News Scan for Mar 21, 2014

News brief

Case report shows evidence of camel-to-human MERS

A Saudi man who contracted Middle East respiratory syndrome coronavirus (MERS-CoV) in November after tending sick camels had a virus nearly identical to that found in one of his camels, suggesting he contracted the disease from them, according to a letter yesterday in Emerging Infectious Diseases.

The man's case was highlighted in the media in November as the first time the virus was clearly found in an animal; yesterday's letter provides new details.

The 43-year-old man had cared for nine sick camels in his herd that had respiratory illness and nasal discharge starting in early October 2013. Part of his routine involved applying herbs to the dromedaries' snouts and nostrils. The man developed symptoms himself on Oct 27, at which point he discontinued animal care.

A team of researchers, led by Ziad Memish, MD, of Al Faisal University in Riyadh, sequenced the nearly complete viral genome of the virus that infected the patient. They were able to compare it with about 15% of the MERS-CoV genome derived from one of two camels that tested positive for the virus.

They found the two sequences to yield "identical nucleotide polymorphism signatures suggestive of cross-species transmission."

The authors conclude, "These data add to recent findings showing high similarity of MERS-CoVs carried by humans and camels, supporting the hypothesis that human MERS-CoV infection may be acquired directly from camels. In addition, both animals that showed signs of recent infection were juvenile, which provides further support to previous findings that mainly young animals are infected by MERS-CoV."
Mar 20 Emerg Infect Dis letter
Nov 11, 2013, CIDRAP News story "Reports: MERS-CoV found in Saudi patient's camel"


UK advisers recommend Bexsero for childhood vaccine schedule

An vaccine advisory group to the UK's Department of Health (DH) today recommended that a vaccine against meningococcal serogroup B disease be added to the immunization schedule for children, contingent on the vaccine's availability from the manufacturer at a cost-effective price to the National Health Service.

The committee recommended that the vaccine be offered to infants starting at 2 months of age, according to a DH statement today. The United Kingdom has the highest incidence of meningococcal disease, mostly from serogroup B, in the European Union, with only Ireland having a higher rate.

Australian vaccine advisors in March made a similar recommendation. The vaccine that covers the strain, Bexsero, made by Novartis, has been approved in the European Union, Canada, and Australia. Though currently unlicensed in the United States, federal officials approved its emergency use in outbreaks at two colleges: Princeton University and the University of California at Santa Barbara.

Elizabeth Power, a spokeswoman for Novartis, told CIDRAP News today that the company intends to file for US approval of Bexsero as early as the second quarter of this year. She added that a pentavalent vaccine that would cover serogroup B as well as the four strains in the current US vaccine is still in clinical development.
Mar 21 UK DH statement
Mar 21 Novartis press release


Cholera cases trending lower in Haiti, Dominican Republic

Though Haiti and the Dominican Republic are still reporting cholera cases, the trends are decreasing and the number of cases reported so far in 2014 is running below this point in 2013, the Pan American Health Organization (PAHO) said yesterday in an epidemiologic update.

Haiti has reported 3,850 new cases and 18 deaths so far this year through Mar 10, PAHO said. Since the outbreak began in October 2010, the country has reported 700,541 illnesses, 8,546 of them fatal.

Elsewhere, Cuba has reported 23 lab-confirmed cholera cases from the end of August through late February, for an outbreak total of 701 illnesses, three of them fatal. Cuba's outbreak began in early July of 2013. No new cases have been reported from Mexico since Nov 15.
Mar 20 PAHO report

In other developments, international donations meant to improve Haiti's sanitation system are well below what's needed to improve the country's sanitation system, considered a key factor in curbing the country's cholera outbreak and providing the area with safe water, according a recent New Yorker blog post by global health reporter Jonathan Katz.

A United Nations official told Katz that the price tag for building a water and sanitation infrastructure for Haiti is $1.6 billion, but so far only $180 million has been disbursed by member states and health organizations.

