September 360: Trending Infectious Disease News of the Month

IDWeek 2019 is only 2 days away which can only mean 1 thing: September has come to a close.

But before we launch into the infectious disease community’s biggest news week, we are recapping the most popular headlines from September.

Early on in the month, the ASM/ESCMID Conference of Drug Development to Meet the Challenge of Antimicrobial Resistance was held in Boston, Massachusetts. The conference featured several interesting poster presentations. One addressed whether the antimalarial mefloquine can be repurposed as an antifungal and another poster tracked potential treatment options for multidrug-resistant gonorrhea.

In US Food and Drug Administration (FDA) news, expanded indications were granted to 2 of Merck’s HIV therapies. The expansion allows treatment-experienced adults living with HIV who are virally suppressed to switch to doravirine or doravirine/lamivudine/tenofovir disoproxil fumarate. A smallpox and monkeypox vaccine was also approved, marking the first FDA-approved non-replicating smallpox vaccine and the only FDA-approved vaccine for the prevention of monkeypox. Finally, last week the FDA approved an expanded indication for glecaprevir and pibrentasvir (Mavyret) which shortens duration of treatment for adults and children with all genotypes of hepatitis C and compensated cirrhosis to 8 weeks.

The second episode of the Contagion® Connect podcast launched earlier this month. The episode takes dual look at the recently announced changes to antibiotic reimbursements from the Centers for Medicare and Medicaid Services. Podcast guests include Susan Davis, PharmD, a clinical professor at Wayne State University and an infectious disease pharmacist at Henry Ford Health System; and Larry Edwards, CEO of Tetraphase Pharmaceuticals. Stay tuned for new episodes on exciting infectious disease topics and be sure to subscribe.

In Ebola news, FDA officials also accepted a Biologic License Application for Merck’s Ebola vaccine. A target action date is set for March 14, 2020.

The current Ebola outbreak in the Democratic Republic of the Congo continues to rage on as officials announced the deployment of a new vaccine. Manufactured by Johnson & Johnson, it attempts to prevent cases of Ebola in areas of the nation without ongoing transmission. This news followed the releasing of a statement by Medicines Sans Frontieres calling into question the World Health Organization’s transparency pertaining to Ebola vaccinations. As of September 26, 2019, there have been 3066 confirmed cases and 2014 confirmed deaths in the outbreak. Visit the Contagion® Outbreak Monitor to keep up with the latest numbers.

Let’s take a look at the top 5 web articles from the month of September:

#5: Baloxavir Marboxil Shows Promise in 2 Phase 3 Studies

In October 2018, the US Food and Drug Administration (FDA) approved baloxavir marboxil (Xofluza) for the treatment of acute, uncomplicated influenza in people 12 years of age and older. The approval marked the first new antiviral flu treatment with a novel mechanism in nearly 2 decades.

On September 1, 2019, at the OPTIONS X Congress in Singapore, investigators from Genentech announced favorable results from 2 phase 3 trials of baloxavir marboxil, MINISTONE-2 and BLOCKSTONE, in a late-breaking session.

Read the full story.

#4: Trump Issues Executive Order on Influenza Vaccine Modernization

President Donald Trump issued an executive order on Thursday, September 19, 2019, in an attempt to improve and modernize influenza vaccine manufacturing processes to develop vaccines that provide more effective and longer lasting protection.

The order directly refers to the method of egg-based vaccine production as being outdated and calls upon expansion or implementation of alternative methods that would allow for quicker responses to emerging influenza virus.

“It is the policy of the United States to modernize the domestic influenza vaccine enterprise to be highly responsive, flexible, scalable, and more effective at preventing the spread of influenza viruses,” the order reads.

Read the full story.

#3: EEE Threat Level Raised in Massachusetts Following First Fatality

Public health officials have raised the risk level for Eastern equine encephalitis (EEE) to critical in 4 Massachusetts towns where the mosquito-borne virus was detected in 4 horses. The new distinction also comes after the first human EEE fatality of the year was reported earlier this week.

According to a statement from the Massachusetts Department of Public Health (DPH), the EEE threat level now stands at critical in Holliston, Medfield, Brookfield, and Granby, putting the total number of critical communities at 28 statewide. Thirty-seven other towns are considered at high risk for EEE, while 126 are at moderate risk.

“As we head into the Labor Day weekend and the month of September people should not forget to bring and use an EPA-approved mosquito repellent for any outdoor activities,” Public Health Commissioner Monica Bharel, MD, MPH, said in the statement. “The peak time for transmission of mosquito-borne illness extends through September here in Massachusetts.”

Read the full article.

#2: Leprosy Outbreak in United States Only a 'Matter of Time,' One Physician Argues

Certain populations in the United States are at risk for a resurgence of leprosy, or Hansen’s disease, according to a New York University physician who penned a public health warning in The Hill this week.

The US Centers for Disease Control and Prevention (CDC) reports there are only about 150 to 250 cases of leprosy reported in the United States in a given year, but between 2 and 3 million people are living with leprosy-related disabilities globally. It is more common in Central and South America, which see a combined average of 20,000 new cases per year.

Even though leprosy is not widespread in the United States, the current landscape in some cities, such as Los Angeles, is creating the perfect environment for so-called “ancient” diseases to flourish. Caused by the slow-growing bacteria Mycobacterium leprae, leprosy spreads more easily in close, unsanitary quarters.

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#1: First Pediatric Flu Death of 2019-20 Season Reported in California

The first pediatric influenza-associated death of the 2019-20 flu season has been reported in California. According to a statement issued by Riverside University Health System a 4-year-old child who tested positive for the flu and had underlying health issues passed away from his illness.

According to the US Centers for Disease Control and Prevention (CDC) a total of 130 influenza-associated pediatric deaths were reported during the 2018-19 flu season. This number was a decrease from the 187 pediatric deaths reported during the 2017-18 season.

CDC investigators hypothesize that the real-world impact of the flu is being underreported. “Using mathematical modeling to account for under-detection, CDC estimates that the actual number of flu-related deaths in children during [the 2017-18] season was closer to 600—nearly 3 times what was reported through existing mechanisms,” the authors of a recent report wrote in a flu spotlight.

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