News Scan for Mar 25, 2015

News brief

Saudi Arabia confirms new MERS case

Saudi Arabia's Ministry of Health (MOH) reported a new MERS-CoV case today, the sixth this week.

The case involves a 48-year-old male expatriate in Riyadh. He is not a healthcare worker but had contact with a MERS-CoV (Middle East respiratory syndrome coronavirus) case in the community, the MOH said in a statement. He is hospitalized in stable condition.

Beginning last week the MOH stopped including information about preexisting disease for newly confirmed cases. It also discontinued information on animal contact and exposure to MERS in healthcare settings in its daily reports, but it says it will provide contact information in its weekly update. The agency, however, has yet to post a weekly update for this week. Its most recent one was published Mar 15.

The MOH today also noted that a 44-year-old male expatriate in Khafji has recovered from the disease. He is not a healthcare worker and had no preexisting disease.

The new infection brings the country's total since 2012 to 965 cases, 419 of which have proved fatal. Twenty MERS patients are still receiving care, while 526 have recovered.
Mar 25 MOH statement

In related news, Saudi Arabian Minister of Health Ahmed ben Aqeel Alkhateeb said the country will open a National Health Laboratory in Banban, a suburb of Riyadh, to provide advanced lab services under high biosafety conditions, the MOH said in a news release.

The lab is designed to give diagnostic support to the MOH, serve as a reference center for advanced clinical lab tests, and conduct research. It is considered the first global central laboratory of its kind in the Middle East, the MOH said.
Mar 25 MOH news release

FDA approves plasma product to treat inhalational anthrax

The Food and Drug Administration (FDA) announced today its approval of a blood plasma product to treat patients for inhalational anthrax, which is usually deadly if not treated.

The product, Anthrasil, Anthrax Immune Globulin Intravenous (Human), is intended for use along with antibiotics, the FDA said in a statement. Made from the plasma of people who have received anthrax vaccine, it contains antibodies that neutralize toxins produced by Bacillus anthracis, the anthrax bacterium.

Anthrasil is already in the US Strategic National Stockpile of drugs and medical supplies, the FDA said. The Department of Health and Human Services (HHS) bought a supply under Project BioShield in 2011 with the intent to use it as an experimental drug, if needed. Until now, its use would have required an Emergency Use Authorization from the FDA.

"Today's approval provides an important additional treatment to other FDA-approved therapies for inhalational anthrax, a life-threatening disease," said Karen Midthun, MD, director of the FDA's Center for Biologics Evaluation and Research.

Anthrasil has been studied only in animals, since it was not feasible or ethical to conduct efficacy studies in humans, the FDA said. It was approved under the agency's Animal Rule, which allows the FDA to rely on findings from appropriate animal studies when human studies are not possible.

The product was tested in monkeys and rabbits. Survival in anthrax-infected monkeys treated with Anthrasil ranged from 36% to 70%, compared with zero in a placebo group, the FDA said. Rabbits treated with a moderate dose of Anthrasil after infection showed 26% survival, compared with 2% in a placebo group.

Anthrasil is made by Cangene Corp. of Winnipeg, Man., and was developed with support from HHS's Biomedical Advanced Research and Development Authority.

Approval of Anthrasil was preceded in December 2012 by the FDA's approval of another anthrax antitoxin, raxibucumab, a monoclonal antibody. It was made to treat inhalational anthrax and also to prevent the disease when other therapies are not available or appropriate.
Mar 25 FDA press release
Related Dec 14, 2012, CIDRAP News item

ASTHO report calls for promoting antimicrobial stewardship

Citing data from a survey and a Web inventory that show room for states to improve regarding antimicrobial stewardship, the Association of State and Territorial Health Officials (ASTHO) last week recommended several steps for agencies to take, such as taking a leadership role and providing access to resources.

In a new report, "Combatting Antibiotic Resistance: Policies to Promote Antimicrobial Stewardship Programs," ASTHO mentions that a 2013 survey of state and territorial health agencies (SHAs) found that only 56% reported that their agency collected surveillance data on antimicrobial resistance (AMR), while only 12% received state funding for work on this issue.

And an ASTHO Web site inventory found that, as of May 2014, 71% of SHA sites addressed AMR, but only 42% specifically addressed the topic of appropriate antibiotic use.

The ASTHO report recommends establishing SHAs as leaders in promoting antimicrobial stewardship programs (ASPs), making relevant resources available on SHA Web sites, promoting advisory committees on healthcare-linked infections, implementing ASP surveys in healthcare facilities, conducting training, and promoting information sharing among SHAs, as well as other steps.
March ASTHO report

Flu Scan for Mar 25, 2015

News brief

CDC: Flu vaccination averted 4,500 deaths per year

Influenza vaccination from the 2005-06 season through last season prevented an estimated 40,127 deaths, or 4,458 a year, US Centers for Disease Control and Prevention researchers reported this week in Vaccine.

The team applied a Monte Carlo analysis to weekly US age-group–specific data for nine flu seasons ending with 2013-14. They estimated that 40,127 deaths were averted over that period (95% confidence interval, 25,694 to 59,210), with a high of 9,398 during the 2012-13 season, which was dominated by the H3N2 strain, as this season has been.

The low estimate was 222 deaths averted during the 2009-10 pandemic, which was marked by a monovalent pandemic-specific vaccine that arrived after the fall peak in 2009 had passed.

The investigators broke down their estimates by age-group (0.5 to 2 years, 5 to 19, 20 to 64, and 65 and older). They found that 88.9% of deaths prevented were in the oldest group.

They called their projections conservative because they don't include indirect vaccination effects. They noted that the number of lives saved via flu vaccination is considerable, even when vaccine effectiveness is modest, such as during the 2012-13 season.
Mar 23 Vaccine study

China reports another H5N1 case in Yunnan province

Chinese officials confirmed an H5N1 avian flu case in Yunnan province today, the second in 3 days, Hong Kong's Centre for Health Protection (CHP) reported.

A 17-year-old boy in Kunming, Yunnan's capital and largest city, developed a fever and headache on Mar 13 and was hospitalized on Mar 20, where he is currently listed in critical condition. The CHP statement said that a clinical specimen was positive for H5N1 but does not mention recent poultry exposure.

Provincial authorities on Mar 23 reported that a 34-year-old man in Kunming was likewise hospitalized with H5N1. He also developed symptoms on Mar 13 but had poultry exposure. Yunnan province lies adjacent to Myanmar, Laos, and Vietnam, but Kunming is about 150 miles north of the nearest border, with Vietnam.

The boy's infection is China's fourth H5N1 case in 2015. "Locally, we will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments," a spokesman for Hong Kong's Department of Health said.
Mar 25 CHP statement
Mar 23 CIDRAP News scan on previous case