Biota Announces Preliminary Phase III Prophylaxis Trial Results For CS-8959

Dr Seizaburo Kashiwagi presented the preliminary data from an influenza Phase III prophylaxis study conducted during the 2009/2010 pandemic flu season in Japan. The SHIELD study (Study of Household Influenza prophylaxis Effect of Long-acting anti-influenza Drug) presentation was made at the 59th Annual Meeting of the Japanese Society of Chemotherapy.

SHIELD was a multicenter, placebo-controlled, double-blind trial that evaluated prevention and safety of laninamivir octanoate (CS-8958 or Inavir®) in families of influenza A and B sufferers. The study measured influenza transmission to other members of the household with a confirmed influenza infected patient. Subjects received one of two dose levels of CS-8958 or placebo. There were no restrictions on other preventative measures undertaken within the household such as the use of masks, hand washing or isolation of the infected patient to a particular room.

The trial demonstrated the protective efficacies of a single, inhaled dose of CS-8958 of 20mg and 40mg as measured by the Risk Reduction Rate (RRR) were 43.7% and 43.2% respectively but were lower than the preset RRR endpoint of 70%.

The possible reasons offered for the lower protective efficacies were the low infection rate within families in the placebo group (8.6%) and the growth in public awareness, resulting in the use of other preventative infection measures during the 09H1N1 pandemic.

Biota will continue to update shareholders when additional trials commence.

Daiichi Sankyo has achieved significant sales with Inavir® in Japan since its approval in September 2010, for the treatment of influenza.

About Inavir®

Inavir® (laninamivir octanoate) is the first of a new class of long acting neuraminidase inhibitors (LANIs) designed to address the limitation of the current influenza anti-virals, which require daily or more frequent dosing. The new class provides the opportunity to treat patients on a “one and done” basis and provides a number of additional potential benefits, these include improved patient compliance that is the patient is more likely to use the product properly and as intended and also offers a reduced cost of storage and transport per course, where the product is intended to be stockpiled.

Inavir® is Daiichi Sankyo’s registered brand and was referred to as CS-8958 during development. Inavir® is delivered via a novel disposable proprietary dry power inhaler.

About Long-Acting Neuraminidase Inhibitors (LANIs)

Current influenza anti-virals or neuraminidase inhibitors for influenza require a minimum of twice daily dosing for the treatment of an influenza infection. LANI compounds persist in the lungs allowing them to be administered once only for treatment and are intended to be used once weekly for prevention of influenza. The ability to dose patients on a less frequent basis offers numerous potential benefits, including greater efficiencies of storage and distribution for a given treatment period and/or number of patients and improved patient compliance. This represents a significant advance over existing influenza anti-virals.

Laninamivir octanoate is a pro-drug and is converted to the active species, laninamivir, in the respiratory tract following administration and is effective on a once only dosing for treatment and intended as a once weekly dosing for prophylaxis.

Features of laninamivir octanoate:

– A Phase III clinical trial in Asia in adults with influenza A or B demonstrated that a single inhaled dose of CS-8958 has equivalent safety and efficacy to Tamiflu® (oseltamivir) dosed twice daily for five days;

– A Phase II/III trial of inhaled CS-8958 in children in Japan also demonstrated equivalent safety and efficacy to Tamiflu dosed orally twice daily for five days;

– CS-8958 is effective against all strains of influenza A and B, including seasonal flu, pandemic influenza A (H1N1) 2009 and avian flu (H5N1);

– CS-8958 is effective against oseltamivir resistant influenza viruses; and

– CS-8958 has an excellent safety profile.

In addition to laninamivir octanoate Biota is currently in preclinical development with FLUNET. Development programs for both laninamivir and FLUNET have been or are supported by US NIH funding. In addition, the advanced development of laninamivir octanoate, for introduction into the US market, is being funded under a contract with the Office of Biomedical Advanced Research and Development Authority of the US Department of Health and Human Services (BARDA).

About Biota

Biota is a leading anti-infective drug development company based in Melbourne Australia, with key expertise in respiratory diseases, particularly influenza. Biota developed the first-in-class neuraminidase inhibitor, zanamivir, subsequently marketed by GlaxoSmithKline as Relenza. Biota research breakthroughs include a series of candidate drugs aimed at treatment of respiratory syncytial virus (RSV) disease and Hepatitis C (HCV) virus infections. Biota has clinical trials underway with its lead compound for human rhinovirus (HRV) infection in patients with compromised respiration or immune systems.

