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March 13, 2015

A roundup of news on drug resistance and other topics in global health.
Which antibiotics has the FDA approved in the last year? Will they help combat antibiotic resistance? A new post on the CDDEP blog by Ursula Theuretzbacher of the Center for Anti-Infective Agents in Vienna, Austria investigates these questions. Theuretzbacher gives an overview of how the six new approvals will help treat resistant bacteria in certain patient populations, but Dr. Theuretzbacher notes that larger economic incentives are still lacking for the development of new antibiotics. She also provides an in-depth description of each antibiotic, giving expert detail and context for these new drugs that have been in development for years and even decades. [CDDEP]

Among the strategies under discussion for reducing falciparum malaria transmission, possibly leading to eradication, is adding a single low dose of primaquine (a drug used mainly to treat vivax malaria) or a related drug, to curative treatment with an artemisinin-combination therapy (ACT).  Primaquine kills the blood-borne gametocyte stages, which, when ingested by mosquitoes, start the cycle for another round of infection when the mosquito bites again in 10 days. Gametocytes do not, however, cause malaria symptoms. A systematic review, co-authored by CDDEP Associate Director Hellen Gelband, confirms that the drug does reduce the numbers of circulating gametocytes, but whether it can reduce community infection levels is still an open question.  Primaquine and drugs like it can sometimes precipitate a severe reaction, especially in people with G6PD deficiency, caused by a range of genetic variants common in Africa and other places where falciparum malaria is endemic. Because eliminating gametocytes is of no clinical benefit to the patient, there is a need to balance any potential community benefit with the potential for individual harm. [Cochrane]

More than 10,000 people have died of Ebola in West Africa, according to a World Health Organization announcement this week, out of an overall 24,350 cases. WHO officials estimate that the region could be declared free of the disease within months if enough funding and support is garnered, but that the greatest challenge to ending the outbreak is waning global interest.  A paper published in Science found that the region may now be in danger of another disease epidemic: vaccination rates for measles have dropped significantly due to the strain on the health care infrastructure, which could cause a resurgence of measles and other vaccine-preventable diseases. [WHO, Reuters, Science]
Poultry giant Tyson Foods has removed the antibiotic gentamicin from its chicken farms. Gentamicin is considered “highly important” for human health according to the FDA; Tyson reported that its 35 hatcheries have not used the drug since October 2014. The company is a major chicken supplier for McDonald’s, which pledged last week to phase out antibiotics important for human health from its US chicken supply. [Reuters]
Europe is experiencing high levels of primary transmission for multidrug-resistant tuberculosis (MDR-TB). A study published in Emerging Infectious Diseases found that half of patients treated for MDR-TB in the WHO European region had not been treated for tuberculosis previously, indicating that multidrug-resistant strains are spreading between individuals. The researchers also found that MDR-TB was ten times more prevalent in non-European Union/European Economic Area countries than those in the EU/EEA. [Emerging Infectious Diseases]
Mozambique, Malawi, and Zimbabwe have seen an outbreak of cholera affecting over 6,000 people after heavy rains in the area spread the bacteria, which is caused by contact with infected water sources. The record-setting rains and poor sanitation likely both contributed to the dispersal, though some human rights advocates have also blamed state governments for not being prepared for potential outbreaks. [Voice of America]
MIT researchers found that the strain of H1N1 swine flu currently circulating in India may have acquired dangerous mutations. Their study, published in Cell Host and Microbe, concluded that the virus contains changes linked to enhanced virulence that may render it distinctly different from the 2009 strain that the current vaccine targets. The Indian Health Ministry responded to the study and stated that their own study’s findings imply no changes in the strain of the virus. [Cell Host and Microbe, Outbreak News Today]
Households can be reservoirs for methicillin-resistant Staphylococcus aureus (MRSA) for years. Researchers studied MRSA samples from 21 homes in Los Angeles and Chicago, and used whole genome sequencing to analyze 146 samples of the predominant community-associated strain of MRSA from the US, US300. They found that a single strain can stay in a household for years and spread between residents, at times eventually evolving to become unique to the specific home. [mBio]
It may be effective for boys to get the HPV vaccine, too. Duke University researchers compared two types of HPV vaccination programs: those that exclusively focus on raising vaccine coverage in girls and those that devote some portion of funding to vaccinating boys as well. Their study found that the latter strategy may “protect more people for the same price”. Since 2014 the CDC has recommended that boys get the vaccine as well and estimates that up to one third of the 27,000 annual HPV-caused cancer cases in the US occur in men. [Epidemics, CDC]
Want to share interesting news with the digest? Email [email protected]
Ebola workers photo courtesy Wikimedia Commons.
 

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