NEWS SCAN: Food safety funding, cholera vaccine trial, low-cost infection prevention, anthrax anniversary, hantavirus in Europe

Sep 9, 2011

US Senate panel, unlike House, boosts food safety funds for FDA
The US Senate Appropriations Committee this week approved a fiscal 2012 appropriations bill that would boost food safety funding for the Food and Drug Administration (FDA) while maintaining meat inspection funding for the US Department of Agriculture (USDA), according to reports from Washington. The action puts the Senate at odds with the House, which moved to cut funds for both functions in a bill passed in June. The Senate bill increases the FDA budget to $2.497 billion, from $2.447 billion in 2011, with the extra $50 million intended to help the agency implement the new FDA Food Safety Modernization Act, according to a National Journal report. The bill provides $1.007 billion for the USDA Food Safety and Inspection Service (FSIS), the same as in 2011, the story said. It said the House version of the bill would cut the FDA's budget by $285 million, or 11%, including an $87 million cut for food safety, and would also cut the FSIS budget by $35 million. Food & Water Watch, a consumer watchdog group, praised the Senate panel's action in a statement. Wenonah Hauter, executive director, commented that the Senate version, unlike the House's, does not expand a pilot program called the HACCP-Based Inspection Models Pilot in poultry plants. She described the program as an attempt to reduce the number of FSIS inspectors by allowing more industry self-inspection.
Sep 7 National Journal report
Sep 7 Food & Water Watch statement

Bangladesh study reports positive findings for cholera vaccine
A study of a killed, bivalent whole-cell oral cholera vaccine in Bangladesh found that it was safe and had satisfactory immunogenicity in young children and adults, opening the door for researchers to study the feasibility of the vaccine in the cholera-endemic country. The findings, in Vaccine, are based on a South Korean reformulation of a similar vaccine that has been used in Vietnam. Study subjects received two doses of the vaccine or placebo administered 14 days apart. Blood samples were obtained before immunization and 7 days after each dose or placebo. Vibriocidal antibody responses were determined based on testing against Vibrio cholerae O1 Inaba, O1 Ogawa, and O139. Of 330 participants, 22 had mild symptoms after vaccination, such as fever or vomiting, with no difference between the vaccine and placebo groups. That finding was similar to other oral cholera vaccines. Researchers found antibody response varied by cholera strain but that. overall, a single dose elicited a high magnitude of vibriocidal and specific Immunoglobulin A responses in adults and children up to 2 years old. They concluded that the findings are promising, because a single-dose vaccine would help boost uptake and reduce cost for use in endemic and outbreak settings. Cholera vaccines aren't typically used in outbreaks, because the vaccines are expensive and provide limited protection. However, new studies over the past year have suggested that vaccination campaigns could be worthwhile.
Sep 8 Vaccine abstract

Study: Infection-control practices drops deaths, costs in peds ICU
A 2-year study found that three low-cost infection-control interventions reduced mortality, decreased length of stay, and lowered costs in a pediatric intensive care unit (PICU). The study, conducted by researchers at the University of North Carolina (UNC) School of Medicine, was conducted between 2007 and 2009 in a 20-bed PICU. A hand-washing intervention required healthcare workers to wash their hands with soap and water or use an alcohol-based rub before and after leaving a patient's room, before putting on and taking off gloves, and before and after touching potentially contaminated surfaces or body fluids. A second group of interventions was aimed at preventing ventilator-associated pneumonia and included measures such as elevating the head of the patient's bed during breathing assistance and providing daily oral care with a long-lasting antiseptic. The third measure was designed to reduce central-line infections and involved ensuring compliance with use and maintenance guidelines. Researchers found that the number of deaths dropped 2%, patients got out of the hospital 2 days earlier, and hospital stays cost about $12,000 less. They projected that the implementation costs were modest but could save a hospital unit about $12 million a year.
September Health Affairs abstract
Sep 8 UNC School of Medicine press release

Center for Biosecurity report marks anniversary of anthrax attacks
The University of Pittsburgh Medical Center (UPMC) Center for Biosecurity yesterday released a package of commentaries marking the 10th anniversary of the US anthrax attacks and outlining efforts that are still needed to prepare the nation for another bioterror event. The 42-page report is titled "A Crossroads in Biosecurity: Steps to Strengthen US Preparedness." The lead commentary is authored by Tom Inglesby, MD, and Anita Cicero, JD, the center's director and deputy director. A piece by D.A. Henderson, MD, MPH, the center's distinguished scholar, a former US health official who led the global effort to eradicate smallpox, discusses challenges in the wake of the Sep 11 terror attacks. He pointed out that several practical problems in implementing prevention and control measures, such as how extensive smallpox vaccination should be in the event of an attack, have still not been addressed. "To be adequately prepared to cope is no less urgent today than it was then. There is still a lot to be done," he wrote. In a piece on insider threats in high containment laboratories, immunologist Gigi Kwik Gronvall, PhD, argues that increased costs for lab security should have solid payoffs and that one neglected effort is management training for lab directors. In a report on biosurveillance gaps, epidemiologist Jennifer Nuzzo used the example of confusion early in Germany's sprout-related Escherichia coli outbreak to point out how better connections are needed between clinicians and public health to provide quicker and more accurate surveillance. Other topics in the issue include establishing standards of care during catastrophic events, preparing hospitals for infectious disease emergencies, addressing anthrax remediation issues, and promoting community resilience.
Sep 8 UPMC Center for Biosecurity commentary report

Europe sees near-doubling of hantavirus reports in last 10 years
Reports of European hantavirus infections almost doubled in the past decade compared with the 1990s, from 1,671 annual cases to 3,138, according to a report yesterday in Eurosurveillance, with several nations reporting spikes in one or more recent years. Among those high-water marks since 2005 have been 2,526 cases in 2005 and 3,259 cases in 2008 in Finland (compared with 1,919 in 2009 and 326 in 2010 through August), 1,688 in 2007 and 1,527 in 2010 through Aug 31 in Germany (compared with 181 in 2009), and 2,195 in 2007 in Sweden (compared with 138 in 2010 through August). Puumala virus, one variety of hantavirus, has caused the most cases, the report says, and rodents continue to be the most common disease carriers, although insectivores like shrews have played a role. The report also highlights hemorrhagic fever with renal syndrome accompanying some infections but doesn't specify its prevalence. The authors say it's unclear whether the recent surge is due to a true increase in infections or to heightened awareness and better diagnosis. They write that epidemics occur "where climatic, biotic and abiotic conditions pave the way for the carrier species to become abundant and humans to come in contact with the virus."
Sep 8 Eurosurveillance report

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