NEWS SCAN: Novel coronavirus steps, new antimalarial studies, TB report card, Avastin-related recall, soda fountain contamination

Mar 21, 2013

Experts: Broad global cooperation required for novel coronavirus cases
Response to novel coronavirus (NCoV) infections requires broad global cooperation and information sharing, employing lessons learned from the SARS outbreak a decade ago, UK and Saudi Arabian health officials write in a Lancet Infectious Diseases commentary today. "A unique opportunity now exists for global collaboration, with transparent sharing of information as was done during the SARS outbreak, to improve elucidation of the risks associated with the novel coronavirus so that another SARS-like epidemic does not begin to spread undetected," writes the group of experts, which includes two top Saudi public health officials and David L. Heymann, MD, who spearheaded much of the global response to SARS (severe acute respiratory syndrome) in 2003 while working with the World Health Organization. The group urgently called for targeted serologic tests, validated treatment protocols, and standardized case-investigation forms. Lessons learned from SARS include the importance of rapid genetic sequencing, which has been applied to NCoV, they say. The experts also write that lab testing does not replace accurate case definitions, regular updates of recommendations, effective infection control, and epidemiologic legwork. They also report that 13 of the 15 NCoV case-patients have required intensive care, which is new information. Nine of the patients have died.
Mar 21 Lancet Infect Dis commentary

Study shows promise for malaria drug candidate
Researchers report promising findings for a potential new antimalarial drug, according to their study yesterday in Science Translational Medicine. The antimalarial drug, called ELQ-300, was developed from an optimized version of a decades-old quinolone called endochin. An international research group, including a team from the University of South Florida (USF), said the drug is designed to target the malaria parasite's mitochondria, while sparing the same structure in human cells, according to a USF press release. So far tests in the lab and in mice suggest the drug is one of the first to kill the parasite, Plasmodium falciparum, in all three stages of its life cycle, which could give it a role in preventing and treating malaria. It has a long half-life to help it remain in the blood long enough to kill the parasite, and ELQ-300 appears to have a low likelihood for developing rapid resistance, the researchers said. Investigations are under way to support preclinical safety and toxicity studies in advance of human trials.
Mar 20 Sci Transl Med abstract
Mar 20 USF press release

Results for malaria vaccine candidate prove disappointing
A second study spelled out disappointing findings about the length of protection of a malaria vaccine candidate, according to a report yesterday in the New England Journal of Medicine. Scientists explored the efficacy of the RTS,S/AS01E malaria vaccine candidate in young Kenyan children ages 5 to 17 months. Investigators compared malaria infections over a 4-year period in 223 kids who received three doses of the vaccine and 224 controls. Researchers also estimated each child's malaria exposure based on local prevalence. During follow-up, investigators found that the vaccine was associated with 29.9% and 16.8% efficacy against first and all episodes of P falciparum malaria. Vaccine efficacy varied over time and by exposure level. Despite waning protection, the group concluded that the vaccine prevented 65 infections per 100 vaccinated children. In a Wellcome Trust press release yesterday the authors of the study said they need to explore if a booster vaccine can boost the length of protection. Dr Ally Olotu, with Wellcome Trust, said in the statement, "We need to consider whether relative efficacy or absolute number of cases averted is the more informative measure."
Mar 21 N Engl J Med abstract
Mar 20 Wellcome Trust press release

WHO: TB numbers in Southeast Asia and Western Pacific improve
Apropos to World TB Day on Mar 24, the World Health Organization (WHO) today issued reports on strides in the containment of tuberculosis (TB) in Southeast Asia and the Western Pacific Region but said work is still needed. Since 1990, the TB death rate in Southeast Asia has declined by more than 40% and disease prevalence about 25%, the agency said, in large part because of expanded access to TB care. In addition to improved access, advances in diagnostics have contributed to the improved numbers. The WHO stressed, however that numbers of TB cases remain high, with 3.5 million new cases and half a million TB deaths in 2011. In addition, concern is focused on multidrug-resistant infections, which constitute nearly a third of cases. A WHO Western Pacific Region (WPRO) notice said a lack of access to diagnosis and treatment for children and the elderly accounts for the still-high numbers of TB patients there. High-burden countries in the region provide free diagnosis and treatment, the statement says, but awareness of the programs and an inability to access care, especially in the elderly, are still lacking. Elimination of TB needs coordinated efforts from the healthcare, environmental, infection control, water, and sanitation sectors, the WHO added. On Mar 18 the agency called for $1.6 billion in increased TB funding.
Mar 21 WHO notice on TB in Southeast Asia
Mar 21 WPRO notice on TB in the Western Pacific
Mar 18 CIDRAP News item on TB funding

Much-expanded recall follows Avastin-related eye infections
The repackager/distributer of the unit-dose syringes of Avastin used for intravitreal injections for macular degeneration that were recalled Mar 18 because of reported eye infections associated with the agent's use has now voluntarily recalled all lots of all sterile products it repackages and/or distributes because of lack of assurance of sterility. According to a US Food and Drug Administration (FDA) notice, there is no evidence of contamination of products beyond the lots of Avastin syringes just recalled, but Clinical Specialties Compounding Pharmacy of Augusta, Ga., has expanded its recall in the interest of patient safety until further notice. Consumers and healthcare providers are advised to stop using all recalled products and return them to the company, including ophthalmic drops, gels, and solutions. The products were distributed nationwide from Oct 19, 2012, to Mar 19, 2013. Compounding pharmacies have been in the spotlight because of a fungal meningitis outbreak related to tainted steroids from a Massachusetts company.
Mar 20 FDA recall notice
Mar 19 CIDRAP News item regarding Avastin recall
Oct 29, 2012, CIDRAP News story on compounding pharmacies

Study finds no antibacterial impact of soda fountain disinfection
A study of fast-food restaurants and convenience stores found high rates of bacterial contamination in beverages dispensed from soda fountains and further found that disinfection had no impact, according to a study today in the International Journal of Food Microbiology. Researchers from Hollins University in Roanake, Va., compared samples taken from the machines in the Roanake area in July 2010 with samples they had taken in June 2009 as part of an earlier study. They also interviewed managers from 26 fast-food restaurants and convenience stores in Virginia and North Carolina about their procedures for disinfecting soda fountains and obtained samples at the stores before and after disinfection. The researchers found more than 70% of samples of soda, diet soda, and water in both years were contaminated with similar levels of coliform and noncoliform bacteria. They also found that disinfection—whether daily, every other day, or weekly—had no effect on contamination levels.
Mar 21 Int J Food Microbiol abstract

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