News Scan for Mar 13, 2019

News brief

HHS appoints NIH cancer chief as acting FDA commissioner

The US Department of Human Services (HHS) said yesterday that Ned Sharpless, MD, will serve as acting commissioner of the Food and Drug Administration (FDA), replacing Scott Gottlieb, MD, who announced his resignation on Mar 5 after less than 2 years in the position.

Sharpless has been director of the National Cancer Institute at the National Institutes of Health since October 2017. He earned his medical degree at the University of North Carolina School of medicine before completing an internal medicine residency at Massachusetts General Hospital and a hematology/oncology fellowship at Dana-Farber/Partners Cancer Care, both with Harvard Medical School in Boston.

In addition to his work at director of the NCI, Sharpless is chief of the Aging Biology and Cancer Section at National Institute on Aging Laboratory of Genetics and Genomics. On his Twitter account yesterday, Sharpless said change is good, but bittersweet, and he thanked President Donald Trump, HHS Secretary Alex Azar, and Gottlieb for their support.

Following the announcement, Gottlieb said on Twitter that he was delighted that Sharpless will serve as acting FDA commissioner. "Ned is a friend to FDA, a great public health champion, a dedicated physician, and will be warmly welcomed into his new role. FDA will benefit greatly from his leadership," he added.
Mar 12 HHS public affairs tweet
Ned Sharpless
Twitter feed
Mar 12 Scott Gottlieb
tweet

 

MERS-CoV detected in Kenyan camels

The World Organization for Animal Health (OIE) yesterday recorded six outbreaks of MERS-CoV among camel herds in Kenya in 2017 and 2018, resulting in 18 cases among 2,025 susceptible animals.

This is not the first time evidence of the coronavirus has been detected in Kenya. Studies conducted in 2015 and 2016 showed that the blood of nearly half of animals tested contained antibodies to MERS-CoV (Middle East respiratory syndrome coronavirus). And humans who worked with animals in Kenya have also tested positive for antibodies to the virus in 2016.

The OIE report, however, confirms detection of the virus itself. It is the agency's first report of MERS-CoV in Kenyan camels.

The current outbreaks occurred on four farms, in one village, and in Kora National Park on the Tana River. The two outbreaks from 2017 took place in Isiolo County, which is in the central part of the country. Other affected counties are Garissa, Marsabit, and Laikipia.

No animals died in the outbreaks.
Mar 12 OIE
report  
Mar 4, 2016, CIDRAP News story on antibodies in people

 

2018 Nipah outbreak in India led to 3 subclinical infections

A study yesterday in Emerging Infectious Diseases describes how a Nipah virus (NiV) outbreak in Kerala, India, last year led to three subclinical infections.

In May 2018, a Nipah outbreak emerged in Kerala connected to fruit bats found in a family's well. A total of 18 people were diagnosed with the emerging infectious disease, and 16 died (case-fatality rate of 89%).

The infections were found via serum sampling conducted on 155 healthcare workers (HCWs) and 124 household and community members who had close contact with the 18 patients. All contacts were considered high-risk; 123 HCWs (79.4%) and 88 household contacts (71.0%) reported physical contact with one or more Nipah patients.

Among the contacts, three had immune markers indicating a Nipah infection.

"We calculated the overall seroprevalence of NiV as 1.08% (95% confidence interval [CI], 0.37% to 3.11%)," the authors wrote. "None of the seropositive persons reported having a febrile illness after their last contact with an NiV patient, indicating subclinical infections. Two seropositive persons were family members of a laboratory-confirmed patient, and the third was a HCW in the emergency medicine department."

The authors also said all three contacts had a history of exposure to an infected patient's bodily fluids, and the risk for subclinical infections was higher for contacts with exposure to bodily fluids compared with those who had physical contact only (4.4% [95% CI, 1.5%–12.2%] vs 0% [95% CI, 0%–1.8%]; P = 0.007).
Mar 12 Emerg Infect Dis
study

 

High-path H5 outbreaks strike poultry in Iran and Vietnam

In the latest highly pathogenic avian flu outbreak developments, Iran reported another H5N8 event in poultry and Vietnam reported an H5N6 detection, according to the latest notifications from the OIE.

Iran's outbreak struck backyard poultry in Tabriz in East Azarbayejan province in the country's northwest. The event began on Feb 26, killing 10 of 31 birds. The surviving ones were destroyed to curb the spread of the virus. The last H5N8 outbreak in Iran occurred in late January.

Vietnam's H5N6 outbreak began Feb 11 in village birds in Quang Nam province in the central part of the country. The virus infected 1,350 of 3,800 susceptible birds. No deaths were reported but authorities culled the flock as part of the response to the event. The country's last H5N6 outbreak occurred in early January.
Mar 9 OIE report on H5N8 in Iran
Mar 13 OIE report on
H5N6 in Vietnam

Stewardship / Resistance Scan for Mar 13, 2019

News brief

EPA urged to deny proposal for more antibiotic spraying on citrus fields

Representatives from the Center for Biological Diversity, Public Interest Network, and US PIRG (Public Interest Research Group) today delivered 45,000 petition signatures to the Environmental Protection Agency (EPA), calling on the agency to deny a proposal that would allow for expanded antibiotic spraying on citrus fields.

Under the proposal, citrus growers would be allowed to spray more than 650,000 pounds of streptomycin on citrus fields to treat the bacteria that causes citrus greening disease. The groups say spraying streptomycin on citrus fields does not cure the disease and would be an irresponsible use of an antibiotic that's considered critically important for human health by the World Health Organization (WHO).

"The more you use antibiotics, the greater the risk that bacteria resistant to the drugs will flourish and spread," Matt Wellington, director of US PIRG's antibiotics program, said in a press release. "The bottom line is that the potential problems created by spraying massive amounts of streptomycin on citrus fields could outweigh the original problem the EPA wants to solve."

The groups say that, if the proposal is allowed, it would be the largest-ever use of a medically important antibiotic in plant agriculture in the United States.

In December, the EPA approved a proposal for wider use of oxytetracycline on citrus trees to combat citrus canker and citrus greening disease.
Mar 13 Center for Biological Diversity press release

 

MCR-1 in France the result of divergent evolutionary paths, study says

French and Swiss scientists isolated 153 colistin-resistant Escherichia coli strains from fecal samples obtained from 152 patients in Paris and discovered the MCR-1 gene in about 5% of the samples and note that colistin resistance is the result of two distinct evolutionary pathways, according to a study yesterday in the Journal of Antimicrobial Chemotherapy.

The researchers conducted the analysis because they say large epidemiological studies to estimate the human burden of colistin-resistant E coli gut carriage are lacking. They screened 1,217 patients in six Parisian hospitals during a 3-month stretch in 2017. Colistin is considered an antibiotic of last resort for multidrug-resistant infections.

They identified the MCR-1 colistin-resistance gene in 7 (4.6%) of the 153 colistin-resistant E coli samples, and the gene was located on various plasmids, which are mobile units of DNA. Genetic analysis indicated an animal origin for the genes, compared with a human origin for the 146 non-MCR-1 isolates.

The team summarized the findings thus: "We showed that the occurrence at a high rate of colistin resistance in human faecal E. coli is the result of two distinct evolutionary pathways, i.e. the occurrence of chromosomal mutations in an endogenous E. coli population and the rare acquisition of exogenous mcr-1-bearing strains probably of animal origin."
Mar 12 J Antimicrob Chemother study

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