in Somalia are at risk to contract cholera. The organization has been working to chlorinate water sources throughout the country.
Jul 27 WHO update

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