News Scan for Nov 06, 2015

E coli outbreak update
Parental vaccination attitudes
Polio vaccination barriers in Pakistan

Chipotle E coli cases stand at 41; isolates show genetic match

The number of cases in an Escherichia coli O26 outbreak linked to Chipotle restaurants in Oregon and Washington, which has fluctuated over the past 2 days as investigations progress and states receive test results, now stands at 41.

Oregon reported 1 more case, lifting its total to 13. Patient ages range from 11 to 61, and four people have been hospitalized, according to an update today posted by the Oregon Health Authority (OHA).

Meanwhile, Washington officials said that state's case count remains at 28 from 6 different counties. Patient ages range from 1 to 67 years, and 10 individuals have been hospitalized, according to an update today from the Washington State Department of Health (WSDH).

Five Chipotle restaurants in each of the states have links to patient illnesses, but so far no food vehicle has been identified. The company has temporarily closed 43 restaurants in the two states. The Centers for Disease Control and Prevention (CDC) said a probe is under way to determine a common food or menu item, but so far there is no information that suggests Chipotle locations in other states are affected by the outbreak.

The CDC said today in an update that isolates from 16 sick people in Washington and Oregon have been uploaded to PulseNet, a national subtyping database. It added that all 16 were infected with E coli O26 strains that share the same DNA fingerprint. A search of the database also turned up one Minnesota patient infected with the matching strain, but he or she didn't eat at a Chipotle the week before symptom onset, and the case doesn't appear to be linked to the outbreak in Oregon and Washington.
Nov 6 OHA update
Nov 6 WSDH update
Nov 6 CDC outbreak update


Expectant mothers may face knowledge barriers to vaccination decisions

Approximately 25% of women expecting their first child did not plan to follow the recommended childhood vaccination schedule, according to findings published Aug 18 in the American Journal of Preventive Medicine.

Researchers from the CDC and the University of Georgia surveyed 200 women in their second trimester of pregnancy (expectant mothers who planned to decline all recommended childhood vaccinations were excluded).

Of the 200 women, 10.5% planned to space out vaccinations between separate clinic visits, 10.5% were undecided about immunization for their child, and 4% planned to have their child receive only some of the recommended vaccinations.

The majority of the women surveyed were confident in the effectiveness (81.4%) and safety (73.5%) of childhood vaccines. Women who planned to follow the vaccination schedule were about three times more likely than women who planned to delay vaccines (odds ratio [OR], 3.38; P < 0.001) or undecided women (OR, 2.62; P < 0.001) to believe vaccination was safe.

Approximately 30% of expectant mothers were familiar with the recommended vaccination schedule, and 42% were dissatisfied with their current level of knowledge about childhood vaccines. Only 36.5% had received information about vaccines from their physician or midwife, the study said.

Of 112 women who sought information about vaccines, 36% used Internet search engines, 27% consulted family members, and 22.5% asked a healthcare provider. Among undecided women, the most common sources of information about vaccination were Internet search engines (28.6%), family members (23.8%), online health sites (19%), and parenting blogs (19%).

About 38% of the pregnant women had identified a pediatrician, and 60% of these said it was important to find a pediatrician who was flexible in allowing the parent to decline or change the schedule of recommended vaccines.

Given the lack of familiarity with childhood immunizations among first-time expectant mothers, the researchers said that healthcare providers should take a more active role in providing information and guidance around pediatric vaccinations.
Aug 18 Am J Prev Med study


Study: Religious, security concerns barriers to polio vaccination in Pakistan

Attitudes and behavior toward polio vaccination in Pakistan, where the disease is still endemic, are significantly influenced by religious beliefs, knowledge about the virus, security concerns, and demographic factors, according to a study yesterday in BMC Public Health.

Researchers surveyed knowledge of and attitudes toward polio immunization among 768 people living in three districts of Pakistan's Quetta division and two districts in the Peshawar division. Quetta and Peshawar have had some of the highest recent case numbers.

Slightly over one third (38.8%) of respondents were knowledgeable about polio, and 23.1% knew that poliomyelitis is incurable. Only 58.4% viewed polio as a severe disease, and 63.6% saw polio as a severe problem in their district. Most (74.3%) of the 768 people surveyed believed incorrectly that children with mild illness should not receive polio vaccination.

Factors associated with a lack of knowledge included older age (> 60 years), a low level of education, rural residence, and unemployment. People living in the Quetta districts were less likely than people living in Peshawar (OR, 0.29; P < 0.001) to be knowledgable about polio and polio vaccination.

People living with children under 5 years of age (OR, 2.13; P < 0.001) and people with previous experience with polio patients (OR, 2.20; P < 0.001) were more likely to have knowledge about the disease.

Most of the survey respondents (84.8%) had negative attitudes toward polio immunization, and 47.4% did not believe the vaccine was stored appropriately. Demographic factors associated with a negative attitude toward polio vaccination included religious beliefs (39.06% of respondents), lack of knowledge (33.7%), fear of infertility (32.2%), and concerns about security of the vaccine (29.4%).

Factors associated with positive attitudes toward polio immunization included high level of education (OR, 9.14; P < 0.001), formal religious training (OR, 5.89, P < 0.001), urban residence (OR, 3.29, P < 0.001), and living with children under 5 years of age (OR 2.49, P < 0.05).

The researchers said that many of the positive attitudes toward polio immunization can be attributed to social media use among younger people, access to regular healthcare, and in-depth knowledge of religious issues affecting vaccination.
Nov 5 BMC Public Health study


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