NEWS SCAN: Kindergarten vaccine coverage, measles up in UK, neti pot warning

Aug 24, 2012

Kindergarten vaccine coverage misses MMR, varicella targets
Vaccine coverage in US kindergartners during the 2011-12 school year met national targets for three immunizations but fell below goals for two: measles, mumps, and rubella (MMR) and varicella. The findings, from the US Centers for Disease Control and Prevention (CDC) in Morbidity and Mortality Weekly Report (MMWR), are based on data the agency collects from states and other grantees. The Healthy People 2020 target for kindergartener vaccine coverage is 95% or more for five vaccines: MMR, diphtheria, tetanus toxoid, and acellular pertussis (DTaP), poliovirus, hepatitis B, and varicella. Median coverage for MMR vaccine last school year was 94.8%, ranging from 86.8% in Colorado to 99.3% in Texas. For the varicella vaccine, median coverage for two doses was 93.2%. However, for the DTaP, poliovirus, and hepatitis B vaccines, coverage was at or above the national target. The median for vaccine exemptions for last year's kindergarteners was 1.5%, ranging from less than 0.1% in Mississippi to 7% in Alaska. The median was up 0.2 percentage points from 2010-11. The CDC said the findings suggest coverage gaps at the local level, which raises concern over vulnerability to diseases such as measles. This was illustrated by last year's measles spike that was mainly linked to imported cases in unvaccinated people.
Aug 24 MMWR report

2012 UK measles cases almost double from early 2011
England and Wales have seen 964 confirmed cases of measles in the first half of 2012, compared with just 497 through the same period last year, according to a press release today from the UK Health Protection Agency (HPA). Rubella cases are also up in the United Kingdom, reaching 57 through June this year, more than the annual totals for the last 9 years, the agency said. HPA immunization director Mary Ramsay, MD, said in the release, "It's extremely concerning that measles cases are continuing to rise. Measles can be very serious, and parents should understand the risks associated with the infection, which in severe cases can result in death." She added that, although UK vaccination uptake has improved over the past several years, "some children do not get vaccinated on time and some older children, who missed out when uptake was lower, have not had a chance to catch up." Measles cases for all of 2011 reached 1,086, compared with 380 in 2010.
Aug 24 HPA press release

Report details deaths from amoebic infection after neti-pot use
Fatal cases of infection with Naegleria fowleri amoebae in a man and woman in Louisiana are the first reported instances of the condition linked to tap water used in nasal irrigation systems called neti pots, according to a report yesterday in Clinical Infectious Diseases, published by the Infectious Diseases Society of America (IDSA). The two unrelated patients—a 28-year-old man and a 51-year-old woman—each died within 5 days of being admitted to a hospital for meningitis-like symptoms. Family members reported no recent recreational freshwater contact, and, ultimately, sinus irrigation using tap water was implicated as the cause of the patients' primary amoebic meningoencephalitis, a very rare, usually fatal, disease. "N fowleri was found in water samples from both homes," lead author Jonathan Yoder, MPH, of the CDC, said in an IDSA press release, but the parasite was "not found in the treatment plants or distribution systems of the municipal water systems servicing the patients' homes." The authors were unable to determine how the parasite entered the water supply and showed that the salt-packet disinfection steps taken by the patients would not kill N fowleri. Yoder instead recommended using distilled or sterile water, boiling tap water, or adequately filtering it. The CDC has recorded 32 US N fowleri infections, but these are the first linked to the use of neti pots, the IDSA release said. In a consumer update yesterday, the US Food and Drug Administration (FDA) provided additional information for neti-pot users.
Aug 23 Clin Infect Dis abstract
Aug 23 IDSA news release
Aug 23 FDA consumer update

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