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March 17, 2016
Experimental dengue vaccine protects all recipients in virus challenge study
A clinical trial in which volunteers were infected with dengue virus six months after receiving either an experimental dengue vaccine developed by
scientists from the National Institutes of Health (NIH) or a placebo injection yielded starkly contrasting results. All 21 volunteers who received the
vaccine, TV003, were protected from infection, while all 20 placebo recipients developed infection.
The study, published in Science Translational Medicine, underscores the importance of human challenge studies, in which volunteers are exposed to
disease-causing pathogens under carefully controlled conditions.
“The findings from this trial are very encouraging to those of us who have spent many years working on vaccine candidates to protect against
dengue, a disease that is a significant burden in much of the world and is now endemic in Puerto Rico,” said Stephen Whitehead, Ph.D., of NIH’s
National Institute of Allergy and Infectious Diseases (NIAID). “In fact, these results informed the recent decision by officials at Brazil’s Butantan
Institute to advance the TV003 vaccine into a large phase 3 efficacy trial.”
Dengue fever, prevalent throughout the tropics and subtropics, is caused by any of four related dengue viruses—called serotypes—that are spread
by Aedes mosquitoes, the same mosquitoes that spread Zika virus. Most of the estimated 390 million people who are infected with dengue virus
each year develop either no symptoms or a mild illness. However, some people develop serious or life-threatening illness and large outbreaks lead
millions to seek care, severely straining healthcare infrastructure in endemic countries.
The experimental vaccine was developed primarily by Dr. Whitehead and his colleagues at NIAID’s Laboratory of Infectious Diseases.
Dr. Whitehead is currently developing a human challenge model using a modified dengue serotype-3 virus. This challenge virus could be used in
future clinical trials to test the efficacy of candidate dengue vaccines or therapies.
Dengue virus is in the same virus family as Zika virus, and the NIAID team is now leveraging their experience with the live-attenuated dengue
vaccine in efforts to develop a Zika vaccine, Dr. Whitehead noted.
Visit NIH for the announcement.
Where's Zika most likely in the U.S.? The answer may surprise you
Zika virus is spreading fast across Latin America and the Caribbean, spread by both people and by the Aedes aegypti mosquito. A new study shows
where in the U.S. it's most likely to spread, too, and some of the vulnerable cities may be surprising.
New York, Philadelphia and Washington D.C. have a moderate risk, the team at the National Center for Atmospheric Research (NCAR) in Colorado
say. That's because the Aedes aegypti mosquitoes can live there and thrive in the hot, humid summers those cities typically enjoy.
Miami, Orlando, Savannah and Charleston are the highest-risk cities - higher even than Houston, the team reports in the PLOS Currents Outbreaks.
Low-risk cities include dry, high-altitude places such as Denver, Albuquerque and Salt Lake City, even though they're warm in summer. "While there
is much we still don't know about the dynamics of Zika virus transmission, understanding where the Aedes aegypti mosquito can survive in the U.S.
and how its abundance fluctuates seasonally may help guide mosquito control efforts and public health preparedness," NCAR's Andrew Monaghan,
who led the study, said in a statement.
"Even if the virus is transmitted here in the continental U.S., a quick response can reduce its impact," added NCAR scientist Mary Hayden, a medical
anthropologist who worked on the study. Two factors are needed for Zika to spread. A human being has to carry the virus in his or her body and the
Aedes aegypti mosquitoes need to be on hand to carry it to others. The virus can also be sexually transmitted, but that results in less spread, the
Centers for Disease Control and Prevention says.
Experts almost all agree that Zika is unlikely to spread much in the U.S., in part because the Aedes aegypti mosquito isn't common except in parts of
the far south and Hawaii, and also because Americans mostly live indoors, with air conditioning and little chance for the mosquitoes to live and breed
inside homes.
They've predicted small, localized outbreaks come summer. This is based on past history. The CDC and other federal agencies have already said
they're looking to see where and how other viruses carried by Aedes mosquitoes spread in the U.S. Those include chikungunya and dengue virus.
Based on all this, there's not much risk of Aedes-transmitted disease anywhere but south Florida and Texas in winter.
"By mid-July, all 50 cities are meteorologically suitable for Aedes aegypti, with far southeastern cities being suitable for high abundance, and other
eastern cities being suitable for moderate-to-high abundance," the team added.
