News Scan for Jun 12, 2015

News brief

Saudi Arabia reports fatal MERS case in Hofuf

Saudi Arabia today reported one new MERS-CoV case, involving a 77-year-old man who died from from his infection, the country's Ministry of Health (MOH) said today in a statement.

The man is from Hofuf and appears to be part of a cluster of cases in that area, many of which have been linked to a number of hospital-related infections, with others part of a family cluster. The man wasn't a healthcare worker but had contact with a confirmed or suspected case either in the community or hospital setting, the MOH said in a statement.

It said the new fatal case raises Saudi Arabia's total from MERS-CoV (Middle East respiratory syndrome coronavirus) to 1,030 cases, 453 of them fatal. So far 568 people have recovered, 8 are still being treated, and 1 is in home isolation.
Jun 12 MOH statement

Meanwhile, the World Health Organization (WHO) yesterday provided more details on eight cases reported from Saudi Arabia between Jun 5 and Jun 8, all but one of them from Hofuf.

Six of the patients were admitted to a hospital that has been experiencing a known MERS outbreak, but it's not clear if all of them were exposed at the facility. Two appear to be hospital employees, a 29-year-old man who got sick after he provided care to an earlier confirmed case-patient and a 41-year-old man who worked as a security guard and also had contact with an already confirmed patient.

One of the patients hospitalized in Hofuf is a 55-year-old foreigner from Asfan who has a history of frequent contact with camels and sheep and also drank raw milk. The only patient without a Hofuf connection is a 58-year-old foreign man from Riyadh, and officials so far haven't determined how he was exposed to the virus.

Among the eight patients, ages range from 29 to 72 years old. All but one are male. Illness onsets range from May 20 to Jun 2. Four are in critical condition, and four are listed as stable.

The WHO said so far it has been notified of 1,277 MERS-CoV cases, which includes 449 deaths.
Jun 11 WHO statement

Risk groups recommended for meningitis B vaccine

The US Centers for Disease Control and Prevention (CDC) today fleshed out more details about its advisory committee's February recommendation that certain high-risk groups receive the meningococcal B vaccine. It detailed the recommendation of its Advisory Committee on Immunization Practices (ACIP) in the latest issue of Morbidity and Mortailty Weekly Report (MMWR).

Two meningoccal B vaccines were approved in recent months—Wyeth's Trumenba last October and Novartis's Bexsero in January. Current quadrivalent vaccines for meningococcal disease in the United States don't include the B serotype, which has been responsible for small college outbreaks and been implicated in an increasing proportion of meningococcal illnesses in the United States.

After reviewing the findings of its working group, ACIP recommended that certain people age 10 or older receive the vaccine, including those with persistent complement component deficiencies, anatomical or functional asplenia, microbiologists exposed to Neisseria meningitidis, and people thought to be at risk during meningitis B outbreaks.

Trumenba is given in a three-dose series, and Bexsero is given as a two-dose series. ACIP recommended that the same product be used for all of the doses and can be given at the same time as the quadrivalent vaccine, but at a different anatomic site, if possible.

Currently, ACIP's recommendation doesn't broaden use in college students, military recruits, or adolescents, but the panel will consider the issue on the first day of its next meeting, on Jun 24.
Jun 12 MMWR report
ACIP agenda for Jun 24-25 meeting
Feb 26 CIDRAP News scan "ACIP recommends meningitis B vaccine for high-risk groups"

WHO says meningitis epidemic in Niger is fading

The meningitis epidemic in Niger, which peaked in early May, has now dropped significantly in all parts of the country, with no cases in the capital in the past week, the WHO's Regional Office for Africa said today.

As of yesterday, Niger's Ministry of Public Health put the count of suspected cases at 8,341 since the beginning of the year, with 557 deaths.

The epidemic was worrisome because it hit an urban area with more than 1 million people, causing many cases and posing a risk of rapid spread, the WHO said, adding, "Despite the improved situation, vigilance is necessary because the risk of transmission remains high."

The WHO reported that the lack of any cases in the past week in Niamey, the capital, has prompted the closure of two support centers.

Despite a worldwide shortage of meningitis vaccines, the WHO and its partners have helped Niger to mobilize more than 1.3 million doses of vaccine through the International Coordinating Group Meningitis Vaccine (ICG), the agency said.

A large consignment of drugs for meningitis was also provided to the country, the WHO said, adding that more than 7,500 patients have been treated and recovered from the disease during the epidemic.
Jun 12 WHO Africa statement
Related Jun 2 CIDRAP News item

World Bank funds effort to combat malaria, neglected diseases in Africa

The World Bank announced yesterday it has approved $121 million to support the Sahel Malaria and Neglected Tropical Diseases Project in an African region hard hit by these diseases.

