NEWS SCAN: Salmonella update, sapovirus outbreaks, drug data access, vaccine exemptions

Apr 11, 2012

Multistate Salmonella outbreak reaches 116 cases
An outbreak of Salmonella Bareilly possibly linked to sushi has now affected 116 people in 20 states, up by 16 cases and 1 state since the previous update on Apr 6, the Centers for Disease Control and Prevention (CDC) said today. The numbers of cases by state are: Alabama (2), Arkansas (1), Connecticut (5), District of Columbia (2), Florida (1), Georgia (5), Illinois (10), Louisiana (2), Maryland (11), Massachusetts (8), Mississippi (1), Missouri (2), New Jersey (7), New York (24), North Carolina (2), Pennsylvania (5), Rhode Island (5), South Carolina (3), Texas (3), Virginia (5), and Wisconsin (12). Florida was added to the list with its first case. Twelve patients have been hospitalized, but none have died, the agency said. The CDC said the investigation has not yet conclusively identified a food source.
Apr 11 CDC update

Report: Sapovirus outbreaks may have increased in nursing homes
Sapovirus, a relative of norovirus, was found in 21 of 93 non-norovirus gastroenteritis outbreaks in Oregon and Minnesota, two thirds of which were in nursing homes, according to a report in Emerging Infectious Diseases. Investigators reviewed 2,161 gastroenteritis outbreaks in the two states that occurred from 2002 through 2009 and found that 1,119 (52%) were caused by norovirus, 466 (22%) were caused by non-viral pathogens, 403 (19%) had no fecal samples to analyze, and 142 (7%) were norovirus-negative. The team tested 93 of the 142 and found that 21 (23%) were caused by sapovirus. Fourteen outbreaks occurred in long-term care facilities, 2 in schools, and 1 each in a psychiatric hospital, prison, cruise ship, restaurant, and bed-and-breakfast. The authors report that their data and a 2009 study in Canada demonstrate that "sapovirus has been circulating among the institutionalized elderly since at least 2002 and that sapovirus outbreaks increased in 2007 as part of a worldwide surge in gastroenteritis outbreaks." Minnesota currently tests for the virus and Oregon will begin soon, according to an MSNBC story today. Sapovirus and norovirus are both members of the Caliciviridae family.
Apr 11 Emerg Infect Dis report
Feb 15, 2009, Canadian study
Apr 11 MSNBC story

Researchers call for open access to industry drug-trial data
Researchers who have tried and failed to gain access to full industry study reports on clinical trials of Tamiflu (oseltamivir) yesterday called for open access to such data for all drugs. Writing in Public Library of Science (PLoS) Medicine, US, UK, and Australian scientists said, "It is the public who take and pay for approved drugs, and therefore the public should have access to complete information about those drugs." They write that drug firms and regulators historically have treated clinical study reports as confidential documents, which impedes scrutiny by independent researchers. As part of a Cochrane review and through a Freedom of Information request, the authors were able to obtain from Tamiflu maker Roche thousands of pages of data but were not given access to many additional pages. In their policy piece yesterday the group outlined several key findings they uncovered that otherwise would not have been revealed, such as unreported serious adverse events with the drug. In an accompanying perspective article, four drug regulators wrote, "We consider it neither desirable nor realistic to maintain the status quo of limited availability of regulatory trials data" and said they recommend maximum transparency while respecting data privacy.
Apr 10 PLoS Med policy forum piece
Apr 10 PLoS Med related commentary
Apr 10 Public Library of Science news release

State legislatures take on vaccine exemption issues
Physician groups in California and Vermont are supporting state efforts to toughen or eliminate personal-belief exemptions for school-required vaccinations, according to an Apr 9 American Medical News (AMN) report. In February, a bill was introduced in the California Assembly that would require parents who opt out of vaccination for their children to get signed verification from a physician, nurse practitioner, or physician assistant that they were informed about the benefits and risks of immunization as well as the risks of disease covered by the vaccines. A similar requirement went into effect in Washington state in July 2011, the report said, adding that the California Medical Association supports the bill. The bill, opposed by anti-vaccine groups, is slated for a hearing before the Committee on Health on Apr 17. Meanwhile, authors of a House version of a bill in Vermont are seeking to eliminate the personal-belief exemption. The measure, supported by the Vermont Medical Society, passed the state Senate in early March, but heated House committee hearings led to a compromise measure that's similar to California's bill. AMN also reported that eight states are considering broadening school-required vaccine exemptions. They are Kansas, Massachusetts, Minnesota, Mississippi, New Jersey, New York, South Dakota, and West Virginia.
Apr 9 AMN story

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