News Scan for Oct 22, 2015

Physician HPV vaccine lapses
Avian flu outbreaks in 4 nations
Zika virus in the Americas

Survey notes doctors lag in HPV vaccine communication

Physicians' lukewarm communication and follow-through about human papillomavirus (HPV) vaccine may likely contributing to low vaccination levels, researchers reported today. A team from Harvard Medical School reported its findings in Cancer Epidemiology, Biomarkers, and Prevention.

They based their findings on an online survey of 776 US pediatrics and family medicine practitioners in 2014, which measured four indicators of the quality of HPV vaccine recommendations: message timeliness, consistency, urgency, and endorsement strength.

About 27% of doctors said they didn't strongly recommend the HPV vaccine, 26% didn't provide timely recommendations for girls, and 39% didn't report timely recommendations for boys. About 59% recommended the vaccine only for those they thought to be at higher risk, rather than routinely for all adolescents. Only 51% recommended same-day vaccination at the time of the visit. They found that the quality of the recommendation was higher when physicians began the discussion about the HPV vaccine by saying the child was due for vaccination.

Melissa Gilkey, PhD, study coauthor and assistant professor of population medicine at Harvard, said in a press release from the American Association for Cancer Research (AACR), "We are currently missing many opportunities to protect today's young people from future HPV-related cancers. Helping providers communicate about the HPV vaccine effectively is a promising strategy for getting more adolescents vaccinated."

In a related editorial in the same issue, Gregory Zimet, PhD, an adolescent medicine specialist at Indiana University School of Medicine, said given the self-report nature of the survey, the findings are a best case scenario, and he noted that the study lays the groundwork for designing better physician interventions for improving vaccine recommendations.
Oct 22 Cancer Epidemiol Biomarkers Prev abstract
Oct 22 AACR press release

Oct 22 Cancer Epidemiol Biomarkers Prev editorial

In a related study, a test of two different HPV vaccine-promotion interventions found results varied by race. Texas researchers reporting in the Oct 19 edition of Pediatrics tested the impact of an educational brochure about the vaccine and the brochure plus telephone calls to parents or guardians who declined immunization for adolescents or as reminders for the second and third doses.

They found that the brochure alone was effective for Hispanic individuals, but not African-American respondents. Phone calls to parents who declined were not effective, but reminder calls to receive the second and third doses were effective, regardless of race.
Oct 19 Pediatrics abstract


Avian flu outbreaks reported in Ghana, South Korea, Taiwan, and Vietnam

Countries that have been battling ongoing highly pathogenic avian flu outbreaks in poultry reported new detections—H5N1 in Ghana, H5N8 in South Korea, H5N2 in Taiwan, and H5N6 in Vietnam—according to a media report and separate reports over the past few days from the World Organization for Animal Health (OIE).

In Ghana, the H5N1 virus turned up in village chickens, ducks, and turkeys in the country's Central state, located in the far southern part of the country. Of 510 susceptible birds, the virus killed 34, and the remaining ones were culled to curb the spread of the virus. Ghana has reported a number of H5N1 outbreaks this year, the first since 2007.

South Korean agriculture officials reported an H5N8 outbreak at a commercial duck farm in Yeongam in South Jeolla province, in the southwestern part of the country, the Korea Herald reported today. Illness in some of the birds prompted testing, and the farms 27,000 birds were culled after tests came back positive for the virus. The country has reported eight avian flu outbreaks over the past month, according to the report.

Meanwhile, animal health officials in Taiwan reported two more H5N2 outbreaks, on at a turkey farm in Yunlin County and the other at a goose farm Taoyuan County. Of 2,600 birds at the two locations, the virus sickened 684 birds and killed 681. The remaining poultry were destroyed as a disease control step. Taiwan's latest report is the 36th to detail H5N2 outbreaks this year.

Vietnam on Oct 20 reported two more H5N6 outbreaks, this time in backyard birds in Nam Dinh province, located in the northern part of the country. Of 3,759 poultry at the two sites, 700 deaths were reported, with the remaining birds slaughtered to stem the spread of the virus. The country has had several H5N6 outbreaks since August 2014 when the officials identified the virus as a new strain.
Oct 22 OIE report on H5N1 in Ghana
Oct 22 Korea Herald story
Oct 21 OIE report on H5N2 in Taiwan
Oct 20 OIE report on H5N6 in Vietnam


WHO confirms recent Zika virus detections in Brazil, Colombia

Brazil reported its first Zika virus case in May, but as of Oct 8 illnesses have been detected in 14 of the country's 26 states, the World Health Organization (WHO) said yesterday in an update.

The states are Alagoas, Bahia, Ceara, Maranhão, Mato Grosso, Para, Parana, Paraiba, Pernambuco, Piaui, Rio de Janeiro, Rio Grande do Norte, Roraima, and Sao Paulo. The detection in Brazil marked the first identification in the Americas of the emerging disease, which is spread by Aedes mosquitoes. The illness is similar to dengue, but symptoms are generally milder.

The WHO also confirmed the first Zika virus cases in Colombia, which were first mentioned in an Oct 18 post from Pro-Med Mail, an infectious disease news service provided by the International Society for Infectious Diseases. The WHO said nine cases have been confirmed, based on tests on 98 samples from Bolivar department—13 from Cartagena and 85 from Turbaco.
Oct 21 WHO statement
Oct 19 CIDRAP News scan "Colombia reports first-ever cases of Zika virus infection"

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