In addition, Biota and Daiichi Sankyo co-own a range of second generation influenza antivirals, of which the lead product lnavir®, is approved for marketing in Japan. Biota holds a contract from the US Office of Biomedical Advanced Research and Development Authority (BARDA) for the advanced development of laninamivir in the USA.

Relenza™ is a registered trademark of the GlaxoSmithKline group of companies.

Inavir® is registered to Daiichi Sankyo.


Daiichi Sankyo

View drug information on Relenza; Tamiflu capsule.

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New Way To Make Malaria Medicine, First Step In Finding New Antibiotics

University of Illinois microbiology professor William Metcalf and his collaborators have developed a way to mass-produce an antimalarial compound, potentially making the treatment of malaria less expensive.

Metcalf set out to understand how this compound, one of a group known as phosphonates, is made in nature by bacteria. He was interested in that process partly because some phosphonates have antibiotic properties. Recently, Metcalf and his lab successfully identified and sequenced the genes and identified the processes by which bacteria make this particular phosphonate compound (FR900098).

His results are reported in the August 25 issue of Chemistry & Biology.

Although the compound has already been chemically synthesized, that is a costly process. By knowing how this phosphonate is biosynthesized, it can now be inexpensively mass-produced by harnessing the cellular machinery of bacteria.

“Malaria is a problem in Third World countries that can least afford expensive medicines, and many antibiotics are expensive,” Metcalf said.

Efforts are already underway by Metcalf’s colleague, chemical engineering professor Huimin Zhao, to engineer E. coli strains to overproduce FR900098, which can then be harvested for medicine.

In addition, says Metcalf, knowing the genes and understanding the pathway that bacteria use to make this antimalarial means the genes can be manipulated to make the compound even more effective against the malaria parasite while remaining harmless to people.

This effort to help treat malaria is just one facet of a major undertaking to find new antibiotics. Last year Metcalf and his colleagues at the U. of I.’s Institute for Genomic Biology, chemistry professor Wilfred van der Donk, Zhao, chemistry professor Neil Kelleher, and biochemistry professor Satish Nair, received a $7.3 million grant from the National Institutes of Health to investigate just this. Jo Handelsman of the University of Wisconsin rounds out the research team.

The need for new antibiotics is at an all-time high because multi-drug resistant bacteria are appearing even outside hospital settings. Consequently, infections that used to be easily curable have become more difficult to treat. For example, tuberculosis has become so resistant to antibiotics that soon “they’ll send you to Arizona to drier air, like they did before they had antibiotics,” Metcalf said.

In the case of malaria, the World Health Organization’s “World Malaria Report 2008″ estimates that “half of the world’s population is at risk of malaria, and an estimated 247 million cases led to nearly 881,000 deaths in 2006.”

Resistance to classic drugs such as chloroquine and sulphadoxine-pyrimethamine is on the rise, and mosquitoes also are developing resistance to insecticides.

“In my opinion malaria is the biggest single infectious disease problem in the world,” Metcalf said.

The World Health Organization now advocates treating malaria with multiple antibiotics simultaneously, to combat the parasites’ ability to develop resistance.

“In an infection, the chances are high that one in 10 million parasites in the patient’s body will become resistant to a given drug,” Metcalf said. “Now, if a patient takes a second drug simultaneously, one in 10 million parasites also becomes resistant to that drug. However, the odds that the same parasite will develop a resistance to both drugs is one in 10 million times one in 10 million, or 10 to the 14th.”

This combination therapy approach is how HIV-AIDS, tuberculosis and other diseases are now treated. In the case of malaria, combination therapy both cures the patient and prevents wider infection, since an uninfected mosquito can acquire (and spread) the parasite by biting an infected person. But in many places where malaria is endemic, this approach is not used, in part because of the cost of medicine.

By making medicines more affordable it increases the chances that they will be used in the most effective way possible, that is to say, in combination with one another.

Metcalf became interested in anti-malarial medicine because of his interest in phosphonates, molecules that contain direct chemical bonds between carbon and phosphorus atoms (as opposed to the carbon-to-oxygen-to-phosphorus bonds that are found in most biological molecules containing phosphorus). As a doctoral student he characterized how microbes metabolized phosphonic acid in glyphosate, known commercially as RoundUp. He began to wonder where this class of compounds comes from and how it is made in nature.

In addition to sequencing the genes that make FR900098, Metcalf and his colleagues are focused on determining just how many naturally occurring phosphonic acids, or phosphonates, there are that have useful antibiotic, antifungal or anti-cancer properties.

The scientific community has known since the 1970s that bacteria routinely produce these types of phosphonates, in a kind of natural biological warfare.

