News Scan for Feb 25, 2019

News brief

Saudi Arabia records 7 new MERS cases, including 3 in Wadi ad-Dawasir

The Saudi Arabian Ministry of Health (MOH) announced seven new cases of MERS-CoV over the weekend, recorded in reports for epidemiologic weeks 8 and 9. Three of the cases are in Wadi ad-Dawasir, two of which appear to be part of an ongoing hospital outbreak.  

On Feb 22, the MOH noted that a 57-year-old man from Wadi ad-Dawasir who both had camel exposure and was a household contact of a previously recorded case was isolated in his home after being diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus). The next day, the MOH said a 35-year-old woman from Wadi ad-Dawasir was also in home isolation after contracting MERS in the healthcare setting.

Also recorded on Feb 23 was a case in Mecca involving a a 41-year-old man and one in Jeddah involving a 70-year-old man, both of whom had recent camel exposure and are hospitalized.

Yesterday the MOH said two women—a 24-year-old from Riyadh and a 96-year-old from Unayzah—were also diagnosed as having MER-CoV infection. The woman from Unayzah died, and her source of infection was listed as "primary." The woman from Riyadh is in home isolation and is a household contact of a previously recorded case. Neither woman had camel exposure.

Finally today, the MOH reported that a 50-year-old man from Wadi ad-Dawasir was hospitalized for MERS. He had camel exposure.

The MOH has now recorded 80 MERS cases since Jan 1, with 51 of those in Wadi ad-Dawasir.
Feb 22-23 MOH
Feb 24-25 MOH


CDC reports 1 more measles outbreak; national cases climb to 159

Since its report last week, the US Centers for Disease Control and Prevention (CDC) today reported 32 more measles cases for 2019, raising the total to 159 in 10 states. Also, one more outbreak was reported, which involves four cases in the Champaign-Urbana area of Illinois, lifting the number of outbreaks to six. The CDC defines an outbreak as three or more cases.

On Jan 24, the University of Illinois' McKinley Health Center said it was working with the Champaign-Urbana Public Health District (CUPHD) regarding a recent measles case. In a Feb 17 update, CUPHD reported the third and fourth cases of measles. The third case-patient was in isolation for the entire infectious period, and the fourth case was pending genotyping from the CDC. The CUPHD noted that all four of the measles patients were no longer infectious.

The biggest outbreak is centered near Vancouver, Washington, in and around Clark County, which reported 4 new cases, raising its total to 65 since early January. Among the other ongoing outbreaks, New York's Rockland County reported 3 more cases, raising its total to 138 since September, and an outbreak under way since October in the Orthodox Jewish community in Brooklyn, New York, has 17 more cases.

Also, New York's Monroe County has 7 cases, 4 of them lab-confirmed and 3 that meet the clinical profile.
Feb 25 CDC update
Jan 24 University of Illinois
measles alert
Feb 17 CUPHD
press release

In international measles developments, Costa Rica's health ministry announced last week that a 5-year-old French boy who arrived in the country with his parents on Feb 18 has been isolated in the hospital with a suspected measles infection, according to a Feb 20 statement. Contact identification to assess susceptibility and the need for vaccination is under way.

If confirmed, it would be Costa Rica's first imported case since 2014. The country hasn't had a locally acquired case since 2006.
Feb 20 Costa Rica health ministry


CEPI announces support for another Nipah virus vaccine

The Coalition for Epidemic Preparedness Innovations (CEPI) and the University of Tokyo have announced a partnership worth up to $31 million to develop and produce a vaccine against Nipah virus, which is harbored by bats that can transmit the disease to humans and other animals.

For the recombinant candidate vaccine, University of Tokyo's vaccine researchers inserted the Nipah virus G gene into an attenuated measles virus vaccine, CEPI said in a news release today. Measles vector replication expresses Nipah virus antigens that provoke a strong and long-term humoral and cellular immune response. The University of Tokyo's vector approach is also being used in an experimental vaccine against highly pathogenic avian flu, and the European Vaccine Initiative is supporting its use to develop vaccine candidates against Zika and dengue viruses.

The University of Tokyo will co-lead the study with the European Vaccine Initiative, and phase 1 and 2 trials will be done in partnership with Stanford University School and Medicine and the International Center for Diarrheal Disease Research in Bangladesh. Batavia Biosciences will handle vaccine manufacturing and stockpiling. Nipah virus is one of CEPI's three priority areas, alongside Lassa fever and MERS-CoV.

Richard Hatchett, MD, chief executive officer of CEPI, said in the release that CEPI has now invested in three Nipah vaccine candidates, worth up to $75 million. "There is an urgent need for accelerated research and development for the Nipah virus. Not only is the case fatality rate for this disease high—ranging between 40% and 100%—there is a serious risk that this disease could become a threat to global health security," he said.

CEPI was founded in 2017 to streamline and fund research for new vaccine candidates against the three priority diseases. The coalition is supported by the governments of Norway, Germany, India, Japan, Belgium, Canada, and Australia, plus groups including the Bill & Melinda Gates Foundation, Wellcome Trust, World Economic Forum, Medical Research Future Fund, and European Commission.
Feb 25 CEPI press release


Study: Tick bite meat allergy trigger risk higher than thought

The risk of experiencing an allergic reaction to red meat after a tick bite could be higher than previously thought, researchers from the University North Carolina (UNC) School of Medicine reported at the American Academy of Allergy, Asthma, and Immunology annual meeting in San Francisco.

Allergy to alpha-gal, a complex sugar found in most mammal blood but not in humans, can occur following a tick bite, with the response leading to a red meat allergy called alpha-gal syndrome (AGS).

Scott Commins, MD, PhD, associate professor of medicine and pediatrics at UNC School of Medicine, said in a UNC press release that scientists originally thought that people developed the allergy after exposure to a tick that had fed on a deer, dog, or other small mammal that has alpha-gal. He said, however, that new data suggest that ticks can trigger the immune response even without the mammal blood meal, which he said probably means the risk of each bite potentially leading to the allergy is higher than anticipated.

To tease out the role of a mammal blood meal in the allergy, the researchers stripped white blood cells of their immunoglobulin E antibodies, which are produced during an allergic reaction. Then they primed them with plasma from people with and without AGS. Next, they added tick salivary gland extract to the cells from four tick species: lone star, deer (black-legged), Gulf Coast, and American dog (or wood tick). Some had recently feed on alpha-gal blood, and some had not.

As expected, saliva from lone star and deer ticks that had recently fed on blood triggered a reaction. But so did the saliva of ticks that hadn't recently fed on blood. Saliva from the lone star tick that hadn't recently fed was 40 times more reactive than control. However, saliva from neither the Gulf Coast nor the American dog tick caused a reaction.

With the range of reactivity seen from both blood-fed and non-blood-fed samples, Commins said, "These results suggest that more tick bites than we initially suspected could pose a risk for developing red meat allergy."
Feb 23 UNC Health Care news release

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