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  • October 05, 2016 2:56 PM | Deleted user

    By David Templeton / Pittsburgh Post-Gazette

    Amid the growing surge of Zika research, the University of Pittsburgh School of Medicine has announced early success with two experimental vaccines that prevented the pups of immunized female mice from becoming infected with the virus.

    Both vaccines, with one more effective than the other, succeeded in producing an immune response to the virus that was transferred from mother to her pups. That would represent an important goal in a human vaccine, given the severe neurological birth defects including microcephaly (an abnormally small head) and Guillan-Barre syndrome that the viral infection can cause.

    “We’ve not only developed a promising vaccine candidate to move toward larger pre-clinical and, eventually, human clinical trials, but also a delivery format that would be inexpensive to produce and distribute to hundreds of thousands of people,” said Andrea Gambotto, an associate professor of surgery at the medical school who was senior author of the study, published online Monday in the EBioMedicine journal.

    Congress recently allocated $1.1 billion for Zika research, money that Pitt researchers hope to tap to advance their vaccines to human clinical trials, potentially within a year, Dr. Gambotto said.

    The Pitt focus is creating a vaccine given to the mother that protects the fetus and newborn against birth defects. So far, so good.

    “Pups born to mice immunized with [the one Pitt vaccine] were all protected against lethal challenge infection without weight loss or neurological signs,” while 50 percent of the pups born to dams immunized with the second Pitt virus were protected, the study says.

    One vaccine involved a standard injection. The other used crystals affixed to a patch similar to a Band-Aid to keep them in contact with the skin until they dissolved.

    The vaccines generate an immune response against an antigen — a protein — on the outer shell of the virus. The Pitt study describes the immunization as “a promising candidate vaccine” for the prevention of Zika virus disease.

    Bites from mosquitoes of the Aedes species represent the key method of viral transmission, with sexual transmission also possible. Various South American, Central American and Caribbean nations are experiencing epidemic levels of infection, while Florida has reported Zika infections contracted from local mosquitoes. The virus already has spread to 50 nations, with 6,400 cases in the United States and its territories, the National institute of Health reports.

    The National Institute of Allergy and Infectious Diseases currently is working on five Zika vaccines, with the Aug. 2 launch of a human clinical trial.

    Once a vaccine is developed, it typically is tested in mice then monkeys. If successful, the next step is three phases of human clinical trials to determine safety and effectiveness before it goes before the U.S. Food and Drug Administration for approval. Even if the institute’s vaccine proceeds on the current fast track, its effectiveness on humans won’t be clear until early to mid-2018, said institute director Anthony S. Fauci. Consider, however, that vaccines typically take seven to 10 years to be developed and approved.

    Developing a Zika virus poses no serious difficulties in vaccine science, given that similar flavivirus vaccines already have been developed for yellow fever and several types of encephalitis.

    Besides the five NIH vaccines, pharmaceutical companies, universities and others also have reported their development of vaccines.

    “The more shots on goal you have, the better the chance of getting a vaccine,” Dr. Fauci said. “If history holds true, there should be an effective vaccine against Zika.”

    David Templeton: dtempleton@post-gazette.com or 412-263-1578.


  • October 03, 2016 11:57 AM | Deleted user

    AAPA
    AAPA President Josanne Pagel with U.S. Surgeon General Vivek Murthy at the HHS Office on Women's Health (OWH) National Meeting on Opioid Use, Abuse and Overdose in Women last Thursday. Pagel was part of the national conversation to examine the unique prevention, treatment, and recovery issues for women who use, abuse, or overdose on opioids. This meeting will build upon the HHS Secretary's opioid initiative, examining the unique and specific needs of women in the context of that epidemic. September is Pain Awareness Month.

    On July 22, in response to pressure from AAPA and other national groups, the Comprehensive Addiction and Recovery Act (CARA) was signed into law. PAs will soon be eligible to become waivered to prescribe buprenorphine for five years as part of medication assisted treatment (MAT) for the treatment of opioid addiction with the passage of this legislation. CARA was overwhelmingly passed by Congress.

  • October 03, 2016 11:54 AM | Deleted user

    By Steven Reinberg
    HealthDay Reporter

    THURSDAY, Sept. 29, 2016 (HealthDay News) -- The vaccine against human papillomavirus (HPV) infection, which doctors believe causes most cases of cervical cancer, appears even more effective than believed, a new study finds.

    "After eight years of vaccination, the reduction in the incidence of cervical neoplasia [abnormal growth of cells], including pre-cancers, have been reduced approximately 50 percent. This is greater than what was expected -- that's pretty exciting," said lead researcher Cosette Wheeler. She is a professor of pathology and obstetrics and gynecology at the University of New Mexico, in Albuquerque.

