News Scan for Aug 11, 2015

News brief

18 buildings positive for Legionnaires' in NY, 11 of them in Bronx

Eighteen cooling tower sites have tested positive for Legionella in or near theSouth Bronx area rocked by an outbreak of Legionnaires' disease that has sickened 113 people recently, according to a New York City Department of Health and Mental Hygiene (DOHMH) press release yesterday.

Eleven of the sites lie within the impact zone; four that lie outside the zone had tested positive previously and three more outside the zone showed Legionella in recent days. The contaminated sites outside the zone are not necessarily related to the current outbreak, says DOHMH.

Cooling towers are used in some buildings to recirculate water as part of the air-conditioning, ventilation, and/or heating system. Every cooling tower that has tested positive in the impact zone has been immediately ordered to be disinfected and remediated.

An Aug 10 New York State Department of Health (NYSDH) update said that 500 building sites in the Bronx had be canvassed over the previous 2 days. All testing is being done by one lab, the Wadsworth Laboratory in Albany, for the sake of uniformity.

On Aug 6, New York Governor Andrew Cuomo announced that buildings across the state that have cooling towers or evaporative condenser units were eligible for free Legionella testing.

Twelve of the 113 patients who have contracted Legionnaires in the South Bronx died; all were adults with underlying medical conditions, says a DOHMH fact sheet. No new cases have been reported since Aug 3.
Aug 10 DOHMH press release
Fact sheet
Aug 6
order for building disinfection
Aug 10 NYSDH


Early results promising for RSV vaccine in seniors

A phase 2 trial of a candidate vaccine against respiratory syncytial virus (RSV) suggests that it is safe and effective in older people, pharmaceutical company Novavax said yesterday in a press release. The study, also designed to show the RSV disease burden in people aged 60 and older, found a 4.9% attack rate.

Novavax's vaccine is a recombinant F-protein nanoparticle candidate, and the company said the trial is the first to show efficacy in any population for any RSV vaccine.

The randomized, observer-blinded, placebo-controlled trial involved 1,600 participants from 10 sites across the United States. It looked at all respiratory illnesses linked to RSV in community-living adults who were part of the placebo group and at the safety and immunogenicity to a unadjuvanted 135-microgram dose when compared with placebo.

Researchers also estimated the vaccine's efficacy in reducing RSV illness. They reported statistically significant vaccine efficacy in preventing all symptomatic RSV disease (44%) and RSV with lower respiratory tract infection (46%). They said the efficacy is in line with that of other licensed respiratory disease vaccines tested in older adults.

The attack rate finding of 4.9%, 95% of which included lower respiratory tract symptoms, confirms the burden of disease in the older population, the company said.

Monitoring of antibody titers after vaccination suggested a robust immune response, and the safety profile in those who received the vaccine was similar to that of unvaccinated participants, according to Novavax.

The company said it looked forward to presenting further data and hopes to launch a phase 3 study in late 2015. It also added that it expects to announce phase 2 findings for the vaccine for infants who were protected by maternal immunization.
Aug 10 Novavax press release


Study outlines wide variation in flu vaccine impact

The impact of flu vaccination varies widely from year to year and from region to region, even in areas with high uptake, US researchers reported today in an early online edition of Vaccine.

Researchers looked at clinic visits for flu at five sites that are part of the US Influenza Vaccine Effective network. The locations are in Michigan, Pennsylvania, Texas, Washington, and Wisconsin. They looked at the patterns for flu and flu clinic visits over two flu seasons: 2011-12, which was mild, and 2012-13, which was more severe. Flu vaccines were well matched to the circulating strains in both seasons.

Overall, flu incidence was eightfold greater during the latter flu season, when 64.5 per 1,000 of the insured population sought care for flu.

Though flu vaccine effectiveness was similar for both seasons, variations in attack rates and vaccine uptake led to dramatic differences in outpatient visits averted by vaccination. The team found that clinic visits averted by the flu vaccine varied tenfold across the sites by season, from 4.1 per 1,000 vaccinees in Texas during the mild season to a high of 41.0 per 1,000 in Wisconsin during the more severe season.

Researchers even saw variation within the same flu season among sites that had high vaccine coverage, due to differences in attack rates.
Aug 11 Vaccine abstract


Infant varicella vaccination linked to shingles increase in younger adults

Childhood vaccination against varicella (chickenpox) may nearly double shingles risk 30 to 40 years later, according to a study today in eLife.

Researchers from the University of Antwerp and Hasselt Universityin Belgium and Australia's University of New South Wales modeled the effect of vaccinating all 1-year-old children in the Belgian population against varicella-zoster virus (VZV).

The model predicted that infant VZV vaccination would lead to 1.75 times more shingles cases than would have occurred without vaccination but that the effect would be temporary. Many of these cases were predicted to occur in people aged 31 to 40, who, unlike older people who have previously been considered to be the main bearers of any increased incidence, are less likely to develop lasting shingles-related complications like post-herpetic neuralgia.

The researchers also found that, among vaccinated people, re-exposure to VZV through contact with infected individualsboosted immunity for only about 2 years . This differs from previous studies suggesting that extra protection from re-exposure can last up to 20 years.

Many countries have hesitated to implement childhood VZV vaccination due to concerns that the vaccine may lead to an increase in shingles cases, particularly in older people,and that it may reduce immune-boosting effects by limiting re-exposure to the virus. The current study's findings, say the authors, "may allay some fears about implementing childhood varicella vaccination programs."
Aug 11 eLife study


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