Top Infectious Disease News of the Week—September 1, 2019

#5: Rethinking How New Antibiotics for Resistant Infections Are Approved: Public Health Watch

In the face of challenges posed by multidrug-resistant (MDR) infections, the world desperately needs new antibiotics—and fast.

And yet, the existing processes for the research and development of novel therapeutics may be flawed to such an extent that quickly and efficiently identifying agents that are safe and effective against MDR organisms may be next to impossible—at least according to an analysis published in The Lancet Infectious Diseases. Among the authors’ recommendations: augmenting the noninferiority trials currently used in the approval process for most new antibiotics with so-called “adaptive” post market studies that allow for modification of design parameters (including endpoints and inclusion/exclusion criteria) while research is ongoing.

Such an approach has been used successfully in the development of novel treatments for Ebola, the authors noted.

Read the full story here.

#4: Why We Need More Open-Source Epidemiological Tools

In the middle of an outbreak, having the right tools can make all the difference. Epidemiological resources, such as modeling systems, are useful but can be costly and have limited use across large teams.

A newer tool, though, is changing the game in outbreak response and modeling. The Spatiotemporal Epidemiologic Modeler (STEM) is an open-source software that is available to the global health community. This is not just a rigid instrument against disease, in that it is not pre-set to a specific disease or environment and has the flexibility for hundreds of variations.

“STEM has been used to study variations in transmission of seasonal influenza in Israel by strains; evaluate social distancing measures taken to curb the H1N1 epidemic in Mexico City; study measles outbreaks in part of London and inform local policy on immunization; and gain insights into H7N9 avian influenza transmission in China. A multi-strain dengue fever model explored the roles of the mosquito vector, cross-strain immunity, and antibody response in the frequency of dengue outbreaks,” the authors of a briefing in Health Security wrote.

Read the full story here.

#3: C Diff and Fungi: An Unexpected Partnership

Few gastrointestinal infections drive fear like that of Clostridioides difficile (C diff). A nasty bacterial infection that can cause diarrhea and colitis, it is increasingly associated with antibiotic use and health care exposure. The US Centers for Disease Control and Prevention (CDC) estimates that nearly half a million cases occur each year in the United States and that among patients infected, 20% will experience a recurrence. Moreover, patients over 65 years of age who are diagnosed with C diff related to health care exposure, 1 in 11 will die due to their infection.

This gut bug has become a growing issue for infection prevention efforts in health care settings and combatting its easy spread has challenged efforts across the country. As investigators push to advance C diffresponse and prevention efforts, part of the challenge is truly understanding how this bacteria works. In a new investigation led by David B. Stewart, MD, FACS, FASCRS, of the University of Arizona, a study team sought to use a new approach to understand the dynamics at play for C diff infections.

Read the full list here.

#2: FDA Activity Tracker: Top Approvals of 2019 to Date

A novel antibiotic for community-acquired bacterial pneumonia, a vaccine for dengue fever, a therapeutic for complicated urinary tract infections—the first half of the year has been a busy one when it comes to US Food and Drug Administration (FDA) activity in the infectious disease specialty.

Now, as the summer comes to a close, our editorial team is looking back at the top FDA approvals for infectious diseases of 2019 to date and looking ahead at what is left on the docket this year.

Read the full list here.

#1: EEE Threat Level Raised in Massachusetts Following First Fatality

Public health officials have raised the risk level for Eastern equine encephalitis (EEE) to critical in 4 Massachusetts towns where the mosquito-borne virus was detected in 4 horses. The new distinction also comes after the first human EEE fatality of the year was reported earlier this week.

According to a statement from the Massachusetts Department of Public Health (DPH), the EEE threat level now stands at critical in Holliston, Medfield, Brookfield, and Granby, putting the total number of critical communities at 28 statewide. Thirty-seven other towns are considered at high risk for EEE, while 126 are at moderate risk.

“As we head into the Labor Day weekend and the month of September people should not forget to bring and use an EPA-approved mosquito repellent for any outdoor activities,” Public Health Commissioner Monica Bharel, MD, MPH, said in the statement. “The peak time for transmission of mosquito-borne illness extends through September here in Massachusetts.”

A total of 4 human cases of EEE have been reported in Massachusetts so far this year, stemming from 7 equine cases. One fatality was reported in a Fairhaven woman who contracted the infection, The Boston Herald reported.

Without a specific antiviral treatment or vaccine to prevent infection, EEE proves fatal in 30% of cases, according to the US Centers for Disease Control and Prevention (CDC). Survivors often suffer ongoing neurological problems.

Read the full here.