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Source: http://www.cidrap.umn.edu/news-persp...an-jul-19-2019
News Scan for Jul 19, 2019
19 new polio cases; Short-course malaria treatment; Bolivia hemorrhagic fever probe
Filed Under:
Polio; Malaria; VHF
GPEI: 19 new polio cases this week as multiple countries report outbreaks
In more bad news for polio eradication efforts, several countries reported a slew of new polio cases in the last week, according to the Global Polio Eradication Initiative's (GPEI's) weekly report. A total of 19 cases in 6 countries, as well as several polio detections in heathy case contacts, were recorded across the Middle East, Africa, and Asia.
Pakistan has four new cases of wild poliovirus type 1 (WPV1), and Afghanistan has one. The new cases raise the number of WPV1 detections in 2019 to 56, already a large spike compared with 2018's total of 33 cases. Pakistan has had 45 wild poliovirus cases alone in 2019, with the 4 latest patients experiencing symptom onset between Jun 21 and Jul 1. Last year at this point Pakistan had confirmed 3 WPV1 cases, en route to 12 for the entire year.
In neighboring Afghanistan, the polio case-patient experienced symptom onset on Jun 5, and represents the 11th WPV1 case in that country this year. Afghanistan had 21 cases in all of 2018.
Officials in Nigeria recorded three cases of circulating vaccine-derived poliovirus type 2 (cVDPV2), and one cVDPV2 was isolated from a healthy child. "Recent confirmation of spread of one of the cVDPV2 outbreaks, both within Nigeria and internationally, underscores the urgent need to fill remaining vaccination gaps in the ongoing outbreak response, and to optimize the geographic extent and operational quality of mOPV2 [type 2 oral polio vaccine] response," the GPEI said.
The Democratic Republic of the Congo reported five cases of cVDPV2, and four cases of cVDPV2 cases have been confirmed in the Central African Republic. In Angola, cVDPV2 was isolated in healthy child on Jun 10. One of the cases in the Central African Republic was confirmed based on a positive contact, and officials also detected cVDPV2 in 10 healthy contacts. The national government has declared a polio emergency as a result.
Finally, Myanmar also noted two cases of vaccine-derived poliovirus type 1 (cVDPV1), and two isolates of cVDPV1 in case contacts.
Jul 19 GPEI report
Short-course primaquine malaria treatment shown similar to longer treatment
A study yesterday in The Lancet suggests that a 7-day course of primaquine may be as effective in treating malaria caused by Plasmodium vivax as a 14-day treatment of the drug. The authors said a shorter treatment may improve patient adherence.
Primaquine is the primary radical treatment for malaria; it prevents relapses, but works best in a daily supervised treatment setting over the course of 14 days, the authors write. Previous studies have shown unsupervised regimens are associated with significantly reduced drug adherence and effectiveness.
For this randomized, placebo-controlled non-inferiority trial, researchers administered the same total dose of primaquine to patients at double the daily dose of the 14-day regime in 7 days (1 milligram per kilogram [mg/kg] per day compared with 0.5 mg/kg per day) at eight study sites in Afghanistan, Ethiopia, Indonesia, and Vietnam. Radical cure is recommended by national guidelines in Indonesia, Vietnam, and Afghanistan.
A total of 2,336 patients were involved in the study, with half of the patients receiving the 14-day treatment and half the 7-day treatment. In both groups, 96% of all participants cleared peripheral parasitemia within 2 days of starting treatment, with no significant difference between treatment groups, the authors said.
"This result is important," Philip J. Rosenthal, MD, of the University of California-San Francisco wrote in an accompanying commentary. "Halving the length of an anti-relapse treatment course for vivax malaria has the potential to markedly increase the number of patients who receive a full course of anti-relapse therapy, thus decreasing recurrent episodes of malaria and transmission of malaria to others."
Jul 18 Lancet study
Jul 18 Lancet commentary
Bolivian arenavirus cluster prompts epidemiologic alert from PAHO
Health officials in Bolivia are investigating a hemorrhagic fever outbreak linked to an arenavirus that has sickened some healthcare workers, the Pan American Health Organization (PAHO) said yesterday in an epidemiologic alert.
The country's health ministry received a report of three cases of an unidentified fever with suspected human-to-human spread on Jun 28. As of Jul 17, there are five cases, three of them fatal. Three are lab-confirmed.
Illness onsets began from Apr 29 to May 29. All patients are adults, and four are men. Three are healthcare workers, and the other two are agricultural workers. The investigation found that the healthcare workers were likely exposed at the hospital, where they had direct contact with blood and other body fluids during invasive procedures performed on one of the patients. Agriculture workers were thought to be exposed during a rice harvest in La Paz department.
Lab tests at Bolivia's Center for Tropical Diseases and at the US Centers for Disease Control and Prevention were positive for arenavirus, typically transmitted to humans by rodents, and partial genetic sequencing suggests Chapare virus. Alongside Machupo virus, Chapare is one of five known New World arenaviruses that have been linked to hemorrhagic fevers in humans in Bolivia.
