NEWS SCAN: PAHPRA reauthorization, select-agent inspections, fungal infection alert, European antimicrobial database

Mar 5, 2013

House sends preparedness law to Obama's desk
The US House of Representatives yesterday passed the final version of the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) of 2013 yesterday, clearing the way for President Obama to sign the bill into law. A version of the legislation died in the Senate late last year after extensive efforts between House and Senate members to find common ground, and lawmakers introduced it again this session. That version passed the House of Representatives on Jan 22. The Senate last week amended the legislation last week by a unanimous vote, and the House approved the final version yesterday 370-28, according to a statement from Rep Mike Rogers, R-Mich., who has led bipartisan efforts to pass the bill. "This legislation will save lives by improving our ability to quickly respond to a bioterror attack or pandemic outbreak," Rogers said. Trust for America's Health (TFAH), a nonprofit, nonpartisan health advocacy group that tracks national preparedness issues, yesterday issued a statement applauding the law's passage. Jeffrey Levi, PhD, TFAH's executive director, said in the statement that the bill will help build an even more prepared nation, "with an increased emphasis on the agility of public health, protecting children, and long-range planning for medical countermeasures and other key government functions—most notably the law." PAHPRA was first passed in 2006. Its reauthorization continues work on medical countermeasures against chemical, biological, radioactive, and nuclear threats, as well as preparedness efforts.
Mar 4 Rep Rogers press release
Mar 4 TFAH press release

GAO cites 'inspection overlap' among those working with select agents
About 15% of labs and other groups working with select agents like Bacillus anthracis experience "inspection overlap," meaning more than one federal regulator inspected the work, according to a report from the US Government Accountability Office (GAO). The report, released yesterday but dated Jan 31, was requested by Congress to monitor the work by almost 400 labs and other institutions on select agents, which, in addition to the bacterium that causes anthrax, include the causative agents of plague, Ebola, tularemia, and SARS (severe acute respiratory syndrome), among others. The report said that overlap between inspections from the Department of Transportation (DOT) and those of the Centers for Disease Control and Prevention (CDC) and the US Department of Agriculture's Animal and Plant Health Inspection Service (APHIS) was "generally not duplicative." It added, "The Department of Homeland Security and Department of Defense inspections, however, tended to be more duplicative with those of CDC and APHIS." The report said quantifying the costs of duplication was difficult. It estimated, though, that all select-agent inspections over 2 years cost federal agencies $2.1 million and each lab from $22,400 to $900,000.
Mar 4 GAO report (dated Jan 31)
Report highlights

Clinicians urged to remain alert for fungal infections from contaminated steroids
The Centers for Disease Control and Prevention (CDC) issued an alert yesterday through its Health Alert Network (HAN) urging clinicians to continue to be vigilant for patients with fungal infections, even mild or baseline cases, that may be related to injections with contaminated steroids. An outbreak of fungal infections, predominantly fungal meningitis, associated with injections of contaminated methylprednisolone acetate was first reported last fall. A total of 720 cases, including 48 deaths, have been reported from 20 states. Cases have tapered off considerably, and most recent ones have been localized spinal or paraspinal infections, but meningitis and arachnoiditis continue to be reported as well. The contaminated steroids were traced to the New England Compounding Center in Framingham, Mass. The CDC has revised its interim treatment and diagnostic guidance for cases in the outbreak with new recommendations regarding surgical management of parameningeal disease, duration of antifungal treatment, monitoring of clinical status after treatment, and non-first-line medications. Clinicians who want more information on the new guidance can participate in a conference call on Mar 13.
Mar 4 HAN alert
CDC current information on the outbreak
CDC interim clinical guidance

ECDC launches antimicrobial database and consumption report
The European Centre for Disease Prevention and Control (ECDC) announced yesterday a new interactive database on antimicrobial consumption in European Union (EU) member states and a new report on 2010 data on consumption in the community (primary care) and the hospital sectors. The interactive data reports come through the European Surveillance of Antimicrobial Consumption Network (ESAC-Net), a network of national surveillance systems coordinated by the ECDC. Selected data in the system can be displayed in tabular form as well as through maps and figures. Data currently available cover consumption from 1997 to 2010 and will be updated each year. Both the database and the 2010 report cover three categories of antimicrobials for systemic use: antibacterials, antimycotics and antifungals, and antivirals.
Mar 4 ECDC news release
ESAC-Net interactive database
2010 ESAC-Net report (33 MB file)

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