Weekly Digest: New guidelines on antimicrobial use; Yellow fever outbreak spreads

“Discussion and collaboration between the United States and European countries is essential, yet we still need innovative strategies to implement policies, stewardship, and surveillance in low- and middle-income countries (LMICs) where health infrastructure is weaker,” was the take-away from “Taking on Antibiotic Resistance: Opportunities to Keep Antibiotics Working for Our Future,” a seminar organized by the Dutch government, held in Washington, D.C. In a CDDEP blogpost, Research Analyst Elena Martinez recapped the event, which included international researchers, government officials, food producers and policy experts. Topics discussed at the seminar included antibiotic stewardship, continued research on connections between animal antibiotic use and human health, data sharing and effective international surveillance of outbreaks. [CDDEP]

U.S. public health officials declared this week that Zika virus is “scarier than we initially thought.” CDC Director Tom Frieden announced that it is clear that Zika causes microcephaly, and also warned that it could also be causing other neurological conditions and serious birth defects. Zika has now been tied to acute disseminated encephalomyelitis (ADME), a rare autoimmune disease that causes inflammation of the brain and spinal cord. Research published in Science examined the virus’ interactions with neural stem cells and concluded that the virus specifically targets brain cells, killing off some and deforming others. The New York Times criticized the U.S. Congress for not “doing its job” when a majority of representatives refused to vote on legislation to appropriate $1.8 billion to fight Zika. [BBC, The Washington Post, Science, The New York Times]

New hospital antibiotic stewardship guidelines recommend preauthorization for broad-spectrum antibiotics and treatment review after two to three days on antibiotics. The new guidelines from the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) were published in Clinical Infectious Diseases. The guidelines are an update to a 2007 edition that has been criticized for being too focused on broad cost-saving measures rather than appropriate use for each patient. The new instructions highlight patient-level measures to optimize use, and encourage hospitals to tailor appropriate treatment to specific cases. “We really wanted to get across the point that every hospital, every facility really could do an activity that is related to antibiotic stewardship,” noted lead author Tamar Barlam. [Medscape, Clinical Infectious Diseases]

The ongoing yellow fever outbreak that began in Angola has spread to the Democratic Republic of the Congo (DRC), where 21 people have died. In a statement released this week, the World Health Organization declared that the outbreak “constitutes a potential threat for the entire world.” A global shortage of the yellow fever vaccine, which is produced at only four facilities in the world, has exacerbated the outbreak. Mass vaccination is the sole strategy for containment, and though a vaccination campaign has reached 6 million out of 7.5 million people living in Luanda, Angola’s capital, travel from the country has spread cases to China, Kenya, the DRC and Mauritania. [WHO, Science, Vox,]

A coalition of 54 investment groups is putting pressure on major fast food companies to end the non-therapeutic use of antibiotics important for human medicine in meat products. The companies, brought together by the Farm Animal Investment Risk & Return Initiative (FAIRR) and charity ShareAction, manage a combined $1 trillion in assets. The campaign is targeting the 10 largest fast food companies in the United States and United Kingdom, half of which have not yet adopted policies to curb inappropriate antibiotic use. [FAIRR, CBS News]

An improved polio vaccine is being introduced worldwide, eliminating the strain that has caused some cases of paralysis. The new formulation targets the Type 1 and Type 3 strains, but not Type 2, which was eradicated in 1999. With the Type 2 component present in the vaccine (as it is currently), about one in a million vaccinations results in a minor mutation of the live virus, which last year caused 32 cases of paralysis. The plan is to replace all current stocks of the old vaccine within two weeks. According to Dr. Walter Orenstein, former head of CDC’s immunization program, “This is going to be hard. For a long time, we’ve driven people to think of vaccine as valuable. Now we’re asking them to destroy it.” [The New York Times]

More than 300 patients in 41 healthcare facilities were exposed to contaminated duodenoscopes between 2010 and 2015—significantly more than previously reported—according to the U.S. Food and Drug Administration (FDA) in a report to the U.S. House Oversight and Government Reform Committee. The report is the latest update on an outbreak of drug-resistant bacteria tied to contaminated scopes. Representative Ted Lieu, who sits on the Committee, has introduced two bills to improve scope safety. The first would require companies to notify FDA when a safety issue is reported outside of the United States, as well as when any design changes or changes to cleaning procedures are made. The second would mandate that cleaning practices be scientifically validated before approval for use, which is not currently the case. [Los Angeles Times]