First FDA-approved vaccine for the prevention of dengue disease in endemic regions
The U.S. Food and Drug Administration announced today the approval of Dengvaxia, the first vaccine approved for the prevention of dengue disease caused by all dengue virus serotypes (1, 2, 3 and 4) in people ages 9 through 16 who have laboratory-confirmed previous dengue infection and who live in endemic areas. Each year, an estimated 400 million dengue virus infections occur globally according to the CDC. Of these, approximately 500,000 cases develop into DHF, which contributes to about 20,000 deaths, primarily among children. Dengvaxia is a live, attenuated vaccine that is administered as three separate injections, with the initial dose followed by two additional shots given six and twelve months later. The FDA granted this application Priority Review and a Tropical Disease Priority Review Voucher under a program intended to encourage development of new drugs and biologics for the prevention and treatment of certain tropical diseases.
Changing climate may affect animal-to-human disease transfer
Climate change could affect occurrences of diseases like bird-flu and Ebola, with environmental factors playing a larger role than previously understood in animal-to-human disease transfer. Dr Nicholas Clark, from UQ’s School of Veterinary Science, said this was a new line of thinking in this area, changing how we understand, and tackle, emerging zoonotic diseases. “These diseases are caused by pathogens – for example, viruses, bacteria or parasitic worms – that cross from animals to humans, including notorious infections like bird flu, rabies virus and Ebola,” he said. “In the past, we’ve primarily looked at how many different types of animal species a pathogen infects – widely considered an indicator of its risk to shift between host species. “This is just one factor, and we’ve found that how infected animals are related is also important. “But importantly, our research also shows that different environments provide new opportunities for pathogens to interact with and infect new host species.”
UNICEF-WHO Philippines: Measles Outbreak, Situation Report 10, 1 May 2019
Current measles outbreak started late 2017 in Mindanao. In 2018, 20,827 cases were reported with 199 deaths. Between 1 January and 13 April 2019, 31,056 measles cases including 415 deaths were officially reported through the routine surveillance system from the DoH, with a Case Fatality Rate (CFR) of 1,34%.
Residents of provinces in the upper South have been warned that dengue could spread now that rains have arrived
Doctor Sirilak Thaicharoen, director of Nakhon Si Thammarat’s 11th Disease Control Office, said 1,165 people in seven upper South provinces had contracted dengue virus this year resulting in one death so far. Dengue is spread by mosquito bites. Between 4 to 7 days after a bite from an infected mosquito, victims develop flu-like symptoms which include a sudden high fever coming in separate waves, pain behind the eyes, muscle, joint and bone pain, severe headache and a skin rash with red spots. There is no antiviral treatment available.The main way to prevent its spread is to avoid being bitten by mosquitos. Use a repellent containing 20-30 per cent DEET or 20 per cent Picaridin.
Predicting and Designing therapeutics against the Nipah virus
Neeladri Sen et al.,
Though every outbreak of the Nipah Virus has resulted in high mortality rates (>70% in Southeast Asia), there are no licensed drugs against it. In this study we have considered all 9 Nipah proteins as potential therapeutic targets and computationally identified putative peptides (against G, F, and M proteins) and small molecules inhibitors (against F, G, M, N, and P proteins). Our strategy was to tackle the development of therapeutics on a proteome wide scale and the lead compounds identified could be attractive starting points for drug development. To counter the threat of drug resistance, we have analyzed the sequences of the viral strains from different outbreaks, to check whether they would be sensitive to the binding of the proposed inhibitors.
The future of global health procurement: issues around pricing transparency
Mikel Berdud et al.,
This paper focuses on the role that price transparency may play in the efficient and effective procurement of medicines by middle- and low-income countries. Will making prices publicly available make procurement more efficient and cost-effective medicines more accessible? The authors conclude that transparency of the procurement process significantly lowers costs by encouraging bidders. They do not recommend price transparency for on-patent medicines as the effect will be to slow the diffusion of innovative products to low-income countries. Differential pricing is important and can best be achieved in the current environment via confidential discounts. Developing country markets are, however, dominated by generic products. Price transparency for off-patent products could improve market efficiency if capacities are there to use the data to inform procurement decisions whilst protecting against supplier collusion.
Pooled procurement of drugs in low and middle income countries
Pierre Dubois et al.,
The authors use data from seven low and middle income countries with diverse drug procurement systems to assess the effect of centralised procurement on drug prices and provide a theoretical mechanism that explains this effect. The empirical analysis is based on exhaustive data on drug sales quantities and expenditures over several years for forty important molecules. It is found that centralised procurement of drugs by the public sector allows much lower prices, but that the induced price reduction is smaller when the supply side is more concentrated.
Addressing critical needs in the fight to end tuberculosis with innovative tools and strategies
Mark Hatherill et al.,
More than 130 years after Koch first described the tubercle bacillus and its etiologic role in tuberculosis (TB) to the Physiologic Society of Berlin, TB is still responsible for an appalling human toll and is the leading single infectious cause of death worldwide. It is clear that the modest decline in global TB incidence and mortality in recent years needs to be accelerated to reach the “End TB” targets for 2035. This can only be achieved if the implementation of current approaches to TB control is optimized and new tools and strategies for TB prevention, screening, diagnosis, and treatment are developed. This special issue highlights the breadth of the approaches currently available, promising new developments as well as identifying some of the challenges still ahead.
UN report calls for urgent action against antimicrobial resistance
That's the conclusion of a report out today from the United Nations (UN) Interagency Coordination Group (IACG), a panel of global experts formed to provide guidance and ensure sustained global action on antimicrobial resistance (AMR). The report by the IACG, which was convened to help UN member states fulfill and implement the pledges made at the UN's 2016 high-level meeting on AMR, is the culmination of a series of meetings, country visits, and stakeholder interviews conducted from March 2017 to December 2018. The aim of the group was to develop a blueprint to help countries respond to the alarming levels of AMR that have been reported in countries of all income levels. Emphasizing a One Health approach, the report calls on UN member states to accelerate national response plans to the AMR crisis, increase and encourage investment in development of new antibiotics and programs to combat drug resistance, collaborate with civil society groups and other stakeholders, and strengthen accountability and global governance.
Viral factors associated with the high mortality of human infections with clade 2.1 influenza A/H5N1 virus in Indonesia
A new study in Clinical Infectious Diseases uses nasal and fecal samples to estimate viral loads in human patients with avian influenza H5N1, finding that higher viral loads are linked to fatal cases. Researchers collected specimens from 180 H5N1 patients between 2007 and 2015, representing 90% of all Indonesian patients and 20% of reported H5N1-infected patients globally. Feces and blood had the highest concentrations of H5N1 RNA, and higher viral loads correlated with fatal cases. Genes that conferred resistance to antivirals were also more prevalent in fatal cases. Detailed clinical virological analyses were performed in specimens from 180 H5N1 patients, representing 90% of all Indonesian patients and 20% of reported H5N1-infected patients globally. These observations confirm the association of viral load with outcome of human H5N1 infections and suggest potential differences in virulence and antiviral responses to oseltamivir that may explain the exceptionally high mortality of clade 2.1 H5N1 infections in Indonesia.