News Scan for Nov 18, 2016

Saudi MERS cases
Ebola convalescent blood
US bioterror threat
Dutch H1N1v case
Malaria vaccine in Africa

Three new MERS cases confirmed in Saudi Arabia

Today the Saudi Arabian Ministry of Health (MOH) said the country has three new cases of MERS-CoV. Two of the cases are linked to camel exposure, one of the most common risk factors for the respiratory illness.

A 29-year-old Saudi man from Az Zulfi and a 34-year-old Saudi man from Arar are both in stable condition after showing symptoms for and being diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus). The MOH said both men had direct contact with camels.

The third MERS patient, a 53-year-old expatriate man in Buqayq, is also in stable condition. His case is also listed as primary, meaning he did not contract the virus from anyone else, but the MOH did not mention camel contact.

The new cases raise Saudi Arabia's MERS-CoV total to 1,484 cases, 617 of them fatal. Thirteen people are being treated for their infections.
Nov 18 MOH update


Promising findings in small trial of Ebola convalescent blood

A small trial of convalescent whole blood (CWB) treatment at a Freetown, Sierra Leone, hospital during the Ebola outbreak yielded promising findings, researchers from the country reported yesterday in the Journal of Infection.

From December 2014 and April 2015 researchers enrolled 69 patients at the hospital, 44 of whom wanted to receive CWB. All of the patients received routine treatment for Ebola.

Of 43 patients in the CWB group who completed the study, 31 recovered and 12 died, for a case fatality rate (CFR) of 27.9%. Of 25 who received only routine treatment, 11 died, for a CFR of 44%. The investigators found that the odds ratio for survival in the CWB group was 2.3 (95% confidence interval 0.8 to 6.5).

When the researchers compared patients' viral loads at admission and 24 hours after treatment began, they found a significant change for the CWB group but not the control group.

CWB could still be a promising treatment for Ebola in resource-poor settings, especially in the early phase of an outbreak, the team concluded, noting that randomized trials are needed to further assess its effectiveness.

Earlier this year a trial of convalescent plasma based at a treatment center in Guinea found that it was safe but didn't offer a significant survival benefit.
Nov 17 J Infect abstract
Jan 6 CIDRAP News story "Ebola studies pan convalescent plasma, find hope for malaria regimen"


Advisers warn Obama of high-tech bioterror threats

Current anti-bioterror efforts by the US government are not keeping up with the times and fail to address changes wrought by new technology such as the gene-editing tool CRISPR, President Barack Obama's scientific advisers said in a letter to the president this week. They suggest quickly establishing a cross-agency panel to address the challenges.

"While the ongoing growth of biotechnology is a great boon for society, it also holds serious potential for destructive use by both states and technically-competent individuals with access to modern laboratory facilities," the President's Council of Advisors on Science and Technology (PCAST) said in a Nov 15 letter.

"The U.S. Government's past ways of thinking and organizing to meet biological threats need to change to reflect and address this rapidly-developing landscape," the PCAST letter says, adding that the advisors "urge you to take immediate action to ensure that the Nation has the ability to meet these challenges."

Foremost among PCAST's immediate recommendations is the formation of an interagency group to plan, coordinate, and oversee national biodefense activities across the intelligence community and the Departments of Defense, Homeland Security, Health and Human Services, and Agriculture. It should have high-level representation from various agencies and be co-led by top administration officials.

The other immediate recommendation is to have Congress establish a Public Health Emergency Response Fund of at least $2 billion to address biosecurity needs, including those from naturally occurring pathogens. The report also includes three "medium-term" recommendations and one long-term recommendation.
Nov 15 PCAST letter
Nov 15 White House blog post on the letter


Netherlands reports severe swine variant H1N1 illness

The Netherlands this week reported a severe swine variant H1N1 (H1N1v) infection in a 9-year-old girl who had contact with swine. The girl required extracorporeal membrane oxygenation (ECMO) while she was hospitalized.

The case was first announced on Nov 16 by the country's National Institute for Public Health (RIVM), according to a statement translated and posted by Avian Flu Diary, an infectious disease news blog.

European health officials shared more details about the illness today in their latest update on flu activity. The girl's symptoms began on Oct 26, a few days after close contact with swine. Her H1N1v (Eurasian avian influenza lineage) infection was detected on Nov 5 and was susceptible to oseltamivir (Tamiflu) and zanamivir (Relenza). She received oseltamivir.

The girl has recovered. Some of her contacts had symptoms, but none tested positive for influenza A.
Nov 16 Avian Flu Diary post
Nov 18 Flu News Europe report


WHO will roll out first malaria vaccine in Africa

Yesterday the World Health Organization (WHO) announced it will begin pilot vaccination projects with RTS,S, the world's first malaria vaccine, in three unnamed Sub-Saharan African countries in 2018. The projects will be funded by $15 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Phase 3 clinical trials of RTS,S have been conducted on 15,000 infants and young children in seven African countries, and  the vaccine has been partially effective in protecting children from the illness caused by the Plasmodium falciparum parasite.

"The pilot deployment of this first-generation vaccine marks a milestone in the fight against malaria," said Pedro Alonso, MD, PhD, director of the WHO Global Malaria Program, in a WHO news release.

The pilot program will determine the feasibility of delivering the required four doses of RTS,S, and the safety of the vaccine during routine use. Despite a 42% reduction in cases in the past 15 years, sub-Saharan Africa still accounts for 90% of the world's malaria illnesses and deaths, the WHO said.
Nov 17 WHO press release

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