News Scan for Jan 24, 2018

News brief

Senate confirms Azar as new HHS secretary

The United States Senate today confirmed Alex Azar, a pharmaceutical executive, to lead the US Department of Health and Human Services (HHS), according to media reports.

In November, President Donald Trump nominated Azar to replace Tom Price, MD, who resigned in September over a travel spending controversy. In the wake of Price's departure, Eric Hargan, a Chicago attorney who worked for HHS during the George W. Bush administration, has been serving as acting HHS secretary.

Azar was confirmed by a 55-to-43 vote, which saw 6 Democrats and Independent Angus King joining the Republican majority, Politico reported.

Azar is familiar with HHS, having worked as its general counsel and deputy secretary during the George W. Bush administration during the time of the response to the 9/11 terrorist attacks and 2001 anthrax attacks. After that, he was president of Lilly USA, part of Eli Lilly and Co., before stepping down in January 2017 to become a healthcare consultant.
Jan 24 Politico story
Nov 13, 2017, CIDRAP News scan "Trump nominates Alex Azar to lead HHS"

Texas issues warning amid 6-case measles cluster

Texas health officials announced yesterday that they are investigating six measles cases in unvaccinated people in Ellis County, located just south of Dallas.

The announcement from the Texas Department of State Health Services (TDSHS) came just days after it issued an alert for people who attended a movie on Jan 9 at a theater in Waxahachie, which was attended by a customer who was sick with measles. Since then, five more cases have been reported, none of them linked to the movie theater. The TDSHS added that people who were at the movie theater that day should monitor themselves for measles symptoms through Jan 30.

Also yesterday, the TDSHS issued a health advisory for providers, warning that more cases could occur because of the highly communicable nature of measles. It urged health workers to consider measles when patients present with the following symptoms, regardless of vaccination history: fever of 101°F (38.3°C) and generalized macropapular rash lasting 3 days or longer and cough, runny nose, conjunctivitis, or Koplick spots.

It also reminded health facilities about infection control practices against the disease, diagnostic testing, control measures, and criteria for when patients with measles should be excluded from group settings.

In 2017, Texas recorded only one case of measles.
Jan 23 TDSHS news release
Jan 23 TDSHS health alert

Saudi Arabia identifies new case of MERS-CoV

The Saudi Arabian Ministry of Health (MOH) reported a new case of MERS-CoV in Ha'il yesterday.

A 65-year-old Saudi man was diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus) and is in critical condition. The man's source of infection is listed as "primary," meaning it's unlikely he contracted the disease from another person.

The MOH also reported the death of a previously reported patient, a 60-year-old Saudi man from Taif. He was not a healthcare worker and had preexisting disease.

Saudi Arabia's MERS-CoV case count since 2012 has now reached 1,778, including 726 deaths. Seven patients are still being treated according to the MOH.
Jan 23 MOH report

Scientists discover new family of bacteria-killing viruses in the ocean

Scientists have discovered a new family of viruses that help control marine bacteria and maintain ocean ecology, they note in a study today in Nature.

For the study, researchers from the Massachusetts Institute of Technology in Cambridge, Mass., and the Albert Einstein College of Medicine in New York City collected daily samples for 3 months off the coast of Massachusetts. After incubating the samples in cultures of Vibrionaceae bacteria, which are common in the ocean, the team conducted genomic analyses on more than 200 viruses that successfully infected and multiplied in the bacteria.

The investigators found that 18 viruses were members of a new family of small, non-tailed dsDNA viruses. They named the new family Autolykiviridae, after Autolykos, a difficult-to-catch character from Greek mythology.

In experiments involving more than 300 strains of Vibrionaceae in water, the Autolykiviridae viruses killed many more strains than did tailed viruses. "They caused about 40% of the bacterial killing observed, despite comprising just 10% of the viruses that we isolated," said co-lead author Libusha Kelly, PhD, of Albert Einstein College of Medicine, in a school news release.

