FLU NEWS SCAN: Pregnancy and severe flu, WHO flu lab manual, flu vaccine mandates, college preparedness resources

Jul 22, 2011

Sydney study: Pregnancy led risk factors for hospitalization in 2009 H1N1 patients
Pregnancy was revealed as the biggest risk factor for hospitalization of patients with pandemic H1N1 influenza in a case-control study in Sydney, Australia, according to an online report from Emerging Infectious Diseases (EID). The study included 302 patients older than 16 years who were hospitalized with confirmed pandemic flu in July or August 2009 and, as controls, 603 Sydney residents older than 16 who were not hospitalized with flu. After adjustment for age and sex, pregnancy was found to be the leading risk factor, with an odds ratio (OR) of 22.4. Other risk factors and their ORs were preexisting lung disease, 6.6; immune suppression, 5.5; asthma requiring regular medication, 4.4; diabetes, 3.8; heart disease, 2.3; and current or previous smoking, 2.0. Obesity was not independently associated with hospitalization, but it was linked to a higher risk of needing mechanical ventilation. "Public health messages should give greater emphasis on the risk for severe disease among pregnant women and smokers," the report states.
Jul 21 EID report

WHO publishes manual on lab diagnosis and surveillance of flu
The World Health Organization (WHO) has published a 151-page Manual for the Laboratory Diagnosis and Virological Surveillance of Influenza, with the aim of providing standard methods for the collection, detection, isolation, and characterization of viruses. The agency said that in some parts of the world, influenza epidemiology and the disease's effects on human health are relatively uncertain, largely because of a lack of virological and disease surveillance. All national and international flu surveillance systems "depend fundamentally upon the consistent and successful implementation of the key laboratory activities" described in the manual, the WHO said.
WHO page with link to manual
Information sheet about the manual

Ethicist Caplan endorses flu vaccination mandates for health workers
In an opinion piece in the Jul 23 Lancet, medical ethicist Arthur Caplan of the University of Pennsylvania argues that it is time to make influenza vaccination mandatory for healthcare workers (HCWs). The ethical obligation of healthcare personnel to put patients' interests before their own and to do no harm demands that they receive flu immunization, Caplan argues. But beyond the fundamental ethical issues, he writes, is the reality that HCWs who refuse flu immunization set a bad example for the public. "By not vaccinating themselves, health-care workers feed vaccine fears, reinforce anti-vaccine sentiments, and set a dismally poor example for the public," Caplan asserts. "Invoking personal choice in the face of obvious patient need for protection and ignoring the overwhelming safety of vaccination simply feeds public distrust of vaccination."
Jul 23 Lancet opinion article

University online flu preparedness resources vary widely
US universities in large part provide Internet-based pandemic preparedness resources, but the completeness of such sites varies broadly, according to St. Louis University researchers who evaluated the sites in September 2009, during the fall wave of the 2009 H1N1 flu pandemic. They applied a set of key words and a list of 10 indicators to measure the accessibility and comprehensiveness of the sites. Of the 51 universities evaluated, 18% either had no flu Web site or had a university flu preparedness plan with no dedicated Web site. Only 14% had information for students' parents, while 55% provided information specifically for faculty and staff, and 57% had information specifically for students. The authors concluded, "We found no guidelines for maximizing the access to and effectiveness of online pandemic communications at institutions of higher learning. Until such time as appropriate guidelines are developed, university authorities must carefully assess their needs," taking into account public health circumstances and resources.
Jul 22 Am J Infect Control abstract

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