New antimicrobials added to WHO essential medicines list
New antimicrobials to treat severe bacterial and fungal infections were among the drugs that the World Health Organization (WHO) included in its new Essential Medicines list, which is updated annually and serves as its recommended list of medicines that every health system should have.
For infectious diseases, new inclusions include cefiderocol, listed as a “reserve” drug that should be accessible but is reserved for treatment of confirmed or suspected multidrug-resistant infections. The reserve designation is part of the WHO’s AWaRe (Access, Watch, and Reserve) classification database, developed in 2017 to guide antimicrobial stewardship actions.
Other infectious disease additions include echinocandin antifungals, as well as monoclonal antibodies for rabies prevention. The list includes new formulations of medicines for common bacterial infections, including tuberculosis, to better meet dosing and administration needs for children and adults.
The WHO also classified 81 more antibiotics under the AWaRe framework.
Oct 1 WHO statement
CDC: 140 more Salmonella cases with unknown origin, 419 total
The Centers for Disease Control and Prevention (CDC) in an updated yesterday confirmed an additional 140 cases in an outbreak of Salmonella Oranienburg illnesses with no confirmed food source, bringing the outbreak total to 419 cases and 66 hospitalizations in 35 states.
So far there have been no deaths reported in this outbreak. Illnesses started on dates ranging from Jun 19 to Sep 14, the CDC said. The CDC first announced the outbreak on Sep 17, and cases have been increasing at a significant pace.
“The true number of sick people in an outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella,” the CDC said.
Multiple investigations into the source of the outbreak are ongoing. Texas has the most cases reported, with 111, followed by Oklahoma (63) and Virginia (38). Six states reported their first cases.
Sep 30 CDC update
Sep 24 CIDRAP News scan on previous update
Cases rise in Madagascar’s plague outbreak
The number of cases in Madagascar’s outbreak has risen to 42, of which 22 are confirmed, the WHO said today in an update based on data as of Sep 15. So far, eight deaths were reported among the confirmed cases, for a case-fatality rate of 37%.
Of the 22 confirmed cases, 19 patients had pneumonic plague, the most severe form of the disease, and 3 had the bubonic version.
So far, the cases are reported from two separate regions: Itasy in the central part of the country and Haute Matsiatra in the south central part of the country. Plague is endemic in both areas, and both were highly affected during a large outbreak in 2017.
Health officials have identified 1,064 close contacts for follow-up and treatment. Initial results from the animal investigation reveal that 1.3% of the rats are carrying Yersinia pestis, the bacterium that causes plague, a level above the alert threshold of 1%. However, the number of fleas collected from the captured rats didn’t exceed the alert threshold.
The WHO said plague cases are reported in Madagascar each year and typically occur from September to April. The main affected area is the central highlands, where the current outbreak is occurring.
Risks of spread to urban areas and other parts of the country are high, due to the close proximity of the current outbreak to the country’s capital, Antananarivo.
Oct 1 WHO update
Two countries report more vaccine-derived polio cases
Two African nations—Madagascar and Senegal—reported polio cases this week, both involving vaccine-derived subtypes, the Global Polio Eradication Initiative (GPEI) said in its latest weekly update.
Madagascar reported two cases involving circulating vaccine-derived poliovirus type 1 (cVDPV1), one from Boeni and one from Menabe. The country has now reported eight such cases for 2021. For comparison, it reported two cVDPV1 cases in 2020.
Elsewhere, Senegal reported one circulating vaccine-derived poliovirus type 2 (cVDPV2) case, which was reported from Kaolack, bringing its total for the year to 14.
Sep 30 GPEI weekly update