Illnesses on flight grounds Emirates flight in NYC, 10 taken to hospital

An Emirates Airline flight arriving at New York's John F. Kennedy International Airport from Dubai in the United Arab Emirates at about 9 am this morning was held on the tarmac after 100 people were reportedly ill on the flight. According Eric Phillips, press secretary with the New York mayor's office, there were 521 people on the flight, which stopped in Mecca, Saudi Arabia, after it began in Dubai.

On Twitter, Phillips said Mecca is experiencing a flu outbreak, and early indications point to that as a possibility. However, the incident raised concerns, given the flight's stop in Mecca, where the annual Hajj pilgrimage wrapped up on Aug 24. Saudi Arabia has been the country hardest hit by Middle East respiratory syndrome coronavirus (MERS-CoV), which often begins with nonspecific symptoms such as cough and fever.

Ambulances arrived on the tarmac to take 10 sick passengers to Jamaica Hospital, and health officials screened each passenger for symptoms before allowing them to proceed to customs, he said.

A few hours later, Phillips said all passengers were off the plane and had been evaluated. He said 19 were sick, 10 went to the hospital, and 9 refused medical attention. "Health officials are processing tests now to determine the cause. Symptoms still pointing to the flu," Phillips tweeted.

Emirates Airline on Twitter today confirmed that of 10 people on the flight who were transferred to the hospital for further medical care and evaluation, 3 were passengers and 7 were crew.

A CDC source told Stat that there were an estimated 100 sick passengers, with passengers and some crew reporting symptoms including cough, with some experiencing fever. Passengers without symptoms will be allowed to continue their travel, with follow-up by health officials, if necessary, according to the report.

Michael Osterholm, PhD, MPH, director of the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP), which publishes CIDRAP News, said that, based on available information, health officials did an efficient job of evaluating the situation, and answers should be available soon.

He said about 4% to 5% of the population is sick at any given time, and that it wouldn't be surprising if 20 to 25 people were sick on a plane carrying about 500 people and there were reportedly others on the Emirates flight who experienced gastrointestinal symptoms.

Osterholm also said it's possible that a small cluster of people were exposed to a respiratory virus during the Hajj and didn't experience symptoms until the flight, given the typical 18- to 36-hour incubation period. He added that "hysterical illnesses" are yet another possibility when symptoms clusters crop up in closed settings such as planes or schools. Symptoms such as lightheadedness due to the power of suggestion aren't uncommon and can quickly swell illness numbers, Osterholm said.
Eric Phillips Twitter feed
Sep 5 New York and New Jersey Port Authority statement
Emirates Airline Twitter feed
Sep 5 Stat story


CDC: 130 people now sickened after eating Honey Smacks cereal

In an outbreak update published yesterday, the Centers for Disease Control and Prevention (CDC) said 30 more people have been sickened with Salmonella after eating Kellogg's Honey Smacks cereal.

Despite a recall by Kellogg's on Jun 14, the cereal is still on some store shelves, and the Food & Drug Administration (FDA) has warned consumers not to buy or eat any Honey Smacks because it could be contaminated with Salmonella Mbandaka.

The outbreak total now stands at 130 cases in 36 states, including Delaware, Minnesota, and Maine, which reported their first cases since the previous update on Jul 12. There have been 34 hospitalizations but no deaths.

The CDC said case-patient's illness onsets range from Mar 3 to Aug 4, and illnesses occurring after Aug 4 may have not yet been reported. In interviews, 77% of case-patients reported eating Kellogg’s Honey Smacks prior to symptom onset.

"Do not eat any Kellogg’s Honey Smacks cereal, regardless of package size or best-by date. Check your home for it and throw it away or return it to the place of purchase for a refund," the CDC said. "Even if some of the cereal has been eaten and no one got sick, throw the rest of it away or return it for a refund."
Sep 4 CDC update


Meta-analysis finds preventive antibiotics effective for COPD but at a cost

A meta-analysis of 12 randomized controlled trials has determined that prophylactic (preventive) antibiotics appear to be effective in preventing chronic obstructive pulmonary disease (COPD) exacerbations and improving quality of life in stable patients who have moderate to severe disease, but also appear to raise antibiotic resistance rates.

Writing in the Journal of Antimicrobial Chemotherapy yesterday, Dutch experts said the 12 studies they analyzed involved 3,683 COPD patients. The researchers found that prophylactic antibiotics reduced the frequency of exacerbations by 26% (range, 8% to 40%) and the number of patients who had at least one exacerbation by 18% (range, 10% to 26%).

Erythromycin and azithromycin appeared to be the most effective antibiotics, with the number needed to treat ranging from four to seven. Quality of life was also significantly improved by prophylactic antibiotics, the authors found, and the time to first exacerbation was prolonged in six studies, with one conflicting result.

The benefits appear to come at a cost, however, as antibiotic-resistant isolates were more than quadruple in patients who received the prophylactic regimens compared with those who didn't.

The authors conclude, "The choice of prophylactic antibiotics should be analysed and considered case by case, especially for long and continuous use."
Sep 4 J Antimicrob Chemother abstract


Kineta launches first human trial of Lassa fever antiviral

Kineta, a biotechnology company based in Seattle, today announced the start of the first human trial of its antiviral drug LHF-535 for treating Lassa fever, a hemorrhagic illnesses estimated to sicken between 100,000 and 300,000 people in West Africa a year, 5,000 of them fatally.

The single-ascending dose study, designed to assess the safety and tolerability of the drug, will involve 56 healthy participants randomized to five to seven cohorts of 8 subjects each, the company said in a statement. Study results are expected the first quarter of 2019, with a multiple-ascending dose study slated to launch following the first phase of the trial.

Preclinical studies have shown that LHF-535 has potent activity against Lassa virus and other arenaviruses. Kineta has received Wellcome Trust support of up to $7.2 million in 2016 to advance the drug's development through phase 1 clinical trials.

Shawn Iadonato, PhD, Kineta's chief executive officer, said in the statement that recent Ebola and Zika outbreaks are a reminder of the critical need to develop new therapies for neglected tropical diseases and biodefense threats. "We were also pleased that the FDA recently added Lassa fever to the Tropical Disease Priority Review Voucher Program, further validating the need for an effective therapy."
Sep 5 Kineta press release



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