News Scan for Jul 06, 2020

More DRC Ebola deaths
;
MERS in Saudi Arabia
;
Underlying conditions and COVID-19
;
Price cut for drug-resistant TB drug

Seven more Ebola cases, 3 deaths, reported in DRC outbreak

Seven more Ebola cases and three more deaths have been confirmed over the past few days in the Democratic Republic of the Congo's (DRC's) Equateur province outbreak, raising the total to 41 cases, which includes 17 deaths.

The DRC's multisectoral Ebola committee (CMRE) in recent statements noted two of the latest confirmed cases, which involve patients from Bikoro and Mbandaka. It also said there was another death, apparently in an earlier reported case from Wangata. The CMRE said in its latest statement that since vaccination with VSV-EBOV began on Jun 5, 8,136 people have been immunized.

The World Health Organization (WHO) regional office for Africa said on Twitter that five more cases were reported, along with two more deaths. Of the 41 cases, 38 are confirmed and 3 are listed as probable.

The outbreak, the DRC's 11th involving Ebola, was first detected in early June and is occurring in the same area where an outbreak in 2018 occurred. Genetic evidence so far suggests a separate jump from animals to humans.
Jul 3 CMRE update
Jul 6 WHO African regional office tweet
Jul 7 CMRE update

 

Saudi MERS rise includes hospital outbreak cases

Saudi Arabia reported nine new MERS-CoV cases in April and May, six of them linked to a hospital outbreak in Riyadh, the WHO said in a Jul 2 update. Five of the latest patients died from their MERS-CoV (Middle East respiratory syndrome coronavirus) infections.

The hospital-linked cases in Riyadh were reported from May 21 to May 31. The index case was a newly admitted patient, and five secondary cases were identified through contact tracing. One was a healthcare workers and four were bedridden patients older than 75 who had been admitted earlier for other conditions. All had underlying health conditions, except for the healthcare worker.

The other three patients not linked to the outbreak were from Riyadh, Assir, and Northern regions. Of the nine latest cases, only one had contact with camels or camel milk. Patient ages range from 31 to 96, and only one is female. Seven had underlying medical conditions.

The new cases from Saudi Arabia raise the number reported to the WHO since 2012 to 2,562, at least 881 of them fatal. Most of the illnesses have been reported from Saudi Arabia.
Jul 2 WHO statement

 

Most US adults have conditions that raise risk of COVID-19 complications

New research indicates that more than half of US adults have underlying conditions that increase the risk of hospitalization from COVID-19, a percentage higher than previously thought, according to a study in Emerging Infectious Diseases.

In an earlier study published on Apr 23 in the same journal, a team of US researchers estimated that 45.4% of US adults were at increased risk for complications from COVID-19 because of cardiovascular disease, diabetes, respiratory disease, hypertension, or cancer. That estimate was based on 2017 Behavioral Risk Factor Surveillance System data and reports of the COVID-19 case-fatality rate in China among people with chronic conditions.

In an update, the same researchers replaced the Chinese data with US data on COVID-19 hospitalization rates and patient characteristics in 14 states and found a 23% increase from the original estimate, mostly from substituting obesity for cancer as an underlying condition. According to the new estimate, 56% of US adults have one or more underlying conditions that increase the risk for complications from COVID-19. Prevalence rates for separate conditions were 8.5% for cardiovascular disease, 6.6% for chronic obstructive pulmonary disease, 9.1% for asthma, 10.8% for diabetes, 32.4% for hypertension, and 30.1% for obesity.

In the updated analysis, 49.2% of employed or self-employed adults reported an underlying condition, and 18.7% reported more two or more underlying conditions. Although the percentage of adults with any of the conditions increased with age, 60.7% of the total population was under 60 years of age.

The study also looked at risk factors associated with increased likelihood of reporting any of the six underlying conditions and found that 48.9% had one or more risk factors, including smoking, a sedentary lifestyle, and inadequate fruit and vegetable consumption.

"These results suggest the potential for policies for opening businesses based on risk stratification of the population and for possible improvement of risk status through lifestyle change," the authors wrote. "A national focus on, and support for, a health promotion campaign would be timely."
Jul 3 Emerg Infect Dis study
Apr 23 Emerg Infect Dis study

 

Johnson & Johnson drops price of bedaquiline for lower-resource nations

The Stop TB Partnership and drug maker Johnson & Johnson today announced a price reduction for the drug-resistant tuberculosis (DR-TB) drug bedaquiline to make the drug more affordable in low- and middle-income countries.

Effective immediately, Johnson & Johnson will make bedaquiline available through Stop TB Partnership's Global Drug Facility (GDF) at a price of $340 per 6-month treatment in 135 countries, down from the original price of $400. The effort to scale up use of the oral drug, which is recommended as part of the first-line all-oral treatment for drug-resistant forms of TB by the WHO in TB-affected countries, is being supported by the US Agency for International Development (USAID) and the Global Fund to Fight AIDS, TB and Malaria.

"In a world filled with worrying news, this new agreement is a welcome development and one that will move us closer to the United Nations High-Level meeting target of treating 1.5 million people with DR-TB by 2022," Lucica Ditu, MD, Executive Director of the Stop TB Partnership, said in a joint press release.

The WHO added bedaquiline to the preferred treatment regimen for DR-TB in 2018, with the hope that the revised, all-oral regimen could improve treatment outcomes and quality of life in patients. The previous regimen included injectable drugs, which had  notable side effects.

Médecins Sans Frontières (MSF), which has been pushing Johnson & Johnson to lower the price of bedaquiline since it was approved in 2012, said that while the price reduction is an important step, the drug needs to be even cheaper and needs to be made available at the lower price to countries that do not buy it through the GDF. The price cut drops the price to $1.50 a day, but MSF has called for the price to be cut to $1 a day.

"J&J received public investments in the hundreds of millions of dollars, including grants from the US government and various financial incentives, and treatment providers like MSF contributed to the research on the drug," Sharonann Lynch, Senior HIV and TB Advisor for MSF's Access Campaign, said in an MSF press release. "J&J should not be charging high prices for this drug anywhere."

MSF also urged countries to scale up the use of bedaquiline for DR-TB treatment.
Jul 6 Stop TB Partnership press release
Jul 6 MSF press release

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