(Credit:istockphoto)

(CBS) An experimental herpes vaccine failed to protect young women from the disease in a new study, dashing hopes that a vaccine may soon be available to help prevent the sexually transmitted disease.

PICTURES: Bogus STD cures: are you taking one?

In a study of 8,300 women ages 18 to 30, the vaccine, developed by GlaxoSmithKline, partially protected against HSV-1, the strain of herpes which typically causes cold sores but can also cause genital herpes. The vaccine, however, did not protect against HSV-2, the strain that most commonly causes genital herpes.

“There is some very good news in our findings. We were partially successful against half of the equation – protecting women from genital disease caused by HSV-1,” study author Dr. Robert Belshe, director of the Saint Louis University Center for Vaccine Development, said in a written statement.

None of the women had any strain of herpes when the study began, and half of the women were given the experimental vaccine while the other half were given a hepatitis a vaccine. Doctors monitored the women for twenty months, and throughout the study, some women got herpes.  The experimental vaccine was 58 percent effective at preventing genital herpes from HSV-1, but did not show protection against HSV-2. The study was published in the Jan. 5 issue of the New England Journal of Medicine.

Belshe said in the statement he was surprised the vaccine protected against one type of vaccine and not the other, but thinks that finding could lead to more research to better understand the disease.

“This is not the final vaccine,” Belshe told WebMD. “This information will help us a lot.”

Some experts aren’t as optimistic.

“I was very disappointed there wasn’t more of a benefit,” Dr. Bruce Hirsch, an attending physician in infectious diseases at North Shore University Hospital in Manhasset, N.Y., who wasn’t involved in the study, told HealthDay. “I’m concerned if we’ll ever find a vaccine effective for HSV-2.”

“Enough vaccines have failed that companies are seeing herpes vaccines as a risky business,” added Dr. David Knipe, a virologist at Harvard Medical School in Boston. Knipe told Nature News he thinks the public sector might need to fund herpes vaccine research to further advance it.

More than 50 million U.S. adults have herpes, according to WebMD, with up to 1.6 new infections occurring each year. Abstinence is the only way to prevent the STD, and latex condoms can reduce the risk of transmission, but the disease still can spread with condom use. The CDC says persons with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms are present. But even without symptoms, herpes can still spread to a partner.

The CDC has more on genital herpes.

In the middle of the biggest outbreak of food poisoning caused by the bacterium enterohemorrhagic Escherichia coli (EHEC) that Germany has ever seen, a group of doctors may have found a way to treat the most severe cases. the finding appears today in The New England Journal of Medicine (NEJM).

At least four people have died in the outbreak, thought to have been caused by eating contaminated vegetables. To date, 276 patients have developed hemolytic uremic syndrome (HUS). the potentially fatal syndrome, characterized by a destruction of red blood cells and severe kidney problems caused by the bacteria’s toxin, is the most severe complication of an EHEC infection.

In the article, Franz Schaefer, a nephrologist at the Center for Pediatrics and Adolescent Medicine in Heidelberg, Germany, and other physicians describe how they successfully treated three EHEC-infected children suffering from HUS with a novel approach. They used the monoclonal antibody eculizumab, which has been on the market since 2007, to treat a rare blood disorder. Eculizumab inhibits a part of the human immune system called the complement system that usually destroys invading cells that have been tagged for destruction by other parts of the immune system.

The complement system has been implicated for some time in certain patients who develop HUS without any EHEC infection, known as atypical HUS patients, and eculizumab has been used successfully to treat them. recent research suggests that the complement system might also be involved in the HUS cases caused by EHEC.

Last autumn, Schaefer saw a young girl suffering from HUS due to an EHEC infection. he first tried the most common treatment, replacing the patients’ blood plasma with donor plasma to rid the body of the toxins. (HUS patients are usually not treated with antibiotics because the antibiotics can aggravate the symptoms by releasing the shiga toxin from the bacteria in large amounts.)

When the girl’s health did not improve, Schaefer tried the antibody. “We did not have any other option. She was showing severe neurological symptoms, paralysis of one side of the body, cramps, and then slipped into a coma,” Schaefer remembers. “But when we finally gave her the antibody, she improved immensely within 24 hours,” Schaefer says. “This was not a controlled experiment, of course,” he says. “But the improvements were very suggestive of being due to the treatment.”

