Pandora Report 4.18.14

I think I was coming down with something yesterday. It manifested as a pretty debilitating headache, so I am pretty sure it wasn’t Ebola, but I also had no desire to drink water, so it might have been rabies. Either way, I’m feeling much better today, and am excited to bring you a Saturday issue of Pandora Report. In fact, I’m pretty sure there is nothing that is more fun on the weekend…so let’s get into it!


Highlights include Bird Flu in North Korea, a TB drug that may be the answer to drug resistance, a new strain of Ebola, MERS CoV’s spread to Asia, and Tamiflu’s real utility. Have a great weekend and see you here next Friday!

Highly Pathogenic Avian Influenza (HPAI) outbreak in North Korea

On April 16, the North Korean veterinary authority sent a notice to the World Organization for Animal Health (OIE) alerting them to two H5N1 outbreaks among poultry in the isolated nation. This is a surprisingly transparent move. The first outbreak occurred at the Hadang chicken factory in Hyongjesan starting on March 21. All 46,217 birds died. A second outbreak occurred on March 27 in the same region at the Sopo chicken factory where an unreported number of birds died in the same cage. The source of the infection remains unknown.

The Poultry Site—“Usual control measures have been put in place to control the spread of infection: quarantine, movement control inside the country, screening and disinfection of infected premises/establishment(s). There is no vaccination and no treatment of affected birds.”

Could a new TB drug be the answer to resistance?

A research study at the University of Illinois shows that a new drug under clinical trials for tuberculosis treatment—SQ109—may be the basis for an entirely new class of drugs that could act against bacterial, fungal, and parasite infection and yet evade resistance. Lead researcher, chemistry professor Eric Oldfield, believes that multiple-target drugs like SQ109 and its analogs hold the key to new antibiotic development in the era of drug resistance and “the rise of so-called ‘superbugs’.” His claim is bolstered by experiments with SQ109 and TB where no instances of resistance have been reported.

Science Codex—“’Drug resistance is a major public health threat,” Oldfield said. “We have to make new antibiotics, and we have to find ways to get around the resistance problem. And one way to do that is with multi-target drugs. Resistance in many cases arises because there’s a specific mutation in the target protein so the drug will no longer bind. Thus, one possible route to attacking the drug resistance problem will be to devise drugs that don’t have just one target, but two or three targets.’”

Outbreak in West Africa is caused by a new strain of Ebola virus

As the death toll from the Ebola outbreak in West Africa climbs above 120, scientists are reporting that the virus is not the same strain that has killed in other African nations.  While the source of the virus is still unknown, blood samples from Guinea victims has confirmed that it is not imported strains of Ebola Zaire—the original strain of the virus discovered in Democratic Republic of Congo (formerly known as Zaire.)

The Huffington Post—“‘It is not coming from the Democratic Republic of Congo. It has not been imported to Guinea” from that country or from Gabon, where Ebola also has occurred, [Dr. Stephan] Gunther [of the Bernhard Nocht Institute for Tropical Medicine in Hamburg, Germany] said.

Researchers think the Guinea and other strains evolved in parallel from a recent ancestor virus. The Guinea outbreak likely began last December or earlier and might have been smoldering for some time unrecognized. The investigation continues to try to identify “the presumed animal source.’”

MERS CoV leaves the Middle East and travels to Asia

Though the method of transmission of Middle East Respiratory Syndrome (MERS) remains unknown—a report last week from the CDC finds the virus can stay alive in Camel milk—and thankfully, transmission from human to human has been rare, the disease has now spread beyond the Middle East to Asia via an infection emerging in Malaysia. A Malaysian man returning from Mecca, in Saudi Arabia, tested positive for, and died from, MERS on April 13. So far, a reported 33 people who have travelled to the Middle East for the Haj have tested negative for presence of the virus in neighboring Singapore.

Today Online—“There is currently no advisory against travel to countries of the Arabian Peninsula, or to countries reporting imported cases of MERS-CoV (including Malaysia).

Frequent travellers to the Middle East and Umrah/Haj pilgrims have been advised to take precautions, such as being vaccinated against influenza and meningitis. Those aged 65 years and above or with chronic medical conditions should also get vaccinated against pneumococcal infections before travelling. Pilgrims with pre-existing chronic medical conditions like diabetes, chronic heart and lung conditions should consult a doctor before traveling, to assess whether they should make the pilgrimage.”

A closer look at Tamiflu

With seasonal flu season behind us in the U.S., maybe it is time to look at better treatment options. A study published last week in the British Medical Journal, calls into question the effectiveness of Oseltamivir—brand name, Tamiflu. The international team of researchers found that while Tamiflu can shorten flu symptoms it does not reduce hospital admissions or medical complications. The study also demonstrated that Tamiflu can also cause nausea and vomiting and increases the risk of headaches and renal and psychiatric symptoms.

Global Biodefense—“‘The trade-off between benefits and harms should be borne in mind when making decisions to use oseltamivir for treatment, prophylaxis, or stockpiling,” concludes the study authors from The Cochrane Collaboration, an independent global healthcare research network. “There is no credible way these drugs could prevent a pandemic,” Carl Heneghan, one of the lead investigators of the review and a professor at Oxford University, told reporters. “Remember, the idea of a drug is that the benefits should exceed the harms. So if you can’t find any benefits, that accentuates the harms.’”

