UN head urges 5-year stamping out of world's deadliest IDs and cholera in Haiti

United Nations Secretary-General Ban Ki-moon told private sector representatives and philanthropists yesterday that they should "make a smart investment in the world's future" by joining the United Nations in helping wipe out the world's deadliest infectious diseases—malaria, polio, tetanus, measles, and HIV—in the next 5 years.

He spoke at the Second Annual Forbes 400 Summit in New York. Large advances have been made, he said, particularly in reducing malaria deaths by 40% in the past 7 years, cutting new HIV infections by 25% in the past 2 years, and eliminating polio in India more than a year ago. But attention should be paid to stopping mother-to-child HIV transmission and preventing tetanus and measles, which get limited international press, he said.

Ban also called for eliminating cholera in Haiti, which has seen 670,000 cases and more than 7,750 deaths since the 2010 outbreak. Providing oral cholera vaccine, which needs to be underwritten to the tune of $1 million per year for 3 to 5 years, is the most immediate need, he said, with longer-term goals of clean drinking water and better sanitation.
Jun 5 UN news story

Islamic scholars push for polio-free Pakistan

Concrete actions to meet the social and political challenges to the ongoing polio vaccination program in Pakistan were suggested at a conference at International Islamic University in Islamabad yesterday, according to an article in The Express Tribune. The conference is a follow-up to a regional meeting in Cairo in March.

Scholars at the conference declared immunization of children as a religious obligation for families and the wider community, vowing to make the Islamic world polio-free by the end of 2014.

The ongoing Polio Eradication Initiative in Pakistan has suffered serious setbacks because of security incidents including the murder in 2012 of 14 polio workers and 2 security guards.

Among the efforts needed to restore the program, said conference scholars, are talks with the Taliban and grassroots advocacy by religious scholars to correct misinformation about the campaign.
Jun 6 Express Tribune article

Medical groups support reintroduced bill to fight antimicrobial resistance

With support from many medical groups, Rep. Jim Matheson, D-Utah, today reintroduced a bill to strengthen the federal government's role in fighting antimicrobial resistance. The legislation is called the Strategies to Address Antimicrobial Resistance (STAAR) Act, according to a press release from the Infectious Diseases Society of America (IDSA).

The bill would boost antimicrobial resistance activities at several federal agencies.

At the Department of Health and Human Services, the legislation would reauthorize the Antimicrobial Resistance Task Force and establish an advisory board of outside experts and an Antimicrobial Resistance Office. For the National Institutes of Health, the bill would create an antimicrobial resistance strategic research plan and authorize a clinical trials network. And at the Centers for Disease Control and Prevention, the bill would authorize an antimicrobial-resistance surveillance and laboratory network and other efforts.

The legislation also would expand current efforts to collect data on antimicrobial use and resistance.

More than 20 organizations representing healthcare and public health professionals and patients voiced support for the STAAR Act in a letter to Matheson today, according to the IDSA. An IDSA spokesman said the bill was introduced in 2009 but died in committee.
Jun 6 IDSA press release

Study tallies obstacles to treating H5N1 patients in Cambodia

A study that profiled H5N1 avian infections and their costs in Cambodia found that care of the typically young patients is hampered by hospitalization delays, inadequate antiviral treatment, and poor access to mechanical ventilation, researchers reported today.

Scientists from Cambodia and the London School of Hygiene and Tropical Medicine reported their findings in BMC Public Health. Their goal was to gauge the burden of the disease in one of Southeast Asia's poorest countries, which has many gaps in its healthcare system and one of the world's highest mortality rates for H5N1 infection.

The study focused on 18 patients who had lab-confirmed infections between January 2005 and August 2011, two of whom were treated in Vietnam. Sixteen of them died within 24 hours of hospital admission.

Although the delay between symptom onset and hospitalization wasn't much different from that in other developing nations, fewer Cambodians received antiviral treatment, and when they did receive it, it was delayed.

No parenteral or oral ostelamivir (Tamiflu) was reported to be available in Cambodia, which the group said may have affected the care of children with H5N1. They also found excessive use of antibiotics and corticosteroids. None of the patients treated in Cambodia received mechanical ventilation.

The average per-patient cost for H5N1 care in Cambodia was $300, most of which went toward diagnostic testing and medications.

The researchers concluded that a highly pathogenic flu outbreak in Cambodia could be catastrophic, but that prompt antiviral treatment could lower costs and improve care.
Jun 6 BMC Public Health abstract

Chickens shed H7N9 virus in quantity; Medicago tests H7 vaccine

Scientists at a US Department of Agriculture (USDA) lab in Athens, Ga., who are conducting tests with the new H7N9 influenza in poultry have found that chickens and quail shed high volumes of the virus, which could shed light on risks to humans in Chinese live poultry markets, the Canadian Press reported yesterday.

David Swayne, PhD, who directs the USDA's Southeast Poultry Research Laboratory, told the Canadian Press that pigeons, ducks, and geese also can be infected by H7N9 but that they don't shed the virus in significant amounts. Swayne said avian flu viruses typically infect birds in the gut and shed the virus through droppings, but researchers found H7N9 in the nasal passages of chickens and quail.

The findings suggest that chickens and quail played a key role in the spread of the virus, given the amount of virus they shed, Swayne said.
Jun 5 Canadian Press story
In other H7N9 developments, Medicago, a pharmaceutical company based in Quebec City, today announced the first results of preclinical tests of its candidate H7N9 vaccine.

Nathalie Landry, Medicago's vice president of product development, said in a statement that the H7 vaccine elicited a solid antibody response in mice after a single dose. The company said 3 micrograms of the plant-based virus-like particle (VLP) vaccine, administered with and without an adjuvant (glucopyranosyl lipid A), induced high antibody titers.

The findings appear to be the first preclinical results for an H7N9 vaccine. Landry said results from challenge studies should be available in the coming month.

Prospective studies haven't yet identified hemagglutination inhibition titers linked to protection against lab-confirmed flu. A lack of recognized correlates of protection for live-attenuated influenza vaccines (LAIV) is expected to pose challenges for interpreting the immunogencity of candidate H7N9 vaccines.
Jun 6 Medicago press release