News Scan for Feb 23, 2018

Japan clears new flu drug
UK Zika vaccine project
Avian flu epi report
Yellow fever in Brazil
Public health readiness

Japan approves new one-dose antiviral flu drug

Japan's health ministry has given fast-track approval to a new flu antiviral with a different mechanism of action than neuraminidase inhibitors that offers a one-dose treatment option, the Wall Street Journal reported today.

The drug—from Shionogi, based in Osaka—is called Xofluza (baloxavir marboxil) and is an endonuclease inhibitor designed to prevent viral replication by inhibiting cap-dependent endonuclease activity of the viral polymerase, a process known as "cap snatching."

According to the report, trials in Japan and the United States found that the drug could wipe out the virus in a median time of 24 hours, three times faster than oseltamivir (Tamiflu). Both drugs, however, took the same amount of time to curb flu symptoms.

Roche has teamed up with Shionogi to license the drug outside of Japan, including in the United States. Another late-stage trial is wrapping up in Japan and the United States, after which the company hopes to file for US Food and Drug Administration (FDA) approval later this year.

In Japan, the drug probably won't be available until May, because the company is still waiting for insurers to set a price.
Feb 23 Wall Street Journal story


UK groups announce Zika vaccine collaboration

The University of Liverpool yesterday announced a new UK collaboration to develop a Zika vaccine that can be used during pregnancy. The project is supported by a £4.7million ($6.5 million) grant from the UK Department of Health and Social Care and managed by Innovate UK, according to a University of Liverpool news release.

The goal of the project is to take two vaccine candidates to trials in humans within the next 3 years. With researchers from the University of Manchester, Public Health England, and the pharmaceutical companies, the group plans to confirm the safety of two new vaccine candidates that are based on a safe version of an existing smallpox vaccine before advancing to the first human trials at the Royal Liverpool University Hospital Clinical Research Unit.

According to a profile for the vaccine, scientists are taking a "twin track" in which the vaccine candidate would produce antibody and killer T cells to prompt better and long-lasting immunity.

Neil French, PhD, director of the Center for Global Vaccine Research at the University of Liverpool, said in the release, "Although the current Zika outbreak has slowed, there remains a significant risk of foetal abnormality when pregnant mothers become infected, and the changing climate raises the possibility of major epidemics occurring in previously unaffected parts of the world. A ready to use vaccine would dramatically reduce the threat that we face from Zika."
Feb 22 University of Liverpool press release


OIE avian flu snapshot notes number, diversity, spread of latest outbreaks

In its latest epidemiologic update on avian influenza, the World Organization for Animal Health (OIE) said that the highly pathogenic avian flu situation in the second panzootic wave, under way since 2013, is notable. Factors include a substantial number of countries and territories affected by outbreaks in domestic birds, a substantial number of outbreaks, and circulation of diverse ubtypes, which has added complexity to control and eradication.

In January of 2018, eight countries (Afghanistan, Cambodia, Taiwan, Iraq, Japan, South Korea, Saudi Arabia, and South Africa) and two of the world's regions (Africa and Asia) were affected by outbreaks in poultry.

Compared with the first panzootic that took place from 2005 through 2012, the current panzootic is marked by triple the number of circulating avian flu subtypes (12 vs. 4). In the current panzootic, nearly 120 million birds were lost through disease and culling, and all regions of the world have been affected, with 68 countries reporting at least one outbreak. H5N1, H5N2, and H5N8 have been the most common strains.

Most recently, new and recurring outbreaks of H5N1, H5N8, and H5N6 have struck Asia, Europe, and the Middle East, with signs that the geographic distribution is increasing. From a public health perspective, H7N9, H5N6, and H5N1 post the greatest threats to humans.
Jan 25 OIE situation update

In outbreak developments, Taiwan today reported four more highly pathogenic H5N2 outbreaks in poultry, three on farms and one detected at a slaughter house, according to a separate report from the OIE.

The events began on Feb 11 and Feb 12, striking locations in Taichung City, as well as Chiayi, Pingtung, and Yunlin counties. Affected species included native chickens and breeding geese. Taken together, the outbreaks killed 1,321 of 30,767 susceptible birds, and the rest were destroyed as part of response steps.
Feb 23 OIE report on H5N2 in Taiwan


Brazil proposes vaccinating entire country against yellow fever

Yesterday Ricardo Barros, the Brazilian minister of health, proposed the entire country be vaccinated against yellow fever in an effort to control the largest outbreak of the flavivirus seen in South America in decades, Xinhua, China's state news agency, reported.

Currently, the government is focusing its vaccination efforts on the country's most populous states, Rio de Janeiro and Sao Paulo. Those states, along with Minas Gerais, have had by far the most yellow fever cases in the last year. But efforts to vaccinate citizens of those states have fallen short, with only about 20% of people receiving a full or fractioned dose of the vaccine.

Libbs Farmaceutica in Sao Paulo is set to begin monthly production of 4 million doses of yellow fever vaccine, the story said. Fractioned doses, one-fifth the standard dose, are being used in an effort to reach as many people as possible.

About 34 million Brazilians live in states in the northeast and southern part of the country not yet affected by yellow fever. Last week, Brazil's Ministry of Health confirmed 941 human cases of yellow fever since Jul 1, 2016, which includes 284 deaths.
Feb 22 Xinhua story


Report says resilient communities key to disaster preparedness

A new report from the Johns Hopkins Center for Health Security said that while America is well prepared to handle small health emergencies (think tornadoes), it is poorly equipped to handle large-scale natural disasters or complex health events, including the next pandemic.

The report, "A Framework for Healthcare Disaster Resilience: A View to the Future," was released yesterday at an event at the National Press Club in Washington, D.C. The authors said focusing on strengthening existing community healthcare coalitions and resilience is the best way to prepare America for complex and large-scale health events, from catastrophic weather to bioterrorism.

"It is now widely recognized that resilience of communities and systems should be the goal rather than just preparedness," the authors wrote in the report. "Resilient communities seek to resist the impact of disasters, recover promptly to normal operational capacity, and learn how better to withstand future events."

The authors make four recommendations for strengthening resilience: launching a federal program that provides incentives for community organizations to become involved in health sector preparedness, creating centers of disaster resource hospitals based on geographic location, supporting healthcare collations, and designating a federal coordinator for catastrophic health event preparedness.
Feb 22 Center for Health Security press release

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