T cell shortage linked to severe COVID-19 in elderly; antiseptic spray may limit virus spread

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Shortage of ‘naive’ T cells raises COVID-19 risk in elderly

A lower supply of a certain type of immune cell in older people that is critical to fighting foreign invaders may help explain their vulnerability to severe COVID-19, scientists say. When germs enter the body, the initial “innate” immune response generates inflammation not specifically targeted at the bacteria or virus.

Within days, the more precise “adaptive” immune response starts generating antibodies against the invader along with T cells that either assist in antibody production or seek out and attack infected cells.

In a small study published on Wednesday in Cell, COVID-19 patients with milder disease had better adaptive immune responses, and in particular, stronger T-cell responses to the coronavirus.

People over age 65 were much more likely to have poor T cell responses, and a poorly coordinated immune response in general, coauthor Shane Crotty of the La Jolla Institute for Immunology said in a news release.

As we age, our supply of “naive” T cells shrinks, he explained. Put another way, we have fewer “inexperienced” T cells available to be activated to respond to a new invader. “Ageing and scarcity of naive T cells may be linked risk factors for failure to generate a coordinated adaptive immune response, resulting in increased susceptibility to severe COVID-19,” the researchers said.

Antiseptic nasal spray may help limit coronavirus spread

An antiseptic nasal spray containing povidone-iodine may help curb transmission of the new coronavirus, preliminary research suggests.

In test tube experiments, a team of ear, nose and throat doctors found that a povidone-iodine nasal spray inactivated the virus in as little as 15 seconds. The nasal spray they tested is typically used to disinfect the inside of the nose before surgery. Formulations designed for use on skin are not safe in the nose, the researchers note.

They reported on Thursday in JAMA Otolaryngology – Head and Neck Surgery that they now have their patients use the spray before intranasal procedures, to reduce the risk of virus transmission through the air via droplets and aerosol spread.

They also suggest instructing patients to perform nasal decontamination before coming to appointments, to “further decrease intranasal viral load and … prevent spread in waiting areas and other common areas.” They caution, however, that routine use of povidone-iodine would not be safe for some people, including pregnant women and patients with thyroid conditions. Larger clinical trials have not yet proved that viral transmission is curbed by intranasal povidone-iodine solutions, but “these studies are already underway,” the researchers said.

Not all COVID-19 antibody tests are equal

Some COVID-19 antibody tests are much more reliable than others. But even with the best ones, reliability varies among patient subgroups, a new study suggests. Some tests look for IgM or IgA antibodies, the first antibodies produced by the immune system in response to an invader, which do not remain long in the body.

Other tests – the most common kind – look for IgG antibodies, which generally develop within seven to 10 days after symptoms begin and remain in the blood for some time after the patient recovers.

In a study posted on medRxiv on Wednesday in advance of peer review, researchers analyzed data from 11,809 individuals whose COVID-19 had been diagnosed with highly rated tests to see how well the various antibody assays would “recall” that the patient had been infected.

The most commonly used assays, which look for IgG, had a 91.2% recall rate. But the IgA and IgM assays had estimated recall rates of 20.6% and 27.3%, respectively, coauthor Natalie Sheils of UnitedHealth Group told Reuters. “Recall varies significantly across sub-populations and according to timing of the tests, with performance becoming relatively stable after day 14,” she said. “The tests performed better for men versus women, for non-whites versus whites and for individuals above age 45.” More research is needed to understand why these variations occur, Sheils added.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

Listeria risk prompts Meijer to recall produce in six U.S. states

Listeria risk prompts Meijer to recall produce in six U.S. states

NEW YORK (Reuters) – Retailer Meijer Inc said it was recalling packaged vegetables in six U.S. states because of possible contamination from Listeria monocytogenes bacteria, which can cause fatal food poisoning in young children, pregnant women and elderly or frail people.

Meijer, based in Grand Rapids, Michigan, said there were no illnesses reported as of Sunday.

The recall affects 35 products and includes vegetables such as broccoli, cauliflower and asparagus as well as party trays sold in Meijer-branded plastic or foam packaging in Michigan, Ohio, Indiana, Illinois, Kentucky and Wisconsin between Sept. 27 and Oct. 20, the company said on Saturday.

