News Scan for Aug 11, 2016

Experimental MERS drug
Nigerian polio cases
More avian flu in France
New TB guidelines
Plague in Zambia

Company announces first phase 1 trial of MERS antibody treatment

SAB Biotherapeutics, Inc., of Sioux Falls, S.D., announced today that its experimental human antibody treatment for MERS-CoV—called SAB-301—has entered human trials, the first potential treatment for the disease to do so.

The phase 1 trial for the treatment for MERS-CoV (Middle East respiratory syndrome coronavirus) infection will evaluate the dosage and safety of the drug candidate. The trial, which began in May, is sponsored, funded, and conducted by the National Institutes of Health (NIH).

The drug is developed using cattle (called Tc Bovine) that are genetically engineered to produce large amounts of human polyclonal antibodies in response to an antigen such as MERS-CoV, according to a company news release.

"Reaching phase 1 clinical trials is a significant milestone for SAB," said Eddie Sullivan, SAB president and CEO. "More importantly, is having the NIH consider our technology as one of the rapid response defenses potentially useful against MERS and other emerging infectious diseases such as Ebola and even Zika.

"Our vision was to develop the first large-scale platform technology to produce human antibody therapeutics with Tc Bovine and have the animals available so that during outbreaks of infectious diseases they can be put to use to generate a large number of doses within a very short timeframe."

The company expects trial results to be available in the first quarter of 2017.
Aug 11 SAB Biotherapeutics news release


Nigeria confirms pair of polio cases after 2-year hiatus

Just weeks after passing the 2-year mark without a wild poliovirus (WPV) case, Nigeria's government today reported that two children in the country's northern Borno state have been paralyzed by the disease, the World Health Organization (WHO) said today in a statement.

Genetic sequencing suggests that the strain that sickened the two children is closely related to a strain detected in Borno in 2011. The WHO said low-level polio transmission is expected in areas where vaccine campaigns have difficulty reaching children. It also noted surveillance gaps in some parts of Borno, as well as in some parts of neighboring countries.

Matshidiso Moeti, MD, the WHO's regional director for Africa, said in the statement that officials are deeply saddened by the children's illnesses. "The Government has made significant strides to stop this paralyzing disease in recent years. The overriding priority now is to rapidly immunize all children around the affected area and ensure that no other children succumb to this terrible disease," she said.

The WHO said an immunization target is hard-to-reach areas such as the Lake Chad region, which cuts across different countries and is often affected by population movement and conflict.

Michel Zaffran, the WHO's director of polio eradication, expressed confidence that Nigeria's government would respond swiftly to eradicate polio from the country once and for all. The WHO said the world is getting close to eradication, with only 21 WPV cases reported so far this year, down from 34 cases reported during the same time last year.
Aug 11 WHO statement


Low-path avian flu strikes two more French farms

France's agriculture ministry today reported two more avian influenza outbreaks—both involving the low-pathogenic H5N3 strain—at farms in the southwestern part of the country, raising the total number of detections since late 2015 to 83.

According to a report to the World Organization for Animal Health (OIE), both outbreaks occurred in the last half of July and were found during surveillance activities. A farm in Tarn department that housed 170 ducks and geese in fattening units and a farm in Gers department that was raising 6,000 free-range ducks were affected.

Response steps included controlling poultry movement, culling, disinfection, and enhanced surveillance.

The outbreaks in France have involved five new avian flu viruses of European origin, with three of the strains being highly pathogenic.
Aug 11 OIE report


ATC, CDC, IDSA issue new treatment guidelines for tuberculosis

In an effort to prevent drug-resistant tuberculosis (TB) infections, the American Thoracic Society, Centers for Disease Control and Prevention (CDC), and Infectious Diseases Society of America (IDSA) issued new guidelines today for treating drug-susceptible TB, including treating patients for HIV and TB.

The guidelines were published in Clinical Infectious Diseases.

The previous TB guidelines, published in 2003, suggested HIV patients wait to begin HIV treatment until they completed treatment for TB. But the authors of the guidelines cite studies that show concurrent treatment for both diseases yields better results. TB infection is a leading cause of death among those with HIV.

Other changes include the recommendation that daily TB treatments begin as soon as the disease is suspected and not delayed until laboratory confirmation. Directly observed treatment (DOT), is also suggested. DOT requires that healthcare providers watch patients take TB medications and is a proven way to increase treatment adherence.

TB is treated for 6 months, and treatment usually consists of four antibiotics drugs. TB is one of the world's deadliest infections: In 2014, 1.5 million people worldwide died from the disease.
Aug 11 Clin Infect Dis article
Aug 11 IDSA press release


2015 Zambia plague outbreak highlights testing problems, malaria co-infection

A 2015 plague outbreak in Zambia resulted in 12 of 21 suspected patients testing positive, but none by culture, the gold standard, in a report today in Morbidity and Mortality Weekly Report (MMWR) that highlights the problem of detecting the disease in resource-poor countries and notes co-infection with malaria and a preponderance of young patients.

Zambian and US researchers reported on 21 suspected cases, including 3 fatal ones, that occurred from Mar 26 to May 5, 2015, in Nyimba district, which had never before reported bubonic plague cases. Twelve patients tested positive for Yersinia pestis on rapid diagnostic test, and six tested positive by polymerase chain reaction (PCR).

Thirteen of the cases (57%), including all three fatal cases and all six PCR-positive ones, also tested positive for malaria. "Malaria positivity might have delayed diagnosis and initiation of antibiotic treatment in some early cases in this outbreak, which might have contributed to poor outcomes," the authors reported.

The authors added, "PCR supported the plague diagnosis in Nyimba, because Y. pestis was not isolated from blood specimens or lymph node aspirates obtained from suspected cases. Bacterial isolation is difficult in rural Zambia because of the lack of local microbiology capacity, inexperience with specimen collection and handling, and transport delays to the reference microbiology and PCR laboratory, 217 miles (350 kilometers) away."

All patients were 18 years or younger, with 20 of them younger than 15. The investigators say the much lower median age compared with other plague outbreaks in Africa might be attributed to children sleeping on the floor of huts, where they might have a higher risk of contact with infected fleas.
Aug 12 MMWR report

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