    The study also showed that the protection appears to occur even when only one or two of the recommended doses of the vaccine are given.

    "Right now, the recommendation is three doses for girls and boys before the 13th birthday, so that you are protected before you become exposed," Wheeler explained.

    "People thought that three doses of vaccine were necessary, but there's a lot of people who are getting one and two doses, and people are getting protection from one or two doses," she said.

    On average, 40 percent of girls aged 13 to 17 in New Mexico had received all three doses in 2014, the researchers found. But, Wheeler said, "It may be that two doses are sufficient."

    Protection from HPV is also coming from what's called herd immunity, which increases as more people are vaccinated and reduces the spread of HPV, Wheeler said. "Herd immunity means that the probability of getting infected decreases for everybody, even the people who aren't vaccinated," she explained.

    Moreover, the vaccines protect against more types of HPV than they were designed to do, she added.

    Although this is not the first report to show the effectiveness of the vaccine, it's the first to show declines in precancerous lesions across a large population, Wheeler said. The researchers also found that the reductions in the number of precancerous lesions were greater than anticipated.

    This study even took into account changes in Pap test screening over the last 10 years.

    In 2009, the American College of Obstetrics and Gynecology said most women under 21 do not need Pap test screening and recommended longer times between screening. In 2012, the U.S. Preventive Services Task Force said women, regardless of age, do not need to get screened more than every three years, Wheeler said.

    If these changes were not taken into account, the effect of the vaccine would appear even greater than it already is, because it would assume that more women were being screened than actually were, she said.

    "Parents and doctors should pay attention. These vaccines are highly efficacious," Wheeler said.

    It's up to doctors to be sure kids are vaccinated, she said. "It's their job, just like other vaccines, to provide them to their patients. They are the key to get this done," Wheeler added.

    In addition to cervical cancer, HPV can cause genital warts in men and women, and some head and neck cancers.

    Although cervical cancer can take decades to develop, it's important to protect children before they become sexually active and risk getting infected with HPV, which is why Wheeler strongly recommends: "Get your kids vaccinated -- both your boys and your girls -- before their 13th birthday."

    For the study, Wheeler and colleagues collected data on young women tested for cervical cancer with Pap tests from 2007 to 2014, who were part of the New Mexico HPV Pap Registry. New Mexico should be considered representative of the whole country, Wheeler said.

    One expert said the findings make the case for HPV vaccination even stronger.

    "These data highlight and provide even more evidence as to the efficacy of the vaccine in preventing HPV infections and related diseases," said Fred Wyand, a spokesman for the American Sexual Health Association/National Cervical Cancer Coalition.

    Increasing HPV vaccination rates "goes back to the importance of health care provider's recommending the vaccine to parents and patients," he said. "Provider recommendation carries much weight, and parents are far more likely to have their child vaccinated if the provider encourages it."

    Another approach to increasing vaccination rates is to "normalize" HPV vaccines, he said. "Rather than treat it as something exotic, it should just be offered as part of the routine adolescent vaccine program," Wyand said.

    Dr. Metee Comkornruecha, an adolescent medicine specialist at Nicklaus Children's Hospital in Miami, agrees that the vaccine "is effective, and parents should have their sons and daughters vaccinated."

    The report was published online Sept. 29 in the journal JAMA Oncology.

    More information

    Visit the U.S. Centers for Disease Control and Prevention for more on the HPV vaccine.

    SOURCES: Cosette Wheeler, Ph.D., professor, pathology and obstetrics and gynecology, University of New Mexico, Albuquerque; Fred Wyand, spokesman, American Sexual Health Association/National Cervical Cancer Coalition, Research Triangle Park, N.C.; Metee Comkornruecha, M.D., adolescent medicine specialist, Nicklaus Children's Hospital, Miami; Sept. 29, 2016, JAMA Oncology, online

    Last Updated: Sep 29, 2016

    Copyright © 2016 HealthDay. All rights reserved.


  • September 28, 2016 12:31 PM | Deleted user

    On September 27, 2016 APAOG hosted a webinar called "Let's Talk about Sex: Addressing reproductive health with patients who are LGBT." This webinar was presented by Lis Shell, PhD, MPAS, PA-C from the University of Texas Medical Branch, Galveston, Texas. The presentation was well received by attendees.

    A webinar recording of this presentation is available to members here.

    APAOG's next webinar is on November 10, 2016 and will cover Zika. Register today!