In February, Meijer recalled its Meijer-branded Colby and Colby Jack cheese sold through its deli counters because of potential contamination with Listeria monocytogenes.

The U.S. Centers for Disease Control and Prevention estimated that 1,600 people develop a serious form of infection known as listeriosis each year, and 260 die from the disease, making it the third most deadly form of food poisoning in the United States.

“The infection is most likely to sicken pregnant women and their newborns, adults aged 65 or older and people with weakened immune systems,” the CDC said on its website. Symptoms include fever and diarrhea and can start the same day of exposure or as much as 70 days later.

(Reporting by Alwyn Scott; Editing by Lisa Von Ahn and Peter Cooney)

Infection experts warn of more U.S. superbug cases

Colonies of E. coli bacteria grown on a Hektoen enteric (HE) agar plate are seen in a microscopic image courtesy of the U.S. Centers for Disease Control

By Ransdell Pierson

NEW YORK (Reuters) – After two confirmed U.S. cases of a superbug that thwarts a last-resort antibiotic, infectious disease experts say they expect more cases in coming months because the bacterial gene behind it is likely far more widespread than previously believed.

Army scientists in May reported finding E. coli bacteria that harbor a gene which renders the antibiotic colistin useless. The gene, called mcr-1, was found in a urine sample of a Pennsylvania woman being treated for a urinary tract infection.

On Monday, researchers confirmed preliminary findings that E. coli carrying the same mcr-1 gene were found in a stored bacterial sample of a New York patient who had been treated for an infection last year, as well as in patient samples from nine other countries.

The report came from a global effort called the SENTRY Antimicrobial Surveillance Program, led by Mariana Castanheira of JMI Laboratories based in North Liberty, Iowa.

The mcr-1 superbug has been identified over the past six months in farm animals and people in about 20 countries, including China, Germany and Italy.

The bacteria can be transmitted by fecal contact and poor hygiene, which suggests a far wider likely presence than the documented cases so far, according to leading infectious disease experts.

Health officials fear the mcr-1 gene, carried by a highly mobile piece of DNA called a plasmid, will soon be found in bacteria already resistant to all or virtually all other types of antibiotics, potentially making infections untreatable.

“You can be sure (mcr-1) is already in the guts of people throughout the United States and will continue to spread,” said Dr. Brad Spellberg, professor of medicine at the University of Southern California.

Dr. David Van Duin, an infectious disease expert at the University of North Carolina in Chapel Hill, said he expects more documented U.S. cases of mcr-1 in coming months because it is already here and will spread from abroad. “We will see a lot more of this gene.”

Colistin causes kidney damage, but doctors have opted for it as other antibiotics increasingly fail. Its overuse, especially in overseas farm animals, has allowed bacteria to develop resistance to it.

PAST AND PRESENT INFECTIONS

To track the mcr-1 gene, U.S. hospitals are working together with state and federal agencies to test bacteria samples of patients that have recently been treated for infections. Many of the largest research hospitals are examining samples of antibiotic-resistant bacteria that have long been stored in their freezers.

Gautam Dantas, associate professor of pathology at Washington University Medical Center in St. Louis, has tested hundreds of U.S. samples of archived bacteria in recent months and has not yet detected mcr-1. But he expects dozens of confirmed cases of the gene will be documented by next year in the country, mostly among current patients.

The concern of many disease experts is that mcr-1 could soon show up in bacteria also resistant to carbapenems, one of the few remaining dependable classes of antibiotics. In that event, with colistin no longer a last-ditch option, some patients would have to rely on their immune systems to fight off infection.

“Within the next two to three years, it’s going to be fairly routine for infections to occur in the United States for which we have no (effective) drugs available,” Dantas said.

Castanheira also believes mcr-1 will find its way into carbapenem-resistant bacteria, formally known as carbapenem-resistant enterobacteriaceae (CRE).

In an interview, she said the resulting virtually impervious bacterium would likely spread slowly inside the United States because CRE themselves are not yet widespread in the country, giving drugmakers some time to create new antibiotics.

