News Scan for Sep 17, 2018

Saudi MERS cases
South Korea MERS update
Inhaled flu vaccine trial in kids
Urban cholera in Algeria

MERS sickens 3 more in Saudi Arabia

Saudi Arabia yesterday reported three more MERS-CoV cases, including two from different cities who contracted the virus from a sick household contact.

In its yesterday report for epidemiologic week 38, the country's ministry of health (MOH) said two of the MERS-CoV (Middle East respiratory syndrome coronavirus) cases are in Riyadh province, one of which involves a 38-year-old man from Rumah, about 74 miles northeast of the capital city of Riyadh. The man's source of the virus is listed as primary, meaning he wasn't exposed to a patient diagnosed with the illness. The other is a 34-year-old man from the city of Riyadh who is listed as a household contact.

The third MERS patient is a 62-year-old man from Buraydah in Qaseem region, an area that has reported other sporadic cases over the past month. The man had been exposed to a sick household member.

All three of the men are currently hospitalized, according to the report. The new cases appear to have pushed the global MERS-CoV total to 2,254 cases since 2012, at least 798 of them fatal.
Sep 16 Saudi MOH epi week 38 update


South Korea passes day 10 with no new MERS cases

South Korea has gone 10 days without reporting any other MERS cases related to an imported case in a business traveler who was diagnosed with the virus after returning from business travel in Kuwait, according to a status report today from the Korea Centers for Disease Control and Prevention (KCDC).

The 61-year-old man's illness was confirmed on Sep 8, and he is hospitalized at Seoul National University Hospital. Health officials are following 21 close contacts who are on home quarantine. Also, health officials have identified 406 others who had less risky contact with the patient.

In a related development, the World Health Organization (WHO) continues to support South Korea with contact tracing, public communications, and information sharing under the International Health Regulations (IHRs), the WHO's Western Pacific Regional Office said today in a statement.

The WHO added that investigations are still under way in Kuwait to determine where the man may have been exposed to the virus and if there are others he came into contact with during his travels. "WHO is facilitating information-sharing between the countries," it said.

Dr. Li Ailan, WHO's regional emergency director for the Western Pacific, said in the statement that the WHO is pleased with South Korea's response so far, especially its rapid detection and timely notifications. "However, the response is still ongoing. We must maintain our vigilance," she said. "WHO will continue to facilitate collaboration among countries and to support the response."

The WHO said that, based on lessons learned in a large outbreak linked to the country's first imported case in 2015, South Korea has invested heavily in strengthening its capacity to detect and respond to infectious disease outbreaks. It also added that MERS-CoV awareness among South Korean health workers and the general public is high, which helped facilitate prompt detection of the case.
Sep 17 KCDC update (in Korean)
Sep 17 WHO Western Pacific regional office statement


Trial of new inhaled vaccine to boost H3N2 flu protection launches in kids, teens

Researchers have started enrolling healthy children ages 9 to 17 years old in a phase 1 trial to assess a new type of inhaled flu vaccine that contains a "single-replication" virus, according to a statement today from the National Institutes of Health (NIH).

The candidate vaccine was developed by FluGen, Inc., based in Madison, Wisc., and is made from a seasonal H3N2 flu virus that has been genetically engineered to replicate only once in the body. The vaccine is in a phase 2 trial in adults. The study site is the Vaccine and Treatment Evaluation Unit, which is funded by the NIH's National Institute of Allergy and Infectious Diseases (NIAID).

A goal of the study is to combine the new inhaled vaccine with one of the current licensed vaccines provides broader protection than that afforded by current vaccines when used alone. The experimental inhaled vaccine is genetically engineered to target H3N2, even when the circulating virus doesn't closely match the vaccine strain, a protection gap inherent with most current seasonal flu vaccine formulations.

Anthony Fauci, MD, NIAID director, said in the statement, "We are hopeful that newer kinds of influenza vaccines, such as the candidate being tested in this trial, will provide protection even if their components do not precisely match the currently circulating influenza virus strains."

The double-blinded trial will enroll 50 participants, half of whom will get the candidate nasal vaccine and the other half an inactive saline solution delivered as a nasal spray. Three months after receiving the nasal spray, all subjects will receive an intramuscular injection of a licensed quadrivalent flu vaccine.  Researchers will analyze blood samples at four points after the first vaccination and at 3 weeks after the second vaccination, looking for evidence of immune responses from antibody-producing cells and from the cellular part of the immune system.

Earlier animal studies suggested that the single-replication virus doesn't cause disease but triggers a robust immune response similar to natural infection.
Sep 17 NIAID press release


WHO: Cholera outbreak strikes Algerian capital area

A rapidly spreading cholera outbreak in northern Algeria in and around the capital province of Algiers that began in early August has hospitalized 217 people, including 83 confirmed case-patients and 2 deaths, the WHO said in a Sep 14 update.

The country's health ministry announced the outbreak on Aug 23, and since then, cases have been reported in 7 of Algeria's 48 provinces. The event marks Algeria's first cholera outbreak since 1996.

The Pasteur Institute in Algeria has confirmed Vibrio cholerae serogroup O1 Ogawa as the outbreak strain, and tests on 21 water sources in the affected areas found that 10 were inappropriate for human consumption. One well that was positive for V cholerae was condemned for human consumption. So far, the source of the bacteria and the transmission vehicle isn't known, but health officials said most cases are clustered within a family group.

An urban setting increases the risk of transmission, especially given that the source of the outbreak hasn't been identified, the WHO said. However, it noted that recent information from the health ministry suggests that the outbreak is slowing down. The WHO said further analysis of the V cholerae specimens should be done, including sequencing the cholera toxin gene, to see if an epidemic strain is fueling the outbreak.
Sep 14 WHO statement

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