Weekly Digest: Measles in California, Ebola cases decline, genetics of malaria drug resistance

Physician competition may be driving up antibiotic prescriptions in certain areas of the US, according to a new study by CDDEP researchers published in the Journal of Antimicrobial Chemotherapy. The study found that changes in the healthcare landscape, particularly the expansion of urgent care and retail clinics in wealthier areas, are increasing physician competition and raising outpatient antibiotic prescription rates. Lead author and CDDEP fellow Eili Klein explained the research in a post on the CDDEP blog. [Journal of Antimicrobial Chemotherapy, CDDEP]

An op-ed was published today in the Nepali Times on the growth of antibiotic resistance in the country, written by Global Antibiotic Resistance Partnership (GARP)-Nepal working group coordinator Buddha Bansyat and CDDEP Associate Director Hellen Gelband. The commentary focused on the growing global problem of antibiotic-resistant bacteria and the variety of ways Nepal can address the issue while ensuring that those who need antibiotics have access to them. Also published this week: part two of our interview with Global Antibiotic Resistance Partnership (GARP)-Kenya coordinator Eveline Wesangula, on the challenges and opportunities of working in Kenya to combat resistance. [Nepali Times, CDDEP]

The measles outbreak in California that began at Disneyland has spread to people who haven’t visited the park. In all, 70 measles cases have been reported since mid-December, with 62 in California and the rest in four surrounding states and Mexico. The outbreak is of particular significance in light of a recent decline in vaccinations in the state following the anti-vaccine movement. Nationwide, 2014 saw by far the most measles cases on record since the disease was declared eliminated in the US, with 644 cases—more than twice as many as any year in the previous two decades. [Los Angeles Times, The Washington Post]

Mali has been declared free of Ebola, after 42 consecutive days of no new cases of the disease. In addition, the United Nations found a decline in new cases of the virus in all the three significantly affected countries in West Africa—Guinea and Sierra Leone reported their lowest counts since last August this past week, and Liberia the lowest since last June. Also this week, the first batch of an experimental Ebola vaccine was sent to Liberia, but with the number of cases declining, experts said that it would be harder to establish the efficacy of the vaccine. [BBC, The Guardian]

Researchers have identified at least twenty genetic mutations that contribute to malarial drug resistance. The study, published in Nature Genetics, revealed genome-wide architecture of the Plasmodium falciparum parasite using data from 15 locations in Southeast Asia, and identified causes of resistance to artemisinin, one of the most widely used and effective treatments currently available for the disease. [Nature Genetics]

Medical charity Doctors Without Borders (MSF) is calling for a major price cut for vaccines in developing countries, asking pharmaceutical companies GlaxoSmithKline (GSK) and Pfizer to reduce the price of the particularly expensive pneumococcal vaccine to $5 per child. The organization also reported a critical lack of data on vaccine prices and is partnering with The Guardian to ask people around the world to fill out a survey on local prices for the vaccine. According to the MSF report, the cost to fully vaccinate a child today is 68 times what it was in 2001. [MSF, The Guardian]

Travelers who use antibiotics abroad are more likely to become infected drug-resistant bacteria, and to bring the bacteria back home after their travels, according to a study published this week in Clinical Infectious Diseases. The researchers investigated 430 Finnish travelers, some of whom had self-treated traveler’s diarrhea with antibiotics while abroad. Twenty-one percent of total travelers had contracted the bacteria, but of those who had taken the antibiotics, the number jumped to 37 percent—and was 80 percent for the highest-risk travel area, South Asia. [Clinical Infectious Diseases, Science Blog]

Bureaucracy is blocking access to life-saving tuberculosis drugs in India, according to an investigation in the Wall Street Journal by columnist Geeta Anand. Anand noted that India has the highest incidence of tuberculosis in the world, where many of the country’s millions of TB cases remain untreated due to paperwork, drug approval hurdles and government over-regulation. A recent article in The Hindu reported that TB cases in India are declining by around 2% per year, a significant contrast the annual decline of 19-20% required to meet the WHO 2050 elimination target. [The Wall Street Journal, The Hindu]

CDDEP is seeking to hire a Research Analyst in Economics for its New Delhi, India office. For more information and to apply, visit CDDEP’s jobs page. [CDDEP]