NEWS SCAN: Anthrax vaccine for first responders, seasonal flu shot and H1N1 risk, H1N1 co-infections, guide to foodborne bugs

Apr 9, 2012

Feds prepare to open anthrax vaccine stockpile to first responders
The Obama administration is preparing to open up anthrax vaccine to first responders in a trial effort that could later be expanded, Global Security Newswire (GSN) reported today. Officials from the White House and at least four federal departments weighed proposals to offer unused federal stockpiles of the vaccine to several groups—in addition to military personnel, who now have access to it—but decided to limit it at first to emergency response personnel because they would typically be the first on the scene of an anthrax attack. There is no date set for the trial distribution, which would allow state and local health officials the option of accepting the federally funded vaccine doses or not. However, Kathryn Brinsfield, MD, MPH, of the Department of Homeland Security said, "I don't think there's any doubt it will move forward. We're certainly fast-tracking this as much as we can, but we also want to make sure as we're rolling this out as fast as possible that we're being really responsible about this." In 2008 the federal Advisory Committee on Immunization Practices (ACIP) reversed an 8-year stance on the topic and opened the door to offering anthrax vaccine to first responders.
Apr 9 GSNreport
Oct 23, 2008, CIDRAP News story on ACIP reversal

Canadian study: No pH1N1 risk tied to seasonal flu shot
Receiving a 2008-09 seasonal flu shot neither raised nor lowered the risk of contracting 2009 H1N1 pandemic flu (pH1N1) during the spring wave, according to a population-based case-control study in Emerging Infectious Diseases. Scientists from Winnipeg, Manitoba, analyzed data from Cadham Provincial Laboratory (CPL, the province's only public health lab) and the Manitoba Immunization Monitoring System. Their analysis included information from all Manitoba residents 6 months or older who had respiratory specimens submitted to CPL for flu testing from Apr 27 through Aug 21, 2009. They identified 831 patients who had lab-confirmed pH1N1 and 2,479 matched controls. The team found that, for those receiving 2008-09 flu shots, the adjusted odds ratio of contracting pH1N1 flu was 1.0 (95% confidence interval, 0.7-1.4), or the same risk as those who hadn't received the vaccine. They also found a statistically nonsignificant 49% risk reduction for hospitalization in those who received the 2008-09 seasonal flu shot—the numbers were too small to achieve significance. Some early studies out of Canada had suggested a higher risk of contracting pH1N1 in those who had received a seasonal flu shot, but subsequent studies from around the world have shown no such risk.
Apr 5 Emerg Infect Dis study
Apr 6, 2010, CIDRAP News story on earlier studies

Australian study: 25% of ICU patients with pH1N1 had co-infections
About a quarter of patients who were treated for flu in a sampling of Australian intensive care units (ICUs) during the 2009 pandemic had bacterial or viral co-infections, according to a study published in Influenza and Other Respiratory Viruses. The researchers gathered data from 14 ICUs on patients who were treated for confirmed severe influenza A infections. Co-infections were identified in 23.3% to 26.9% of patients. Of these, 20.5% to 24.7% were bacterial and 3.2% to 3.4% were viral. Staphylococcus aureus was the most common bacterial co-infection, followed by Streptococcus pneumoniae and Haemophilus influenzae. Patients with co-infections were younger by a mean of 8.46 years (95% confidence interval [CI], 0.18 to 16.74 years), less likely to have significant co-morbidities (32.0% versus 66.2%, P = 0·004) and less likely to be obese (mean difference in body mass index, 6·86 [95% CI, 1.77 to 11]) than those without co-infections. Despite these differences, the investigators found no significant differences in outcomes. "It is likely that co-infection contributed to a need for ICU admission in those without other risk factors for severe influenza disease," they write. "Empiric antibiotics with staphylococcal activity should be strongly considered in all patients with severe influenza A infection."
Apr 6 Influenza Other Respi Viruses abstract

FDA releases new edition of its guide to foodborne pathogens
Information on all the major types of pathogens and natural toxins that can find their way into food is provided in the second edition of the US Food and Drug Administration's (FDA's) guide to the subject, released last week. The Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Handbook covers scores of types of bacteria, viruses, parasites, and natural toxins. The 264-page volume offers scientific and technical information about disease agents, though it is not intended to be a comprehensive scientific or clinical reference, the agency says. Each major pathogen or toxin (or class thereof) has a chapter, and each chapter includes a consumer sidebar with nontechnical information in everyday language. "The boxes describe plainly what can make you sick and, more important, how to prevent it," the FDA says. The book has 26 chapters covering bacteria, 5 on viruses, 10 on parasites, 11 on natural toxins, and 1 on prions.
Apr 3 FDA statement on the book
Full text of book

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