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Weekly Digest: Novel coronavirus deaths surpass SARS; Antibiotic exposure during pregnancy tied to childhood asthma; Purell producer warned to correct unproven claims that their antiseptics prevent viral infections.

Weekly Digest: Novel coronavirus deaths surpass SARS; Antibiotic exposure during pregnancy tied to childhood asthma; Purell producer warned to correct unproven claims that their antiseptics prevent viral infections.

Novel coronavirus deaths surpass SARS as health officials prepare for continued spread. As of February 10, 2020, there were more than 40,000 confirmed cases and at least 910 reported deaths of the novel coronavirus (2019-nCoV) across 25+ nations worldwide. Fifty million people remain quarantined in China as public health officials around the globe attempt to stop the spread of the virus. A $675 million preparedness and response plan was launched last week by the international community to protect countries with weak health systems against 2019-nCoV. The Strategic Preparedness and Response Plan (SPRP)outlines the activities and resources needed to prepare for and respond to the current outbreak between February and April, 2020. [WHO, WHO, CDC, NYTimes]

  • In an analysis of 425 of the first 2019-nCoV cases in Wuhan, researchers estimated that 55 percent of cases with onset prior to January 1, 2020 were linked back to the Huanan Seafood Market, compared to just 8.6 percent of cases with onset after January 1st. The average incubation period of the virus was 5.2 days, and in the early stages of the outbreak, it doubled in size nearly every week. The reproductive number of 2019-nCoV was estimated to be 2.2. [NEJM]
  • Researchers from Hong Kong used data on confirmed 2019-nCoV cases, flight bookings, human mobility across China before and after city-wide quarantines, and previous studies on severe acute respiratory syndrome coronavirus (SARS-CoV) to model the spread of 2019-nCoV. They estimated that as of January 25, 2020, 75,815 individuals in Wuhan had been infected with the pneumonia-like virus, and the reproductive number was 2·68. The study also found that localized outbreaks are likely occurring in other Chinese cities, with a 1-2 week lag time behind the epidemic in Wuhan. [The Lancet]
  • In two op-eds, CDDEP director Ramanan Laxminarayan wrote about the widespread effects of the novel coronavirus outbreak, which has caused worldwide panic. He credits the Chinese government for their prevention and control response which has been more robust than during SARS in 2003, but says that these efforts may have come too late given the initial delays in reporting. Many patients who have died from the coronavirus did not have a fever, meaning airport screenings may be completely ineffective, and individuals with the virus may not seek timely medical attention due to mild symptoms. [LiveMint, Hindustan Times]

Antibiotic exposure during pregnancy tied to childhood asthma. A Tennessee cohort study including nearly 85,000 mother-child pairs found a significant link between prenatal antibiotic exposure and childhood asthma (adjusted OR=1.23). Broad-spectrum antibiotic exposure during pregnancy was significantly associated with increased odds of childhood asthma compared to narrow-spectrum antibiotic exposure (OR=1.14). Taking antibiotics early on in pregnancy was associated with an increased risk of childhood asthma among women who received more than one antibiotic course during pregnancy. [Clinical Infectious Diseases]

Purell producer warned to correct unproven claims that their antiseptics prevent viral infections. The US Food and Drug Administration (FDA) sent a warning letter to Gojo Industries, the producer of Purell hand sanitizers, noting several violations including unproven marketing claims that suggest Purell hand sanitizer products are “intended for reducing or preventing disease from the Ebola virus, norovirus, and influenza.” The claims also indicate that Purell products are effective at killing drug-resistant pathogens including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Candida auris; none of which have been backed by scientific evidence. The FDA is treating Purell products as unapproved drugs and will take legal action if the false marketing claims are not corrected. [FDA, CNN]

