Quick takes: Philadelphia measles cluster, more WEE cases in Argentina, global polio update

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  • The Philadelphia Department of Public Health (PDPH) yesterday said it is investigating a measles cluster involving unvaccinated residents, with four confirmed cases and two additional suspected cases. In a statement, PDPH said there is an index case, plus three locally acquired cases, of which two were hospitalized. Officials said the two suspected cases were exposed to measles after one of the confirmed cases attended daycare, disregarding quarantine and exclusion instructions. As they track cases and potential exposures, officials are urging people to get up to date on their measles, mumps, and rubella (MMR) vaccination and asking health providers to be on the lookout for new cases.
  • Following Argentina's recent report of a rare case of Western equine encephalitis (WEE), its first human case in more than two decades, the country has reported 11 more detections, the European Centre for Disease Prevention and Control (ECDC) said today in its weekly communicable disease update, which cites the Argentina health ministry. The initial patient was reported from Santa Fe. As of the week starting December 18, 12 cases have been confirmed among 63 suspected cases of the mosquito-borne disease. Six patients are from Santa Fe, including a 66-year-old man who died from his infection. Five are from Buenos Aires and one is from Entre Rios. Patient ages range from 30 to 70 years old, and most are men. All were hospitalized.
  • Seven countries reported more polio cases this week, mostly from Africa and all involving vaccine-derived types, according to the latest weekly update from the Global Polio Eradication Initiative (GEPI).  Six reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases, including the Democratic Republic of Congo (1), Guinea (10), Mali (3), Niger (1), South Sudan (1), and Tanzania (1). The cases from Niger and South Sudan were their first for 2023. Also, two countries reported more circulating vaccine-derived poliovirus type 1 (cVDPV1) cases: the DRC (2) and Madagascar (1).

Updated COVID vaccine 71% effective against hospitalization for older adults

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Woman getting vaccinated against COVID
Phil Roeder / Flickr cc

The estimated effectiveness of the updated COVID-19 vaccine among people aged 60 and older in the Netherlands was 70.7% against hospitalization and 73.3% against intensive care unit (ICU) admission in fall and early winter 2023, according to a study published yesterday in Eurosurveillance.

Researchers at the National Institute for Public Health and the Environment and University Medical Center Utrecht parsed data on hospitalizations with admission dates from October to December to estimate the effectiveness of the XBB.1.5 Pfizer/BioNTech COVID-19 vaccine among recipients of at least one previous vaccination. The study included 2,050 hospitalized adults aged 60 and older, 14.4% of whom had received the 2023 COVID-19 vaccine.

"Since October 2023, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA load in sewage water has been rising steadily up to the highest level since start of this surveillance system in 2020, indicating a high level of SARS-CoV-2 transmission during the past months," the authors noted.

More effective than 2022 vaccine

The vaccine effectiveness (VE) was estimated at 70.7% (95% confidence interval [CI], 66.6% to 74.3%) against hospitalization and 73.3% (95% CI, 42.2% to 87.6%) against ICU admission. 

In comparison, the estimated VE of the bivalent (two-strain) COVID-19 vaccine available from October 2022 to December 2022 was 64% (95% CI, 59% to 68%) against hospitalization for recipients aged 60 to 79 years. "However, a direct comparison between these seasonal estimates could be confounded by the fact that the 2022 autumn campaign was closer in time to the previous campaign in spring 2022," the researchers wrote.

Based on our results, we expect that seasonal COVID-19 vaccination is an effective intervention for reducing the burden of severe COVID-19 during the winter months.

The VE is expected to decline as the time since vaccination increases in the coming months, as was seen in previous COVID-19 vaccination campaigns in Europe, they authors said. "Based on our results, we expect that seasonal COVID-19 vaccination is an effective intervention for reducing the burden of severe COVID-19 during the winter months," they wrote. "An increase in uptake of the seasonal vaccine could further enhance its public health benefit."

Cystic Fibrosis Foundation to fund development of new antibacterial therapy

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The Cystic Fibrosis (CF) Foundation announced today that it's investing up to $5 million in Ohio-based Clarametyx Biosciences to develop a drug that could help CF patients clear difficult-to-treat bacterial infections.

Lung infection caused by Pseudomonas
Dr_MIcrobe / iStock

The money will support development of CMTX-101, a monoclonal antibody that has shown the ability to disrupt biofilm formation across several species of bacteria, including the species that tend to cause chronic infection in CF patients, such as Pseudomonas aeruginosa, Burkholderia cepacia, and nontuberculosis mycobacteria.

CF patients with chronic P aeruginosa infections are currently being enrolled in a phase 1b/2a clinical trial that will investigate the safety and tolerability of CTXM-101 in combination with inhaled tobramycin.

Biofilm disruption

Because of the mucus that builds up in their lungs, CF patients are prone to bacterial infections that can exacerbate their condition. Most of those infections involve bacteria that form biofilms—communities of microbes that can grow on human tissue, medical devices, and prosthetic joints and form a protective layer around the bacteria, shielding them from the immune system and antibiotics.

CTXM-101 is designed to collapse biofilms by targeting a region of proteins that help stabilize and maintain biofilm integrity. Without the protection of the biofilm, the bacteria causing the infection become more susceptible to antibiotics. CF Foundation officials say the approach may also reduce the inflammation that results from chronic infections in CF patients.

"We hope that this potential therapy will ultimately help people with CF clear many different types of difficult-to-treat infections," JP Clancy, MD, senior vice president of clinical research at the Cystic Fibrosis Foundation, said in a press release. "This could provide a crucial new tool that could be used alongside traditional antibiotics in the fight against antimicrobial resistance."

CTXM-101 is among the antibacterial candidates that have received pre-clinical funding from CARB-X (the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator).

This could provide a crucial new tool that could be used alongside traditional antibiotics in the fight against antimicrobial resistance.

At least 24 sickened in multistate Salmonella outbreak linked to charcuterie

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Today the Centers for Disease Control and Prevention (CDC) shared more information on an ongoing Salmonella outbreak linked to contaminated charcuterie products. The 11,000 pounds of meat were recalled by New Jersey meat processor Fratelli Beretta USA earlier this week.

Twenty-four cases in 14 states have been identified, with 5 hospitalizations. No fatalities have been reported in this outbreak. Of interviews with 11 sick patients, 6 reported eating a variety of charcuterie products, and of 3 who recalled a specific brand, all reported eating the brand subject to the recall. Whole genome sequencing of bacteria from sick people suggests that the samples are closely related, adding evidence that the they were sickened by the same food.

Check your fridge for recalled products. Do not eat them.

Earlier this week, Salmonella was identified in an unopened sample of "Busseto Foods Charcuterie Sampler Prosciutto, Sweet Soppressata, and Dry Coppa," collected by the Minnesota Department of Agriculture as a part of the investigation after one Minnesotan fell ill in December. The CDC said tests on the Minnesota product sample yielded Salmonella I 4:I:- and that sequencing is underway to determine if the strain matches the one from sick patients. So far, it's not clear which component of the sampler was contaminated.

The sampler was sold at Sam's Club stores in Georgia, Illinois, Indiana, Minnesota, North Carolina, Ohio, Oklahoma, and Texas, and has a sell-by date of April 27, 2024. Eleven illnesses have been identified in Ohio, with other states reporting only a single case.

"Check your fridge for recalled products. Do not eat them. Throw them away or return them to where you bought them," the CDC said.

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