“If you are a bacterium and you can kill off your neighbors you’re better off yourself. It’s kill or be killed,” Metcalf said.

However, until now no one has done a systematic search for phosphonates in nature. Phosphonates work by disrupting biological pathways that use phosphate esters and organic acids. Each phosphonate disrupts a particular pathway. For example, FR900098 inhibits the pathway that creates isoprenoids, building blocks for important cellular components. When the parasites that cause malaria were discovered by others to have a pathway that FR900098 could disrupt, researchers saw a way to put the compound to good use. That same biosynthetic pathway does not exist in animals, which have a different way of making isoprenoids.

Understanding these pathways “opens the door to finding other antibiotics in this class of compounds. The more we can understand about these pathways the better we can find unknown phosphonates with antibiotic properties,” Metcalf said.

His lab has developed a directed strategy to clone and sequence the genes that are required for phosphonate synthesis in bacteria, making the search efficient and exhaustive. Metcalf is optimistic that he and others will be able to mine phosphonates for other antibiotics.

“We’ve grown up in the Golden Age of antibiotics,” he said. “But now kids can come home with an infection in their arm that can’t be treated. And what happens if you can’t treat it? You may have to amputate the arm. This is no joke; we better find new treatments.”


Source: Melissa Edwards

University of Illinois at Urbana-Champaign

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Antioxidant Effects Of Caffeine In Coffee May Protect Against Alzheimer’s And Heart Disease

Scientists are reporting an in-depth analysis of how the caffeine in coffee, tea, and other foods seems to protect against conditions such as Alzheimer’s disease and heart disease on the most fundamental levels. The report, which describes the chemistry behind caffeine’s antioxidant effects, appears in ACS’ The Journal of Physical Chemistry B.

Annia Galano and Jorge Rafael LeГіn-Carmona describe evidence suggesting that coffee is one of the richest sources of healthful antioxidants in the average person’s diet. Some of the newest research points to caffeine (also present in tea, cocoa, and other foods) as the source of powerful antioxidant effects that may help protect people from Alzheimer’s and other diseases. However, scientists know little about exactly how caffeine works in scavenging the so-called free radicals that have damaging effects in the body. And those few studies sometimes have reached contradictory conclusions.

In an effort to bolster scientific knowledge about caffeine, they present detailed theoretical calculations on caffeine’s interactions with free radicals. Their theoretical conclusions show “excellent” consistency with the results that other scientists have report from animal and other experiments, bolstering the likelihood that caffeine is, indeed, a source of healthful antioxidant activity in coffee.

Michael Bernstein

American Chemical Society

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Johnson Outlines New Measures To Tackle Hospital Bugs, UK

Health Secretary Alan Johnson outlined a package of measures to
help reduce healthcare associated infections in hospitals including
new responsibilities for matrons, new guidance on clothing and the
isolation of patients who are infected.

Alan Johnson said:

“I’m determined that patient safety, including cleanliness, should be
the first priority of every NHS organisation. Across the NHS we
continue to bring the number of MRSA cases down and make progress on
measures to reduce C.difficile. Today’s package of measures will give
more responsibility to matrons and set guidelines on clothing that
will help ensure thorough hand washing and prevent the spread of
infections. This is a clear signal to patients that doctors, nurses,
and other clinical staff are taking their safety seriously.”

Further options that may be needed to tackle healthcare associated
infections will be examined in Lord Darzi’s interim report into the
future of the NHS, due to be published in October. The announcement
comes as the Government carries out one of the biggest public
engagement exercises in NHS history on the issues that matter to
staff, patients and the public.

The new package includes the following measures:

1. Matrons and clinical directors will report quarterly directly to
trust boards on infection control and cleanliness. These reports will
focus on compliance with statutory obligations and will increase the
ability of senior clinical staff to raise concerns over infection
control with trust boards directly.

2. New guidance on clothing will mean that hospitals will adopt a new
“bare below the elbows” dress code i.e. short sleeves, no wrist
watch, no jewellery and allied to this the avoidance of ties when
carrying out clinical activity. The traditional doctors’ white coat
will not be allowed. The new clothing guidance will ensure good hand
and wrist washing.

3. New clinical guidance to increase the use of isolation for those
patients who are infected with MRSA or Clostridium difficile.
Although the best trusts will already be meeting this standard, for
the majority of trusts this will mean greater use of single rooms,
cohort nursing and better management of isolated patients.

4. The National Patient Safety Agency will extend its sccessful
cleanyourhands campaign to care settings outside hospitals. The
campaign, designed to improve hand hygiene among healthcare workers
in order to combat healthcare associated infections, will be rolled
out to primary care, ambulance, mental health and care trusts as well
as to care homes and hospices.

