News Scan for Jan 05, 2017

News brief

MERS-CoV infects 5 more in Saudi Arabia, 1 fatally

In updates yesterday and today, Saudi Arabia's Ministry of Health (MOH) announced five new MERS-CoV cases, one of them fatal.

Yesterday the MOH reported four new MERS-CoV (Middle East respiratory syndrome coronavirus) cases, two in Riyadh and a pair from Buraydah, located about 200 miles northwest of Riyadh in the north central part of the country.

One of the Riyadh patients is a 58-year-old man who has an asymptomatic infection and is listed as a household contact of an earlier case. The other three had primary exposure to the virus, meaning they aren't thought to have contracted their infections from another patient. They are a 56-year-old foreign man in Riyadh who is in critical condition, an 87-year-Saudi woman from Buraydah who is listed as stable, and an 88-year-old Saudi woman from Buraydah who died.

Today the MOH reported an additional MERS patient in Buraydah, a 70-year-old Saudi woman who is in stable condition and has a primary infection source.

The new cases boost Saudi Arabia's MERS-CoV total to 1,527, including 636 deaths. Eleven people are still being treated.
Jan 4 Saudi MOH update
Jan 5 Saudi MOH update

CDC releases heavily redacted lab-mishap reports after FOIA request

Two years after filing a Freedom of Information Act (FOIA) request to see reports of recent biosafety breaches at Centers for Disease Control and Prevention (CDC)-affiliated labs, USA Today reported yesterday that the agency has finally complied—but with much of the key information blacked out, including the dangerous pathogens involved.

From the information that was left to read, the newspaper noted that CDC scientists apparently lost a box of deadly and highly regulated influenza specimens and experienced multiple exposures involving viruses and bacteria, including equipment failure in a biosafety-level 4 lab, in which the most dangerous pathogens are studied and contained.

"The 503 pages of records the CDC released in many cases look like Swiss cheese when an incident involves any pathogen that is on a federal list of potential bioterror pathogens, called 'select agents,' " the story says. "They include pathogens such as those that cause anthrax, Ebola, plague, or certain avian or reconstructed flu virus strains."

Several reports had every word redacted. In an Aug 1, 2014, e-mail about a lab incident, the only words not blacked out were "When I came in this morning" at the beginning and "Please let me know if you have any questions" at the end.

The CDC would not respond to USA Today's questions about specific incidents, which occurred at CDC labs in Atlanta and Fort Collins, Colo., during 2013 through early 2015. "None of the incidents described in these documents resulted in reported illness among CDC staff or the public," the agency said in a brief e-mailed statement. In justifying the redactions, the CDC cited a 2002 bioterrorism law that allows withholding information from the public for security reasons.
Jan 4 USA Today story

Scientists alter genes in promising new malaria vaccine candidate

Researchers from Washington state successfully altered Plasmodium falciparum, allowing the malaria parasite to be used as a vaccine in 10 healthy volunteers. The study was published yesterday in Science Translational Medicine.

While using whole but weakened malaria parasites has been a target of vaccine research, there is concern such vaccines could cause breakthrough malaria infections. To combat this, researchers knocked out three genes that cause liver infection before using the parasite on human subjects. The subjects were tested with exposure to the altered parasites (via 150 to 200 mosquito bites per person), and all developed antibody responses without malaria symptoms.

The modified parasite was then transferred to humanized mice, where antibodies blocked malaria infection in the liver. The promising results pave the way to a phase 1b trial of the GAP3KO vaccine candidate using controlled human malaria infection, the researchers said, according to a news release from the American Association for the Advancement of Science (AAAS), which publishes the journal.

Malaria is still the world's most threatening mosquito-transmitted disease, with over half the global population at risk for infection.
Jan 4 Sci Transl Med study
Jan 4 AAAS news release

Poultry producer reports avian influenza outbreak in Chile

Reuters reported today that a poultry production plant in Chile (run by Agrosuper) has detected avian influenza in a flock of turkeys. The plant is located in the country’s Valparaiso region.

According to the infectious disease news tracking blog Avian Flu Diary (AFD), Chilean officials have said a H7 strain of avian influenza was detected in the birds. On Wednesday, Chile's Agriculture and Livestock Service said all infected birds will be culled and the area will be kept under surveillance.