Novel antibiotic therapy treats resistant infections among cystic fibrosis patients. UK researchers found that a novel antibiotic combination consisting of amoxicillin, imipenem, and relebactam, was 100 percent effective in treating antibiotic-resistant Mycobacterium abscessus in 16 patients with cystic fibrosis. Resistant M. abscessus infections have become increasingly prevalent in cystic fibrosis patients, and current treatments come with toxic side effects. The authors say that the next step is to test the combination therapy against current treatments for resistant M. abscessus infections. [Nature Scientific Reports]

Healthcare-associated bacteria may spread through toilet flushing. A pilot study at the University of Iowa found that toilet flushing could contribute to the spread of healthcare-associated pathogens in hospitals and clinics. Researchers collected bioaerosol samples from toilet rims in 24 hospital bathrooms of patients infected with Clostridioides difficile infection (CDI). Cultures that tested positive for healthcare-associated bacteria doubled after the toilet was flushed, increasing from 13 percent among pre-flush samples to 26 percent among post-flush samples. Enterococcus faecalisE. faecium, and C. difficile were the most common bacteria cultured. The study suggests that interventions such as toilet lids should be assessed to prevent the spread of healthcare-associated pathogens through toilet flushing. [Infection Control and Hospital Epidemiology]

Antibiotic prescribing common among US Medicaid patients who lack doctor’s visits or evidence of infection. US researchers analyzed Medicaid claims data between 2004 and 2013 and found that antibiotic prescribing is common among patients who do not visit a provider or receive an infection-related diagnosis. Out of nearly 300 million antibiotic prescriptions filled throughout the 10-year study period, only 55 percent were associated with a doctor’s visit that resulted in an infection-related diagnosis. Seventeen percent of antibiotic fills were linked to a provider visit without evidence of an infection-related diagnosis, and 28 percent were not linked to a provider visit. Non-visit-based antibiotic fills were more common among adults than children. [Health Affairs]

UK supermarkets lack comprehensive antibiotic use policies. In a new report, the Alliance to Save Our Antibiotics assessed the antibiotics policies of ten major supermarkets in the United Kingdom and found that 40 percent of supermarkets studied allowed their meat, dairy, and egg suppliers to routinely use antibiotics for disease prevention. The retailer Aldi recommends that suppliers avoid routine antibiotic use in food production, although they do not ban such suppliers. Retailers Asada and Iceland do not have any antibiotic policies in place aside from minimum legal requirements. Waitrose and M&S have the most comprehensive antibiotic policies respectively, with both supermarkets prohibiting the use of last-resort antibiotic, colistin in food production. Compared to their last report in 2017, the Alliance to Save Our Antibiotics suggests that although antibiotic policies among UK supermarkets are not yet optimal, significant progress has been made. [Alliance to Save Our Antibiotics]

Environmental transmission drives antibiotic resistance in Tanzania. Researchers analyzed 62,376 bacterial isolates from people, wildlife, and water sources across three ethnic groups in Tanzania.  They found that compared to antibiotic use, environmental transmission is an important driver in the spread of antibiotic resistance. In some communities, more than 65 percent of bacteria isolated from humans were resistant to one or more of the antibiotics tested, and nearly half of the bacterial samples isolated from dogs were resistant, although dogs in these communities were not exposed to antibiotics. Resistance levels found in wildlife feces correlated with resistance levels isolated from domestic animals, which further emphasizes that environmental transmission of resistant bacteria is an important factor to focus on in terms of prevention interventions.  [Nature Communications]

High HPV vaccination coverage in Europe linked to school-based delivery and use of reminders. Researchers assessed human papillomavirus (HPV) vaccination coverage, policies, and program implementation across Europe and found that coverage was high (≥71 percent)in ten countries and very low (≤30 percent)in four. Seven countries reported 51-70 percent HPV vaccination coverage and four reported 31-50 percent coverage. School-based delivery of the HPV vaccine as well as the use of reminders were both linked to higher country-level HPV vaccination coverage. [Vaccine]

Novel coronavirus infects five times as many as SARS, as of February 10, 2020.  [CDDEP]

Novel coronavirus infects five times as many as SARS, as of February 10, 2020.