Katz wrote that the country's new National Directorate for Potable Water and Sanitation opened in 2009 with nine staff members. International aid helped open two new waste treatment plants north of Port-au-Prince, but one closed due to lack of funds, and the other is operating below capacity.
Mar 12 New Yorker blog post


NIAID funds new $35 million antiviral center

The National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health (NIH), is funding the establishment of an Antiviral Drug Discovery and Development Center, or AD3C, funded by an up to $35 million, 5-year grant, according to a press release yesterday from the University of Alabama at Birmingham (UAB).

The UAB School of Medicine will lead the center, which will focus on developing drugs against four virus families: influenza, flaviviruses, coronaviruses, and alphaviruses. Richard Whitley, MD, director of the UAB medical school's Division of Pediatric Infectious Diseases, will serve as the principal investigator and program director of the AD3C.

Research will be directed toward diseases such as influenza, West Nile, MERS, chikungunya, and dengue. Researchers from UAB, the Southern Research Institute in Birmingham, and other institutions will look to target and inhibit specific enzymes essential for viral replication and expression of viral genes.

"These families of viruses are of the highest priority for the US government; they represent both biologic threats and unmet medical needs," Whitley said in the release.
Mar 20 UAB press release


NIH awards $28 million to study antibody therapy against Ebola

The NIH has awarded a 5-year grant of up to $28 million to establish a new center for excellence to find an "antibody cocktail" to combat Ebola virus and other serious hemorrhagic fever viruses.

The project, which involves researchers from 15 institutions, will be led by Erica Ollmann Saphire, PhD, professor at the Scripps Research Institute, according to a Scripps press release. Several types of antibodies, including monoclonal antibodies, have been identified as possibly therapeutic against Ebola and related viruses. Antibodies are effective even a couple of days after exposure, according to the release.

"It's a global collaboration," Saphire said of the project. "Everyone in the field got on the same page to collaborate on a set of definitive experiments." Her team, for example, will use x-ray crystallography to study the structure of various antibodies and how they bind to the virus.

Other involved institutions and companies include the Public Health Agency of Canada, US Army Medical Research Institute of Infectious Diseases, Albert Einstein College of Medicine of Yeshiva University, Ben Gurion University, Uganda Virus Research Institute, Tulane University, University of Texas, University of Wisconsin, Mapp Biopharmaceutical, Zalgen Labs, and Cangene.
Mar 20 Scripps news release

Avian Flu Scan for Mar 21, 2014

News brief

Two Chinese provinces report H7N9 cases

Chinese health officials today reported two new H7N9 cases from different provinces today. One is in a 32-year-old man from Guangdong province who is hospitalized in Shenzhen in stable condition, according to a provincial health department statement translated and posted by FluTrackers, an infectious disease news message board.

Meanwhile, Xinhua, China's state news agency, reported that the other patient is an 82-year-old man whose illness was announced by Jiangsu province's health department. The report appeared in a Chinese language report from Xinhua and was translated and posted by FluTrackers. The man is hospitalized in critical condition.

The two new cases boost the outbreak's overall total to 398, according to a human case list kept by FluTrackers. So far 262 of the cases have been reported during the second wave of infection that began in October, compared with 136 during the first last spring. The unofficial number of deaths remains at 120.
Mar 21 FluTrackers thread
FluTrackers human H7N9 case list


H5N1 strikes flocks in Cambodia, Vietnam

Two countries that have had multiple outbreaks of H5N1 avian flu in domestic birds this year—Cambodia and Vietnam—experienced new outbreaks that affected more than 7,000 poultry, according to reports posted by the World Organization for Animal Health (OIE) today and yesterday.

In Cambodia, 301 chickens, ducks, and geese died in a village flock of 526 birds in Kampot province near the border with Vietnam. The remaining birds were culled to prevent disease spread, and other measures were taken, according to an OIE report today. The outbreak began on Mar 18.

The outbreak in Vietnam struck a village flock of 6,800 poultry in the southern province of Binh Thuan. It also began Mar 18.

In that outbreak, H5N1 sickened 750 birds, killing 500 of them. The remaining 6,300 poultry were culled to contain the outbreak. The country has reported almost 40 outbreaks to the OIE so far this year.
Mar 21 OIE Cambodia report
Mar 20 OIE Vietnam report

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