News Scan for Mar 18, 2015

Tick-borne disease treatment
;
Attacks on polio workers
;
Typhoid in Uganda

CDC: Despite warning, drug for tick-borne disease doesn't harm kids' teeth

Concern over a potential for causing dental staining often prevents doctors from using the best drug to treat Rocky Mountain spotted fever (RMSF) in young children. But a new study suggests that this concern is groundless, says the Centers for Disease Control and Prevention (CDC).

The agency said doxycycline, the most effective antibiotic for RMSF, carries a label warning about a risk of tooth staining in children less than 8 years old. Children are five times more likely than adults to die of tick-borne diseases like RMSF, the CDC noted.

To test the concern about doxycycline-linked dental staining, researchers from the CDC and the Indian Health Service examined the medical records and teeth of more than 250 children who lived on an American Indian reservation with high rates of RMSF. Their study was reported yesterday in the Journal of Pediatrics.

Dentists inspected the permanent teeth of 58 children who had received doxycycline for suspected RMSF before their 8th birthday and 250 who had not, without knowing which children had received the drug, according to the journal article. They found no "tetracycline-like staining" in any of the children's teeth and no significant difference in tooth shade or enamel.

Since 1970, all tetracycline-class antibiotics have carried a warning label about a risk of dental staining in young children, the CDC said. The warning was based on studies of children who received older tetracyclines.

The agency said that for RMSF, doctors must prescribe treatment early, before they have lab confirmation of the infection.

Jennifer McQuiston, DVM, MS, a CDC epidemiologist and a coauthor of the study, said the findings show clearly that the concern about dental effects "shouldn't be a reason to avoid this life-saving drug. Changing the drug's label may encourage physicians to use doxycycline earlier to treat suspected RMSF in children, which will help save lives."
Mar 17 CDC press release
Mar 17 J Pediatr report

 

Four killed, one injured in Pakistani polio vaccination campaigns

Three health workers administering oral polio vaccine to children in Pakistan and a police officer have been killed, plus another worker injured, according to media sources today.

A story in Karachi-based The News International reports the death of two women and a guard working in Danna, in the Mansehra district in the northeastern part of the country, during the second of a 3-day polio vaccination campaign in the area. An unidentified gunman attacked them and has not yet been apprehended.

Government officials condemned the violence, and other members of the "Ladies Health Workers Association" vowed to continue their work after a 3-day period of mourning.

In a separate attack in Bajaur, which lies in the Federally Administered Tribal Areas of northwestern Pakistan, a gunman killed one member of a vaccination team and injured another, who was rushed to the hospital, says a story in Pakistan Today. A Taliban group took responsibility for the attack.

Militants who consider the vaccination efforts to be acts of espionage from the West have killed 76 health team members and security personnel since December 2012, says the Pakistan Today article. Polio remains endemic in only three countries—Afghanistan, Nigeria, and Pakistan—with the latter seeing more than 300 cases last year, the highest in 14 years.
Mar 18 News International story
Mar 18 Pakistan Today story

 

Uganda home to typhoid fever outbreak of nearly 2,000 cases

An outbreak of typhoid fever in Uganda has reached 1,940 cases as of Mar 5, according to a statement yesterday from the World Health Organization (WHO).

Cases began in downtown Kampala City early this year and have since spread to all parts of the city and its outskirts. Young men aged 20 to 39 years are most affected, and most case-patients are casual laborers or in the business sector, including food/juice vendors and cooks, says the notice.

The main sources of infection identified to date are contaminated drinking water and juices, the WHO said. Salmonella Typhi and Salmonella Paratyphi group A bacteria have been identified in laboratory testing. Symptoms of typhoid fever can include fever, headache, malaise, constipation, diarrhea, spots on the chest, and an enlarged spleen and liver; paratyphoid is similar but typically follows a more benign course.

A task force in Uganda, with support from the WHO and other organizations, has improved surveillance and implemented control measures, including provision of safe water.
Mar 17 WHO report

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