CARB-X to fund development of novel antibacterial for pneumonia

CARB-X announced today that it is awarding up to $2.5 million to GangaGen Biotechnologies of Bangalore, India, to develop novel antibacterial proteins to treat hospital-acquired and ventilator-associated pneumonia caused by Klebsiella pneumoniae.

The money will fund preclinical development of klebicins, which are naturally occurring protein antibiotics that have shown potent activity against K pneumoniae in in vivo studies. Klebicins specifically target and kill K pneumoniae without harming beneficial bacteria in the microbiome.

"We are delighted to receive CARB-X's support to progress the klebicin programme," GangaGen president Tanjore Balganesh said in a press release from CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator). "K. pneumoniae is a hard-to-treat pulmonary pathogen resistant to many of the current antibiotics. Additionally, hypervirulent strains of the pathogen are being isolated in many parts of the globe."

GangaGen will be eligible for an additional $8.1 million in funding from CARB-X if project milestones are met.

Since its launch in 2016, CARB-X has provided $252 million in funding to accelerate the development of 69 antibacterial products.
Oct 5 CARB-X press release


The 2018-19 flu vaccine was effective in children even with antigenic drift

A study published today in Pediatrics reports that even when the H3N2 flu strain showed antigenic drifting in the 2018-19 flu season, the vaccine was effective in protecting children 6 months to 17 years of age from flu-associated hospitalization and emergency department (ED) visits.

Results of the study's test-negative design indicate that vaccine effectiveness (VE) in preventing flu-related hospital stays was 41% against H3N2 and 47% against H1N1, the two dominant strains of the season and both influenza A strains. Overall, VE was 41% in any flu-related hospitalizations and 51% in any flu-related ED visits for children.

Unlike other flu VE studies that focus on children, the study's researchers looked beyond ambulatory care using the New Vaccine Surveillance Network at seven pediatric US hospitals.

Of the 1,792 children who were hospitalized with flu-like symptoms in 2018-19, 226 (13%) tested positive for the flu: 47% were infected with H3N2, 36% with H1N1, 9% with nonsubtyped A, and 7% with B viruses. For the 1,944 children admitted to the ED, 420 (22%) tested positive with the flu, with 48% having H3N2, 35% having H1N1, 11% having a nonsubtyped A, and 5% having B viruses.

By integrating vaccination data from parental reports, state immunization databases, and provider records (the last for inpatients only), the researchers determined that VE for H3N2 was 41% for hospitalized cases and 39% for ED cases. The VE for H1N1 was 47% and 61%, respectively. VE against all flu viruses was 46% against hospitalization for children 6 months to just under 5 years of age and 23% in children 5- to 17-year-olds. Against ED visits, VE was 55% in the younger age-group and 35% for the older age group.
Oct 5 Pediatrics study


Global flu activity stays low, with sporadic detections

Flu activity remains at lower levels than expected for this time of the year, with the flu season still not under way in the Southern Hemisphere and flu activity below interseasonal levels in the Northern Hemisphere, likely due to the effects of COVID-19 and control measures, the World Health Organization (WHO) said in its latest weekly update.

Some areas reported sporadic cases, including the Caribbean, Central America, tropical countries, and Laos.

Testing of respiratory specimens at WHO network flu labs in roughly the first half of September found only 56 positives out of nearly 130,000 samples. Of the positive results, 62.5% were influenza B, and of the subtyped influenza A samples, all were H3N2.
Sep 28 WHO global flu update


Alaska reports second novel orthopox case

Alaska health officials last week reported the second known case of "Alaskapox," a viral infection caused by a novel species from the same genus as smallpox.

The Alaska Department of Health and Social Services (ADHSS) said in an epidemiologic alert that the patient is a woman from Fairbanks who had an upper arm lesion in August that was accompanied by other symptoms, such as shoulder pain, fatigue, and night fevers. Officials sent a sample of the lesion to the Centers for Disease Control and Prevention for orthopoxvirus testing, which confirmed that it belonged to a lineage found in another Fairbanks woman who experienced similar symptoms in 2015.

Neither patient had a history of out-of-state travel, and no epidemiologic links were found between the two patients, who were sick 5 years apart. Based on what's known about other orthopox viruses, health officials said the Alaskapox virus may be enzootic to one or more mammal species living in the interior of Alaska, and that human infections may occur occasionally.

Both illnesses occurred in mid to late summer in people in forested parts of Fairbanks, which the ADHSS said could reflect greater human exposure to animals and a time of peak population of smaller animals. It added that so far, there is no sign of human-to-human transmission, but more study is needed to gauge the incidence and illness spectrum. Efforts are under way to identify the animal reservoir.
Sep 30 ADHSS epidemiologic bulletin


More high-path avian flu in Russian and Kazakh poultry

Russia and Kazakhstan reported more highly pathogenic avian flu outbreaks in poultry, Russia's involving H5N8 and Kazakhstan's due to an H5 virus, according to the latest notifications from the World Organization for Animal Health (OIE).

In Russia, animal health officials reported four more H5N8 outbreaks, all in backyard birds in earlier affected oblasts in the southwestern part of the country: Kurgan, Tyumen, and Omsk. The outbreaks began from Sep 23 to Sep 25, killing 234 of 5,222 susceptible birds. The survivors were slated for culling.

In neighboring Kazakhstan, veterinary officials reported three more H5 outbreaks, all in backyard poultry in three different regions: Kostanay, Akmola, and Pavlodar. All are in the north central part of the country. The outbreaks started from Sep 17 to Sep 25, killing 108 of 191 susceptible birds. The rest were destroyed as part of the outbreak response.