5. A new legal requirement will be placed on all chief executives to
report all MRSA bacteraemias and C. difficile infections to the
Health Protection Agency. It will be backed up by fines for non
compliance – failure to report will be an offence.

This package follows the announcement in July from Alan Johnson of an
extra ВЈ50 million to tackle healthcare associated infections, asking
each Director of Nursing in every Strategic Health Authority to make
sure that frontline clinicians are supported in the work they do to
reduce infection and doubling the size of the Department of Health’s
infection Improvement Team. The cash is being spent on a range of
things, including: staff training and education; increased infection
surveillance; more sinks for handwashing; upgrading isolation
facilities; and new cleaning equipment.

England’s Chief Nursing Officer Professor Christine Beasley said:

“Working alongside their clinical directors, we are asking matrons to
monitor staff compliance with the ‘bare below the elbow’
recommendation and the implementation of the Saving Lives high impact
interventions. They will be required to report to the Trust’s
Director of Infection Control and Prevention on at least a quarterly

General Secretary of the Royal College of Nursing Dr Peter Carter

“We support any initiative that promotes good hand hygiene in
clinical practice. This guidance offers a positive step forward in
introducing dress code standards across all health professions to
help reduce healthcare associated infections.

“Nurses are at the forefront of initiatives to tackle healthcare
associated infections but in order to be successful we need
commitment from the entire NHS team; from all staff, in all
disciplines and in every healthcare setting.”

Dame Karlene Davis, General Secretary of the Royal College of
Midwives said:

“Before the inception of the NHS, one of the biggest killers of child
bearing women was puerperal sepsis. This has improved significantly
with the recognition of the need for hand hygiene to reduce cross

“This situation remains as relevant today as it did many decades ago
and the RCM wholly supports any measure which seeks to avoid
infection and harm to mothers and newborns.”

– Uniforms and Workwear: An evidence base for developing local policy
can be found at dh. The guidance suggests that white
coats should not normally be worn, as the cuffs are likely to be
heavily contaminated. Where staff have direct patient contact, then
suitable protection – for example, plastic aprons – should be worn.

The guidance can be found

– All acute Trusts are expected to go ‘bare below the elbows’ by
January 2008.

– New clinical guidance on the isolation of infected patients can be

– The extension of the National Patient Safety Agency’s
cleanyourhands campaign is being piloted by 19 ‘pioneer’
organisations, selected to represent a mix of non-acute care settings
throughout England and Wales. More information on cleanyourhands is
available here.

– Patient Environment Action Teams (PEATs) were established in 2000
to assess NHS hospitals. Under the programme, every inpatient
healthcare facility in England with more than ten beds is assessed
annually and given a rating of excellent, good, acceptable, poor or
unacceptable. Cleanliness and the environment are two of the areas
that PEATs cover.


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Second Peace Corps Volunteer Reports Being Discharged After Testing HIV-Positive, Washington Post Reports

Washington Post columnist Stephen Barr on Friday examined the case of a second Peace Corps volunteer who said she was discharged from service after testing HIV-positive. Rebecca Coulborn, a former volunteer in Burkina Faso, said she was required to leave her post immediately in 2001 after she tested positive for the virus.

Coulborn spoke about her case after reading an April 28 Post article on former Peace Corps volunteer Jeremiah Johnson, who was discharged from his post in Ukraine after he was diagnosed with HIV.

In a May 7 letter responding to a previous letter from the American Civil Liberties Union, the Peace Corps said Johnson was the first case of a volunteer “to our knowledge” who wanted to continue service after testing HIV-positive, the Post reports.

However, Coulborn, an epidemiologist at the University of Michigan, said that she “did not want to be medically separated” from the agency. According to Coulborn, she was told that it was “Peace Corps policy. If you did test HIV-positive, you were medically separated” from service. She said, “I really thought it was their policy to automatically separate people” with HIV/AIDS, adding, “I felt for a long time that this was something done to me that was wrong, and very unethical.”

During her Peace Corp service, Coulborn provided health education in a village of 800 people in Burkina Faso. She said she thinks she contracted HIV when helping a person who had been injured in a bicycle accident. According to Barr, Coulborn did not expect her HIV-positive test result. However, Barr writes that Coulborn was more surprised when the local agency medical officer, following instructions from headquarters, told her “to pack up [her] stuff and not expect to return.”

