NEWS SCAN: US measles cases, TB undertreatment, immunization exemptions

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May 5, 2011

US measles cases reach 89
US measles cases are already approaching double the number seen in a typical year, the Associated Press (AP) reported today. So far officials have confirmed 89 cases, compared with about 50 in a typical year. In the past 10 years the highest case total was in 2008, when 140 were reported. The disease typically produces a whole-body rash, fever, runny nose, conjunctivitis, and cough. Patients are contagious for 4 days before and 4 days after the rash develops. "Measles is really the most contagious of the vaccine-preventable diseases. It has a knack for finding those who have not been vaccinated," said Dr. Greg Wallace of the Centers for Disease Control and Prevention. The story said that in developed countries 1 or 2 children die for every 1,000 who contract measles. The United States has about 90% vaccination coverage in teens, and almost all the recent outbreaks were sparked by imported cases.

Meanwhile, Finland is reporting 4 recent measles cases in adults and 2 in children in the Helsinki region and elsewhere in Uusimaa province, bringing the 2011 total to 9 in a country that has an estimated 97% vaccination coverage. The Finnish news outlet YLE reports that measles cases have been rare in recent years, and this year's cases apparently originated outside the country. The report said that all who contracted the disease were either not vaccinated or had received only one of the two recommended doses.
May 4 YLE report

Study says private-sector drug sales may lead to TB undertreatment
Private-sector sales of tuberculosis (TB) drugs in heavily affected nations equal those in the public sector, according to a study published today, and at least a third of private-sector dosages of first-line TB drugs fall outside national and international treatment recommendations. Such undertreatment could be responsible for many treatment failures and for promoting the emergence of multidrug-resistant TB (MDR-TB), which is further worsening the global TB epidemic, according to a release today from IMS Health (a healthcare market research firm) and the TB Alliance, which conducted the study. The findings are from the first detailed study of the private TB drug market across multiple high-burden countries, according to the release. The 10 countries studied—Bangladesh, China, India, Indonesia, Pakistan, the Philippines, Russia, South Africa, Thailand, and Vietnam—represent 60% of the world's TB burden. The study demonstrated that the private-sector treatment landscape in these countries is largely unregulated and fragmented; for example, the investigators detected 111 different first-line TB drug dosages and combinations, compared with the 14 deemed necessary by the Stop TB Partnership's Global Drug Facility. "The private sector is keeping alive the confusion that existed previously in the public sector," said Dr. William Wells of the TB Alliance, the study's lead author.
May 5 TB Alliance, GCI Health press release

Medical group speaks out against childhood vaccine exemptions
The Pediatric Infectious Disease Society (PIDS) recently released a position statement opposing legislation or rules that allow exemptions from childhood vaccinations based on parents' or adolescents' own secular personal beliefs. However, the group said it recognizes that failure to pass proposed personal belief exemptions could cause a backlash that could hurt support for immunization efforts. The PIDS said that in those situations, the legislation should contain provisions to minimize use of the exemptions for children who are behind on their immunizations. For example, the group suggests that parents receive state-approved counseling on the importance of vaccination and the consequences of opting out.
March PIDS position statement

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