Beginning in August, the U.S. Centers for Disease Control and Prevention will use $21 million to expand surveillance at laboratories operated by all 50 state health departments and seven larger regional labs. The federal funding will help pay for more-sensitive equipment to test for antibiotic resistance in bacteria samples provided by hospitals.

Jean Patel, deputy director of the CDC’s Office of Antimicrobial Resistance, said the effort will provide the CDC improved national surveillance of antibiotic-resistance trends, including any spread of mcr-1.

“This is data for action,” she said, adding that special procedures to prevent infections from spreading in hospitals could be taken once a patient is identified with mcr-1 related infections or with multidrug-resistant bacteria.

(Reporting by Ransdell Pierson; Editing by Marguerita Choy)

Five states issue health advisories for beaches, Florida declares emergency from Toxic Algae

By Kami Klein

Five states have issued health advisories and have closed beaches ahead of the 4th of July holiday weekend.  According to an article from The Weather Channel,  officials in Texas, Louisiana, Florida, Mississippi and Alabama report that bacteria levels are high and “no swim” orders have been issued for many beaches along these states. None of these advisories are related to the Vibrio bacteria, commonly referred to as “flesh eating bacteria.”

Texas has 15 beaches with high or medium levels of bacteria, Louisiana with a dozen under advisory, Mississippi and Alabama each with one.  Florida issued a “no swim” order for eight beaches along the coast due to bacteria and toxic algae.  Florida Gov. Rick Scott has declared an emergency due to bright blue-green algae blooms taking over waterways and beaches. The executive order allows state and local governments to take action against the spread of the algal blooms by redirecting the water flow in and out of Lake Okeechobee.

The algae forced Treasure Coast officials to close some beaches in Martin County (insert link)  this week, just days before the Fourth of July holiday weekend and has been spotted in waterways and canals across much of South Florida.

“It’s just been incubating and growing and growing,” Matt Athan, who lives near the St. Lucie River in Stuart, told WPBF. And you can see how thick it is. And the smell is just atrocious.”

Experts also said the toxins in the algae can easily sicken and kill animals, so owners should keep their pets away from the water.  

It is strongly advised by experts to stay clear of the water if an advisory is up or if a beach has been closed.  Stay aware and look for signs for a safe holiday!

 

G7 told to act on antibiotics as dreaded superbug hits U.S.

Colonies of E. coli bacteria are seen in a microscopic image courtesy of the CDC

By Kylie MacLellan and Ben Hirschler

ISE-SHIMA, Japan/LONDON (Reuters) – Britain told the G7 industrial powers on Friday to do more to fight killer superbugs as the United States reported the first case in the country of a patient with bacteria resistant to a last-resort antibiotic.

U.S. scientists said the infection in a 49-year-old Pennsylvania woman “heralds the emergence of truly pan-drug resistant bacteria” because it could not be controlled even by colistin, an antibiotic reserved for “nightmare” bugs.

In Japan, British Prime Minister David Cameron said leading countries needed to tackle resistance by reducing the use of antibiotics and rewarding drug companies for developing new medicines.

“In too many cases antibiotics have stopped working. That means people are dying of simple infections or conditions like TB (tuberculosis), tetanus, sepsis, infections that should not mean a death sentence,” he told a news conference at a summit in Japan.

“If we do nothing about this there will be a cumulative hit to the world economy of $100 trillion and it is potentially the end of modern medicine as we know it.”

A review commissioned by the British government and published last week said a reward of between $1 billion and $1.5 billion should be paid for any successful new antimicrobial medicine brought to market.

If the problem is not brought under control, antimicrobial resistance could kill an extra 10 million people a year by 2050, the review warned.

The U.S. case is a further wake-up call for the world, although it is not the first time that colistin resistance has appeared.

Medics around were alarmed last year by the discovery in China of a new gene that makes bacteria highly resistant to the medicine. Since then, the deadly strain has also been detected in Europe and Canada.

The development of colistin resistance is linked to the drug’s widespread use in livestock and the European Medicines Agency on Thursday called for a 65 percent cut in the amount of the medicine used in farming.

