News Scan for Aug 29, 2016

Vaccine-reluctant parents
New H9N2 case in China
H5N2 in Alaskan mallard

Survey: 87% of pediatricians face parents who refuse to vaccinate kids

The proportion of pediatricians facing parents who refuse to vaccinate their children has grown markedly in recent years, to 87% according to a new survey from the American Academy of Pediatrics (AAP) published today in Pediatrics.

The AAP surveyed 627 vaccinating pediatricians in 2013 and found that 87.0% reported parental vaccine refusal, a figure that climbed from 74.5% in 2006. Also, 73.1% of respondents said parents are increasingly refusing vaccines because they believe they are unnecessary, which was up from 63.4% in 2006.

A total of 75.0% of pediatricians reported that parents delay vaccines over concern about discomfort, and 72.5% said parents delay because of concern for the children's immune system burden. In 2006, 6.1% of pediatricians reported always dismissing patients for continued vaccine refusal, which climbed to a significant 11.7% in the new survey.

"The perceived rise in refusals and delays does not seem to be solely attributable to any one vaccine, because pediatricians reported increased rates of parents who refused just one vaccine and those who refused more than one immunization," said study author Catherine Hough-Telford, MD, in an AAP news report. This supports previous findings that suggest the public's memory of vaccine-preventable diseases may be fading, she added. "Clearly, though, additional research is needed to evaluate vaccine hesitancy and how it relates to different vaccines," she said.

The AAP also published an accompanying guide today called "Countering vaccine hesitancy," which includes such pointers as remembering that vaccine-hesitant parents are a heterogenous group, and their individual concerns should be respected and addressed.

The guide also noted, "Pediatricians and other health care providers play a major role in educating parents about the safety and effectiveness of vaccines. Strong provider commitment to vaccination can influence hesitant or resistant parents."
Aug 29 Pediatrics study
Aug 29 AAP news release
Aug 29 Pediatrics AAP guidance
AAP vaccine refusal resource page


China reports another human H9N2 case

Chinese authorities have reported a new case of H9N2 avian flu in a baby boy, the second human case in as many days.

The Yunnan Provincial Health and Family Planning Commission on Aug 26 said a 10-month-old boy in Mengzi City has tested positive for the virus, according to report translated by FluTrackers, an infectious disease news message board. The case was detected during stepped-up surveillance efforts, and the boy has since recovered, the agency said. No other details were provided, such as whether the boy had contact with live poultry, which is the typical risk factor.

The report said the risk of transmission is very low, with no apparent human-to-human spread.

On Aug 25 local officials reported that a 29-year-old woman in Guangdong province had contracted H9N2, FluTrackers previously noted.
Aug 26 FluTrackers post
Aug 26 CIDRAP News scan on previous case


Avian flu found in wild Alaskan duck

The United States Department of Agriculture's (USDA's) Animal and Plant Health Inspection Service (APHIS), confirmed that a wild mallard caught in an animal refuge near Fairbanks, Alaska, tested positive highly pathogenic avian influenza. This the first time H5N2 has been found in the United States since June of 2015.

The duck was identified during routine surveillance and testing of wild birds. "Since July 1, 2016, USDA and its partners have tested approximately 4,000 samples, with a goal to collect approximately 30,000 samples before July 1, 2017," a press release from the USDA stated. The agency tested 45,500 samples in the year before Jul 1, with none testing positive for avian flu.

The risk of infection to humans remains low. According to the USDA, there has never been human infection in the United States with Eurasian H5 viruses. Still, the USDA said that proper handling of birds and eggs, including cooking poultry to an internal temperature of 165°F will kill highly pathogenic avian flu viruses.

Hunters are reminded to wash their hands if they come into contact with wild birds, and dress game birds in the field whenever possible.
Aug 26 USDA press release

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