News Scan for Aug 30, 2018

Epilepsy in Zika-affected babies
Global health security strategy

Study of Zika-affected babies shows early epilepsy onset, treatment resistance

Clinical follow-up of 141 babies born with congenital Zika virus problems who were evaluated at a referral center in Brazil revealed that 67% experienced epilepsy, a prevalence that was higher than the 9% to 50% reported in earlier studies. Researchers from Brazil described their findings today in a letter to the New England Journal of Medicine.

The mean age of epilepsy in the group of infants was 4.9 months, and parents reported that seizures occurred during the first 6 months of life in 74% of the babies. The main seizure types were epileptic spasms (72%), followed by focal motor seizures (21%) and tonic seizures (4%). A single seizure type was noted in 77% of the infants.

All of the children received antiepileptic medication, with 56% receiving more than one drug. At the last clinic visit, 62 infants (65%)—24 on monotherapy and 38 on polytherapy—had experienced remission.

Electroencephalography (EEG) pattern analysis showed that classic or modified hypsarrhythmia or a burst-suppression pattern was associated with drug-resistant epilepsy. Only one child in the group that had those patterns experienced remission.

The scientists concluded that, for children at the referral center, epilepsy occurred early and was often drug-resistant. They added that some EEG features, such as the burst-suppression pattern, seemed to predict severe epilepsy.
Aug 30 N Engl J Med letter


Experts give recommendations for next phase of US global health strategy

A spending bill passed by Congress in March that extended funding for global health security programs for another 3 years directed the Trump Administration to create a strategy to guide future US efforts in the area, which is due this fall.

In July, a group of stakeholders brought together by the Johns Hopkins Center for Health Security met to contribute their input. The center yesterday released a summary report that covers the major recommendations from the daylong event, which involved discussion among more than 70 experts.

Among the main recommendations, the US strategy should define global health security in a flexible way that keeps the focus on health security, call for meaningful integration of nongovernmental groups into global health security efforts, recognize that continued US investments are needed, establish clear targets for measuring progress, and address gaps in existing efforts.

In a press release, the Center for Health Security said it would share the report with US government agencies and departments that oversee global health security programs.

In its summary report, the center said as the next phase of the US global health security strategy approaches, "communicating the benefits of these programs, engaging with diverse non-governmental partners, ensuring sustained funding, strengthening health systems, allowing targeted strategic flexibility, and maintaining robust measurements will all be critical steps toward continued progress."
Aug 29 Johns Hopkins Center for Health Security press release
Aug 29 stakeholder recommendations for US Global Health Security Strategy

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