“The more we look at drug resistance, the more concerned we are,” Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, told reporters in Washington.

“The medicine cabinet is empty for some patients. It is the end of the road for antibiotics unless we act urgently.”

The problem is aggravated by drugmakers’ reluctance to invest in developing new antibiotics, preferring to focus on more profitable disease areas, although recently there has been some increase in investment, prompted by the superbug threat.

In January, 83 companies, including Pfizer, Merck, MRK., Johnson & Johnson JNJ.N and GlaxoSmithKline, signed a declaration urging governments to support work on new antibiotics.

(Reporting by Kylie MacLellan; Writing by Elizabeth Piper; Editing by Louise Ireland)

Dead Illinois resident had bacteria linked to Wisconsin outbreak

(Reuters) – A northern Illinois resident who died after being diagnosed this year with a blood infection known as Elizabethkingia had the same strain of the bacteria linked to more than a dozen deaths in Wisconsin, health officials said on Tuesday.

Neither the resident’s age nor many other details were released, but Melaney Arnold, spokeswoman for the Illinois Department of Public Health (IDPH), said the individual had suffered from underlying health issues.

IDPH officials have sent alerts to hospitals requesting they report all cases of Elizabethkingia and save any specimens for possible laboratory testing, Arnold added in a statement.

The infection has infected 48 mostly elderly people in Wisconsin, killing 15. Both Michigan and Illinois have each reported one death and one person infected, the statement said.

The patients who died in Wisconsin had serious underlying conditions, health officials have said, and it remains unclear whether the bacteria caused all the fatalities.

Wisconsin, Michigan and Illinois investigators are working with Atlanta-based The Centers for Disease Control and Prevention to determine the possible source of the bacteria.

Elizabethkingia bacteria are rarely reported to cause illness in humans, and can sometimes be found in the respiratory tract. Symptoms can include fever, shortness of breath and chills or cellulitis. Confirmation of the illness requires a laboratory test.

(Reporting by Justin Madden; Editing by Daniel Wallis and James Dalgleish)

Some Antibiotics to Blame for Turning MRSA into a “Superbug”

According to a recent study published in Cell Host & Microbe, the first antibiotics used to usually treat MRSA could actually make the skin infection worse by triggering the body’s pathogen defense system.

The bacterium Staphylococcus aureus – also known as a “staph infection” – is carried on the skin or in the nose of most healthy people. Nature World Report states that 25% of the population is colonized with staph, but only 1% of the population is colonized with MRSA. MRSA is a form of Staphylococcus aureus, but it is resistant to methicillin along with other medicines.

“Individuals infected with MRSA who receive a beta-lactam antibiotic–one of the most common types of antibiotics–could end up being sicker than if they received no treatment at all,” George Liu of Cedars-Sinai Medical Center and co-senior study author said in a press release.

“Our findings underscore the urgent need to improve awareness of MRSA and rapidly diagnose these infections to avoid prescribing antibiotics that could put patients’ lives at risk,” he added.

Tech Times reports that the study showed that MRSA not only responds to beta-lactam antibiotics, but it will also adapt to them, which makes the disease stronger. The antibiotics weaken the bacteria’s enzymes that produces cell walls. However, the study found that some antibiotics were less effective, allowing the bacteria to rebuild a weaker cell wall. When this happens, the body’s immune system goes into overdrive, trying to destroy the weak cell wall, according to the Huffington Post.

“In situations where there is a lot of infection, this highly aggressive response can cause extensive inflammation and tissue damage, effectively making the consequences of the infection worse,” Liu said.

The challenge for physicians lies in prescribing the right antibiotics for people who have staph infections, or worse, MRSA. It can take a few days to determine if a specific antibiotic is going to make the infection worse.

And while the study did find these disturbing results, the researchers only performed these tests on rats. They say that they will need to conduct trials on humans before they can nail down the correct antibiotics to use in the treatment of staph and MRSA.

Scarlet Fever Making a Comeback and May Now Resist Antibiotics

After nearly 100 years, the bacterial infection, scarlet fever, has made a comeback in Britain and in parts of Asia. And to make matters worse, it may no longer be an easy treatable infection as new research suggests that the infection is showing signs of antibiotic resistance.

