Trump budget proposal includes cuts to CDC funding

The Trump administration yesterday released its budget proposal for the 2019 fiscal year, and it would cut the US Centers for Disease Control and Prevention (CDC) budget by about $900 million, with some increases for the National Institutes of Health (NIH) and the US Food and Drug Administration (FDA).

Lawmakers don't typically enact presidential budgets, which mainly serve as an outline of administration priorities. On Feb 8, Congress passed a temporary budget that funds the government for another 6 weeks, allowing time for the House and Senate to come up with a longer-term spending bill that would keep the government running through the rest of the 2018 fiscal year, which ends on Sep 30.

According to a report from The Hill, a daily newspaper that covers Congress and US politics, the Trump administration requested $11 billion for the CDC, reflecting a cut of about $900 million, or about 8%. The funding, however, includes $175 million in new money to address the opioid crisis.

One of the CDC areas targeted for the Trump cuts is the Global Health Security Agenda (GHSA), a program that helps low-income countries scale up their ability to detect infectious diseases by expanding lab capacity and training epidemiologists, National Public Radio (NPR) reported yesterday. The proposal would cut the program by about two-thirds, from $180 million a year to about $60 million, forcing the CDC to dramatically limit the number of countries it could help. Many public health officials see the GHSA as part of an early warning system regarding disease outbreaks and have voiced deep concerns about the impacts of program cuts.

In addition, the budget proposes moving the Strategic National Stockpile of emergency drugs, vaccines, and other measures from the CDC to the Department of Health and Human Services's (HHS's) Assistant Secretary for Preparedness and Response, Medpage Today reported.

The NIH would receive $1.4 billion more, which includes $750 million as part of money earmarked for the HHS to address opioid issues. According to the NPR report, the FDA would get an increase of $673 million.
Feb 12 Hill story
Feb 12 NPR report
Feb 12 Medpage Today story


WHO ramps up response to Nigeria’s Lassa fever outbreak 

Today the World Health Organization (WHO) said it was scaling up its efforts to help Nigeria contain a growing Lassa fever outbreak. In the past 5 weeks, officials have reported as many as 450 cases (132 of them lab-confirmed) in 17 Nigerian states.

So far, 43 deaths have been reported in connection to the outbreak. Lassa is a hemorrhagic fever endemic to Nigeria, usually spread by rats. In this outbreak, however, 11 healthcare workers have been infected by sick patients, 4 of them fatally.

"The high number of Lassa fever cases is concerning. We are observing an unusually high number of cases for this time of year," said Wondimagegnehu Alemu, MD, MPH, WHO representative to Nigeria, in a press release.

The WHO said it is deploying international experts to coordinate response, strengthen surveillance, provide treatment guidelines, and raise awareness on prevention and treatment.
Feb 13 WHO press release


Possible MERS outbreak detected in Hafar Al Batin hospital in Saudi Arabia

After more than 2 weeks without a case, the Saudi Arabian Ministry of Health (MOH) today confirmed a new case of MERS-CoV in Riyadh.

A 42-year-old male expatriate is in critical condition after being diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus). The man's source of infection is listed as "primary," meaning it's unlikely he contracted the disease from another person.

The MOH also noted three recovered cases in Hafar Al Batin yesterday. All three cases involved healthcare workers, hinting at a possible hospital outbreak. The three expatriates included 25- and 28-year-old women and a 47-year-old man.

The new case brings Saudi Arabia’s MERS totals since 2012 to 1,794, including 731 deaths. Four people are still being treated for their infections.
Feb 13 MOH report
Feb 12 MOH report


Investigation shows 40 British lab errors in past 2 years

On Feb 9 the UK newspaper The Guardian published an exposé on an investigation by the Health and Safety Executive (HSE) into more than 40 lab errors that occurred in the United Kingdom from 2015 to 2017. 

Bacteria and viruses that cause Shigella, dengue fever, and Salmonella infections were among the pathogens lab workers handled improperly or contracted through unsafe lab procedures. In several instances, samples of bacteria or fungi were improperly mailed from private laboratories to National Health System hospital labs.

"The sector has a good health and safety record, with a high level of control of the most hazardous organisms," an HSE spokesperson said. "There have been a limited number of instances over the past two years where biological agents have been received by UK labs from other labs within the UK that were unsolicited, mislabelled or unlabelled."

Ultimately, the HSE concluded there were never any major public health threats from these incidents, but added that the frequency of errors should lead to enhanced safety procedures.
Feb 9 Guardian


Study: Opioid users more likely to contract severe infections

A study published today by researchers at Vanderbilt University shows that opioid users are more liked to contract serious infection that requires hospitalization, including pneumonia and meningitis, compared to non-users.

The study was published in the Annals of Internal Medicine and shows that people who use opioids, including prescription painkillers, have a 1.62-times higher risk of invasive pneumococcal disease caused by Streptococcus pneumoniae. The case-control nested study matched patients from prescription opioid registries with patient data in the Active Bacterial Core surveillance system databases.

High doses of prescription opioids taken for long periods were most highly associated with invasive pneumococcal infections, the authors said. Long-acting opioids carried a 1.87-times greater risk for infection.

In a press release, the study authors said their work sheds new light onto the immunosuppressive nature of opioids.
Feb 13 Ann Intern Med study 
Feb 13 Vanderbilt University
press release

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