http://www.caribbean360.com/thumbnail.php?file=images/Caribbean/MERS_CoV_virus_407518030.jpg&size=article_medium...ENEVA, Switzerland, Wednesday June 26, 2013 – With
the deadly new Middle East Respiratory Syndrome (MERS) virus continuing
its slow but steady spread, concerns are being expressed about next
month's Ramadan, when millions of Muslim pilgrims from all over the
world will be converging on Saudi Arabia, the site of what appears to be
an ongoing outbreak of the disease.
The death of a Saudi man from the virus on Monday brought the
kingdom's death toll from the SARS-like infection to 34, according to
the ministry of health.
Other new cases have also been recorded, especially in Eastern
Province where most of the infections have occurred, the ministry added
on its website, noting that there have been 66 cases of infection from
MERS in the kingdom since the disease surfaced.
One week previously, the World Health Organisation (WHO) said that 64
laboratory-confirmed cases of the disease had been recorded worldwide,
including 38 deaths.
MERS is a member of the coronavirus family, which includes the
pathogen that causes Severe Acute Respiratory Syndrome (SARS), a disease
that sparked global panic 10 years ago after it jumped to humans from
animals in Asia and killed about 800 people.
Like SARS, MERS appears to cause a lung infection, with patients
suffering from fever, coughing and breathing difficulties. But it
differs in that it also causes rapid kidney failure and appears far more
lethal than SARS.
Compared to SARS' eight percent death rate, the fatality rate for
MERS is about 65 percent, though experts concede that they could be
missing mild cases that might skew the figures.
While most of the cases have been concentrated in Saudi Arabia, the
MERS virus has also spread to neighbouring Jordan, Qatar and the United
Arab Emirates (UAE), and cases have also been found in France, Germany,
Italy, Tunisia and Britain.
An international team of doctors who investigated nearly two dozen
cases in eastern Saudi Arabia found the new coronavirus has some
striking similarities to SARS.
Unlike SARS, however, scientists remain baffled as to the source of MERS.
While SARS was traced to bats before jumping to humans via civet
cats, the source of the MERS virus remains a mystery. It is most closely
related to a bat virus though some experts suspect people may be
getting sick from animals like goats or camels.
Another hypothesis is that infected bats may be contaminating foods like dates, commonly harvested and eaten in Saudi Arabia.
Meanwhile, doctors around the world have struggled to treat patients infected with the new virus.
"We need more information from other countries to find out what the
best treatment is," said Dr Clemens Wendtner, who treated a MERS patient
who later died in Germany. "Our patient got everything possible and it
still didn't help him."
Other experts are concerned about the worrying signs surrounding MERS.
"As long as it is around, it has every opportunity at the genetic
roulette table to turn into something more dangerous," said Michael
Osterholm, an infectious diseases expert at the University of Minnesota.
WHO Director-General Dr Margaret Chan has previously called MERS the
single biggest public health threat and acknowledged officials were
"empty-handed" regarding prevention measures.
"We understand too little about this virus when viewed against the
magnitude of its potential threat," she said last month in Geneva. Click here to receive free news bulletins via email from Caribbean360. (View sample)
Wednesday 26 June 2013
RAPID CURE FOR HIV
HIV-positive mothers who take antiretroviral therapies while pregnant can be prevented from transmitting the virus to their babies 99% of the time — a resounding success story in the decades-long fight against the virus. But what about infants whose mothers do not receive the drugs? Energized by the case of the ‘Mississippi baby’ — who seemed to be cured of HIV after aggressive treatment was begun within hours of birth — researchers are hoping to show that these infants, too, can get off to a healthy start.
At a symposium on HIV cure research on 29 June at the International AIDS Society’s biennial meeting in Kuala Lumpur, Malaysia, investigators will describe how they are racing to design a clinical trial to test whether the early treatment works, and why. They hope to treat the first babies by the end of this year.
The trial, sponsored by the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Group, marks a change for the field: so far, most research worldwide has focused on adults. In 2012, the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, spent US$18 million on HIV cure research in adults and adolescents, and just $45,000 on children. Yet 3.3 million children worldwide have HIV.
“Children have been an afterthought,” says Jeffrey Safrit, director of clinical and basic research for the Elizabeth Glaser Pediatric AIDS Foundation, who is based in Los Angeles, California. “But the immune system of the child might be more easily manipulated to allow a cure.”
This was highlighted in March, when virologist Deborah Persaud of the Johns Hopkins Children’s Center in Baltimore, Maryland, announced that a baby in Mississippi who received treatment for HIV within 31 hours of birth stopped medication at 18 months without the virus rebounding (see Nature http://doi.org/m2d; 2013). Researchers knew that early treatment could help infants to control HIV, but were surprised that they could essentially wipe it out from an infant’s body using existing drugs.
Early HIV treatment is helpful for patients of any age. It stops the virus from replicating before it can infect central memory T cells, the main immune-cell reservoir where HIV ‘hides’ from drugs. But researchers think that babies are better targets for HIV cures than adults because of their immature immune systems, which respond more mildly when provoked. Because the cells involved in this ‘inflammatory response’ are the same ones that are most susceptible to HIV, this could mean that infants are less prone to the infection spreading. Moreover, babies are born without central memory T cells, so they are likely to have a smaller reservoir of infected cells, says Mike McCune, an immunologist at the University of California, San Francisco.
The IMPAACT study, to be conducted across some of the group’s 71 sites worldwide, will screen and treat hundreds of babies to find 20–30 infants who have acquired HIV from untreated mothers or from those whose HIV was not well controlled during pregnancy. Because diagnosing HIV takes up to 7 days, all screened babies will automatically receive a similar treatment to the Mississippi baby: a cocktail of three drugs within 48 hours of birth. Physicians will add a fourth drug if babies then test positive for HIV. Around the age of three, the 20–30 children will be tested to see whether their immune systems make antibodies to HIV or if it can be detected in their blood. Those testing negative on both counts would then be taken off the drugs to see whether they can remain HIV-free.