What happens if Zika can be spread by other Aedes mosquitoes, such as Aedes albopictus, aka the Asian tiger mosquito? Then all bets are off -those mosquitoes can survive in much colder climates, the researchers say.
Visit NBC News for the story.
McKesson eliminates 1,600 jobs, 4% of its U.S. workforce
McKesson Corp. is firing 1,600 people, or about 4 percent of its U.S. workforce, to cut costs after the drug distributor lost some key customers.
The company began a strategic review in January and determined that “reductions to our workforce would be necessary to align our cost structure
with our business needs,” according to an e-mailed statement. San Francisco-based McKesson began telling workers about the firings in mid-March,
the statement said.
McKesson’s business has been hurt by the expiration of a contract with Optum, a unit of UnitedHealth Group Inc., and changes in contracts with
Omnicare Inc., a provider of pharmaceuticals to nursing homes and assisted living facilities, and Target Corp. A slowdown in price increases on
generic drugs also hurt operating profit in the second half of the current fiscal year, McKesson said in January.
The company has been making acquisitions to boost growth. McKesson purchased Rexall Health, Canada’s No. 2 drugstore chain, for $2.23 billion
in early March, and bought two oncology companies in February for $1.2 billion.
McKesson shares fell less than 1 percent to $156 on Wednesday in New York trading. The shares have lost 32 percent in the past 12 months.
Visit Bloomberg for the report.
Antibiotic resistance in children is high and associated with previous antibiotic use
Antibiotic resistance in children with urinary infections is high and could render some antibiotics ineffective as first-line treatments, warns a study
published by The BMJ.
Antimicrobial resistance is an internationally recognized threat to health. Throughout the world, children are frequent consumers of antibiotics -- and
such routine use has been shown to increase the probability of antibiotic resistance in adults with urinary tract infections. Yet little is known about the
prevalence of bacterial resistance in children or the risk factors of importance in this group.
So a team of UK researchers from University of Bristol and Imperial College London set out to review studies investigating the prevalence of
antibiotic resistance in urinary tract infections caused by Escherichia coli, a bacterium responsible for over 80% of all urinary tract infections in
children. The team also set out to measure the association between previous exposure to antibiotics and subsequent resistance in the same child.
They reviewed the results of 58 observational studies in 26 countries involving over 77,000 E. coli samples. Although observational studies cannot
tell us about cause and effect, meta-analysis of observational data is useful for pulling evidence together.
The results show a high global prevalence of resistance -- to some of the most commonly prescribed antibiotics in primary care -- in urinary tract
infections in children caused by E coli.
Visit EurekAlert for the story.
Human toll of pollution: WHO estimates 12.6 million die from unhealthy environments each year
The World Health Organization has put a number on the people estimated to have died as a result of living or working in an unhealthy environment
and it's big -- 12.6 million. That number represents one in four of all deaths globally and underscores the devastating impact of the chemicals and
waste we've been putting into the air, water and earth since the end of World War II.
The WHO said deaths due to non-communicable diseases, which include heart disease and cancer and are related to exposure to pollution, now
make up 8.2 million or nearly two-thirds of the total deaths. Deaths from infectious diseases, such as malaria and diarrhea, due to unsafe water and
lack of sanitation represent one-third and are on the decline.
The report is part of an effort by world leaders over the past year to inform the public of the close link between seemingly theoretical issues like
climate change to something an individual can relate to their own health.
While every corner of the world has been impacted by changes in the environment, those in low- and middle-income countries in Asia that are
manufacturing hubs are the worst affected. The WHO's South-East Asia Region, which includes India and Bangladesh, and its Western Pacific
Region, which includes China, had 7.3 million of the total deaths.
Most of the environment-related deaths were due to cardiovascular diseases, including stroke and heart disease, according to the report. Here's a
breakdown:
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Stroke – 2.5 million deaths annually
Ischaemic heart disease – 2.3 million deaths annually
Unintentional Injuries (e.g. road traffic deaths) – 1.7 million deaths annually
Cancers – 1.7 million deaths annually
Chronic Respiratory Diseases – 1.4 million deaths annually
Diarrheal Diseases – 846,000 deaths annually
Respiratory Infections – 567,000 deaths annually
Neonatal Conditions – 270,000 deaths annually
Malaria – 259,000 deaths annually
Intentional injuries (e.g. suicides) – 246,000 deaths annually
Visit the Washington Post for the report.
