NEWS SCAN: HUS treatment patented; cholera in Haiti; bloodstream infections; polio in Pakistan, DR-Congo; hand washing in schools

Feb 28, 2011

Treatment for hemolytic uremic syndrome patented
Researchers at Tuft University's Cummings School of Veterinary Medicine have received US patent approval for an antibody-based treatment for hemolytic uremic syndrome (HUS), a potentially fatal complication of Escherichia coli infection and a leading cause of kidney failure in children. HUS is caused by the forms of E coli that produce Shiga toxins and sicken about 100,000 people in the United States each year, according to a Tufts press release. The patented approach developed by Dr. Saul Tzipori, director of the Cummings School's Division of Infectious Diseases, uses human monoclonal antibodies that seek out and bind to Shiga toxins and neutralize them. Tzipori and his colleagues used antibodies from transgenic mice specially bred to express human antibodies. Typically, patients infected with E coli will develop bloody diarrhea and recover, but from 5% to 15% of children, the elderly, and the immunocompromised may develop HUS, according to the release. The condition can lead to chronic, irreversible kidney damage and even death.
Feb 28 Tufts press release

Haiti's cholera outbreak numbers continue to drop
Haiti's cholera outbreak has stabilized, and the number of new cases reported each day continues to decline in all 10 of the country's departments, the Pan American Health Organization (PAHO) said in a Feb 25 update. Clusters of cholera cases are still being reported in isolated areas. As of Feb 21 the health ministry reports 234,303 cholera cases, including 4,533 deaths. PAHO said the health ministry has raised concerns about health partners pulling out of Haiti without identifying facilities that can replace them. Some groups have stopped public information campaigns about the disease, due to a lack of funding. However, in West department, community officials are seeking support for a public information campaign about methanol poisoning. Since late January a disease diagnosed as encephalitis caused by ingestion of adulterated clairin, an alcoholic beverage made in Haiti, has killed 12 and sickened 30 more.
Feb 25 PAHO cholera update

CDC notes major reduction in ICU central-line bloodstream infections
Over the past 9 years, the number of central line–associated bloodstream infections (CLABSIs) in US intensive care units (ICUs) has decreased by an estimated 58%, according to a Centers for Disease Control and Prevention (CDC) study released today in Morbidity and Mortality Weekly Report (MMWR). This large reduction in these particularly deadly healthcare-associated infections represents as many as 6,000 lives and $414 million saved in 2009 alone, and as many as 27,000 lives saved and $1.8 billion cumulative healthcare savings since 2001. The ICU reductions have likely been driven by coordinated efforts of state and federal agencies, professional societies, and healthcare providers to implement best practices for central-line insertion. In non-ICU settings, the number of CLABSIs remained high: an estimated 23,000 in non-ICU wards in 2009 and 37,000 among hemodialysis patients in 2008. The CDC report stresses that in these settings, where central lines are inserted less frequently, further preventive strategies are needed, such as improved implementation of post-insertion line maintenance, prompt removal of unneeded central lines, and, in hemodialysis patients, avoidance of central lines in favor of arteriovenous fistulas or grafts. The study found that the reduction in CLABSI incidence from 2001 to 2009 was greater for Staphylococcus aureus (73%) than for other organisms.
Mar 1 MMWR article

Pakistan, DR-Congo address polio concerns
Pakistan has confirmed three new polio cases in its conflict-hit tribal region, bringing to 11 the total number of cases in the country so far this year, according to the country's Dawn newspaper. Two of the cases are from Khyber Agency and one from FR Kohat, according to an official, and all three were caused by poliovirus type 1. Last year at this point Pakistan had confirmed 10 polio cases. In January the country launched a campaign to vaccine 32 million children under the age of 5 against the disease. Pakistan's president declared 2011 as the "Emergency Year for Polio Eradication."
Mar 1 Dawn story
Elsewhere, the head of the United Nations Children's Fund (UNICEF) arrived in the Democratic Republic of the Congo (DRC) today to meet with government officials and to assess efforts to curb a rapidly spreading polio outbreak. "Eradicating polio in DRC and everywhere requires an absolute commitment by government and its partners to vaccinate every child," said UNICEF Executive Director Anthony Lake in an agency news release. From January 2010 to last month the country has confirmed 112 new polio cases. In January Lake visited Angola, which is also experiencing a major polio outbreak.
Feb 28 UNICEF news release

Study: Hand washing in Egyptian elementary schools cuts flu in half
Egyptian researchers found that an intensive hand-hygiene campaign reduced influenza in elementary schoolchildren 50% and diarrhea 30%. The scientists instituted the campaign in 30 schools in Cairo governorate that had previously low levels of hand hygiene: Students typically only rinsed hands without using soap and dried them on clothing or air-dried them. Thirty schools without the campaign served as controls, and data were collected over 12 weeks from Feb 16 through May 12, 2008. Compared with the control group, absences in the intervention schools for flu-like illness fell 40%, diarrheal illness dropped 30%, conjunctivitis was reduced 67%, and lab-confirmed flu was cut in half.
Feb 28 Emerg Infect Dis study

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