News Scan for Nov 28, 2018

More measles in NY, NJ
PPE after MERS
RSV in older people

New York, New Jersey record more measles cases

Both New York and New Jersey reported more cases of measles in ongoing outbreaks in communities near New York City.

Rockland County, New Jersey, reported 4 more cases, bringing its total to 80. And health officials in New York confirmed 5 more cases in an Orthodox Jewish community in Brooklyn. Outbreak totals there now stand at 29.

According the Rockland County health department, the current outbreak began in September with a case in an unvaccinated foreign traveler. Subsequent cases have been in unvaccinated residents.

In New York, the index case involved an unvaccinated child who contracted the virus in Israel in October, where this is a large, ongoing measles outbreak. "If you plan to travel to Israel, protect yourself against measles and get vaccinated at least two weeks in advance of your trip. If you have traveled to Israel and you have a fever, cough, red eyes, runny nose and body rash, contact your doctor," NYC Health said on its website.

Both health departments recommend vaccination. Typically, the measles vaccine is given in two doses, one between the ages of 12 and 15 months, and a second before kindergarten. In Rockland County, children 6 months through 11 months are encouraged to start the vaccine now.
Nov 27 Rockland County statement

Nov 28 NYC Health statement


MERS outbreaks in Saudi Arabia led to increased PPE use

According to a study yesterday in the American Journal of Infection Control, the MERS-CoV epidemic that began in Saudi Arabia in 2012 resulted in more use of personal protective equipment (PPE) among Saudi healthcare workers.

To conduct the study, the authors tracked the use of gloves, surgical masks, N95 respirators, alcohol-based hand sanitizer, and soap during April and May of 2013 at a Saudi hospital, which had 17 positive and 82 negative cases of MERS-CoV (Middle East respiratory syndrome coronavirus) from Apr 1 through Jun 3 of that year. Use was compared with the previous year, before any MERS cases were diagnosed at the hospital, and the months immediately following the first confirmed cases.

The researchers determined that PPE use rose from 2,947.4 to 10,283.9 per 1,000 patient-days compared with the period before MERS cases. Hand hygiene compliance rates increased from 73% just before the occurrence of the first MERS case to 88% during MERS cases (P = .0001).

"The monthly added cost was $16,400 for the included infection control items, such as hand sanitizers, soap, surgical masks, and N95 respirators," the authors wrote. "Such an increase is a challenge and adds cost to the health care system."
Nov 27 Am J Infect Control study


Study: 11% of adults over 60 contract RSV in winter

Though the dangers of respiratory syncytial virus (RSV) among infants are well-documented, less is known about how the seasonal virus affects adults. A new study from investigators at the Marshfield Clinic Research Institute in Wisconsin tracked RSV among adults over the age of 60 from the 2004-05 winter through the 2015-16 season to determine the virus's epidemiology and burden of disease.

The study results are published in Open Forum Infectious Diseases.

According to the study, 13% of patients over the age of 60 who had acute respiratory symptoms tested positive for RSV (241 of 1,832 individuals). The clinical outcome was serious in 47 (19%) of patients, moderate in 155 (64%), and mild in 41 (17%). Twenty-nine patients were hospitalized (13 in the emergency department), and 23 developed pneumonia.

Patients who were older than 75 and those with chronic obstructive pulmonary disease were more likely to suffer more serious outcomes.

"Moderate or serious outcomes, including change in therapy, hospital admission, and pneumonia, occurring in over 80% of patients with laboratory-confirmed RSV infection," the authors concluded, noting that RSV was the second most common viral pathogen in this age-group.
Nov 27 Open Forum Infect Dis study



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