The scientists also conducted computational analyses showing that viruses related to the Autolykiviridae infect many other types of marine bacteria, suggesting that the newly identified viruses are important predators, possibly in the entire ocean. "We showed that viruses related to the Autolykiviridae are infecting many diverse groups of ocean bacteria as well as other bacterial groups that we cannot currently identify," said Kelly.

The effect of the discovery on human health is so far not known. Kelly said, "We've found related viral sequences in the gut microbiome, but we don't yet know how they influence microbial communities in the gut or how important they are for health."
Jan 24 Nature study
Jan 24 Albert Einstein College of Medicine news release

Flu Scan for Jan 24, 2018

News brief

Study of Taiwan seniors finds flu vaccine can cut TB risk

A large longitudinal study of an elderly population in Taiwan found that flu vaccination reduced the risk of tuberculosis (TB) infection by 18%. Earlier studies, including animal ones, have hinted that flu vaccination might protect against a range of pathogens, including TB, due to activation of T-cell mediated immunity. A team from Taiwan reported the findings yesterday in Emerging Infectious Diseases.

The group's data come from Taiwan's comprehensive universal health insurance program. The setting provides a unique opportunity to study the disease, because TB has been Taiwan's most prevalent notifiable infectious disease for decades, and health officials keep track of cases through a national surveillance system. The cohort study from 2005 to 2012 included 99,982 seniors, 64,290 who were vaccinated and 35,692 who were not. Flu vaccination is voluntary in Taiwan.

During the study period, 1,141 TB cases were reported, for an incidence of 1.14%. Among vaccinated older people, the team found 142.2 cases per 100,000 person-years, compared with 175.5 cases per 100,000 person-years in the unvaccinated group.

After adjusting for demographic factors, concurrent medical conditions, and income level, the group concluded that elderly people in Taiwan who were vaccinated against flu had a lower risk of TB than their unvaccinated peers. They added that given an earlier report that suggested even a partially effective vaccine against TB would reduce the burden of the disease, their new findings suggest that flu vaccination should be offered to seniors to prevent TB infections.
Jan 23 Emerg Infect Dis study

Nanoparticle universal flu vaccine shows promise in mouse study

A nanoparticle universal flu vaccine designed to protect against a range of influenza A viruses was protective and produced long-lasting immunity in mice, a research team based at Georgia State University (GSU) reported today in Nature Communications.

Many experts have called for flu vaccines that are more effective, with gaps in protection in the current flu season, especially against H3N2, and unpredictable pandemic threats, such as from H7N9 in China, underscoring the urgency. In 2012, a team led by the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP), the publisher of CIDRAP News, pressed for better flu vaccines, emphasizing that new efforts should target viral components other than the head of the hemagglutinin (HA) protein on the virus's surface, which is always changing, requiring constant reformulation and revaccination.

In the new study, researchers designed a vaccine that targets surface glycoproteins on the stalk of the virus, a more conserved part that all influenza viruses share. They assembled the stalk domain into a protein nanoparticle as part of a vaccine.

In a press release from GSU, Bao-Zhong Wang, PhD, study coauthor and associate professor in the Institute for Biomedical Sciences, said once the vaccine is given, the nanoparticle protects the antigen protein so it won't be degraded. "Our immune cells have a good ability to take in this nanoparticle, so this nanoparticle is much, much better than a soluble protein to induce immune response."

To test the effectiveness, the team immunized mice twice intramuscularly, then challenged them with several influenza viruses, including H1N1, H3N2, H5N1, and H7N9. The vaccine provided universal and complete protection against lethal virus exposure and dramatically cut the amount of virus in the lungs.

The group's next goal is to test the nanoparticle vaccine in ferrets, an animal model used for studying human influenza because of the animals' generally similar clinical signs and respiratory physiology.
Jan 24 Nat Commun abstract
Jan 24 GSU press release