June 07, 2018
Outbreak of Nipah virus in India. As of June 1 of this year, Nipah virus had killed 16 of the 18 confirmed cases in Kozhikode, in the state of Kerala, India. The zoonotic virus, spread to humans by contact with an infected person or animal or by ingesting contaminated food or water, can cause acute respiratory symptoms or encephalitis. Among the fatal cases were three members of one family whose well was believed to be contaminated by fruit bats, and a nurse who cared for the ill family members. Health officials believe the current outbreak is controlled. Outbreaks have occurred in India in 2001 and 2007 and in Bangladesh almost every year since 2001. A vaccine is in development. [World Health Organization, The Quint, BBC, MediBulletin, The Times of India, The News Minute, Al Jazeera]
Even low-efficacy influenza vaccines can reduce flu impact. Researchers at Yale School of Public Health estimate that even a low-efficacy seasonal influenza vaccine can have a high impact in reducing population morbidity and mortality. According to results from their mathematical modeling analysis, annual flu infections in the US cause 9.2 to 35.6 million infections, between 140,000 and 710,000 hospitalizations, and 12,000 to 56,000 deaths. Without the flu vaccine, those numbers would likely go up to 77 million infections, 470,000 hospitalizations, and 130,000 deaths. [EurekAlert, PNAS]
Risk of adverse effects from oral antibiotics is higher in young adults. A study of adverse events based on US national surveillance data and databases of dispensed prescriptions has found that antibiotics were responsible for 13.7% of emergency department visits for adverse events (AE). Over half of the antibiotic AE visits were by adults under fifty years of age, and 71.8% were females. Young adults went to the emergency department at twice the rate of adults over age sixty-five. The main reason for these visits was allergy to the antibiotic. [Journal of General Internal Medicine]
Diagnostic test does not reduce antibiotic prescribing. In 2017, a rapid test measuring the level of procalcitonin in blood was approved by the US Food and Drug Administration as a diagnostic tool to indicate the likelihood that a patient’s infection is bacterial rather than viral. In a clinical trial examining the impact of the diagnostic test on physicians’ antibiotic prescribing, researchers found that the availability of test results did not reduce antibiotic prescribing for lower respiratory tract infections. In the patient group whose physicians had access to the diagnostic test results, 57% of patients received antibiotics within 30 days of their initial consultation and 34% received a prescription in the emergency department. Results for the patients whose doctors did not have the test results were 62% and 39% for the same measures. The differences were not statistically significant. [NEJM, EurekAlert, CIDRAP]
New hurdles in struggle to eliminate leishmaniasis.Newly discovered strains of visceral leishmaniasis parasites in Nepal and Sri Lanka could change the epidemiology of the infection in the region, with implications for diagnosis, treatment, and disease elimination strategy. In a recent paper about the new strains, genetic sequencing and metabolic analysis were used to compare the new strains and the dominant strain. Researchers identified differences in pathogenicity, drug susceptibility, and virulence. [SciDevNet, Infection, Genetics, and Evolution]
Pointed stewardship is needed to protect newborns from unnecessary antibiotic exposure. A study of forty thousand infants in 300 US neonatal intensive care units reported that over three-fourths of very low birthweight premature infants (1500 g.) received antibiotics within the first three days of birth. Prolonged duration (more than five days) of antibiotics in premature infants ranged from zero to seventy-five percent across 113 hospitals. [JAMA, EurekAlert, JAMA Editorial]
“Mosquito disease will increase unless we limit global warming.” In a paper published in the Proceedings of the National Academy of Sciences, researchers have quantified the potential expansion of dengue territory due to global warming in Latin America and the Caribbean. They predicted that by limiting global warming to 2°C above preindustrial levels, approximately 2.8 million dengue cases could be avoided each year. [EurekAlert, PNAS]
Researchers define what it takes for a pathogen to cause a pandemic. Johns Hopkins Center for Health Security has released a list of the characteristics of microorganisms most likely to cause an infectious disease pandemic. According to their Pandemic Pathogens Report, in order to meet the criteria of a global catastrophic biological risk (GCBR), a pathogen—probably a virus—will likely be transmitted from human to human via respiratory secretions, have the ability to evade the immune system, be fatal to some people while other infected people remain asymptomatic, and be transmissible during the incubation period. [EurekAlert, Center for Health Security]
New Zealand hopes to prevent Mycoplasma bovis from becoming endemic on farms. The Ministry of Primary Industries plans to cull 126,000 cows in New Zealand in order to eradicate Mycoplasma bovis, a tiny infectious bacterium with no cell wall that is spread via the respiratory secretions and milk of infected cows. The infection causes bovine illnesses including mastitis, arthritis, pneumonia, ear infections, and abortion, which are costly to dairy operations even though the bacterium is not a threat to human health. M. bovis was found for the first time in New Zealand in July 2017 and has spread from one farm to almost two hundred. [CBS News, The Guardian]
Image adapted from original (CC BY 4.0).
