Malaysia reports vaccine-derived polio case
Malaysia's health ministry yesterday announced a vaccine-derived poliovirus type 1 (cVDPV1) case, marking the country's first polio case in 27 years, according to a statement.
The patient is a 3-year-old boy from the city of Tuaran in Sabah state who was hospitalized for fever followed by a weak limb, which required admission to the intensive care unit. Tests confirmed his cVDPV1 infection on Dec 6.
Tests conducted by the World Health Organization (WHO) polio regional lab in Australia found that the virus was linked to that of an acute flaccid paralysis case in the Philippines, which is battling a cVDPV2 outbreak and has also reported cVDPV1.
A survey of children ages 2 months to 15 years in Sabah found that 23 of 199 did not receive polio vaccine. As of Dec 5, surveillance of 646 people near the infected child's residence found no other acute flaccid paralysis cases. Further investigation is still under way, including tests on stool samples from close contacts and on environmental samples.
Polio immunization activities will continue in residential areas and will be expanded in high-risk areas, the ministry said, adding that the efforts are designed to ensure immunization coverage of over 95%.
Malaysia's last polio case occurred in 1992 and the country was declared free of the disease in October 2000. It switched from oral polio vaccine to inactivated polio vaccine in 2008.
Dec 8 Malaysian health ministry statement
Sanofi awarded $226 million to expand pandemic flu vaccine capacity
The US Department of Health and Human Services (HHS) today announced that it awarded a 6-year contract worth $226 million to Sanofi Pasteur to boost its capacity to produce recombinant flu vaccine in the United States as part of pandemic preparedness. In a statement, HHS said the contract aligns with the Sep 19 presidential executive order to modernize flu vaccines and technologies.
HHS said the work will take place through a partnership between Sanofi and the HHS Biomedical Advanced Research and Development Authority (BARDA), part of the Assistant Secretary for Preparedness and Response.
Rick Bright, PhD, BARDA director, said in the statement that flu virus can spread rapidly across the globe in a matter of weeks, making technologies that quickly and safety produce flu vaccines fundamental to outbreak response. "Keeping vaccine manufacturing in the United States is essential to protect Americans from pandemic influenza and to save lives. Better, faster vaccine technologies, produced in the U.S. will improve access, protect more people and, ultimately, strengthen our nation's health security," he said.
HHS said Sanofi is the only company with a seasonal recombinant flu vaccine licensed in the United States that has resources to leverage the technology for pandemic preparedness. According to the contract, Sanofi will retrofit its vaccine manufacturing facilities in Swiftwater, Pennsylvania, which will double its US recombinant protein-based flu vaccine capacity. Agreement options include retrofitting an additional facility at the site to produce adjuvant, development and licensing an adjuvanted recombinant pandemic vaccine, and HHS access to vaccine production capacity for up to 25 years after the manufacturing facilities are completed. The agreement projects that Sanofi could provide nearly 100 million doses of recombinant flu vaccine for use during a pandemic.
Sanofi said today in a press release that the investigational pandemic vaccine will use the same recombinant technology as its Flublok quadrivalent vaccine. It also notes that the contract will expand the site's role as a center for excellence for pandemic preparedness by adding both recombinant and adjuvant alongside current egg-based manufacturing.
Dec 9 HHS press release
Dec 9 Sanofi Pasteur press release
2018's romaine-linked E coli outbreak largest in decades
According to a study today in Clinical Infectious Diseases, a multistate outbreak of Escherichia coli O157:H7–tainted romaine lettuce in 2018 was the largest American outbreak in decades, eventually sickening 240 people in 37 states. That's 30 more case-patients than the Centers for Disease Control and Prevention (CDC) noted in a final update on the outbreak.
Of the 240 cases, 104 people were hospitalized, 28 developed hemolytic uremic syndrome, and 5 patients died, according to the study authors, led by CDC scientists. Of 179 people who were interviewed, 152 (85%) reported consuming romaine lettuce in the week before illness onset, the authors said, and eventually 20 sub-clusters of cases were identified. All romaine lettuce implicated in the outbreak was grown in Yuma, Arizona.
The New Jersey Department of Health first notified the CDC of two E coli outbreaks in April of 2018, with clusters of patients having eaten at the same restaurant chain. Eventually 20 more clusters of patients were identified across the country, many having eaten chopped salads at the same restaurant chains.
"This outbreak was the largest multistate STEC O157 outbreak in several decades, eclipsing in magnitude a 2006 outbreak linked to fresh spinach," the authors said. "The true size of this outbreak was likely much larger than the 240 illnesses reported through PulseNet, suggesting that thousands of people were actually sickened in this outbreak."
Though a single source of contamination was not identified, the E coli strain was found at multiple points along a 3.5-mile irrigation canal that ran along 36 romaine fields.
Dec 9 Clin Infect Dis study
Jun 28, 2018, CDC final outbreak update
Health officials confirm 3 yellow fever cases in Mali, Ivory Coast
The Ministry of Health in Mali has confirmed three cases of yellow fever in that country and Ivory Coasst as of Dec 3, according to a post late last week on ProMED Mail, the online reporting system of the International Society for Infectious Diseases.
The three cases are in different locations: Kati (Bamako region), Manankoro in the health district of Bougouni (Sikasso region) and the village of Keregouana in Ivory Coast.
The Ministry of Health is sending extra surveillance teams to the villages. The outbreak has also been reported to the WHO.
Yellow fever is a viral hemorrhagic disease primarily spread by Aedes aegypti mosquitoes. One dose of the yellow fever vaccine offers lifelong protection against the virus.
Dec 5 ProMed Mail post