NEWS SCAN: CDC lab safety questioned, flu vaccine effectiveness, Oregon plague infection, heroin-related anthrax death

Jun 13, 2012

Newspaper: Internal CDC records raise lab biosafety concerns
An investigation by USA Today detailed internal concerns about airflow problems at a Centers for Disease Control and Prevention (CDC) biosafety level 3 (BSL-3) lab in Atlanta. The report published today cited e-mails among CDC employees discussing concerns about an incident in February in which air from a potentially contaminated lab blew into a "clean" corridor where visitors weren't wearing protective gear. The report said CDC engineers have aired written concerns about the air containment systems and that scientists working with poxviruses expressed at a meeting worries about working in the lab as currently designed. The CDC didn't address the newspaper's direct questions, but it issued a statement saying no pathogen releases have occurred and no one has been injured. Although the safety systems at times experience challenges, multiple systems are in place to cover worker and public safety, the agency added. The story said a CDC decision to re-engineer ventilation within the labs and animal holding areas prompted some of the internal safety concerns. BSL-3 labs are designed for work with pathogens that can spread through the air and cause potentially serious or fatal disease, whereas BSL-4 labs are designed for work on aerosol-transmitted agents for which there are no vaccines or treatments, such as the Ebola virus.
Jun 13 USA Today story

UK flu vaccine study shows moderate benefits for 2010-11
A study of influenza vaccine effectiveness during the United Kingdom's 2010-11 flu season found that the trivalent seasonal vaccine was effective against both the seasonal strains and the 2009 H1N1 pandemic strain circulating that year and that vaccination with the adjuvanted 2009 H1N1 vaccine in the previous season offered little extra protection in 2010-11 except in very young children. The European-based research group published its findings today in an early online report in Epidemiology and Infection. The study was conducted from Sep 1, 2010, through Mar 17, 2011, among patients at five UK primary care sentinel sites. Investigators looked at those with flu confirmed by real-time polymerase chain reaction testing and those with flulike illness who tested negative for flu. Vaccination data were obtained from patients' medical records. A total of 7,797 patients were swabbed, and 39 were dropped because they were positive for H3 or influenza A other than 2009 H1N1. Effectiveness for the seasonal flu vaccine was 56% (95% confidence interval [CI], 42%-66%) overall; age-adjusted effectiveness was 87% for children younger than 5 and 84% for kids aged 5 to 14 years. Effectiveness of the vaccine against influenza B was 57% overall, which increased to 75% in school-aged children. Vaccination with the H1N1 monovalent vaccine during the 2009-10 season followed by trivalent vaccine in 2010-11 afforded protection against 2009 H1N1 in only 28% of patients (95% CI, 6%-51%) overall but in 72% (95% CI, 32%-91%) in children under 5. The study found lower vaccine effectiveness for the Yamagata lineage B strain. The researchers concluded that the findings provide evidence of seasonal flu vaccine effectiveness in school-aged children, which could help guide decisions about whether to extend national vaccine programs to children. They also noted that the study was consistent with midseason estimates of protection, confirming their value in guiding vaccine-strain selection.
Jun 13 Epidemol Infect abstract

Oregon man critical with suspected plague infection
An Oregon man is hospitalized in critical condition in Bend with a suspected severe form of Yersinia pestis infection, the Oregonian reported yesterday. The man, in his 50s and from rural Crook County, got sick after he was bitten Jun 2 after trying to rescue a mouse from a stray cat. Authorities aren't sure if he was bitten by the mouse or the cat, but the cat died and its body was sent for testing to the Centers for Disease Control and Prevention (CDC). Karen Yeargain, communicable disease coordinator with the Crook County Health Department, told the Oregonian that tests are under way to confirm the man's infection, but she said he appears to be suffering from symptoms of septicemic plague, one of the three classic forms of the disease. Health officials said Oregon typically records about one plague case each year, the last one in 2011. Yeargain said the man is being treated with antibiotics and that his family has been given prophylactic treatment.
Jun 12 Oregonian story
CIDRAP plague overview

Germany reports another heroin-related anthrax death
After a 2-year lull in deaths linked to anthrax-contaminated heroin in Europe, German officials have identified a new case in an injecting heroin user who died on Jun 5 at a Regensburg hospital, according to a post yesterday from ProMED Mail, the online reporting system of the International Society for Infectious Diseases. Most of the cases 2 years ago were reported from Scotland, but cases were also identified in England and Germany. Thomas Holzmann, MD, who submitted the post and is with the University of Regensburg, wrote that the patient was admitted with acute septic disease and died that same day. Bacillus anthracis in blood cultures was confirmed at the University of Regensburg and at the Bundeswehr Institute of Microbiology in Munich. Further molecular typing and a police investigation are ongoing. Health officials believe contaminated heroin or a contaminated cutting agent mixed with the drug may be responsible for the infection, Holzmann said. A ProMED moderator commented that one problem with heroin-related anthrax infections is that patients don't seek care promptly, though early treatment is often successful. The moderator added that it is important to keep the injection site drained to minimize the impact of the anthrax toxins.
Jun 12 ProMED Mail post

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