Hepatitis A Outbreak to Greet IDWeek

— Homeless bear brunt of disease; delegates at low risk

MedpageToday

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SAN DIEGO -- It's rare that the world's premier medical meeting on infectious diseases -- IDWeek -- finds itself in the same place as an important outbreak.

But this year's meeting -- sponsored jointly by the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), the Society for Healthcare Epidemiology of America (SHEA), and the HIV Medicine Association (HIVMA) -- comes as the host city is battling an outbreak of hepatitis A that has left 17 people dead.

The outbreak is mainly among the city's homeless population and city officials have recorded more than 400 cases this year. Meeting officials said they're confident the risk to delegates is small but warned they should practice proper hand hygiene during their visit.

And, of course, the outbreak will not go unremarked during the meeting, according to David Andes, MD, of the University of Wisconsin Hospital in Madison and IDWeek Chair for IDSA. A late-breaker symposium Wednesday will feature two presentations on the San Diego outbreak, as well as talks on other pathogens causing disease outbreaks in the U.S.

One of the most worrisome of those, Andes told MedPage Today, is Candida auris, an emerging multi-drug resistant yeast that is often transmitted in health-care settings.

The pathogen has been known but not commonly found in the U.S. until recently, he noted, adding: "What's unique about Candida auris is unfortunately this species is resistant to the majority of antifungals that we have."

"It's the new kid on the block," Andes said, and the meeting will feature more than 24 presentations on what's known about it, as well as talks on well-known but still dangerous illnesses, such as Legionnaire's disease.

Andes said the meeting, expected to have a record number of delegates and abstracts, has "something for everyone, from antibiotic resistance to HIV to infection control -- there's path-breaking research being presented in all of them."

One of the most exciting things, he said, is the prominence of new antibiotics at this year's meeting. For several years, IDSA and its partners have pushed for more research and development on new antibiotics, urging legislative changes to promote the science and encouraging drugs companies to re-enter a field that had been all but abandoned.

The goal, of course, was to help overcome the increasingly dangerous problem of antibiotic resistance.

This year, Andes said, meeting organizers are particularly happy to see evidence that their efforts have borne fruit -- in a single session, delegates will hear about late-stage clinical data on 10 new antibiotics, including some from new classes.

"To have 10 new antibiotics that we hope will have utility soon is very exciting," Andes said. "It's the only time I can think of that happening."

The flip side of antibiotic resistance is antimicrobial stewardship -- how to use drugs in ways that don't promote resistance. It's a recurring theme of the meeting, and delegates can expect to hear about the latest in methods, epidemiology, and how stewardship programs are expanding throughout the healthcare system.

The outbreaks of emerging diseases of the past few years won't go unnoticed either, he said, with updates on both Ebola and Zika viruses, including new experimental treatments and vaccines.

Finally, HIV -- with its associated opportunistic infections -- remains a key area of interest, Andes said, with more than 2,800 presentations touching on aspects of the pandemic. Two clinical drug trials, with what he called "guideline-changing" results, are expected to be presented.

Delegates can also expect a host of presentations on HIV prevention, including many on pre-exposure prophylaxis (PrEP), a drug-based approach that is gaining wider acceptance among physicians, Andes said.