Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2014/01/news-scan-jan-31-2014
News Scan for Jan 31, 2014
IV zanamivir guidance; RSV in the elderly
Filed Under:
Respiratory Syncytial Virus (RSV); Influenza, General
CDC outlines steps for emergency use of IV zanamivir
The US Centers for Disease Control and Prevention (CDC) yesterday released information detailing how clinicians can get investigational intravenous (IV) zanamivir (Relenza) for severely ill flu patients. The drug is in phase 3 clinical trials and can only be obtained by enrolling patients in ongoing clinical trials or an emergency investigational new drug request.
Ongoing surveillance of circulating flu strains shows that oseltamivir (Tamiflu) resistance is low so far, but it can emerge during or after oseltamivir treatment in patients with prolonged virus shedding, such as those who are severely immunocompromised, the CDC said. So far neuraminidase-resistance testing activities have found 21 oseltamivir-resistant 2009 H1N1 viruses among 2,254 (0.9%) samples, according to the CDC?s latest flu surveillance report.
Tests show that most oseltamivir-resistant 2009 H1N1 viruses so far are sensitive to zanamivir.
The CDC said it recommends that IV zanamivir be considered for severely ill patients with oseltamivir-resistant 2009 H1N1 infections or for those who can't absorb oral oseltamivir because of known or suspected gastric stasis, malabsorption, or gastrointestinal bleeding.
Clinicians who want to get IV zanamivir for those patients can call a GlaxoSmithKline help desk number, staffed around the clock, to see if patients are eligible for a clinical trial and to obtain information on the steps needed to obtain an emergency use authorization from the Food and Drug Administration
Jan 30 CDC information on IV zanamivir
Jan 31 CDC FluView report
Substantial portion of elderly with ILI have respiratory syncytial virus
Respiratory syncytial virus (RSV) is an important respiratory pathogen in older patients with moderate to severe influenza-like illness (ILI), according to a large international study of elderly community-dwelling individuals published in the Journal of Infectious Diseases.
The study population comprised participants in the INFLUENCE65 clinical trial, which studied influenza vaccine efficacy in people 65 or older in 15 countries in America, Europe, and East Asia.
Active surveillance of 36,132 subjects by means of weekly or biweekly phone contact or home visits from the first-season surveillance period (Nov 15, 2008, through Apr 30, 2009) was carried out. The subjects were told to report any ILI meeting a prescribed definition, and nose and throat swabs were collected from those reporting ILI.
A total of 4,582 samples were collected (from 5,389 ILI episodes); 556 samples (12%) from subjects who fulfilled criteria for moderate to severe disease (ie, pneumonia, hospitalization, or maximum daily influenza symptom severity score [ISS] of over 2) were tested by multiplex reverse-transcription polymerase chain reaction.
A total of 320 (57.6%) of the 556 samples showed any virus; 104 of the 556 samples (18.7%) were influenza A, 82 (14.7%) rhinovirus/enterovirus, 41 (7.4%) RSV, and 32 each (5.6%) coronavirus and human metapneumovirus. Most of the RSV-positive samples (39) were single infections.
RSV prevalence was 12.6% (8 of 63) in ILI with hospitalization, 7.1% (2 of 28) in ILI with pneumonia, and 6.7% (32 of 480) in ILI with maximum ISS of over 2. There was a significant association between country and RSV detection (P = .004); prevalence ranged from 2.0% (1 of 50 samples) in Mexico to 17.1% (12 of 70) in the Czech Republic.
The authors note that prevention of viral infections such as RSV in addition to prevention of influenza could decrease severe illnesses in the elderly.
Jan 29 J Infect Dis study
News Scan for Jan 31, 2014
IV zanamivir guidance; RSV in the elderly
Filed Under:
Respiratory Syncytial Virus (RSV); Influenza, General
CDC outlines steps for emergency use of IV zanamivir
The US Centers for Disease Control and Prevention (CDC) yesterday released information detailing how clinicians can get investigational intravenous (IV) zanamivir (Relenza) for severely ill flu patients. The drug is in phase 3 clinical trials and can only be obtained by enrolling patients in ongoing clinical trials or an emergency investigational new drug request.
Ongoing surveillance of circulating flu strains shows that oseltamivir (Tamiflu) resistance is low so far, but it can emerge during or after oseltamivir treatment in patients with prolonged virus shedding, such as those who are severely immunocompromised, the CDC said. So far neuraminidase-resistance testing activities have found 21 oseltamivir-resistant 2009 H1N1 viruses among 2,254 (0.9%) samples, according to the CDC?s latest flu surveillance report.
Tests show that most oseltamivir-resistant 2009 H1N1 viruses so far are sensitive to zanamivir.
The CDC said it recommends that IV zanamivir be considered for severely ill patients with oseltamivir-resistant 2009 H1N1 infections or for those who can't absorb oral oseltamivir because of known or suspected gastric stasis, malabsorption, or gastrointestinal bleeding.
Clinicians who want to get IV zanamivir for those patients can call a GlaxoSmithKline help desk number, staffed around the clock, to see if patients are eligible for a clinical trial and to obtain information on the steps needed to obtain an emergency use authorization from the Food and Drug Administration
Jan 30 CDC information on IV zanamivir
Jan 31 CDC FluView report
Substantial portion of elderly with ILI have respiratory syncytial virus
Respiratory syncytial virus (RSV) is an important respiratory pathogen in older patients with moderate to severe influenza-like illness (ILI), according to a large international study of elderly community-dwelling individuals published in the Journal of Infectious Diseases.
The study population comprised participants in the INFLUENCE65 clinical trial, which studied influenza vaccine efficacy in people 65 or older in 15 countries in America, Europe, and East Asia.
Active surveillance of 36,132 subjects by means of weekly or biweekly phone contact or home visits from the first-season surveillance period (Nov 15, 2008, through Apr 30, 2009) was carried out. The subjects were told to report any ILI meeting a prescribed definition, and nose and throat swabs were collected from those reporting ILI.
A total of 4,582 samples were collected (from 5,389 ILI episodes); 556 samples (12%) from subjects who fulfilled criteria for moderate to severe disease (ie, pneumonia, hospitalization, or maximum daily influenza symptom severity score [ISS] of over 2) were tested by multiplex reverse-transcription polymerase chain reaction.
A total of 320 (57.6%) of the 556 samples showed any virus; 104 of the 556 samples (18.7%) were influenza A, 82 (14.7%) rhinovirus/enterovirus, 41 (7.4%) RSV, and 32 each (5.6%) coronavirus and human metapneumovirus. Most of the RSV-positive samples (39) were single infections.
RSV prevalence was 12.6% (8 of 63) in ILI with hospitalization, 7.1% (2 of 28) in ILI with pneumonia, and 6.7% (32 of 480) in ILI with maximum ISS of over 2. There was a significant association between country and RSV detection (P = .004); prevalence ranged from 2.0% (1 of 50 samples) in Mexico to 17.1% (12 of 70) in the Czech Republic.
The authors note that prevention of viral infections such as RSV in addition to prevention of influenza could decrease severe illnesses in the elderly.
Jan 29 J Infect Dis study