NEWS SCAN: Neglected diseases, US ventilator supply, vaccinia infections, cleaning leafy greens, global rubella

Oct 15, 2010

WHO announces push to combat neglected tropical diseases
Neglected tropical diseases, whose burden is borne largely by the world's poorest people, can and should be substantially curtailed, the World Health Organization (WHO) said yesterday as it released a report to address the situation. The diseases, including dengue, rabies, Chagas disease, sleeping sickness, leishmaniasis, leprosy, and schistosomiasis, typically thrive in destitute regions that have substandard housing, filthy environs, and disease-spreading insects and vermin. The report, "Working to overcome the global impact of neglected tropical diseases," covers 17 diseases. "These are debilitating, sometimes horrific diseases that are often accepted as part of the misery of being poor," said WHO Director-General Dr Margaret Chan in a news release. "The strategies set out in this report are a breakthrough. If implemented widely, they can substantially reduce the disease burden, breaking a cycle of infection, disability and lost opportunities that keep people in poverty." One important step in the report is to expand supplies of effective medication. To that end, the WHO announced new pledges of neglected-disease drugs from several major pharmaceutical firms.
Oct 14 WHO news release
Oct 14 WHO report

Number of US acute-care ventilators varies widely by state
A survey of US acute-care hospitals found that the country leads other developed nations in its per-capita mechanical ventilator supply, which can be stretched quite thin during an influenza outbreak or other emergency involving respiratory conditions. Researchers found, however, that per-capita rates vary widely by state, and that pediatric-capable ventilators outpace those designed for adult patients. The analysts received responses from 4,305 acute-care hospitals (75%), which accounted for 84% of intensive care beds in the country. They projected that 62,188 full-feature mechanical ventilators exist in the United States, along with 98,738 ventilators not as fully equipped. The median number of full-feature ventilators per 100,000 population for individual states is 19.7, but it ranges from 11.9 to 77.6 per 100,000. The median number of pediatric-capable full-feature ventilators for the states is 52.3 per 100,000 children younger than 14, with a range of 22.1 to 206.2.
Oct Disaster Med Public Health Prep abstract

Report details vaccinia infections linked to military smallpox shots
The US Armed Forces Health Surveillance Center has documented 100 vaccinia virus infections in people who had contact with smallpox vaccine recipients between December 2002 and May 2010. About 2 million US military members have been vaccinated against smallpox since 2002, according to the institute's Medical Surveillance Monthly Report (MSMR). It says 58 of the index vaccinees were identified as military members, but most if not all of the other 42 cases probably also involved military vaccinees. If all the cases are counted, the vaccinia transfer rate would be 5.7 cases per 100,000 vaccinees, which is comparable to US rates of contact transfers in the 1960s (2 to 6 per 100,000), the report states. Most of the vaccinia infections involved only mild skin problems, but six patients were hospitalized, two of them with serious complications: a 2-year-old child was hospitalized for 6 weeks with eczema vaccinatum and another patient who was confined for a week for treatment of ocular vaccinia. For several reasons, the documented cases probably represent only a fraction of the actual number of vaccinia cases that are due to contact with military vaccinees, the report says.
September issue of MSMR

Fresh Express says acid solution will make salad greens safer
Fresh Express, the nation's leading producer of bagged salad greens, says it has found that a mild acid solution is much more effective than the standard chlorine solution for killing bacteria on leafy greens, the New York Times reported yesterday. The company said it has begun using the acid solution, called FreshRinse, at one of its processing plants and will adopt it at four other plants early next year. The solution includes two organic acids commonly used in the food industry: lactic acid, found in milk, and peracetic acid. The company said the solution is at least nine times as effective as chlorine in killing bacteria attached to the leaves of produce, according to the Times. But Fresh Express has not published its research, so food safety experts told the newspaper they couldn't evaluate the company's claims. The produce industry has been looking for a better way to clean its products in the wake of a number of disease outbreaks tied to contaminated leafy greens in recent years, the story noted.
Oct 14 New York Times story

Global rubella cases down sharply
In today's Weekly Epidemiological Record, the WHO reports that global rubella cases have decreased dramatically from 2000 totals, while the number of countries using rubella vaccine has increased by more than half since 1996. The WHO, which in 2000 published its first position paper to guide countries on introducing rubella vaccine into childhood immunization schedules, said 130 countries had introduced the vaccine as of December 2009, up from 83 in 1996. Cases of rubella dropped from 670,894 in 102 countries in 2000 to 121,344 in 167 countries in 2009, though the agency warned that the disease is substantially underreported. Africa remains the region with the lowest immunization coverage, with only 2 of 46 countries administering the vaccine.

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