News Scan for Nov 13, 2015

Global measles
US flu stays low
Flu vs other respiratory diseases
Fecal transplant for C diff

Measles vaccine has saved 17.1 million lives since 2000, CDC says

Global measles deaths have dropped 79% in the past 15 years, and the measles vaccine saved an estimated 17.1 million people in that span, but vaccine uptake has stagnated in recent years, the US Centers for Disease Control and Prevention (CDC) reported today in Morbidity and Mortality Weekly Report (MMWR).

About 114,900 people worldwide died of measles in 2014, down dramatically from 546,800 in 2000, the CDC said. Measles cases decreased 69%, from 853,479 to 267,482, and incidence of the disease declined 73%, from 146 to 40 cases per million population. Declines in 2014 would have been even more dramatic if not for large outbreaks in China (52,628 cases), the Philippines (58,848), and Vietnam (15,033).

After rising from 72% to 85% from 2000 to 2010, coverage of the first dose of the measles vaccine has remained unchanged for 4 years, the report notes.

The authors conclude, "Measles can serve as an indicator of the strength and reach of the health system, as measles outbreaks reveal populations poorly served by health services."

In a World Health Organization (WHO) news release on the report, Jean-Marie Okwo-Bele, MD, MPH, director of the WHO's Department of Immunization, Vaccines and Biologicals, said, "We cannot afford to drop our guard. If children miss routine vaccination and are not reached by national immunization campaigns, we will not close the immunization gap."
Nov 13 MMWR report
Nov 12 WHO news release

US flu markers still at low levels

US flu indicators changed very little last week, remaining at low levels, the US Centers for Disease Control and Prevention (CDC) said today.

The percentage of outpatient visits for flulike illness remained the same as the previous week at 1.4, well below the national baseline. The percentage of respiratory specimens testing positive for flu dropped slightly, to 1.2%. Nearly 59% of positive specimens reported to the CDC by clinical labs were influenza A. Of the influenza A viruses subtyped by public health labs, H3N2 predominated.

No pediatric flu deaths were reported to the CDC, and the overall deaths from pneumonia and flu remained below the seasonal baseline.

Puerto Rico was the only area that reported moderate flulike illness activity, another marker based on clinic visits. Widespread geographic circulation was reported by only one area, Guam, with Puerto Rico reporting regional activity. Four states—Hawaii, Iowa, Massachusetts, and Oregon—reported local activity, up from two the previous week.
Nov 13 CDC weekly flu update


Study: Flu more severe than other respiratory illnesses

Lab-confirmed influenza illness was more severe and resulted in more missed work than other acute respiratory illnesses, and flu vaccination may modestly reduce severity, US researchers reported yesterday in Clinical Infectious Diseases.

The researchers analyzed data on acute, medically attended respiratory cases from the US Influenza Vaccine Effectiveness Network for the 2012-13 flu season. Cases were subjectively assessed for severity based on multiple factors such as health status, activity level, and sleep quality.

Flu cases were deemed significantly more severe than non-flu cases. Also, flu patients reported missing 20.5 hours of work for their illness, compared with 15.0 for non-flu patients. Finally, flu patients who had received a flu vaccine had modest but statistically significant better health status and activity level than non-vaccine flu patients, but there was no difference in terms of sleep quality, missed work hours, or lost work productivity.

The authors conclude, "These findings highlight the burden of influenza illnesses and illustrate the importance of laboratory-confirmation of influenza outcomes in evaluations of vaccine effectiveness."
Nov 12 Clin Infect Dis abstract


Fecal transplant drug shows early promise against C difficile

An experimental fecal microbiota transplantation drug cured almost 90% of Clostridium difficile patients, according to a small study yesterday in Clinical Infectious Diseases.

The commercially prepared drug, called RBX2660, is administered via an enema. Of 31 patients who received treatment at 1 of 11 US centers in late 2013 for recurrent or severe C difficile and completed 6-month follow-up, 16 patients were cleared of the bacterium with one dose and 11 with two doses, for an overall efficacy of 87.1%.

Common side effects included diarrhea, flatulence, abdominal pain or cramping, and constipation, but their frequency and severity decreased over time. Twenty serious adverse events were reported in 7 patients, but none were related to RBX2660 use.
Nov 12 Clin Infect Dis abstract

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