Stewardship / Resistance Scan for Oct 29, 2019

News brief

CARB-X announces funding for new drugs targeting Staph aureus

CARB-X announced today funding of up to $4.98 million for BioVersys's new small-molecule drugs targeting Staphylococcus aureus bacteria, including methicillin-resistant S aureus. The drugs could be used as a stand-alone to treat uncomplicated skin and skin-structure infections, as well as in combination with other antibiotics for more severe infections.

According to CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator), BioVersys's candidate biologicals are a new type of drug that acts not as a direct antibiotic—instead, the small molecules are able to disarm Staphylococcus aureus bacteria of virulence factors. BioVersys will receive $3.94 million in non-dilutive funding for the drugs, the BV200 series molecules, with a possibility of up to $4.98 million if certain milestones are met.

"Drug-resistant bacteria represent one of the greatest threats to public health globally. New approaches, like the BioVersys' project, are urgently needed to help save lives and to curb the spread of drug-resistant bacteria," said Kevin Outterson, executive director of CARB-X, in a press release. "This project is in early stages of development but if successful and approved for use in patients."

Since its inception in 2016, CARB-X has announced 49 awards exceeding $155 million, to develop antibacterial products. Through 2021, CARB-X plans to invest $500 million into the research and development of novel antibacterial products.
Oct 29 CARB-X press release

UK veterinary antibiotic sales cut in half since 2014, report shows

A report today from the United Kingdom's Veterinary Medicines Directorate highlights the steep reductions in antibiotic use by UK livestock producers in recent years.

The 2018 UK Veterinary Antibiotic Resistance and Sales Surveillance Report (UK-VARSS) shows a 53% reduction in overall sales of antibiotics for food-producing animals since 2014 (measured in milligrams per kilogram), along with a 68% reduction in highest-priority critically important antibiotics (HP-CIAs). Data on antibiotic usage (the amount of antibiotics purchased, prescribed, and/or administered per sector) show significant reductions among pigs, chickens, turkeys, ducks, and dairy cows.

Data on antibiotic resistance in food-producing animals is also encouraging, showing further reductions and less resistance among indicator Escherichia coli bacteria from poultry examined at slaughter. In addition, a high percentage of Salmonella isolates (76% of 4,414) from pigs, turkeys, chickens, cattle, and sheep were susceptible to all antibiotics tested, with data showing an increase in susceptibility since 2016.

Writing in a foreword to the report, Peter Borriello, PhD, chief executive officer of the Veterinary Medicines Directorate, calls the antibiotic sales reductions "a remarkable achievement" and says future UK-VARSS reports will include data on companion animal antibiotic sales data, more detailed analysis of susceptibility in a range of animal pathogens, and data on vaccine uptake.
Oct 29 UK-VARSS 2018 report

News Scan for Oct 29, 2019

News brief

Four more Ebola cases reported in DRC, 3,268 total

In a continuation of the steady stream of Ebola cases recorded in recent days in the Democratic Republic of the Congo (DRC), the World Health Organization (WHO) Ebola dashboard shows 4 new cases today, raising the outbreak total to 3,268, a number that includes 117 probable cases.

Another 400 suspected cases are still under investigation. No new deaths were recorded, so the fatality total stands at 2,181.

The DRC's Ebola technical committee (CMRE) said in an update today that yesterday's single case originated from Mabalako. The CMRE also said that the DRC government is organizing an operational review of the outbreak today through Oct 31, including addressing any bottlenecks in implementing response activities. It involves both national and international leaders.

Today the International Rescue Committee (IRC) reaffirmed its commitment to ending the 14-month-long outbreak in the DRC, saying it would "double down on our efforts to reach zero cases."

"We are walking on a tightrope. We know that it does not take much for cases in a new area to escalate quickly, as we have seen following previous lulls in cases in this outbreak," said Dalia al-Awqati, MA, the Ebola response director for the IRC in DRC, in a press release. "It only takes one infected person to travel to a new area to start a new transmission chain. Given the 21 day incubation period, the chances of this are relatively high."

