NEWS SCAN: Historian grades pandemic response, promoting flu shots, food safety standards, Bangladesh H5N1 project

Jul 7, 2010

Barry says world's pandemic response flawed by political missteps
In an assessment of how the world has handled the H1N1 pandemic, historian John M. Barry, author of a widely acclaimed 2004 book on the 1918 pandemic, praised the scientific and medical response but said the arrival of a pandemic that was milder than anticipated threw the world off balance, revealing flaws in some national health systems and in international relations. Barry's analysis appears in the summer issue of World Policy Journal, a publication from the Massachusetts Institute of Technology. He wrote that public health officials have learned many lessons, such as the potential usefulness of a pandemic severity scale and the need for better and faster vaccine technology, from the pandemic response. But he said countries don't seem as willing to learn political lessons from their experience. For example, he wrote that the World Health Organization (WHO) has become a scapegoat for critics of the response, whose charges of pharmaceutical industry influence he called "nonsense." Barry said some countries, out of fear or political reasons and against the advice of global health and agriculture groups, imposed unwarranted trade and travel restrictions. He criticized the United States for backpedaling on a commitment to share vaccine with developing countries, Egypt for slaughtering pigs, Indonesia for underestimating the disease threat, and China for efforts to brand the virus a "foreign disease." Barry wrote that such actions are counterproductive, hurt national credibility, and make the world vulnerable to other disease threats such as H5N1 avian influenza.
'Opt-out' approach may boost flu immunization rates
Automatic scheduling of influenza shots—making vaccination the "default" option—may be an effective way to increase flu vaccination rates in institutional settings, according to a research letter published today in the Journal of American Medical Association (JAMA). To test the approach, researchers at Rutgers University randomly assigned 480 faculty and staff members to "opt-out" or "opt-in" groups. Those in the opt-out group were notified by e-mail that they had been scheduled to receive a flu shot but that they were free to cancel or change the appointment. The opt-in group received an e-mail saying that free flu shots were available and pointing to a Web page where recipients could make an appointment. Those with appointments were sent a reminder 5 days later. The results were that 108 of 239 (45%) people in the opt-out group were vaccinated, versus 80 of 239 (33%) in the opt-in group, a significant 36% increase. Only 18 opt-out participants (8%) canceled their appointments, while 50 opt-in participants (21%) made appointments, and those with appointments were more likely to be immunized than those without. Both approaches give people a choice, but the opt-out approach increases the likelihood of their getting vaccinated, the researchers conclude.
Jul 7 JAMA research letter abstract

Global food safety group addresses melamine, fresh greens, seafood
The Codex Alimentarius Commission, the United Nations (UN) food standards group, which met this week in Geneva, has offered new guidance on several food safety issues. The commission issued a ruling limiting melamine content in food, offered guidance on fresh greens and seafood safety, set maximum levels of aflatoxins in Brazil nuts, and established new methods for food sampling and analysis. The melamine limits are designed to help governments distinguish low levels of melamine that get into food during production processes from levels associated with deliberate adulteration, according to a statement from the World Health Organization (WHO), which runs the commission along with the UN Food and Agriculture Organization. Though the melamine standards aren't legally binding, they allow countries to refuse importation of products that contain excessive melamine. The group's new guidance for fresh greens covers production, harvesting, packing, processing, storage, distribution, marketing and consumer education to reduce risks associated with these products. To minimize bacterial contamination in seafood, such as Vibrio in oysters, the commission's new guidance describes how to control the pathogen throughout the food chain.
Jul 6 WHO statement

US efforts help reduce H5N1 risk in more Bangladesh bird markets
A US government agency and its Bangladeshi partners yesterday launched new efforts to decrease the risk of H5N1 avian influenza at live bird markets in Bangladesh, according to a press release from the US State Department. Funded by the US Agency for International Development (USAID), the STOP AI (Stamping Out Pandemic and Avian Influenza) Bangladesh project started conducting cleaning and disinfection at a live bird market in Sreepur in the country's Gazipur district. USAID collaborated with local and market officials to develop a plan to prevent the spread of H5N1 in birds and people. Improvements include renovating the water supply and adding a proper waste-disposal facility and a slaughterhouse. USAID had previously piloted cleaning and disinfection programs at two markets in Dhaka, which led to a program expansion that upgraded 19 more markets in Gazipur and Dinajpur districts.
Jul 6 US State Department press release

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