News Scan for Aug 22, 2018

HPV vaccine and premature menopause
Cyclospora expert panel

Study shows HPV, other vaccines not tied to premature menopause

Preteen girls, teens, and young women who receive recommended vaccinations, including for human papillomavirus (HPV), have no increased risk of primary ovarian insufficiency (POI), also called premature menopause, according to a study published yesterday in Pediatrics.

Published case series have suggested a potential association between HPV vaccination and POI, the authors wrote. Kaiser Permanente researchers sought to estimate the risk of POI after vaccines targeting HPV, flu, meningococcus bacteria, and tetanus, diphtheria, and pertussis (the Tdap vaccine).

The investigators combed through Kaiser Permanente Northwest electronic health records for outpatient diagnoses suggestive of POI in female patients aged 11 to 34 years from 2006 (when HPV vaccines became available at Kaiser) through 2014. From a cohort of 199,078 female patients, they identified 46 cases of POI with an unknown cause.

The team calculated an adjusted hazard ratio of 0.30 after HPV vaccine, 0.88 after Tdap, 0.94 after meningococcal vaccine, and 1.42 after flu vaccine.

"Reports of premature menopause after HPV vaccination have received a lot of media attention, including on social media," said lead author Allison Naleway, PhD, in a Kaiser Permanente news release. "However, these reports were based on a small number of isolated cases and must be interpreted with caution. To bring clarity to this issue, we conducted a study of nearly 200,000 young women and found no elevated risk of POI after HPV or other recommended vaccinations.

"In a population of 58,871 young women who received the HPV vaccine during the study period, we found only one case of an individual who possibly had symptoms of primary ovarian insufficiency after vaccination. If POI is triggered by the HPV vaccine or another recommended adolescent vaccine, we would have expected to see higher incidence."
Aug 21 Pediatrics study
Aug 21 Kaiser Permanent news release


Fresh Express announces expert panel to help industry solve Cyclospora

Fresh Express, whose produce has been tied to a large McDonald's-related outbreak of cyclosporiasis cases, yesterday announced it has formed a "blue ribbon" panel to study the Cyclospora parasite with the aim of reducing outbreaks in fruits and vegetables.

The panel will be chaired by renowned epidemiologist and infectious disease expert Michael T. Osterholm, PhD, MPH, of the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP), the publisher of CIDRAP News.

"Recent Cyclospora outbreaks, with limited evidence as to how they originated, have perplexed federal and state public health officials as well as food safety experts throughout the fresh produce industry, including Fresh Express," said Fresh Express President John P. Olivo in a news release. "The purpose of the Fresh Express Blue-Ribbon Panel is to assemble an interdisciplinary group of independent scientific experts to better understand Cyclospora's mode of action and how the industry can better guard against future outbreaks."

"The Cyclospora organism has contaminated certain fresh produce during spring and summer months, leaving public health officials unable to determine a confirmed origin despite their best efforts," Osterholm said. "Although the fresh produce industry works hard to ensure strong food safety standards, the yearly rounds of Cyclospora outbreaks now demand industry-focused attention."

According to Fresh Express, the full roster of panel members will be announced soon, with a final report and recommendations planned for release in early 2019.

The Cyclospora outbreak linked to McDonald's salads and a Fresh Express processor in Illinois has caused at least 476 illnesses and 21 hospitalizations, according to an update last week from the Centers for Disease Control and Prevention.
Aug 21 Fresh Express press release
Aug 17 CIDRAP News scan on outbreak

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