Coulborn said that she remains in good health and has not had to start antiretroviral therapy, adding that she believes she “could have completely and totally served out my term as a Peace Corps volunteer.” Being forced to leave her assignment “was devastating,” she said, noting that her departure ended ongoing and upcoming projects for the village. “Testing positive for HIV should not disqualify you from serving your country internationally,” Coulborn said.

Amanda Beck, Peace Corps press director, said the statement about Johnson being the first volunteer who wanted to continue his service was “based on personal knowledge of the currently serving Peace Corps staff members,” who generally turnover every five years under the agency’s staffing policies. “Our primary concern is that Peace Corps volunteers receive the best medical care and treatment possible,” Beck said, adding, “In the case of HIV, the Peace Corps Office of Medical Services has historically determined that the best testing, evaluation and treatment for volunteers is available from specialists in the United States.” Beck said that 75,000 U.S. citizens have served in the Peace Corps since 1989 and that 36 have tested HIV-positive during or at the close of their service.

Under a Peace Corps general policy, if a volunteer develops a medical condition that cannot be resolved within 45 days, he or she is medically separated from the agency. Initial evaluation and treatment for HIV can take from three to six months — meaning that Peace Corps volunteers who are HIV-positive experience what ACLU calls automatic separation, Barr writes.

According to Barr, the Peace Corps in its letter to ACLU said that its policy “appears to be evolving.” The letter said that the agency “is now committed to extending the individualized assessments in these types of cases to include whether a newly infected volunteer could be reasonably accommodated and either kept at post or sent to another post in lieu of medical separation.” It added that it “cannot commit to a guarantee of reassignment” (Barr, Washington Post, 5/16).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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Funding For Superbug Spin-Out

Procarta Biosystems, the company spun-out of the John Innes Centre in 2007 to develop a technology designed to defeat antibiotic-resistant superbugs, has received significant seed funding. The Rainbow Seed Fund and the Iceni Seedcorn Fund will enable Procarta to further develop its DNA decoy technique, which aims to restore antibiotic efficacy against resistant superbugs, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE).

Procarta’s pioneering approach to combating the threat of superbugs is based on injectable DNA therapies, called Transcription Factor Decoys (TFDs). TFDs are short pieces of DNA which inactivate the resistance genes the bacteria need to counter antibiotics. This new funding will initially allow Procarta to develop TFDs that prevent resistance to vancomycin, the so-called antibiotic of last resort.

“We plan to be able to use this latest and valuable support to further validate the outstanding potential of our proprietary approach to combating resistant superbugs,” said Procarta’s Research Director, Dr Michael McArthur.

Mark White of the Rainbow Seed Fund said: “We have worked alongside the John Innes Centre and its commercialisation arm PBL for some time and have a high regard for their ability to spot promising commercial opportunities. In Procarta’s case we were particularly impressed by the skills of the key people involved as well as the scale of the opportunity. In addition, we were attracted to the possibility of achieving a significant breakthrough in an important but somewhat neglected area of healthcare. There remains a lot of work to be done, but the venture holds a great deal of promise.”

Procarta’s unique technology can breathe new life into existing drugs and prolong the commercial usefulness of antibiotics and in doing so counter growing concern over the rise of drug-resistance in bacterial infections. The scientific founders, Dr. Michael McArthur and Professor Mervyn Bibb, hope to move to pre-clinical trials in 2009 with their first product, after which Procarta will work with pharmaceutical companies to bring it to market. Having established the proof of concept with vancomycin, Procarta plans to build a strong product pipeline by applying its proprietary technology to reinvigorate the use of a broad range of valuable antibiotics.

“We are extremely excited about the promise of Procarta’s technology, targeting as it does one of the most significant issues to hit the public healthcare system in the 21st Century,” said a spokesman for Iceni.

Procarta Biosystems will be moving its operations to the Norwich Bioincubator on 1st July 2008 and has also recently appointed Dr Nigel Crockett as Commercial Director. Dr Crockett has over 15 years of experience in the Pharma-biotech sector, especially in early stage R&D collaborations and licensing.


About John Innes Centre:

The John Innes Centre, Norwich, UK is an independent, world-leading research centre in plant and microbial sciences with over 800 staff. JIC carries out high quality fundamental, strategic and applied research to understand how plants and microbes work at the molecular, cellular and genetic levels. The JIC also trains scientists and students, collaborates with many other research laboratories and communicates its science to end-users and the general public. The JIC is grant-aided by the Biotechnology and Biological Sciences Research Council.

