News Scan for Dec 16, 2019

News brief

Study: The common cold and flu appear to cancel each other out

Today in Proceedings of the National Academy of Sciences (PNAS) British authors offered evidence supporting a long-observed phenomenon of the cold and flu season: Having either a rhinovirus or influenza makes a person less likely to contract the other virus.

This is the first study with enough samples to show evidence of the relationship between rhinoviruses, which cause the common cold, and influenza viruses, at both an individual and population level. To conduct the study, the researchers looked at 44,230 cases of acute respiratory illness, in 36,157 patients, who were tested for 11 types of respiratory viruses over 9 years in Glasgow and Clyde, Scotland.

In the strongest study finding, patients with influenza A were approximately 70% less likely to also be infected with rhinovirus than were patients infected with the other virus types. In general, only 8% of patients testing positive for either rhinoviruses or influenza viruses were co-infected with another virus.

The contradictory relationship was also seen on a population level.

Sema Nickbakhsh, PhD, from the MRC-University of Glasgow Centre for Virus Research at the University of Glasgow, said in a UK Research and Innovation press release, "One really striking pattern in our data is the decline in cases of the respiratory virus rhinovirus, which is typically a mild common cold causing virus, occurring during winter, around the time that flu activity increases."
Dec 16 PNAS study

Dec 16 UK research and innovation press release


Montana reports its first chronic wasting disease case in wild elk

For the first time, state officials in Montana have tracked chronic wasting disease (CWD), a deadly prion disease that affects cervids, in a wild elk. The animal was harvested on private land northeast of Red Lodge in November.

According to ProMed Mail, the reporting system of the International Society for Infectious Diseases, Montana last reported CWD in captive elk in 1999.

CWD was found in wild mule deer in Montana in 2017. Earlier this year, a moose in the state was also found to have the disease. In total, Montana's Fish, Wildlife, and Parks office has recorded 91 animals with CWD this year, with the rest in deer.

Montana's general hunting season ended on Dec 1. Though there have been no documented cases of CWD jumping from animals to humans, the Centers for Disease Control and Prevention recommend testing all animals harvested from areas with known CWD transmission. 
Dec 14 ProMed post
Dec 9 Montana Fish, Wildlife, and Parks news release


MERS sickens 2 more in Saudi Arabia

Saudi Arabia over the past few days reported two new MERS-CoV cases, bringing the total for December to three, an apparent decline from November when 12 cases were reported.

The patients are 66-year-old man from the city of Abha in Asir region and a 72-year-old woman from the city of Riyadh, the country's capital, according to updates from the ministry of health (MOH). Neither of the people are healthcare workers and both had primary exposure to Middle East respiratory syndrome coronavirus (MERS-CoV), meaning they probably didn't contract the virus from another known case.  Contact with camels is listed as unknown for both.

Asir region is southwestern Saudi Arabia, and Riyadh is located in the central part of the country.

The World Health Organization (WHO) said in an update earlier this month that since MERS-CoV was first detected in humans in 2012, it has received reports of 2,484 cases, at least 857 of them fatal. Most were reported from Saudi Arabia.
Dec 14 Saudi MOH statement


Stewardship / Resistance Scan for Dec 16, 2019

News brief

BARDA to fund development of antibiotics for resistant gram-negatives

San Diego-based biopharmaceutical company Qpex Biopharma today announced it will receive a second round of funding from the Biomedical Advanced Research and Development Authority (BARDA) to develop a portfolio of antibiotics targeting antibiotic-resistant gram-negative bacteria.

Under the Other Transaction Authority (OTA) agreement with BARDA, Qpex will receive $20 million to advance three products into clinical studies: ORAvanceTM, an orally administered beta-lactamase inhibitor (BLI)-based product for treating infections caused by extended-spectrum beta-lactamase (ESBL)- and carbapenemase-producing Enterobacteriaceae; OMNIvanceTM, an intravenous (IV) BLI-based product; and QPX9003, a next-generation IV-administered polymyxin designed to address highly-resistant Pseudomonas and Acinetobacter infections.

The $20 million option is the second award under the OTA agreement, which provides for up to $132 million in funding.

"We are grateful for our successful and longstanding partnership with BARDA, whose commitment to address the global and growing threat of antimicrobial resistance has been unparalleled," Qpex Biopharma President and CEO Michael Dudley, PharmD, said in a company press release. "Our team has made rapid progress since forming the company just over a year ago, and the continued support from BARDA puts us in a strong position as we transition to a clinical-stage company."
Dec 16 Qpex Biopharma press release


WHO announces updates to drug-resistant TB treatment

The World Health Organization (WHO) last week issued a rapid communication outlining updated treatment recommendations for patients with drug-resistant tuberculosis (TB), based on evidence reviewed in a November meeting of its Guideline Development Group (GDG).

The main change suggested by the GDG is the introduction of a shorter, all-oral, bedaquiline-containing drug regimen for patients with multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) that would replace shorter regimens with injectables. The recommendation is based on analysis of data from a South African TB program that showed that replacing the injectable with bedaquiline resulted in significantly better treatment success and a considerable reduction in loss-to-follow up in MDR/RR-TB patients who had no previous exposure to second-line drugs, confirmed fluoroquinolone-susceptibility, and no extensive disease or severe extrapulmonary TB.

The group also recommended that in certain patients with extensively drug-resistant TB (XDR-TB), the novel 6- to 9-month bedaquiline, pretomanid, and linezolid (BPaL) regimen may be used under operational research conditions as an alternative to the standard, 18-to-24 month regimen. That recommendation is based on results from the phase 3 Nix-TB trial, in which the BPaL regimen showed high treatment success in 108 South African XDR-TB patients. But the WHO says that the regimen may not considered for programmatic use worldwide until additional safety and efficacy evidence has been generated.

The communication was released to inform national TB programs in advance of the WHO's updated guidelines on drug-resistant TB treatment, which are expected to be published in 2020.
Dec 11 WHO rapid communication


FDA clears disposable duodenoscope

The US Food and Drug Administration (FDA) recently announced that it has cleared the first fully disposable duodenoscope, which is designed to reduce the risk of infection due to difficulties sterilizing the devices.

Duodenoscopes are threaded through a patient's mouth into the top of the small intestine and are used to visualize the upper gastrointestinal tract, and they provide a less invasive way to treat some problems, such as removing pancreatic and biliary duct blockages. However, the devices have many small parts, making them difficult to clean. Some models have been linked to a number of outbreaks involving multidrug-resistant bacteria in US and European hospitals.

The disposable model, called the EXALT Model D single-use duodenoscope, is made by Boston Scientific Corp. In a Dec 13 statement, the company said the device is made for use in endoscopic retrograde cholangiopancreatography procedures (ERCP), and the FDA had granted it breakthrough device designation. Each year, more than 1.5 million ERCPs are performed in the world, according to the company, which added that it plans to start selling the device on a limited basis during the first quarter of 2020.

Jeff Shuren, MD, JD, who directs the FDA Center for Devices and Radiological Health, said in the FDA statement, "The availability of a fully disposable duodenoscope represents another major step forward for improving the safety of these devices, which are used in more than 500,000 procedures in the U.S. each year."

The new approval comes about a month after the FDA approved a new type of duodenoscope with fewer parts needing disinfection.
Dec 13 FDA statement
Dec 13 Boston Scientific
press release
Nov 18 CIDRAP News scan "
FDA clears duodenoscope with fewer parts needing disinfection"

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