News Scan for Dec 12, 2014

EV-D68 cases rise by 28
Symposium on gain-of-function studies

CDC reports 28 more EV-D68 cases, 1 polio-like illness

After several weeks with no new reports of enterovirus D68 (EV-D68) respiratory infections, the Centers for Disease Control and Prevention (CDC) has reported 28 more illnesses, raising the national count since August to 1,149 cases in 48 states and Washington, DC. But an official said the agency is not aware of any new case clusters.

In addition, the agency has identified one more case of acute flaccid myelitis (AFM), a polio-like illness that involves unexplained limb weakness in children and seems related to EV-D68. The new AFM count is 94 cases in 33 states.

EV-D68, which was rare until recently, typically triggers cold-like symptoms but can cause a severe respiratory illness, almost exclusively in children, many of whom have asthma. The CDC says the pathogen has been the most common enterovirus identified in the United States this year.

Before yesterday's update, the CDC count of EV-D68 cases had remained at 1,121 in 47 states since Nov 20. The new update mentions 48 states but does not name the new state added to the list.

CDC spokeswoman Jeanette St. Pierre, when asked about the increase in cases, said today, "The number we are reporting includes cases confirmed by the CDC and the states. Sometimes there is lag time for the specimens reaching the CDC. We are not aware of a new cluster of cases."

Regarding the AFM cases, a CDC official said recently that close to half of the AFM patients had tested positive for EV-D68 in nasal or stool samples, suggesting a likely link between the two conditions. But the connection was not certain, because the virus had not been found in any cerebrospinal fluid samples, which would signal infection in the nervous system.

The CDC has said that 12 patients died after EV-D68 infections, but it has not reported any conclusions about the role of the virus in the deaths, saying that determination is up to the states. The number of such deaths listed by the CDC has not changed recently. In October, New Jersey officials said EV-D68 contributed to the death of a 4-year-old boy who died in his sleep.
CDC 2014 EV-D68 page
CDC Dec 12
update on AFM cases
Related Dec 2
CIDRAP News story
Related Nov 21
CIDRAP News item


NRC/IOM symposium will air gain-of-function research issues

The National Research Council (NRC) and Institute of Medicine (IOM) will hold a 2-day symposium next week to discuss issues related to "gain-of-function" (GOF) research on certain viruses, as part of an effort to develop a US policy on the controversial topic while funding is suspended.

The symposium will take place Dec 15 and 16 at the National Academy of Sciences Building in Washington, DC, and will be streamed over the Web.

In October the Obama administration announced it was suspending funding of GOF studies on influenza, MERS-CoV (Middle East respiratory syndrome coronavirus), and SARS (severe acute respiratory syndrome) coronavirus to allow time to assess risks and benefits and develop a federal policy.

The term GOF is generally used to refer to experiments that involve enhancing the pathogenicity, transmissibility, or host range of a pathogenic microbe, with the aim of better understanding disease pathways and developing vaccines and drugs. It emerged as a major issue in 2011 in connection with two studies that resulted in H5N1 avian flu viruses with increased transmissibility in ferrets.

The aim of the symposium, according to an NRC/IOM statement, is to "examine the underlying scientific and technical questions that are the source of current discussion and debate over GOF research involving pathogens with pandemic potential." It will look at potential risks and benefits of GOF research and whether other research methods might yield similar knowledge.

The conference is being organized by an ad hoc NRC/IOM committee chaired by IOM member Harvey V. Fineberg, MD, PhD. Among the many experts expected to participate is Yoshihiro Kawaoka, DVM, PhD, of the University of Wisconsin, author of one of the two H5N1 studies that put GOF research in the spotlight.

In related news, several of the leading voices in the GOF research debate aired their views this week in a question-and-answer article in Nature Reviews Microbiology. The authors are W. Paul Duprex, PhD, of the Boston University School of Medicine; Ron A. M. Fouchier, PhD, of Erasmus Medical Center in the Netherlands; Michael J. Imperiale, PhD, of the University of Michigan; Marc Lipsitch, PhD, of the Harvard School of Public Health, and David A. Relman, MD, of Stanford University.
Information on Dec 15-16 GOF symposium, with Webcast link
symposium agenda
Oct 17
CIDRAP News item on GOF funding pause
Dec 8 Nat Rev Microbiol


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