The Global Coalition on Aging (GCOA) last week issued a report calling on G7 countries to commit to funding pull incentives and making other investments in antibiotic innovation.

The report, which summarizes a GCOA-convened April meeting that included experts and government officials from Japan, the United States, Canada, the United Kingdom, Italy, and the European Union, asserts that the lack of new antibiotics and rising resistance to current antibiotics is having a severe impact on those most at risk of infection and that the current antibiotic pipeline is inadequate and must be prioritized.

Therefore, the experts concluded, incentive structures to develop new antibiotics, such as the subscription-based model adopted in the United Kingdom, must be supported, and other countries in the G7 must "rise to the challenge" and complement the UK model with their own incentives. To date, the United Kingdom is the only country to follow up on pledges to incentivize new antibiotic research and development made at the 2022 G7 meeting. 

Call for 'fair share' contributions

Noting that the current healthcare burden of antimicrobial resistance (AMR) is estimated at $1 trillion globally, the experts agreed that if all G7 countries contributed their "fair share" to a $4.5 billion pull incentive to fund a single new antibiotic, the return on investment would be 5:1.

The report urged G7 countries to use the opportunity presented by the upcoming United Nations High-Level Meeting on AMR and demonstrate their commitment to solving the problem.

"There will never be more political momentum on AMR than this year," the report states. "All countries must take this opportunity to address AMR through collaborative multi-stakeholder action and commitments to invest a fair share in our most vital healthcare infrastructure."

Scotland's government last week reported a classical bovine spongiform encephalopathy (BSE) case involving a cow that died on a farm in Ayrshire, its fifth such case since 2014.

In a statement, officials said the fallen cow was tested as part of its BSE surveillance program and did not enter the food chain. The animal died after showing clinical signs consistent with BSE. The cow had been used for breeding. Ayrshire is in southwest Scotland.

A notification today from the World Organization for Animal Health (WOAH) said the cow was 7-and-a-half-years old and was close to calving. Over a 2-week period, the indigenous cow displayed illness symptoms and was recumbent and aggressive before it died. There are 206 cows on the breeding farm.

BSE is not contagious and comes in two forms, classical and atypical. Classical BSE is associated with the outbreak in the United Kingdom in the 1980s and Creutzfeldt-Jakob disease (mad cow disease). 

Precautionary culling for cow's farm cohorts

Restrictions remain in place for the cow's cohorts and offspring as a precaution, and those born in the last 2 years have been identified, will be humanely culled, and will be tested for BSE.

The United Kingdom's Animal and Plant Health Agency has launched an epidemiological investigation to determine the cause of the case.

BSE is a fatal neurogenerative disease that is part of a group of prion-related illnesses that includes chronic wasting disease (CWD), which affects deer and other cervids.

Interactions involving sex workers in bars is likely driving rapid mpox transmission in densely populated areas of the Democratic Republic of Congo (DRC), researchers reported in an observational preprint study of hospitalized patients in Kamituga health zone.

The outbreak involves a novel clade 1 mpox lineage that is more virulent and deadly than the clade 2 virus mpox virus spreading globally since 2022. 

Researchers examined the demographic and clinical characteristics of 371 patients with suspected mpox infections who were admitted to the hospital between September 2023 and April 2024. Slightly more than half were women, and cases were reported from 15 health areas. 

Four cases were fatal, and four of eight pregnant women experienced fetal loss. Three healthcare workers were infected while caring for patients.

Overwhelming majority had connections to sex workers in bars

Data revealed that 88.4% had recently visited bars for professional sexual interactions, which researchers said was the likely source of infection. 

Expanding case numbers and spillover to other health zones points to a need for cross-border surveillance, as well as vaccination and health education to curb the spread of the virus, the group wrote.

A higher proportion of people who trekked through at least one country with endemic malaria on their way to three southern US border cities arrived with cases of the mosquito-borne illness—nearly a third of them with severe disease—in 2023 than in 2022, finds a study published in Morbidity and Mortality Weekly Report.

Researchers from the Centers for Disease Control and Prevention (CDC) and local health departments conducted enhanced imported malaria case investigations from January to December 2023.

People born outside the United States who arrived in the three cities within the past 6 months were classified as newly arrived refugees officially admitted through the US Refugee Admissions Program, other new arrivals such as asylum seekers, or people of unknown immigration status.

72% of cases in other newly arrived migrants

Sixty-eight imported malaria cases were identified in Pima, Arizona (18 cases); San Diego, California (27); and El Paso, Texas (23), compared with 28 cases in 2022 in Pima (3), San Diego (12), and El Paso (13). Of the 68 cases in 2023, 22% occurred in US residents, 3% among newly arrived refugees, 72% in other newly arrived migrants, and 3% in travelers of unknown immigration status. 

Outreach and education about malaria directed to local health care professionals and to new arrivals with recent travel in areas with endemic malaria are crucial.

US residents and refugees had traveled directly from another country with endemic malaria. Of the 49 other newly arrived migrants, 94% had traveled through at least one endemic country, including the country of origin. 

The median length of travel was 29 days, and 73% of travelers said they had crossed land borders. Thirty-one percent of malaria patients were severely ill, and severe disease was more common in other newly arrived migrants (37%) than in US residents (7%). A total of 91% were hospitalized; none died.

"Outreach and education about malaria directed to local health care professionals and to new arrivals with recent travel in areas with endemic malaria are crucial because prompt care seeking, diagnosis, and treatment of malaria will reduce morbidity in this population," the researchers concluded.