News Scan for Dec 10, 2013

Pneumonia in kids
Caribbean chikungunya update
Pakistani polio vaccine support
Hepatitis E in Tanzania

Study supports narrow-spectrum approach to pneumonia in kids

Narrow-spectrum antibiotics were associated with a 10-hour shorter hospital stay compared with broad-spectrum therapy for community-acquired pneumonia (CAP) in children—an 18% drop—according to a multicenter retrospective cohort study yesterday in Pediatrics.

US researchers analyzed the medical records of 492 CAP patients 2 months to 18 years old who were treated at one of four hospitals in 2010. Fifty-two percent of the patients were empirically treated with a narrow-spectrum antibiotic and 48% with a broad-spectrum agent.

Length of hospital stay for the broad-spectrum group was 52.3 hours, compared with 43 hours for the narrow-spectrum group, a reduction of 9.7 hours and 17.8%. The authors found no significant between-group differences for 7-day readmission rates, daily costs, fever duration, or length of supplemental oxygen.

They say their findings "support national consensus recommendations for the use of narrow-spectrum antibiotics in children hospitalized with CAP," but note that, before their study, the evidence for such recommendations was scant.
Dec 9 Pediatrics abstract


WHO, PAHO weigh in on Caribbean chikungunya cases

The World Health Organization (WHO) today said it has received reports of two lab-confirmed chikungunya infections on the Caribbean island of St. Martin, which it said were identified during an investigation of an ongoing dengue outbreak.

In a statement, the WHO said chikungunya infections were found in patients with joint pain and fever who recently tested negative for the dengue virus. So far four other probable infections have been reported, as well as 20 suspected cases.

The WHO said the cases represent the first locally acquired chikungunya infections in its Americas region and that health authorities on the French and Dutch parts of St. Martin are cooperating closely on outbreak response. The two confirmed cases were detected on the French part of the island.

The cases triggered an epidemiologic alert yesterday from the Pan American Health Organization (PAHO), which said imported cases had previously been reported from Brazil, Canada, French Guyana, Guadeloupe, Martinique, and the United States. It said the broad distribution of Aedes aegypti and A albopictus in the Americas, combined with highly mobile populations within the Americas and globally, puts the region at further risk.

It urged countries with circulation of mosquitoes that can transmit the chikungunya to establish and maintain the capacity to detect the disease.
Dec 10 WHO statement
Dec 9 PAHO epidemiologic alert
Dec 9 CIDRAP News scan "Chikungunya cases confirmed on St. Martin in Caribbean"


Pakistani religious leader issues fatwa supporting polio vaccine

Pakistani Muslim scholar Maulana Sami-ul-Haqknown as the "Father of the Taliban"has issued a fatwa (religious decree) supporting vaccines against polio and other serious diseases, Agence France-Presse (AFP) reported today.

Haq urged parents to have their children immunized against polio and other fatal diseases, noting that vaccination comply with Islamic law. The fatwa comes more than a year after the Pakistani Taliban banned polio vaccination in the wake of a false immunization campaign that was set up by the US Central Intelligence Agency (CIA) to help track and kill al-Qaida head Osama Bin Laden.

The ban has led to a surge in polio cases in Pakistan and violent attacks on polio workers. But a statement signed by Haq that was dated Oct 30 said parents should disregard the militants' warnings.

"According to Sharia there is no harm in using vaccines which medical experts recommend to save children against deadly diseases," the statement said, mentioning polio, measles, tetanus, and tuberculosis.

"Parents should give the injections and drops of these vaccines to their children to save from fatal diseases," it added.
Dec 10 AFP story

'Mystery' Tanzanian outbreak was due to hepatitis E, WHO says

A large outbreak in Tanzania previously reported as caused by an unknown illness was due to hepatitis E, the WHO's African region reported last week.

Health authorities noted 690 cases of acute febrile illness from Aug 20 to Oct 29 in the Buhigwe district, Kigoma region of Tanzania. Fifteen of 46 samples tested in Nairobi were positive for hepatitis E. Genotyping and molecular characterization tests are scheduled.

Most of the patients had headache, high fever, abdominal pain, body weakness, loss of appetite, and vomiting. The delay in detection and confirmation of the outbreak cause was largely the result of most early cases being treated as malaria, the report said.
Dec 5 WHO report

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