News Scan for Jul 29, 2013

H7N9 vaccine
Malaria drug warning
WHO on latest MERS case
Avian flu in Nepal

Novavax says H7N9 virus-like particle vaccine shows promise in mice

A virus-like particle (VLP) vaccine for H7N9 avian flu protected mice against the virus in a challenge trial, Novavax Inc. reported in a Jul 26 article in Vaccine.

The company, based in Rockville, Md., said it made a recombinant vaccine consisting of full-length hemagglutinin and neuraminidase from an H7N9 virus and the matrix 1 protein from a 2005 strain of H5N1. A baculovirus vector was used to induce insect cells to manufacture the VLP vaccine.

The vaccine was tested in genetically modified mice, with control mice receiving an H7N3 VLP vaccine, an H5N1 VLP vaccine, or a placebo. Each vaccine group received a dose with or without the adjuvant Iscomatrix, made by CSL Biotherapies.

The H7N9 vaccine induced hemagglutination-inhibition antibody titers of at least 1:64 against H7N9 and cross-reactive antibodies against H7N3, with three- to fourfold greater antibody responses in the adjuvanted-vaccine groups. Also, the H7N9 vaccine induced anti-neuraminidase antibodies.

When the mice were exposed to a wild-type H7N9 virus, all those that received the H7N9 and H7N3 vaccines survived, while all those in the H5N1 vaccine and placebo groups died. The company said the results support human trials of the H7N9 vaccine as a potential pandemic vaccine.

At least two other companies have reported developing H7N9 vaccines since the virus spread in China during the spring. Medicago has a plant-based VLP vaccine, while Inovio has a DNA vaccine. In June, both companies reported that their vaccines were immunogenic in mice.
Jul 26 Vaccine report
Jun 14 CIDRAP News item on Inovio H7N9 vaccine


FDA toughens malaria drug safety warning

The US Food and Drug Administration (FDA) today announced an updated and stronger warning about possible neurologic and psychiatric side effects of the antimalarial drug mefloquine hydrochloride.

The drug, available as a generic medication in the United States, will now carry a boxed warning on its label, which is the most serious advisory of its kind. The current labeling states that the drug should not be used to prevent malaria in patients who have major psychiatric disorders or a history of seizures.

The change includes new details about the possibility of persistent neurologic vestibular adverse events after the drug is stopped or the possibility that the vestibular damage may be permanent. The FDA said it based its recommendation on a review of reports from the FDA Adverse Event Reporting System (FAERS) and published literature that described patients with one or more vestibular symptoms.

Some of the patients were healthy before taking the drug to prevent malaria, and some did not suspect that their symptoms were related to mefloquine and continued taking it after symptoms began. In many cases symptoms began after just one or two doses of the drug. Some experienced concomitant psychiatric symptoms such as anxiety, confusion, paranoia, or depression, which in some instances persisted after discontinuation of the drug.

In 2011 the US Army announced that it would stop using the nearly 40-year-old drug because of its side effects.
Jul 29 FDA statement
Nov 21, 2011, CIDRAP News scan "
Army stops using anti-malarial mefluoquine"


WHO notes new MERS case and another death in Saudi Arabia

The World Health Organization (WHO) has recognized the latest MERS-CoV (Middle East respiratory syndrome coronavirus) case and another death from the infection, both in Saudi Arabia, raising the agency's MERS count to 91 cases and 46 deaths.

The illness is in an 83-year-old man from the southwestern region of Assir who fell ill on Jul 17 and is hospitalized, the WHO said in a statement e-mailed to journalists. Also, a patient whose case was announced previously, also from Assir, has died. No other details about the deceased patient were given.

News of the new case and the death surfaced on Jul 25, when a Saudi government statement was translated and posted by FluTrackers, an infectious disease message board. At this writing, the Saudi Ministry of Health has not yet reported the case and death on its English-language MERS-CoV site.

Saudi Arabia has had 71 MERS cases and 39 deaths, according to a count maintained by the US Centers for Disease Control and Prevention.
WHO MERS-CoV information


More H5N1 outbreaks hit Nepal

Nepal's capital, Kathmandu, has reported 12 new outbreaks of avian flu (H5N1) in just the first 13 days of the country's new fiscal year, more than twice the total number reported in all of the last fiscal year, says a report from Xinhua, China's state news agency.

About 6,000 chickens have been destroyed in the areas where bird flu has been detected—Bhaktapur, Mahadevsthan, Kirtipur, Ramkot, and Nailkap—and about the same number have died of the disease. In addition, about 4,000 kilograms of chicken feed and 8,000 eggs have been destroyed to help stop transmission of the disease, the program director at Livestock Services Directorate said, according to the story.

Two farms near Pokhara, a tourist city west of Kathmandu, have also reported avian flu outbreaks in poultry. Hundreds of chickens there have been culled by authorities.

Dead chickens are commonly disposed of in open areas, the report says, posing public health threats. Members of the public are being warned to stop this practice and instead bury the chickens.

Nepal has had poultry outbreaks of H5N1 since it was first reported there in 2008, including 24 in the 2012-13 fiscal year.
Jul 29 Xinhua story


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