News Scan for May 28, 2014

WHA smallpox no-decision
Failed dengue therapy
Ultraviolet disinfection

WHA again delays decision on smallpox lab stock

The World Health Assembly (WHA) again did not decide on when the last laboratory stocks of variola virus, the pathogen that causes smallpox, should be destroyed, Nature reported today on its news blog.

The issue was on the WHA's agenda late on May 24, the last day of the group's annual meeting. Opinions were sharply divided, Nature News reports, so the assembly was only able to decide on the formation of an expert panel to address the issue.

Two World Health Organization (WHO) panels—the Advisory Committee on Variola Virus Research and the Advisory Group of Independent Experts to review the smallpox research program (AGIES) —are split over the timing of virus destruction, with AGIES calling for immediate action. The new committee, whose details remain to be worked out, is designed to broker a consensus.

The WHA in 2011 voted to destroy the virus stocks but left it to this year's meeting to decide on timing.

The United States is opposed to immediate virus destruction over bioterror concerns, and most health ministers of WHO member states favor destroying stocks at some point, according to the blog post. The only known variola stocks are in the United States and Russia.
May 28 Nature News blog post


Experimental antiviral shown ineffective in phase 1 dengue trial

The experimental antiviral drug celgosivir did not reduce viral load or fever burden in a phase 1 trial of patients with dengue, according to a report today in The Lancet Infectious Diseases.

Researchers examined 50 patients in Singapore, 24 of whom received celgosivir, an alpha-lucosidase inhibitor, and 26 of whom received a placebo. Virologic log reduction was greater and the area under the curve for fever higher in the celgosivir group, but neither finding was significant.

"Although generally safe and well tolerated, celgosivir does not seem to reduce viral load or fever burden in patients with dengue," the authors concluded.

An accompanying commentary states, "Because few side-effects of oral celgosivir have been reported in people, a large trial might be necessary to test whether celgosivir reduces elements of the vascular permeability syndrome," referring to a typically severe manifestation of dengue.
May 28 Lancet Infect Dis abstract
May 28 Lancet Infect Dis commentary extract


Ultraviolet cleaning tied to fewer drug-resistant infections

Infections caused by multidrug-resistant organisms (MDROs) and Clostridium difficile dropped 20% among hospital patients after adding ultraviolet environmental disinfection (UVD) to the cleaning regimen, according to a study in the June issue of the American Journal of Infection Control.

Researchers from the Westchester Medical Center in Valhalla, N.Y., assessed the rates of vancomycin-resistant Enterococcus, methicillin-resistant Staphylococcus aureus (MRSA), resistant gram-negative bacteria, and C difficile in their hospital from July 2011 through April 2013 when UVD was employed. They compared them with rates during the previous 30 months.

They found that the rate of healthcare-associated infections caused by MDRO and C difficile dropped from 2.67 cases per 1,000 patient-days before UVD to 2.14 cases per 1,000 patient-days during the 22 months of UVD use, a statistically significant difference that translates to a rate ratio of 0.80. Rate ratios for individual pathogens ranged from 0.73 for MRSA to 0.83 for C difficile.

During the study period, hospital workers were able to complete UVD for 76% of contact precautions discharges.

The authors conclude, "Although the possibility of a cumulative effect of the multiple infection control interventions that were occurring during the pre-UVD period and continuing into the UVD period cannot be eliminated, our data suggest UVD use had an impact on these reductions."
June Am J Infect Control study

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