News Scan for May 29, 2019

New tick-borne disease
;
Antiviral for Nipah virus
;
Avian flu in Nigeria, Bangladesh

Chinese researchers highlight new tick-borne disease, Alongshan virus

A group of patients in Inner Mongolia likely represent the first identified human cases of a new tick-borne illness, Alongshan virus (ALSV), which belongs to the jingmenvirus group in the flavivirus family. A description of ALSV and these cases was published today in the New England Journal of Medicine.

In 2017, an index patient presented to an Inner Mongolian hospital with a headache, fever, and history of tick bite. A total of 86 patients were eventually identified with similar symptoms. The patients were infected with a previously unknown segmented RNA virus, which the authors named ALSV.

All patients recovered with supportive care and the administration of antimicrobials and antivirals. There were no deaths. Thirty patients, however, experienced a coma, which suggests ALSV can cause severe illness.

"Our findings suggest that ALSV may be the cause of a previously unknown febrile disease, and more studies should be conducted to determine the geographic distribution of this disease outside its current areas of identification," the authors concluded. Inner Mongolia is an autonomous region of northern China.

In a related commentary, experts from the University of Texas Medical Branch at Galveston wrote, "The nature of ALSV, a unique virus in the family Flaviviridae with a vector that has a wide distribution, should warn us of its potential. . . . However, we caution that although new technologies and broad genomic surveys of viruses will enhance our understanding of virus diversity and evolution, they may provide limited value in understanding the mechanisms of disease emergence.

"A far more cost-effective way to understand the emergence of diseases and to mitigate their outbreak is a proactive, real-time surveillance of human populations."
May 29 N Engl J Med study
May 29 N Engl J Med commentary

 

Ebola antiviral protects monkeys against Nipah virus

The Ebola antiviral treatment remdesivir (GS-5734) effectively protected African green monkeys during a Nipah virus challenge, suggesting further tests should be conducted in humans, according to a study today in Science Translational Medicine.

Nipah virus is often fatal in humans, and there are no known treatments for the disease, which is often transmitted by fruit bats. In this study, two groups of four African green monkeys were inoculated with a lethal dose of Nipah virus Bangladesh.

"None of the treated animals developed severe respiratory disease, and all survived the acute lethal Nipah virus Bangladesh challenge," the authors wrote. The animals were followed for 3 months after the challenge.

Remdesivir is currently being used as part of a clinical trial in the Democratic Republic of the Congo's Ebola outbreak. The antiviral has been previously shown to inhibit filovirus, coronavirus, and paramyxovirus replication.

The authors of the study conclude that the results support the use of remdesivir in response to the next Nipah virus outbreak, either under a compassionate use protocol or possibly a randomized clinical trial protocol.
May 29 Sci Transl Med
study

 

H5N8 strikes more poultry in Nigeria; study details H5N6 in Bangladesh

Nigeria's agriculture ministry yesterday reported another highly pathogenic H5N8 avian flu outbreak, this time in poultry at a livestock market, according to a new World Organization for Animal Health (OIE) report.

The event began on Apr 21, affecting chickens, ducks, and turkeys in the market in Edo state in south central Nigeria. Culling was planned for 20 susceptible birds. Nigeria has been battling sporadic H5N8 outbreaks since 2016. The country reported its last event involving the strain in April, which also involved poultry in Edo state.
May 28 OIE report on H5N8 in Nigeria

In other avian flu developments, a team from Bangladesh and the US Centers for Disease Control and Prevention yesterday detailed the first identification of H5N6 avian influenza in Bangladesh. They described their findings, based on live-poultry market surveillance in the country that has been under way since 2007, yesterday in Virology.

The H5N6 virus was found among other strains during market surveillance that took place from June 2016 to June 2017. Genetic analysis suggested the H5N6 virus was part of the 2.3.4.4 clade and probably entered the country about March 2016. Though no human infections involving H5N6 have been reported in Bangladesh, the researchers said the virus had several markers that suggest the potential to infect humans.

"Vigilant surveillance at the animal-human interface is essential to identify emerging avian influenza viruses with the potential to threaten public and animal health," they wrote.
May 28 Virology abstract

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