Schaefer was apparently not the only one with this idea. When he wrote a case report for NEJM, the editors notified him that two other groups had sent in similar reports around the same time. “So we wrote something all together and it was accepted for publication 14 days ago,“ Schaefer says. a few days later, HUS cases started appearing en masse in northern Germany.

“I could not believe it,” Schaefer says. “HUS cases with severe neurological symptoms are very rare, but now they are everywhere.” he also informed his colleagues elsewhere. “a lot of them have asked about the new treatment, and a few patients are already being treated with it.”

At the university clinic in Essen, Andreas Kribben is treating two HUS patients with the antibody. “We have seven HUS patients altogether, but we are using eculizumab only on the two patients that are not responding to the plasmapheresis,” he says. Kribben wrote the original paper on using eculizumab to treat atypical HUS, so he had experience with the drug. “We actually started treating the first patient on Wednesday, before Schaefer’s paper came out. Sadly, we have not seen the kind of response that Schaefer describes and that we know from the atypical HUS patients,” he says.

Jens Nürnberger, nephrologist at a clinic in Schwerin is somewhat skeptical of the treatment. “There is no real evidence for this treatment,” he says. “it might work or it might not.” the cases described in Schaefer’s paper could also be spontaneous remissions, he cautions. “The other problem is that this drug is hugely expensive, costing at least €15000 per patient, and the health insurance is not going to pay for it.“

However, in cases in which no other option remains, doctors would be right to try the new drug anyway, Nürnberger says. “But we should really be defining groups of patients who will get the drug and groups who do not and make this into a kind of controlled study,” he says. “instead, a lot of people will be treated this way, some will get better, some will not. In the end, we will not have learned anything.“ But he, like everyone else, is still hoping that this will turn out to be the right treatment at the right time.

U.S. Army 2nd Lt. Jamie Howell examines Wilda Jean-Charles, 12, for an ear infection. A bulging eardrum is the one of indicators doctors check for in middle-ear infections. (Carole Devillers/Reuters)

Parents of babies and toddlers suffering from painful ear infections are often told to wait before antibiotics can be prescribed, but new research shows the treatment can ease symptoms faster in some cases.

The American Academy of Family Physicians and the Canadian Pediatric Society recommend a “watchful waiting” period that reserves antibiotics for children whose symptoms do not improve with time.

Many European countries use watchful waiting for nearly all cases of middle-ear infections in children, and comparisons of the two strategies have given conflicting results because of differing definitions of middle-ear infections. Symptoms can resemble upper respiratory infections.

Thursday’s findings are “the best data yet” to show the effectiveness of antibiotics, an editorial accompanying the study in the New England Journal of Medicine said, based on research that used strict criteria to diagnose ear infections.

To sort out the discrepancy, researchers randomly assigned 291 children between six and 23 months of age with acute middle ear infections — defined by a bulging eardrum and common symptoms reported by patients.

The toddlers received either amoxicillin-clavulanate or a placebo for 10 days.

“More young children with a certain diagnosis of [middle ear infection] recover more quickly when they are treated with an appropriate antimicrobial agent,” Dr. Jerome Klein of the Boston University School of Medicine wrote.

Among those who received amoxicillin-clavulanate:

• 35 per cent had their symptoms resolve by day two.
• 61 per cent by day four.
• 80 per cent by day seven.

In contrast, among those on placebo:

• 28 per cent had their symptoms go away by day two.
• 54 per cent by day four.
• 74 per cent by day seven.

Study author Dr. Alejandro Hoberman of the Children’s Hospital of Pittsburgh and his co-authors cautioned the results need to be weighed against concerns about side-effects of antibiotics and spurring antimicrobial resistance.

A second study by Finnish research looked at 319 children between the ages of six months and 35 months for seven days.

Treatment failure (lasting signs of acute infection during ear exams) occurred by the end of the study period in 18.6 per cent of children who received amoxicillin, compared with 44.9 per cent of those on placebo, Dr. Aino Ruohola of the University of Turku and colleagues found.

Common side-effects of amoxicillin-clavulanate include diarrhea, nausea and vomiting.

Prescribing antibiotics for children who don’t really have ear infections are another concern.