News Scan for Sep 02, 2016

Meningitis C outbreak
Vaccine development alliance forms
Hepatitis A in strawberries

Officials report 25 cases of meningitis C in Southern California

Local and US health officials today reported that 25 people in Southern California have contracted meningitis C, most of them men who have sex with men (MSM).

Two of the cases, which occurred from Mar 4 to Aug 11, have proved fatal, according to a report in Morbidity and Mortality Weekly Report (MMWR) by scientists from the US Centers for Disease Control and Prevention (CDC) and from California. Twenty-four of the cases were caused by serogroup C Neisseria meningitidis and one by N meningitidis of an undetermined serogroup.

Of the 25 patients, 23 (92%) were male, 20 of whom self-identified as MSM. Among the MSM, 8 (40%) reported Hispanic ethnicity, consistent with the proportion of Hispanic people in in Los Angeles County, the city of Long Beach, and Orange County, where the cases have occurred. The median age of the patients is 32 (range, 17 to 74 years).

The estimated attack rate among MSM in the affected region is 6.4 cases per 100,000, which is more than 50 times the incidence of meningococcal disease among all US men in 2015, the report said. Clusters of meningitis C in MSM were confirmed in New York City in 2010 to 2013, in Los Angeles County in 2012 to 2014, in Chicago in 2015 and this year, in Berlin in 2012 and 2013, and in Paris in 2014, the authors noted.

In response to the current outbreak, local health departments on Jul 26 recommended the four-strain meningococcal vaccine, MenACWY, for all MSM regardless of risk behaviors, because no risk groups have yet been identified in the current outbreak. That step expanded recommendations that were in place that focused on certain risk groups.

The most recent update from the California Department of Public Health (CDPH) on the outbreak, on Aug 3, listed 22 cases. The CDPH this week also highlighted an outbreak of Shigella infections in MSM in Southern California.
Sep 2 MMWR report
Aug 3 CDPH meningitis C update
Aug 29 CDPH Shigella notice


New group established to overcome epidemic vaccine barriers

A new alliance to finance and coordinate the development of new vaccines to curb infectious disease epidemics—the Coalition for Epidemic Preparedness Innovations (CEPI)—has been formally established, and its Web site launched today.

John-Arne Rottingen, MD, PhD, CEPI's interim chief executive officer, said in the group's newsletter today that stakeholders met in London Aug 30 to weigh in on the business plan and its ongoing work.

He said CEPI is anticipating a more formal launch at the World Economic Forum in Davos, Switzerland, in January.

At an earlier meeting the interim board elected as its chair Vijay Raghavan, PhD, who is with the biotechnology department at the Indian Ministry of Science and Technology. It elected Peter Piot, MD, PhD, director of the London School of Hygiene and Tropical Medicine, as its vice chair.

According to the CEPI Web site, the group's work is targeted to overcoming barriers to developing vaccines against new disease threats with a new funding model. It noted that developing a safe and effective vaccine against an emerging disease can take more than 10 years because of unique challenges that more commercially viable vaccines don't face  and because of regulatory hurdles. CEPI adds that outbreaks often hit developing countries the hardest.

The alliance includes governments, industry, academia, philanthropists, intergovernmental groups such as the World Health Organization, and nongovernmental organizations. The five founding partners are the Norwegian and Indian governments, Wellcome Trust, the Bill and Melinda Gates Foundation, and the World Economic Forum.
CEPI Web site


CDC, FDA investigating hepatitis A in frozen strawberries

Yesterday both the CDC and the Food and Drug Administration (FDA) said they were investigating a multistate hepatitis A outbreak linked to frozen strawberries imported from Egypt.

As of today, 70 people in seven states have contracted the foodborne illness, with 32 people requiring hospitalization. There have been no deaths. The outbreak total is 1 more than news media reported yesterday before the CDC update.

According to the FDA, "Nearly all ill people interviewed report eating smoothies containing strawberries at Tropical Smoothie locations in a limited geographic area." Tropical Smoothie Cafes stopped making smoothies with imported strawberries on Aug 8.

The CDC said the outbreak is tied to restaurants in four states: Virginia, West Virginia, Maryland, and North Carolina. People from other states reporting illness said they recently visited a Tropical Smoothie in one of those states.

In epidemiologic interviews conducted by the CDC, 97% of people who fell ill (68) reported visiting Tropical Smoothie in the month before they got sick, and all 70 interviewed said their smoothies contained strawberries.

At this time, the FDA said it has no reason to believe there is an ongoing risk of contracting hepatitis A at Tropical Smoothie Cafes.
Sep 1 CDC announcement
Sep 1 FDA announcement

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