NEWS SCAN: H1N1 and lost work, combining TB drugs, Afghanistan polio challenges, measles in Europe

Apr 13, 2011

Pandemic doubled the hours of work lost in Canada
Work hours lost in Canada because of the 2009 H1N1 influenza pandemic were double the number in a seasonal flu year, according to a new study. Researchers from the Public Health Agency of Canada and Ottawa-based Statistics Canada studied data from Statistic Canada's monthly labor force survey from 1998 through 2009. They found that employees who stayed home because of pandemic flu missed an average of 25 hours of work, compared with 14 hours for seasonal flu. And pandemic H1N1 caused an estimated loss of 0.2% of potential annual work hours, compared with 0.08% for seasonal flu. Overall absenteeism rates during the two waves of the pandemic, however, were similar to rates during a typical flu season: 13% versus 12%, respectively.
Mar 12 BMC Infect Dis abstract

Study supports use of fixed-dose combination drug regimen for TB
In a 6-year study, a fixed-dose combination (FDC) drug regimen for tuberculosis (TB) compared well with a standard regimen of separately administered drugs, according to a report published yesterday by the Journal of the American Medical Association (JAMA). FDCs, which are included in the World Health Organization's (WHO's) TB treatment guidelines, involve fewer pills and are seen as a way to reduce the threat of drug resistance resulting from "selective drug intake," according to a JAMA news release. The study involved 1,585 newly diagnosed TB patients at 11 sites in Africa, Asia, and Latin America.  They were randomly assigned to receive four drugs given either as an FDC or separately for 8 weeks. In a per-protocol analysis, by 18 months after the start of treatment, 93.9% of the FDC patients and 94.6% of patients in the separate-drugs group had a favorable outcome. Intention-to-treat analyses yielded similar results. The results show that the FDC regimen may be noninferior to a regimen of separately administered drugs. In the press release, the authors said the FDC approach involves only 3 or 4 pills per day, versus 9 to 16 for standard regimens, thus making treatment easier and aiding compliance.
Apr 12 JAMA news release
JAMA study abstract

Kandahar instability threatens Afghanistan's polio prevention
Immunization workers have made headway with the polio vaccine in Afghanistan's most secure provinces, but tough challenges still remain in southern and eastern areas, particularly the Kandahar region, the Integrated Regional Information Networks (IRIN), part of the UN Office for the Coordination of Humanitarian Affairs, reported today. Over the past 3 years the bulk of the country's polio cases have been reported from Kandahar, and so far this year Afghanistan's only polio case has been reported from the province. Abdul Qayum Pokhla, the province's public health director, told IRIN that the main problem is that security problems have hampered the immunizers access to children. Instability has also made it difficult for health officials to supervise and monitor the effectiveness of the polio vaccine problems, he said. In 2009 Taliban leaders showed signs of supporting the vaccine campaigns, but in March insurgents in neighboring Zabul province allegedly opposed an immunization drive, which kept tens of thousands of children under age 5 from getting their polio vaccines, according to IRIN. A health ministry spokesman said that coverage gaps have led to the disease still being endemic in Afghanistan.
Apr 13 IRIN story

European measles outbreaks spur WHO advisory
Measles outbreaks in the European region are large and spreading between countries and to other parts of the world, the WHO's Regional Office for Europe reported yesterday. So far this year 24 of 53 countries in the region have reported measles cases, with the largest outbreak occurring in France, which reported 3,749 cases in January and February. Genotype studies suggest that the measles virus in France has spread to six other countries. Belgium, the most recent country to report imported cases from France, has noted 100 cases so far, particularly in Ghent, where the virus is striking unimmunized children younger than age 1 and students who attend schools that are philosophically opposed to immunizations. Andalusia, Spain, reported 400 cases in the first 2 months of the year, and outbreaks are also occurring in Serbia, Turkey, and Macedonia. The WHO urged countries to be vigilant and deploy timely prevention and control measures to stop the spread of measles not only in the region but also to other parts of the world such as Africa and Southeast Asia, where the disease can be especially lethal.
Apr 12 WHO statement

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