News Scan for Oct 29, 2014

6 Saudi MERS cases
FDA OK's group B mening vaccine
Delamanid for MDR-TB
Twitter flu forecasting
Global outbreak increase

Saudi Arabia confirms 6 new MERS cases, 1 fatal

The recent pattern of a Saudi MERS-CoV case or two a day changed today, as the country's Ministry of Health (MOH) confirmed 6 new cases, 3 of them in Taif and 1 of those fatal.

Three of the new case-patients had contact with a suspected or confirmed MERS-CoV (Middle East respiratory syndrome coronavirus) patient in a hospital or clinic, one had contact with a MERS patient in the community, and two of them are healthcare workers (HCWs).

All reported preexisting diseases and are listed in stable condition. Only one reported recent animal exposure.

The fatal MERS case in Taif was in an 84-year-old male expatriate. He had contact with a MERS patient in a healthcare setting. The second Taif patient is a 36-year-old Saudi man who also had healthcare exposure. The third Taif patient is one of the HCWs, a 38-year-old Saudi man. Interestingly, he had no contact with a MERS patient.

Taif is near Mecca and has reported numerous recent cases.

The other infected HCW is in Riyadh, a 30-year-old female expatriate. She had contact with a MERS-CoV patient in a healthcare setting. Riyadh also reported a case in a 54-year-old male expatriate who had contact with a MERS case in the community.

The sixth case, in a 60-year-old Saudi in Hafar Al-Batin, was the only one that involved animal contact. The man reported no contact with MERS case-patients.

Saudi Arabia has now confirmed 786 MERS-CoV cases, including 334 fatalities. Just yesterday the agency said to expect more cases.
Oct 29 Saudi MOH update
Oct 28 CIDRAP News scan on Saudi situation


FDA approves first US serogroup B meningococcal vaccine

The US Food and Drug Administration (FDA) today approved Trumenba, the first vaccine licensed in the United States to prevent meningococcal disease caused by Neisseria meningitidis serogroup B, the strain that has caused cases in the past year on several US college campuses.

Trumenba is made by Wyeth Pharmaceuticals, a subsidiary of Pfizer. The vaccine is approved for people 10 to 25 years old and had been fast-tracked. The other two vaccines approved for US use cover the A, C, Y, and W-135 serogroups.

Both Pfizer and Novartis submitted applications to the FDA in June for marketing approval of their serogroup B vaccines. Novartis's vaccine, Bexsero, has also been fast-tracked for approval.

The safety of Trumenba was assessed in about 4,500 volunteers in the United States, Europe, and Australia, the FDA said in a news release. In addition, three randomized trials in the United States and Europe in about 2,800 adolescents found that 82% had post-vaccine antibodies to four different serogroup B strains, which are the ones that cause serogroup B meningococcal disease in the United States.
Oct 29 FDA news release
Jun 17 CIDRAP News scan on drug company filings


WHO issues guidance for conditional use of MDR-TB drug delamanid

Guidance on use of delamanid, a new drug for multidrug-resistant tuberculosis (MDR-TB) that works through a novel mechanism of action, was issued yesterday by the World Health Organization (WHO).

The agent, was given conditional approval by the European Medicine Agency in April of this year. It currently has been through only phase IIb trials and studies for safety and efficacy, so information on it is limited. Consequently, the WHO lists five conditions for use of the agent at this time:

  • Proper patient selection
  • Adherence to WHO recommendations in designing treatment regimens
  • Sound treatment protocols and effective monitoring
  • Pharmacovigilance and proper management of adverse events
  • Informed consent

The WHO is strongly recommending acceleration of phase III trials on delamanid, the agency says, and will review and update its guidance as more information on the drug becomes available.

Another novel drug, bedaquiline, which was granted accelerated approval for MDR-TB by the FDA in 2013, is in phase III trials. The WHO issued interim guidance on its use in June 2013, according to the WHO notice.

The WHO says about half a million cases of MDR-TB occur worldwide each year and that less than half are treated successfully.
Oct 28 WHO notice with link to guidance document

Study shows Twitter reduces error in flu surveillance

Monitoring Twitter content reduced error in calculating influenza prevalence rates and forecasting weekly trends compared with other methods, a study yesterday in PLoS Currents found.

The study evaluated Twitter content over 3 flu seasons from Nov 2011 through Apr 2014, using the Centers for Disease Control and Prevention's (CDC's) ILINet (Outpatient Influenza-Like Illness Surveillance Network) final reports as a baseline. The effectiveness of monitoring flu information on Twitter was compared with similar methods used by Google Flu Trends (GFT), the report said.

Study coordinators found that using Twitter data reduced error in calculating current flu prevalence by 29.6% when combined with real-time ILINet reports. Twitter reduced forecasting error by 6.09% when combined with final ILINet reports, which include updated data from all US sentinel sites. GFT failed to reduce error in current and forecasted flu rates in two of the three flu seasons, the study reported.

CDC flu surveillance reports can often lag behind current numbers due to the time it takes to receive data from all sentinel sites, the authors said. The study suggested that use of Twitter content can augment official flu prevalence and forecasting data with significant accuracy.
Oct 27 PLoS Curr study


Study finds 30-year increase in infectious disease outbreaks

Infectious disease outbreaks, case numbers, and pathogen diversity increased globally from 1980 to 2013, according to a study today in the Journal of the Royal Society Interface.

Brown University researchers built a dataset containing information from 12,102 outbreaks of 215 infectious diseases occurring over the past 34 years. Bacteria and viruses were responsible for 88% of outbreaks, and non-vector pathogens caused 87% of outbreaks, the study said. The largest increases in outbreaks and pathogen diversity occurred from 2005 to 2010.

Salmonella had the highest outbreak rate (7%), causing 855 outbreaks globally during the study period. Viral gastroenteritis had the highest case rate, responsible for 15 million illnesses worldwide, the study said.

The study found that several pathogens responsible for causing outbreaks during the 30-year period were new to the list, most notably influenza A, chikungunya, mumps, and pertussis.

Researchers controlled for the effect of technological or structural influences on disease reporting. The study suggested that changes in land management, climate, and population connectedness may be responsible for the increase in global infectious disease outbreaks.
Oct 29 J R Soc Interface study
Oct 29 Brown University press release


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