  • September 27, 2016 9:24 AM | Deleted user

    If you’re a pregnant woman and have a backache or headache, or a fever, your options for over-the-counter treatment basically boil down to one medication: the pain reliever acetaminophen, better known as Tylenol. Doctors advise against using nonsteroidal anti-inflammatories, like ibuprofen and aspirin, during late pregnancy because they can compromise fetal circulation and have other adverse consequences.

    But evidence has accumulated that, when taken during pregnancy, acetaminophen may increase the risk that children will develop asthma or attention deficit hyperactivity disorder. The elevated risk in most studies is small, and whether the drug itself is really to blame is debatable. But considering that more than 65 percent of pregnant women in the United States use acetaminophen at some point during their pregnancy, the number of children with problems stemming from it could be substantial.

    The odd thing about acetaminophen is that even after decades of widespread use, no one knows precisely how it blunts pain. But it has earned a reputation for strange side effects. Experiments indicate that it impedes people’s ability to empathize. It may undercut the brain’s ability to detect errors. When taken after a vaccine, it may suppress the immune system. Why might the drug affect both asthma and A.D.H.D. rates? Scientists have variously speculated that it could tweak the immune system during pregnancy, or disrupt hormones, or change growth factors in the developing brain. In short, no one knows.

    The prevalence of asthma doubled between 1980 and 2000. At the same time, worries over Reye’s syndrome, a rare complication in children who take aspirin, led to a rise in the popularity of acetaminophen. On the basis of this circumstantial — and rather weak — evidence, 16 years ago, scientists at King’s College London proposed a link between rising acetaminophen use and the so-called asthma epidemic. Their reasoning was that acetaminophen depleted the body’s native antioxidant, called glutathione, spurring inflammation of the lungs.

    Numerous studies followed showing an association with asthma, but they often relied on mothers’ potentially unreliable memories of what they took, or simply compared one group — mothers of asthmatic children, say — to a control group, a suboptimal study design.

    Recently, however, much stronger studies showing a link have emerged. A study of Norwegian women and children published this year in the International Journal of Epidemiology found that prenatal acetaminophen use increased 7-year-olds’ risk of asthma by 13 percent.

    Then, in August, a JAMA Pediatrics study on a British cohort noted that a mother’s use of the pain reliever in midpregnancy increased 7-year-olds’ risk of hyperactivity by 31 percent.

    Of course, some familial trait may push people to reach for acetaminophen, and this quality, as opposed to the drug itself, may explain the increased risks. But that doesn’t seem to be the case. A mother’s use after she gave birth wasn’t associated with more problems in the British and Norwegian studies. Nor was a father’s.

    Still, the authors are the first to note that perhaps they missed something. They don’t always know how much of the drug women take, or why they’re taking it. And there are reasons to think that the infections whose symptoms women might be treating with the pain reliever could themselves increase the risk of asthma and developmental problems. And yet these and some previous studies controlled for infections, and the association remained.

    Not all of the research has confirmed the relationship. But at this point, the number of strong studies that do find a link are hard to overlook, and are unnerving.

    Moreover, there’s evidence that the drug interacts more strongly with certain genotypes. Some of us carry gene variants that naturally alter the activity of the antioxidant glutathione, reducing its ability to detoxify. A 2010 study by Columbia University scientists found that, at age 5, the children with this variant, whose mothers had taken acetaminophen while pregnant, had double the risk of wheezing compared with children without the gene. In fact, without the gene, children had no increased risk of wheezing. So perhaps only a subset of people are vulnerable to the drug’s harmful effects.

    Petra Arck, a professor of fetal-maternal medicine at the University Medical Center Hamburg-Eppendorf, and colleagues gave the pain reliever to pregnant mice, and found it stressed the liver, altered the placenta and increased the pups’ vulnerability to wheezing.

    During pregnancy, the immune system must tolerate the fetus, which is half foreign, while also retaining enough firepower to fend off pathogens. Professor Arck argues that the drug can interfere with this balancing act.

    But two other mouse studies found no such effect on asthma or behavior. A major difference is the amount of acetaminophen given to the animals. Professor Arck used a big dose. The other two studies used less.

    Antonio Saad, a researcher at the University of Texas Medical Branch at Galveston whose own study failed to produce A.D.H.D.-like symptoms in mice, thinks that Professor Arck used an unrealistically high amount. But the dose was intentional, Professor Arck told me. Acetaminophen is in hundreds of medications, making it easy for pregnant women to take too much. Professor Arck thinks some women overdose without knowing it.

