Proposal: Pay docs for counseling parents on childhood vaccines
Amid a widespread measles outbreak, the National Vaccine Advisory Committee (NVAC) is considering recommending that physicians be compensated for counseling parents about the importance of childhood vaccines, Bloomberg News reported yesterday.
The committee is also looking at a recommendation that would set a minimum vaccination coverage goal for clinicians, the story said.
It said the proposals were presented at an NVAC meeting yesterday by the co-chairs of a vaccine acceptance working group, Vish Viswanath, PhD, of the Harvard School of Public Health and Charles Mouton, MD, MS, of Meharry Medical College.
The panel will meet again in June to vote on its recommendations to the National Vaccine Program Office of the Department of Health and Human Services.
The report said the US government has vowed to reduce the number of measles infections acquired within the country to 30 or fewer within 5 years, compared with more than 600 last year.
Feb 11 Bloomberg News story
In related news, California added three more measles cases late yesterday to its count for an ongoing outbreak related to exposures at Disneyland, raising the total to 110 cases. That includes 39 people who visited Disneyland between Dec 17 and 20, and 37 with unknown sources of exposure.
Most of the patients were unvaccinated, the California Department of Public Health (CDPH) said in the update. Of 84 patients with available information, 17 (20%) were hospitalized.
Elsewhere, a measles outbreak in the Chicago area has increased to 11 cases with the addition of another case involving an infant who attends a day care center in the suburb of Palatine, according to an Associated Press (AP) report last night. Eight other infants and one adult also have measles linked to the center.
Feb 11 CDPH measles update
Feb 11 AP story
Study: More focus on marginalized may cut TB outbreaks in US
Initial source case-patients in tuberculosis (TB) outbreaks in the United States most commonly have a long infectious period and are part of marginalized populations, according to a study yesterday in Emerging Infectious Diseases.
The results underscore the importance of prompt diagnosis and improved contact investigations, particularly in these populations, in reducing the risk of outbreaks, the authors said.
Researchers from the Centers for Disease Prevention and Control (CDC) studied 26 TB outbreaks among the 65 that the CDC helped investigate in the United States from 2002 through 2011 that met selection criteria that included three or more culture-confirmed cases with epidemiologic links and matching Mycobacterium tuberculosis genotypes as well as an identifiable source case-patient.
Source patients were the first case-patients to come to the attention of public health authorities in 20 of the 26 selected outbreaks. The source patients had a median infectious period, defined as 3 months before symptom onset to start of treatment, of 10 months (range, 3 to 36 months). The predominant reason for the prolonged infectious periods was delayed diagnosis after seeking care in 15 (58%), with less common reasons being a delay in seeking care after symptom onset in 8 (31%) and noncompliance with treatment in 7 (27%).
Most source patients were male (23, or 88%) and US-born (19, or 79%), and black non-Hispanics outnumbered other racial/ethnic groups at 13 (50%). Excess alcohol use was present in 16 (62%) of source patients, as were illicit drug use in 14 (54%), homelessness in the previous year in 11 (42%), and a history of incarceration in 13 (50%).
The authors conclude that "Public health departments should work with local health care providers to address barriers to accessing care faced by marginalized populations and in recognizing and diagnosing TB once symptomatic patients seek medical attention."
Feb 11 Emerg Infect Dis dispatch
