NEWS SCAN: UK flu activity, flu-test guidance, cholera update, NDM-1 threat, antimicrobial resistance

Dec 15, 2010

Increased flu activity prompts warnings in Northern Ireland, Wales
Authorities in Northern Ireland and Wales are urging people to get influenza shots amid signs of more flu activity. The Public Health Agency for Northern Ireland has issued a warning about H1N1 flu and urged all pregnant women to be vaccinated, following the deaths of three pregnant women, according to the newsletter Hospital Management.net. In Wales, a flu outbreak was reported at the Cathedral School in Cardiff, with 120 children sick and 3 confirmed H1N1 cases, according to a report today from WalesOnline. The story said Welsh health officials are concerned about low uptake of flu vaccine, especially among pregnant women. By the end of November, vaccine coverage was 52% in people 65 and older and 34% among younger people at risk for flu complications. Flu-like illness cases have increased sharply in the past week in Wales and across the United Kingdom, the story said.
Dec 15 Hospital Management.net story
Dec 15 WalesOnline story

CDC updates guidance on rapid flu tests
The US Centers for Disease Control and Prevention (CDC) yesterday issued guidance on the use of rapid flu diagnostic tests for the current flu season. Rapid tests can identify influenza A or B in 15 minutes or less but do not identify influenza A subtypes. Like previous versions of the guidance, the latest version says the rapid tests may be useful in clinical settings for deciding whether to prescribe antivirals, but because of the tests' limited sensitivity, negative results do not exclude flu in patients with flu-like illness. The guidance also says rapid tests can be useful for identifying flu as a cause of outbreaks in institutions such as nursing homes, hospitals, summer camps, and schools.
CDC guidance on use of rapid flu tests

Haiti more stable, but cholera toll still rising
Haiti's cholera toll had increased to 52,033 hospital cases, 2,359 deaths, and 104,918 hospital visits as of Dec 10, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reported yesterday. The agency said violence that followed the release of presidential election results on Dec 7 decreased over the weekend, allowing humanitarian teams to resume their work. However, access to rural areas remains a challenge for water, sanitation and hygiene workers. Also, 2.2 million school children in 20,000 schools nationwide need safe drinking water, and water purification tablets were running short in camps for displaced people.

Expert warns of threat posed by NDM-1 resistance factor
An infectious disease expert warns in a New England Journal of Medicine (NEJM) perspective article that the new antibiotic resistance factor known as NDM-1 poses a serious global threat. NDM-1, which stands for New Delhi metallo-beta-lactamase 1, is an enzyme that has been found in a number of bacterial species and renders them resistant to nearly all antibiotics, Robert C. Moellering, Jr., MD, of Harvard University Medical School, notes in the article. "What makes this enzyme so frightening is not only its intrinsic ability to destroy most known beta-lactam antibiotics but also the company it keeps," he writes. When NDM-1 was discovered in a strain of Klebsiella pneumoniae, the gene that encodes it was found on a genetic element that easily transferred to other Enterobacteriaceae and contained various other resistance determinants, including genes that block erythromycin, ciprofloxacin, rifampicin, and chloramphenicol. Although the CDC has said standard infection control practices can contain NDM-1, "history warns that this is not likely to be the final answer," Moellering writes. "Early experience with NDM-1 has shown that it has all the properties necessary to turn organisms that contain it into superbugs after all."
Dec 15 NEJM perspective article

IOM releases summary of workshop on antimicrobial resistance
The Institute of Medicine has released a report from a workshop it held in April to discuss antimicrobial resistance. The workshop covered the nature and sources of drug-resistant pathogens, the implications for global health, and strategies to lessen the current and future impact of the organisms. The 97-page summary of the workshop can be downloaded free from the National Academies Web site.
National Academies page with links to the workshop summary and related materials

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