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0 Legionnaires Sickens 12 in California , Including 9 at Disneyland , USA
13 November 2017 (Reuters [Dan Whitcomb])-Disneyland has shut down and decontaminated 2 cooling towers following an outbreak of Legionnaires disease that sickened 12 people, 9 of them guests or employees at the theme park in Anaheim, county health officials said. One of the 3 cases of the respiratory illness not linked to Disneyland was fatal in an individual who had additional health issues, said Jessica Good of the Orange County Health Care Agency. The chief medical officer for Walt Disney Parks and Resorts, Pamela Hymel, said in a written statement that after learning of the Legionnaires cases, park officials ordered the cooling towers treated with chemicals to destroy the bacteria and shut them down. Cooling towers provide cold water for various uses at Disneyland and give off a vapor or mist that could have carried the Legionella bacteria. Disneyland, which opened in 1955 and attracts tens of thousands of visitors a day, is owned by The Walt Disney Company. There was no information on the condition of the remaining 11 victims, due to patient confidentiality laws. Good said an investigation of Legionnaires cluster discovered that the 12 people sickened by the serious lung disease had traveled to, lived in, or worked in Anaheim during the month of September. Ten of the victims, who ranged in age from 52 to 94, were hospitalized. Older people and those with health issues are particularly at risk. According to the Orange County health agency, Legionella is becoming more common in the United States and in Orange County, where 55 cases have been reported through October 2017, compared with 53 for all of 2016 and 33 in 2015.
Editorial comment: For the record
there is possible transmission of Legionella
from person to person (Correia et al. N Engl
J Med. 2016; 374:497). As of November 15,
the number of cases has risen to 15 with 2
deaths. The number of cases of
legionellosis in any area is undoubtedly understated.
The most commonly used test to diagnose
legionellosis is the urinary antigen test,
which only identifies L. pneumophila
serogroup 1 and which is not sent routinely for
patients with pneumonia, especially mild
or ambulatory pneumonia. Cultures and
polymerase chain reaction (PCR) are not
done except in the sickest patients. The
outbreak at Disneyland might be much
larger than detected, considering the
attendance nationally and internationally,
with people getting sick after returning to
their home state or country. This is unlike
the outbreaks in hospitals and nursing
homes where the scope of the outbreak is
obvious. Genotyping to make sure all of
the strains are the same with comparison
with the strain(s) in the cooling towers
would be useful.
Nationally, the number of cases of
legionellosis has increased over 4-fold
since 2000. This could be due in part to
better diagnosis and reporting.
Biotech Firms Race to Recruit
Good Bugs in War on Cancer
14 November 2017 (Reuters [Ben
Hirschler])—Biotech companies are
competing to develop medicines using
“bugs as drugs” to fight cancer,
building on the latest scientific findings that
patients with high levels of good gut
bacteria are more likely to respond to
Certain bacteria seem to help in cancer
by priming immune cells and
smoothing the path for immunotherapy drugs
known as PD-1 drugs that work by taking
the brakes off the immune system.
Seres Therapeutics hopes to become
the first company to leverage this
discovery through a collaboration with the
MD Anderson Cancer Center in Texas
and the Parker Institute for Cancer
Immunotherapy that will see its microbe
medicine tested in a clinical trial.
MD Anderson scientists were among 2
groups of cancer researchers who reported
on the benefits of good gut microbes in
the journal Science earlier this month.
The work underscores the importance
of the microbiome which has been linked
to everything from digestive disorders to
Seres Chief Executive Roger Pomerantz
told Reuters the aim was to start the
randomized, placebo-controlled clinical trial
in metastatic melanoma in 2018,
evaluating the impact of giving a newly
developed Seres microbiome drug alongside a
There are currently 2 approved PD-1
drugs, Merck & Co’s Keytruda or
BristolMyers Squibb’s Opdivo, but Pomerantz
declined to say which would be used.
Seres, which is backed by Swiss food
giant Nestle, became the first microbiome
drug developer to go public in June 2015,
but it suffered a setback last year when
its leading drug candidate failed in a trial
against Clostridium difficile.
Other companies are competing hard.
