News Scan for Jun 05, 2014

News brief

CDC warns of more imported chikungunya cases

The US Centers for Disease Control and Prevention (CDC) today warned health providers that the number of imported chikungunya cases is likely to increase, given ongoing outbreaks in Caribbean countries and territories and some parts of South America, according an update in Morbidity and Mortality Weekly Report (MMWR).

The number of cases doubled in affected areas during the last 2 weeks of May, with more than 95% of cases reported from five jurisdictions: the Dominican Republic, Martinique, Guadeloupe, Haiti, and the French side of St. Martin. The CDC noted that the highest incidences were in St. Martin, Martinique, Saint Barthelemy, and Guadeloupe.

Though chikungunya isn’t a nationally notifiable disease, public health department can report cases to ArboNET, a surveillance system that tracks arthropod-borne diseases. With 28 cases reported for the year as of Jun 2, the US had already equaled the average number reported in a typical year. One was Puerto Rico’s first locally acquired infection, 26 were in travelers returning from the Caribbean, and one was in a traveler returning from Indonesia.

The CDC warned that the imported cases could result in the local spread of the virus in areas where Aedes species are active. It urged providers to consider chikungunya in patients who have acute-onset fever and joint pain, especially in travelers. It added that people infected with the virus should be protected from mosquito exposure during the first week of illness to curb further spread.
Jun 5 MMWR report

Chia seed products recalled as Canada reports new Salmonella cases

Health Matters America Inc., of Cheektowaga, N.Y., has recalled chia seed products over possible Salmonella contamination in the wake of a US and Canadian outbreak, the US Food and Drug Administration (FDA) announced yesterday, and Canadian officials today confirmed 18 new cases.

The company has voluntarily recalled Organic Traditions Sprouted Chia Seed Powder and Sprouted Chia/Flax Seed Powder in 8-ounce and 1-pound packages, as well as in 50-pound bulk bags. The products were sold to distributors, to retailers, and through Internet sales in 25 states, the company said in an FDA press release.
Jun 4 FDA press release

Cases in Canada, meanwhile, have grown from 9 on May 31 to 27 in four provinces: Ontario, 15; British Columbia, 6; Alberta, 4; and Quebec, 2, the Public Health Agency of Canada (PHAC) said today.

Twenty of the cases are in women, and patients' ages range from less than a year to 89. Four patients have been hospitalized, but no deaths have been reported. Illness-onset dates range from the week of Dec 13 to the week of May 4.

As in the United States, two Salmonella strains have been linked to the outbreak: Newport and Hartford.

"The investigation is ongoing but currently, 12 of 13 cases that have been interviewed have reported consumption of sprouted chia seeds or sprouted chia seed powder," the agency said, "and 10 of 13 cases specifically report sprouted chia seed powder."
Jun 5 PHAC update

CDC confirms nation’s fourth vCJD case

Lab results on autopsy samples from a patient in Texas have confirmed variant Creutzfeldt-Jakob disease (vCJD), the fourth such case to be detected in the United States, the CDC said this week.

The confirmation was made after lab tests on samples from the patient’s brain after death were positive for the disease. The CDC in a Jun 2 statement said it has assisted Texas health officials with investigating the case and will help confirm more details about the patient’s history, including how he or she was exposed.

The patient died in May, according to CDC background materials on the disease.

The patient had traveled extensively to Europe and the Middle East and was probably infected outside the United States, the CDC said. Of the other three cases reported from the US, two were likely infected in the United Kingdom and one was probably exposed in Saudi Arabia.

Globally, more than 229 vCJD cases have been reported since 1996, most of them in the United Kingdom (177 cases) and France (27 cases).

Variant CJD is a rare degenerative and fatal brain disorder in humans that results from exposure to the bovine spongiform encephalopathy (BSE) agent. BSE is commonly known as "mad cow disease."
Jun 2 CDC statement
CDC vCJD fact sheet

FDA clears new antibiotic for skin infections, including MRSA-caused

The FDA recently announced that it has approved dalbavancin (Dalvance), a new antibiotic use for treating acute skin infections in adults, including ones caused by methicillin-resistant Staphylococcus aureus (MRSA).

In a May 23 statement the FDA said the approval is the first under its new Qualified Infectious Disease Product (QIDP) designation, which involves an expedited review and qualifies the drug for an extra 5 years of marketing exclusivity. The program is part of FDA efforts to spur the development of new antibiotics, especially ones designed to treat serious or life-threatening conditions.

Durata Therapeutics, the Chicago-based maker of the drug, said in a May 23 press release that Dalvance is the first IV antibiotic approved for acute bacterial skin and skin structure infections (ABSSSI).
May 23 FDA statement
May 23 Durata press release

In a related development, a US-India research team today reported that a single dose of oritavancin, an antibiotic effective against gram-positive bacteria, is as effective as twice-daily vancomycin given for 7 to 10 days for treating ABSSSI. Their findings appear in the New England Journal of Medicine (NEJM).

One of the pathogens the drug showed efficacy against was MRSA. Adverse events were similar for both drugs, but nausea was more common in patients who received oritavancin.

The intravenous drug, made by The Medicines Company, based in New Jersey, was granted the FDA's QIDP designation in December 2013, according to a Feb 19 company press release. The FDA action date for oritavancin is Aug 6.
Jun 5 NEJM abstract
Feb 19 Medicine Company press release

Flu Scan for Jun 05, 2014

News brief

Flu exit nearly final in Northern Hemisphere

Most Northern Hemisphere countries are at or approaching interseasonal flu levels, with North America and eastern Asia still reporting some influenza B circulation, the World Health Organization (WHO) said in its latest global flu update.

The countries at interseasonal levels included China, with the percentage of positive flu tests low in both the northern and southern parts of the country.

In southern and southeastern Asia, levels dropped, except in Iran, which reported a slight increase, much of it from the 2009 H1N1 virus, the WHO said. Tropical countries saw little flu activity, except for slight increases in Peru and Bolivia, mostly from H3N2.

In the Southern Hemisphere, flu detections increased in Australia and New Zealand, but levels were still low. Paraguay reported higher-than-expected flu activity for this time of year, mainly driven by H3N2 and influenza B.

During the first half of May, testing of flu virus samples by global flu labs found slightly more influenza B than influenza A, at 51.5% influenza B. Of the subtyped influenza A strains, H3N2 was dominant, at 70.2%.
Jun 2 WHO global flu update

UK study: No clear benefit to universal LAIV program in young kids

A pilot program of universal live-attenuated influenza vaccination (LAIV) among British 4- to 11-year-olds during this past flu season was associated with decreased flu levels, but the drop was not statistically significant, according to a study today in Eurosurveillance.

UK researchers selected seven areas in England for the pilot 2013-14 program, representing about 5% of children of primary school age. In the areas, 104,792 children received LAIV out of an estimated 199,475 possible, for an overall vaccine uptake of 52.5%. Uptake ranged in the seven areas from 35.8% to 71.5% and declined with increasing age.

Although markers for influenza were generally lower in pilot areas than in non-pilot areas during a season of low influenza activity—such as 2.6 lab-confirmed hospitalizations per 100,000 population, compared with 5.0—the difference was not statistically significant, the researchers reported.
Jun 5 Eurosurveillance study