“We have not yet had an outbreak in Australia, but over the past five years there have been more than 5,000 cases in Hong Kong (a 10-fold increase) and more than 100,000 cases in China,” said Mark Walker, one of the researchers, in a news release. “And an outbreak in the UK has resulted in 12,000 cases since last year.

The Washington Post reports that scarlet fever is caused by a group of A Streptococcus bacteria that can turn strep throat into scarlet fever. Most people who are affected are children between the ages of 5 and 12. The disease develops a red, sandpaper-like rash on the person’s body, and while it’s unpleasant, it can easily be treated with antibiotics. There is currently no vaccine.

“We now have a situation which may change the nature of the disease and make it resistant to broad-spectrum treatments normally prescribed for respiratory tract infections, such as scarlet fever,” said Nouri Ben Zakour, one of the researchers.

The idea that this new outbreak of scarlet fever could easily be treated was rethought when researches from the University of Queensland discovered that the new scarlet fever cases were resisting antibiotics. While penicillin is still effective, other treatments such as tetracycline, clindamycin, and erythromycin may not be, which poses an immediate threat to people who are allergic to penicillin.

The rise in scarlet fever could pre-empt a future rise in rheumatic heart disease, which causes permanent heart damage. Knowing this, researchers hope to continue studying the patterns of the disease and the effects it has on a person’s health, according to Science World Report.

Legionnaires’ Disease Closes Three Chicago-Area Schools

Students were sent home and three schools were closed when higher than normal amounts of Legionella, the bacteria that causes Legionnaires’ disease, were found in cooling towers.

The schools were located in the U-46 school district, located 45 miles northeast of Chicago. Officials found the high level of bacteria during an annual air quality check.

The district stated in an alert on their website: “While risk of exposure to the bacteria was low, we decided, in consultation with the Kane County Health Department, to evacuate staff and students to safe locations as a precaution.”

Reuters reported that the district was properly cleaning and sanitizing all 19 water cooling towers. So far, there have been no reports of anyone within the schools contracting Legionnaires’ disease.

Illinois has been concerned with the disease after 12 residents of a western Illinois veteran home died of Legionnaires’ last month. USA Today reports that dozens of home residents have contracted the disease. Legionnaires’ also infected 119 people and killed 12 in the New York City Outbreak earlier this year.

Legionnaires’ disease is a pneumonia-like disease that is caused by inhaling bacteria infected vapor. The vapor can come from air conditioners, showers, or hot tubs. The disease can lead to kidney failure, respiratory failure, and septic shock. Most people recover, but the CDC reports that 5% to 30% who contract the disease will die. It cannot be transmitted between people.

New York Legionnaires Death Toll Now Seven

New York health officials held a public meeting Monday on the current Legionnaires’ Disease outbreak and admitted the death toll has reached seven.

In addition to the seven deaths, more than 80 others have been confirmed to have the deadly bacteria.

Health officials made a point to say those who died were older and had other health problems.  They were also confident they found the source of the outbreak. Health officials are currently investigating five cooling towers in the South Bronx. All five towers tested positive for legionella bacteria, but health officials believe one of the towers is the source of the outbreak. Since the investigation, all five cooling towers have been cleaned and flushed to remove the bacteria.

 

“The five sites we have found, we’re confident based on scientific evidence we have identified only sites that are causing this outbreak,” New York Mayor Bill DeBlasio told reporters.

“This is the largest outbreak of Legionnaires’ disease that we are aware of in New York City,” Health Commissioner Mary Bassett told NBC. “Although we will continue to see cases, we expect the case rate to decline and the number of cases to fall over the coming weeks.”

One infectious disease expert said it’s surprising we don’t see more outbreaks.

“What surprises me more is that we don’t see it more often, it’s common in cooling towers or central air conditioning systems,” Dr. Stephen Morse, an infectious disease expert at the Columbia University Mailman School of Public Health, said to ABC News. “You’re going to find it in a lot of places where there are no reports of people being sick.”