News Scan for Jun 28, 2013

News brief

Brazil reports first Latin American VRSA finding

The Pan American Health Organization (PAHO) yesterday urged its member countries to establish and maintain rapid detection and reporting systems for vancomycin resistance, based on the first isolation of vancomycin-resistant Staphylococcus aureus (VRSA) in Latin America.

In an epidemiologic alert, PAHO said the strain was isolated in December in the blood culture of a hospitalized 35-year-old man from Brazil who has underlying conditions and infections. He had previously been treated with vancomycin and teicoplanin.

His bacteremia was controlled with daptomycin, but he continued to have infections and died 3 months after VRSA was found in his blood sample. The findings were confirmed by labs in Colombia and the United States.

The Van A gene was also found in Enterococcus faecalis isolated from the patient. Further molecular studies are under way, and no other cases have been reported.

The first VRSA isolates were found in the United States in 2002. Eleven isolates had been reported by 2012, most from the United States, but one from India and one from Iran, according to PAHO.

VRSA infection typically causes skin and soft-tissue infections in people with underlying medical conditions.
Jun 27 PAHO epidemiologic alert

 

No immediate health risks linked to aerial mosquito spraying

Aerial spraying to prevent West Nile virus doesn't appear to cause an immediate public health risk, as measured by visits to emergency departments immediately after the spraying or in the 3 days afterward, according to a study in the May-June issue of Public Health Reports.

A research team from the University of California, Davis (UC-Davis), and the California Department of Public Health analyzed Sacramento County emergency department records during and immediately following area-wide spraying in and around Sacramento during the summer of 2005, according to a UC-Davis press release yesterday.

They found no increase in diagnoses most likely to be linked to pesticide exposure, such as respiratory, gastrointestinal, skin, eye, and neurologic conditions.

Estella Geraghty, MD, associate professor of clinical internal medicine at UC-Davis, said in the press release that West Nile virus is endemic in California and the United States, and controversies about managing mosquitoes are likely to arise every summer.

"Findings from studies such as this one help public health and mosquito control agencies better understand the risks and benefits of their practices," she said.

An ultra-low volume pyrethrin insecticide was used during the 2005 spraying. Though exposure to the pesticide has been linked to some human health problems such as eye irritation and respiratory problems, researchers said exposure to it was minimal, with only three-quarters of an ounce of the chemical per acre.

Geraghty said the study didn't address the long-term effects, which would be difficult to gauge in human populations.
Jun 27 UC-Davis press release
May-June Public Health Reports issue

 

Polio outbreak sparks vaccination campaign in Kenya

A polio outbreak in Kenya's Garissa district that resulted in six illnesses has prompted an emergency vaccination campaign that will target 4.3 million children, the Daily Nation, a newspaper based in Nairobi, reported yesterday.

The campaign begins Jul 3 and will focus on 22 counties, the country's public health director, Shahnaz Sharif, said. A repeat activity covering the same area is scheduled for Aug 17 to 21.

The main focus is children under age 5, except for in the Dadaab refugee camp, where everyone will be immunized, according to the report. Sharif said the polio outbreak this year is Kenya's fourth since 2006. The last one occurred in 2011.
Jun 27 Daily Nation story

Study: GBS risk much higher with flu than with flu vaccine

The risk of Guillain-Barre syndrome (GBS) after flu vaccination was much lower than the risk of GBS after flu infection, according to a study today in Lancet Infectious Diseases.

Canadian researchers used a self-controlled study design and data from universal healthcare systems in Ontario from 1993 through 2011. They determined exposures to flu vaccine and flu illness from physician billing claims.

They identified 2,831 patients admitted for GBS, 330 of whom received a flu vaccine and 109 of whom had an influenza-coded healthcare encounter 42 weeks or less before hospitalization.

The risk of GBS within 6 weeks after vaccination was 52% higher than in the control interval of 9 to 42 weeks (relative incidence 1.52; 95% confidence interval [CI], 1.17-1.99), with the greatest risk during weeks 2 through 4 post-vaccination. The risk of GBS within 6 weeks after an influenza diagnosis, however, was much higher (15.81; 95% CI, 10.28-24.32).

The attributable risks were 1.03 GBS admissions per million vaccinations, the researchers noted, compared with 17.2 GBS admissions per million flu diagnoses.

"Patients considering immunisation should be fully informed of the risks of Guillain-Barre syndrome from both influenza vaccines and influenza illness," the authors concluded.
Jun 28 Lancet Infect Dis abstract


No H5N1 found in Alaska birds, but state has possible entry point

Researchers say they found no highly pathogenic (HP) H5N1 avian flu viruses in four years of monitoring wild birds in a part of western Alaska where three flyways converge. But they did find some low-pathogenicity flu viruses with Eurasian genes, which supports the view that HP viruses could enter North America in that area.

The Yukon-Kuskowim Delta is an important breeding ground for many bird species, said a press release yesterday from the US Geological Survey (USGS), which worked on the study with the US Fish and Wildlife Service (USFWS) and several local partners. They launched their study after H5N1 was found in wild birds in China in 2005 and published their findings in the July issue of the Journal of Wildlife Diseases.

From 2006 through 2009, the researchers tested more than 24,000 samples gathered from 82 bird species in the Yukon-Kuskowim Delta and found 90 low-pathogenicity viral strains in samples from 11 species, according to the report. At least one gene segment in 39% of the isolates had a Eurasian origin.

Target species—those ranked as having a relatively high potential to bring HP H5N1 to North America—were no more likely than non-target species to carry viruses with Eurasian-origin genes.

Subsistence hunters in 11 local villages provided many of the bird samples used in the study, a USFWS official said in the press release.
Jun 27 USGS press release
July J Wild Dis abstract

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