NEWS SCAN: Sick leave in Seattle, flu vaccine in kids with cancer, malaria in Greece, AAP vaccination guidance, hospital-acquired infections

Sep 26, 2011

Seattle becomes third US city to mandate paid sick leave
Seattle Mayor Mike McGinn on Sep 23 signed legislation ensuring workers in all but the city's smallest businesses paid sick leave, according to a press release from the Seattle Coalition for a Healthy Workforce, a group of 75 organizations that supported the law. The Seattle City Council passed the ordinance on an 8-to-1 vote. The law takes effect in September 2012 and applies to companies with more than four workers. It requires businesses with fewer than 49 workers to offer 1 hour of sick time for every 40 hours worked, and those with 250 or more employees to offer 1 hour of sick pay for every 30 hours worked, according to a Sep 12 Seattlepi.com story. Those supporting the legislation said nearly 200,000 Seattle workers lacked paid sick days, which could threaten the health of the workforce. However, opponents raised concerns that the policy could place a burden on business owners. The National Partnership for Women and Families (NPWF), a nonprofit group based in Washington, D.C., said Seattle becomes the third US city, alongside Washington, D.C., and San Francisco, to pass sick leave legislation. In July Connecticut became the first state to pass paid such legislation.
Sep 23 Seattle Coalition for a Healthy Workforce press release
Sep 12 Seattlepi.com story
Sep 23 NPWF press release

TIV more immunogenic than LAIV in kids with cancer
The first study comparing the safety and immunogenicity of live, attenuated influenza vaccine (LAIV) with the trivalent inactivated vaccine (TIV) in a small cohort of children with cancer found that serum antibody response against influenza A strains were greater, both vaccines were well tolerated, and prolonged shedding with LAIV was not apparent. The study group included 55 children and young adults ages 2 to 21 with cancer who were mild-to-moderately immunocompromised. They were randomly assigned to receive either LAIV or TIV. Researchers collected information on adverse events for 28 days after each vaccination. Local injection-site information was also collected for TIV. Investigators collected blood samples before vaccination and 28 to 42 days after each dose. Hemagglutination inhibition was used to measure antibodies for the three flu strains, and microneutralization assays were used to determine humoral responses. Adverse events up to 28 days after vaccination were similar in both groups. Of two possibly vaccine-related serious adverse events, one patient was determined to have a fungal infection and one had a febrile seizure that clinicians attributed to mild hyponatremia. TIV induced higher titers against influenza A viruses, showed greater seroprotection against H1N1, and greater seroconversion against H3N2.
Sep 23 J Infect Dis abstract
In an editorial on the study that appeared in the same issue, Dr Natasha Halasa, with the Department of Pediatric Infectious Diseases at Vanderbilt University in Nashville, wrote that the group unexpectedly found that TIV was more immunogenic for influenza A, with no differences noted for influenza B. She speculated that lower response to LAIV in children with cancer might stem from previous exposure to flu vaccines.
Sep 23 J Infect Dis editorial extract

Greece reports more locally acquired malaria cases
Ten more locally acquired Plasmodium vivax malaria infections have been reported by Greek public health officials, raising the total since June to 16, according to a report today from the European Centre for Disease Prevention and Control (ECDC). Ten of the 16 infections were reported from Evrotas, a municipality in southeastern Greece that has reported sporadic cases over the past 3 years. Other cases were reported from Evoia, Eastern Attki, Larissa, and Viotia prefectures. In addition, 12 more malaria cases have been reported in migrant workers in Lakonia prefecture: 10 from Pakistan, 1 from Morocco, and 1 from Romania. The worker from Romania had worked in Evrotas and was diagnosed after returning to his home country, according to the report. The Hellenic Centre for Disease Control and Prevention has enhanced surveillance in the affected areas, and local authorities are carrying out mosquito-control measures. Greek officials said the affected areas have large populations of workers from malaria-endemic countries and are not tourist destinations. ECDC officials are in Greece to assess the situation. In an August update on Greek malaria infections, the agency said more research is needed to determine if the source of transmission was imported cases that involved onward spread by local mosquito vectors or if an established human reservoir of P vivax is contributing to annual clusters.

AAP announces some changes in vaccination guidance
The American Academy of Pediatrics (AAP) has announced minor changes in its vaccination recommendations, including those covering polio, hepatitis A virus (HAV), and Tdap (tetanus toxoid, reduced-content diphtheria toxoid, and acellular pertussis). The changes are described in articles published online today in Pediatrics. The polio advisory offers guidance on the optimal use of the three inactivated polio virus (IPV) vaccines that have been licensed since 2000. The recommended vaccination schedule stays the same, but the guidance says that if a child faces an imminent risk of polio exposure, such as travel to a polio-endemic country, the minimum age and intervals for the first three doses should be used. For the Tdap vaccine, the AAP, along with the Centers for Disease Control and Prevention, says there is no longer any minimum interval between receiving a tetanus or diphtheria toxoid–containing vaccine and Tdap. A third revised recommendation fine-tunes the guidance on HAV vaccination for family members and close contacts of children adopted from countries with high rates of HAV infection.
Revised polio vaccination guidance

Study: Staph, enterococci up in hospital-acquired infections, E coli down
Hospital-acquired infections (HAIs) caused by Staphylococcus aureus, coagulase-negative staphylococci (CoNS), and Enterococcus species have increased most in frequency over the past 29 years, while those tied to Escherichia coli, Pseudomonas aeruginosa, and Enterobacter species have shown the greatest decrease, according to University of North Carolina (UNC) researchers. Using comprehensive hospital-wide surveillance data from the UNC's 800-bed teaching facility, they tabulated infections for 5-year blocks (and one 4-year block) for several sites: bloodstream infections (BSIs), urinary tract infections (UTIs), respiratory tract infections (RTIs), and surgical site infections (SSIs). They isolated at least one pathogen from 28,208 (83.5%) of 33,797 HAIs. Over the 29 years studied, S aureus increased 5.3%, CoNS 4.8%, and enterococci 3.8%. In contrast, HAIs caused by E coli or P aeruginosa fell 3.1%, while Enterobacter infections fell 2.7%. By site, S aureus increased in UTIs, RTIs, and SSIs, CoNS in BSIs and SSIs, Candida in SSIs, and enterococci in BSIs and UTIs. The authors write that recording such data is important "given the lack of development of new antibiotics and growing importance of changes in health care-associated pathogens including antimicrobial resistance."
Sep 23 Am J Infect Control abstract

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