The practical and ethical challenges of the trial are significant. Babies of untreated HIV-positive women have only a 15–30% chance of infection at birth, so the trial will need to recruit many babies to try to cure the few who are infected. Those who do not contract HIV will be treated anyway, perhaps exposing them to drug side effects. These are usually mild, but can deplete certain blood cells.
But children born to untreated HIV-positive women are already given up to three drugs after birth as a precaution. The potential for finding a cure far outweighs the risks of adding another drug, or of stopping treatment to test whether the cure has worked, says Yvonne Bryson, a physician at the Mattel Children’s Hospital at the University of California, Los Angeles, and co-chair of the trial. “There’s much more benefit to be gained than risk,” she says.
Physicians are already considering changing the way they treat children infected by the virus. Bryson says that families of HIV-positive teenagers who were treated soon after birth and kept on medication are now asking that the teens be taken off the drugs.
Ultimately, the 34 million people worldwide who live with HIV could also benefit, researchers say. If it turns out that infants are more amenable to cures because they have a less active inflammatory response, that might encourage physicians to prescribe treatments that are less likely to trigger inflammation in adults, McCune says.
Bryson, who has worked on HIV since the first case was detected, thinks that the end could be in sight. “I saw patient zero,” Bryson says. “I’ve always been so excited to think that I would see the day that we would arrive at a cure, and I think we’re here.”
HIV-positive mothers who take antiretroviral therapies while pregnant can be prevented from transmitting the virus to their babies 99% of the time — a resounding success story in the decades-long fight against the virus. But what about infants whose mothers do not receive the drugs? Energized by the case of the ‘Mississippi baby’ — who seemed to be cured of HIV after aggressive treatment was begun within hours of birth — researchers are hoping to show that these infants, too, can get off to a healthy start.
At a symposium on HIV cure research on 29 June at the International AIDS Society’s biennial meeting in Kuala Lumpur, Malaysia, investigators will describe how they are racing to design a clinical trial to test whether the early treatment works, and why. They hope to treat the first babies by the end of this year.
The trial, sponsored by the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Group, marks a change for the field: so far, most research worldwide has focused on adults. In 2012, the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, spent US$18 million on HIV cure research in adults and adolescents, and just $45,000 on children. Yet 3.3 million children worldwide have HIV.
“Children have been an afterthought,” says Jeffrey Safrit, director of clinical and basic research for the Elizabeth Glaser Pediatric AIDS Foundation, who is based in Los Angeles, California. “But the immune system of the child might be more easily manipulated to allow a cure.”
This was highlighted in March, when virologist Deborah Persaud of the Johns Hopkins Children’s Center in Baltimore, Maryland, announced that a baby in Mississippi who received treatment for HIV within 31 hours of birth stopped medication at 18 months without the virus rebounding (see Nature http://doi.org/m2d; 2013). Researchers knew that early treatment could help infants to control HIV, but were surprised that they could essentially wipe it out from an infant’s body using existing drugs.
Early HIV treatment is helpful for patients of any age. It stops the virus from replicating before it can infect central memory T cells, the main immune-cell reservoir where HIV ‘hides’ from drugs. But researchers think that babies are better targets for HIV cures than adults because of their immature immune systems, which respond more mildly when provoked. Because the cells involved in this ‘inflammatory response’ are the same ones that are most susceptible to HIV, this could mean that infants are less prone to the infection spreading. Moreover, babies are born without central memory T cells, so they are likely to have a smaller reservoir of infected cells, says Mike McCune, an immunologist at the University of California, San Francisco.
The IMPAACT study, to be conducted across some of the group’s 71 sites worldwide, will screen and treat hundreds of babies to find 20–30 infants who have acquired HIV from untreated mothers or from those whose HIV was not well controlled during pregnancy. Because diagnosing HIV takes up to 7 days, all screened babies will automatically receive a similar treatment to the Mississippi baby: a cocktail of three drugs within 48 hours of birth. Physicians will add a fourth drug if babies then test positive for HIV. Around the age of three, the 20–30 children will be tested to see whether their immune systems make antibodies to HIV or if it can be detected in their blood. Those testing negative on both counts would then be taken off the drugs to see whether they can remain HIV-free.
The practical and ethical challenges of the trial are significant. Babies of untreated HIV-positive women have only a 15–30% chance of infection at birth, so the trial will need to recruit many babies to try to cure the few who are infected. Those who do not contract HIV will be treated anyway, perhaps exposing them to drug side effects. These are usually mild, but can deplete certain blood cells.
But children born to untreated HIV-positive women are already given up to three drugs after birth as a precaution. The potential for finding a cure far outweighs the risks of adding another drug, or of stopping treatment to test whether the cure has worked, says Yvonne Bryson, a physician at the Mattel Children’s Hospital at the University of California, Los Angeles, and co-chair of the trial. “There’s much more benefit to be gained than risk,” she says.
Physicians are already considering changing the way they treat children infected by the virus. Bryson says that families of HIV-positive teenagers who were treated soon after birth and kept on medication are now asking that the teens be taken off the drugs.
Ultimately, the 34 million people worldwide who live with HIV could also benefit, researchers say. If it turns out that infants are more amenable to cures because they have a less active inflammatory response, that might encourage physicians to prescribe treatments that are less likely to trigger inflammation in adults, McCune says.
Bryson, who has worked on HIV since the first case was detected, thinks that the end could be in sight. “I saw patient zero,” Bryson says. “I’ve always been so excited to think that I would see the day that we would arrive at a cure, and I think we’re here.”
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