News Scan for May 16, 2018

News brief

Johns Hopkins pandemic exercise highlights US readiness gaps

The federal government needs to develop better vaccine production capacity, support strong global security, and bolster nationwide public health to be better prepared for the next pandemic, a high-level tabletop exercise yesterday sponsored by the Johns Hopkins Center for Health Security found.

The exercise, called Clade X, simulated a series of National Security Council–convened meetings of 10 US government leaders, played by experts in the fields of national security or epidemic response, according to a Center for Health Security news release. Among them were Margaret Hamburg, MD, former Food and Drug Administration commissioner, playing the role of Secretary of Health and Human Services, and Julie Gerberding, MD, reprising her role as director of the Centers for Disease Control and Prevention (CDC).

Their dialogue and decision making as the scenario unfolded highlighted significant uncertainties in US prevention and response capabilities, which have been hamstrung by policy challenges and underfunding.

The desktop scenario opened with an outbreak of a serious respiratory disease in Germany and Venezuela. The pathogen, dubbed Clade X, turned out to be an engineered strain of parainfluenza virus with elements of Nipah virus released by a terrorist group. Within a year, 150 million people worldwide and 15 million in the United States died from the fictitious but realistic pandemic.

At the conclusion of the exercise, the Center for Health Security presented six strategic policy goals that the US government needs to commit to for adequate pandemic preparedness:

Develop the capability to produce new vaccines and drugs for novel pathogens within months, not years
Pioneer a strong, sustainable global health security system
Build a robust national public health system
Develop a national plan to effectively harness all US healthcare assets
Implement an international strategy for addressing research that increases pandemic risks
Ensure the national security community is well prepared

May 15 Center for Health Security news release
Clade X homepage

New MERS case found in Saudi woman from Tabuk

In its first notification of a new case of MERS-CoV in 2 weeks, the Saudi Arabian Ministry of Health (MOH) said a woman from Tabuk has the coronavirus.

Officials diagnosed the 42-year-old woman as having MERS-CoV (Middle East respiratory syndrome coronavirus) after she presented with symptoms. The probable source of her infection, recorded in a May 13 report that was posted on the MOH site today, is listed as "primary," meaning it's unlikely she contracted the virus from another person.

The new case brings Saudi Arabia's MERS-CoV total since 2012 to 1,839, including 745 deaths. Two people are still being treated for their infections.
May 13 MOH report

CDC develops new rapid test for rabies that could mean fewer shots

A new rapid test for rabies designed for use in animals and developed by CDC scientists could mean that people exposed to potentially rabid animals could forego the weeks-long regimen of shots to prevent the deadly disease, according to a study in PLoS One and a CDC news release today.

The researchers used the LN34 assay to test 2,978 samples from Africa, the Americas, Asia, Europe, and the Middle East, 1,049 of which were positive via direct fluorescent antibody (DFA), the current gold standard for testing. Compared with DFA, LN34 displayed high diagnostic specificity (99.7%) and sensitivity (99.9%), and no DFA-positive samples were negative on LN34 testing. Even better, use of the LN34 assay led to the identification of one false-negative and 11 false-positive DFA results.

The LN34 test can be run on polymerase chain reaction testing platforms already widely used in the United States and abroad, without any extra training, the CDC said. And it yields results even from decomposing animal brain tissue. The DFA test, in contrast, must be interpreted by laboratory workers with special skills, extensive training, and a specific type of microscope.

"Many of the areas hardest hit by rabies are also the areas least prepared to run current tests to diagnose it," said Crystal Gigante, PhD, a CDC microbiologist and the study's first author. "The LN34 test has the potential to really change the playing field. Quickly knowing who needs to receive rabies treatment—and who does not—will save lives and families' livelihoods."
May 16 PLoS One study
May 16 CDC press release

Flu Scan for May 16, 2018

News brief

Chinese researchers report novel triple-reassortant flu viruses in swine

Chinese researchers today reported novel triple-reassortant influenza strains in swine, and the viruses carry genes that have been noted in human flu infections, according to a study in Emerging Microbes & Infections.

During surveillance of pigs in Guangxi province, the investigators isolated 11 H1N1 and 3 H3N2 viruses of swine origin. Out of the 14 isolates, 10 were novel triple-reassortant viruses that contained the surface genes hemagglutinin and neuraminidase from Eurasian avian-like (EA) H1N1 or seasonal human-like H3N2, matrix (M) genes from 2009 H1N1 pandemic or EA H1N1, nonstructural (NS) genes from classical swine flu, and the remaining genes from 2009 H1N1.

In addition, mouse studies indicated that the novel swine-origin viruses replicate efficiently, with some isolates demonstrating lethality in the animals. The researchers also noted that the reassortant EA H1N1 viruses with EA-like M gene have been reported in human infections.

"Further investigations will help to assess the potential risk of these novel triple-reassortant viruses to humans," the authors concluded.

In related research, a separate group of Chinese researchers analyzed flu isolates from environmental and animal sampling and report that influenza viruses are widespread on pig farms and demonstrate an association between the different types of environmental sampling used. Their study was also published today in the same journal.
May 16 Emerg Microb Infect study on triple-reassortant viruses
May 16 Emerg Microb Infect study on swine surveillance

H5N8 avian flu reported in South Africa, Denmark

South Africa and Denmark yesterday reported new highly pathogenic H5N8 avian flu detections, according to separate reports to the World Organization for Animal Health (OIE).

South African officials confirmed that the virus infected 29 ostriches on a farm of 3,720 birds in Western Cape province, beginning on May 5. Outbreak response steps have included destruction of animal products, disposal of droppings, and disinfection.

In a separate OIE report, South African agriculture officials reported 11 separate outbreaks, mostly affecting terns, gulls, and cormorants, but also a backyard swan. The largest of the wild bird outbreaks involved 4,177 swift terns found dead in West Cape province and 1,728 deaths and 1,778 cases in swift terns in the same province. Both outbreaks occurred in March.

The swan died on Apr 12 and was part of a flock of 40 backyard birds in Mpumalanga province, which is near Johannesburg. All told, the 11 outbreaks involved 1,966 H5N8 cases and 5,909 deaths in birds.

Denmark, meanwhile, reported that, from wild birds found dead Feb 13 through Apr 4, H5N8 avian flu was confirmed in 19 separate outbreaks throughout the eastern half of the country. Affected species were white-tailed eagles, common buzzards, crows, gulls, mute swans, and a cormorant. Testing revealed the virus in 23 birds.
May 15 OIE report on South Africa ostrich outbreak
May 15 OIE report on other South Africa detections
May 15 OIE report on Denmark