News Scan for Dec 04, 2018

Resistant gonorrhea in Europe
Prior-season flu vaccine impact
Avian flu in Iran, Taiwan
MERS-CoV in Saudi camels

Gonorrhea in Europe becoming less susceptible to ceftriaxone

Annual sentinel surveillance of Neisseria gonorrhea isolates in 25 European countries has found decreasing susceptibility to ceftriaxone, according to a study yesterday in BMC Infectious Diseases.

The analysis of 2,660 N gonorrhea isolates collected in 2016 by the European Gonococcal Antimicrobial Surveillance Program found no isolates that were resistant to ceftriaxone, but 14 isolates had a ceftriaxone minimum inhibitory concentration (MIC) of 0.125 milligrams per liter (mg/L), which is the resistance breakpoint. One of these isolates was also resistant to azithromycin. In addition, the proportion of isolates with decreased susceptibility to ceftriaxone (MICs from 0.032 mg/L to 0.125 mg/L) increased from 15% in 2015 to 17.7% in 2016.

Azithromycin resistance remained stable, with a resistance rate of 7.5% in 2016 compared with 7.1% in 2015. But seven isolates (0.3%) from five countries displayed high-level azithromycin resistance, up from five in 2015. Cefixime resistance was detected in 2.1% of isolates in 2016 compared with 1.7% in 2015, and ciprofloxacin resistance remained stable at 46.5% (compared with 49.4% in 2015).

The authors of the study—a team of researchers from Public Health England, the European Centre for Disease Prevention and Control, and the World Health Organization—say the decreasing ceftriaxone susceptibility and relatively high azithromycin resistance are a major concern, since European guidelines recommend ceftriaxone plus azithromycin as the first-line therapy for gonorrhea. "With azithromycin resistance at 7.5%, the increasing ceftriaxone MICs might soon threaten the effectiveness of this therapeutic regimen and requires close monitoring," they write.
Dec 3 BMC Infect Dis study


Hospital study finds little negative impact of prior-season vaccination

An analysis of the impact of prior flu vaccination on current-season effectiveness in Canadian patients hospitalized for lab-confirmed flu over four consecutive flu seasons mainly found no significant impact. A team from the SOS Network, a flu surveillance system that tracks outcomes in hospitalized Canadian adults, published its findings yesterday in Clinical Infectious Diseases.

Some recent studies that looked at the potential effects of prior flu vaccination on current protection have found potentially negative associations between the two, depending on season and strain.

For the new investigation, researchers used a matched test-negative design to compare lab-confirmed cases and controls to tested negative over four seasons from 2011-12 to 2014-15. Patients were stratified into four groups based on their flu vaccination history: not vaccinated during the previous and current seasons, the previous season only, the current season only, and both seasons.

Researchers observed decreased flu vaccine effectiveness in those immunized both seasons, but it wasn't statistically significant and was seen only during two seasons when the H3N2 virus was dominant. In seasons when influenza B viruses or 2009 H1N1 circulated widely, being vaccinated in the previous and current seasons was associated with high vaccine effectiveness against the dominant strain.

The researchers concluded that even when they noted a negative impact of consecutive-year flu vaccination, repeated vaccination was still more effective than not receiving the current season's vaccine, which they said supports current recommendations for annual flu vaccination.
Dec 3 Clin Infect Dis abstract


Iran, Taiwan report high-path H5 avian flu outbreaks

In highly pathogenic avian influenza developments, Iran reported an outbreak of H5N8 in backyard poultry and Taiwan reported two more H5N2 events on commercial poultry farms, according to separate notifications from the World Organization for Animal Health (OIE).

Iran's outbreak, its first involving H5N8 since 2017, occurred in a village in Tehran province in the northern part of the country. The event began on Sep 30, killing 5 of 138 susceptible birds, which included geese, ducks, and free-range chickens. The surviving poultry were culled to curb the spread of the virus.

In Taiwan, veterinary authorities reported two more H5N2 outbreaks in Yunlin County, part of ongoing activity involving the strain since 2015. One of the outbreaks began on Nov 15 at a duck farm in Taixi township, while the other began on Nov 21 and affected a goose farm in Yuanchang township. Taken together, the virus killed 146 of 3,730 birds, and the remaining ones were destroyed as part of outbreak response steps.
Dec 1 OIE report on H5N8 in Iran
Dec 4 OIE report on H5N2 in Taiwan


More Saudi camels test positive for MERS-CoV

Saudi Arabia's agriculture ministry yesterday reported a MERS-CoV outbreak in camels in the city of Taif in Mecca province, located in the eastern part of the country, according to yet another notification from the OIE.

The outbreak began on Sep 25, and 13 of 82 susceptible camels tested positive for MERS-CoV (Middle East respiratory syndrome coronavirus). The report didn't say if the camels were screened as part of an investigation into potentially related human cases. Officials said the outbreak is now considered resolved.

Saudi Arabia reported its last MERS-CoV detection in camels in early November, which involved animals in Taif and in Buraydah in Qassim province in the north central part of the country.
Dec 3 OIE report on MERS-CoV in Saudi Arabia

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