News Scan for Apr 06, 2021

News brief

CARB-X awards funding for rapid sexually transmitted infections test

CARB-X announced today that it is awarding up to $3.6 million in funding to Novel Microdevices, Inc. of Baltimore to develop a rapid, portable molecular diagnostic test for sexually transmitted bacterial infections.

Novel's rapid point-of-care test, which is in the early stages of development, would be able to diagnose Neisseria gonorrhoea or Chlamydia trachomatis infections in 25 minutes from a vaginal swab or urine sample, and detect genetic mutations that indicate resistance to antibiotics. The lightweight, battery-powered device is particularly suited to low-resource healthcare settings.

The device will be eligible for an additional $10.2 million from CARB-X (the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator) if certain project milestones are met.

"Novel's technology is in the early stages of development and, if successful, could be used world-wide to help health-care providers diagnose gonorrhea, including resistance markers, more rapidly, thus improving treatment decisions, and mitigating the devastating effects of these diseases," CARB-X research and development chief Erin Duffy, PhD, said in a press release.

Drug-resistant gonorrhea has been identified by the World Health Organization (WHO) as a high-priority pathogen.
Apr 6 CARB-X press release

Four more Ebola cases reported in Guinea's outbreak

Four more cases have been reported in Guinea's Ebola outbreak, raising the total to 23, the WHO African regional office said today on Twitter.

On Apr 1, the country confirmed a new case after not reporting any new infections in the outbreak since Mar 4. Media reports said last week's case was found amid a cluster of suspicious deaths in the area and reports that some sick people had fled the area.

Today's WHO update also reflects 3 more deaths, raising the fatality count to 12.
Apr 6 WHO African regional office tweet
Apr 2 CIDRAP News scan

In another Ebola development, Bavarian Nordic announced today that it has received a new supply order from Janssen worth $28 million to make and deliver bulk MVA-BN Filo, the prime-boost vaccine Ebola vaccine licensed to Janssen.

The vaccine was developed during West Africa's massive outbreak and has been tested in Europe and Africa. The European Commission approved the vaccine in 2020, and the WHO is assessing the vaccine for prequalification, which would allow broader rollout in at-risk African countries.

Bulk production will begin in May, with delivery expected in the second half of 2021.
Apr 6 Bavarian Nordic press release

Study shows HPV vaccine exposure in pregnancy is safe

New data on women who received the human papillomavirus (HPV) vaccine inadvertently in early pregnancy shows the vaccine did not cause miscarriages or adverse birth outcomes, according to a study yesterday in JAMA Network Open.

The HPV vaccine is not recommend in pregnancy, but safety data are limited on inadvertent exposure.

To conduct the study, US researchers looked women with vaccine exposures from 12 months before the last menstrual period before conception through 20 weeks of pregnancy at seven Vaccine Safety Datalink (VSD) sites across the country. A total of 1,493 pregnancies were included.

Neither the nine-valent (9v, or nine-strain) nor quadrivalent (four-strain) HPV vaccines were associated with an increased risk of miscarriage or preterm birth. HPV vaccine exposures during pregnancy (relative risk [RR], 1.31; 95% confidence interval [CI], 0.78-2.20), peripregnancy (RR, 1.10; 95% CI, 0.65-1.88), and during pregnancy or peripregnancy (RR, 1.18; 95% CI, 0.75-1.85) were not associated with small-for-gestational-age at birth, either, the authors wrote.

"We believe that this research supports current recommendations by the Advisory Committee on Immunization Practices that 9vHPV vaccine, although not recommended for use during pregnancy, can be administered to female individuals of reproductive age without routine pregnancy testing," the authors concluded.
Apr 5 JAMA Netw Open study

COVID-19 Scan for Apr 06, 2021

News brief

Nearly 40,000 US children have lost a parent to COVID-19, study estimates

Nearly 40,000 US children 17 or younger may have lost a parent due to COVID-19 infection, according to a statistical model in JAMA Pediatrics today.

The results, published as a research letter, suggested that 1 in 13 COVID deaths result in a child losing a parent and that, as of February 2021, 37,300 children have been affected—more than 43,000 if using excess death data.

A quarter of children who have lost a parent are of elementary school age, according to the model, and 20% of all children experiencing parental bereavement are Black, even though Black children make up only 14% of the country's population. And the pandemic has increased parental bereavement 18% to 20%, according to the researchers. Estimates were calculated using demographic microsimulations from SocSim.

Losing a parent can cause prolonged traumatic grief and depression, reduced educational achievement, greater economic insecurity, and more accidental death or suicide, the researchers write. While evidence-based, brief interventions can help with some of these issues, the researchers note that some children may need longer-term support.

"The first thing we need to do is to proactively connect all children to the available supports they are entitled to, like Social Security child survivor benefits—research shows only about half of eligible children are connected to these programs in normal circumstances, but that those who do fare much better," said senior author Ashton Verdery, PhD, in a Penn State press release.

"We should also consider expanding eligibility to these resources. Second, a national effort to identify and provide counseling and related resources to all children who lose a parent is vital."
Apr 5 JAMA Pediatr research letter
Apr 5 Penn State press release

Church chorister tied to 12 COVID cases, with aerosol spread likely

A member of a church choir was identified as an index patient for COVID-19, causing 12 secondary cases, at a church in Sydney, Australia, this past summer, with aerosol transmission very likely, according to Emerging Infectious Diseases yesterday.

A number of secondary cases were 15 meters (49 feet) or greater away from the index patient, so researchers believe transmission primarily occurred through aerosols.

The index patient, an 18-year-old man, first got tested Jul 17, 2020, after learning of possible exposure at a venue he attended on Jul 11 and developing symptoms of malaise and headache (Jul 16) as well as cough and fever (Jul 17). During his infectious period (which began 48 hours before symptom onset), the man acted as a church chorister and sang at four 1-hour services on Jul 15, 16, and 17.

While Centers for Disease Control and Prevention (CDC) guidelines indicated that only 10 other choristers and staff were close contacts, the first two positive COVID tests came from physically distanced congregation members whom the index patient did not know. The investigators then considered all church attendees to be close contacts (508), resulting in a 2.4% attack rate after 12 secondary cases were identified from 434 tests taken up to 17 days after exposure.

All secondary patients sat within a section of the round church 3.5 meters below the choir loft and 1 to 15 meters away from the index patient, the investigation found. The index patient faced away from the congregation while playing a piano, used a microphone, and didn't touch any church objects or interact with the congregation. The church did not have any mask guidelines in place and had minimal ventilation.

After the outbreak occurred, Sydney's COVID guidelines for places of worship became stricter, such as increasing distance from singers to audience to 5 meters, but the researchers say additional mitigations may be needed.
Apr 5 Emerg Infect Dis report