NEWS SCAN: New hantavirus death, kids' vaccine coverage, H5N1 in Vietnam, OTC oseltamivir and resistance, proposed OTC antibiotic ban

Sep 6, 2012

Yosemite hantavirus deaths rise to three
West Virginia health officials today announced the hantavirus death of a resident who had visited Yosemite National Park in recent months, pushing the number of deaths reported in people who stayed at the park to three. The Kanawha-Charleston Health Department (KCHD) said the patient died recently, and the US Centers for Disease Control and Prevention (CDC) confirmed this week that the lab specimens were positive for hantavirus. So far eight infections related to exposure at Yosemite National Park have been confirmed, and several health jurisdictions across several states are investigating more suspected cases, according to the KCHD, which asked providers to consider the illness in people with symptoms resembling hantavirus infection and ask about possible rodent exposure or a recent visit to Yosemite. The CDC has said up to 10,000 people—including residents from 39 other countries—may be at risk after staying in tent cabins in the park's Curry Village from Jun 10 to Aug 24.

Vaccine coverage stable or rising in children 19 to 35 months old
A national survey of immunizations in 19- to 35-month-old US children in 2011 brought mostly good news: coverage was stable or rising for all recommended vaccines. The CDC said today that coverage was above the "Healthy People 2020" goal of 90% for the recommended number of doses of four vaccines: measles, mumps, and rubella (MMR) (91.6%); hepatitis B (91.1%); poliovirus (93.9%); and varicella (90.8%). The survey showed year-on-year increases in the uptake of two recently recommended vaccines: hepatitis A, from 49.7% to 52.2%, and rotavirus, from 59.2% to 67.3%. However, poverty-related differences in coverage persisted for newer vaccines and those requiring four doses, the CDC reported. Children living below the poverty level had lower coverage than children at or above poverty level for four vaccines: diphtheria, tetanus toxoid, and acellular pertussis; pneumococcal conjugate; Haemophilus influenzae type B; and rotavirus. In addition, coverage varied by state, and clusters of unvaccinated children left some areas vulnerable to disease outbreaks. The findings come from the National Immunization Survey, a random telephone poll, and were presented in the Sep 7 Morbidity and Mortality Weekly Report (MMWR).
Sep 7 MMWR article

H5N1 strikes birds in three Vietnamese villages
Animal health officials in Vietnam today reported three H5N1 avian outbreaks in poultry, two in Thanh Hoa province and one in Quang Ngai province, according to a report from the World Organization for Animal Health (OIE). Of 2,205 susceptible birds, the virus sickened 153 and killed 53. The remaining birds were destroyed to control the spread of the disease. Thanh Hoa province is in north central Vietnam, and Quang Ngai is in the south central region of the country on the coast of the South China Sea.
Sep 6 OIE report

New Zealand data show nonprescription oseltamivir did not raise resistance rates
Five years after making the antiviral drug oseltamivir (Tamiflu) available over the counter (OTC, or nonprescription), New Zealand has found no significant change in influenza virus resistance to the drug, according to a study in the Journal of Antimicrobial Chemotherapy. In 2007 New Zealand became the first country to allow OTC oseltamivir. Researchers analyzed national resistance data on influenza isolates from 2008 to 2011 and uptake data on flu vaccination from 2005 to 2011. They found no increased drug resistance in flu isolates and no statistically significant change in vaccine uptake. A survey of 70 New Zealand pharmacies found that OTC oseltamivir accounted for 11% of sales in 2009 and 2010, with the rest being prescribed, compared with 27% in 2007 and 31% in 2008.
Sep 4 J Antimicrob Chemother abstract

India proposal to curb OTC antibiotics moves forward
In an effort to curb the overuse of antibiotics, which is fueling the global emergence of resistant bacterial strains, drug regulators in India have proposed a rule that would stop OTC sales of 92 antibiotics, including anti-tuberculosis drugs, the Economic Times, a daily financial newspaper in India, reported. A draft rule that would establish a new schedule for the drugs has been published and awaits public feedback. India's drug controller general, Dr G N Singh, has notified the health ministry about the proposed new rule. Once the law ministry clears the rule, the antibiotics will be classified as H1 drugs and can't be sold without a prescription, according to the report. Singh said the drugs will carry a prominent label and warning that reflects the rule. CDC Director Tom Frieden, MD, MPH, has said that India needs a policy to control antibiotic overuse, and a study by the Center for Disease Dynamics, Economics, and Policy (CDDEP), a nonprofit organization with offices in Washington, DC, and New Delhi, recently found a rapid increase in carbapenem antibiotic sales in India and Pakistan between 2005 and 2010. The drug is considered a "last resort" medication for treating multidrug-resistant infections.
Sep 4 Economic Times story
May 14 CDDEP report

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