News Scan for Jan 06, 2017

Zika birth defects
Ebola lung findings
AFM increase
Botulism and prison hooch
Chikungunya vaccine plan

CDC reports 2 more babies born with Zika-related birth defects

Two more babies have been born in the United States with Zika-related birth defects, raising the total to 36, the Centers for Disease Control and Prevention (CDC) said yesterday in an update. The number of Zika-related pregnancy losses remained at 5.

Of 1,292 women who were included in the US Zika Pregnancy Registry as of Dec 27, 875 pregnancies have been completed with or without birth defects. Health officials in the US territories are monitoring 2,842 pregnant women who have evidence of Zika infection.

The United States now has 4,835 Zika infections, 4,618 of them travel-related. The number of local infection in the US territories is now at 35,021, up 427 from the previous week.
Jan 5 CDC Zika update


Ebola study finds evidence of lung involvement

Italian scientists involved in the care of an Ebola-infected health worker evacuated from Sierra Leone in May 2015 yesterday reported that tests on respiratory samples revealed RNA markers suggesting virus replication in the lungs, raising questions about the clinical impact of the disease and the risk of human-to-human spread by the respiratory route. The team published its findings in PLoS Pathogens.

Not much is known about lung involvement in Ebola infection, though pneumonia has been documented in some patients and lab studies suggest that the virus can infect lung tissue.

The researchers collected blood, ocular, urine, nasopharyngeal, and sputum samples throughout the patient's hospitalization. They found that viral RNA and replication markers remained in the lungs for about 5 days after the virus cleared the blood, hinting that the virus may have been replicating in the lungs, which might have provided a protected environment for Ebola to linger. However, the only replicating virus they found from any of the samples they collected was in plasma early in the patient's treatment.

More research is needed to better understand the clinical significance of respiratory tract involvement, but the new findings help shed new light on how the virus might be transmitted and on new treatment approaches, the group concluded.
Jan 5 PLoS Pathog abstract
Jan 5 PLoS press release


CDC confirms 12 more cases of AFM in last month

The CDC today updated its acute flaccid myelitis (AFM) information for the first time in a month and noted 12 more cases of the mysterious disease and one more affected state. From Jan 1, 2016, and Nov 30, 2016, the agency confirmed 120 cases in 37 states.

In the update, the CDC said it is concerned about the uptick of cases and is "intensifying efforts to understand the cause and risk factors of AFM." In 2015, the CDC confirmed only 21 cases of the rare illness, which attacks the spinal cord and can mimic polio. In 2014, the first year the disease was reported to the CDC, there were also 120 cases reported.

Although the CDC said children are at greater risk for AFM, there is little known about why a person may develop the infection, what pathogens are linked to the disease, and what causes the muscles in the arms and legs to weaken during the course of infection.

The CDC said officials are doing many things to monitor and understand AFM, including working with local health departments to improve reporting, and testing the stool, blood, and cerebrospinal fluid of people confirmed to have AFM.
Jan 6 CDC update


Officials detail 2016 outbreak of botulism linked to prison hooch

Today the CDC and local officials provided details on cases of botulism poisoning in Mississippi prisoners that occurred last summer, according to a report in Morbidity and Mortality Weekly Report (MMWR). Tainted hooch, an illicitly made alcoholic beverage was the source of the outbreak, the largest in the United States since 1978.

A total of 33 inmates reported consuming the hooch from Jun 1 to Jun 19, and 31 (94%) had at least some symptoms of botulism poisoning. On average, symptoms developed 3 days after consuming the hooch. All cases were in men, and the median age was 36 years old.

A total of 24 inmates were hospitalized, including 15 (63%) in an intensive care unit and 9 (38%) who needed mechanical ventilation and suffered severe nerve damage and near-total paralysis. There were no reported deaths. Investigators said 20 patients (83%) received botulinum antitoxin; 11 who had mild illness did not receive antitoxin.

Questionnaires revealed the possible sources of contamination; honey, apples, potatoes, and tomato paste were all used to make the alcoholic beverage. The CDC said prison workers should educate inmates on the dangers of drinking hooch.
Jan 6 MMWR report


PaxVax partners with NIH and DoD to advance chikungunya vaccine

PaxVax yesterday announced that it has partnered with the National Institutes of Health (NIH) and the Department of Defense to develop a virus-like particle (VLP) vaccine against chikungunya.

The vaccine was developed by the NIH and is already in phase 2 clinical trials, PaxVax, based in Redwood City, Calif., said in a press release. According to the terms of the collaboration, the company will license the NIH's vaccine technology and carry it through to full commercialization. Over the past year PaxVax has been developing a manufacturing process and release assays. PaxVax will conduct additional clinical trials, including one with the Walter Reed Army Institute of Research to assess possible benefits of adding an alum adjuvant.

Nima Farzan, MBA, PaxVax's chief executive officer and president, said in the press release, "The spread of chikungunya represents a significant unmet public health need. At PaxVax, we are committed to ongoing collaboration with the US government for the development of a vaccine to halt the spread of this debilitating infectious disease."

The NIH published results of its phase 1 trial in 2014, which suggested that the vaccine was well tolerated and highly immunogenic. Results from the phase 2 trials are expected in the first quarter of this year.
Jan 5 PaxVax press release

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