    Last year, the Food and Drug Administration reviewed evidence on acetaminophen and developmental outcomes and deemed it “inconclusive.” That was before the more recent studies appeared. When I asked, an F.D.A. spokeswoman told me that the F.D.A. was “actively reviewing” the new research. A spokeswoman for Johnson & Johnson, the maker of Tylenol, said the company wasn’t aware of evidence showing a “causal link” between prenatal use and later problems, but recommended discussing risks and benefits with a doctor.

    The greater problem is that the kind of study that would definitively answer the prenatal acetaminophen question — a trial on pregnant women — is unlikely to happen, because such studies are generally considered unethical.Top of Form

    This leaves mothers-to-be awash in uncertainty when contemplating a drug that’s widely recommended. So what to do? No one I spoke with proposed they avoid acetaminophen outright. There’s nothing else to take. And untreated fever during pregnancy can have severe consequences, premature birth among them.

    Instead, experts suggested that women use the minimum amount possible. Augusto Litonjua, a pulmonologist at Harvard Medical School who follows the research, noted that if women found themselves taking lots of acetaminophen, maybe they should consider non-pharmacological approaches to pain management, like acupuncture or meditation. For what it’s worth, in the recent JAMA Pediatrics study, the No. 1 reason for taking acetaminophen wasn’t infection or more severe problems, but backache. So maybe women’s partners should offer more massages, although that’s unlikely to help women dealing with serious pain.

    The broader takeaway, said Evie Stergiakouli, lead author on the JAMA study, is that just because acetaminophen is easy to acquire doesn’t mean it’s not a drug, and that it doesn’t have potential side effects.

    Moises Velasquez-Manoff, the author of “An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases,” is a contributing opinion writer.

    Follow The New York Times Opinion section on Facebook and Twitter (@NYTOpinion), and sign up for the Opinion Today newsletter

    A version of this op-ed appears in print on September 25, 2016, on page SR5 of the New York edition with the headline: The Trouble With Tylenol. Today's Paper|Subscribe


  • September 27, 2016 9:22 AM | Deleted user

    Date: September 26, 2016
    Source: University of East Anglia

    Summary: Researchers using DNA sequencing to profile antibiotic resistance in infection have achieved a turnaround time from 'sample to answer' of less than four hours for urinary tract infections (UTIs). 

    The nanopore MinION device is being researched by the University of East Anglia (UEA) as a way to speed up investigation of infection including UTIs -- one of the most common reasons patients are prescribed antibiotics.

    Traditional culture methods take two to three days to characterise bacteria and test their antimicrobial resistances from a urine sample. Early results from the UEA group's method showed that the Oxford Nanopore Technologies device can characterise bacteria and predict their antimicrobial resistances in just 12 hours from a urine sample.

    This has now been shortened to as little as four hours, as published in the Journal of Antimicrobial Chemotherapy.

    While most UTIs are mild, serious cases can lead to hospitalisation. At worst, bacteria can enter the bloodstream causing urosepsis, a life-threatening condition. In this case antibiotics are vital and must be given urgently.

    Faster prediction of whether the UTI is caused by a highly-resistant type of bacteria will allow precise tailoring of treatment. The patient will get an antibiotic that is sure to be active against their pathogen, and society's limited antibiotic resource will be better managed. This will help in the fight against increasing antibiotic resistance, one of the biggest challenges facing society today.

    As highlighted in the O'Neill report in May of this year, overuse of antimicrobials and the resulting increase in antibiotic resistance could -- if all antibiotics fail -- lead to the loss of 10 million lives a year by 2050 if no action is taken. This government-commissioned report stresses the potential of rapid diagnostics to improve both treatment and antibiotic stewardship and called on the governments of the richest countries to "mandate now that by 2020, all antibiotic prescriptions will need to be informed by up-to-date surveillance information and a rapid diagnostic test wherever one exists."

    Prof David Livermore from UEA's Norwich Medical School said: "Identifying specific pathogens and resistance to antibiotics as quickly as possible is the key to reducing the number of patients who are 'over treated' with broad-spectrum antibiotics while waiting for results to come through from the micro lab -- a process that presently takes a couple of days'.

    "This 'carpet-bombing' approach -of giving a broad spectrum antibiotic whilst you wait for results -leads to poor antibiotic stewardship. It's vital that we move beyond it. The way to do so lies in accelerating lab investigation. That way, treatment can be refined earlier. This will benefit the patient, who gets an effective antibiotic, and society, whose diminishing stock of antibiotics is better managed."

    The findings published today showed the MinION nanopore sequencing can significantly accelerate diagnosis and resistance profiling, identifying pathogens and acquired resistance genes correctly, without culture.

