Global health investment neglects vaccines for HIV, malaria, and TB. Effective vaccines against HIV, malaria, tuberculosis, dengue, hepatitis C, and many other diseases are unlikely to be developed in the near future, according to an economic analysis of current research and product development efforts. Researchers at Duke University’s Global Health Institute estimated a $1.5-2.8B annual funding gap for neglected disease product development over the next five years as funding continues to decline. [Gates Open ResearchDuke Global Health InstituteHomeland Preparedness NewsNY Times]

Antibiotic resistance genes in Houston floodwaters after Hurricane Harvey. Elevated levels of pathogenic Escherichia coli bacteria and two key antibiotic resistance genes (sul1 and intl1) were present in urban floodwaters immediately following and for weeks after Hurricane Harvey caused historic flooding in Houston in 2017. According to researchers at Rice University and Virginia Tech, the bacteria and resistance genes were significantly more abundant in indoor floodwater samples compared to street floodwater and bayou water samples. [Environmental Science and Technology LettersPopular Science]

Progress and setbacks in the global fight against polio. The Global Polio Eradication Initiative reported three new cases of vaccine-derived poliovirus in Papua New Guinea, where an outbreak is ongoing, bringing the current case count to nine. In Pakistan, there has been a reduction in wild poliovirus (WPV) with only three cases identified so far in 2018, according to the World Health Organization’s International Health Regulations Emergency Committee. In Afghanistan, however, eleven WPV cases have been confirmed in 2018 compared to six cases at this time in 2017. Environmental samples collected in Pakistan and Afghanistan continue to test positive for WPV, indicating transmission is ongoing. [Global Eradication InitiativeWHO]

Ministry of Health and WHO respond to yellow fever outbreak in Republic of Congo. An unvaccinated man sought care at a health clinic on July 10, 2018 near Point-Noire, a densely populated city in the Republic of Congo near the border with Angola; sixteen days later, a serology test in a Kinshasa lab confirmed the man had yellow fever. In August, 69 ill individuals were identified as having symptoms consistent with the yellow fever case definition; 43 specimens were collected, and all tested negative for the disease. The Ministry of Health and Population and the World Health Organization (WHO) have collaborated on an emergency response, implementing targeted mosquito control, an awareness campaign, and case-finding efforts. WHO and the International Coordinating Group, which manages the global vaccine supply, are preparing a mass vaccination campaign targeting the Pointe-Noire area. [WHOCIDRAP]

Paper towels spread significantly fewer microbes than jet-air hand dryers. A study carried out in hospital washrooms in Italy, France, and England found that jet-air dryers distributed greater microbial contamination than paper towels did. The air, floor, and surfaces in the washrooms were tested for bacteria capable of causing skin infections, sepsis, or gastroenteritis, especially in immunocompromised hospital patients.  Fewer antibiotic resistant bacteria were collected from bathroom floors when paper towels were used versus when air dryers were used (7 vs. 21 colony-forming units). [Journal of Hospital InfectionMedicalXPress]

Genomic sleuthing unearths connections between farm-raised meat and extra-intestinal E. coli ST131 in humans. Escherichia coli sequence type 131 (ST131), the most prevalent extra-intestinal strain infecting humans, was responsible for 72% of human urinary and blood infections in a year-long study carried out by researchers in Flagstaff, Arizona examining the connection between retail meat and human illness. Genomic analysis comparing the bacteria in the clinical specimens to bacteria collected from meat in retail markets revealed that 96% of the meat isolates and 13% of the human isolates were of the same lineage, H22. Analysis of the relative prevalence of an avian-associated plasmid, CoIV, further supports the hypothesis that the direction of transmission in the Flagstaff study was from poultry to human. [mBioWired]

Ultrasensitive tests for subclinical malaria infection are unwarranted. Researchers carried out a study to evaluate whether more sensitive diagnostic tools offer advantages from an epidemiological perspective in areas where asymptomatic infections function as reservoirs for ongoing transmission. The study was conducted in a community in Papua New Guinea where malaria infection is beginning to wane. The study found that compared to standard quantitative PCR (qPCR), ultra-sensitive qPCR did not detect substantially more low density infections of Plasmodium falciparum or Plasmodium vivax, except when a high volume of blood was used (2 mL compared to the standard 200 µL). The authors concluded that the cases missed by the lower volume tests were of such low density that they were unlikely to be infective to mosquitoes. [Lancet Infectious DiseasesComment]

Vaccine potential seen in HIV-1 envelope protein. A small portion of individuals with HIV-1 infection produce antibodies that can demobilize numerous strains of human immunodeficiency viruses (HIV). In seeking to understand factors influencing the creation of these broadly neutralizing antibodies (bNAbs), scientists at the University of Zurich studied the viruses those individuals carry. The team has discovered an envelope protein on the surface of the HIV-1 virus that triggers the production of the bNabs and may be a candidate immunogen for an HIV vaccine.  [NatureEurekAlertNewsweek]

Fluoroquinolones pose small but significant risk of aortic damage. The risk of aortic aneurysm (AA) or aortic dissection (AD) was 2.05 times higher in patients who took fluoroquinolones compared to unexposed patients, after adjusting for confounders, according to an analysis of data from researchers in Taiwan. In a comment published alongside the original article, medical faculty from the University of Massachusetts Medical School and Albany Medical College suggest that healthcare providers inform patients of the small but significant risk of aortic or tendon damage before prescribing fluoroquinolones. [Journal of the American College of CardiologyComment]

Image modified from Cindy Liu et al (http://creativecommons.org/licenses/by/4.0/)