FLU NEWS SCAN: Flu and neurologic conditions, H1N1 vaccine for prisoners

Jan 5, 2012

CDC: Flu in Ohio facility killed 7 young people with neurologic disorders
An influenza outbreak last year struck more than half of the residents in an Ohio facility for children and young adults with neurodevelopmental conditions and killed seven of them, pointing up the need for prompt testing and early antiviral treatment in such patients, the Centers for Disease Control and Prevention (CDC) reported today. The article in Morbidity and Mortality Weekly Report notes that young people with neurologic and neurodevelopmental conditions face an increased risk of severe outcomes with flu. In the outbreak in February 2011, 76 of 130 residents suffered respiratory illnesses. Of 13 who became severely ill (median age, 22), 7 had confirmed flu, 6 had suspected flu, and 7 died. Eight of the 13 patients had received oseltamivir (Tamiflu) treatment, but only 4 received it within 48 hours of illness onset. The report, noting that diagnosing flu in patients with severe neurologic conditions can be challenging, says the patients probably would have benefited from earlier antiviral treatment. It also says that all 13 patients had received seasonal flu vaccine in the fall of 2010. An investigation suggested that the vaccine might have been inactivated by storage at too low a temperature. Also, flu vaccine effectiveness—which preliminary findings suggest was about 60% overall in the 2010-11 season—can be reduced in people with underlying medical conditions, the article states.
Jan 6 MMWR article

More than half of US jails did not get H1N1 vaccine, survey shows
More than half of US city and county jails, which house short-term inmates, did not receive pandemic 2009 H1N1 (pH1N1) vaccine when it became available during the pandemic, compared with less than 15% of federal and state prisons not getting the vaccine, according to an MMWR report today. Medical authorities in 38% of facilities contacted (447 of 1,186) responded to a fax and e-mail survey from Emory University researchers from July through November 2010. Response rates varied from 94% (29 of 31) in federal prisons to 39% (132 of 341) in state prisons and 35% (286 of 814) in jails. All 31 federal prisons contacted were randomly selected, but 19% of state prisons included were selected for convenience to bolster numbers, as well as 14% of jails. Respondents indicated that 55% of jails, 14% of federal prisons, and 11% of state prisons did not receive pH1N1 vaccine. An editorial note with the report said the study had three limitations: (1) it assessed only vaccine delivery, not coverage; (2) it relied in part on convenience samples, which is common in prison studies; and (3) response rates were below 50% for jails and state prisons. Nonetheless, the article said, "Some states might need to reexamine their priorities in dispensing vaccine so that they can protect persons in jails who might otherwise be missed during vaccination efforts and pandemic influenza planning."
Jan 6 MMWR report

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