News Scan for Oct 06, 2015

Some global flu upticks
Duodenoscope safety steps
CDC hospital infection centers
Nobel Prize for medicine

Global flu activity stays low, with upticks in Asia, Latin America

Influenza activity worldwide remains low, with upticks in some Asian and Latin American countries, the World Health Organization (WHO) said yesterday in an update.

Countries in Southern and Southeast Asia reported low flu activity except in India and Laos, which are seeing increases in 2009 H1N1 and H3N2 activity, respectively. Activity is likewise low in Latin America, except in Cuba and Chile, where 2009 H1N1 circulation has ramped up a bit. Colombia is seeing elevated respiratory disease attributed to respiratory syncytial virus (RSV).

Flu activity seems to be past its peak in Australia except in South Australia, where it continues to rise and influenza B is predominant, followed by influenza H3N2.

Few flu detections were reported in Africa, with West Africa nations noting decreased activity. Flu activity remains low in South Africa, with "B" strains predominating in recent weeks.

Of recent specimens that were typed, 82% have been influenza A and the rest flu B. Of the "A" strains, 79% are H3N2 and 21% 2009 H1N1.
Oct 5 WHO update


FDA orders new duodenoscope cleaning studies

The US Food and Drug Administration (FDA) yesterday ordered three duodenoscope makers to conduct postmarket surveillance studies to get a better fix on how the devices are processed in everyday healthcare settings.

William Maisel, MD, MPH, the deputy director for science and chief scientist at the FDA's Center for Devices and Radiological Health, said in a statement that the step will be useful in the battle against infections spread through duodenoscopes.

The action is among several taken in the wake of outbreaks linked to the devices, such as a Pseudomonas outbreak at a Pasadena, Calif., hospital that was detected in June. Health officials suspect that design flaws could make the tip of the devices difficult to clean.

Maisel said the FDA is conducting an in-depth investigation into duodenoscope-related disease transmission and that the postmarket studies will provide critical information to help guide the next steps.

The three manufacturers that market the devices in the United States are Olympus America, Inc.; Fujifilm Medical Systems, U.S.A., Inc.; and Hoya Corp (Pentax Life Care Division). The FDA hasn't urged the withdrawal of the devices, because they are the only equipment that is available to do endoscopic retrograde cholangiopancreatography procedures (ERCP).
Oct 5 FDA statement

In a related development, the Centers for Disease Control and Prevention (CDC) on Oct 2 modified Health Alert Network (HAN) guidance that it sent to clinicians in the middle of September regarding reusable medical device cleaning The guidance didn't specifically mention duodenoscopes but did mention media reports of infections related to medical device cleaning lapses.

In its updated guidance, federal officials rescinded one of the steps regarding device maintenance and repair contracted by health facilities to third-party vendors.

The initial guidance said facilities should ensure that vendors are certified by manufacturers to provide the services. The new HAN notes that manufacturers don't have formal procedures or processes for certifying third-party vendors.
Oct 2 CDC HAN notice


CDC adds 6 more hospital infection research centers

The CDC yesterday announced six more institutions have been added to its group of Prevention Epicenters, bringing the total to 11. The CDC is funding projects at the centers, which were established in 1997, to discover new ways to protect patients from dangerous pathogens such as the Ebola virus.

The $11 million in new CDC support will fund work from 2015 to 2018 at Emory University, Johns Hopkins University, the University of Illinois (Chicago), the University of Iowa, the University of Maryland (Baltimore), and the University of Utah.

CDC director Tom Frieden, MD, MPH, said in the statement that it's difficult and challenging to prevent the spread of diseases in healthcare facilities. "To protect Americans, it's critical that we develop the cutting edge science needed to stay ahead of the germs. The six institutions receiving these funds are doing just that."

The University of Illinois yesterday provided details about plans for its center, a collaboration between the College of Medicine and industrial hygienists at the School of Public Health. It added that research projects will be conducted at three Chicago hospitals.

The University of Iowa said yesterday in a statement that its group will work on four projects, which will include tracking healthcare worker compliance with wearing personal protective equipment (PPE) and improving PPE donning and doffing protocols in Ebola healthcare settings.
Oct 5 CDC press release
Oct 5 University of Illinois press release
Oct 5 University of Iowa press release


Trio wins Nobel Prize for work battling parasites

Three scientists have won the Nobel Prize for Physiology or Medicine for their discoveries that led to effective drugs for parasitic diseases that include malaria and elephantiasis, the Nobel Assembly at Karolinska Institutet in Solna, Sweden, announced yesterday.

Tu Youyou of China won half the award for discovering artemisinin, which has been instrumental in malaria control for years. She is China's first Nobel laureate in medicine. The other half of the award went to Ireland's William Campbell and Japan's Satoshi Omura for discovering avermectin, whose derivative has treated hundreds of millions of people with river blindness and lymphatic filariasis, or elephantiasis.

"This year’s Nobel Laureates have developed therapies that have revolutionized the treatment of some of the most devastating parasitic diseases," the assembly said in a press release.

"These two discoveries have provided humankind with powerful new means to combat these debilitating diseases that affect hundreds of millions of people annually. The consequences in terms of improved human health and reduced suffering are immeasurable."

The World Health Organization (WHO) said in response to the award, "WHO welcomes the decision to award the Nobel Prize in Physiology or Medicine for discoveries of drugs that have radically improved treatment against tropical diseases such as malaria, onchocerciasis and lymphatic filariasis."

Wellcome Trust Director Jeremy Farrar, MD, also expressed congratulations. But he added, "The restrictions of the Prize, however, mean that other Chinese scientists who played a critical role in the discovery of artemisinin are unfortunately not acknowledged alongside Dr Tu Youyou.

"The pivotal role they played in China's first Nobel Prize for medicine should be honoured and celebrated. We should also remember those whose work ensured it was developed as a medicine and then used worldwide."
Oct 5 Nobel Assembly news release
Oct 6 WHO statement
Oct 5 Wellcome Trust statement

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