(Image credit: Robert Sharp/Flickr)

The Pandora Report 9.13.13

Highlights this week include further evidence linking camels to MERS, a big innovator turning his eye to biodefense, tracking influenza A in Norwegian birds, the “eradicated” measles in the US,  tripling Tamiflu to help us all survive a serious H1N1 pandemic, and this week’s weird piece. Happy Friday!

Blame the Camel

It looks like dromedary camels are indeed the vector transmitting MERS from its proposed bat reservoir to humans. Antibodies against the deadly respiratory virus have been found in blood samples collected from camels across the Middle East, including Egypt, Sudan, Oman, and the Canary Island. However, before everyone starts shunning the desert beast of burden, it should be noted that the vast majority or MERS cases have had no contact with the animals, further suggesting person-to-person spread. Officials are calling for greater surveillance, which to date has been spotty in most states.

New York Times – “…it appears that the first confirmed or suspected cases in three separate clusters may have [had contact with camels], and in two cases, the camels were observed to be ill. According to the Saudi newspaper Asharq, a 38-year-old man from Batin, Saudi Arabia, who died of what was diagnosed as bacterial pneumonia was a camel dealer with at least one obviously sick camel. Later, other members of his family, including a mother, daughter and cousin, fell ill with what was diagnosed as MERS, and two died. They were part of a cluster of cases reported Sept. 7 by the World Health Organization.”

Tech Visionary Focuses Now On Biological Weapons Threat

An interesting interview with a tech mogul formerly associated with Microsoft. Like so many of us in the biodefense field, he’s worried about a domestic terror threat operating out of a small lab. It’s refreshing to see someone outside of the industry, with potential means, getting involved with biodefense in a way that doesn’t just involve anthrax.

NPR – “Biological terror is interesting because it is so damn cheap and yet can be even more lethal than nuclear…In this case, the adversary is going to be hidden. It’s going to be a small lab of people who could be cooking up a bio-terror weapon. They’re very unlikely to announce themselves until after the attack.”

Influenza virus in wild birds in Norway

A group of researchers in Norway have determined that ducks and gulls are a natural host of influenza A. Dabbling ducks in particular are the most prevalent host of the virus. Researchers were interested in determining the primary host in order to better understand patterns of seasonal infection.

Phys.org – “The complete genetic material from a total of five influenza viruses from mallard and common gull were sequenced and characterized. The results showed that the genes of the Norwegian viruses resembled the genes found in influenza viruses from other wild birds in Europe…Due to limited overlap between the routes used by migratory birds in Eurasia and America, influenza viruses with different genetic material have developed between these two continents. However, in some areas, it has been observed that genes can be exchanged between influenza viruses from Eurasia and America.”

Measles still poses threat to US, health officials warn

Measles is making a comeback in the US, thanks to the groups of people who think that vaccinating for measles is a bad idea. Of the 159 cases last year, 82 percent involved those who had not been vaccinated. Technically the disease has been eradicated in the US.

FOX – “Of the patients who had not received measles immunizations, 79 percent had philosophical objections to vaccination, federal health officials said. Results of a National Immunization Survey released today show that 90.8 percent of U.S. toddlers between the ages of 19 and 35 months have received at least one dose of the measles, mumps and rubella vaccine (MMR) – just above the federal government’s target of 90 percent. However, federal health officials warned that measles imported from other countries can still cause large outbreaks in the U.S., especially if introduced into areas with clusters of unvaccinated persons.”

Triple Dose Tamiflu Beats Back H1N1

If at first you don’t succeed, try, try again. A study from the University of Manitoba in Winnipeg revealed that patients critically ill with H1N1 were able to clear the virus within five days if given triple the normal dose of Tamiflu. According to study researcher Dr. Anand Kumar, amongst those patients administered the triple dose of the flu drug, 79%  cleared the virus within the 5-day timeframe, compared with just 11% of patients given the normal dose. It should be noted that past studies involving the doubling  of Tamiflu doses did not yield significant clearance times.

MedPage Today – “‘What we found was that the treatment was well-tolerated, and there were many more patients achieving viral clearance at day 5, which was our study endpoint,’ Kumar said during a session at the Interscience Conference on Antimicrobial Agents and Chemotherapy. Kumar noted that the 5-day endpoint was important because of increased survival benefits from the shortened clearance time and the reduced amount of time a patient has to endure in continued isolation, “which is a source of significant manpower demand for an intensive care unit.”

This week’s weird piece: ‘US provided chemical and biological weapons to Saddam Hussein’ – retired military officer

Disclaimer: This is from Voice of Russia, which is  the Russian government’s broadcast network and therefore not exactly a pillar of journalistic integrity.

(image Adam Foster/Flickr)

British Medical Journal Slams Roche on Tamiflu

Via the Boston Globe

LONDON — A leading British medical journal is asking the drug maker Roche to release all its data on Tamiflu, claiming there is no evidence the drug can stop the flu.

The drug has been stockpiled by dozens of governments worldwide in case of a global flu outbreak and was widely used during the 2009 swine flu pandemic.

On Monday, one of the researchers linked to the BMJ journal called for European governments to sue Roche.

‘‘I suggest we boycott Roche’s products until they publish missing Tamiflu data,’’ wrote Peter Gotzsche, leader of the Nordic Cochrane Centre in Copenhagen. He said governments should take legal action against Roche to get the money back that was ‘‘needlessly’’ spent on stockpiling Tamiflu.

World Health organization spokesman Gregory Hartl said the agency had enough proof to warrant its use for unusual influenza viruses, like bird flu.

In a statement, Roche said it had complied with all legal requirements on publishing data and provided Gotzsche and his colleagues with 3,200 pages of information.