News Scan for Oct 03, 2017

Saudi MERS case
Measles in the US
Pup-borne Campylobacter
H5N8 outbreaks
VHF vaccine contract
Kidney injury and antibiotics

New MERS case found in Saudi Arabia

The Saudi Arabian Ministry of Health (MOH) announced a new case of MERS-CoV today.

The patient is a 72-year-old man from Tabuk, a city in northwestern Saudi Arabia near the Jordanian border. He presented with symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus) infection and is in stable condition. The man had direct contact with camels, a known risk factor for contracting MERS.

The new case raises Saudi Arabia's MERS count to 1,727 since 2012, including 699 deaths. Five people are currently being treated for the disease.
Oct 3 MOH report


Report: Increasing US measles cases likely tied to lower vaccine uptake

A research letter today in the Journal of the American Medical Association details the US incidence of measles cases after 2000, when the disease was no longer considered endemic, and notes an upsurge in recent years likely attributed to falling immunization rates.

Researchers looked at reported cases from 2001 through 2015 to determine changing incidence. Though the overall rate of measles remained extremely low (fewer than 1 case per million population), there were relative increases observed after 2010. According to the letter, 10 of 13 outbreaks with 20 or more cases occurred after 2010.

From 2001 through 2015, a total of 1,789 measles cases were reported among US residents. Of those patients, 1,243 (69.9%) were unvaccinated, and 316 (17.7%) had unknown vaccination status, meaning that 12.9% were vaccinated.

Overall, 535 (26.6%) of 2,012 cases were imported, and 1,477 (73.4%) were acquired in the United States. Measles incidence was 0.39 per million population, and it was highest in babies ages 6 to 15 months. Incidence decreased with age, and rates declined over the study period among imported cases and those occurring in people who were vaccinated. By far the highest number of cases occurred in 2014, when 667 were confirmed.

"The declining incidence with age, the high proportion of unvaccinated cases, and the decline in the proportion of vaccinated cases despite rate increases suggest that failure to vaccinate, rather than failure of vaccine performance, may be the main driver of measles transmission, emphasizing the importance of maintaining high vaccine coverage," the authors concluded.

So far in 2017, there have been 119 measles cases reported in 15 states, according to data from the Centers for Disease Control and Prevention (CDC), including more than 40 linked to an outbreak among Somali-Americans in Minneapolis. The number has already surpassed 2016's total of 70 cases.
Oct 3 JAMA letter
CDC measles outbreak page


Pup-borne pathogen: 16 new Campylobacter infections linked to puppies

The Centers for Disease Control and Prevention (CDC) today confirmed 16 new Campylobacter infections in people who recently came into contact with puppies from Petland pet stores, bringing the outbreak total to 55 cases.

There are now cases of the bacterial infection diagnosed in 12 states, which is 5 more than in the CDC's initial outbreak announcement on Sep 11. Thirteen people have been hospitalized, but no deaths have been reported. Fourteen of the patients are Petland employees, and 35 recently purchased a puppy from Petland or came into contact with a Petland puppy.

One person had sexual contact with someone who had confirmed Campylobacter illness, four people were exposed to puppies outside of Petland, and only one person had unknown puppy exposure.

Officials said that illnesses appear to be resistant to first-line antibiotics used to treat Campylobacter infections. Isolates collected from seven sick people and six sick puppies showed resistance to azithromycin, ciprofloxacin, clindamycin, erythromycin, nalidixic acid, and telithromycin.

Campylobacter infections are spread when someone comes into contact with animal feces. The CDC said Petland is cooperating with officials to address this outbreak.
Oct 3 CDC update


Italy, South Africa report more H5N8 avian flu outbreaks

In the latest highly pathogenic H5N8 avian flu developments, Italy reported four more outbreaks in poultry, and South Africa reported five more events in poultry and other types of birds, according to the latest notices from the World Organization for Animal Health (OIE).

Among Italy's outbreaks, three are in Veneto region and one is in Lombardy region, both in the country's north. Three of the locations are farms, two housing fattening turkeys and the other raising ducks, chickens, and Guinea fowl. The fourth outbreak involved backyard birds. Taken together, the virus killed 593 of 50,650 susceptible birds, and authorities culled the surviving ones as part of response steps. The outbreaks began Sep 25 and Sep 26 and are now considered resolved.

In South Africa, the outbreaks struck two commercial farms in Western Cape province in the country's southeast, according to one OIE report. Of 193,000 susceptible poultry on the two farms, the virus killed 99.

A separate notification said H5N8 was detected in three types of birds in Western Cape province, including domestic geese and wild birds found dead. One of the wild bird detections involved pied crows found dead near the city of Swartland and a spotted eagle-owl found dead in the city of Cape Town.

The outbreaks started between Sep 2 and Sep 14, killing eight birds.
Oct 2 OIE report on H5N8 in Italy
Oct 2 OIE report on
H5N8 in South African poultry
Oct 2 OIE report on
H5N8 in other South African birds


Profectus awarded NIAID contract for vaccine against Ebola, related viruses

Profectus BioSciences yesterday announced that it has received a contract for up to $22.5 million from the National Institute of Allergy and Infectious Diseases (NIAID) to further development of its multi-component vaccine against two Ebola strains, Marburg virus, and Lassa virus.

In a press release, the Baltimore-based vaccine company said the $6.96 million base part of the contract will cover a proof-of-concept study in nonhuman primates and preparations for manufacturing the vaccine. The $15.29 million in options would support manufacturing and clinical trials.

The vaccine, using Profectus's VesiculoVax platform, is being developed in a lyophilized form to allow distribution without a cold chain and to ease routine mass immunization. Preclinical studies suggest that the vaccine triggers rapid durable protection in nonhuman primates, and a phase 1 clinical trial of the Ebola VesiculoVax vaccine suggested a low level of side effects and antibody responses at the top dose of the vaccine that corresponded with complete protection in nonhuman primates.

John Eldridge, PhD, chief scientific officer at Profectus, said in the statement that the company's Lassa virus vaccine has shown excellent immunogenicity when combined with its Ebola-Marburg vaccine. "We look forward to the clinical testing of a vaccine designed to prevent the annual burden of Lassa fever and the sporadic, but increasing, severe outbreaks of Ebola and Marburg."
Oct 2 Profectus press release


Acute kidney injury tied to combo antibiotics in hospitalized kids

Researchers from Philadelphia and Cincinnati yesterday reported a potential tripling of the risk of acute kidney injury in children administered intravenous (IV) vancomycin combined with piperacillin/tazobactam, according to their study in JAMA Pediatrics.

The retrospective cohort study included 1,915 children hospitalized for 3 or more days and prescribed IV vancomycin plus one other antipseudomonal beta-lactam combination therapy at six large US children's hospitals from Jan 1, 2007, through Dec 31, 2012. Patients with underlying kidney disease or abnormal serum creatinine levels on hospital days 0 to 2 were excluded from the analysis.

Of the 1,915 patients, 157 (8.2%) had antibiotic-associated acute kidney injury. After adjusting for various potential confounders, the investigators determined that the adjusted odds ratio for sustaining such injuries after receiving IV vancomycin plus piperacillin/tazobactam was 3.4 compared with IV vancomycin plus other beta-lactam combo therapies.

The authors conclude, "Pediatricians must be cognizant of the potential added risk of this combination therapy when making empirical antibiotic choices."
Oct 2 JAMA Pediatr study

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