News Scan for Aug 08, 2016

H3N2v cases in US
Yellow fever vaccine update
Saudi Arabia MERS case
Anthrax vaccine developments
Measles in Myanmar
AI in Ghana and Denmark
Polio eradication

Michigan reports two fair-linked H3N2v cases

Michigan health officials recently announced two variant H3N2 (H3N2v) influenza illnesses in Muskegon County residents who exhibited swine at the Muskegon County fair in late July. The cases appear to be the nation's first for 2016.

In an Aug 5 statement, the Michigan Department of Health and Human Services (MDHHS) said a sick pig from the fair tested positive for H3N2v at the National Veterinary Services Laboratories in Ames, Iowa. The county health department is contacting others who exhibited swine at the fair to identify any other possible illnesses, and health providers in the area have been asked to watch for patients with respiratory symptoms who were exposed to swine or the fair.

The virus was first found in humans in 2011, and cases the following summer, most of them linked to swine exhibit exposure, topped 300. Since then, only sporadic H3N2v cases have been detected. The virus is a swine H3N2 that contains the matrix (M) gene of the 2009 H1N1 virus, which researchers say could enhance its transmissibility.
Aug 5 MDHHS statement
CDC H3N2v case counts


17 million to be vaccinated against yellow fever in August and September

The World Health Organization (WHO) said 17 million more people in Angola and the Democratic Republic of the Congo (DRC) will be vaccinated against yellow fever in August and September. The vaccine campaigns will begin before the rainy season, and with it mosquitoes, descends on the area in September.

According to the WHO, the outbreak has slowed significantly in the last 6 weeks, no new confirmed cases. Nineteen million doses of the vaccine have already been given, but dense urban centers, like Kinshasa are still at risk for outbreaks. The WHO said that dose sparing, administering the vaccine at one-fifth standard dose, will be used in Kinshasa to ensure that 8.5 million people in that city are vaccinated.

The vaccine update comes days after the Associated Press (AP) published a story based on leaked emails that showed the WHO mismanaged their initial response to the current yellow fever outbreak, which began in Luanda in Jan 2015. The emails suggest 1 million doses of yellow fever vaccine were lost, and delivery of syringes, ice packs, and other supplies were bungled in Angola at the start of the outbreak.
Aug 6 WHO statement
Aug 5 AP story

New case of MERS in Saudi Arabia

The Saudi Arabia Ministry of Health (MOH) reported a new case of MERS-CoV over the weekend.

A 36-year old Saudi man from Huraymila is in stable condition after presenting with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus). The MOH said he had primary exposure to the virus, meaning not from another patient. He is not a healthcare worker, and has no known contact with camels.

The case brings the total in the country since the outbreak began in 2012 to 1,445, including 608 fatalities.
Aug 8 MOH report


Pfenex reports promising results for next-generation anthrax vaccine

Pfenex, a biotechnology company based in San Diego, today reported promising interim phase 1 trial findings for its next-generation anthrax vaccine. The vaccine, known as Px563L, is an adjuvanted mutant recombinant protective antigen (rPA) anthrax vaccine that has been developed with support from the US Department of Health and Human Services' Biomedical Advanced Research and Development Authority (BARDA).

In a statement, the company said the day 70 analysis suggests that the vaccine is well-tolerated and offers potentially superior protection after two doses. The randomized, double-blind, placebo-controlled phase 1a study included three groups that were vaccinated in a dose-escalating manner. They received Px563L, RPA563 (Pfenex's unadjuvanted anthrax vaccine), or a placebo, in two doses 28 days apart.

After two doses, all Px563L recipients that received 10-microgram (mcg) and 80-mcg doses reached a target antibody level correlated with survival in animal models. In the 50-mcg group, 87.5% reached the target threshold. For comparison, all three groups had a higher share of volunteers who met the target antibody level than had been reported in a group that received three doses of BioThrax, the currently approved vaccine against Bacillus anthracis. Mild injection-site reactions were seen for the two lowest Px563KL doses and for all the RPA563 doses.
Aug 8 Pfenex press release

In other anthrax vaccine developments, PharmAthene, based in Annapolis, Md., filed a formal protest on Aug 5 against HHS regarding its bidding process for a next-generation anthrax vaccine.

