NEWS SCAN: Flu in New Zealand, fatal resistant infection, Q fever and raw milk, SE Asian pandemic exercise

Aug 16, 2010

Rising H1N1 flu in New Zealand may exhaust vaccine supply
New Zealand's health ministry said today that a continued rise in pandemic flu activity has prompted the government to begin issuing public updates twice a week rather than weekly. Calls to New Zealand's flu phone line are running 35% higher than the normal seasonal level, with about 1,400 calls each day over the weekend, according to a ministry statement. Ten people are being treated in intensive care units (ICUs). Six deaths so far this year have been reported as linked to pandemic H1N1 flu, but four of those have not yet been confirmed. School surveillance, however, suggests that absenteeism rates are normal for this time of year. The health ministry is urging the public to get vaccinated, though it warned that only about 6,400 doses remain, enough to last through the end of August. Officials are exploring options for extending immunizations.

First death related to new bacterial resistance factor reported
A Belgian who died in June is the first person known to have died of an infection with a bacteria carrying a recently identified enzyme, called NDM-1, that confers resistance to carbapenem and other powerful antibiotics, according to an Aug 13 Associated Press report. The Belgian became infected while hospitalized in Pakistan after a car accident, and he died in a Brussels hospital after returning home, despite treatment with colistin, the story said. Although the resistance factor had been reported previously, it sparked widespread news coverage when it was described in Lancet Infectious Diseases Aug 11. The report said NDM-1–producing bacteria are spreading in India and Pakistan and have also been found in Britain. NDM-1 is encoded by a gene that can jump bacterial species and has been reported in several species in the Enterobacteriaceae family. Meanwhile, the Times of India reported today that discovery of the resistance problem has triggered a discussion about the need for an Indian national policy to curtail the "irrational use" of antibiotics and increase surveillance for resistance. In other developments, a news report noted that a March study in the Journal of the Association of Physicians of India (JAPI) described 22 cases of NDM-1 infections at a hospital in Mumbai. In an accompanying editorial, an Indian infectious disease specialist harshly criticized Indian physicians for overusing antibiotics.
Aug 16 Times of India report
March 2010 JAPI report
March 2010 JAPI editorial

Q fever agent found in US raw milk
A small study suggests that Coxiella burnetii, the cause of Q fever, is fairly common in raw milk sold in the United States, possibly adding to the well-known risks posed by this commodity. The researchers found the pathogen in 9 of 21 (43%) raw milk samples taken at dairies in seven states: Washington, California, Oklahoma, Texas, Florida, Georgia, and South Carolina. The positive samples came from 8 of 20 dairies included in the study, says the report, published online Aug 12 by Foodborne Pathogens and Disease. The pathogen was found in 8 of 14 cow milk samples and 1 of 7 goat milk samples. The 43% rate of contamination was lower than what was found (over 90%) in a 2005 study that tested commercial dairy milk before pasteurization (which kills the pathogen), but the authors said the small sample size in this study prevents comparison. C burnetii is found in cattle, sheep, and goats worldwide, and humans most commonly contract it by inhaling contaminated barnyard dust, according to the Centers for Disease Control and Prevention (CDC). Although the CDC lists consumption of raw milk as a risk factor for Q fever, the study authors write, "The pathogenesis of Q fever after oral exposure in humans is unknown, limiting our ability to assess the public health risk of this finding." They say further research is needed to learn the infectivity and pathogenicity of C burnetii after ingestion.
Foodborne Dis Path study

Southeast Asian nations test severe pandemic scenario
Ten countries that are part of the Association of Southeast Asian Nations (ASEAN) began a 4-day exercise today to gauge for the first time how a severe pandemic would affect essential services in each country and the whole region. The group is meeting in Phnom Penh, Cambodia, according to a statement today from the United Nations, which is cohosting the event with ASEAN. The simulation is designed to test how a pandemic would affect a range of services, especially energy, transportation, and healthcare. The scenario features a communicable disease that arises on the continent of Pandemica, with five countries having economic and infrastructure conditions resembling those of Southeast Asia.
Aug 16 United Nations press release

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