    Dr Justin O'Grady from Norwich Medical School said: "This study is the first to use MinION sequencing to rapidly diagnose pathogens and antimicrobial resistance in clinical samples, without growing them. Improvements in the sequencing technology, data analysis and sample preparation mean we've reduced the turnaround time to four hours.

    "Getting results this fast would allow clinicians to adjust antimicrobial very early, even before the second dose is given -- most antibiotics are given around once every eight hours."

    In the study, human cells were removed from patients' urine samples, then the bacteria were recovered and their DNA was sequenced by MinION. Sequences were analysed and the results compared with standard culture and antibiotic susceptibility testing.

    Dr O'Grady said: "Both the type of bacteria and the acquired resistance genes were identified reliably, agreeing with conventional laboratory testing.

    "Challenges remain, though. The approach is currently best suited to difficult cases, but improving hospitals' antibiotic stewardship requires new diagnostics to be deployed widely.

    "Our method currently requires heavily-infected urine and our rapid analysis can't yet predict those resistances that arise by mutation -- changes to existing genes. But the technology is developing rapidly and we expect to overcome these limitations in the near future."


    Story Source:

    Materials provided by University of East AngliaNote: Content may be edited for style and length.


    Journal Reference:

    1. K. Schmidt, S. Mwaigwisya, L. C. Crossman, M. Doumith, D. Munroe, C. Pires, A. M. Khan, N. Woodford, N. J. Saunders, J. Wain, J. O'Grady, D. M. Livermore. Identification of bacterial pathogens and antimicrobial resistance directly from clinical urines by nanopore-based metagenomic sequencingJournal of Antimicrobial Chemotherapy, 2016; dkw397 DOI: 10.1093/jac/dkw397

    University of East Anglia. (2016, September 26). UTI testing technology cuts screening time to four hours. ScienceDaily. Retrieved September 27, 2016 from www.sciencedaily.com/releases/2016/09/160926100125.htm


  • September 26, 2016 11:25 AM | Deleted user

    By John Pope, Kaiser Health News

    The Zika virus has struck fear throughout the Americas, but determining whether people have been infected can be difficult.

    Here’s why: Most infected people don’t display symptoms or they choose to tough out what may seem like nothing more than influenza instead of seeking medical help. Moreover, infected people don’t have much detectable virus, and what’s in the body doesn’t linger.

    There is no commercial test approved by the Food and Drug Administration to detect Zika infections, but the agency has given emergency-use authorization for 10 tests to be used by health officials in the meantime. But processing these tests takes time because they must be shipped to laboratories. In addition, there are concerns about accuracy — one test, developed by the federal Centers for Disease Control and Prevention, which looks for antibodies to the virus, has been plagued by false-positives. It often shows infection by the Zika virus when the culprit is really a closely related microorganism from the same family.

    Researchers are seeking to streamline the process. Among them is Robert Garry, a Tulane University virologist who has been working for the past six months to develop a test that doesn’t look for the virus but, like the CDC-developed process, searches for the immune system’s reaction to it. Unlike the existing procedures, he said, “we’re trying to put together a test that anybody could use” and process within 20 minutes without having to use a lab.

    The procedure Garry and his colleagues want to develop will look for antibodies because, Garry said, they stay in the body longer, especially in urine.

    “The virus goes away quickly, but the damage can be done,” said Garry, a professor of microbiology and immunology.

    According to the CDC, Zika antibodies show up in the blood four to five days after the onset of illness and can last 12 weeks — or longer.

    Garry said the CDC’s test looks for immunoglobulin M, or IgM, antibodies that show up relatively early in an infection.

    “They wouldn’t detect a longer-term infection,” said Garry, adding that the test he and his colleagues want to develop would find antibodies that appear later.

    The Zika virus, which now has a toehold in the United States after sweeping through Brazil and other Latin American countries, is most commonly spread by mosquitoes but can also be transmitted via blood, sexual contact and by mother to fetus.

    The CDC has logged more than 2,900 cases in the United States and since July reported cases in Florida that were likely caused locally by mosquito bites. Nearly 16,000 cases have been reported in U.S. territories, primarily Puerto Rico.

    In California, there have been no reported cases of Zika contracted locally from mosquito bites. However, there were 282 known cases of travel-associated Zika in the state as of Friday, according to the most recent data from the California Department of Public Health.

     Advertisement

    On Thursday, the chairman of the state Senate’s Health Committee, Sen. Ed Hernandez (D-West Covina) convened a town hall in Los Angeles, where experts discussed what Californians can do to minimize the public health risk Zika poses.

