News Scan for Sep 12, 2018

Nigeria assist for UK monkeypox
Measles and public health cuts
Global Fund disease progress
Seqirus cell-based flu vaccine

Nigeria, which has 113 confirmed monkeypox cases, aiding UK officials

The Nigeria Centre for Disease Control (NCDC) said today it is helping UK officials respond to their two recent monkeypox cases, which involve travelers from Nigeria, a country that has now reported 262 suspected cases.

In related news, Public Health England (PHE) today issued guidance for primary care physicians and for those cleaning and decontaminating the hospital rooms of patients who have monkeypox, which is related to smallpox (both of which are caused by orthopox viruses) and can be mistaken for chickenpox (caused by the varicella virus).

The NCDC said in a news release, "Following the recent report of the two cases in the UK, NCDC has been working with the UK’s public health agency; Public Health England (PHE), the public health departments in the affected states and other partners in Nigeria to investigate these cases." The NCDC has also been working closely with states across Nigeria to strengthen monkeypox surveillance, detection, and response and meets weekly to ensure coordination with the World Health Organization, the US Centers for Disease Control and Prevention (CDC), and other officials.

The NCDC said that, from September 2017 through Aug 31, 2018, Nigeria has had 262 suspected cases in 26 states. Of these, 113 have been confirmed in 16 states, with 7 fatalities. Southern Nigeria has been hardest hit.

PHE announced the UK cases on Sep 8 and yesterday. It said the cases don't appear to be epidemiologically linked. The first patient is being treated at Royal Free Hospital in London, while the second is at Royal Liverpool University Hospital.

In its guidance for primary care physicians, PHE emphasized that monkeypox does not spread easily between people, but human-to-human transmission can occur. The guidance includes diagnostic tips and prevention and control advice, such as the importance of wearing disposable gloves for patient contact. The cleaning and disinfection guidance includes proper use of personal protective equipment such as gowns, respirators, and eye protection.
Sep 12 NCDC news release
Sep 12 PHE primary care guidance
Sep 12 PHE decontamination guidance
Sep 11 CIDRAP News scan


Measles resurgence in Italy affected by public health cuts, study says

Cuts in public health funding—and not just the growing anti-vaccine movement—are to blame for the return of measles infections in Italy, according to a study today in the European Journal of Public Health.

The study, conducted by researchers at Bocconi University, looked at public health funding across different regions of Italy from 2000 to 2014, and found that for every 1% of funding cut from a region's healthcare budget, measles, mumps, and rubella (MMR) vaccination coverage decreased by 0.5 percentage points (95% confidence interval: 0.36–0.65 percentage points.)

MMR coverage rose from 74.1% in 2000 to 90.6% in 2012, which coincided with an increase in public health funding from 2000 to 2009 at an average rate of 3.5% per year. Between 2010 and 2014, funding dropped by about 2% per year. MMR coverage rose from 74.1% in 2000 to 90.6% in 2012, but by 2014 fell to  85.1%.

"The consequences can be illustrated by comparing two regions, Lazio, where public health spending fell by 5% and MMR coverage by over 3 percentage points, and Sardinia, a historically deprived region, where public health spending partly rose and MMR rates remained approximately steady," the authors said.

"Our analysis suggests that austerity measures adopted in Italy contributed significantly to the resurgence of measles," the authors concluded.
Sep 12 Eur J Public Health study
Sep 12 Bocconi University press release


Global Fund report says 27 million lives saved in 16 years

The Global Fund to Fight AIDS, Tuberculosis and Malaria announced today an estimated 27 million lives have been saved because of the fund's efforts, according to their 2018 annual report. That number represents a cumulative total since the Global Fund, an international public-private partnership based in Geneva, began in 2002.

"The numbers in this report show how far we have come. We have in our sights, but not yet firmly in our grasp, the prospect of freeing communities from the burden of HIV, TB and malaria," said Peter Sands, MPA, executive director of the Global Fund in a press release.

In 2018, the group distributed $4.2 billion in an effort to stop the world's deadliest diseases and said that drug-resistant tuberculosis (TB) was a major threat to curbing TB deaths. Last year, the Global Fund aided 102,000 people in getting treatment for drug-resistant TB.

The Global Fund reported allocations to prevent HIV in key and vulnerable populations rose by nearly 30% for 2017-2019 over the previous funding period. The group said that momentum in the fight against HIV must continue to be harnessed.

"Together, we can end these epidemics, but achieving this goal will require change—increased investment, accelerated innovation, even more effective partnerships and a relentless focus on impact," said Sands.
Sep 12 Global Fund press release
Sep 12 Global Fund report summary


FDA approves Seqirus's new process for cell-based flu vaccine

Flu vaccine maker Seqirus recently announced that the US Food and Drug Administration (FDA) has approved the next generation cell-based manufacturing process for use at its Holly Springs, N.C., facility, a step it says paves the way for more than doubling production of its Flucelvax quadrivalent vaccine for the 2019-20 flu season.

The company acquired the cell-based technology from Novartis in 2015, which at the time was producing about 3 million doses of the vaccine at the Holly Springs facility, which was built in a partnership with the US Biomedical Advanced Research and Development Authority (BARDA) as part of federal efforts to prepare for pandemic influenza threats.

In an Aug 23 statement on the FDA approval, Seqirus said technical improvements helped boost production to about 20 million doses last year.

Preliminary data during the 2017-18 flu season hinted that the cell-based vaccine provided better protection against H3N2, given that the formulation didn't involve the mutation in the egg-based vaccine seed strain thought to be a cause of lower efficacy. In its statement, Seqirus said it has worked with scientific partners to gather more effectiveness data from the 2017-2018 flu season, which it expects to release later this year. "Increased availability of cell-based vaccines in future seasons will provide further opportunities to study their effectiveness," the company said.

Gordon Naylor, Seqirus president, said, "The approval of our next generation process will enable us to meet increasing demand for this innovative vaccine in the US market as well as support its launch in Europe next season."

In its projections for flu vaccine supply for the 2018-19 season, the CDC said 85% will be made using egg-based technology, with the remaining 15% composed of recombinant and cell-based vaccine.
Aug 23 press release
CDC 2018-2019 seasonal flu vaccine supply backgrounder

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