News Scan for May 24, 2019

WHA and antimicrobial resistance
FDA OKs Zika test
US pediatric flu deaths
Pakistan polio cases

WHA adopts resolution to combat antimicrobial resistance

Yesterday member states at the World Health Assembly (WHA)—the annual meeting of the decision-making body of the World Health Organization (WHO)—adopted a resolution calling for continued high-level commitments to implement and adequately fund multisectoral national action plans addressing antimicrobial resistance, the WHO said in a news release.

The resolution urges countries to strengthen infection prevention and control measures, including water sanitation and hygiene; enhance participation in the Global Antimicrobial Surveillance System; ensure prudent use of antimicrobials; and support multisectoral annual self-assessment surveys.

The resolution acknowledges the work of the Interagency Coordination Group on Antimicrobial Resistance to provide practical guidance to enhance global action to address antimicrobial resistance, and stresses the importance of addressing antimicrobial resistance to the achievement of the 2030 Agenda for Sustainable Development. 

It requests the WHO director-general to significantly enhance support to countries in implementing their national action plans and help mobilize needed financial resources, in collaboration with other United Nations agencies and partners. It also calls on the WHO director-general to maintain the WHO list of critically important antimicrobials for human medicine.
May 23 WHO news release


FDA OKs marketing of first test for detecting Zika virus antibodies

The US Food and Drug Administration (FDA) yesterday authorized the marketing of a diagnostic test to detect Zika virus immunoglobulin (IgM) antibodies in human blood, the agency said in a news release.

The ZIKV Detect 2.0 IgM Capture ELISA is the first Zika diagnostic test the FDA has allowed to be marketed in the United States. Other tests for detecting Zika virus IgM antibodies—including the ZIKV Detect 2.0 IgM Capture ELISA—had been approved only for emergency use under the FDA's Emergency Use Authorization.

The newly approved test is designed to identify IgM antibodies to Zika virus, which indicate an early immune response, in the blood. The FDA reviewed data from a clinical study of 807 test samples and a variety of analytical studies, which demonstrated that the ZIKV Detect 2.0 IgM Capture ELISA was safe and effective at identifying IgM antibodies against Zika virus in blood.

"At the onset of the Zika virus outbreak, when little was known about the disease or how to diagnose it, the FDA worked quickly with manufacturers to encourage the development of diagnostic tests and ensure they were available using our emergency use authorities," said FDA Acting Commissioner Ned Sharpless, MD. "Today's marketing authorization is a great demonstration of the FDA's work to protect the public health in emergency response situations."
May 23 FDA news release


CDC reports 3 new pediatric flu deaths, 111 for the season

Although US flu activity continues at only low levels now that the flu season is over, the Centers for Disease Control and Prevention (CDC) today reported two new flu-related deaths in children for 2018-19, raising the season's total equal to or higher than several other recent seasons. The agency also confirmed a pediatric death from the 2017-18 season.

The two latest flu-related deaths in children were caused by an influenza A virus that was not subtyped and occurred in January and late April. The 2017-18 death was caused by the H3N2 strain.

This season has now reached 111 pediatric flu deaths, compared with the same number in 2013-14, 148 in 2014-15, 95 in 2015-16, 110 in 2016-17, and 187 last season.

The proportion of outpatient visits for influenza-like illness (ILI) last week remained at 1.5%, well below the national baseline of 2.2%. All regions reported ILI below their region-specific baseline levels. ILI activity was low in Louisiana, Minnesota, and Puerto Rico and was minimal everywhere else. Massachusetts was the only state reporting widespread flu activity.

While influenza A(H1N1) viruses predominated from October to mid-February, influenza A(H3N2) viruses have been more common since then. Also, the typical late-season surge of influenza B strains has been muted this year. Last week clinical labs reported that they made up 44.7% of all flu viruses tested, while public health labs reported a 35.7% prevalence.
May 24 CDC FluView report


Pakistan reports 2 more polio cases; experts update eradication progress

Pakistan has reported two more wild poliovirus type 1 (WPV1) cases in separate provinces, and Niger reported circulating vaccine-derived poliovirus type 2 positives in a case contact, according to an update today from the Global Polio Eradication Initiative (GPEI).

Of the two WPV1 cases in Pakistan, one is in Karachi district in Sindh province and the other is in North Waziristan in Khyber Pakhtunkhwa province. Patients' paralysis onsets were Apr 29 and Apr 26, respectively. The country has now reported 17 cases in 2019 compared with 3 at this point last year and 12 for all of 2018.

In related news, the WHO today provided more details about a recent positive WPV1 environmental sample in Iran, first reported by the GPEI on May 17. The WHO said the sample was from sewage collected on Apr 20 in Sistan-Baluchistan province.

No related paralysis cases have been detected, and follow-up testing of sewage samples at the location on May 4 were negative for the virus. The area borders Pakistan and Afghanistan, two countries in which the virus is still endemic, with the other being Nigeria. Genetic tests suggest the virus found in Iran is most closely linked to WPV1 circulating in Pakistan's Sindh province. Iran's last indigenous WPV case was reported in 1997.

In Niger, cVDPV2 was found in an isolated collected on Mar 16 from a healthy community contact of an earlier confirmed case-patient in Zinder state, where an outbreak has been linked to one in Nigeria's Jigawa state.
May 24 GPEI update
May 24 WHO statement

Meanwhile, no WPV cases have been detected in the WHO's African region in 30 months, and continued improvements in surveillance and vaccinating children in Nigeria and the Lake Chad Basin may have interrupted WPV transmission, experts said today in Morbidity and Mortality Weekly Report (MMWR). A team from the CDC and the WHO published an assessment of eradication progress from January 2017 to March 2019.

In Afghanistan and Pakistan, the number of WPV cases in 2018 rose for the first time since 2014, and genetic sequencing of patient and environmental samples suggests persistent transmission along two common corridors due to transborder population movements. Efforts are under way to enhance vaccination at border points, and the group wrote that a ban on house-to-house vaccination in Kandahar province since the middle of 2018 has hindered immunization campaign effectiveness.
May 24 MMWR report

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