News Scan for Jul 24, 2018

News brief

Dengue in pregnancy may increase risk of congenital brain malformations

Prenatal dengue infection may increase the risk of any neurologic congenital anomaly in an infant by roughly 50%, according to new research published yesterday in Emerging Infectious Diseases.

The population-based study was conducted in Brazil from 2006 to 2012, involving more than 16 million live births. Dengue-infected pregnant women were matched with controls, and the study was conducted before Zika virus was introduced into the country. Half of the women with confirmed dengue reported symptoms in the first trimester of pregnancy.

Researchers found that confirmed dengue during pregnancy increased the odds of a neurologic congenital anomaly by 50%, but the results were not statistically significant (95% confidence interval, 0.97-2.27). Congenital malformation of the spinal cord, however, and some congenital brain malformations were more than four times more frequent in dengue-affected births.

"The pattern of anomalies we described has similarities with congenital Zika syndrome. Brain images and autopsies from infants with Zika and other infectious diseases have revealed abnormalities similar to those we described," the authors said.

The authors said the findings raise more questions about the congenital defects caused by flaviviruses, and recommend further study of the teratogenic effects of dengue.
Jul 23 Emerg Infect Dis study

 

More cases reported in Uganda's Rift Valley fever outbreak

Uganda has reported six more cases in its Rift Valley fever outbreak, raising the total to eight, according to the latest weekly health emergencies update from the World Health Organization (WHO) regional office for Africa.

Of the eight cases, six are confirmed and two are suspected. The lab-confirmed cases are from five different districts: Kasese, Isingiro, Ibanda, Mbarara, and Sembabule, an area described as the "cattle corridor" that stretches from the southwest to northeast regions of the country. One of the suspected case-patients ran away from an isolation ward at the regional hospital in Mbarara before further medical assessment was done, and the other patient is in isolation while awaiting test results. Three people have died from their illnesses.

In Kenya, where a Rift Valley fever outbreak has been unde rway since May, no new cases were reported in the past week, keeping its outbreak total at 94 cases, including 10 deaths.

Livestock contract the virus from mosquitoes, and most human illnesses occur from exposure to the blood or milk of infected animals.
Jul 23 WHO African regional office weekly report

 

FDA approves single-dose treatment for P vivax malaria

The US Food and Drug Administration (FDA) last week approved the first single-dose medication to prevent relapsing Plasmodium vivax malaria infection, GlaxoSmithKline (GSK) and Medicines for Malaria Venture (MMW) announced on Jul 20.

The FDA cleared the drug called Krintafel (tafenoquine), under priority review with an indication for treating patients ages 16 years and older who are receiving appropriate antimalarial therapy for acute P vivax infection.

Hal Barron, MD, GSK's chief scientific officer and president of research, said in the statement that the approval marks the first new treatment for P vivax in more than 60 years, is an important milestone for people living with this type of relapsing malaria, and will contribute to global efforts to eradicate the disease.

David Reddy, PhD, chief executive officer of MMV, added that the single-dose indication will help improve patient compliance. "Our focus is now on working to ensure the medicine reaches the vulnerable patients that need it most," he said.

The FDA had also awarded GSK a tropical disease priority review voucher, which is designed to stimulate the development of new drugs and biological products to battle neglected tropical diseases. GSK has also submitted an application for approval to the Australian Therapeutics Good Administration and is awaiting its decision.
Jul 20 GSK press release

Stewardship / Resistance Scan for Jul 24, 2018

News brief

Report: US seeking weaker global guidelines for antibiotic use in livestock

The Trump administration is working behind the scenes to weaken global recommendations on antibiotic use in food-producing animals, according to a story yesterday in Bloomberg.

Bloomberg reports that US officials are helping to shape the recommendations through the Codex Alimentarius Commission, an agency that develops food standards and guidelines for international trade. The US is leading a working group to update guidelines for antibiotic use along the food chain.

According to a draft document obtained by Bloomberg, the recommendations from the group are weaker than those put forth in a report by the World Health Organization (WHO) in November 2017. While the WHO called for an end to the use of medically important antibiotics for growth promotion and disease prevention in healthy food-producing animals, the draft document suggests medically important antibiotics could still be used for disease prevention. In addition, the draft contains a loophole that would allow antibiotics to be used for growth promotion, a practice that's banned in the United States and other countries.

The US Department of Agriculture has criticized the WHO report, arguing that the recommendations are not supported by sound science.
Jul 23 Bloomberg story
Nov 7, 2017, CIDRAP News story, "WHO calls for an end to antibiotic use in healthy animals"

 

Open-access database of forgotten antibiotics launches

Today UK researchers launched AntibioticDB, a free, open-access database of forgotten antibiotics in hopes of generating new leads in the fight against antimicrobial-resistant pathogens.

The searchable database brings together many once-promising leads from the past 50 years that have for various reasons stalled or been dropped, according to a news release from the John Innes Centre (JIC). The team behind AntibioticDB, led by Prof Laura Piddock of the University of Birmingham, argue that discontinued agents are an untapped resource that has been overlooked for drug development.

The researchers used a range of sources to identify compounds of interest, including leaders in the pharmaceutical industry and other key scientists. They obtained information on each compound or drug using online searches, literature archives, and interviews with experts. They include other data, as well, such as reasons for the lack of development.

Piddock said, "It can take up to 15 years and cost up to $5 billion from the discovery of a compound to progress through pre-clinical and clinical development before a medicine can be licensed and then marketed. There is no doubt that the antibiotic pipeline needs revitalization; however, the answer may be not only the development of new drugs, but also re-investigating compounds previously discontinued."

The team detailed its efforts last month in the Journal of Antimicrobial Chemotherapy.
Jul 24 JIC news release
Jun 11 J Antimicrob Chemother report

AntibioticDB website

 

Study notes highest rate of ESBL colonization in travelers to North Africa

A systematic review of three studies involving data on extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) among travelers from Europe to Africa found that the ESBL-PE colonization rate was highest in North Africa, according to a study yesterday in BMC Infectious Diseases.

The studies were conducted from 2009 through 2013 and involved 396 Finnish and Dutch travelers. The researchers also compared the data to two recent large investigations reporting data by subregion and country in Africa.

The ESBL-PE colonization rate was highest in North Africa, followed by middle and eastern Africa, and lowest in southern and western Africa. Of individual countries with more than 15 visitors, the highest rates were seen for Egypt (12/17, 70.6%), Ghana (6/23, 26.1%), and Tanzania (14/81, 17.3%). The rate among travelers to Egypt is comparable to those reported in South and Southeast Asia, the authors write.

They conclude, "Even in areas with relatively low risk of colonization, antimicrobials clearly predispose to colonization with ESBL-PE. Travellers to Africa should be cautioned against unnecessary use of antibiotics."
Jul 23 BMC Infect Dis study

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