News Scan for May 18, 2018

Declining US flu markers
MERS treatment trial launch
Novel poxvirus in Texas
H5N1 in Nepalese poultry

US flu levels continue late-season drop as 3 more kids' deaths reported

US flu levels fell sharply again last week with the approach of summer, but the Centers for Disease Control and Prevention (CDC) recorded three more pediatric flu deaths, according to the latest weekly update posted today.

Flu was reported as widespread in only two states: Massachusetts and New York.

Most flu markers are well below baselines, with clinic visits for flulike illness falling to 1.2%. The CDC said flu has now been below the national baseline for the sixth consecutive week. Of respiratory specimens tested at clinical labs last week, only 3.9% were positive for flu, and influenza B made up about 71% of the detections. At public health labs, of subtyped influenza A samples, half were H3N2 and half 2009 H1N1.

Of the three newly reported pediatric flu deaths, one occurred in April involving 2009 H1N1, another was from influenza B and occurred last week, and the other was unsubtyped in a child who was sick in April. So far this season the CDC has reported 168 pediatric flu deaths.

The overall hospitalization rate last week was 106.6 per 100,000 population, about the same as the previous week. The highest level is still in seniors: 460.3 per 100,000 population.

In a separate weekly summary, the CDC said localized or sporadic flu activity may continue for a number of weeks and that it recommends prompt antiviral treatment for those who are at high risk for flu complications.
May 18 CDC FluView report
May 18 CDC situation update


First human study of MERS monoclonal antibody treatment set to launch

Federal health officials today announced the start of enrollment for the first human clinical trial to test the safety of two monoclonal antibody (mAb) treatments for Middle East respiratory syndrome coronavirus (MERS-CoV) infections.

In a press release, the National Institute of Allergy and Infectious Diseases (NIAID), the trial's sponsor, said the mAbs—REGN3048 and REGN3051—were discovered and developed by scientists at Regeneron, a biotechnology company headquartered in Tarrytown, N.Y. The trial is partly funded the Department of Health and Human Services Biomedical Advanced Research and Development Authority (BARDA). Earlier studies in mice at Regeneron and the University of Maryland suggested the mAbs can neutralize MERS-CoV.

Anthony Fauci, MD, NIAID's director, said in the statement that currently there are no specific treatments for MERS-CoV. First detected in humans in 2012, the disease so far has caused 2,206 cases, 787 of them fatal, in 27 countries, mostly in Saudi Arabia. "Having targeted therapeutics available to treat this unpredictable and frequently fatal respiratory disease would help us reduce MERS-associated deaths and control future outbreaks," Fauci said.

Investigators will enroll 48 healthy adults ages 18 to 45 divided into six groups that will receive placebo or both mAbs intravenously. The first group will receive the lowest dosage, with successive groups receiving successively higher dosages. Decisions to continue and give higher dosages will be made by an independent safety review committee that will monitor safety and tolerability data before clearing the next group to receive the higher dose. The group expects to complete the study by June 2019.
May 18 NIAID press release


Researchers report novel poxvirus in wild mice in Texas

Wild mice in Texas have been found infected with a new poxvirus, researchers reported this week in Emerging Infectious Diseases.

Investigators with Texas A&M and the CDC report on the capture of an adult northern pygmy mouse in August of 2014 that had large (4- to 8-millimeter [mm]) lesions on its hind paws and tail but otherwise appeared healthy. Two years and 8 months later researchers captured a second adult northern pygmy mouse 100 miles north of the first mouse that had similar but smaller lesions (1 to 2 mm) on one hind paw and its tail. Both mice were found in east-central Texas.

Polymerase chain reaction testing of DNA from lesions on both mice revealed a poxvirus not reported before. The phylogenetic position of the virus revealed that it belonged to the Chordopoxvirinae family but diverged from other Chordopoxvirinae poxviruses by an average of 35%.

The authors conclude that the poxvirus "is distinct from previously identified viruses, with genetic distances similar to those observed between genera . . . the genetic data strongly suggest this poxvirus does not belong to any recognized genus as of March 2018."

In 2014 US researchers reported a different novel poxvirus in a girl from Tennessee and a woman from Missouri.
May 15 Emerg Infect Dis report
Oct 10, 2014, CIDRAP News scan on human cases


H5N1 avian flu strikes layer farm in Nepal

Nepal today reported a highly pathogenic H5N1 avian flu outbreak at a layer farm, its first involving the strain since March of 2017, according to a notification from the World Organization for Animal Health (OIE).

The outbreak began on May 3 at a farm in Chitwan district in the south central part of the country.

Farmers noticed symptoms and sudden deaths in 72-week-old layers about 2 weeks after deaths were noted in free-range domestic ducks. The report suggests the virus killed 1,500 layers over a 2-week period, and culling is slated for the surviving poultry.
May 18 OIE report on H5N1 in Nepal

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