News Scan for Jan 05, 2016

MCR-1 in Canada
Medical countermeasures for kids
Impact of minor flu strains

Canada reports finding MCR-1 resistance gene

Canada can now be added to the growing list of countries that have detected MCR-1, the recently identified worrisome gene that disables the last-line antibiotic colistin, after it was detected in a patient and in ground beef sold in 2010, the Toronto Star reported today.

After being identified for the first time in China in November, the gene has now been confirmed in samples from at least 11 countries.

MCR-1 was found in three samples of Escherichia coli in Canada, all previously collected for research. One was from a 62-year-old woman in Ottawa, and two were samples from ground beef sold in Ontario. The Ottawa patient likely picked up MCR-1 in Egypt, where she lived for several years, the story said.

The meet samples were taken almost a year apart in a butcher shop and a grocery chain in 2010, before the samples in China, which were collected from 2011 to 2014.

The Public Health Agency of Canada (PHAC) began searching for the resistance gene in December and has submitted a case report to The Lancet, which published the initial MCR-1 findings and several follow-up studies.

"To see it show up was a surprise for me," said Michael Mulvey, PhD, chief of antimicrobial resistance with the PHAC lab in Winnipeg. "It supports that there's global dissemination of this gene already … we're now going to have to look back even prior to [2010], because maybe it's been around for even longer."
Jan 5 Toronto Star report


AAP urges ensuring kids are protected during public health emergencies

Medical countermeasures (MCMs) appropriate for children in case of a pandemic, bioterror attack, or other public health emergency need to be added to the US Strategic National Stockpile (SNS) and research into pediatric MCMs must be bolstered, according to recommendations published yesterday by the American Academy of Pediatrics (AAP).

"The nation's stockpiles and other caches (designated supply of MCMs) where pharmacotherapeutic and other MCMs are stored are less prepared to address the needs of children compared with those of adults in the event of a disaster," the AAP's Disaster Preparedness Advisory Council said in the recommendations. The advisors recommended taking the following steps:

  1. Acquire and maintain sufficient quantities of MCMs appropriate for children of all ages in caches such as the SNS.
  2. Research and develop pediatric MCMs for any public health emergency.
  3. Ensure reasonable steps to protect children as human subjects in MCM research.
  4. Address the needs of children and families in planning for MCM implementation, distribution, and administration.
  5. Identify anticipated uses of MCMs for children during a public health emergency.
  6. Use subject matter experts for advice about pediatric MCMs and MCM distribution planning.
  7. Provide pediatric healthcare professionals with access to current information on the appropriate use of MCMs and local distribution plans.

Jan 4 AAP recommendations in Pediatrics


Study shows minor flu strains readily transmissible

Minor variants of influenza strains, which are not specifically targeted in vaccines, were found along with major strains during the 2009 pandemic in Hong Kong and were readily transmitted among households and may cause a greater impact than previously realized, according to a small study yesterday in Nature Genetics.

"A flu virus infection is not a homogeneous mix of viruses, but, rather, a mix of strains that gets transmitted as a swarm in the population," said Elodie Ghedin, PhD, of New York University in an NYU press release. "Current vaccines target the dominant strains, because they are the ones that seem to infect the largest number of individuals. But our findings reveal an ability of minor strains to elude these vaccines and spread the virus in ways not previously known."

A team of Hong Kong and US researchers performed whole-genome deep sequencing of upper nasal cavity swabs taken from 67 confirmed 2009 Hong Kong flu patients and 17 of their household contacts. Using sophisticated methods, the scientists not only identified variants in flu strains, but also quantified what strains were being transmitted.

Their results showed that, as expected, most carried the dominant viruses 2009 H1N1 or H3N2. In addition, though, all carried minor strains and variants of both major and minor strains, as well. The variants were readily transmitted among the volunteers studied.

"We were able to look at the variants and could link individuals based on these variants," said Ghedin in the NYU release. "What stood out was also how these mixes of major and minor strains were being transmitted across the population during the 2009 pandemic—to the point where minor strains became dominant."
Jan 4 Nat Genet letter
Jan 4 NYU press release

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