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Weekly Digest: Mistrust and misinformation amid Ebola outbreak in DRC; Only FDA-approved drug for severe malaria discontinued; Increased prevalence of E. coli in China.

Weekly Digest: Mistrust and misinformation amid Ebola outbreak in DRC; Only FDA-approved drug for severe malaria discontinued; Increased prevalence of E. coli in China.

Mistrust and misinformation affect outbreak control and response to DR Congo Ebola outbreak. Researchers interviewed 961 adults in North Kivu, Democratic Republic of Congo between September 1-16, 2018 to investigate the effect of mistrust and misinformation on individual Ebola prevention behaviors. Only 40.5 percent of respondents trusted the government in terms of Ebola response, and 25.5 percent of respondents did not believe the Ebola outbreak was real. Lack of trust in authorities and institutions as well as misinformation about Ebola were associated with lower Ebola avoidance, health seeking, and vaccine acceptance behaviors. [The Lancet Infectious Diseases]

Only FDA-approved drug for severe malaria discontinued. Quinidine, the recommended first-line treatment for severe malaria in the US has been discontinued by its manufacturer. The US Centers for Disease Control and Prevention (CDC) has revised its treatment protocol for severe malaria to include artesunate, the World Health Organization (WHO)-recommended first-line treatment for severe malaria. Artesunate is not yet approved by the US Food and Drug Administration (FDA) nor commercially available in the US, however, IV artesunate is available through an FDA investigational drug protocol and can be obtained following CDC consultation with the patient. [CDC]

Increased prevalence of E. coli strains in China. Researchers isolated multidrug-resistant Escherichia coli strains from 2,147 food samples in China between 2015-2017. All isolates were tested for antimicrobial susceptibility using the agar dilution and broth-microdilution methods, and screened for the bla NDM and mcr-1 gene. E. coli resistance rates to colistin and meropenem were calculated. Of the samples tested, 1,166 isolates were cephalosporin-resistant, and proved to be resistant to most of the antibiotics tested as well. The E. coli resistance rate to colistin and meropenem significantly increased by 20 percent and 16.97 percent, respectively, between 2015-2017. The bla NDM and mcr-1-bearing plasmids found in the colistin-resistant strains structurally resemble those found in clinical strains, suggesting the transmission of animal-acquired strains to food products. [Eurosurveillance]

EU and 15 member states sign pandemic influenza vaccines framework. Under the “EU Joint Procurement Agreement to procure medical countermeasures,” the European Commission and 15 Member States along with the pharmaceutical company Seqirus signed a framework for increased production and supply of influenza vaccines to prepare for a pandemic. The framework will ensure affordable vaccine and medication access for citizens in Member States in case of a future outbreak.  [European Commission Press Release]

Risk factors associated with infant measles deaths during outbreak in Mongolia. Surveillance data collected from two waves (March-September 2015 and October 2015-June 2016) of a measles outbreak in Mongolia was used to conduct a case-control study to identify risk factors associated with infant measles deaths. Fatal measles cases were compared to nonfatal measles cases among hospitalized infants. Inpatient hospital admission for pneumonia or influenza were significantly associated with death (adjusted matched OR = 4.5). Infant measles case fatality ratios increased from 0.13 percent in wave one to 2.31 percent in wave one, likely due to an increase in respiratory infections among the infants. [The Journal of Infectious Diseases]

Trends in HIV incidence and HIV-associated risk behaviors of people who inject drugs. Researchers examined three consecutive prospective studies to evaluate temporal trends in HIV incidence and associated risk behaviors among people who inject drugs (PWID) in Bangkok, Thailand from 1995-2012. HIV incidence rates decreased among the populations between the first and last study, from 5.7 to 0.7 cases per 1000 person-years. Findings indicate that HIV incidence in PWID peaked in 1996 and declined from 2005-2012, which is thought to be attributable to a reduction in frequency of injections and needle sharing as well as improved access to HIV prevention and treatment interventions. [EClinicalMedicine]

Multistate Salmonella outbreak linked to contact with pet hedgehogs. The US Centers for Disease Control and Prevention (CDC) has reported 17 cases of Salmonella Typhimurium across 11 states in the US, causing two hospitalizations but no deaths. Contact with pet hedgehogs was noted through interviews in 87 percent of the cases and is likely the source of the outbreak. A common provider of the hedgehogs has not been identified. The CDC urges hedgehog owners to be aware of Salmonella symptoms and use proper sanitation with their pets. [CDC]

Photo Credit: CDC PHIL- Patrick Adams