News Scan for Dec 03, 2015

News brief

CDC notes 43 cases of highly resistant CRE 'superbug'

The US Centers for Disease Control and Prevention (CDC) today noted that it has received reports of 43 cases of an especially resistant form of carbapenem-resistant Enterobacteriaceae (CRE) in recent years, often among patients who traveled internationally, according to a report in Morbidity and Mortality Weekly Report (MMWR).

The specific CRE strain produces what scientists call OXA-48-like carbapenemases, which inactivate carbapenem antibiotics, some of the last lines of defense against bacteria. OXA-48-like carbapenemases were first identified in the United States in 2013.

From June 2010 through August 2015, the CDC received reports of 52 OXA-48 CRE isolates from 43 patients in 19 states. Four patients were part of two separate clusters identified last year.

OXA-48-like carbapenemase was identified in Klebsiella pneumoniae isolates in 35 patients (81%), in Escherichia coli isolates in 7 (16%), and in Enterobacter aerogenes and Klebsiella ozaenae in 1 patient each (2%). Isolates with both New Delhi metallo-beta-lactamase and OXA-48-like carbapenemase genes were obtained from five patients (12%).

Median age among 35 patients with available data was 70 (range, 29 to 91 years).

Among 29 patients for whom a travel history was available, 19 (66%) had traveled outside the country during the year before specimen collection, and 16 (55%) were hospitalized in another country. When excluding the two domestic clusters, those percentages increased to 76% and 64%, respectively.
Dec 4 MMWR report

 

As Ebola R&D funds spike, investments in other neglected diseases flat-line

While research and development (R&D) funding for Ebola spiked in 2014, the increase appears to have come at the expense of other neglected diseases, according to the annual G-FINDER report released today by the nonprofit Policy Cures.

The report found that global Ebola R&D investment totaled $165 million last year in response to West Africa's massive outbreak, which has sickened almost 29,000 people and killed more than 11,000. That investment equaled the sole increase in global R&D for neglected diseases, as funding for all other such diseases was down $14 million, or 0.4%, according to a press release from PATH: Global Health Technologies Coalition.

Total global R&D spending for neglected diseases was $3.4 billion in 2014, according to the eighth annual report. The only neglected diseases for which spending surpassed Ebola last year were HIV/AIDS, malaria, tuberculosis (TB), and diarrheal diseases. This was the first year that Ebola was included in the G-FINDER report, but past global investment has been minimal, at a little over $10 million a year, according to the release.

The report also noted that when Ebola is excluded, public funding for neglected disease R&D was at its lowest level in 7 years. And US government spending for non-Ebola neglected disease R&D fell again in 2014, to about $221 million below its peak in 2009.

After the previous G-FINDER report highlighted concerns about declining R&D contributions from the pharmaceutical industry, such funding increased by more than a quarter—or $98 million—from the previous year, only partly due to Ebola, the report notes. The increase was the first since 2010, and the largest industry investment in the history of the G-FINDER survey. Industry withdrawal from TB R&D investment continued, however, and was a third lower than its 2010 peak.
Dec 3 G-FINDER report
Dec 3 PATH news release

Flu Scan for Dec 03, 2015

News brief

Study: Preexisting flu antibodies may impede broad immune response

Past exposure to influenza virus or antigens—whether by infection or vaccine—might reduce a person's ability to mount a broadly protective antibody response to the virus, a finding that could complicate efforts to develop a "game-changing" universal flu vaccine, according to a study yesterday in Science Translational Medicine.

US researchers analyzed the antibody response to the 2009 H1N1 virus over time in vaccinated people. They found that subjects with low levels of H1N1 antibodies before vaccination produced a broadly protective immune response against the hemagglutinin (HA) stalk—a part of the virus that does not change much across various strains and has been eyed as a promising site for a universal, or broadly protective, flu vaccine.

The investigators found, however, that people with high levels of preexisting H1N1-specific antibodies mounted a reaction that primarily targeted the HA head, leading to a weaker immune response. These subjects tended to be older and thus had encountered a wider range of H1N1 strains.

The findings suggest that prior exposure to influenza, including in vaccines, may actually leave people with fewer broadly protective immune cells, the authors note. This could well present a hurdle to the development of a universal flu vaccine.

Commenting on the study in a STAT story today, infectious disease expert Michael Osterholm, PhD, MPH, said, "So one of the key questions is going to be for any kind of game-changing flu vaccine is how do you overcome that? And to the extent that that occurs, when does it jeopardize protection if, for example, you create a vaccine against the … stalk versus the head?"

Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota, which publishes CIDRAP News.
Dec 2 Sci Transl Med study
Dec 2 STAT story

 

H5N2 avian flu confirmed for first time in France

A recent outbreak of avian flu reported in the media this week in France has been confirmed as being caused by the H5N2 strain, the first detection of that strain in the country, according to a report yesterday posted by the World Organization of Animal Health (OIE).

The outbreak is in the same general region as one caused by H5N1 reported to the OIE on Nov 25, and the country has had at least one other recent outbreak caused by an as-yet unidentified highly pathogenic avian flu strain, according to a report yesterday in Farmers Weekly, a UK publication. France's agriculture ministry had reported the two most recent outbreaks on Nov 29, according to French-language media.

The H5N2 outbreak began Nov 27 in Domme in Dordogne department in southwest France, French officials noted in the OIE report. H5N2 was confirmed in a sample from a dead gosling on Nov 30.

All told, 3 geese on a farm of 1,338 geese and ducks died, but the report attributes only 1 of the deaths to H5N2 avian flu. Three geese were also culled for sampling, then the entire flock was euthanized to contain the outbreak after nucleotide sequencing and polymerase chain reaction tests came back positive for the virus.

Officials have created 3- and 10-kilometer surveillance zones around the farm.

A rapid risk assessment published by the European Centre for Disease Protection and Control (ECDC) yesterday said the H5N1 strain is not related to H5N1 strains circulating elsewhere in the world but appears to have evolved from a low-pathogenic avian flu virus circulating on the continent.

Also, the ECDC said that a phylogenetic analysis of the H5N2 strain is under way to determine if it is related to H5N2 strains circulating elsewhere. So far no human illnessess have been linked to H5N2, the agency said.
Dec 2 OIE report
Dec 2 Farmers Weekly story
Nov 25 CIDRAP News scan on earlier H5N1 outbreak
Dec 1 CIDRAP News scan on initial reports of latest outbreaks
Dec 2 ECDC risk assessment

This week's top reads

Our underwriters