According to a company press release, the protest, filed with the Government Accountability Office, (GAO) says the request for proposal was written in a way intended to eliminate competition and assure that the contract would be awarded to Emergent BioSolutions, Inc., which has long been the only provider of the vaccine.

PharmAthene's protest asks the GAO to suspend the process while it reviews the company's complaint. Federal contracting rules give the GAO 100 days to review the complaint. Anthrax Vaccine Adsorbed (now called BioThrax) was developed by the government and was purchased by the company now known as Emergent BioSolutions. PharmAthene has been working on two next-generation anthrax vaccine formulations with support from the federal government: SparVax and SparVax-L.
Aug 5 PharmAthene press release


40 dead from measles in Myanmar

At least 40 people, 35 of them children, are dead after contracting measles in remote villages in Myanmar, the New York Times reported recently. Two hundred or more cases of measles have been reported in Myanmar since mid-July, all in the northwestern Naga Self-Administered Zone.

The mountainous regions in Myanmar have been slow to receive basic health care services after the National League for Democracy took power of the country in April, after 50 years of military rule. Officials in the country said the measles outbreak is spreading because it takes doctors up to a week to travel to the villages, and two or more weeks before public health professionals can diagnose the disease.

Soe Lwin Nyein, MD, Myanmar’s director of public health, said the department was asking to use military helicopters to reach villages more quickly. The government reports that 94 % of Myanmar's population is vaccinated against measles.
Aug 6 New York Times story


Ghana, Denmark report more AI outbreaks

Ghana's agriculture ministry recently reported three more H5N1 avian influenza outbreaks in poultry, according to two Aug 5 reports from the World Organization for Animal Health (OIE). All three of the outbreaks began in early July and affected backyard birds.

Two of the outbreaks occurred in Greater Accra state, and the third was detected in Central state. All are in southern Ghana. Affected flocks included layers, free-range local birds, and exotic birds. Of 2,894 susceptible birds, the virus killed 1,649. The remaining ones were culled to curb the spread of the virus.

The H5N1 virus has caused several outbreaks in Ghana, as well as a handful of other African nations, since it reemerged in 2015 after a several-year hiatus.
Aug 5 OIE report on one Ghana outbreak
Aug 5 OIE report on two Ghana outbreaks

Elsewhere, Danish veterinary officials reported a second avian flu outbreak, on the heels of an event reported at the end of July involving low-pathogenic H7N7 at a mallard duck farm in Brenderup.

According to a Danish Veterinary and Food Administration statement yesterday that was translated and posted by Avian Flu Diary, an infectious disease news blog, the new outbreak struck a flock of 1,200 ducklings in North Jutland county and has tentatively been identified as a low-pathogenic H5 strain. The virus was detected during routine surveillance.

Response steps include culling, controlling poultry movement, and thorough cleaning and disinfection of the farm.
Aug 7 Avian Flu Diary post


Final push begins to end polio in Afghanistan and Pakistan

On Aug 5, the WHO reported that the Islamic Advisory Group for Polio Eradication (IAG) approved a new work plan during their third annual meeting that would eradicate the disease from the two Muslim countries where polio is still active: Afghanistan and Pakistan.

According to the WHO, previous eradication campaigns have failed in those countries because of a distrust of the polio vaccine. The misperceptions about vaccine safety often come from fatwas prohibit vaccinating children.

In a statement, the IAG said part of its mission was to help Muslim leaders "trust in the safety and effectiveness of all routine childhood vaccinations as a life-saving tool which protects children."

Deputy of Al-Azhar Al Sharif, Abbas Shouman, MD, said, "It is the duty of Al-Azhar AlSharif to explain the truth to people and clarify the facts, … [Al Sharif] has to explain that vaccination as a form of preventive treatment against disease is a manifestation of the purposes behind Islamic law which aim to protect lives and offspring."
Aug 5 WHO press release

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