NEWS SCAN: H5N1 & FMD in Egypt, flu vaccine in toddlers, biodefense bill's chances, antimicrobial stewardship, dog food Salmonella

May 14, 2012

Avian flu, FMD pose dual threat to Egypt's health
Because of a barely functioning public health infrastructure made worse by the February 2011 revolution, Egypt is reeling from rampant avian flu and foot-and-mouth disease (FMD), according to a story in The Atlantic today. By late April, FMD had claimed more than 20,000 cattle, buffalo, sheep, goats, camels, and other livestock across Egypt after being imported from Libya, where it resurged last year. The rapid spread of FMD has sent meat prices soaring in Egypt, which has made poultry all the more vital as a source of protein. However, avian flu continues unabated in the country for a seventh year, leading to the demise of millions of birds. In addition, the country has now confirmed 167 H5N1 avian flu cases in people, including 60 fatal ones, according to World Health Organization data. Both threats require extensive government involvement, something the new president—who will be elected May 23—will need to address, according to the story.
May 14 Atlantic article

Study finds very low flu vaccine uptake in Ontario toddlers
Offering free flu shots to children under 2 years old has boosted uptake in this age-group very little in Ontario, and, in fact, the percentage of those who received them has fallen to 4% to 6% in recent flu seasons, according to a study today in Pediatrics. Canadian researchers looked at data on 760,000 young children born from April 2002 to March 2008. Ontario began offering flu vaccine in 2000, according to a Canadian Press (CP) story today on the study. The investigators found that 1% of kids aged 6 to 23 months in the first year of the study (2002-03) were fully immunized. That rate climbed to 7% to 9% for the following three seasons but then dropped to 4% to 6% from 2006-07 to 2008-09. Senior author Astrid Guttmann, MD, MSc, a Toronto pediatrician, attributed the low uptake to "vaccine fatigue": the phenomenon of parents growing weary of having their children receive multiple shots. "I think the prioritization that goes on, again, at physicians' offices really is: If parents are going to say yes to two and not three [vaccines], which ones are you going to give?" Guttmann told the CP.
May 14 Pediatrics abstract
May 14 CP story

Ex-senator says committee rivalries may doom biodefense bill
The former co-chair of a congressionally appointed commission on terrorism said a biodefense bill that cleared a House committee last week is likely to fail because of rivalries among the multiple congressional committees that deal with homeland security, according to a report by The Huffington Post. The story said the proposed WMD Prevention and Preparedness Act of 2011—approved last week by the House Homeland Security Committee—now must go before four other House committees: Energy and Commerce, Transportation and Infrastructure, Foreign Affairs, and Select Intelligence. Because of these overlapping jurisdictions and related rivalries, former Sen. Bob Graham, who co-chaired the Commission on the Prevention of Weapons of Mass Destruction [WMD] and Terrorism, said the bill is "almost assured of failure." The bill calls for appointing a special White House advisor to lead the development of a national biodefense plan and biosurveillance strategy and to identify gaps and duplication in biodefense activities. The story said 108 House and Senate committees and subcommittees claim influence over the Department of Homeland Security, which took over the functions of all or parts of 22 federal agencies.
May 11 Huffington Post story

Study: Antimicrobial stewardship program cut C difficile rate in half
An antimicrobial stewardship program (ASP) at a Michigan hospital cut the rate of Clostridium difficile infections in half while reducing antimicrobial use and pharmacy costs, according to a report today in the American Journal of Infection Control. Staff members at St. Joseph Mercy Hospital, a 535-bed community hospital in Ann Arbor, assessed the program's effects by comparing data from its first year with data from the preceding year. In the program, an ASP team made up of infectious disease (ID) physicians and intensive care unit pharmacists audited the use of eight antimicrobials daily. Of 510 antimicrobial orders that were reviewed in the first year, 63% were rated as appropriate, 18% prompted a switch to an agent with a narrower spectrum, 12% were denied, and 5% led to a consultation with an ID physician. A multivariate analysis indicated that the program reduced the rate of C difficile infections by about half (odds ratio, 0.46; 95% confidence interval, 0.25 to 0.82), although there was no decrease in mortality at 30 days after discharge or in readmission rate. The antimicrobial budget dropped by 15.2% (a $228,911 savings), and defined daily doses of the target antimicrobials shrank by 25.4%.
May 14 AJIC abstract

Another case cited in dog food Salmonella outbreak
A multistate outbreak of Salmonella Infantis infections linked to contact with dry dog food has sickened one more person, raising the total to 15 cases in nine states, the US Centers for Disease Control and Prevention (CDC) reported on May 11. The latest reported illness onset was Apr 16. The outbreak has also caused one case in Quebec, according to a recent statement from the Public Health Agency of Canada (PHAC).The outbreak was uncovered by PulseNet, the CDC's national subtyping network for identifying foodborne bacteria, after routine tests on dry dog food by Michigan officials found Salmonella contamination. The investigation has prompted the recall of several brands made by Diamond Pet Foods at its facility in Gaston, S.C. The PHAC said the pet food was distributed in British Columbia, Ontario, Quebec, and New Brunswick and may have been distributed in other provinces and territories. Diamond Pet Foods has recalled certain batches of 11 different pet food brands made at the Gaston facility.
May 11 CDC outbreak update
PHAC statement

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