Jul 18 PAHO epidemiologic alert
News Scan for Jul 19, 2019
19 new polio cases; Short-course malaria treatment; Bolivia hemorrhagic fever probe
Filed Under:
Polio; Malaria; VHF
GPEI: 19 new polio cases this week as multiple countries report outbreaks
In more bad news for polio eradication efforts, several countries reported a slew of new polio cases in the last week, according to the Global Polio Eradication Initiative's (GPEI's) weekly report. A total of 19 cases in 6 countries, as well as several polio detections in heathy case contacts, were recorded across the Middle East, Africa, and Asia.
Pakistan has four new cases of wild poliovirus type 1 (WPV1), and Afghanistan has one. The new cases raise the number of WPV1 detections in 2019 to 56, already a large spike compared with 2018's total of 33 cases. Pakistan has had 45 wild poliovirus cases alone in 2019, with the 4 latest patients experiencing symptom onset between Jun 21 and Jul 1. Last year at this point Pakistan had confirmed 3 WPV1 cases, en route to 12 for the entire year.
In neighboring Afghanistan, the polio case-patient experienced symptom onset on Jun 5, and represents the 11th WPV1 case in that country this year. Afghanistan had 21 cases in all of 2018.
Officials in Nigeria recorded three cases of circulating vaccine-derived poliovirus type 2 (cVDPV2), and one cVDPV2 was isolated from a healthy child. "Recent confirmation of spread of one of the cVDPV2 outbreaks, both within Nigeria and internationally, underscores the urgent need to fill remaining vaccination gaps in the ongoing outbreak response, and to optimize the geographic extent and operational quality of mOPV2 [type 2 oral polio vaccine] response," the GPEI said.
The Democratic Republic of the Congo reported five cases of cVDPV2, and four cases of cVDPV2 cases have been confirmed in the Central African Republic. In Angola, cVDPV2 was isolated in healthy child on Jun 10. One of the cases in the Central African Republic was confirmed based on a positive contact, and officials also detected cVDPV2 in 10 healthy contacts. The national government has declared a polio emergency as a result.
Finally, Myanmar also noted two cases of vaccine-derived poliovirus type 1 (cVDPV1), and two isolates of cVDPV1 in case contacts.
Jul 19 GPEI report
Short-course primaquine malaria treatment shown similar to longer treatment
A study yesterday in The Lancet suggests that a 7-day course of primaquine may be as effective in treating malaria caused by Plasmodium vivax as a 14-day treatment of the drug. The authors said a shorter treatment may improve patient adherence.
Primaquine is the primary radical treatment for malaria; it prevents relapses, but works best in a daily supervised treatment setting over the course of 14 days, the authors write. Previous studies have shown unsupervised regimens are associated with significantly reduced drug adherence and effectiveness.
For this randomized, placebo-controlled non-inferiority trial, researchers administered the same total dose of primaquine to patients at double the daily dose of the 14-day regime in 7 days (1 milligram per kilogram [mg/kg] per day compared with 0.5 mg/kg per day) at eight study sites in Afghanistan, Ethiopia, Indonesia, and Vietnam. Radical cure is recommended by national guidelines in Indonesia, Vietnam, and Afghanistan.
A total of 2,336 patients were involved in the study, with half of the patients receiving the 14-day treatment and half the 7-day treatment. In both groups, 96% of all participants cleared peripheral parasitemia within 2 days of starting treatment, with no significant difference between treatment groups, the authors said.
"This result is important," Philip J. Rosenthal, MD, of the University of California-San Francisco wrote in an accompanying commentary. "Halving the length of an anti-relapse treatment course for vivax malaria has the potential to markedly increase the number of patients who receive a full course of anti-relapse therapy, thus decreasing recurrent episodes of malaria and transmission of malaria to others."
Jul 18 Lancet study
Jul 18 Lancet commentary
Bolivian arenavirus cluster prompts epidemiologic alert from PAHO
Health officials in Bolivia are investigating a hemorrhagic fever outbreak linked to an arenavirus that has sickened some healthcare workers, the Pan American Health Organization (PAHO) said yesterday in an epidemiologic alert.
The country's health ministry received a report of three cases of an unidentified fever with suspected human-to-human spread on Jun 28. As of Jul 17, there are five cases, three of them fatal. Three are lab-confirmed.
Illness onsets began from Apr 29 to May 29. All patients are adults, and four are men. Three are healthcare workers, and the other two are agricultural workers. The investigation found that the healthcare workers were likely exposed at the hospital, where they had direct contact with blood and other body fluids during invasive procedures performed on one of the patients. Agriculture workers were thought to be exposed during a rice harvest in La Paz department.
Lab tests at Bolivia's Center for Tropical Diseases and at the US Centers for Disease Control and Prevention were positive for arenavirus, typically transmitted to humans by rodents, and partial genetic sequencing suggests Chapare virus. Alongside Machupo virus, Chapare is one of five known New World arenaviruses that have been linked to hemorrhagic fevers in humans in Bolivia.
Jul 18 PAHO epidemiologic alert