News Scan for Oct 03, 2018

Ebola treatment trial
More egg-linked Salmonella
New tetracycline approved
Cholera in Zimbabwe

Massachusetts General announces participation in ZMapp study

Massachusetts General Hospital (MGH) said today it was part of an international multisite study evaluating ZMapp, an experimental Ebola treatment. ZMapp contains three antibodies and is being used in the current outbreak in the Democratic Republic of the Congo (DRC)

"While there are currently no patients with Ebola in the United States, having ready access to experimental therapeutics such as ZMapp has been a priority for MGH, in our role as the Regional Ebola and Other Special Pathogens Treatment Center (RESPTC)," says Erica Shenoy, MD, PhD, associate chief of the MGH Infection Control Unit, medical director of hospital's Biothreats Care Unit, and the study's local principal investigator in a press release.

The aim of the study is to create a ZMapp expanded access protocols in 10 RESPTCs across the United States, of which MGH is one. There are currently no Ebola patients in the United States.

In an update on the ongoing Ebola outbreak posted late yesterday afternoon, officials in the DRC said there were no new cases, but one new death noted in a patient from Butembo. There are still 18 cases under investigation, the DRC said. The outbreak total stands at 161 cases and 106 deaths. Of the total cases, 129 have been laboratory confirmed.

Officials also offered clarification about two Congolese refugees who are being tracked after crossing the border into Uganda.

"Contrary to what has been reported in some media, the two Congolese nationals who arrived in Uganda where they are followed by the national health authorities did not participate in the burial of a confirmed case of Ebola in Kasenyi," the DRC said.

So far, no cases of Ebola have been confirmed outside the DRC in this outbreak.
Oct 2 MGH press release
Oct 2 DRC update


Egg-related Salmonella outbreak sickens 24 more and reaches 7 states

The US Centers for Disease Control and Prevention (CDC) yesterday reported 24 more illnesses in a Salmonella Enteritidis outbreak linked to eggs from Alabama-based Gravel Ridge Farms, and health officials have identified the outbreak strain in environmental and egg samples from the farm that produced the eggs.

In its update, the CDC said the outbreak total has grown to 38 cases, including 10 patients who were hospitalized for their infections. No deaths have been reported. Five more states reported cases (Colorado, Iowa, Kentucky, Ohio, and Montana), raising that total to seven. Illness-onset dates range from Jun 17 to Aug 16.

Of 29 people interviewed about foods they ate and other exposures a week before they got sick, 22 had eaten restaurant dishes made with eggs, significantly higher than the percentage of healthy people who were surveyed. The Food and Drug Administration (FDA) and state health partners traced the eggs supplied to the restaurant and found that Gravel Ridge Farms supplied them to restaurants where 19 of the 22 people ate. Eight people live in states where the company's eggs are not sold, including six who traveled to states where Gravel Ridge eggs were sold.

An FDA update yesterday said it and the Alabama Department of Agriculture began an inspection at the farm on Sep 5 and collected environmental samples for testing. It said results confirm that Salmonella Enteritidis isolates collected from the environment and from egg samples were genetically related to samples from sick patients.

The company had recalled the eggs on Sep 8, which were primarily distributed to restaurants and retail stores in Alabama, Georgia, and Tennessee.
Oct 2 CDC update
Oct 2 FDA update

Sep 11 CIDRAP News scan "Eggs linked to Salmonella infections in 2 states"


FDA approves new antibiotic for bacterial pneumonia, skin infections

The FDA yesterday approved Nuzyra (omadacycline) for the treatment of adults with community-acquired bacterial pneumonia (CABP) and acute bacterial skin and skin-structure infections (ABSSSIs), according to a press release yesterday from drug maker Paratek Pharmaceuticals.

Nuzyra is a "modernized" tetracycline that's designed to overcome tetracycline resistance and exhibits activity against gram-positive and gram-negative bacteria, atypicals, and drug-resistant strains. It comes in both intravenous and oral formulations.

"In the face of ever-increasing antibiotic resistance, the FDA approved Nuzyra with a label having full approval for both CABP and ABSSSI," Paratek president and chief medical officer Evan Loh, MD, said in the press release. "We are excited to bring to physicians an effective, well-tolerated monotherapy option for patients."

The approval was based on multiple clinical trials in which Nuzyra was found to be efficacious, safe, and well-tolerated in nearly 2,000 patients. Paratek plans to make the drug available in the first quarter of 2019.
Oct 2 Paratek Pharmaceuticals press release

WHO: 1.4 million in Zimbabwe to be vaccined against cholera

The government of Zimbabwe and the World Health Organization (WHO) today announced plans to vaccinate 1.4 million people in the country's capital, Harare, with the oral choral vaccine (OCV).

According to the WHO, the vaccine comes from the global stockpile, which is funded by Gavi, the Vaccine Alliance. Gavi is also funding operational costs for the campaign.

"The current cholera outbreak is geographically concentrated in the densely populated suburbs of Harare," said Matshidiso Moeti, MD, the WHO's regional director for Africa, in a press release. "We have a window of opportunity to strike back with the oral cholera vaccine now, which along with other efforts will help keep the current outbreak in check and may prevent it from spreading further into the country and becoming more difficult to control."

The vaccination campaign will be rolled out in two waves and take place at fixed sites, including  health facilities, schools, and shopping centers.

The Ministry of Health and Child Care (MoHCC) of Zimbabwe said the outbreak began on Sep 6 in Harare, after 25 patients were hospitalized with symptoms of the diarrheal disease. The index patient was identified as a 25-year-old woman who died in Harare.

As of Sep 15, the MoHCC has recorded 3,621 illnesses, including 71 confirmed cases and 32 deaths (case-fatality rate, 0.8%). Ninety-eight percent (3,564 cases) were in Harare.

In August 2008 to May 2009, Zimbabwe experienced a massive cholera outbreak that took more than 4,000 lives.
Oct 3 WHO

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