News Scan for Aug 04, 2016

News brief

Saudi Arabia reports new MERS case in Medina

Saudi Arabia confirmed a new MERS-CoV case today in Medina, according to its Ministry of Health (MOH).

Although little information was provided on the MERS-CoV (Middle East respiratory syndrome coronavirus) case in the MOH's English-language update, the Arabic version provided more details, according to a post today from Avian Flu Diary, an infectious disease blog. A 70-year-old man is infected and is hospitalized in stable condition, according to the post. How he contracted the virus is under investigation.

The most recent previous case in Medina was reported by the MOH on Jun 15. Today's case brings the total in the country since the outbreak began in 2012 to 1,444, including 608 fatalities.
Aug 4 MOH statement
Aug 4 Avian Flu Diary blog post

CDC announces biosafety director for high-containment federal labs

After months of security issues at US high-containment government labs, the Centers for Disease Control and Prevention (CDC) this week announced a permanent director of the agency's Division of Select Agents and Toxins (DSAT), the department that coordinates work on the most dangerous pathogens, like those that cause anthrax, Ebola virus disease, and highly pathogenic avian flu.

In September Samuel S. Edwin, PhD, will replace Dan Sosin, MD, MPH, who has been acting as the division's director since November 2015. Sosin will return to his position as deputy director and chief medical officer of the CDC's Office of Public Health Preparedness and Response.

Edwin most recently was head of biosafety at the US Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick, Md. He has 30 years of experience in biomedical research.

"DSAT oversees two regulatory programs—the Federal Select Agent Program [FSAP] and the Import Permit Program [IPP]—to ensure that laboratory work with infectious biological agents is conducted as safely and securely as possible," the CDC said in an Aug 2 news release.

The FSAP, which is managed jointly by the CDC and the US Department of Agriculture, oversees about 300 labs across the country that are registered to work with 65 select agents and toxins. It employs almost 10,000 researchers.

The IPP regulates the importation of infectious biological agents that could cause human disease.

In September 2015 the CDC appointed Stephan Monroe, PhD, as permanent director of safety in its own labs. He had served as interim director since May 2015.
Aug 2 CDC news release
Sep 15, 2015, CIDRAP News story "CDC appoints permanent lab safety chief"

H5N1 strikes poultry in Nigeria again

The H5N1 avian influenza virus has struck another poultry farm in Nigeria, government officials said in a report to the World Organization for Animal Health (OIE) yesterday.

The virus killed 886 of 1,647 chickens and turkeys on a farm in the southwestern province of Oyo, the report said. The outbreak was continuing, and plans called for destroying all the birds on the farm to prevent further spread of the infection. The source of the virus was unknown.

Nigeria has had dozens of H5N1 outbreaks since the virus re-emerged there in December 2014 after a several-year hiatus. The latest previous outbreak was reported in June.
Aug 3 OIE report

Human H5N6 cases in China were preceded by spread in poultry markets

Two human cases of H5N6 avian flu in Shenzen, China, were foreshadowed by the spread of the virus in local live poultry markets (LPMs), illustrating the importance of poultry market surveillance for public health, according to a report published yesterday in Emerging Microbes & Infections.

China has reported 15 human H5N6 infections with 9 deaths since April 2014, according to a case list maintained by FluTrackers, an infectious disease message board.

The new report says routine H5N6 surveillance was conducted in Shenzen's LPMs from June 2015 until January 2016. No H5N6 viruses were detected until November 2015, but the number of detections increased sharply in December, with the virus cropping up in markets throughout the city.

Two human H5N6 cases were identified in late December and early January, and both patients had a history of exposure to poultry, the report says. H5N6 isolates from the patients were similar to those from LPM environmental samples. They differed from previous H5N6 viruses in that they had six internal genes derived from H9N2 or H7N9 viruses.

"The increased H5N6 virus-positive rate in the LPMs and the subsequent human infections demonstrated that sustained LPM surveillance for avian influenza viruses provides an early warning for human infections," the authors wrote. "Interventions, such as LPM closures, should be immediately implemented to reduce the risk of human infection with the H5N6 virus when the virus is widely detected during LPM surveillance."

The report notes that LPM closures have been effective in reducing the risk of H7N9 and H5N1 cases in humans.
Aug 3 Emerg Microb Infect report
FluTrackers H5N6 case list

Antimicrobial Resistance Scan for Aug 04, 2016

News brief

Reports note steps for streamlining antibacterial clinical trials

A series of articles in a supplement to the latest issue of Clinical Infectious Diseases address what is termed a "crisis" in antibiotic development with recommendations to improve a critical stage in the process—clinical trials.

The journal supplement, titled "Facilitating Antibacterial Drug Development in a Time of Great Need," focuses on advancing and streamlining clinical trials, which are a critical part of the drug development process but which for antibiotics have become overly complicated, expensive, and lengthy to conduct. In particular, the supplement features articles that address the challenges of designing such trials for hospital-acquired or ventilator-associated bacterial pneumonia (HABP/VABP), which are hampered by low enrollment, protocol complexities, and high costs.

The recommendations from the Clinical Trials Transformation Initiative (CTTI)—a public-private partnership that includes government officials, academics, and pharmaceutical industry executives—focus on four keys area areas that could improve HABP/VABP clinical trials: informed consent, protocol design, choice of institutional review board, and efficacy outcome measures. In another paper, CTTI offers suggestions to streamline the process of collecting safety data. These approaches will be tested in an upcoming pilot study.

"The need for new therapeutic and diagnostic options to address the public health crisis of antibiotic resistance and the need to modernize the design and conduct of clinical trials are international issues," Leanne Madre and Pamela Tenaerts of CTTI write in the introduction to the supplement. "Our hope is that the recommendations, activities, and ideas presented highlight the importance of public-private partnerships that are patient-centric and provide proof that streamlining HABP/VABP trials is possible."
Aug 2 Clin Infect Dis supplement

Drug-resistant Salmonella isolates identified in imported food products

A new study by the Food and Drug Administration has found antibiotic resistance in more than 20% of Salmonella enterica serovars isolated from food products imported into the US between 2011 and 2013.

The study, published this week in the Journal of Food Protection, found that 23 of 110 nontyphoidal S enterica (NTS) isolates showed resistance to various classes of antibiotics, including beta-lactams and fluoroquinolones, with 12 of the 23 showing resistance to more than three classes. One strain in particular was resistant to all antimicrobial agents tested except amoxicillin and clavulanic acid. The most common strains identified among the 23 drug-resistant isolates were S senftenberg and S enteritidis.

The contaminated food products included vegetables, fruits, meats, and seafood imported mainly from Southeast and East Asian countries. Drug-resistant NTS strains were predominantly found in products imported from Taiwan, Vietnam, Indonesia, and China.

According to the authors, NTS strains are considered the most common foodborne causes of gastroenteritis, enteric fever, diarrhea, and bacteremia. But only some NTS serovars are commonly associated with outbreaks. Serotyping NTS isolates is important for monitoring and tracking these pathogens, the researchers said, and this type of monitoring data could be used to improve food safety programs.
August J Food Prot abstract