    “The Zika virus does not discriminate against county, state or country borders and we must do everything in our power to ensure our communities are aware of Zika and protected against its negative impacts,” Hernandez said. “While Zika has not reached epidemic proportions in the state, it is vital that the public be equipped with knowledge and resources to effectively combat anything in the future.”

    In addition to avoiding travel in parts of the world where Zika is prevalent, especially if you are pregnant, “you can prevent mosquito breeding in your neighborhood by eliminating standing water and reporting mosquitoes to your local vector control office,” said Jeffrey Gunzenhauser, Interim Health Officer for Los Angeles County, who spoke at the town hall.

    Zika symptoms can include fever, rash, joint and muscle pain, and nausea, but most infected people may not realize they have the virus. There is no specific medicine or vaccine. The CDC recommends rest and plenty of fluids.

    The virus is most dangerous when transmitted to a pregnant woman because it can cause microcephaly, a condition in which the brain does not develop properly in the fetus, resulting in a smaller-than-normal head.

    In addition to the CDC’s antibody-detection test, which is known as Zika MAC-ELISA, another test from the CDC is designed to distinguish the Zika virus from closely related microorganisms that cause dengue and chikungunya.

    In both, a specimen of blood, urine or other fluid from the body is put onto a plastic plate and subjected to several hours of incubation and washing, followed by the addition of a reagent that will produce a color pattern. An instrument that measures colors is then used to confirm the presence of the virus, said Randall Kincaid, the senior scientific officer at the National Institute of Allergy and Infectious Diseases.

    The turnaround time on each should be about a day, he said.

    “It isn’t my favorite or anyone’s favorite type of an assay,” Kincaid said, “but it’s what the CDC had available as a template for evaluating infections by endemic virus.”

    Acknowledging that this takes time, Kincaid said, “If your concern is knowing that you’ve been infected, you’re willing to sacrifice a day to get the most reliable answer.”

    The other procedures also use blood and other body fluids to look for the Zika virus’ RNA, a molecule that is important to genetic expression. Each test, Kincaid said, teases out the virus — if it’s there. The result should be available within hours.

    The confidence in these tests is “quite different, based on the virological truths that underlie these tests,” Kincaid said.

    The research is still relatively new, Garry said, so it may take time for articles to appear in peer-reviewed journals.

    Like other Zika-detection tests, Garry said the device he is working on would be similar to a pregnancy test. Blood or urine would be put on a plastic sheet or in a cassette that would show the results.

    Results would be ready within 20 minutes without resorting to a lab, he said.

    So far, results have been “promising,” according to Garry, but he and his colleagues are still working to rule out what is known as cross-reactivity, in which the test reacts to a virus similar to the one that causes Zika.

    The Zika virus is a flavivirus, a member of a gene that includes the viruses that cause West Nile fever, dengue fever and yellow fever.

    Garry said he hopes to have a test ready in a few months and then apply for emergency-use authorization from the FDA.

    He said he is aiming for a test that would provide results quickly and could be used in what he called “low-resource settings,” where a clinic or laboratory might not be available.

    “That’s something we’d love to have access to in the best of worlds,” Kincaid said, because it would become easier to administer the tests in areas where the virus is endemic but access to health care is, at best, scarce.

    This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.



  • September 26, 2016 9:52 AM | Deleted user

    Mosquitoes can spread viruses like Zika, chikungunya, and dengue.This flipbook gives basic information about mosquito control activities and how to protect from mosquito bites. Mosquito control approaches that incorporate community education, and mosquito surveillance and control are often called “integrated vector control.” A vector is an insect, like a mosquito, that can spread viruses.

    Download here

  • September 26, 2016 9:44 AM | Deleted user

    THURSDAY, Sept. 22, 2016 -- An experimental DNA-based vaccine protected monkeys from infection with the birth defects-causing Zika virus, and it has proceeded to human safety trials, researchers report.

    "The vaccine universally elicited antibodies from all primates, but for the animals that got a full dose of vaccine, 17 of 18 were protected from infection," said study co-author Ted Pierson. He is chief of the Viral Pathogenesis Section at the U.S. National Institute of Allergy and Infectious Diseases.

    Based on these findings, researchers have begun clinical safety trials in healthy human beings, Pierson said. These trials will show whether the vaccine is safe in humans, and whether it prompts an immune system response as it did in monkeys.

    "When a vaccine is effective in a lower primate species, it is a good signal that it will be effective in humans," said Dr. Amesh Adalja, a senior associate at the University of Pittsburgh's UPMC Center for Health Security in Baltimore. "The NIH vaccine candidates have cleared an important hurdle, and we are awaiting results from phase 1 human studies."

