NEWS SCAN: Firing over meningitis outbreak, dengue in Madeira, polio in Nigeria, HFMD in Vietnam

Nov 8, 2012

State official fired for ignoring complaint about firm tied to fungal meningitis
The director of the Massachusetts Board of Registration in Pharmacy has been fired for ignoring a complaint in July that the compounding pharmacy since linked to a widespread fungal meningitis outbreak was shipping drugs in bulk, violating its license, Massachusetts Interim Health Commissioner Lauren Smith, MD, MPH, announced yesterday. James D. Coffey, who was executive director of the board, has been fired for failing to investigate a complaint from a Colorado pharmacy inspector about New England Compounding Center (NECC), Smith said. In addition, Susan Manning, a pharmacy board attorney and member of a bargaining unit, has been put on administrative leave. The Colorado pharmacy board complained to Coffey about NECC on July 26, saying the firm had distributed manufactured drugs to many Colorado hospitals from 2010 to 2012 without patient-specific prescriptions, Smith wrote. She said Coffey forwarded the complaint to Manning and pharmacy board inspectors but failed to order an investigation or inform the Massachusetts Department of Health. The Boston Herald reported that Coffey and Manning failed to tell investigators about the complaint even when news of the meningitis outbreak surfaced in September. Smith called Coffey and Manning's inaction "incomprehensible," given past problems at NECC. Smith also noted that Colorado officials also told the Food and Drug Administration about NECC's actions. Yesterday the tally in the meningitis outbreak was 424 cases (including 10 peripheral joint infections), with 31 deaths in 19 states.
Nov 7 statement by Smith
Dengue outbreak in Madeira reaches 1,148 cases
A dengue fever outbreak that surfaced in early October on the Portuguese resort island of Madeira has grown rapidly, reaching 1,148 cases on Nov 4, the European Centre for Disease Prevention and Control (ECDC) reported today. The agency said 517 cases have been lab-confirmed and 57 people have been hospitalized for observation, but no serious illnesses or deaths have occurred. A few visitors to Madeira have been sick with dengue after returning to their home countries: 6 in the UK, 2 each in France and Germany, and 1 in Sweden. The ECDC said the numbers suggest that the outbreak has not yet peaked. The peak breeding period for mosquitoes, including Aedes Egypti, which spreads dengue, continues until January and includes the busiest tourism season over Christmas, the agency said.
Nov 8 ECDC update

Polio cases have risen in Nigeria this year
Nigeria has had more than twice as many polio cases so far this year as in the same period last year, and the country remains a major barrier to eradicating the disease, the US Centers for Disease Control and Prevention reported today in Morbidity and Mortality Weekly Report (MMWR). From January through September of this year, Nigerian authorities reported 99 wild poliovirus (WPV) cases, compared with 42 for the same months in 2011. Only six cases of vaccine-derived polio virus type 2 cases have been reported this year, compared with 32 in the first 9 months of 2011, but surveillance has revealed "extensive" continued circulation of the virus in one area, the report said. Nigeria's polio immunization campaign has shown "modest" improvements this year, but available information shows gaps in surveillance, the agency said. "Continuing WPV transmission in Nigeria poses an ongoing risk for WPV reintroduction and outbreaks in polio-free countries and is a major obstacle to achieving global eradication," the report concludes. Nigeria is one of three countries, along with Afghanistan and Pakistan, where polio remains endemic.
Nov 9 MMWR article

Vietnam confirms 116,000 HFMD cases
Vietnam has confirmed 116,418 cases of hand hand, foot, and mouth disease (HFMD) in 63 provinces this year through Oct 7, the US Centers for Disease Control and Prevention (CDC) said yesterday in a travel notice. Of those cases, 42 in 15 provinces have proved fatal. Slightly more than half of cases and 91% of deaths have occurred in the southern part of the country, the agency said. HFMD is a common viral illness that typically affects children under 5 years old, but adults can contract it, too. Symptoms include fever, often painful blister-like mouth sores, and a rash. The CDC said travelers can protect themselves by practicing good personal hygiene such as washing hands frequently and should consider packing alcohol-based hand sanitizer for when soap and water are not available.
Nov 7 CDC notice

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