News Scan for Dec 06, 2018

Flu shot rejection
Migrant heath misperceptions
Deadly yellow fever outbreak

Survey: 41% of Americans have no plans to get flu vaccine

According to a survey conducted in the middle of November, only 43% of Americans said they have been vaccinated against flu, 14% plan on being vaccinated, while 41% said they don't plan on being immunized against the disease.

The findings are from the National Opinion Research Center (NORC) at the University of Chicago, which conducts the national immunization survey for the US Centers for Disease Control and Prevention (CDC). This week marks the CDC's annual National Influenza Vaccine Week, designed to boost immunization levels ahead of the expected seasonal rise in flu activity.

Of adults with children in their households, 39% said they do not vaccinate their children against flu. The top reasons for declining the flu vaccine include concerns about side effects (36%), perceptions that the vaccine doesn't work (31%), or a belief they won't get sick (30%). Cost and lack of time were far down the list.

When asked about their perceptions of last flu season, which was severe, 63% incorrectly said they didn't think it was worse than usual or that they didn't know. However, those who were already immunized had higher levels of awareness.

Caitlin Oppenheimer, MPH, senior vice president of Public Health Research at NORC, said in a press release from the group that school and workplace flu clinics have made the vaccine more accessible. "Unfortunately, many people are still not getting flu shots due to broader misconceptions about the value of receiving a flu shot and concerns about the safety and efficacy of the vaccines," she said.

The poll included 1,202 interviews from a nationally representative sample of adults from randomly selected US households. It had a margin of error of plus or minus 3.9 percentage points at the 95% confidence interval, according to Eric Young, NORC senior external affairs manager.
Dec 5 NORC press release


Mortality analysis challenges perception that migrants pose health burdens

A large meta-analysis of studies on deaths in international migrants found that they have a mortality advantage compared with host country populations, contradicting the common perception that migrants are a health burden in high-income countries, a London-based team reported yesterday in The Lancet.

For their review, the researchers looked at 96 studies on mortality outcomes in international migrants that were published from January 2001 to April 2017. Though the studies covered all geographic regions, few studies included mortality estimates for refugees, asylum seekers, and labor migrants.

Overall, migrants had a mortality advantage across most categories, except for infectious diseases, including viral hepatitis, tuberculosis (TB), and HIV, and external causes such as assault or car accidents. However, the investigators said the results likely aren't generalizable to more marginalized groups and those in low- and moderate-income countries, because of much more limited data.

They said the findings highlight the need to improve data collection in groups such as refugees, asylum seekers, and undocumented migrants. Regarding the mortality findings in the group that had an advantage, they said the exceptions they found—infectious diseases and external causes—show where focused actions can improve migrant health and that of host countries, yielding several potential benefits that could include stronger global health security, improved infection prevention and control, and reduced burden of some infectious diseases.

Since mortality from infectious disease varies widely among migrants, the team said screening should be context-specific, developed with migrants, and be done only when a health benefit to migrants can be demonstrated.
Dec 5 Lancet

In a related development, the European Centre for Disease Prevention and Control (ECDC) yesterday published guidance on screening and vaccination for newly arrived migrants.

The agency said in a press release that it's probably cost-effective to screen children, adolescents, and adults for active and latent TB, HIV, hepatitis C, hepatitis B, strongyloidiasis and schistosomiasis. Also, the ECDC said there are clear benefits for enrolling migrants in vaccination programs and ensuring that they receive catch-up immunizations as needed, depending on disease burden in migrants' countries of origin.

The ECDC said migrants don't generally pose a threat to the host population, but some groups such as refugees and asylum seekers may be vulnerable to infectious diseases and have worse health outcomes than people in host countries.
Dec 5 ECDC statement


Nine new deaths in Nigeria yellow fever outbreak as trial of new drug begins

Nine people in Edo state, Nigeria, have died from yellow fever infections in the last month, according to Nigerian health officials yesterday, as reported by Xinhua. The Nigeria Centre for Disease Control (NCDC) said in a situation report that the cluster of cases in Edo were reported on Nov 22.

Nigeria has been battling a yellow fever outbreak since Sep 12, 2017. As of Nov 25, 2018, a total of 3,510 suspected cases, including 74 deaths, have been reported in all 36 states. The case-fatality rate is 2.1%.

Young people ages 1 to 10 years are the most affected, representing 40.5% of cases. Fifty-eight percent of cases have been in males.

In related news, Tychan, a biotechnology company based in Singapore, today announced the launch of a phase 1 trial of its first-in-class candidate drug for the treatment of yellow fever. The drug, TY014, is a monoclonal antibody. TY014 prevent viral replication of the virus by attacking its envelop protein.

The first healthy human volunteers were dosed with TY014 on Nov 26, and the trail will assess safety and tolerability. There are currently no approved drugs for treating yellow fever.  
Dec 5 Xinhua news story
Dec 5 NCDC situation report
Dec 6 Tychan press release

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