About Plant Bioscience Ltd:

PBL develops innovative technologies from public and private sources worldwide – turning ideas into patented, scientifically validated and licensable technologies. PBL invests in building intellectual property protection, and develops technologies through proof-of-concept and prototype stage and licenses onwards to a wide variety of industry sectors. Its interests cover AgBiotech, Food / Nutrition, Microbiology, Biotechnology and related Life Science industries. PBL was formed in 1994, and is now jointly and equally owned by The John Innes Centre, The Sainsbury Laboratory, and the BBSRC (Biotechnology and Biological Sciences Research Council).

About the Rainbow Seed Fund:

The Rainbow Seed Fund is an early stage technology venture capital fund with close links to the UK’s leading centres of scientific research outside the universities. As well as the research centres attached to BBSRC (the parent of the John Innes Centre), the fund is linked with such major sites as the Rutherford Appleton Laboratory in Oxfordshire, the Babraham Institute in Cambridge and Porton Down in Wiltshire. It has a portfolio of 16 high tech companies engaged in a broad range of areas from advanced detection systems for counterterrorism through to medical devices for monitoring and management of cholesterol levels

About Iceni:

The Iceni Seedcorn Fund was established following a successful bid by a regional consortium of universities and institutes to the Department of Trade and Industry’s University Challenge Fund and invests in the commercialisation of research results arising in partner academic institutions in the Eastern region of the UK such as the University of East Anglia, the John Innes Centre, the Institute of Food Research, the Sainsbury Laboratory, PBL and the University of Essex, through either the creation of new ventures or through licensing.

Source: Andrew.chapple

Norwich BioScience Institutes

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Meningitis Causes Death Of Student And Counselor In New York

A guidance counselor of a school in Queens, as well as a student in Massapequa, Long Island, have both died as a result of meningitis – both in the same week. According to authorities, the guidance counselor worked at the Saint Francis Preparatory High School, Fresh Meadow.

Officials are currently trying to track and meet anybody who has had contact with the counselor who died – meningitis can be passed on to another person if there is close contact.

The high school student was called Michael Gruger, he was 17. Authorities say he died from bacterial meningitis. Last Wednesday evening he had flu-like symptoms and went to bed. On Thursday morning his condition was such that he had to be hospitalized – he died that same day in the afternoon. This is the first meningococcal meningitis death in Nassau County since 2004, according to officials.

What is meningitis?

Meningitis is an inflammation of the membranes (called meninges) that surround the brain and spinal cord.

How can you become ill with meningitis?

– Meningitis may be caused by many different viruses and bacteria, or by diseases that cause inflammation of tissues of the body without infection.

– In meningococcal meningitis, (also known as cerebrospinal fever and spotted fever), the symptoms may appear suddenly causing widespread infection and blood poisoning (septicemia), and can be rapidly fatal if not diagnosed and treated promptly in hospital

– In meningococcal meningitis, there can be a characteristic rash of red or brownish pin prick spots caused by blood under the skin (hemorrhagic rash) which can develop into purple bruises and blood blisters.

Glass tumbler test for hemorrhagic rash

If a glass tumbler is pressed firmly against this hemorrhagic rash, the rash will not fade; it will remain visible through the glass. If this happens you should seek medical advice immediately.

How serious is Meningitis?

– Meningitis is very serious and can be life-threatening.

– Symptoms of meningitis may appear abruptly.

– Symptoms often include high fever, severe and persistent headache, stiff neck, sensitivity to light, nausea and vomiting.

– Changes in behavior such as confusion, sleepiness, and difficulty waking up are extremely important symptoms and may require emergency treatment.

– In infants, symptoms of meningitis may include irritability or tiredness, poor feeding and fever.

How long does Meningitis last?

This will vary depending on the type of meningitis, certain bacterial forms being the most severe.

How is Meningitis treated?

– If meningitis is suspected, medical advice should be sought immediately. Because some of the early symptoms might be similar to other conditions, a high level of suspicion is required, especially with children.

– Prevention is better than cure! Effective vaccines are now available against some types of meningitis.

– Individuals with bacterial meningitis are hospitalized and treated with antibiotics given directly into a vein, in order to achieve the rapid high blood and tissue levels of antibiotic that this life-threatening condition requires.

– People with viral meningitis may not require specific treatment, but they are usually observed in a hospital and examined to ensure they do not have bacterial meningitis.

Other medicines used to control the symptoms may include:

– Anticonvulsant medications to prevent or treat seizures.

– Corticosteroid drugs to reduce brain swelling and inflammation.

– Sedative drugs for irritability or restlessness.

