Infections resist 'last antibiotic' in US

The first case of an infection that resists the antibiotic of last resort - colistin - has been detected in the US.

The 48-year old woman from Pennsylvania recovered and the infection was vulnerable to other antibiotics.

However, colistin is hugely symbolic as it is used when other drugs fail and officials warned the world was now reaching "the end of the road" for antibiotics.

Colistin resistance was first discovered in China at the end of 2015.

The study sparked concern around the world, and intensive testing rapidly discovered bugs that can resist colistin in Europe and Asia.

Now data from the US has identified the first case in a patient, who had a urinary-tract infection, as well as colistin-resistant bacteria in farm animals and meat on supermarket shelves.

It is not clear where the infection came from as the patient had not travelled recently and colistin is not widely used in the US.

Bleak future

The DNA that gives bacteria resistance to colistin - the mcr-1 gene - can spread rapidly between species.

The concern is that colistin resistance will now hook-up with other forms of antibiotic resistance to create infections that cannot be treated.

Thomas Frieden, the director of the Centers for Disease Control and Prevention, said: "The more we look at drug resistance, the more concerned we are.

"The medicine cabinet is empty for some patients, it is the end of the road for antibiotics unless we act urgently."

However, Dr Beth Bell, also from the CDC, said in an interview: "Luckily haven't seen actual bacteria that are resistant to every single antibiotic."

Commenting on the reports Dr Nasia Safdar, from the University of Wisconsin School of Medicine and Public Health, said: "The results are very concerning.

"It is almost inevitable that more cases will come to light. It's just a matter of how quickly things spread. With carbapenem-resistant Enterobacteriaceae, soon after the initial description it became fairly widespread and not just in the US but globally.

"It wouldn't be a stretch to say that we are towards the end of effective antimicrobial therapy for antibiotic resistant bacteria."

Zika virus may reach Europe this summer

The Zika virus could spread to Europe this summer, although the likelihood of an outbreak is low to moderate, the World Health Organization has said.

Areas most at risk are those where Aedes mosquitoes may spread the virus, like the Black Sea coast of Russia and Georgia and the island of Madeira.

Countries with a moderate risk include France, Spain, Italy and Greece, while the risk in the UK is low.

The UN agency is not issuing any new travel advice at this time.

The WHO is calling on countries to eliminate mosquito breeding sites and to make sure that people - particularly pregnant women - have information on the potential harmful consequences of the disease.

The agency says most countries that could be affected are well prepared to pick up any new cases and deal with them quickly - but others must bolster their ability to diagnose the virus.

Brain defects

Zika has been linked to a rise in brain defects in babies and the virus has been seen in more than 50 countries during this outbreak.

And WHO experts say the risk of spread increases in late spring and summer as Aedes mosquitoes - thought to carry the virus - become more active.

The report suggests 18 countries are at moderate likelihood of seeing Zika cases while the UK is one of 36 countries which have a low, very low or no likelihood of transmission.

Dr Zsuzsanna Jakab, at the WHO, said: "We call particularly on countries at higher risk to strengthen their national capacities and prioritise the activities that will prevent a large Zika outbreak."

Meanwhile Prof Jimmy Whitworth, at the London School of Hygiene & Tropical Medicine, said the the risk of Zika spreading to Europe was real and called for holidaymakers to heed health advice.

He added: "The main mosquito vector for Zika, Aedes aegypti, is only found in Madeira and around the Black Sea, but another mosquito, Aedes albopictus, is more widespread and is capable of transmitting Zika, although not very efficiently.

"Countries in Southern Europe, including France and Italy, need to be especially vigilant and it's important that holidaymakers follow public health advice while abroad, including taking all the necessary precautions to avoid getting bitten.

"This is especially so for pregnant women, or women planning to become pregnant, travelling to areas where there is Zika, as there is now a proven link with microcephaly and other birth defects."