The IRC said the rural hot spots of the viral disease already face significant challenges, including limited access to drinking water and inaccessible roads.
WHO Ebola dashboard
Oct 29 CMRE update
Oct 29 IRC press release

Second MERS case detected in Unayzah, Saudi Arabia

Saudi Arabia reported a new MERS-CoV infection in a 43-year-old man from Unayzah, the second recent case in that city, according to a report today from the country's Ministry of Health (MOH).

So far, Saudi Arabia has reported 11 MERS-CoV (Middle East respiratory syndrome coronavirus) infections in October, up from 4 in September. Over the weekend, a 10-year-old boy from Unayzah was also diagnosed as having MERS. Infections in children are rare.

Today's patient had unknown camel exposure. His case is listed as primary, meaning he probably didn't contract the illness from another patient.

Since the first human cases were detected in 2012, the WHO as of the end of September has received reports of 2,468 cases, at least 851 of them fatal. The vast majority of the illnesses have been reported in Saudi Arabia.
Oct 29 Saudi MOH report

Phase 1 study of Lassa fever vaccine launched

Today Themis Bioscience and the Coalition for Epidemic Preparedness Innovations (CEPI) announced the launch of a phase 1 trial for Themis's vaccine candidate against Lassa fever, MV-LASV.

"Lassa fever remains a serious public health threat across West Africa, with Nigeria alone experiencing its largest ever outbreak of the disease this year," said Melanie Saville, MD, director of vaccine development at CEPI, in a Themis press release. "This first in-human trial for Themis' MV-LASV Lassa candidate is an important first step in its evaluation in the clinic and toward developing an effective vaccine which will be available to at-risk populations during outbreaks of this deadly emerging infectious disease."

According to Themis, MV-LASV is a live-attenuated vaccine, based on the backbone of the measles Schwarz virus strain. The phase 1 trial will be a randomized, placebo-controlled, dose-finding study in 60 healthy adults, and will test the safety, tolerability, and immunogenicity of MV-LASV after administration of two different dose levels.

Lassa fever, MERS-CoV, and Nipah virus, are among the first viruses targeted by CEPI, a private-public organization aimed at developing vaccines for emerging infectious disease threats. CEPI will support the candidate vaccine's development through phase 2 trials.
Oct 29 Themis press release

Malaria spike in Burundi sickens 7.2 million so far

A massive malaria outbreak in Burundi continues and has now sickened more than 7.2 million people, nearly 2,700 of them fatally, since the first of the year, the WHO African regional office said today in its weekly outbreaks and health emergencies report.

Since its last update on the outbreak in the middle of August, Burundi has reported 1.5 million more cases and 836 more deaths, the WHO said. Disease activity is up 64.6% compared with 2018. Nearly half of the country's 47 health districts have passed the epidemic threshold for the disease.

The WHO said malaria is endemic in Burundi, but this year the decrease typically seen after May did not occur. The country's last epidemic, in 2017, affected all of the country's districts, sickening 6.2 million people and killing 2,752.

Investigations into this year's spike in activity suggest multiple complex drivers, including climate change, permanent presence of mosquito breeding sites, the extension of rice cultivation, changes in vector behavior, low coverage of prevention measures, and factors that make populations vulnerable. Also, health officials suspect a drop in treatment effectiveness, which is under investigation.

Vector control efforts are under way, and a national insecticide-treated bed net distribution campaign is slated for the middle of December. The WHO added that Burundi's government is ordering new malaria medicines, with artemether-lumefanthrine to replace artesunate-amodiaquine.
Oct 29 WHO African regional office weekly report

WHO: Influenza A predominates in October flu activity

In its latest global flu update, the WHO said yesterday that, in the first half of October, influenza A made up 60.5% of positive samples, and among those subtyped samples, 64.4% were H3N2.

Throughout much of the Northern Hemisphere, influenza activity remained at interseasonal levels, but activity continued to rise across the Arabian peninsula. Influenza A (H3N2) viruses are predominating in Qatar, the WHO said, and all seasonal influenza subtypes are co-circulating in Kuwait and Oman.

Laos, the Philippines, and parts of West Africa also report elevated flu levels. "In the temperate zones of the southern hemisphere, influenza activity continued to decrease overall," the WHO said.

Even though influenza A is predominating so far this season, B detections are on the rise, the WHO said. Influenza B represented 39.5% of influenza typed in the first half of October.
Oct 28 WHO update