News Scan for Nov 21, 2016

News brief

New case of MERS confirmed in Saudi Arabia

The Saudi Arabian Ministry of Health (MOH) reported a new case of MERS-CoV yesterday. The patient is in critical condition.

A 59-year-old Saudi woman from Najran had symptoms of MERS-CoV (Middle East respiratory syndrome coronavirus) before being admitted to a hospital. The MOH listed her source of infection as primary, meaning she did not contract the virus from another person.

The new case raises Saudi Arabia's MERS-CoV total to 1,485, of which 617 have been fatal. Thirteen people are being treated for their infections.
Nov 21 MOH report

2-dose HPV vaccine schedule as effective as 3-dose

The results of a new noninferiority trial, published today in the Journal of the American Medical Association (JAMA), suggest that 2 doses of the 9-valent human papillomavirus (HPV) vaccine in boys and girls aged 9 to 14, are as effective as 3 doses of the vaccine in adolescent girls and young women aged 16 to 26 years. In October, the Centers for Disease Control and Prevention (CDC) recommended a 2-dose schedule for adolescents starting the HPV vaccination series before the age of 15.

The post-licensure study looked at the antibody responses in 1,518 subject 4 weeks after receiving the vaccine on a 2-dose schedule (each dose given 6 months apart) compared to antibodies in those who received 3 doses of the vaccine within 6 months. Immunogenicity was noninferior in the 2-dose group. More than 98% of participants in each cohort group seroconverted to the HPV vaccine strains within 1 month.

A 2-dose regimen could help with vaccine compliance and uptake. An editorial in JAMA written by Lauri E. Markowitz, MD, and colleagues from the CDC, said "…[r]educed dose schedules might help achieve higher HPV vaccination coverage, advance HPV vaccine program introductions in more countries, and further reduce the burden of HPV-associated cancers and disease worldwide"

The 9-valent vaccine protects against 7 high-risk types of HPV responsible for 90% of cervical cancers and 2 other HPV types accounting for 90% of genital warts. The European Medicines Agency and the World Health Organization had already approved a 2-dose schedule for the vaccine earlier this year.
Nov 21 JAMA study
Nov 21 JAMA editorial

Trump met with anti-vaccine group during campaign

President-elect Donald Trump met with prominent anti-vaccine proponents during fundraising events this summer, including disbarred physician Andrew Wakefield, the man who erroneously linked autism to the measles-mumps-rubella (MMR) vaccine in 1998. Details of Trump's meeting appeared in a Nov 18 Science magazine story.

The story alleges that Trump met with key leaders in the anti-vaccine movement during an Aug 11 Florida fundraiser, and promised to watch "Vaxxed," Wakefield's documentary about autism and immunizations. According to attendees, Trump listened to a 45-minute presentation about autism and its potential link to vaccines, which has been disproved and discredited several times in the last 20 years, and which the US Institute of Medicine does not support.

In 2014, Trump tweeted "Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn't feel good and changes – AUTISM. Many such cases!" and used anti-vaccine rhetoric during debates and speeches.

As president, Trump will be able to appoint the head of the Centers for Disease Control and Prevention (CDC), and the head of the Food and Drug Administration (FDA).
Nov 18 Science article

PAHO reports 231 new chikungunya cases in the Americas

After reporting well over 100,000 new chikungunya cases a week ago, the Pan American Health Organization (PAHO) late last week reported only 231 new cases, mostly in Guatemala.

Countries and territories in the Americas this year have now reported 441,306 suspected, confirmed, and imported cases, according to the Nov 18 PAHO update. The 2 previous weeks saw increases of 440 and 137,528 new cases, respectively.

Guatemala saw the largest increase, with 209 new cases and 5,036 for the year. Costa Rica had 87 new cases, to bring its 2016 total to 3,215. Colombia, in contrast, dropped its official count by 121 cases, from 19,399 to 19,278.

Many countries, however, have not reported for several weeks. Brazil, , which was largely responsible for the previous week's large spike as it did catch-up reporting, has yet to report on its most recent 9 weeks of data. Brazil has by far the most cases this year, at 352,810.

PAHO reported no new chikungunya-related deaths last week, leaving that figure at 135.

Starting in late 2013 on the Caribbean island of St. Martin, the Americas' chikungunya outbreak has now sickened 2,319,746 people.
Nov 18 PAHO update

Flu Scan for Nov 21, 2016

News brief

China reports fatal H5N6 infection

Health officials from China's Hunan province today said a 47-year-old woman who worked as a farmer in Shaoyang City has died from an H5N6 avian flu infection, Xinhua, China's state news agency, reported today. The woman's illness marks the 16th infection from H5N6, 10 of which were fatal.

According to the report, she had contact with dead poultry before she got sick and was admitted to the hospital in critical condition on Nov 18, where she died yesterday. Her infection was also reported in a notification to the United Nations Food and Agriculture Organization (FAO).

The virus is a novel reassortant between H5N1 and H6N6 that was first detected in a Chinese poultry market in 2014, with the country reporting its first human case a few months later. H5N6 has been detected in other locations, such as Vietnam, Laos, Hong Kong, South Korea, and Japan. But so far human cases have been comfirmed only in China, which reported its most recent such illness in May.
Nov 21 Xinhua story
Nov 21 FAO page with link to H5N6 case report
FluTrackers H5N6 case list

FDA approves expanded indication for GSK flu vaccine

GlaxoSmithKline (GSK) announced it has received approval from the US Food and Drug Administration (FDA) for an expanded indication for its FluLaval Quadrivalent flu vaccine to allow its use in children 6 months of age and older. The vaccine had previously been approved for use in those 3 years and older.

In a Nov 18 statement announcing the FDA approval, GSK said that, before the expanded age indication for FluLaval Quadrivalent, providers who preferred using prefilled syringes had to order and stock two separate flu vaccines to immunize all patients. The FDA's action allows providers to use the same dose of FluLaval to vaccinate all people age 6 months and older who are recommended to be vaccinated.

GSK said its application for the expanded indication was based on a pivotal phase 3 study and three supportive clinical studies in children ages 6 through 35 months old.
Nov 18 GSK press release