News Scan for Apr 30, 2018

Universal flu vaccine funds
Pneumococcal vaccine failure
Saudi MERS deaths
Hospital-acquired malaria
Aspergillosis burden

Gates Foundation announces $12 million universal flu vaccine challenge

In a speech at the annual meeting of the Massachusetts Medical Society on Apr 27, philanthropist and Microsoft cofounder Bill Gates announced the launch of a $12 million Grand Challenge to speed the development of a universal flu vaccine. He said the Lucy and Larry Page family is a partner in the challenge and is also supporting Sabin Vaccine Institute efforts to encourage new approaches to curb the pandemic flu threat.

During the speech, Gates prefaced the announcement with a sobering assessment of global pandemic preparedness, for which he said the world isn't making much progress. "This should concern us all, because if history has taught us anything, it's that there will be another deadly global pandemic."

Referencing an Institute for Disease Modeling estimate that a highly contagious and lethal airborne pathogen similar to the 1918 pandemic flu virus today would kill nearly 33 million people in 6 months, Gates said despite the sobering message, growing scientific, corporate, and philanthropic interest in a universal flu vaccine is more feasible now than 10 to 20 years ago.

The Grand Challenge announcement broadens the Bill and Melinda Gates Foundation's earlier support for flu vaccine candidate research groups. "The goal is to encourage bold thinking by the world's best scientists across disciplines, including those new to the field," he said.

Gates acknowledged that the next big threat might not be flu but some other unknown pathogen. He praised the work the Coalition for Epidemic Preparedness Innovations (CEPI) to advance work on vaccines for three of the World Health Organization's (WHO's) priority diseases, while also highlighting the importance of developing new drugs, antibody therapies, and diagnostic tests for battling the threats.
Apr 27 Gates Foundation speech transcript


Study: 13-strain pneumococcal vaccination fails to protect older adults

A new study finds the 13-valent pneumococcal conjugate vaccine (PCV13) unable to reduce the risk of pneumococcal pneumonia in adults. The large study, based in Catalonia, Spain, was published in BMC Infectious Diseases.

The population-based cohort study followed more than 2 million adults over the age of 50 for all of 2015 to determine what role, if any, PCV13 had in reducing the risk of pneumococcal pneumonia, all-cause pneumonia, or death. Researchers matched vaccination status from electronic health records. 

The researchers found that PCV13 vaccination did not significantly reduce the risk of pneumococcal pneumonia or death, but was statistically significantly associated with higher all-cause pneumonia (multivariable hazard ratio of 1.17, 1.07, and 1.69, respectively).

"Our unadjusted and adjusted data show that PCV13 vaccination did not provide clinical benefits in reducing hospitalisation from overall pneumococcal pneumonia, as in the general people over 50 years old as well as in immunocompromised subjects and elderly individuals (main targeted groups where PCV13 is currently recommended in adults)," the authors concluded.

This is the largest study of PCV13 since researchers conducted the CAPITA trail in the Netherlands to establish PCV13's efficacy. A 2015 study on that trial reported a PCV13 efficacy of 46% against vaccine-type invasive pneumococcal infections among adults 65 and older.
Apr 27 BMC Infect Dis study


Saudi MOH records two new deaths from MERS

The Saudi Arabian Ministry of Health (MOH) confirmed two new deaths from MERS-CoV, one of which may be a previously unreported case.

Officials said in an Apr 27 report posted over the weekend that a 93-year-old Saudi man from Al Qunfudhah died from MERS-CoV (Middle East respiratory syndrome coronavirus). He was not a healthcare worker and had preexisting illness.

On Apr 28 the Saudi MOH said a 60-year-old Saudi man from Aluyuon Ahsaa also died after MERS-CoV infection. He likewise was not a healthcare worker and had preexisting disease. This case may have been previously unrecorded by the MOH.  

The fatalities bring Saudi Arabia's MERS totals since 2012 to 1,836, including 744 deaths. One person is still being treated for MERS-CoV infection.
Apr 27 MOH report
Apr 28 MOH report  


Six cases of hospital-acquired malaria in Europe demonstrate risk

Since January of 2016, four European Union countries reported six cases of hospital-acquired malaria. A new report from the European Centre for Disease Prevention and Control (ECDC) highlights the rare possibility of hospital-acquired malaria transmission and explains possible routes of transmission.

Though the number of hospital-acquired cases is not necessarily alarming, ECDC officials said the concomitant infections in Italy (2 cases), Spain (2), Greece (1) and Germany (1) are unusual.

The route of transmission in these cases is not known, but hospital-acquired malaria has been associated with procedures related to blood-borne transmission, including injections or infusions. The ECDC said the risk of further malaria transmission in isolated hospital-acquired cases is negligible.

"Even if hospital-acquired malaria is uncommon, clinicians and healthcare providers should consider it in patients with unexplained fever or a malaria-like clinical syndrome, especially if their hospital stay coincides with that of a malaria-infected patient," the ECDC said in a news release on the report.
Apr 30 ECDC report

Apr 30 ECDC news release


Study tracks evolving aspergillosis patterns in hospitalized patients

An updated assessment of invasive aspergillosis burden in hospitalized patients in the United States found that the illnesses is still rare, even in those at high risk, and is associated with a 40% increase in readmission. Researchers reported their findings in Clinical Infectious Diseases.

Invasive aspergillosis is a potentially fatal fungal infection that more frequently occurs in people with weakened immune systems, such as cancer patients and organ transplant recipients. Though the condition is rare, even in those most at risk, it's been about two decades since the last morbidity and mortality study.

The researchers analyzed inpatient data from the Health Care Utilization Project administered by the Agency for Healthcare Research and Quality for the years 2009 to 2013, comparing high-risk patients who did and didn't have invasive aspergillosis.

Of 66,634,683 patients who met the study criteria, 154,888 (0.2%) had been diagnosed as having invasive aspergillosis. Compared with the earlier study, hospitalizations for the condition have quadrupled, which the authors said is likely due to improved diagnosis, greater use of immunosuppressive therapy, and an increase in organ transplants.

However, they said deaths from the disease dropped from 19% to 14%, with costs also falling from 12 to 6 hospitalization days and from $51,000 to $15,000 per admission. The group said a drop in hospital use has likely stabilized total national costs for invasive aspergillosis hospitalizations, at about $600 million per year, despite a dramatic rise in prevalence.

At the same time, the team found a 40% increase in the chance of hospital readmission after 30 days, which they say is a novel and important observation, especially given current cost-containment efforts and shrinking hospital reimbursements.
Apr 28 Clin Infect Dis abstract

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