NEWS SCAN: Pandemrix and narcolepsy in Sweden, H5N1 vaccine, fungal infections, food outbreaks, urinary tract infections

Mar 26, 2013

Swedish registry study finds Pandemrix-narcolepsy link in kids, young adults
A large registry study in Sweden confirms the increased risk of narcolepsy after vaccination with the Pandemrix 2009 H1N1 influenza vaccine in those 20 years old and younger, and it showed an increased risk in young adults 21 to 30 as well, the country's Medical Products Agency (MPA) said today in a press release. Researchers examined data on 3.3 million vaccinated and 2.5 million unvaccinated people for more than 50 neurologic and immunologic disorders from Oct 1, 2009, to Dec 31, 2011. The study showed the incidence of narcolepsy tripled in vaccinees 20 years old or younger, which amounted to about 4 cases per 100,000 person-years. "The increased risk is slightly lower compared to results from an earlier registry study in Sweden," the MPA said in the release. "This discrepancy may be explained by an increase of diagnosed cases of narcolepsy also in unvaccinated children and adolescents." The risk of narcolepsy doubled in those 21 to 30, the agency said, while no increased risk was observed in those 40 and older. Previous studies have found a narcolepsy link in Sweden, Finland, Denmark, and Ireland, and last month the finding was also reported in England.
Mar 26 MPA press release
Jan 30 CIDRAP News story on findings in Scandinavia
Feb 27 CIDRAP News story on UK study

GSK H5N1 vaccine approval held up by FDA
Approval of an H5N1 influenza vaccine for use in a pandemic has been delayed by the US Food and Drug Administration (FDA) for an apparently administrative reason, said a Reuters story yesterday. The vaccine is made by GlaxoSmithKline (GSK), Britain's largest drug company and maker of the H1N1 vaccine Pandemrix, which is similar to the H5N1 product and has been associated with an increase in narcolepsy (see above item). Both vaccines contain the adjuvant AS03, which boosts the body's immune response. A GSK spokesman claims the delay in approval of the H5N1 vaccine is not related to the H1N1 narcolepsy controversy but is rather "due to an administrative matter that has recently been rectified," the story said. Last November a panel of 14 FDA advisors considered early studies on the potential narcolepsy link but voted unanimously to recommend the H5N1 vaccine for approval, saying the benefits of the vaccine outweighed any risks.
Mar 25 Reuters story

Fungal infections from contaminated steroids reach 730 cases, 51 deaths
The ongoing outbreak of fungal infections associated with contaminated injectable steroids has increased by 8 cases and 1 death since the last report Mar 11, for a total of 730 cases with 51 deaths, according to an update yesterday from the Centers for Disease Control and Prevention (CDC). The illnesses to date include 236 cases of meningitis only, 144 of meningitis with paraspinal or spinal infection, 7 of stroke without lumbar puncture, 308 of paraspinal or spinal infection only, 33 of peripheral joint infection only, and 2 of paraspinal or spinal infection with peripheral joint infection. The outbreak has affected 20 states, with the largest number of cases in Michigan (259) and Tennessee (150). Implicated in the outbreak, which began last fall, are three recalled lots of methylprednisolone acetate produced by New England Compounding Center in Framingham, Mass.
Mar 25 CDC outbreak update

Report: US food outbreaks declined in last decade
Outbreaks of foodborne disease decreased more than 30% in the first decade of the 21st century, according to a review of outbreaks published yesterday by the nonprofit Center for Science in the Public Interest (CSPI). During the study period (2001 through 2010), however, the percentage of outbreaks in which both the culprit food and the pathogen were identified dropped from 46% to 33%. Food outbreaks reported to the CDC, whether a pathogen like Salmonella or a food item was identified or not, dropped from 1,226 in 2001 to 851 in 2010, a 31% decrease. From the peak year, 2004, to the nadir, in 2009, the drop was 48%, from 1,303 outbreaks to 672. The CSPI also found that, per pound, seafood was the most likely type of food to lead to illness, having a foodborne disease risk almost 20 times higher than poultry and fruit.
Mar 25 CSPI report
Mar 25 CSPI news release on the report

Study: Prevention practices may reduce catheter-related UTIs
A survey of 470 US infection preventionists found that 94% of Michigan hospitals undertook efforts to reduce catheter-associated urinary tract infections (CAUTIs), compared with 67% in other states, and that more frequent use of the preventive practices reduced CAUTIs 25% in Michigan, compared with 6% elsewhere. Writing in JAMA Internal Medicine yesterday, researchers said they surveyed preventionists at a sample of US hospitals and at all Michigan hospitals. They found that Michigan hospitals, compared with other US hospitals, more frequently employed collaboratives to reduce healthcare-related infections (94% vs 67%, P < .001), bladder scanners (53% vs 39%, P = .04), and catheter discontinuation steps (44% vs 23%, P < .001). The higher rate of these practices was associated with the 25% reduction in Michigan CAUTI rates, which was significantly better than the 6% decrease noted elsewhere.
Mar 25 JAMA Intern Med abstract

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