News Scan for Jan 18, 2018

News brief

Analysis: Reminders boost vaccination numbers

Reminding people when it's time to receive immunizations—through postcards, texts, and automated phone calls—can increase vaccination numbers, a team of Cochrane researchers reported today, based on an extensive review of 75 studies from 10 countries. Their findings appear in the Cochrane Library.

They noted that although immunization rates are improving, under-vaccination is still a problem, especially for diseases such as measles. And they added that reminders, sent when vaccination is due, and recalls, sent when vaccines are overdue, target common reasons for missed immunizations, such as forgetting, missing appointments, not knowing immunization schedules, and having concerns about vaccinations.

Some of the studies involved multiple interventions addressing more than one vaccination target group. Some of the vaccines included in the studies included routine ones for children, flu shots for children and adults, adolescent vaccines, and routine vaccines for adults such as tetanus or hepatitis B. The studies compared different reminder methods with no reminders, media-based activities, or practice-based awareness campaigns.

Combining results from children and adults, researchers found that 8% more people were vaccinated after a reminder compared with no reminder, with high-quality evidence that postcards, text messages, and phone calls were all effective delivery methods.

Julie Jacobson Vann, PhD, MS, RN, lead author who is with the University of North Carolina at Chapel Hill School of Nursing, said in a press release from Wiley, the Cochrane Library's publisher, "All types of patient reminder and recall are likely to be effective, and reminding people over the telephone was most effective. Even a small effect of patient reminders and recalls, when scaled to a whole population, could have a large beneficial effect on public health."
Jan 18 Cochrane Library report
Jan 18 Wiley press release

 

Second UK H5N6 outbreak expands protection zone to entire country

The United Kingdom today reported its second recent detection of a highly pathogenic H5N6 avian influenza reassortant in wild birds, this time at a nature park in Warwickshire, according to a notification to the World Organization for Animal Health (OIE). The detection comes just 7 days after the country's first detection of the virus, which involved mute swans found dead in Dorset, located in far southern England about 150 miles south of Warwickshire.

In the latest outbreak, 13 birds were found dead, mostly black-backed gulls and tufted ducks.

In a statement today, the UK's Department for Environment, Food, and Rural Affairs (DEFRA) announced that as a result of the second outbreak it was extending a protection zone to all of the country requiring bird keepers to follow strict biosecurity measures. It added that 31 infected wild birds have now been found at the outbreak site in Dorset, up from 17 reported last week.
Jan 18 OIE report on H5N6 in the UK
Jan 18 DEFRA report

In avian flu developments elsewhere, Japan's government reported that H5N6 has been found in a hawk found dead in a Tokyo park and that H5 has been detected in a wild bird from Shimane prefecture, according to environment ministry reports translated and posted yesterday by Avian Flu Diary (AFD), an infectious disease news blog.

Meanwhile, Taiwan reported three more highly pathogenic H5N2 outbreaks on poultry farms in different counties with start dates ranging from Jan 2 to Jan 10. One death was reported among 8,447 susceptible birds, and the remaining ones were culled to control the spread of the virus. The affected counties are Yunlin, Pingtung, and Chiayi.
Jan 17 AFD post
Jan 18 OIE report on H5N2 in Taiwan

 

Gunmen kill 2 polio workers in Pakistan

Two female health workers administering oral polio vaccine were murdered in the city of Quetta today, according to Reuters. Though no group has claimed responsibility for the violent attack yet, in the past similar acts have been carried out by Islamic militants who believe childhood immunization is un-Islamic.

The women were a mother and daughter team who were giving oral drops to children when two men on a motorcycle shot them. They died en route to the hospital.

The current immunization campaign is taking place in five districts of Baluchistan province, of which Quetta is the capital. In 2015, suicide bombers in Quetta killed 15 people outside a vaccination center. That act was claimed by the Pakistani Taliban and another militant group, Jundullah.

Pakistan, Afghanistan, and Nigeria are the only countries in the world in which polio is endemic.
Jan 18 Reuters story

Stewardship / Resistance Scan for Jan 18, 2018

News brief

Spanish clinicians report successful ICU stewardship program

An antimicrobial stewardship program (ASP) in an intensive care unit (ICU) in a Spanish hospital was associated with a 22% drop in antimicrobial doses, according to a new study in Antimicrobial Agents and Chemotherapy.

Investigators evaluated defined daily doses (DDDs) of antimicrobials per 1,000 patient-days and days of therapy (DOT) per 100 occupied bed-days in a Barcelona ICU before and after ASP implementation (2007-2010 vs. 2011-2015). They also measured associated costs. Data were compiled on 1,971 patients in the pre-ASP period and on 3,031 patients after ASP implementation.

The researchers reported that the percentage of patients treated with one or more antimicrobials dropped from 88.6% to 77.2%, DDDs decreased from 246.8 to 192.3, or 22.1%, and DOT were reduced from 66.7 to 54.6 (an 18.1% drop). The mean cost per trimester decreased from €115,543 ($141,302) to €73,477 ($89,858), a €42,065 ($51,443) savings, and the percentage of the total cost of hospital antimicrobials attributed to ICU antimicrobials decreased from 28.5% to 22.8%.

The cost savings over the 5 years that the program was implemented amounted to almost €1 million ($1.2 million).
Jan 16 Antimicrob Agents Chemother study

 

German study finds varying antibiotic resistance levels in gonorrhea

A German study published yesterday in BMC Infectious Diseases found low levels of cephalosporin resistance in gonorrhea cases, but resistance was moderate to high against other antibiotics.

Researchers with the country's Gonococcal Resistance Network surveillance system analyzed susceptibility data on samples collected from patients from April 2014 to December 2015. All told, 90% of the 537 Neisseria gonorrhoeae isolates were from men, with a median age of 32 for men and 25 for women.

None of the isolates were resistant to ceftriaxone, and 1.9% (in 2014) and 1.4% (in 2015) of the isolates were resistant to cefixime. But 11.9% and 9.8% of samples showed resistance against azithromycin in 2014 and 2015, respectively, compared with 72.0% and 58.3% for ciprofloxacin and 29.1% and 18.8% for penicillin.

The authors concluded, "Continued surveillance of antimicrobial drug susceptibilities for N. gonorrhoeae remains highly important to ensure efficient disease management."
Jan 17 BMC Infect Dis study

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