The project will be implemented in three countries initially—Burkina Faso, Mali and Niger—in the Sahel region, which borders the south of the Sahara Desert across the continent. The project will benefit an estimated 3.7 million people, the World Bank said in a news release.

The burden of illness from neglected diseases is especially high in the Sahel, and four of the most debilitating tropical diseases are strongly associated with the region's climate, the World Bank said. An estimated 88% of trachoma cases in Africa are in the Sahel, as are 59% of lymphatic filariasis cases, 50% of schistosomiasis cases, and 49% of onchocerciasis cases.

"By supporting regional collective actions, this project will enhance disease control strategies to eliminate and reduce the spread of malaria and neglected tropical disease along international borders in endemic areas, helping to boost livelihoods for the millions of families in Africa's Sahel region," said Colin Bruce, World Bank regional director.

The Project will focus on scaling up disease control interventions at the community level in cross-border areas in the three countries, but other Sahel nations may join during project implementation.
Jun 11 World Bank news release

Ebola Scan for Jun 12, 2015

News brief

HHS funds nine regional treatment centers for Ebola, other diseases

To prepare the nation better for cases of Ebola or other serious diseases, the Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) has earmarked about $20 million to develop nine regional treatment centers across the country, HHS said today in a news release.

The funds will help the treatment centers ramp up their capabilities, and ASPR will provide an additional $9 million over 4 years to sustain continual readiness. The centers will involve joint efforts with health departments and partner hospitals in Colorado, Georgia, Maryland, Massachusetts, Minnesota, Nebraska, New York, Texas, and Washington.

"This approach recognizes that being ready to treat severe, highly infectious diseases, including Ebola, is vital to our nation's health security," said Nicole Lurie, MD, MSPH, HHS assistant secretary for preparedness and response. "This added regional capability increases our domestic preparedness posture to protect the public's health."

Each center will receive about $3.25 million over the 5-year project period. The funding is part of $339.5 million in emergency funding that Congress approved to enhance state and local preparedness following US Ebola cases last year.
Jun 12 HHS news release

HHS announces support for development of Ebola rapid test

HHS's ASPR also announced today that it is funding the development of an Ebola virus diagnostic test for use in a healthcare setting or in the field that is intended to provide results within 20 minutes.

The development of OraQuick, a simple, low-cost, lateral-flow test, will take place under a $1.8 million contract with OraSure Technologies Inc. of Bethlehem, Pa., HHS said in a press release. Lateral-flow tests detect the presence of a virus with a drop of the patient’s blood or saliva on a test strip. The contract could be extended for up to 39 months and $10.4 million.

"Fast and inexpensive point-of-care diagnostics will improve our ability to control Ebola virus disease outbreaks," said Robin Robinson, PhD, director of ASPR’s Biomedical Advanced Research and Development Authority (BARDA), which will oversee the development of the device. "Faster diagnosis of Ebola virus infections allows for more immediate treatment and an earlier response to protect public health worldwide."

OraSure will also evaluate whether the test can be used in post-mortem analyses of oral fluids, which could help in detecting the presence of Ebola virus after death and decrease the problem of disease spread at funerals and in preparing dead bodies, which helped fuel the epidemic in West Africa.

OraQuick is the first point-of-care Ebola testing device to receive BARDA support, HHS said in the release.
Jun 12 HHS press release

China-produced Ebola drug questioned over patent, safety issues

China late last year rapidly produced multiple doses of a knockoff of the experimental Ebola drug ZMapp in response to the outbreak in West Africa, but some US officials have expressed concern about possible patent infringement and over safety The New York Times reported yesterday.

The drug, MIL77, is produced by Beijing Mabworks. ZMapp is produced by Mapp Biopharmaceutical of San Diego and resulted from a collaboration between US and Canadian scientists.

"People think international collaboration could easily happen between the U.S. and Canada," said Beijing Mabworks chief executive Feng Li. "But these days, China could play a role" by making emergency response drugs "better and faster in some cases."

Last summer in response to the Ebola epidemic Chinese officials spurred production of MIL77 plus an Ebola vaccine, which is now in human safety trials. Within 3 months, Beijing Mabworks used information from ZMapp's patent that it obtained in a licensing agreement to produce antibodies to the Ebola virus. And a month later it had produced 100 doses of the drug, the story said.

But some US officials have voiced concern, as the US government holds a patent on one of the antibodies in ZMapp.

BARDA Director Robin Robinson, PhD, said the Chinese scientists might have infringed on patents if they tried to sell MIL77 outside China without an agreement with Mapp Biopharmaceutical.

He added, "They have not done all the testing that we would normally do for safety before these products would go into humans." ZMapp is currently in clinical trials.
Jun 11 New York Times story