OFFICES IN Washington D.C. & New Delhi

Center For Disease Dynamics, Economics & Policy

Weekly Digest: Challenges with implementing AMR activities in Pakistan; Discovery of contaminated polio vaccines in India sparks investigation; Third confirmed monkeypox case reported in the UK.

Weekly Digest: Challenges with implementing AMR activities in Pakistan; Discovery of contaminated polio vaccines in India sparks investigation; Third confirmed monkeypox case reported in the UK.

Challenges with implementing AMR activities in Pakistan. A letter in The Lancet Infectious Diseases describing successes and difficulties in implementing Pakistan’s AMR National Action Plan highlighted the work of the CDDEP-led Global Antibiotic Resistance Partnership (GARP) in that country. Challenges included the availability of over-the-counter antibiotics without prescription, preference for broad-spectrum antibiotics, lack of AMR surveillance systems, insufficient numbers of experts, and widespread use of antibiotics in meat production. [The Lancet Infectious Diseases, Situation Analysis Report on AMR in Pakistan] 

Discovery of contaminated polio vaccines in India sparks investigation. Batches of an oral polio vaccine (OPV) in India were found to be contaminated with poliovirus type 2, a strain previously eradicated in India and worldwide. The affected doses, manufactured by Biomed, were administered to children through government immunization programs. India’s Health Ministry has taken measures to minimize the impact, and Drugs Controller General of India asked Biomed to halt drug production and recall distributed vials of the affected vaccine. In response to rumors that OPV should be avoided, CDDEP’s Jyoti Joshi was quoted in The Quint, saying “it is a public health success that the contamination was detected through surveillance and traced back to its source” and “children should continue to be vaccinated, as polio is a larger threat to the country.” [Times of India, NDTV, Reuters, The Indian Express, The Quint, The Quint]

Third confirmed monkeypox case reported in the UK. On September 26, Public Health England (PHE) reported that a third person in the UK had contracted monkeypox, a zoonotic virus that is rare outside central and west Africa. While the first two cases, reported September 8 and 11, 2018 were deemed to have been in infected in Nigeria before returning to the UK, this third case represents the first time monkeypox has been transmitted on UK soil. Public health officials and health workers are taking necessary precautionary measures to prevent further spread, according to a PHE statement. [GOV.UK, Stat News]

DRC’s Ebola outbreak at a “critical juncture,” says WHO. With over 120 deaths among 150 cases across seven health zones in the Democratic Republic of the Congo (DRC), the likelihood that Ebola could spread to nearby countries continues to rise.  Although global spread remains unlikely, public health officials believe the risk is “very high” that the outbreak will spread to neighboring Uganda, Rwanda, or South Sudan. [WHO, New York Times, Reuters]

Antibiotics may be effective and safer than surgical treatment of acute appendicitis. Researchers in Finland conducted a randomized trial in which 273 patients underwent a surgical appendectomy and 257 underwent antibiotic therapy for the treatment of uncomplicated acute appendicitis. After five years of follow-up, there was no significant difference between the primary end points in the two groups—successful completion of appendectomy for the surgical group, and discharge from the hospital without need for surgery for the antibiotic treatment group. Antibiotic therapy led to significantly fewer post-treatment complications compared to surgery. The overall rate of complications—surgical site infections, incisional hernias, abdominal pain, etc.—was 6.5 percent among those treated with antibiotics versus 24.4 percent among those who underwent surgery. [JAMA, Ars Technica]

US announces AMR Challenge to unite international stakeholders to combat drug resistance. During the United Nations General Assembly in New York last week, Secretary Alex Azar of the Department of Health and Human Services (HHS) launched the US government’s Antimicrobial Resistance Challenge, an initiative to bring together international stakeholders and leaders to accelerate the fight against antimicrobial resistance (AMR). The US Centers for Disease Control and Prevention and HHS plan to engage governments, non-governmental organizations, pharmaceutical and health insurance companies, and other leaders in the private and public sectors to reduce antibiotic use, improve infection control and prevention, enhance AMR surveillance and data sharing, and develop vaccines, drugs, and diagnostic tests. Organizations can join the initiative on the AMR challenge webpage. [CDC AMR Challenge Webpage, American Society for Microbiology, Express]

Common weed killer found to weaken immune response in honey bees by altering gut microbiome. Glyphosate, a common chemical ingredient found in weed killers such as Roundup, has been found to alter the gut microbiota of honey bees, causing them to be more susceptible to infections. Researchers at the University of Texas in Austin found that exposing honey bees to glyphosate altered the makeup of the microbiota in the bees.  Glyphosate-exposed bees had a significantly higher mortality rate when challenged with a bacterial infection than those not exposed. However, the mortality rate of bees unchallenged with infection was not significantly different between glyphosate exposed and non-exposed bees. [PNAS, EurekAlert]

At the UN, world leaders sign declaration to ramp up fight against TB. Last week during the United Nations first-ever high-level meeting on Tuberculosis (TB), member states signed a political declaration reaffirming their commitment to end the TB epidemic by 2030. Signatories agreed to contribute $2 billion to TB research and drug development and another $13 billion a year by 2022 to implement TB prevention and treatment measures. The declaration also sets clear targets to treat 40 million TB patients between now and 2022. During the meeting, attendees debated intellectual property rights in regard to TB research and discussed access to affordable TB drugs and the need to promote antimicrobial stewardship as drug-resistant strains of TB are on the rise. [UN Political Declaration on the Fight against Tuberculosis, Associated Press, Forbes, Global Health Now, Science Speaks]

A new record for US influenza deaths and hospitalizations in 2017-2018. Flu caused an estimated 80,000 deaths and 900,000 hospitalizations during the 2017-2018 flu season, according to the US Centers for Disease Control and Prevention (CDC). Contributing factors included low rates of vaccination, especially in young children, and a vaccine that was only 25 percent effective against Influenza A H3N2, the most common strain circulating last year. In the past three decades, the highest number of deaths in a regular flu season was 56,000. Influenza can be debilitating for the very young, immunosuppressed, or elderly, and a flu vaccine can reduce the severity of infection and reduce complications. Experts encourage yearly vaccination for everyone six months and older (excluding those with medical contraindications), preferably before the end of October. [CDC, Washington PostCareDash News]


Photo Credit: Vero cells for Inactivated Polio Vaccine (IPV) production- Sanofi Pasteur / Alain Grillet on flickr