News Scan for Mar 05, 2019

FDA chief resigns
MMR vaccine not tied to autism (again)
MERS across Saudi Arabia
Lassa fever decline in Nigeria
Global flu update

Scott Gottlieb resigns as FDA commissioner

Scott Gottlieb, MD, announced today that he will resign as commissioner of the US Food and Drug Administration (FDA) in the coming weeks to spend more time with his family.

"I'm immensely grateful for the opportunity to help lead this wonderful agency, for the support of my colleagues, for the public health goals we advanced together, and the strong support of @SecAzar and @realDonaldTrump - This has been a wonderful journey and parting is very hard," Gottlieb said in a tweet.

Gottlieb has been universally popular in the 2 years since he's had the job, most recently managing the FDA during the government shutdown. His resignation was not requested by President Donald Trump.

In a statement posted to Twitter, Health and Human Services Director Alex Azar said Gottlieb oversaw a record number of approvals for innovative drugs while simultaneously increasing the number of affordable generic drugs. His signature issue, according to the Washington Post, was teenage vaping.

Gottlieb, 45, commuted to Washington D.C. each week from Connecticut, where he and his wife have three school-age children.

At this time there is no word on a replacement.
Scott Gottlieb Twitter feed
Alex Azar Twitter feed
Mar 5 Washington Post story


Study—again—shows no connection between MMR vaccine and autism 

Another study, this one a massive undertaking in Denmark, demonstrates no connection between the measles, mumps, and rubella (MMR) vaccine and autism. The study was published today in the Annals of Internal Medicine.

The study followed 657,461 children born in Denmark from 1999 through 2010, with follow-up from 1 year of age and through August of 2013. Hazard ratios of autism were calculated according to MMR vaccination status, with adjustment for age, birth year, sex, other childhood vaccines, sibling history of autism, and autism risk factors (based on a disease risk score).

During follow-up, 6,517 children were diagnosed as having autism (incidence rate, 129.7 per 100 000 person-years).

"Comparing MMR-vaccinated with MMR-unvaccinated children yielded a fully adjusted aHR [autism hazard ratio] of 0.93 (95% CI [confidence interval], 0.85 to 1.02)," the authors wrote. "Similarly, no increased risk for autism after MMR vaccination was consistently observed in subgroups of children defined according to sibling history of autism, autism risk factors (based on a disease risk score) or other childhood vaccinations, or during specified time periods after vaccination."

The study comes more than 20 years after British physician Andrew Wakefield published a retracted study in The Lancet showing that 8 out of 12 case-patients with autism first exhibited symptoms within 4 weeks of receiving the MMR vaccine. 

Several studies have since disproved and discredited Wakefield's work and have demonstrated no link between vaccines—including the MMR vaccine—and autism, but this is the first study to show that the MMR vaccine does not trigger autism in subgroups of susceptible children, according to a summary of the study for patients published in the same journal.
Mar 5 Ann Intern Med study
Mar 5 Ann Intern Med summary
Mar 5 Ann Intern Med editorial


Saudi Arabia records 4 new MERS cases, including 1 in Wadi ad-Dawasir

The Saudi Arabian Ministry of Health (MOH) today recorded four more cases of MERS-CoV, including one case in Wadi ad-Dawasir, the site of a large hospital-based outbreak.

Two cases of MERS-CoV (Middle East respiratory syndrome coronavirus) are in women from Riyadh, which saw a number of cases this past weekend. A 22-year-old and 44-year-old, whose infections are both listed as secondary cases, were diagnosed with the virus. Neither woman reported contact with camels.

In addition, a 47-year-old man from Wadi ad-Dawasir who had contact with camels was also diagnosed as having MERS, as was a 40-year-old man from Mecca who had no recent camel contact. The source of both infections is listed as "primary," meaning they likely did not contract the virus from another person.

The latest infections push Saudi Arabia's MERS-CoV total so far this year to 91, which includes 52 from Wadi ad-Dawasir, where cases have been tied to both healthcare and camel exposure.
Mar 5 MOH update


Lassa fever outbreak in Nigeria slows but includes almost 400 cases

For the fourth consecutive week, Nigeria has reported declining case counts in an ongoing Lassa fever outbreak. Despite the progress, 23 cases and 6 deaths were reported in the most recent week recorded (ending Feb 24).

According to an update from the World Health Organization's (WHO's) African regional office, the outbreak peaked at the end of January, when 77 confirmed cases with 11 deaths were reported. Between Jan 1 and Feb 25, a total of 396 cases and 86 deaths (case-fatality ratio, 21.7%) have been reported across the country.

Two of the most recent cases were in healthcare workers, bringing the total number of healthcare workers infected during the outbreak to 15. Sixty-three percent of the confirmed cases have been reported from the two most affected states—Edo (129 cases, 34%) and Ondo (110 cases, 29%).

The Nigeria Centre for Disease Control declared this outbreak an emergency on Jan 22. Lassa fever is endemic in Nigeria.

"The current Lassa fever outbreak in Nigeria is beginning to show an overall downward trend although it is very early to draw conclusions as the peak season for the disease is still not yet over," the WHO said.
Mar 3 WHO African regional report


WHO: Brisk flu continues in many Northern Hemisphere spots

Flu activity in temperate areas of the Northern Hemisphere continued to rise or remained high, with both influenza A viruses circulating and little influenza B detected so far, the World Health Organization (WHO) said yesterday in its latest global update, based on information up to Feb 17.

In North America, flu activity increased in the United States, decreased or peaked in some parts of Canada, and remained elevated in Mexico. Many European countries reported widespread flu, with high-intensity activity reported in six southwestern countries and hospitalization rates high in France and the United Kingdom.

Flu has peaked in some Western Asia countries, the WHO said, but is still rising in Cyrus and is still elevated in Kuwait and Saudi Arabia. In Eastern Asia, flu is declining in most countries but is still above seasonal thresholds in China and Hong Kong, with 2009 H1N1 as the dominant strain.

In tropical countries, flu levels are low in most locations, except for Southern Asia, with India and Bhutan reporting increased activity, mainly from the 2009 H1N1 strain.

At the global level, 98.6% percent of respiratory specimens that tested positive for flu were influenza A, and, of subtyped A strains, 65.2% were 2009 H1N1 and 34.8% were H3N2.
Mar 4 WHO global flu update

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