NEWS SCAN: Polio progress, cholera in Haiti, scarlet fever, duct-tape infection control, rural flu-vaccination sites, pandemics and world economy

Jun 27, 2011

India sees progress in campaign to banish polio
Scientists and health workers in India believe they are close to eliminating polio from the country, according to a Jun 26 Los Angeles Times report. The number of wild polio virus infections has dropped from hundreds 2 years ago to just one so far this year, thanks to a more effective vaccine, billions of dollars worth of prevention efforts, and other factors. Other promising developments include record numbers of immunizations and polio-free water samples in the slums of New Delhi and Mumbai. "It's a little premature to take out the champagne. But we're extremely encouraged," Lieven Desomer, chief polio manager for the United Nations Children's Fund, told the Times. But some in India remain wary, because there have been near-victories before, the story said. The real test is expected to come after the July-September monsoon season, when water-borne transmission of the disease is greatest. To be considered polio-free, a nation must go 3 years without an outbreak.
Jun 26 Times report

Cholera cases rising in Haiti, Dominican Republic
The number of cholera cases is rising in Haiti and the neighboring Dominican Republic, partly because of rainy season flooding, especially in Haiti's capital, Port-au-Prince, the United Nations (UN) said in a Jun 24 statement. According to World Health Organization (WHO) figures, 18,000 new infections were recently reported in Port-au-Prince. Tarik Jasarevic, WHO spokesman, said in the statement that the occupancy rate in Haiti's treatment centers is about 72%. In a Jun 22 epidemiologic alert, the Pan American Health Organization (PAHO) said that as of Jun 12 Haiti had had 344,623 cholera infections, 5,397 of them fatal, since the epidemic began last fall. For the same period the Dominican Republic confirmed 1,727 infections, along with 46 deaths. Besides the capital, Haiti's hardest hit areas include Centre, South East, Grand Anse, Nippes, North, and West departments. In the Dominican Republic over the past 2 weeks, 21 provinces and 41 cities have reported cholera transmission, though so far the attack rate is less than 0.01%, which is considered a low-intensity epidemic, according to PAHO. Though the country's cholera epidemic has links to Haiti's, one water sample in the Dominican Republic recently yielded another serotype, Vibrio cholerae Inaba, nontoxigenic. An isolate has been sent to the US Centers for Disease Control and Prevention (CDC) for confirmation.
Jun 24 UN statement
Jun 22 PAHO epidemiological alert

Hong Kong reports 71 more scarlet fever cases
Hong Kong's Centre for Health Protection (CHP) reported another 71 cases of scarlet fever in the past 3 days, bringing the total for this year to 617. The latest cases involved 39 males and 32 females, ranging in age from 11 months to 24 years. The outbreak, first publicized a week ago, has caused two deaths, but no new deaths were reported in the past 3 days, nor were any patients admitted to intensive care units, officials said. Scarlet fever is a respiratory infection caused by Group A streptococcus and usually affects children, causing fever, sore throat, and rash.
Jun 27 CHP update

Study: Duct-tape box marks isolation safe zone
Inexpensive duct tape markers can help hospitals improve staff communications with patients on contact precautions and save money on gowns and gloves, according to an abstract presented today at the annual meeting of the Association for Professionals in Infection Control and Epidemiology (APIC) in Baltimore. Researchers at Trinity Medical Center in the Quad Cities area on the Iowa-Illinois border tested a method consisting of a 3-foot-square safe zone—marked by red duct tape—at the threshold of rooms where patients were on contact precautions, APIC said in a press release today. They found that healthcare workers could safety enter the "red box" area to quickly communicate with or assess patients without having to don gowns and gloves. The study found that 30% of interactions with patients on contact precautions were performed in the safe zone. The trial, which took place from January 2009 to December 2010, saved the 504-bed health system up to 2,700 hours and $110,000 a year. The method also improved the quality and frequency of communication with patients in isolation. A staff satisfaction survey found that 67% of workers said the "red box" lowered barriers to communication with patients, and 79% said the technique saved time otherwise spent donning and taking off personal protective gear. They said the box also served as an extra visual cue that they were entering an isolation room.
Jun 27 APIC press release

Rural residents more dependent on medical settings for flu shots
Rural residents are significantly more likely than city dwellers to receive an influenza vaccination in a traditional clinical setting, according to researchers from the University of South Carolina who published their findings in Vaccine. They note that the use of nontraditional settings such as pharmacies and retail stores has emerged as a strategy to increase flu vaccination coverage in groups not covered by the traditional healthcare system. The researchers analyzed data for 2002 through 2005 from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing nationwide telephone survey conducted by the CDC. They classified rural areas as large rural, defined as counties with a town of 10,000 to 49,999 people, and small rural, meaning counties with no town over 10,000. Compared with urban residents, people in large rural counties were 17% more likely and those in small rural counties 45% more likely to get their flu shot in a clinical setting. About 81% of people in small rural counties received their immunization at a clinic, versus 69% of people in cities, the study showed. On the basis of the latest BRFSS data, the CDC recently reported that overall, about 40% of US residents received their 2010-11 flu shot in a doctor's office.
Jun 25 Vaccine report
Jun 16 CIDRAP News item covering CDC report on vaccination settings

OECD report lists pandemics among major threats to world economy
Disruptive shocks to the global economy are likely to become more frequent and severe because of globalization, and pandemics are among five major potential causes of such shocks, according to a report from the Organization for Economic Cooperation and Development (OECD). The report, "Future Global Shocks," analyzes the threat of a pandemic, a cyber attack disrupting critical infrastructure, a financial crisis, socioeconomic unrest, and a geomagnetic storm. In a press release, the OECD said the threat of a pandemic was illustrated by the severe acute respiratory syndrome (SARS) outbreak in 2003, which spread quickly around the world from Hong Kong. "The increasing number of heavily populated megacities, notably in Asia, exacerbates the risk, particularly in business travel, tourism and migration hubs like Dhaka, Manila and New Delhi," the OECD said. The organization also commented on the urgent need for new antibiotics to cope with rising drug resistance. It called for increased investment in surveillance and monitoring of threats and greater international cooperation in preparing for them. The OECD, headquartered in Paris, is a group of 34 mostly high-income countries dedicated to stimulating economic progress and world trade.
27 OECD press release
Full OECD report (139 pages)

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