NEWS SCAN: Tertiary vaccinia infection, Haiti's cholera plan unveiled, fuel for polio fight

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Feb 28, 2013

CDC reports tertiary transmission of vaccine-derived vaccinia
A man vaccinated against smallpox last year passed vaccinia virus on to a sexual partner, who transmitted the disease to a third man during sex, the Centers for Disease Control and Prevention (CDC) reported in today's Morbidity and Mortality Weekly Report (MMWR). The first sexual partner went to a San Diego County hospital on Jun 24, 2012, after experiencing a painful perianal rash of 3 days' duration and more recent onset of a lesion on his upper lip, along with fever, malaise, nausea, and vomiting. He said he had had anal intercourse 9 days earlier with a civilian who had been vaccinated against smallpox through a military program and had noticed moisture on an uncovered area of the vaccinee's upper arm. The patient's lesions tested positive for nonvariola orthopoxvirus. The infected patient said he also had had sexual intercourse with a third man on Jun 22. That man was seen by the same specialist on Jun 25 and had lesions on his penis and arm suggestive of vaccinia. He reported having malaise, sore throat, and nasal congestion the day after sexual contact with the secondary patient, and over the next several days he also developed lesions on his groin and scrotum. Testing revealed a nonvariola orthopoxvirus. The secondary patient had detectable antivaccinia antibodies before being treated with intravenous vaccinia immune globulin, while the tertiary patient did not. Both recovered fully. Health officials contacted the military clinic that administered the vaccine to ensure that personnel emphasized prevention steps such as keeping the injection site covered.
Mar 1 MMWR study

Funding sought as Haiti unveils $2.2 billion plan to oust cholera
The Haitian government yesterday announced a 10-year, $2.2 billion plan to eliminate cholera through improvements in the country's water and sanitation systems. At the same time, the Pan American Health Organization (PAHO) and World Health Organization (WHO) called on the rest of the world to finance the ambitious plan. The National Plan for the Elimination of Cholera in Haiti envisions increased investments in water and sanitation infrastructure and management and in water-quality monitoring systems, according to a joint PAHO/WHO statement. The plan also includes measures for cholera prevention, surveillance, and treatment; efforts for community-based behavior change; and vaccination for targeted groups. The plan calls for spending US $485.9 million over the next 2 years. Specific goals of the plan, according to a report in the British newspaper the Guardian today, include increasing population access to potable water from 69% to 85%, to toilets and latrines from 27% to 90%, and to healthcare from 54% to 80%. The PAHO/WHO statement noted that cholera has struck nearly 650,000 people in Haiti and killed more than 8,000 since October 2010. Although the epidemic's pace is much slower now than in the early months, cases so far this year have averaged more than 1,500 a week.
Feb 27 PAHO/WHO press release
Feb 28 Guardian story

Bloomberg gives $100 million to polio eradication campaign
Michael R. Bloomberg, philanthropist and mayor of New York City, today announced a $100 million gift to support the Global Polio Eradication Initiative's 6-year plan to stamp out the disease. "It's unthinkable that polio still exists in the world when we have the tools and technology to protect children from this preventable, debilitating disease. Now is the time to invest in making polio history," Bloomberg said in a press release from his charitable organization, Bloomberg Philanthropies. The statement noted that polio remains endemic in only three countries—Afghanistan, Nigeria, and Pakistan—and that fewer than 225 cases were reported in 2012, the fewest ever. The target date for eradicating polio has been moved back several times, and the current strategy calls for achieving the goal by 2018. Recent polio immunization efforts in Pakistan and Nigeria have been hampered by attacks on vaccinators and security personnel guarding them. Bloomberg said his donation is the result of a deepening collaboration between Bloomberg Philanthropies and the Bill and Melinda Gates Foundation in the realm of global health.
Feb 28 Bloomberg Philanthropies press release

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