News Scan for Feb 25, 2015

New MERS case, study
Measles surge in Europe
Group B mening vaccine
; ;

New Saudi MERS case; study of 2014 outbreak notes healthcare link

As Saudi Arabia's Ministry of Health (MOH) reported a new MERS-CoV case today, a study in the New England Journal of Medicine (NEJM) noted a high incidence of MERS cases linked to healthcare centers in a 2014 outbreak in Jeddah.

The latest case of MERS-CoV (Middle East respiratory syndrome coronavirus) infection involves a 56-year-old Saudi man in Riyadh with preexisting disease who is hospitalized in critical condition, according to an MOH update today. He is not a healthcare worker (HCW) and had no recent contact with animals or with MERS patients in the community. Possible exposure in a healthcare setting is under investigation.

The MOH also reported the death of a previously confirmed MERS-CoV patient, a 58-year-old Saudi man in Riyadh. He had preexisting disease. The agency also said a 37-year-old Saudi man and a 54-year-old Saudi woman have recovered from the disease. None of the three are HCWs.

Saudi Arabia has now confirmed 913 MERS-CoV cases, including 389 deaths.

The MOH also posted an English-language statement today (but dated Feb 23) that was reported in the media yesterday noting that it had closed a private Riyadh hospital for not complying with infection-control guidelines. The agency said that, especially because of the possibility of hospital MERS cases, similar actions will face other healthcare facilities if they don't comply.
Feb 25 MOH update on cases
Feb 23 MOH
statement on infection control

The NEJM study, by an international team of researchers, involved all 255 patients with lab-confirmed MERS-CoV in Jeddah from Jan 1 through May 16 of last year—a period that saw a surge of MERS cases in the area.

Of the 191 symptomatic patients, 40 (20.9%) were HCWs. And of the 112 non-HCWs for whom data could be assessed, 109 (97.3%) had contact with a healthcare facility, a confirmed MERS-CoV patient, or someone with severe respiratory illness in the 14 days before they had symptoms.

In addition, of 64 patients who had been reported as asymptomatic, 33 were interviewed. Of these, 26 (79%) reported at least one symptom consistent with a viral respiratory disease.
Feb 26 NEJM study


WHO calls for vaccination amid measles surge in Europe

The World Health Organization's (WHO's) European office today called for increased vaccination efforts after more than 22,000 measles cases were reported in seven hard-hit European nations in 2014 and so far in 2015, WHO/Europe said today in a press release.

That number compares with 10,271 measles cases in 30 European nations in all of 2013, according to European Centre for Disease Prevention and Control (ECDC) data. Although complete data for 2014 do not appear to be available, the ECDC reported that 3,840 cases occurred in 30 countries from December 2013 through November 2014. WHO/Europe said in today's release that European cases fell 50% from 2013 to 2014.

"When we consider that over the past two decades we have seen a reduction of 96% in the number of measles cases in the European Region, and that we are just a step away from eliminating the disease, we are taken aback by these numbers. We must collectively respond, without further delay, to close immunization gaps," says Zsuzsanna Jakab, PhD, WHO regional director for Europe.

The countries reporting 22,149 cases in 2014-15 are Kyrgyzstan (7,477 cases), Bosnia and Herzegovina (5,340), Russia (3,247), Georgia (3,291), Italy (1,674), Germany (583), and Kazakhstan (537).
Feb 25 WHO/Europe press release
Feb 28, 2014, ECDC
report on 2013 cases
data on December 2013 – November 2014


Group B meningococcal vaccine found immunogenic in phase 2 trial

Trumenba, a meningococcal group B vaccine made by Wyeth Pharmaceuticals, a subsidiary of Pfizer, was found in a phase 2 trial to be immunogenic when co-administered with MCV4 (meningococcal conjugate vaccine) and Tdap (tetanus, diphtheria, pertussis) in adolescents, the company said in a press release yesterday.

The vaccine was granted accelerated approval by the Food and Drug Administration (FDA) last October. The release also notes that the vaccine was found to be safe and well tolerated in adolescents and young adults in a recent phase 3 trial.

In the phase 2 study, 2,600 healthy children 10 to 12 years of age were divided into three groups who were given Trumenba along with MCV4 (which is effective against meningococcal groups A, C, Y, and M) and Tdap (group 1), MCV4 and Tdap only (group 2), or Trumenba only (group 3).

When immune responses were checked 1 month after vaccination, the responses in group 1 were "noninferior" to those in groups 2 and 3, says the release. Safety and tolerability also met the study objectives.

William Gruber, PhD, senior vice president of vaccine clinical research and development at Pfizer, said that the results of the phase 2 study have been "shared with the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices to review as they consider recommendation of meningococcal B vaccination for adolescents and young adults," according to the press release.

Trumenba is indicated to prevent invasive disease caused by Neisseria meningitides serogroup B in individuals 10 through 25 years of age, says the Pfizer release. Although its immunogenicity against the four serogroup B strains that are prevalent in the United States has been demonstrated, its effectiveness against diverse strains has not been confirmed, it noted.
Feb 24 Pfizer press release
Oct 29, 2014, CIDRAP News
item on Trumenba

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