The events are part of a small but steady stream of outbreaks that began in Russia over the summer, and European agriculture officials have urged poultry owners to be on the alert because of the risk of the virus spreading by migratory waterfowl.
Oct 5 OIE report on H5N8 in Russia
Oct 5 OIE report on H5 in Kazakhstan

COVID-19 Scan for Oct 05, 2020

News brief

More mental health web searches detailed during NY COVID-19 lockdown

A JAMA study today analyzing trends in internet searches found increased queries for anxiety, panic attack, and insomnia during the New York statewide lockdown in March, with searches for depression and suicide remaining at expected levels.

Quarantines have demonstrated negative effects on mental health arising from social isolation, restriction of activities, financial losses from workplace closures, and fears of illness. The JAMA study sought to assess mental health concerns during a portion of the New York lockdown by analyzing trends in internet searches for mental health issues from Mar 22 to May 15.

The study authors used anonymous, publicly available Google Trends and user location data to compare search volumes for specific mental health terms with expected volumes based on historical search data. Relative search volumes (RSV)—absolute search volumes standardized from 0 to 100—were calculated for each week of the lockdown.  

Searches for anxiety increased significantly and RSVs remained an average of 18% higher than expected for three consecutive weeks following the Mar 22 lockdown order [95% prediction interval (PI), 5% to 29%]. RSVs for panic attack soared during the first week of lockdown (56% increase, 95% PI, 37% to 97%), and remained at higher-than-expected levels for 5 consecutive weeks, while searches for insomnia were 21% higher than expected (95% PI, 1% to 55%) during the study period.

Significantly, despite a 40% increase in calls to the New York City crisis line during the lockdown, internet searches for suicide and depression did not increase. The study authors caution that continued quarantines with resulting economic turmoil might lead to future increases in these queries.

While recognizing limitations in internet search trends, the study authors advocate for providing competent online and telemedicine service during quarantines. "With the possibility of a second wave of [SARS-CoV-2] looming and a return to lockdowns, we should ensure that individuals searching the internet can rapidly obtain reliable information on strategies to cope with distress and online help from authoritative sources," the study authors wrote.
Oct 5 JAMA


COVID-19 virus survives on skin, hand hygiene highly effective, study finds

SARS-CoV-2, the virus that causes COVID-19, survives on human skin for 9 hours, much longer than a strain of influenza A virus (IAV). A study in Clinical Infectious Disease indicates that the long survival time on human skin may increase the contact-transmission risk of SARS-CoV-2 compared to other viruses, but finds hand hygiene is highly effective at neutralizing the virus.

Contact transmission is considered a significant risk factor in the spread of COVID-19, highlighting the critical need for information about survival of the virus on skin. Previous studies have identified higher stability for coronaviruses compared with other enveloped viruses—those bearing a protective, fatty outer wrapping—like IAV.

The stability of viruses on human skin is not well understood because of the dangers of exposing test subjects to pathogenic viruses. The study authors developed a model for testing viral stability using human skin obtained from autopsy specimens and compared viral survival of SARS-CoV-2 to a common strain of IAV that is transmitted through droplets and contact transmission. They recorded survival times for viral samples in human mucus and culture medium on a variety of surfaces (human skin, stainless steel, glass, and polystyrene plastic), and evaluated the effectiveness of 80% ethanol on viral survival on human skin.

The researchers found that both types of virus were inactivated faster on skin than on other surfaces, suggesting that human skin is a less hospitable environment for viruses. The study also found, however, that SARS-CoV-2 survived on skin significantly longer than IAV: 9.04 hours (95% confidence interval, 7.96 to 10.2 hours) versus 1.82 hours (1.65 to 2.00 hours), leading to the possibility of a higher risk of contact transmission for COVID-19.

Notably, the study authors also found that SARS-CoV-2 was completely inactivated within 15 seconds of exposure to 80% ethanol—the type of alcohol found in many over-the-counter alcohol-based hand sanitizers—highlighting the importance of proper hand hygiene for the prevention and spread of COVID-19. The US Centers for Disease Control and Prevention (CDC) recommends 60% to 95% alcohol in hand sanitizers for COVID-19.
Oct 3 Clin Infect Dis study


Summer family gathering leads to COVID-19 outbreak

An investigation today in Morbidity and Mortality Weekly Report (MMWR) concludes that a COVID-19 outbreak at a 3-week family gathering—which affected people across four states—likely originated from a 13-year-old girl who was exposed to a large outbreak in June 6 days before arriving.

Fourteen relatives (including the index patient) stayed in a four-bedroom, two-bathroom house from 8 to 25 days, and all but two were eventually infected. Six others visited outside in a physically distanced manner for 10 hours on day 3 and three hours on day 10, and while none of the 20 wore face masks, the more cautious relatives did not get COVID-19.

Of the infected relatives, one person sought hospitalization and another went to the emergency department for respiratory issues. Both have recovered.

Prior to the family gathering, the index patient received a SARS-CoV-2 rapid antigen test 4 days after her exposure, which came back negative. However, the authors of the report, who are from the CDC and state and local health departments, say this was probably because the test—the only type available to her at the time—was meant to be used within the first 5 days of symptoms, and she was asymptomatic. The only symptom she displayed was nasal congestion on the sixth day after exposure, which was also the start of the family gathering.

The authors note that this outbreak is yet another example showing that children and adolescents are viable COVID-19 vectors. The report also reiterates the importance of quarantining after any exposure, confirming negative rapid antigen tests with polymerase chain reaction tests, and following physical distancing and mask guidelines, pointing out that the relatives who practiced distancing were not infected.
Oct 5 MMWR report

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