Avian flu is not as common in South America as it is in China, Europe, and North America. Authorities said no humans have been infected in Chile and there is little to no risk to the general public. In 2002, Chile experienced its first avian influenza outbreak, which severely limited poultry exports.
Jan 5 Reuters story
Jan 5 AFD post

H5N6 genotype causing widespread bird flu activity in South Korea

In today's Eurosurveillance, a new study explains that a novel genotype of highly pathogenic H5N6 avian influenza is behind South Korea's current avian influenza outbreak. South Korea has been hard hit with H5N6 this fall and winter.

The researchers examined the H5N6 clade 2.3.4.4, first found in wild bird fecal samples in October of 2016 in South Korea. They determined the strain is a novel reassortant of virus subtypes H5N6, H4N2 and H1N1. By mid-November, this strain was causing poultry outbreaks across the country.

Initial animal studies have shown this strain to be particularly pathogenic in chickens, which explains why it traveled from wild birds to poultry populations quickly, the researchers said.
Jan 5 Eurosurveill study

Stewardship / Resistance Scan for Jan 05, 2017

News brief

Decreasing susceptibility to front-line antibiotics seen in Dutch gonorrhea

An analysis of Neisseria gonorrhea isolates from a sexually transmitted infection (STI) clinic in Amsterdam shows a rise in decreased susceptibility to azithromycin and ceftriaxone, researchers report today in Eurosurveillance.

Researchers found that, of the 3,151isolates obtained from the STI Outpatient Clinic from January 2012 through September 2015, only 38 (1.2%) were resistant to azithromycin, while none were resistant to ceftriaxone. But analysis of minimum inhibitory concentrations (MICs) showed that the percentage of isolates with intermediate MICs (> 0.25 and ≤ 0.5 mg/L) for azithromycin increased from 3.7% in 2012 to 8.6% in 2015, an indication of decreased susceptibility. In addition, the proportion of isolates showing decreased susceptibility to ceftriaxone rose from 3.6% in 2012 to 8.4% in 2015.

Decreasing susceptibility to both azithromycin and ceftriaxone was noted particularly among men who have sex with men, with isolates from more recent infections (those diagnosed in 2014) were also more likely to show decreased susceptibility. Among heterosexuals, decreased susceptibility to azithromycin and ceftriaxone was more likely to be observed in individuals who had more than 10 sexual partners, while being diagnosed in 2014 or 2015 was only significantly associated with decreased susceptibility to ceftriaxone.

International guidelines currently recommend dual therapy with ceftriaxone and azithromycin as the primary treatment for gonorrhea. But the bacterium's history of developing resistance to antibiotics, along with recent reports of high-level azithromycin-resistant gonorrhea in the United Kingdom and rising resistance to ceftriaxone in other countries, has raised the concern that the STI could become much more difficult to treat.

While the study shows that resistance to azithromycin and ceftriaxone is lower in Amsterdam than in other European countries, the authors caution that the rise in decreased susceptibility, coupled with higher resistance in other countries and increasing globalization, highlights the need for continued surveillance and development of new treatment strategies.
Jan 5 Eurosurveill research article

Petition calls for fast-food companies to ban antibiotics in meat, poultry

A petition signed by more than 125,000 people was delivered today to the CEOs of 16 fast-food companies, calling on them to stop selling meat and poultry raised on medically important antibiotics.

The fast-food companies targeted in the petition effort all received an "F" in the most recent Chain Reaction report from the Center for Food Safety, Consumers Union, Friends of the Earth, Natural Resources Defense Council, and Food Animals Concerns Trust. The report grades America's 25 largest fast-food and fast-casual chains on their meat and poultry antibiotics policies. Experts believe the use of medically important antibiotics in food-producing animals is contributing to the emergence of antibiotic resistance.

The petition is the latest in a series of campaigns to put public pressure on restaurant chains to commit to eliminating the use of medically important antibiotic in the meat and poultry they sell. The Center for Food Safety, Consumers Union, and US Public Interest Group have been gathering signatures since the Chain Reaction report was released in September.

"Antibiotics should only be used to treat disease, not wasted on healthy animals or to compensate for filthy conditions on factory farms," Jean Halloran, director of food policy initiatives at Consumers Union, said in a press release. "It's time for restaurants to help protect public health by demanding that their suppliers end the irresponsible use of these important medications."

One of the targeted companies is Burger King, whose parent company—Restaurant Brands International—announced last week that it would stop selling chicken raised on antibiotics in 2017. But that move was deemed insufficient because the company agreed only to eliminate those antibiotics considered "the most critical" in human medicine.

Other companies on the list include Wendy's, KFC, Arby's, and Taco Bell.
Jan 5 Consumers Union press release