    However, animal research does not always pan out in humans.

    Zika is the first mosquito-borne virus known to cause terrible birth defects, most of them brain-related. The most common defect is microcephaly, in which a child is born with an abnormally small brain and skull. Thousands of babies have been born with Zika-linked microcephaly, most of them in Brazil, since an outbreak began in South America in April 2015.

    Zika infections have been occurring in south Florida, with 43 cases as of Sept. 21, according to the federal Centers for Disease Control and Prevention. There have been no reports of microcephaly in the state.

    Because of the ongoing transmissions, a Zika vaccine is important to prevent future birth defects, Adalja and Pierson said.

    This potential vaccine contains a piece of DNA created synthetically in the laboratory from the Zika virus, Pierson said.

    When introduced into the body, the DNA causes small virus-like particles to be secreted from cells, Pierson explained. These particles are not full-fledged Zika, but are similar enough to the virus that the immune system might produce an antibody response that will also protect against Zika.

    "This kind of vaccine, which we call a DNA vaccine, there's precedent for this," Pierson said, noting that similar technology was used years ago to create a candidate vaccine for West Nile virus.

    To test the potential effectiveness of the Zika vaccine, researchers provided a single dose to six rhesus monkeys and two shots to 18 monkeys.

    None of the monkeys that received a single dose was protected from Zika infection, but the vaccine did appear to create an antibody response, the researchers found.

    Their blood contained less Zika virus than animals who did not receive the vaccine.

    The two-dose vaccine series protected 17 out of the 18 monkeys against exposure to Zika, and provided researchers with an idea of how much antibody response is needed to protect against infection.

    "The DNA vaccines leading the way in the Zika vaccine rush are an important innovative development, and would represent the first commercially available DNA vaccines if proven to be effective and safe," Adalja said.

    This vaccine could protect fetuses against Zika by creating an immune response in pregnant women that prevents a full-fledged viral infection, Pierson said. The vaccine is not expected to cause Zika-like birth defects itself, because it does not cause Zika infection.

    "The reason why there are Zika-associated neurodevelopmental defects is because the virus is actually infecting the fetus and attacking developing neurons in the fetus, causing direct harm," Pierson explained. "The neurodevelopmental defects are a result of what the viral infection is doing, not a result of the body's immune response."

    It's unclear when this or some other Zika vaccine will be available for use. Any vaccine candidates will have to be tested during a future Zika outbreak, to see whether it is able to protect people against active viral transmission, Pierson said.

    Adalja added that other potential Zika vaccines are in earlier stages of development, including an inactivated virus approach at Walter Reed National Military Medical Center in Bethesda, Md., and RNA vaccines under development by two private companies.

    The findings on the DNA vaccine were published Sept. 22 in the journal Science.

    More information

    The U.S. Centers for Disease Control and Prevention provides more information onmosquito-borne diseases.

    This Q & A will tell you what you need to know about Zika.

    To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.

    Copyright © 2016 HealthDay. All rights reserved.


  • September 23, 2016 9:39 AM | Deleted user

    By Lena H. Sun September 21 at 4:54 PM 

    Drug-resistant Neisseria gonorrhoeae diplococcal bacteria, which causes gonorrhea, the second most common infectious disease in the United States. (James Archer/CDC)

    U.S. health officials have identified a cluster of gonorrhea infections that show sharply increased resistance to the last effective treatment available for the country's second most commonly reported infectious disease.

    The findings from a cluster of Hawaii cases, presented Wednesday at a conference on prevention of sexually transmitted diseases, represent the first cluster of cases in the United States that have shown such decreased susceptibility to the double-antibiotic combination used when other drugs have failed. If the bacteria continue to develop resistance, that end-of-the-line therapy ultimately will fail, and an estimated 800,000 Americans a year could face untreatable gonorrhea and the serious health problems it causes, health officials said.

    This latest news about antibiotic resistance came as world leaders gathered at an unusual meeting at the United Nations to address the rising threat posed by superbugs, microbes that can’t be stopped with drugs. Leaders adopted a joint declaration committing them to address the root causes of antimicrobial resistance, especially in human health, animal health and agriculture.

    Nations called for better use of existing tools to prevent infections in humans and animals, including farmed fish. Norway's prime minister spoke about how her country has been vaccinating every single "baby salmon, just like small kids," and as a result, has cut antibiotic use in one of its principal foods and exports to virtually zero.

