Evening Ebola Update, 4/5/15: New vaccine candidates work in small tests/Plasmids confer antibiotic resistance/Sloppy safety in Guinea closes ETCs/Rainy season effects of EBOV   Leave a comment

Easter Sunday

Dear Colleagues:

l.  Tonight’s posting begins with a antibiotic resistance article that has important implications.  Washington University in St. Louis Newsroom March 25 has a review of a June Emerging Infectious Disease article by Dantas, et. al. about antibiotic resistance of Enterobacteriaceae strains in the Americas and in South Asia.  The bacterial genes producing antibiotic resistance in these strains are different (KPC in the Americas; NDM-1 in South Asia), but some plasmids carrying both KPC and NDM-1 are nearly identical in both strains and can cross into both strains, spreading antibiotic resistance.  The authors state:

“The researchers also sequenced a special portion of bacterial genetic material called plasmids. Most of a bacteria’s DNA is found in its chromosome, but bacteria also have many extra, smaller and circular bits of DNA known as plasmids that easily can pass from one bacterial strain to another. A plasmid is like a bacterial gene delivery truck; it is the primary way antibiotic resistance genes spread between bacteria.

The researchers identified a few key instances in which the plasmids carrying NDM-1 or KPC were nearly identical, meaning they easily could facilitate the spread of antibiotic resistance between disease-causing bacteria found in the United States and South Asia. Recent evidence suggests that this intermingling already may be happening in parts of China.”

See the Newsroom report at: https://news.wustl.edu/news/Pages/Common-bacteria-on-verge-of-becoming-antibiotic-resistant-superbugs.aspx

2.  The U.S. Department of Health and Human Services (HHS) has contracted with BioCryst for $12 Million toward development/testing of a small molecule called BCX4430 which has shown activity against EBOV and Marburg virus in non-primate animal models.  See the HHS release at: http://www.hhs.gov/news/press/2015pres/03/20150331a.html

3.  NEJM April 1 published an article by Regules, et. al. from Walter Reed Army Institute of Research on the safety of a new attenuated, replication-competent recombinant VSV vaccine candidate called rVSV-ZEBOV which replaces the glycoprotein of VSV with the glycoprotein of EBOV Zaire strain.  No serious side-effects were reported on Phase 1 testing and the vaccine candidate is active against EBOV so Phase 2/3 testing is underway in Liberia.  See the NEJM article at: http://www.nejm.org/doi/full/10.1056/NEJMoa1414216#t=article.  See the NIH news release at: http://www.nih.gov/news/health/apr2015/niaid-01.htm

4.  Ebola Deeply’s Executive Summary April 2 reports breakdowns in safety precautions at two EBOV treatment centers in Guinea, resulting in new EBOV cases, including 3 infected doctors.  These two EBOV treatment centers have been closed down by the U.N.  The 3 day quarantine of residents in Sierra Leone has identified 10 new EBOV cases, compared with 100 EBOV cases identified with the previous quarantine.  See: http://www.eboladeeply.org/articles/2015/04/7666/ebola-executive-summary-april-2-2015/

5.  The CDC’s MMWR report April 3 gives a detailed accounting of the steps taken to prevent NYC residents and Bellevue Hospital employees from EBOV infection via Dr. Craig Spencer after he became symptomatic in NYC and had to be transported to Bellevue Hospital for treatment.  Data management of contact tracing required 12 full time staff alone; the overall cost of Spencer’s hospitalization is estimated at $4.3 Million.  See this revealing report at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6412a3.htm?s_cid=mm6412a3_e

6.  ACAPS has published a 12 page report on the status of EBOV in West Africa as of March, 2015.  The indirect effects of the EBOV epidemic are being felt as the region enters the rainy season.  Vaccinations for measles and pertussis are down; pre-natal visits are down; malaria cases are not coming to clinic; food supplies are short because harvests severely limited by EBOV epidemic. See: http://www.acaps.org/img/documents/m-acaps-monthly-overview-ebola-west-africa-2-april-2015.pdf

7.  Lancet 24 March published a report by Zhu, et. al. from Beijing Institute of Biotechnology re: another EBOV vaccine candidate.  This candidate is replication-deficient adenovirus which has its glycoprotein replaced by the glycoprotein from the 2014 Sierra Leone EBOV strain (not the much earlier Zaire EBOV strain).  Safety and efficacy were proven in a study involving 80 high dose + low dose participants.  See: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60553-0/fulltext

RGL, MD

Advertisements

Posted April 6, 2015 by levittrg in Uncategorized

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: