News Scan for Nov 11, 2019

MERS in Saudi Arabia
Maternal flu vaccination benefits
Kids' flu vaccination factors
Infectious diseases in Africa

MERS infects 2 more in Saudi Arabia, 1 fatally

In updates yesterday and today, Saudi Arabia's Ministry of Health (MOH) reported two more MERS-CoV cases, one of them fatal and both from Riyadh.

One of the patients is a 33-year-old man whose contact with camels isn't known. He is not a health worker, and his exposure is listed as primary, meaning he probably didn't contract MERS-CoV (Middle East respiratory syndrome coronavirus) from another patient.

The other is a 38-year-old man who died from his infection. Like the first case, he wasn't a health worker and his case is classified as involving primary exposure.

Saudi Arabia has now reported seven MERS-CoV cases for November.

The World Health Organization (WHO) said in a recent update that since the virus was first detected in humans in 2012, it has received reports of 2,470 cases as of early October, at least 851 of them fatal. Most are from Saudi Arabia.
Nov 11 Saudi MOH report


Study adds more evidence that maternal flu vaccination protects babies

A study over two influenza seasons in England added more evidence that immunizing pregnant women helps reduce lab-confirmed flu and related hospitalizations in babies younger than 6 months old. A team from Public Health England reported their findings on Nov 9 in the Journal of Infectious Diseases.

For the study, they used information from a clinical practice database that included a newly available pregnancy registry, which allowed the researchers to more accurately assess pregnancy timing and maternal flu vaccine uptake. Their goal was to reassess the effectiveness of maternal flu vaccination in preventing flu and flu-related hospitalizations in infants younger than 6 months in England during the 2013-14 season and the 2014-15 season. The former was dominated by 2009 H1N1, and the latter by a drifted H3N2 strain.

They found overall vaccine effectiveness (VE) of 66% (95% confidence interval [CI], 18% to 84%) in the 2013-14 season and a VE of 50% (95% CI, 11% to 72%) for 2014-15. VE for flu-related hospitalization was similar. Against the dominant 2009 H1N1 strain in 2013-14, VE was higher at 78% (95% CI, 16% to 94%), and against the drifted H3N2 strain the following season, VE was 60% (95% CI, 16% to 81%).

The results provide further evidence that maternal flu vaccination is effective against lab-confirmed flu and flu hospitalizations in young babies, even against a drifted H3N2 strain. Researchers noted their findings were similar to earlier studies from Bangladesh and South Africa, were somewhat higher than results from Mali and Nepal, and in the midrange of two observational studies from the United States. "Maternal vaccination is a valuable approach to protect infants (for whom seasonal influenza vaccine is not currently licensed) from influenza-related morbidity," they wrote.
Nov 9 J Infect Dis abstract


Flu vaccination in kids not tied to season severity, vaccine effectiveness

A study that looked at flu season severity, vaccine effectiveness, and flu vaccination rates in children found no association between vaccination rates and severity of the current or prior season. A team based at Columbia University reported their findings today in JAMA Pediatrics.

They based their findings on their analysis of publicly available data from the US Centers for Disease Control and Prevention for 2010 to 2017 seasons, looking at vaccination rates for four different pediatric age groups, flu severity designations for pediatric patients, and flu VE.

Along with a lack of association between vaccination and flu season severity, they also found no significant link between uptake and current or prior year flu VE, which over the study period ranged from 19% to 60%. However, they did see a slight decline in vaccination rates in 2015 after a very low flu VE of 19% in 2014.

Researchers said it's possible that effects of season severity and VE may be cumulative, reducing uptake if trends persist for multiple years.

The general decline in flu vaccination rates across age groups over recent years is alarming, they wrote, adding that the pattern could reflect the antivaccine movement or a mix of factors, which could include misperceptions about flu risk and severity, and lack of confidence in vaccine effectiveness, vaccine safety, and healthcare authorities. More studies are needed to tease out the factors that drive vaccination decisions, the group said.
Nov 11 JAMA Pediatr abstract


Cholera tops infectious diseases in WHO African member states in 2018

A new survey of infectious disease outbreaks in WHO African member states in 2018 shows that cholera was the most commonly reported disease outbreak, accounting for 20.8% of outbreak events. The study appears today in Epidemiology & Infection.

The WHO African region carries the largest infectious disease burden in the world, and the study was a retrospective descriptive analysis using records of all infectious disease outbreaks formally reported to the WHO in 2018 by member states of the African region, the authors said.

A total of 96 new disease outbreaks were reported across 36 of the 47 member states in 2018, and a total of 107,167 people were directly affected including 1,221 deaths (mean case fatality rate, 1.14%; 95% CI, 1.07% to 1.20%).

In addition to cholera, measles and yellow fever accounted for a large proportion of outbreaks, 11.5% and 7.3%, respectively.

About 25% of all outbreaks were reported to the WHO by member states based on signals detected through media monitoring.
Nov 11 Epidemiol Infect study

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