News Scan for Mar 24, 2015

Saudi MERS cases
Adjuvanted anthrax vaccine
TB drug availability
Global flu situation

MERS sickens 3 more in Saudi Arabia

Saudi Arabia's Ministry of Health (MOH) reported three more MERS-CoV cases today, including the second one from Mecca this year, along with one death in a previously reported case.

Two of the new MERS-CoV (Middle East respiratory syndrome coronavirus) cases are in foreigners, a 42-year-old man who got sick in Mecca and a 20-year-old man whose infection was detected in Jeddah. Neither are healthcare workers, and the younger man had contact with suspected or confirmed MERS cases in the community. Both are hospitalized in stable condition.

The third patient is a 55-year-old Saudi woman from Arar, located in the northern part of the country near the border with Iraq. She is also listed in stable condition. She didn't have contact with suspected cases in the community and is not a healthcare worker.

The MOH said it would include more information on exposure history in its weekly MERS-CoV update, which usually comes out early in the week. The agency adopted a policy of including less exposure information in its daily updates last week.

The patient who died is a 61-year-old man from Riyadh who had underlying medical conditions.

In addition, the MOH noted three MERS-CoV recoveries, all of them involving foreign healthcare workers who got sick in Riyadh. They are a 37-year-old man and two women, 48 and 51.

The new cases and death lift Saudi Arabia's MERS-CoV totals to 964 infections, 416 of them fatal. The new cases would boost the global total from the disease to 1,109 cases, according to a list kept by FluTrackers, an infectious disease news message board.
Mar 24 MOH statement
FluTrackers MERS-CoV case list


Emergent wins US contract to perfect adjuvanted anthrax vaccine

Emergent BioSolutions Inc. has won a $31 million contract from the US government for advanced development of its adjuvanted anthrax vaccine, called NuThrax, which officials hope will provide protection with fewer doses than the three required for the company's licensed anthrax vaccine.

The Department of Health and Human Services (HHS) announced the 30-month contract in a press release yesterday. NuThrax consists of the licensed vaccine, BioThrax, paired with the adjuvant CPG 7909.

The funds will be used to support clinical studies, product development, and manufacturing to fuel phase 3 safety studies with larger groups than previous studies, HHS reported.

"Anthrax remains a national health security threat, and we're striving to develop an anthrax vaccine that affords immunity sooner and with fewer doses," said Robin Robinson, PhD, director of HHS's Biomedical Advanced Research and Development Authority (BARDA). "If it works, this vaccine may help achieve better preparedness at a lower cost."

Previous studies of NuThrax indicate that two doses are sufficient to protect against anthrax, according to HHS.

In a statement today, Emergent said a phase 2 study in 2014 tested the safety and immunogenicity of two and three doses of NuThrax for postexposure prophylaxis against anthrax. The results, presented at a meeting last month, warranted further study of a two-dose schedule.

The Gaithersburg, Md., company noted that earlier development of NuThrax was supported by the National Institute of Allergy and Infectious Diseases (NIAID). The agency is continuing to fund NuThrax activities, having awarded Emergent a $29 million contract last September for development of a dry formulation of the vaccine, which would eliminate the need for refrigeration.

The HHS statement said, "NuThrax represents the successful transition of a vaccine from early development under NIAID into advanced development under BARDA and resulted from more than six years of collaboration on the vaccine's development between the two HHS agencies."
Mar 23 HHS press release
Mar 24 Emergent
press release
Related Sep 9, 2014,
CIDRAP News item


MSF urges action to boost access to new TB drugs

Action must be taken to ensure that two tuberculosis (TB) drugs approved in 2012 and 2014 are administered to patients with drug-resistant TB (DR-TB) who desperately need them, Doctors without Borders (Medecins sans Frontieres, or MSF) said today in an issue brief and press release marking World TB Day.

Fewer than 1,000 people worldwide have been able to access the drugs, bedaquiline (made by Janssen/Johnson & Johnson) and delamanid (by Otsuka), MSF said. It treats people in more than 20 countries for DR-TB.

The agency said, "Two facts should be front and center: that the glacial rollout of these new drugs has cost too many lives already, and that our frustration must be galvanized into action."

MSF's issue brief looks at causes of the slow rollout and makes recommendations that apply to TB-endemic nations, the World Health Organization (WHO), drug manufacturers, donors, and global health professionals in general.

Earlier this month, MSF and 88 other groups signed a call to action urging key global health stakeholders to form a consortium to help increase use of the new drugs in DR-TB treatment. In response, the WHO will convene a meeting next month in Geneva to address the issue.
Mar 23 MSF news release
Mar 23 MSF
issue brief


Northern Hemisphere flu declining but still elevated

Flu activity in the Northern Hemisphere remained elevated through Mar 8 with H3N2 dominant, the World Health Organization (WHO) reported in its weekly update yesterday, but some countries in Asia, Europe, and North Africa reported high levels of 2009 H1N1.

Influenza activity in North America was decreasing but remained above threshold levels, while circulation in Europe appeared to have peaked in many nations, the agency said. Flu activity also decreased in northern Africa and the Middle East, with H1N1 predominant, except in Egypt, where H3N2 co-circulated with influenza B.

H3N2 predominated in the temperate countries of eastern Asia, while in western Asia, H1N1 and influenza B dominated. Patterns varied in tropical Asia, with H1N1 predominant in Bhutan and India, H3N2 predominant in Hong Kong, and, and flu B predominant in southern China.

Flu activity remained low in tropical nations of the Americas and in the Southern Hemisphere.

FluNet reporting showed that about two thirds of recently tested specimens have been influenza A. Of the "A" strains, two thirds were H3N2. Of the influenza B strains, 97% belonged to the Yamagata lineage, which matches the "B" strain in trivalent vaccines.
Mar 23 WHO weekly flu update
Mar 23 WHO FluNet summary


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