Like Seres, some are also eyeing the new
opportunity in cancer, as microbiome
science moves beyond the initial focus
on gastrointestinal conditions like
C. difficile, ulcerative colitis, and inflammatory
Vedanta Biosciences, another US
biotech firm that is an affiliate of PureTech
NEWS • CID 2018:66 (15 February) • i
Health, plans to file for approval to start
a clinical trial in immuno-oncology in
2018, whereas Synlogic is also working
on experimental cancer therapies.
French biotech company Enterome,
meanwhile, is working with
BristolMyers on microbiome-derived
diagnostic tests and potential drugs to use with
the US drugmaker’s immunotherapy
Advocates argue that microbiome
medicine offers a smart way to both tone
down the immune system response—
useful for conditions like rheumatoid
arthritis and allergies—or ramp it up,
which is needed for the body to fight back
The first wave of microbiome drugs
rely on fecal microbiota transplantation
(FMT), or samples of microbes distilled
from human feces, delivered either as a
capsule or by enema. But companies are
also working on synthetically fermented
Copyright © 2017 Reuters Limited. All rights reserved.
Could Giant Rats Help Fight
Tuberculosis in Major Cities?
15 November 2017 (Reuters [Heba
Kanso])—Giant rats are probably not the
first thing that come to mind to tackle
tuberculosis, but scientists hope their
sniffing skills will speed up efforts to
detect the deadly disease in major cities
around the world.
African giant pouched rats, trained by
Belgian charity APOPO, are known for
sniffing out landmines in countries from
Angola to Cambodia and for detecting
tuberculosis cases in East Africa.
Over the next few years, APOPO
plans to fight tuberculosis at the source
by launching TB-detection rat facilities
in major cities of 30 high-risk countries
including Vietnam, India, and Nigeria.
The rats learn to recognize the
presence of tuberculosis in samples of mucus
that is coughed up from the patient’s
In Tanzania, people in communities
where tuberculosis is most common,
including in prisons, often fail to show up
for screening because of a lack of money
or awareness, placing a huge burden on
health authorities, health experts said.
The APOPO has seen the TB
detection rate increase by 40% in clinics
it has worked with in Tanzania and
Mozambique, according to James Pursey,
APOPO spokesman, who said that using
rats to screen did not negate the need for
proper diagnostic testing.
Although a technician may take 4 days
to detect a case of tuberculosis, a trained
rat can screen 100 samples in 20 minutes,
and a rat screening costs as little as 20 US
cents, APOPO said.
Copyright © 2017 Reuters Limited. All rights reserved.
Editorial comment: The rats have a
sensitivity of 75% compared with culture
and 82% compared with the Xpert MTB/
RIF PCR assay but only 41%
specificity (Mulder et al. Int J Tuberc Lung Dis
Stop Using Antibiotics in Healthy
Animals, WHO Urges Farmers
7 November 2017 (Reuters [Kate Kelland
and Tom Polansek])—The World Health
Organization (WHO) urged farmers to stop
using antibiotics to promote growth and
prevent disease in healthy animals because
the practice fuels dangerous drug-resistant
superbug infections in people.
Describing a lack of effective
antibiotics for humans as “a security threat”
on a par with “a sudden and deadly
disease outbreak,” WHO Director-General
Tedros Adhanom Ghebreyesus said
“strong and sustained action across all
sectors” was vital to turn back the tide of
resistance and “keep the world safe.”
The WHO “strongly recommends
an overall reduction in the use of all
classes of medically important
antibiotics in food-producing animals, including
complete restriction of these antibiotics
for growth promotion and disease
prevention without diagnosis,” the United
Nations agency said in a statement.
Any use of antibiotics promotes the
development and spread of so-called
infections that can evade the medicines
designed to kill them.
According to the WHO’s statement, in
some countries, around 80% of total
consumption of medically important
antibiotics is in the animal sector. They are largely
used in healthy animals to stop them
getting sick and to speed up their growth.
The WHO said such use should be
halted completely. In sick animals, it
added, wherever possible, tests should
first be conducted to determine the most
effective and prudent antibiotic to treat
their specific infection.
Some countries have already taken
action to reduce the use of antibiotics in
food-producing animals. The European
Union has since 2006 banned the use of
the drugs for growth promotion.
Consumers are also driving a demand
for meat raised without routine use of
antibiotics, with some major food chains
adopting “antibiotic-free” policies for
The WHO said alternatives to using
antibiotics for disease prevention in
animals include improving hygiene and
farming practices, and making better use