Latest Saudi MERS case has camel connection

The Saudi Arabian Ministry of Health (MOH) reported a new case of MERS-CoV today in a man from Medina.

The 67-year-old expatriate is in stable condition after presenting with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus). The man had indirect contact with camels. Indirect contact with camels, including drinking camel milk, is a known risk factor for the disease.

Also, the MOH reported a death in a previously announced patient, an 89-year-old Saudi man from Baljurashi who had an underlying health condition.

The latest developments push Saudi Arabia's total number of MERS-CoV illnesses since the virus was detected for the first time in humans in 2012 to 1,696, which includes 690 deaths. Ten people are still being treated for their infections.
Aug 15 MOH report


Fatal H7N9 case reported in China

A new H7N9 avian influenza infection has been reported in China, involving a man from the Xiangxi autonomous region of Hunan province, according to a Hunan Center for Disease Control statement translated and posted by FluTrackers, an infectious disease news message board.

Following an unprecedented number of cases in the fifth wave of H7N9 activity, China is now reporting sporadic cases, and the new illness is the first since Aug 4.

The 48-year-old man from the city of Jishou, Xiangxi's capital, got sick on Aug 9 and died from his illness. He worked in waste collection and has an underlying health condition. Xiangxi is in the western part of Hunan province.

The latest case lifts China's fifth-wave total to 753 cases, when added to the total listed today in the Hong Kong Center for Health Protection's weekly avian influenza report. At least 246 deaths have been reported.
Aug 14 FluTrackers post
Aug 15 CHP
avian influenza report


Study: Bezlotoxumab reduces hospital readmission in C difficile patients

A new study in Clinical Infectious Diseases reports that treatment with bezlotoxumab reduced 30-day hospital readmissions in patients with high risk of recurrent Clostridium difficile infection(CDI).

Bezlotoxumab is a human clonal antibody that acts against toxin B, the primary virulence factor in causing CDI symptoms. The drug is used in combination with antibiotic treatment to reduce the risk of recurrent CDI, which occurs in approximately 25% of patients after completing initial antibiotic therapy. In two large phase 3 randomized clinical trials, MODIFY I and MODIFY II, bezlotoxumab significantly reduced recurrent CDI and had a favorable safety profile. The drug was approved for use in C difficile patients by the Food and Drug Administration in October 2016.

In the current study, researchers used pooled data from MODIFY I and MODIFY II to estimate 30-day CDI-associated hospital readmission rates and all-cause readmission rates among a subgroup of patients who were hospitalized at the time of randomization and for participants who had high-risk prognostic factors for recurrent CDI. One group of patients received bezlotoxumab, and the other group received a placebo.

In the 30 days after hospital discharge, the 530 patients treated with bezlotoxumab had fewer CDI-associated hospital readmissions compared to the 520 patients in the placebo group (absolute difference -6.1%, relative difference -53.4%), and fewer all cause readmissions (absolute difference -3.7%, relative difference -12.1%), although that difference did not reach statistical significance. Bezlotoxumab also reduced CDI-associated hospital readmissions in patients at high risk of recurrent CDI, including those aged 65 years and older (absolute difference -8.3%, relative difference -60%) and those with severe CDI (absolute difference -7.7%, relative difference -69%).

The authors say the results of the analysis, combined with previously reported findings, provide support for using bezlotoxumab as a treatment option in CDI patients.
Aug 11 Clin Infect Dis study


Brazil monitoring Oropouche virus threat

Sporadic cases of Oropouche fever—a vector-borne illness with symptoms similar to dengue, chikungunya, and Zika—have been detected in Brazil's Amazonas state since 2011, according to an investigation by the Fiocruz Institute and state-based surveillance.

In a report from Brazil's public radio network, translated and posted yesterday by ProMED Mail, a Fiocruz official said that of 306 samples from 20 cities in Amazonas state between 2011 and 2016, 9 were positive. ProMED Mail is the online reporting system of the International Society for Infectious Diseases.

In their commentary on the report, ProMED moderators said it's not clear if the Oropouche virus is emerging in Brazil, but it has the potential to pose another public health challenge to the country. They noted that sporadic cases or outbreaks of Oropouche fever can be expected in Brazil, where the midge that spreads the disease is present.

The virus is a member of the Orthobunyavirus genus, which also includes La Crosse and Jamestown Canyon viruses.

In 2016, the WHO reported an Oropouche fever outbreak in Peru's Cusco region, which had not reported cases before.

In July, Brazilian researchers reporting in a Fiocruz medical research journal described a multiplex test for simultaneously detecting Oropouche, Mayaro, and other related viruses.
Aug 14 ProMED Mail post
Jun 6, 2016, CIDRAP News scan "
WHO notes 57 cases of Oropouche fever in Peru"
Jul Mem Inst Oswaldo Cruz 

Study: Hendra virus threat rises as bat habitats change

Encroaching humans, deforestation, and urbanization are some of the reasons more people are becoming infected with Hendra virus, according to Australian researchers writing in Scientific Reports. Fruit bat habitats, known reservoirs for a number of diseases, including Hendra virus, are changing rapidly as human populations displace the animals.

Hendra virus "spills over" from bats to horses to humans. It was first reported along Australia's east coast in 1994; by 2017, there were 60 outbreaks of the disease, which has killed four people.

To study this phenomenon, researchers looked at data from 1980 to 2015 to measure changes occurring to the ecological habitats of Australia's bat populations as determined by sightings of different bat families. Increasing spillover incidents occurred throughout each decade of the study, as climate change and increasing human populations helped shrink the areas where bats were found.

"The human footprint, proximity to woody savanna, and vegetation loss were additional components of the landscape required to adequately describe the spatial dependence of spillover across eastern Australia,” the authors reported in a press release from the University of Sydney.
Aug 15 Sci Rep study
Aug 15 University of Sydney
press release


Plant-based polio vaccine show promise in animal study

A new study published is Nature Communications described promising results from experiments on mice for a plant-derived polio vaccine. The virus-like particle (VLP) vaccine offers protection against polio virus without the risk of vaccine-derived infection, which could make it a major player in the final steps of polio eradication.

The vaccine uses non-pathogenic copies of poliovirus genes which are grown in plants. Because VLPs do not contain nucleic acids, they cannot replicate in a human host and cause infection. The vaccine was developed in purified nicotine plants, and protected mice challenged with poliovirus.

Unlike the Sabin vaccine (live-attentuated) or the inactivated vaccine, a plant-derived polio vaccine would not require live quantities of the poliovirus, which increase the risk of accidental reintroduction of the virus.
Aug 15 Nat Commun study

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