NEWS SCAN: Antiviral drugs for H1N1, pertussis vaccine in pregnant women, measles advisory, scarlet fever in Hong Kong

Jun 23, 2011

Early antiviral treatment linked to low death rate in kids hospitalized with H1N1
Children hospitalized for pandemic 2009 H1N1 influenza in Japan had low death rates, which the authors of a new study attributed to early administration of antiviral drugs. Writing in the Journal of Infection today, researchers describe a retrospective chart review of 1,000 pediatric inpatients who had 2009 H1N1 flu. Of those, 984 (98.4%) received treatment with neuraminidase inhibitors, primarily oseltamivir (Tamiflu), and 889 (88.9%) received treatment within 2 days of illness onset. Only 12 (1.2%) of patients required mechanical ventilation, and 1 died. The authors conclude, "Although a high proportion of the patients in this study had severe respiratory complications, the case fatality rate was only 0.1%. The low mortality rate of children due to the H1N1/09 epidemic in Japan was probably attributable to the universal implementation of early treatment with neuraminidase inhibitors."
Jun 23 J Infect abstract

ACIP recommends pertussis vaccine for pregnant women
To protect infants in a time of increasing pertussis cases, pregnant women as well as teens and other adults in close contact with newborns should receive pertussis (whooping cough) vaccine, an advisory group to the US Centers for Disease Control and Prevention (CDC) said yesterday. The panel, the Advisory Committee on Immunization Practices (ACIP), also recommended meningococcal vaccine for high-risk infants at 9 months, according to MSNBC. The CDC still needs to decide on the recommendations but often follows ACIP guidance. Current recommendations are for women to receive pertussis vaccine just after childbirth, but the group said immunization during pregnancy may confer antibodies, and thus protection, to the fetus. Infants get their first pertussis shot at 2 months. Several states have reported increased levels of pertussis. For meningococcal vaccine, the ACIP classified as high risk those babies who travel to or live in countries in which the disease is common and those with certain immune deficiencies.
Jun 22 MSNBC report

CDC issues measles advisory as Indiana reports outbreak
Citing high numbers of cases, the CDC issued a health advisory about measles yesterday as an outbreak was detected in northeastern Indiana. E-mailed via its Health Alert Network (HAN) and posted on the CDC Web site, the advisory urges healthcare professionals to be on the alert for measles and recommends that all people update their immunizations. The agency has confirmed 156 cases this year through Jun 17, the highest in 15 years. Of those, 136 (87%) were imported from countries in which the disease is endemic or where large outbreaks are occurring, and 133 (85%) were in unvaccinated people or in those with undocumented vaccine status. The CDC said 12 US outbreaks (three or more linked cases) have occurred, accounting for 47% of the cases. In addition to saying all patients should be up to date on their measles, mumps, and rubella (MMR) immunizations, the advisory says, "For those who travel abroad, CDC recommends that all U.S. residents older than 6 months be protected from measles and receive MMR vaccine, if needed, prior to departure."
Jun 22 CDC HAN advisory
In related news, the Indiana Department of Health has confirmed an outbreak of five measles cases in northeastern Indiana, according to an Associated Press (AP) story. The cases were in Noble County, but surrounding counties may also be affected, according to the article. Indiana Health Commissioner Gregory Larkin said the state is working with local health officials to contain the outbreak.
Jun 23 AP story

Hong Kong reports 32 new scarlet fever cases, 526 total
Hong Kong's Centre for Health Protection (CHP) confirmed 32 new scarlet fever cases today, bringing the week's total to 98 cases and the year's number to 526. CHP officials said four new outbreaks were identified and that the ages of the new case-patients range from 1 to 18 years, which is typical of the disease. The weekly total already surpasses last week's total of 69. Today's update said, "Local scarlet fever activity is now at a high level, but all isolates are sensitive to penicillin." Scarlet fever is caused by a group A streptococcus.
Jun 23 CHP report

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