New data: Interferon-alpha nasal spray cuts COVID infections in adult cancer patients by 40%

News brief

Woman using nasal spray — NIAID / Flickr cc

Daily use of an interferon-alpha (IFN-α) nasal spray lowers the risk of COVID-19 infection in adults with cancer, a new randomized controlled trial finds.

For the multicenter study, published last week in Clinical Infectious Diseases, researchers at the University of Melbourne in Australia randomly assigned participants to receive daily IFN-α nasal spray (217 participants) or a saline placebo (216) from December 2020 to April 2023. Participants had solid-tumor or blood cancer with no history of COVID-19 infection.

Participants who developed influenza-like symptoms in the 90 days after randomization collected nasal swabs for polymerase chain reaction (PCR) testing for COVID-19, influenza A/B, respiratory syncytial virus, parainfluenza, adenovirus, seasonal coronavirus, picornavirus, and/or human metapneumovirus, or they had COVID-19 rapid antigen testing.

Study visits occurred at 30, 60, and 90 days, at which time participants provided blood samples and completed a questionnaire.

"Preventative measures, such as vaccination and monoclonal antibodies, have dramatically improved outcomes but many cancer populations experience breakthrough infections and have suboptimal vaccine responses," the authors wrote.

Lower rates in younger, female, vaccinated patients

The COVID-19 infection rate was lower in the IFN-α group than in placebo recipients (8.3% vs 14.4%), for a 40% reduced risk. The incidence of other viral respiratory infections was 5.1% in both groups, but the case numbers were too low to reach a conclusion about efficacy.

There may be a role for short-term IFN-α nasal spray in addition to vaccination and monoclonal antibodies in preventing COVID-19.

In the 389-person per-protocol cohort, rates of COVID-19 infection in IFN-α and placebo recipients were 7.7% and 16.0%, indicating half the risk. Other respiratory virus incidence was 4.6% and 5.7% in the two groups, respectively.

A subgroup analysis demonstrated lower COVID-19 incidence in IFN-α recipients younger than 65 years (relative risk [RR], 0.48), women (RR, .44), and vaccinated recipients (RR, 0.50) but no difference by cancer type, disease severity, hospitalization, or death. IFN-α was well tolerated.

The researchers noted that IFN-α has antiviral, antimicrobial, antiproliferative, and immunomodulatory effects. "There may be a role for short-term IFN-α nasal spray in addition to vaccination and monoclonal antibodies in preventing COVID-19," they wrote.

West Coast governors form health alliance to ensure vaccine access

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Stephanie Soucheray, MA

gov newsom — **California Governor Gavin Newsom.** Photo: Bureau of Reclamation/Flickr cc

Governors from Washington, Oregon, and California today announced the formation of the West Coast Health Alliance in the wake of drastic shakeups at the Centers for Disease Control and Prevention (CDC) last week and confusion over immunization recommendations, including new limits placed on who is eligible to receive COVID vaccines.

"The CDC has become a political tool that increasingly peddles ideology instead of science, ideology that will lead to severe health consequences. California, Oregon, and Washington will not allow the people of our states to be put at risk," the governors said in a joint statement this morning.

The alliance will "help ensure the public has access and credible information for confidence in vaccine safety and efficacy," according to the statement.

No info yet on COVID-19 vaccines

The alliance said they will be safeguarding scientific expertise by ensuring that public health policies in California, Oregon, and Washington are informed by trusted scientists, clinicians, and other public health leaders, per the press statement.

Our communities deserve clear and transparent communication about vaccines—communication grounded in science, not ideology.

Sejal Hathi, MD, MBA, director of the Oregon Health Authority, said, "Our communities deserve clear and transparent communication about vaccines—communication grounded in science, not ideology. Vaccines are among the most powerful tools in modern medicine; they have indisputably saved millions of lives."

It is unclear at this time if the alliance will distribute COVID-19 vaccines, which have been a feature of in-fighting at the CDC this summer. The press statement also did not address potential costs of COVID-19 vaccines for recipients who are not in the recommended use groups.

"In the coming weeks, the Alliance will finalize shared principles to strengthen public confidence in vaccines and in public health," the statement said. "In a vacuum of clear, evidence-based vaccine guidance, manufacturers lack reliable information to plan production, health care providers struggle to provide consistent plans of care, and families face uncertainty about access and coverage."

US measles total climbs to 1,431 cases

News brief

Lisa Schnirring

In a weekly update, the US Centers for Disease Control and Prevention (CDC) today reported 23 more measles cases, lifting the country’s total to 1,431, the most since the country reached elimination status in 2000.

baby measles back — *Aleksandr Pykhteev/iStock*

For the first time, health officials divided out the cases confirmed in international visitors, which account for 18 of the national cases.

The number of outbreaks remained the same, at 35, double the number for 2024. So far, 86% of cases are linked to outbreaks, compared to 69% last year. To date, 92% of patients were unvaccinated or have an unknown vaccination status. School-age kids are the most affected group, followed closely by adults ages 20 years and older.

In a related development, the CDC yesterday announced the rescheduling of a Clinician Outreach and Communication Activity (COCA) call to update the situation with US measles cases. The call was originally scheduled for August 14 and is now slated for September 11.

More detections in Colorado, Texas

Following two measles cases in August, an outbreak in Colorado’s Mesa County has now grown to seven cases, according to Colorado Department of Public Health and Environment (CDPHE) measles dashboard. The CDPHE reported more potential measles exposures in the Grand Junction area for late August, which include the local hospital, a few restaurants, gas stations, and a music store.

Elsewhere, health officials in Rains County, Texas, east of Dallas, yesterday announced a travel-related measles case in an adult resident. The patient remained isolated at home during the infectious period and has recovered, according to a statement from the Northeast Texas Public Health District posted on the county's web page.

CARB-X funds development of novel diagnostic for lower respiratory tract infections

News brief

Chris Dall, MA

CARB-X (Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator) announced today that it is awarding $1 million to biotechnology company Zeteo Tech to advance work on a noninvasive diagnostic test that can diagnose lower respiratory tract infections (LRTIs) from exhaled breath.

The funding will enable Maryland-based Zeteo Tech to execute a workplan for BreathBiomics, a noninvasive diagnostic platform that employs a matrix-assisted laser desorption and ionization mass spectrometry (MALDI-MS) assay to analyze breath aerosol to distinguish between viral and bacterial infections, differentiate active infection from colonization, and assess antibiotic susceptibility.

CARB-X says the company will use the money to explore the use of breath samples from children as an alternative to bronchoalveolar lavage or sputum collection, the methods typically used to collect samples from children with suspected LRTIs. The hope is that a rapid, less invasive diagnostic test for LRTIs like pneumonia, which claims the lives of 700,000 children under 5 years annually, could expedite diagnosis, reduce unnecessary antibiotic treatment, and guide more effective treatment for drug-resistant LRTIs.

Focus on novel diagnostics for LRTIs

The award is the latest from CARB-X's March 2024 funding round, which is focused on four distinct product themes, including proof-of-concept for tests using novel sample types to diagnose LRTIs.

"Diagnosing lower respiratory tract infections rapidly and accurately remains a significant clinical challenge, particularly in critical care settings," CARB-X research and development (R&D) chief Erin Duffy, PhD, said in a press release. "We look forward to seeing how Zeteo's technology performs in early-stage development and what insights it may bring to inform improved patient outcomes."

Since its inception in 2016, CARB-X has supported 118 early-stage R&D projects designed to prevent, treat, and diagnose antibiotic resistant infections. Twenty-two of those projects have advanced into or completed clinical trials.