News Scan for May 04, 2018

Yellow fever in Brazil
;
3 more kids' flu deaths
;
Antibiotic resistance in ICUs
;
Chikungunya vaccine fast-tracked

Brazil reports 39 more yellow fever cases, 30 more deaths

In its weekly update on yellow fever activity, Brazil yesterday reported 39 more lab-confirmed cases, along with 30 more deaths.

Since Jul 1, 2017, the country has reported 1,257 cases and 394 deaths.

The new cases were reported in Sao Paulo (30), Rio de Janeiro (6), and Minas Gerais (3) states, all in the southeast. Brazil also reported three more epizootics in monkeys, two in Rio de Janeiro state and the other from Espirito Santo.

In a related development, the Czech Republic recently reported a yellow fever infection in a traveler returning from Brazil, the European Centre for Disease Prevention and Control (ECDC) reported today in its weekly communicable disease threat report. The unvaccinated patient had traveled in Brazil between Feb 20 and Mar 6. Since the first of the year, six European countries have reported yellow fever infections in travelers who visited Brazil.
May 3 Brazilian health ministry update
May 4 ECDC communicable disease threat report

 

US flu continues late-season decline

As flu markers continued their late season decline last week, the US Centers for Disease Control and Prevention (CDC) today reported three more pediatric flu deaths, lifting the total this season to 163. One of the pediatric deaths occurred in the week of Apr 21, while the other two fatalities were from January and March.

Clinic visits for flulike illness—at 1.5%—declined further last week and are well below the national baseline of 2.2%.

Only three states are still reporting geographically widespread flu, down from four the previous week. All are in the northeast: Connecticut, Massachusetts, and New York.

The overall rate of hospitalization for flu, a marker that often lags other indicators, rose slightly, to 106.0 per 100,000 population. For seniors, the number rose to 457.2 per 100,000 population, up from 454.3 per 100,000 the week before.

Among respiratory samples tested positive for flu at public health labs last week, 71.1% were influenza B and 28.9% were influenza A. Of 36 subtyped influenza A strains, 58.3% were 2009 H1N1 and 41.7% were H3N2.
May 4 CDC FluView

 

ECDC surveillance report shows high level of antibiotic resistance in ICUs

The burden of antibiotic resistance in European intensive care units (ICUs) remains high, according to a surveillance report today from the European Centre for Disease Prevention and Control (ECDC).

The report on healthcare-associated infections (HAIs) in ICUs, based on 2016 data from 1,159 hospitals and 1,451 ICUs in 14 countries, revealed that 30% of Staphylococcus aureus isolates were resistant to oxacillin, and resistance to third-generation cephalosporins was detected in 18.1% of Escherichia coli isolates, 32.1% of Enterobacter isolates, and 37.8% of Klebsiella isolates. In addition, carbapenem resistance was reported in 10.7% of Klebsiella isolates, 26.4% of Pseudomonas aeruginosa isolates, and 66.1% of Acinetobacter baumannii isolates. Those percentages are comparable to the 2015 report.

"The high percentages of resistance to carbapenems of P. aeruginosa, A. baumannii, and K. pneumoniae isolates reflect the challenges in the treatment of ICU patients, a highly vulnerable patient population. . . . Moreover, the burden of antimicrobial resistance is high in ICUs, due to the severity of the clinical condition of the patients, the frequent use of antibiotics, and varying infection prevention and control practices," the authors write. "Strengthening infection prevention and control practices and implementing antimicrobial stewardship are essential to prevent HAIs and counteract the emergence and spread of antimicrobial resistance in ICUs."

Overall, the report found that, of 151,709 patients staying in an ICU for more than 2 days, 12,735 patients (8.4%) presented with at least one HAI. The most common HAI was pneumonia, reported in 6.3% of patients; bloodstream infections occurred in 3.7% of patients, and 1.9% acquired urinary tract infections.
May 4 ECDC report

 

FDA grants fast-track designation for PaxVax chikungunya vaccine

PaxVax, a vaccine company based in Redwood City, Calif., announced today that the US Food and Drug Administration (FDA) has granted fast-track designation to its candidate chikungunya vaccine. The FDA's fast-track designation is designed to streamline the development and to speed the review of therapies or vaccines for serious conditions that address unmet medical needs.

PaxVax licensed the vaccine from the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. The company recently announced the enrollment of the first of 400 participants in a phase 2b study to help determine the dose of the virus-like particle vaccine. PaxVax said it expects results from the trial in early 2019.

Eva Harris, PhD, professor of infectious diseases and director of the Center for Global Public Health at the University of California, Berkeley, said in a PaxVax press release that it's exciting to see the vaccine more forward with FDA fast-track designation. "As there are currently no therapies or vaccines available for treatment or prevention of chikungunya, we are in desperate need for a medical and public health intervention," she said.
May 4 PaxVax press release

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