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Vaccine Made With Synthetic Gene Protects Against Deadly Pneumonia

Researchers at Albert Einstein College of Medicine of Yeshiva University have developed an experimental vaccine that appears to protect against an increasingly common and particularly deadly form of pneumococcal pneumonia. Details of the new vaccine, which was tested in an animal model, are reported in a paper published in the Journal of Infectious Diseases.
Pneumococcal pneumonia can occur when the lungs are infected with the bacterial species Streptococcus pneumoniae (also known as pneumococcus). “Like many microbes that cause pneumonia, pneumococcus is spread from person to person through coughing or sneezing,” said principal investigator Liise-anne Pirofski, M.D., professor of medicine and of microbiology & immunology and the Selma and Dr. Jacques Mitrani Chair in Biomedical Research. Symptoms include cough, fever, shortness of breath, and chest pain.

The National Foundation for Infectious Diseases estimates that 175,000 people are hospitalized with pneumococcal pneumonia in the United States each year. In addition to pneumonia, pneumococcus causes 34,500 bloodstream infections and 2,200 cases of meningitis annually. It is responsible for more deaths in the United States – 4,800 a year – than any other vaccine-preventable disease. It poses a particular problem in the developing world, where it is estimated to cause more than one million deaths in children each year, according to the World Health Organization.

A pediatric vaccine has dramatically reduced the incidence of pneumococcal disease in children and adults, both by protecting vaccinated children and by reducing person-to-person transmission of the bacterium to others – a phenomenon known as herd immunity.

“The pediatric vaccine is a great victory for modern medicine, but it doesn’t cover all strains of disease-causing pneumococcus – some of which have recently emerged and are very virulent,” said Dr. Pirofski. “This problem, coupled with the fact that herd immunity doesn’t protect immunocompromised patients as effectively as people with normal immunity, led us to look for a better vaccine.”

The researchers focused on developing a vaccine against serotype 3 – a pneumococcal strain that was not included in the pediatric vaccine used for the past decade and that has emerged as a cause of serious pneumonia in adults and children. Serotype 3 can trigger inflammation so overwhelming that it can result in very severe disease or even death.

The goal of this study was to produce a vaccine consisting of a live, attenuated (weakened) version of serotype 3 S. pneumoniae. To create their vaccine, the researchers focused on the serotype 3 gene that codes for pneumolysin, a toxin produced by all pneumococcal strains. The researchers replaced this gene with a synthetic version that they hoped would reduce the amount of toxin produced.

“Our idea was to design a live vaccine that would stimulate the immune system sufficiently to ward off disease but wouldn’t lead to the severely damaging inflammatory response that this strain can cause,” said lead author J. Robert Coleman, Ph.D., a postdoctoral fellow in microbiology & immunology at Einstein, who helped develop the gene-modification technique, known as synthetic gene customization, while a graduate student at Stony Brook University.

“The novelty of this approach lies in the fact that the gene’s expression would be reduced, but not eliminated,” Dr. Coleman added. “Previous approaches to genetic regulation of virulence relied on knocking out genes, which eliminates their expression completely.”

Altering the pneumolysin gene in the seroptype 3 bacteria resulted in less pneumolysin toxin produced in vitro. When mice were injected with either attenuated or unattenuated serotype 3 bacteria, mice receiving the attenuated strain developed an inflammatory response much weaker than was observed in mice receiving the unattenuated serotype 3 strain. Most important, of the five mice injected with the attenuated strain, four survived a subsequent challenge from the highly virulent unattenuated serotype 3 strain, which was lethal in five of five unvaccinated, control mice.

This method of reducing gene expression had been used for viral pathogens, but this is the first time that gene customization has successfully controlled virulence in bacteria. The study’s findings could potentially lead to pneumococcal vaccines based on weakened strains, and the Einstein researchers are now investigating whether they can reduce the expression of other genes associated with pneumococcal virulence.

The paper, “Designed reduction of Streptococcus pneumoniae pathogenicity via synthetic changes in virulence factor codon-pair bias,” was published in the February 22 online edition of the Journal of Infectious Diseases. Co-authors include Masahide Yano at Einstein; Dimitris Papamichail at the University of Miami, Miami; and MarГ­a del Mar GarcГ­a-SuГЎrez, at Biozell Diagnostico Molecular SL, Asturias, Spain.

This research was funded by the National Institutes of Health and the National Institute of Allergy and Infectious Diseases.

Source: Albert Einstein College of Medicine of Yeshiva University

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Japanese scientists kill bacteria by electrocution

A science team led by Tokyo University of Technology has developed a membrane that electrocutes infectious agents such as Legionella bacteria found in bathwater.

The team confirmed with a high-powered microscope that the bacteria were killed by the membrane. The team will announce the results at a meeting of the Society for Antibacterial and Antifungal Agents to be held in Tokyo on May 26.