Olympus unveils big screen surgery in 4K
Olympus unveiled VISERA 4K UHD System, its new state-of-the art Big Screen surgical system, at the Society of American Gastrointestinal and
Endoscopic Surgeons (SAGES) 2016 Annual meeting in Boston.
The VISERA 4K UHD System delivers four times the resolution of HD with better light and wider color spectrum, promising to help surgeons operate
with increased precision and confidence. The fully integrated 4K imaging system allows operating room personnel to get closer to the operating field
as they view cases live on a 55-inch operative display that magnifies anatomical features to deliver more visual information to the entire surgical
team.
VISERA 4K UHD, is the first of many products from the Sony Olympus Medical Solutions joint-venture. Olympus' first customers began using
VISERA 4K UHD during the first week of March 2016.
For more information visit Olympus.
Sentinel event statistics updated, released through end of 2015
The Joint Commission updated its sentinel event statistics through the end of 2015. They reviewed a total of 936 sentinel events through the end of
2015. The 10 most frequently reported types of sentinel events and the 10 most frequently identified root causes (spanning several types of events)
are shown in the tables.
Data from the 9,581 incidents reviewed from 2004 through the end of 2015 show that a total of 9,884 patients have been affected by these events,
with 5,540 (56.1 percent) resulting in the patient’s death, 863 (8.7 percent) resulting in permanent loss of function and 2,909 (29.5 percent) resulting
in unexpected additional care and/or psychological impact.
The Joint Commission Office of Quality and Patient Safety (OQPS) collaborates with organizations on identifying a sentinel event’s root causes and
creating an action plan to reduce the risk that similar events might occur in the future.
Visit Joint Commission for the release.
Emails: EPA chief warned Flint crisis could get 'very big'
U.S. Environmental Protection Agency chief Gina McCarthy ordered some top staff members in late September to focus on lead contamination in
Flint, MI — after university researchers and local doctors warned that city residents were in danger — and said the matter "could get very big very
quickly," according to emails released Wednesday.
"Seems like the Flint lead issue is really getting concerning," McCarthy wrote Sept. 26 in a message to other EPA officials, among 1,200 pages of
emails The Associated Press obtained under a Freedom of Information Act request.
McCarthy was responding to an email the previous day from Susan Hedman, then the head of the EPA's regional office in Chicago, who resigned in
January amid complaints from the public and elected officials that the agency hadn't reacted urgently enough after learning Flint's water was tainted.
By then a Virginia Tech professor and local doctor had issued warnings about elevated lead levels, although an EPA staffer had raised alarms about
the lead problem five months earlier.
Flint had switched its water source from the Detroit system to the Flint River as a temporary cost-saving measure in April 2014 while under state
management, with plans eventually to use lake water again. The river water wasn't treated with anti-corrosion chemicals, an omission that let lead
leach from old pipes into the drinking water.
McCarthy is scheduled to testify Thursday before the U.S. House Committee on Oversight and Government Reform, whose Republican majority has
been sharply critical of the agency's actions.
An EPA scientist began raising concerns about the water's lead content in April 2015, pressing the Michigan Department of Environmental Quality for
information about whether the city was using anti-corrosive chemicals. In a June memo, the scientist, Miguel Del Toral, urged EPA colleagues to
review whether Flint had violated federal corrosion control requirements.
Hedman wrote to McCarthy on Sept. 25: "Controversy surrounding lead levels in drinking water in Flint increased again this week, when a group of
local physicians released a report suggesting that blood lead levels in a sample of Flint children have doubled since the city started using water from
the Flint River." She described actions the EPA was taking on the regional level, including meeting with city and state officials and discussing federal
financial assistance with U.S. Rep. Dan Kildee, a Michigan Democrat whose district includes Flint.
Over the next two months, the EPA established a task force to help state and local agencies with corrosion control and home water sampling, while
beginning an audit of the DEQ's oversight of public water supplies. Yet it wasn't until Jan. 21 that the federal agency issued an order demanding
action, saying the state and city were moving too slowly. (Associated Press) Visit ABC News for the story.