    One form of Staphylococcus aureus bacteria known as methicillin-resistant Staphylococcus aureus, causes a range of potentially deadly illnesses. (National Institute of Allergy and Infectious Diseases)

    In the United States, drug-resistant gonorrhea already is one of the country's three most urgent superbug threats, according to the Centers for Disease Control and Prevention. In each case, as with other diseases such as pneumonia and tuberculosis, overexposure to antibiotics has allowed the particular germ to more rapidly develop resistance.

    CDC warned this summer that evidence of gonorrhea's diminished vulnerability to one of the last-resort drugs, azithromycin, was emerging nationwide. But it said the other antibiotic, ceftriaxone, was still effective.

    That's why the latest findings are so distressing for health officials. It means current treatment options are in jeopardy, said Gail Bolan, director of CDC's division of STD prevention. "What's unique about this cluster now identified in Hawaii is that these strains, we've really never seen before," she said.

    Laboratory tests of the gonorrhea samples collected from seven people in Honolulu in April and May showed resistance to azithromycin at "dramatically higher levels" than typically seen in the United States, according to researchers from Hawaii's state health department. Five of the seven samples also showed increased resistance to ceftriaxone.

    Hawaii is on the front line for antibiotic-resistant gonorrhea, health officials say, and monitors resistance patterns closely. So the state was able to catch this cluster of cases early. Although the patients were treated successfully with the recommended two drugs, and no other cases were identified, officials are worried that the resistance pattern and cluster indicate the strain was able to spread.

    Many people don't actually know they're infected with gonorrhea because they have no symptoms. As a result, the disease goes undetected and untreated, which can cause a range of problems. Women risk chronic pelvic pain, life-threatening ectopic pregnancy and even infertility. And for both women and men, infection also increases the risk of contracting and transmitting HIV.

    History has shown that gonorrhea bacteria have been able to outsmart and become resistant to a long list of antibiotics that includes penicillin, tetracycline, and fluoroquinolones. CDC has been closely monitoring early warning signs of resistance not only to azithromycin but also to cephalosporins, the class of antibiotics that includes ceftriaxone.

    But officials now say there are no back-up options that are highly reliable, widely available, affordable and well tolerated. An oral antibiotic under development might offer a possible new treatment, researchers from Louisiana State University said at the CDC-sponsored conference in Atlanta. The drug was generally safe and effective in treating gonorrhea in a phase 2 clinical trial; those results will need to be confirmed in a large-scale clinical study.

    The experimental drug works differently from any currently marketed antibiotic. It is a single-dose oral therapy and could be used as an alternative to a ceftriaxone injection. In the randomized controlled trial reported Wednesday, researchers treated 179 people with gonorrhea using the experimental drug alone (at two different dosages) or ceftriaxone alone. Virtually all the patients receiving the experimental drug were cured, they said. Every patient given ceftriaxone also was cured.

    At the UN meeting in New York, antibiotic use in animals was a major focus. Norway long depended on antibiotics to protect farmed salmon from a bacterial fish disease, and the fish industry was concerned that "you couldn't have growth if you don't use antibiotics," Prime Minister Erna Solberg said.

    But that turned out not to be the case, she said. In the late 1980s, scientists there developed an effective vaccine that has no side effects in humans. By 1994, fish farmers had made the switch from antibiotics to vaccination. For 15 years, farmers vaccinated the baby salmon by hand until better technology was developed, she said.

    "We need an international ban on using antibiotics as growth improvement," she said. "To combat illness, yes, but not as growth improvement."

    Participants welcomed what everyone agreed was long overdue attention to antimicrobial resistance. But several said declarations and "action plans" aren't enough without measurable goals and concrete targets.

    At a fundamental level, antimicrobial resistance is a public health failure, some experts said. Governments need to accept that responsibility, stressed Joanne Liu, international president of Doctors Without Borders, which is known by its French acronym, MSF. "I am running out of options," she said. Too often, MSF doctors are treating children injured by war wounds who "end up dying from a bone infection weeks later," she said.

    Martha Tellado, president and chief executive of Consumer Reports, said countries need to launch high-profile public awareness campaigns, and institutions such as hospitals need to be more transparent so consumers can be informed about drug-resistant outbreaks.

    Martin Khor, executive director of the South Centre, an intergovernmental organization of developing countries, said there have been similar declarations to fight antimicrobial resistance in the past.

    "For 40 years, governments have not stepped up enough to take a leadership role," he said. Developing countries need to be convinced of the seriousness of the issue, and their civil societies need to become engaged to exert pressure on elected officials. "If it comes from society, and society says to politicians, 'This is what we want you to do,' then it will create a political will," he said.

    Original Post: The Washington Post

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