News Scan for Nov 25, 2015

News brief

South Korean man dies from MERS after 6-month battle

A South Korean man who recently suffered a MERS-CoV relapse died from his illness today, according to a report from the Korea Herald, which cited the country's health ministry. The 35-year-old man had also been battling lymphoma.

He initially contracted MERS-CoV (Middle East respiratory syndrome coronavirus) in May while he was being treated at Samsung Medical Center's emergency department in Seoul. His illness was confirmed on Jun 7, and he was treated at an isolation unit until Oct 3, when two rounds of tests showed that he was clear of the virus.

He was hospitalized again on Oct 11, however, and again tested positive for the virus.

South Korea's health ministry said the man's illness was the longest ever recorded for MERS-CoV. His death raises the country's fatality total for the outbreak, which largely ended in July, to 38. Overall, 186 cases were linked to the hospital-related outbreak.
Nov 25 Korea Herald story

In other MERS developments, a research team led by Saudi Arabia recently published a protocol for studying the impact of convalescent therapy for patients. The report was published online Nov 19 in SpringerPlus. The study will enroll 20 consecutive critically ill patients, who will receive 2 units of convalescent plasma. The trial is also designed to gauge the feasibility and safety of the treatment.

No MERS cases have been reported in Saudi Arabia for 13 straight days, and, according to today's Ministry of Health (MOH) report, only one patient remains in treatment.
Nov 19 SpringerPlus abstract
Nov 25 Saudi MOH update

NIH announces phase 2 trial of experimental chikungunya vaccine

Researchers will begin testing an experimental vaccine for the mosquito-borne disease chikungunya in a 400-person phase 2 trial, the National Institutes of Health's National Institute of Allergy and Infectious Diseases (NIAID) said in a news release yesterday.

Study participants age 18 to 60 years old will be divided equally into two groups: those who receive either two doses of the candidate vaccine spaced 28 days apart or those who get two doses of an inactive placebo.

The trial will be conducted in the Caribbean, where the virus appeared for the first time in the Americas in December 2013. The outbreak in regions of the Caribbean and Americas has since grown to more than 1.7 million cases.

"The recent re-emergence of chikungunya virus in this hemisphere has rapidly become a significant health burden," said NIAID Director Anthony S. Fauci, MD. "Our chikungunya vaccine development efforts are part of a broader research effort to prevent, diagnose, treat, and ultimately control this painful illness, which can strike anyone unlucky enough to be bitten by an infected mosquito."

The experimental vaccine, developed by NIAID investigators, uses virus-like particles instead of either inactivated or weakened whole virus. A phase 1 trial conducted last year demonstrated a good immune response and no serious safety concerns in 25 volunteers, the NIAID said in the release.
Nov 25 NIAID news release

Flu Scan for Nov 25, 2015

News brief

FDA approves first US adjuvanted flu vaccine

The US Food and Drug Administration (FDA) yesterday approved the nation's first seasonal flu vaccine containing an adjuvant—an immune-boosting substance—although European and other countries have used adjuvanted vaccines for years.

The agency approved Novartis's Fluad, a trivalent (three-strain) vaccine for preventing seasonal flu in people age 65 and older, it said in a press release. The egg-based vaccine contains MF59, an oil-in-water emulsion of squalene oil, which is a naturally occurring substance that is highly purified for use in vaccines.

"Fluad provides another alternative for a safe and effective influenza vaccine in people 65 years of age and older," said Karen Midthun, MD, director of the FDA's Center for Biologics Evaluation and Research. "Immunizing individuals in this age group is especially important because they bear the greatest burden of severe influenza disease and account for the majority of influenza-related hospitalizations and deaths."

In a multicenter clinical trial of 7,082 seniors, Fluad showed comparable immune-boosting capabilities as Agriflu, a trivalent flu vaccine also made by Novartis. Studies of about 27,000 other people 65 and older demonstrated the safety of Fluad, the FDA said.
Nov 24 FDA press release

UK sees 151% rise in excess winter deaths, many caused by flu

Excess winter deaths were up 151% in Britain last season compared with the year before, partly attributed to deaths from influenza, UK officials reported today.

The UK Office for National Statistics (ONS), in its annual report, estimated that England and Wales had 43,900 excess winter deaths 2014-15, the highest number since 1999-2000. It said respiratory diseases were the underlying cause of death in a third of cases.

The ONS noted that the 2014-15 flu season was dominated by the H3N2 strain. "This strain of flu had a particularly noticeable effect on the elderly, resulting in numerous care-home outbreaks and far higher levels of excess mortality than the last notable H3N2 season of 2008/09," the report said.

The agency added that the weeks beginning Dec 29 and Jan 5 saw 14,428 and 14,632 deaths caused by flulike illness, respectively—35% and 39% higher than the same weeks in 2013-14.

The ONS also noted the low effectiveness of the flu vaccine last season. Claudia Wells, head of mortality analysis at ONS, told the UK's The Guardian newspaper, "It [flu] was associated with more deaths than we expected. As it wasn't a particularly cold winter, we do think it was probably down to ineffectiveness of the flu vaccine."
Nov 25 ONS news release
Nov 25 ONS report
Nov 25 Guardian story

France, Vietnam report H5N1 outbreaks in poultry

France has detected highly pathogenic H5N1 avian flu for the first time in 8 years, while Vietnam has again detected the virus in poultry, officials said today in separate reports.

H5N1 killed 22 of 32 chickens in a backyard flock in Biras in the Perigord, a southwestern region in France known for poultry and foie gras (poultry liver) production, Reuters reported. The outbreak comes as foie gras demand rises for the holidays, but French officials were quick to reassure the public about its safety.

"This virus has no effect as far as consuming poultry meat or anything that comes from poultry products is concerned—I am thinking particularly about foie gras since we are approaching times of high consumption," said French Agriculture Minister Stephane Le Foll.

After previous H5N1 outbreaks in France, however, several countries, including Japan, Egypt, and Hong Kong, had banned French poultry, Reuters noted. Japan is the largest importer of French foie gras.
Nov 25 Reuters story

In Vietnam, meanwhile, 100 birds in a backyard flock of 649 poultry died in an H5N1 outbreak in Ha Tinh province in the north-central part of the country, Vietnamese officials said in a World Organization for Animal Health (OIE) report posted today.

The outbreak began on Nov 7 and was confirmed on Nov 12. All surviving birds were euthanized to contain disease spread, and other measures such as disinfection were taken. The country has had several H5N1 and H5N6 outbreaks in recent weeks.
Nov 25 OIE report