News Scan for Sep 01, 2016

2009 H1N1 risk for health workers
Malaria in a time of Ebola
Hepatitis cases rise

Study: Risk of H1N1 during 2009 pandemic was double for health workers

A meta-analysis by German researchers yielded the conclusion that healthcare personnel (HCP) faced about twice as high a risk of H1N1 infection as other groups during the 2009 influenza pandemic, says a report published yesterday in PLoS One.

The authors found 15 studies of 2009 H1N1 risk for HCP during the pandemic that met their quality standards. Some of the studies compared HCP with the general population, while others compared them with hospital workers not involved in direct patient care.

Prevalence rates for 2009 H1N infection varied from 1.7% to 27.1% among HCP and from 1.0% to 30% among controls and comparison groups; the pooled H1N1 prevalence rate for HCP was 6.3%. Compared with controls, HCP had a significantly increased risk of H1N1 infection, with an odds ratio of 2.08 (95% confidence interval, 1.73 to 2.51), the researchers found.

"This review corroborates the assumption that healthcare personnel were particularly at risk of influenza A (H1N1) infection during the 2009 pandemic," the authors concluded. "Healthcare facilities should intensify their focus on strategies to prevent infections among healthcare personnel, especially during the first period of pandemics."
Aug 31 PLoS One report


Mass handout of malaria drugs may have cut fever cases during Ebola

The mass distribution of malaria drugs in Monrovia, Liberia, may have reduced malaria cases during the country's Ebola epidemic, even though uptake of the drugs was fairly low, according to a report by researchers with Medecins Sans Frontieres (MSF).

The aim of the mass drug administration (MDA) program, conducted in the fall of 2014, was to prevent malaria at a time when medical services were disrupted by the Ebola epidemic, according to the report, published yesterday in PLoS One.

A PLoS press release about the study notes that the similar clinical presentation of Ebola and malaria cases meant that an unknown number of malaria patients were treated as suspected Ebola patients, putting them at risk of exposure to Ebola and further straining treatment units.

MSF distributed the combination treatment artesunate/amodiaquine in two rounds of MDA targeting four Monrovia neighborhoods. The researchers systematically selected 222 households in the distribution area and administered questionnaires to household members.

All 222 households attended the first round of MDA, and 96% attended round 2. But only 52% of household members actually began taking the drugs in round 1, and the uptake dropped to 22% in round 2, the survey showed. In both rounds, sizable minorities of household members (29% and 47%) said they were saving the drugs for later.

The incidence of self-reported fever dropped from 4.2% (52 of 1,229 household members) in the month before round 1 to 1.5% (18 of 1,229) afterward, a significant difference (P < .0001). Those who reported completing the treatment had a greater decrease in fever incidence than those who didn't (from 6.4% to 1.5%, versus 2.2% to 1.6%).

The authors said their findings suggest that MDAs may be effective in reducing fever cases in malaria-ridden areas during Ebola outbreaks. They commented that the low drug uptake may have been due to health messaging and behavior in the pre-Ebola period and the ongoing lack of healthcare services.

"Combining MDAs during Ebola outbreaks with longer term interventions to prevent malaria and to improve access to healthcare might reduce the proportion of respondents saving their treatment for future malaria episodes," they wrote.
Aug 31 PLoS One report
Aug 31 PLoS press release


More hepatitis cases linked to smoothies, scallops

Eighteen more people have been infected with hepatitis A after consuming smoothies made with imported frozen strawberries, Food Safety News (FSN) reported today.

So far, 69 people in six states have gotten sick, 55 of them in Virginia. The Centers for Disease Control and Prevention (CDC) is now leading an epidemiologic investigation of the outbreak, according to the story.

The Virginia Department of Health (VDH) said that all of that state's victims became ill after having smoothies made with strawberries at Tropical Smoothie Cafe restaurants. There are other patients in West Virginia, Maryland, North Carolina, Oregon, and Wisconsin, but those states have yet to name a restaurant source for the foodborne illness.

The VDH said on its Web site that the smoothies were made with imported strawberries from Egypt, and consumed between early May and Aug 9. About 46% of case-patients have been hospitalized for their illness.

In related news, Hawaiian health officials now say 241 (13 more than last week) people have been infected with hepatitis A after consuming imported frozen scallops served raw at fast-food sushi restaurants, according to another FSN story today.

Sixty-four people have required hospitalization. On Aug 15, Hawaii embargoed the scallops imported from the Philippians, and 11 Genki Sushi restaurants have closed on Oahu and Kauai.
Sep 1 FSN smoothie story
Sep 1 FSN Hawaiian outbreak

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