News Scan for Dec 28, 2015

Saudi MERS case
Ebola vaccine emergency use
Zika in French Guiana, Martinique
Dengue vaccine, new cases
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Saudi officials report MERS case in Jeddah

After going 9 days without reporting a MERS-CoV infection, Saudi Arabia's Ministry of Health (MOH) confirmed a case yesterday.

The MERS-CoV (Middle East respiratory syndrome coronavirus) case involves a 54-year-old foreign man in Jeddah. He is not a healthcare worker and is listed in stable condition. His infection is listed as primary, meaning that he appears to have not contracted the disease from someone else. The MOH did not list any risk factors for the man.

Today the agency reported that a 41-year-old female foreign health worker in Buraidah has recovered from the disease, leaving only two MERS patients still undergoing treatment.

The newly reported case brings the country's MERS-CoV totals since 2012 to 1,282 cases, including 551 deaths.
Dec 27 MOH update
Dec 28 MOH update


WHO considers emergency use for Ebola vaccine

The World Health Organization (WHO) has agreed to review an emergency use application for the experimental Ebola vaccine VSV-EBOV for Merck, one of the two companies that has licensed the vaccine, the pharmaceutical firm announced in a Dec 23 press release.

The emergency use assessment and listing (EUAL) process is meant to speed the availability of vaccines for public health emergencies, such as another Ebola outbreak. Achieving the emergency use designation helps clear the way for United Nations agencies to procure the vaccine and for member countries to use it.

Merck said the EUAL is not the same as WHO prequalification, but rather is a special procedure used when an outbreak has high morbidity or mortality and there are few treatment or prevention options. It added that the WHO may recommend making the vaccine available for a limited time until clinical trials are completed and the vaccine is formally reviewed by regulatory agencies.

The VSV-EBOV vaccine has shown high effectiveness in a ring vaccination trial in Guinea, which has also been extended to Sierra Leone and Liberia. VSV-EBOV was developed by Canadian researchers and is licensed by NewLink Genetics and Merck.
Dec 23 Merck press release


French Guiana and Martinique report local Zika virus transmission

Two more countries in the Americas—French Guiana and Martinique—are reporting locally acquired Zika virus infections, according to a surveillance update today from the Pan American Health Organization (PAHO). The detections raise the number of affected countries in the region to 13.

The developments follow the confirmation of French Guiana's first imported case, in an individual who had traveled to Suriname, where Zika had already been detected, according to a Dec 18 press release from the Pasteur Institute in French Guiana.

Zika virus is spread by Aedes mosquitoes and causes an illness similar to dengue fever, though generally milder. Zika disease, however, is raising alarm because of its rapid spread in Central and South America and association with microcephaly (small heads and brains in infants) and other neurologic conditions, especially in Brazil, the country hit hardest by the disease so far.
Dec 28 PAHO update for Dec 20-26
Dec 18 Pasteur Institute press release


Brazil OKs Sanofi's dengue vaccine as Hawaii notes 32 new cases

Brazil became the third country to approve Sanofi's dengue vaccine Dengvaxia, while another vaccine showed promise in a phase 2 trial and Hawaii's outbreak total grew to 181 cases.

Sanofi Pasteur, Sanofi's vaccines division, announced today that Brazilian officials have granted regulatory approval for Dengvaxia in children and adults 9 to 45 years old against all four strains of dengue. Mexico and the Philippines approved the vaccine earlier this month.

Brazil saw more than 1.4 million dengue cases this year, according to Sanofi, with up to 70% affecting people in the age-group targeted by the vaccine. In January phase 3 trial results showed 60% overall efficacy for the vaccine, and in July phase 2 and 3 results indicated that it might drop hospital risks in older children.
Dec 28 Sanofi news release
Dec 10 CIDRAP News scan on vaccine approval in Mexico

Jan 9 and Jul 27 CIDRAP News items on clinical trials

In related news, a phase 2 study conducted in Puerto Rico, Colombia, Singapore, and Thailand showed that a tetravalent (four-strain) dengue vaccine candidate made by Takeda Vaccines of Deerfield, Ill., was immunogenic and safe in volunteers 1 to 45 years old, according to a study in the Journal of Infectious Diseases.

In the first part of the study, 148 people 1.5 to 45 years old were randomized 2:1 to receive either the vaccine or a placebo. The second stage involved 212 children 1.5 to 11 years old who were randomized 3:1. After two vaccine doses, seropositivity reached higher than 95% for the first three strains and 73% to 100% for dengue 4. Adverse events were mild.
Dec 23 J Infect Dis abstract

And in outbreak developments, the Hawaii Department of Public Health (HDPH) on Dec 25 reported 32 new dengue cases on the big island of Hawaii in the previous 11 days, raising the outbreak total to 181 cases.

Of the confirmed infections, 163 are in Hawaii residents and 18 involve visitors. Most of the total cases (145, or 80%) have occurred in adults, while 36 cases (20%) involve children. Illness onset occurred from Sep 11 to Dec 20.

The HDOH has excluded 708 potential cases after negative test results or failure to meet case criteria. "This is the first cluster of locally-acquired dengue fever since the 2011 outbreak on Oahu," the agency said in the update. That outbreak involved four cases.
Dec 25 HDOH update

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