News Scan for Jul 23, 2019

Massachusetts Cyclospora spike
India bans colistin in food animals
Tamiflu OTC deal

Massachusetts reports more than 100 Cyclospora cases

Since May 1 state health officials have reported more than 100 cases of Cyclospora infections, compared with 18 to 33 over the previous 3 years, the Massachusetts Department of Public Health (MDPH) said in a news release yesterday.  Other states are also reporting increased cases.

Most of the Massachusetts cases have been in the greater Boston area, while the rest have been across the state. "Other states have also reported increases in the number of cyclosporiasis cases; the cause of the outbreak is not yet known," the MDPH said. The agency is working with local boards of the health, other state officials, the Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration to trace the cause of the outbreak.

Previous US Cyclospora outbreaks have been tied to imported and US-grown produce.

"Individuals usually become symptomatic approximately one week after eating contaminated food," said Public Health Commissioner Monica Bharel, MD, MPH. "Symptoms typically include watery diarrhea, loss of appetite, abdominal cramping, nausea, and prolonged fatigue. Immunocompromised people may have more prolonged symptoms."

One of the other affected states is New York. New York City has had more than 90 cases since Jan 1, compared with 56 last year and 43 in 2017 during the same period, NYC Health said in an update late last week. Forty of the city's 2019 cases have been reported this month. And state officials have confirmed 11 recent cases tied to restaurants in Albany, Schenectady, and Colonie, the New York State Department of Health (NYSDH) said.

As of Jun 27, the CDC said 11 states have reported cyclosporiasis cases, and two patients required hospitalization; it didn't specify a total case count.
Jul 22 MDPH news release
Jul 18 NYC Health press release
Jul 11 NYSDH news release
Jun 27 CDC update


Indian government prohibits use of colistin in food-producing animals

The Indian government has banned the use of the last-resort antibiotic colistin in food-producing animals, according to Indian media reports.

The Hindu reports that India's Ministry of Health and Family Welfare issued an order on Jul 19 directing manufacturers of colistin and its formulations to add a label to containers stating the drug should not be used in "food-producing animals, poultry, aqua farming, and animal feed supplements." The ministry said the ban was necessary because colistin use in animals poses a risk to humans.

The World Health Organization has classified colistin a "highest priority critically important antimicrobial." The antibiotic is used in human medicine to treat serious, multidrug-resistant infections that aren't responding to other antibiotics. Antimicrobial resistance and infectious disease experts are concerned that using the drug in food-producing animals promotes the emergence of colistin-resistant pathogens that can spread from animals to humans. The emergence of the colistin-resistance gene MCR-1, first identified in Chinese pigs and pork products in 2015, has been linked to widespread use of colistin on Chinese farms.

Banning colistin from being used in food-producing animals puts India in line with the European Union, United States, China, and Brazil, which have all stopped using colistin in animal agriculture in recent years.

"We welcome the health ministry's move to ban colistin use in food-producing animals," Chandra Bhushan deputy director general of India's Centre for Science and Environment (CSE), said in a press release yesterday. "It will help preserve this last-resort antibiotic for humans and save lives from deadly antibiotic-resistant infections. It will go a long way in fighting antibiotic resistance."
Jul 20 The Hindu story
Jul 22 CSE press release


Sanofi signs deal for rights to pursue Tamiflu OTC switch

Sanofi today announced that it has signed an agreement with Roche for exclusive over-the-counter (OTC) rights in the United States to the influenza drug Tamiflu (oseltamivir). In a statement, Sanofi said, under the terms of the agreement it will lead Food and Drug Administration (FDA) negotiations for the over-the-counter switch and will have exclusive marketing, scientific engagement, and Tamiflu distribution in the United States.

Tamiflu is currently sold in the United States by Genentech, part of the Roche Group.

Alan Main, Sanofi's executive vice president of consumer healthcare, said in the statement that a switch to OTC Tamiflu supports the company's cough and cold strategy by expanding into flu. "Tamiflu will offer a significant public health benefit once switched by providing increased access to a safe and efficacious treatment for the prevention and treatment of flu," he said. "People would be able to either reduce their chances of getting the flu or, at the first signals, appropriately treat as early as possible during the crucial first 48 hours without having to wait for a doctor’s appointment."

Currently, there are no OTC antiviral products to treat flu.

As part of the agreement, Sanofi is responsible for leading and funding all studies needed to support the OTC switch in the United States.
Jul 23 Sanofi press release

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