News Scan for Sep 02, 2014

News brief

Chikungunya outbreak in Caribbean tops 650,000 cases

With 69,343 new cases, mostly from the Dominican Republic, the chikungunya outbreak in the Caribbean reached 658,466 cases last week, according to an Aug 29 update from the Pan American Health Organization (PAHO).

The jump in cases marks the end of an apparent 2-week slowdown. The region reported only 3,325 and 9,798 new chikungunya cases in the preceding 2 weeks. PAHO's outbreak numbers include both confirmed and suspected cases.

Of the 69,343 new cases, 59,280 were in the Dominican Republic, which now has 429,492 total cases, making it by far the hardest-hit area.

Other areas reporting the most new cases are Martinique, with 3,520 new cases (60,955 total); El Salvador, 2,926 (8,040); Guadeloupe, 2,280 (76,728); French Guiana, 452 (2,206); the French side of St. Martin, 130 (4,783); and St. Barthelemy, 40 (1,042).

As reported by the US Centers for Disease Control and Prevention last week, US cases have reached 696, of which only 6 have been locally acquired, all in Florida.

Also of note: Haiti, which had been an outbreak hot spot, hasn't reported new numbers in 7 weeks. And no new chikungunya-related deaths were reported last week, leaving that number at 37.

PAHO also released an epidemiologic alert for the region concerning chikungunya and dengue fever, asking for nations that are seeing circulation of both diseases to ramp up mosquito-control efforts. The alert also outlined patient care. It cited a slightly higher outbreak total—659,367.
Aug 29 PAHO outbreak update
Aug 29 PAHO epidemiologic alert
Aug 25 CIDRAP News scan "Caribbean chikungunya outbreak continues to slow"

New MERS case raises Saudi count to 726

In recent days Saudi Arabia confirmed one new MERS-CoV case and the death of a previously announced case-patient, raising the country's total cases to 726, according to statements by the Saudi Ministry of Health (MOH).

The new case is in a 34-year-old non-Saudi healthcare worker in Jubail in the northeastern part of the country on the Persian Gulf coast, the MOH said in an Aug 29 update. The man is in home isolation. As is characteristic of MOH reports on MERS-CoV (Middle East respiratory syndrome coronavirus), no other details were given.

The case is the third reported by the MOH last week, after almost 2 weeks without a MERS case.

The death was in a 69-year-old Saudi national in Dammam, which is about 50 miles down the coast from Jubail. He was not a health worker and had preexisting disease, the MOH said in an Aug 28 statement. On Aug 25 the MOH announced his case, saying the man was in intensive care.

Of the 726 cases, 302 have proved fatal.
Aug 29 MOH statement
Aug 28 MOH statement
Aug 25 MOH statement

Japan's dengue fever outbreak reaches 34 cases

Japan's Health Ministry today announced 12 more cases of dengue fever linked to contact with mosquitoes in Tokyo's Yoyogi Park, bringing the country's outbreak total to 34, according to a report today from The Asahi Shimbun, a national newspaper in Japan.

The newest patients are from Tokyo, Osaka, Aomori, and Yamanashi prefectures. As with the other 22 cases, all had visited the park and its vicinity and had not traveled abroad recently. All 12 patients are listed in stable condition.

The outbreak is the first in Japan in about 70 years. Workers have been spraying Yoyogi Park and draining standing water to eradicate mosquitoes, the story said.
Sep 2 Asahi Shimbun story

Ebola Scan for Sep 02, 2014

News brief

HHS contract aims to boost ZMapp development for Ebola

The US Department of Health and Human Services (HHS) will spend up to $42.3 million to help accelerate development of the experimental Ebola drug ZMapp, the agency said in a press release today.

The HHS's Office of the Assistant Secretary for Preparedness and Response (ASPR), through its Biomedical Advanced Research and Development Authority (BARDA), will provide funding as well as access to subject matter experts and technical support, HHS said. The contract covers manufacturing, regulatory, and nonclinical activities for ZMapp through a $24.9-million, 18-month contract with Mapp Biopharmaceutical Inc., of San Diego to speed development of the drug, which has been used without known efficacy on several patients with Ebola virus disease (EVD).

If all goes well, ASPR can extend the contract for up to $42.3 million total, HHS said. The goal is to gain Food and Drug Administration approval.

The funds will go toward manufacturing a small amount of ZMapp for early-stage clinical safety studies and nonclinical studies to demonstrate safety and efficacy in people. Mapp Biopharmaceutical will also work with BARDA on increasing production yields and the scale of manufacturing to make more doses.

"While ZMapp has received a lot of attention, it is one of several treatments under development for Ebola, and we still have very limited data on its safety and efficacy," said Nicole Lurie, MD, MSPH, assistant secretary for preparedness and response, in the news release.

"Developing drugs and vaccines to protect against Ebola as a biological threat has been a long-term goal of the US government, and today's agreement represents an important step forward," she added.
Sep 2 HHS news release

China approves experimental Ebola drug for emergency use

China's first drug against EVD, called JK-05, has obtained regulatory approval for use in emergencies in China, the South China Morning Post reported yesterday.

The drug was developed by Professor Wang Hongquan of the Institute of Microbiology and Epidemiology in the Academy of Military Medical Sciences in Shanghai and has been in studies for 5 years. It has passed preclinical and safety tests, the story said.

The drug is a "micro-molecular chemical," that selectively contains the RNA enzymes of the Ebola virus to inhibit replication, Wang said.

JK-05 resisted the replication of Ebola cells in experiments and animal tests, the story said.
Sep 1 South China Morning Post article

Japanese researchers develop 30-minute Ebola test

Researchers in Japan said they have developed a new test to detect Ebola virus in patients in 30 minutes, potentially speeding diagnosis, Agence France-Presse (AFP) reported today.

"The new method is simpler than the current one and can be used in countries where expensive testing equipment is not available," Professor Jiro Yasuda of Nagasaki University said. He added that technology developed by his colleagues and him is less expensive than polymerase chain reaction (PCR), the current gold standard and the test most commonly used in the current massive outbreak in West Africa.

Yasuda said his team developed a "primer," which amplifies only genes specific to the Ebola virus in a patient's blood or other fluid sample. RNA extracted from the sample is used to synthesize viral DNA, which is then heated and mixed with the primer to amplify Ebola DNA.

PCR requires technicians to heat and cool samples repeatedly and takes up to 2 hours, the story said. Yasuda said the new testing system costs only hundreds of dollars, "which developing countries should be able to afford."
Sep 2 AFP story