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Weekly Digest: Antibiotic developer files for bankruptcy; California ban on nonmedical exemptions tied to increased vaccine coverage; Airplane sewage may contribute to the global spread of AMR.

Weekly Digest: Antibiotic developer files for bankruptcy; California ban on nonmedical exemptions tied to increased vaccine coverage; Airplane sewage may contribute to the global spread of AMR.

Antibiotic developer files for bankruptcy. Late last month, Melinta Therapeutics, an antibiotic developer for serious bacterial infections, filed for bankruptcy after facing financial difficulties. The company became the second antibiotic developer in the United States to file for bankruptcy in 2019, which emphasizes the common economic and regulatory challenges that impede antibiotic development. Melinta plans to operate normally while they sort out a restructuring agreement with their lenders. [Melinta Therapeutics]

California ban on nonmedical exemptions tied to increased vaccine coverage. A study assessing the impact of a 2016 California policy restricting nonmedical vaccine exemptions found that the policy was linked to increased vaccine coverage and decreased nonmedical exemptions at state and county levels. At the state level, the 2016 bill was associated with a 3.3 percent increase in measles-mumps-rubella (MMR) vaccine coverage and a 2.4 percent decrease in nonmedical exemptions. At the county level, overall vaccine coverage increased 4.3 percent, and nonmedical exemptions decreased 3.9 percent following implementation of the ban, although medical exemptions increased 2.4 percent. [PLOS Medicine]

Airplane sewage may contribute to the global spread of antibiotic resistance. Researchers identified an abundance of antibiotic resistance genes in airplane sewage, which stems from an international population and may contribute to the global spread and emergence of resistance. Among Escherichia coli samples isolated from the airline sewage, 28.9 percent showed combined resistance against third-generation cephalosporins, fluoroquinolones, and aminoglycosides. This prevalence of combined resistance is eight times higher than that found in E. coli isolates collected from municipal sewage in Germany. [Environmental Science and Technology]

FDA approves first vaccine for Ebola prevention. The US Food and Drug Administration (FDA) has approved the first vaccine for the prevention of Ebola. Ervebo was first implemented as an investigational vaccine during the second largest Ebola outbreak in the Democratic Republic of Congo (DRC) in 2018, and was deemed 100 percent effective in a 2014-2016 study in Guinea. Ervebo is a live attenuated vaccine given as a single injection, and has been approved for individuals 18 years and older. [FDA]

Global tobacco use is on the decline. In a report on global tobacco use, the World Health Organization (WHO) notes that overall use has decreased by 60 million people between 2000 and 2018. Although tobacco use among males has increased by 40 million people in the same time period, the report estimates that male tobacco use will decrease by 1 million in 2020 and up to 5 million by 2025. These reductions in global tobacco use are thought to be driven by stricter government control efforts. [WHO]

Obesity and undernutrition simultaneously affect LMICs. A new four-part series published in The Lancet notes that the double burden of malnutrition (the coexistence of undernutrition and obesity) is present in more than one-third of all low- and middle-income countries (LMICs).  A majority of these countries are located in sub-Saharan Africa, Asia, and the Pacific, and the issue is thought to be driven by rapidly changing food systems. Authors suggest that this double burden of malnutrition must be treated comprehensively, rather than as two separate public health crises. [The Lancet, WHO]

Exposure to multiple antibiotic classes during infancy increases risk of childhood allergies. Researchers from the Uniformed Services University of the Health Sciences in Bethesda, Maryland conducted a retrospective study of nearly 800,000 children and found a link between exposure to multiple classes of antibiotics during infancy and the risk of developing a childhood allergy later on. Infants exposed to penicillin, penicillin with a β-lactamase inhibitor, cephalosporins, sulfonamides, and macrolides were all more likely to develop a childhood allergy compared to infants not exposed. Exposure to antibiotics in infancy may disrupt the gut microbiome, which could explain these findings. [JAMA Pediatrics]

Infection-attributable cancers common in eastern Asia and sub-Saharan Africa. Researchers in France estimate that 2.2 million cancers diagnosed worldwide in 2018 were caused by infections. A majority of cases were caused by Helicobacter pylori, human papillomavirus, hepatitis B, and hepatitis C. In eastern Asia and sub-Saharan Africa, age-standardized incidence rates of infection-attributable cancers were the highest, at 37.9 and 33.1 cases per 100,000 person years. Rates were the lowest in northern Europe and western Asia at 13.6 and 13.8 cases per 100,000 person years. [The Lancet Global Health]

Diarrheal diseases increase risk of death among children in LMICs. Using data from the Global Enteric Multicenter Study (GEMS), researchers found that diarrheal disease is associated with an increased risk of death among children ages 0-59 months in low-and middle-income countries (LMICs). Children with moderate-t0-severe diarrhea or less-severe diarrhea were more likely to die than matched controls between study enrollment and 60-days follow-up (hazard ratio: 8.16, 2.78). Infection with Shigella spp was strongly correlated with risk of death among children aged 12 to 59 months with non-dysenteric, moderate-to-severe diarrhea (hazard ratio: 2.2). [The Lancet Global Health]

Antibiotic use is high in the US Southeast. [CDDEP]