The Pandora Report 9.27.13

Highlights include MERS, more MERS, Marburg & Ebola, chemical weapons antidotes, universal vaccine. Happy Friday!

Saudi Efforts to Stop MERS Virus Faulted

Saudi Arabia is being accused both of withholding information and conducting incomplete epidemiological investigations on MERS. While health officials have been careful to collect as much information as possible from infected individuals, they have been accused of neglecting to interview healthy contacts of infected patients. Such interviews are critical to determining possible routes of transmission. Saudi officials have vehemently denied these accusations, arguing it’s impossible to withhold what they don’t know.

Wall Street Journal – “‘It’s very difficult to give all the details to the people when we don’t know all the details,’ Ziad Memish, the deputy health minister, said last week at his office in Riyadh, the Saudi capital. ‘”Where’s it coming from? We don’t know. How is it transmitted? We don’t know.'”

Middle Eastern Respiratory Syndrome Update

Speaking of MERS, the CDC has updated its epi information on the virus. According to this week’s Morbidity and Mortality Weekly Report, there are now 130 cases, of which 45% of were fatal. While cases have occured in eight countries, all infected patients had recently visited or resided in just four countries – Jordan, Qatar, Saudi Arabia, and the UAE. Also of note, just over a fifth of cases (21%) were asymptomatic. No new information on mvectors, reservoirs, or route of infection.

CDC –  “To date, the largest, most complete clinical case series published included 47 patients; most had fever (98%), cough (83%), and shortness of breath (72%). Many also had gastrointestinal symptoms (26% had diarrhea, and 21% had vomiting). All but two patients (96%) had one or more chronic medical conditions, including diabetes (68%), hypertension (34%), heart disease (28%), and kidney disease (49%). Thirty-four (72%) had more than one chronic condition (7). Nearly half the patients in this series were part of a health-care–associated outbreak in Al-Ahsa, Saudi Arabia (i.e., a population that would be expected to have high rates of underlying conditions) (8). Also, the prevalence of diabetes in persons aged ≥50 years in Saudi Arabia has been reported to be nearly 63% (9). It remains unclear whether persons with specific conditions are disproportionately infected with MERS-CoV or have more severe disease.”

New Marburg & Ebola Theraputics?

Tekmira Pharmaceuticals Corporation has developed a Marburg treatment which protects non-human primates from the virus completely (100%), even if administered 24 hours after post infection. This is very exciting. The company has also received funding to undertake a similar Ebola treatment, with Phase I clinical trials set to begin early next year.

Street Insider – “In a presentation entitled ‘Medical Countermeasures for Filovirus Infection: Development of siRNA Therapeutics Under the Animal Rule’ data were presented that showed successful anti-viral therapy with the application of Tekmira’s LNP technology to hemorrhagic fever viruses, including multiple strains of the Ebola and Marburg viruses. Newly presented data resulting from a collaboration between Tekmira and the University of Texas Medical Branch (UTMB) showed 100% survival in non-human primates infected with the Angola strain of the Marburg virus in two separate studies. In the first study, 100% survival was achieved when dosing at 0.5 mg/kg TKM-Marburg began one hour after infection with otherwise lethal quantities of the virus. Dosing then continued once daily for seven days. In the second study, 100% survival was achieved even though treatment did not begin until 24 hours after infection.

Scientists at UNC-Chapel Hill, Wake Forest work on antidotes to nerve gas

The Defense Threat Reduction Agency has awareded UNC-Chapel Hill a $4.47 million grant to develop antidotes to nerve gas. While the timing of the award may seem a little reactionary, apparently discussions on the project began over a year ago. Researchers are hoping to create an adhesive bandage, pre-loaded with the antidote which would be administered through tiny needles in the bandage itself. The advantage of a bandage over an injected serum is self-administration – no medical professional would be needed to administer it.

Charlotte Observer – “‘We can load them up with antidotes to nerve agent, including enzymes that combat nerve agent,’DeSimone [a professor of chemistry at UNC-CH and chemical engineering] said. ‘The idea was to put them directly into a dissolvable microneedle that’s painless – just a patch – and rapidly get them into the bloodstream’ Such a device could be used by the military or civilians during an attack, when poison gas can kill within minutes. The patch could be easily disseminated and transported, DeSimone said, and would have a long shelf life.

Researchers Move Step Closer to Universal Seasonal Flu Vaccine

It’s nearly flu season again, and for many of us that means shots. For scientists, it means hoping their predictions as to which strain of flu will strike are right, and that the vaccine in the shots is actually useful. Making things easier for everyone, scientists at the Imperial College of London have determined a “blueprint” for a single vaccine against all types of influenza. Scientists there have found that by boosting CD8 killer T cells, rather than trying to trigger antibody production, the vaccines are significantly more effective.

Voice of America – “’Such a vaccine would induce T cells that would be able to recognize new viruses that have not even been identified yet. In other words, future pandemic strains. In that sense, it’s a universal vaccine. And it will be different to existing vaccination where currently every year a new vaccine has to be developed, which is why we are always one step behind…'”

(image courtesy of CIDRAP)