The membrane was made simple and safe to use by applying electromagnetic induction–a phenomenon whereby an electric current passes through an object as it moves around a magnet.

The membrane has small holes containing magnetic powder. When water from a bath passes over the membrane, a low-grade electric current emanates from the membrane, striking infectious agents in the water and killing them.

The team conducted an experiment by pouring water through two membranes, one of which was coated with magnetic powder, for six days. They found that the number of Legionella bacteria decreased to about one-thousandth of the number found in the water that passed through the membrane without the magnetic powder. The team also found that the membrane can kill Staphylococcus aureus and Bacillus coli.

Shinichiro Ishibashi, a professor at the university, said the membrane had a high purification ability because it killed the bacteria rather than just capturing them.

Yomiuri Shimbun

Copyright 2004 The Yomiuri Shimbun

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Earth Institute Supports Accelerated Expansion of Health System for Ethiopia

Center for National Health Development in Ethiopia to boost government capacity

In the summer of 2004 Professor Awash Teklehaimanot, a health expert with the Earth Institute at Columbia University and member of the Center for Global Health and Economic Development, launched the Center for National Health Development in Ethiopia, a project of the Earth Institute in support of accelerated expansion of primary health care facilities in Ethiopia.

The government of Ethiopia has committed to train up to 25,000 health workers over five years to provide basic promotive and preventive health services throughout Ethiopia. After a one year training, the graduates will be placed in 15,000 villages (average population 5,000 each). In addition to the training and placement of these health workers, the government plans to build and upgrade nearly 3000 new primary health care centers and construct thousands of basic care facilities called health posts. The estimated total investment required to implement this plan, which will provide health services to 85 percent of the population, is $1.6 billion. “The government of Ethiopia’s health care plan is very ambitious, as the government realizes that improved health is essential for growing other areas of the economy,” says Teklehaimanot.

The Center for National Health Development in Ethiopia will provide a critical boost to the capacity of Ethiopia’s Ministry of Health, helping it to succeed in its bold plan. The center, which started its work in August 2004, is staffed by Ethiopian professionals with extensive experience and training in planning and health systems development, epidemiology, vector biology, and prevention and control of infectious diseases, The Center’s staff have a special focus on malaria and HIV/AIDS, data management and program evaluation.

Ethiopia’s health care system is among the least developed in Sub-Saharan Africa. The present government has recognized that ill health of a fast growing population, now over 70 million, is an impediment to social and economic development. The government has chosen to strengthen primary health care as a strategic approach, to address the lack of physical access to even basic health care facilities in rural areas.

Widespread poverty, poor nutritional status, low education levels, and poor access to health services have contributed to the high burden of ill health in the country. Life expectancy at birth is currently about 54 years and is expected to decline to 46 years if the present HIV infection rates are maintained. Malaria is the primary health problem in the country; it is the leading cause of outpatient visits and is responsible for 8 to 10 million annual clinical cases and a significant number of deaths. In total, as much as 90 percent of the health problems in Ethiopia are due to preventable communicable and nutritional diseases.

Professor Teklehaimanot’s long history of working on health issues in Ethiopia, particularly on malaria, has given him an opportunity to work closely with the Ethiopian government in designing this program and assessing what outside support is needed. Providing this support will be the mission of the Center for National Health Development in Ethiopia. The center will assist Ethiopia’s Ministry of Health in resource mobilization, and will provide technology for evaluation, data management, and analysis that will contribute to operations management and quality control. The center will also provide technical support to facilitate work with civil society, the private sector, UN agencies, and the donor community toward the accelerated expansion of primary health services in Ethiopia.

The Ministry of Health in collaboration with the Ministry of Education initiated the program by selecting 85 trainers; the training of the trainers took place in 2003. The one-year training of the first 2,800 women destined to become rural extension health workers is being undertaken this year in fourteen Technical and Vocational Education Training Centers. The government’s plan is that all extension health workers in rural Ethiopia will be women, as it is thought that female health workers will be able to gain the confidence of women in rural households to pass along important knowledge throughout the population.

The Earth Institute at Columbia University is among the world’s leading academic centers for the integrated study of Earth, its environment, and society. The Earth Institute builds upon excellence in the core disciplines-earth sciences, biological sciences, engineering sciences, social sciences and health sciences-and stresses cross-disciplinary approaches to complex problems. Through its research, training and global partnerships, it mobilizes science and technology to advance sustainable development, while placing special emphasis on the needs of the world’s poor.

Contact: Jennifer Freeman
The Earth Institute at Columbia University

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