News Scan for Dec 13, 2017

More puppy Campylobacter
Food safety panel phased out
Urine TB test developed
Zika vaccine durability
MenB vaccine in young adults

More cases of puppy-linked Campylobacter reported in several states

The Centers for Disease Control and Prevention (CDC), in an update on an ongoing outbreak of multi-drug resistant Campylobacter infections linked to puppies sold in pet shops today, confirmed 30 new cases reported since the last outbreak update published on Oct 30.

As of yesterday, officials have reported that 97 people in 17 states have laboratory-confirmed infections or symptoms consistent with Campylobacter infection. A total of 22 people have been hospitalized, but no deaths have been reported. The first cases were reported to the CDC in June.

The vast majority of patients (98%) reported contact with a puppy in the week preceding illness. Ninety percent of people interviewed said they had contact with a puppy from a Petland store, or had contact with a person who became sick after contact with a puppy from a Petland store. Twenty-one ill people worked at a Petland store.

Using while genome sequencing, the CDC identified multiple antimicrobial resistance genes and mutations in most isolates from 35 ill people and 9 puppies, including resistance to azithromycin, ciprofloxacin, clindamycin, erythromycin, nalidixic acid, telithromycin, and tetracycline.
Dec 13 CDC update


FDA cancels Food Advisory Committee

Yesterday the Food and Drug Administration announced it will not renew the charter of the independent Food Advisory Committee, instead saying the agency plans to use standing committees and individual experts on an as-needed basis.

The FDA cited infrequent meetings (the last committee meeting was in 2015) as the main reason for this change. "FDA has determined that the effort and expense of maintaining the advisory committee is no longer justified," the administration said in a press release.

The Food Advisory Committee was created in 1992. Termination was effective immediately.

In a reaction to the news, Lisa Lefferts, a senior scientist with the Center for Science in the Public Interest (CSPI), writes that this decision is further evidence the current administration does not value independent scientific advice. Lefferts said that among the 18 remaining committees that advise the FDA, none address food issues.

"The agency says it will get scientific advice in other ways, such as through its Science Advisory Board. But many of its members lack expertise on food issues," Lefferts writes.
Dec 12 FDA announcement
Dec 12 CSPI statement   


Researchers report urine TB test development advancement

Researchers have found a way to test urine for the bacteria that causes tuberculosis (TB), a type of testing that had previously only been available to people who had HIV. An international research team based at George Mason University in Virginia reported its findings today in Science Translational Medicine.

A urine-based test for a broader range of TB patients would help with screening, transmission control and treatment management, because it is noninvasive, doesn't require specialized training, and is well suited for low-resource settings.

However, earlier attempts to develop a urine-based TB tests were only able to detect TB infections in those with HIV, presumably because immune suppression in HIV disease elevates systemic bacteria levels.

After screening 37 different compounds, researchers found a complex copper dye called RB221 that they embedded in tiny hydrogel meshes to trap small amounts of a sugar called LAM in the TB bacteria's outer coat that are in patients' urine. When they used the test on a group of 48 HIV-negative participants from Peru who had TB, they found that sensitivity at detected TB infections was 95%. The team also found a connection between elevated LAM concentrations and disease severity.

They wrote that their next steps are to compare urinary LAM findings in patients before and after therapy to gauge possible treatment-related changes.
Dec 13 Sci Transl Med abstract


Animal study sheds light on duration of protection for Zika vaccines

A Zika virus vaccine that provides long lasting protection is desirable, given unknowns about the disease circulation and the lingering threat to people who live in regions where mosquitoes that carry the disease are common.

To see what Zika vaccine candidates might afford more durable protections, scientists did tests on monkeys at the 1-year mark to see which ones performed best. A team led by Harvard Medical School reported their findings today in Science Translational Medicine.

Researchers immunized the animals using one of three Zika vaccine platforms: purified inactivated virus, adenovirus vectored, and DNA. A year later they infected the monkeys with Zika virus to see how well the vaccines protected them.

One dose of the adenovirus-vectored vaccine protected 100% of the animals. Two doses of PIV protected 75% of them, with 25% showing temporary viremia spikes after Zika challenge. The DNA vaccine, which had been shown to be highly effective in short-term studies, failed to protect at one year, with 71% of the monkeys experiencing viremia after being challenged with Zika virus.

Also, the team measured Zika antibodies in animal blood samples, which allowed them to define a minimum threshold of protection, which they said might be useful for the clinical development of Zika vaccines for humans.
Dec 13 Sci Transl Med abstract


Vaccine effective against diverse meningococcal B strains

A new study published today in the New England Journal of Medicine shows that the meningococcal B bivalent vaccine (MenB-FHbp ), Pfizer's Trumenba, was safe and immunogenic in young adults, but it did cause more injection site irritation than the hepatitis A vaccine and saline used in controls.

The data were gathered from phase 3 trials conducted in 10- to 18-year-olds and 18- to 25-year-olds. The vaccine was administered in three doses, at baseline, 2 months, and 6 months. Researchers found primary immunogenic endpoints obtained after doses 2 and 3 of the vaccine.

A total of 3,596 adolescents (10 to 18 years) were randomly assigned to receive either hepatitis A virus vaccine or saline or MenB-FHbp, the licensed meningococcal B vaccine. A group of 3,304 young adults (18 to 25 years) were also similarly assessed.

Immunogenicity was assessed via serum bactericidal assays. By dose 2, 85.3% of the adolescents who received the MenB vaccine had an immunogenic response; that number rose to over 90% by dose 3. Young adults had similar results. However, most of the participants who received MenB-FHbp reported mild or moderate pain at the vaccination site.

Meningitis B is a dangerous bacterial infection caused by Neisseria meningitidis serogroup B that can be fatal in young people.

"Our findings provide assurance that observed immune responses to the primary strains are representative and indicative of vaccine responses to diverse disease-causing meningococcal B strains," the authors concluded. The US Food and Drug Administration (FDA) approved the vaccine, the first for meningitis serogroup B, in 2014.
Dec 13 N Engl J Med abstract

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