News Scan for Sep 30, 2014

MERS in Austria
Hospital C diff rise
Vaccine adjuvant research
Countermeasures in emergencies

Austria has first MERS case; Saudi Arabia reports another

Austria has reported its first MERS case, involving a visiting Saudi Arabian woman, while her home country has reported yet another case.

The Austrian health ministry said yesterday that the Saudi woman arrived in the country a few days ago and is now isolated in a Vienna hospital in critical condition, according to a Deutsche Presse Agentur (DPA) story today.

"The patient is responding to therapy and is on the path to stable condition," a hospital spokeswoman told DPA. The story did not list the woman's age, home city, or possible exposure sources.

Austria apparently is the 22nd country to have a MERS-CoV (Middle East respiratory syndrome coronavirus) case. An Aug 21 report from the European Centre for Disease Prevention and Control (ECDC) listed 21 countries that had reported cases by that date.

All the cases in countries outside the Middle East have had links to that region via travel, residence, or contact with another case-patient who visited there. In Europe, cases have also been reported in Germany, France, the United Kingdom, Italy, Greece, and the Netherlands, according to the ECDC.

Meanwhile, Saudi Arabia today reported that a 70-year-old Saudi man in Medina is hospitalized with MERS, marking the 12th case this month, after a summer lull. The country's Ministry of Health (MOH) said the man has preexisting disease and had contact with camels, which are suspected of spreading the virus to humans.

The case raises Saudi Arabia's MERS count to 754 cases, including 319 deaths; 426 case-patients have recovered and 9 are still being treated, according to the MOH.
Sep 30 DPA story
Sep 29 Austrian health ministry statement (in German)
Aug 21 ECDC report
Sep 30 Saudi MOH statement


Study: C diff rose 82% in US hospitals in 10 years

Clostridium difficile infections in US hospitals rose 82% from 2001 to 2010, according to a study today in the American Journal of Infection Control.

University of Texas researchers analyzed data on adult hospitalized patients from US National Hospital Discharge Surveys (NHDS) representing 2.2 million discharges for C difficile infection (CDI). From 2001 to 2010, CDI rates rose from 4.5 to 8.2 discharges per 1,000 total hospital discharges. The rate peaked in 2008, then tapered slightly, according to a press release from Elsevier, publisher of the journal.

Meanwhile, in-hospital mortality increased only slightly over the study period, from 6.6% in 2001 to 7.2% in 2010. The overall in-hospital mortality rate was 7.1%.

"Several factors may have contributed to the rise in CDI incidence in recent years," said Kelly Reveles, PharmD, PhD, lead author on the study. "Antibiotic exposure remains the most important risk factor for CDI."

According to the Centers for Disease Control and Prevention (CDC), C difficile is the most common bacterium responsible for healthcare-associated infections in US hospitals and is linked to 14,000 deaths each year, the release noted. Reducing the use of high-risk, broad-spectrum antibiotics by 30% could lower CDI by 26%, the CDC estimates.

Of the CDI discharges, 33% involved a principal diagnosis of CDI and the rest were classified as secondary CDI. And 7.1%, or 154,184 patients, died during the study period.

Reveles added, "The leveling off of CDI incidence toward the end of our study period may be the result of increased antibiotic stewardship programs and improved infection control measures."
October Am J Infect Control abstract
Sep 29 Elsevier press release


NIAID funds contracts for novel adjuvant candidates for vaccines

Seven institutions and companies are sharing in research contracts from the National Institute of Allergy and Infectious Diseases (NIAID) aimed at enhancing the protective ability of vaccines that could amount to $70 million over the contracts' 5-year span, the NIAID announced yesterday in a news release.

Adjuvants are components of vaccines that boost the body's immune response. Contracts awarded by NIAID in 2003 and 2009 "identified adjuvants that trigger a small set of receptors of the innate, or inborn, immune system," which confers long-term protection against various pathogens through helping shape adaptive (acquired) immunity, says the release.

The new contracts are meant to expand the scope of the earlier research to find any compounds involved in the direct or indirect activation of the adaptive immune system. Researchers will screen more than 1 million molecules to find ones potentially capable of doing this, determine how they work, make structural changes in them to optimize their immune-boosting abilities and safety, and test vaccines to which new adjuvant candidates have been added in animals.

The adjuvants currently approved for use in the United States are alum, included in many vaccines including those for hepatitis B and pneumococcal infections; AS04, which combines alum and a lipid and is used in Cervarix, a human papillomavirus (HPV) vaccine; and AS03, an oil-in-water compound added to the vaccine that would be used if an H5N1 avian flu epidemic were to occur.

Recipients of the new contracts are the University of California, San Diego; Boston Children's Hospital; Vaccine PTY LTD; Corixa Corporation; Duke University; Oregon Health & Science University; and the University of Kansas, Lawrence.
Sep 29 NIAID press release


FDA announces contract for medical countermeasures in emergencies

A 4-year, nearly $5 million contract to speed access to and evaluation of medical countermeasures used during public health emergencies has been awarded to the Critical Illness and Injury Trials Group (USCIITG), the US Food and Drug Administration (FDA) has announced.

The award, given through a collaboration of the FDA and the US Biomedical Advanced Research and Development Authority (BARDA), will fund the USCIITG Program for Emergency Preparedness (USCIITG-PREP) in developing processes and protocols to smooth the challenging process of collecting efficacy and safety data on medical products used in real-time, rapid-response situations.

Desired outcomes of the project include:

  • Developing and prepositioning a simple flu treatment protocol using intravenous zanamivir, an investigational flu treatment, in 10 US hospitals in the 2015-16 flu season and eventually in 20 hospitals
  • Creating an agreement between USCIITG-PREP hospitals to use a central institutional review board to speed approval of clinical protocols for emergency situations
  • Developing an electronic case report form for collecting data that converts it to a tabulation format
  • Creating a plan for dissemination of key findings from countermeasures in emergency settings to the FDA and other entities

It is hoped that the streamlined data collection and dissemination methods developed through the project will aid the FDA and federal partners in facilitating "timely decision-making about these important medical countermeasures to protect public health," states the FDA.
Sep 26 FDA press release


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