NEWS SCAN: H5N1 death confirmed, H1N1 infection rate, MRSA in veterinarians, uptake of teen vaccines

Nov 15, 2011

WHO confirms latest H5N1 death in Indonesia
Today the World Health Organization (WHO) confirmed yesterday's report from Indonesia's health ministry that a 29-year-old mother of two children who previously died of H5N1 avian flu also died from the disease. The woman, from Bangli district in Bali, became ill Oct 10 and died Oct 17. Her 5-year-old daughter died from H5N1 on Oct 9, followed by her 10-year-old son on Oct 10, according to the WHO. An investigation into the cause of the woman's death determined that she lived in an area with poultry and that poultry in her household and in the neighborhood had died before family members got sick. Lab tests have now confirmed all three cases. The woman's death raised the country's H5N1 totals to 182 cases and 150 deaths. So far this year Indonesia has confirmed 11 H5N1 cases, including 9 deaths. Worldwide H5N1 totals have now reached 570 cases and 335 deaths
Nov 15 WHO update
Nov 2 WHO global case count (does not include today's case)

Seroprevalence study finds 20% to 30% infected with 2009 H1N1 in Ontario
Twenty to thirty percent of Ontarians were estimated to be infected by pandemic 2009 H1N1 influenza by the time the pandemic was over, according to a seroprevalence study yesterday in PLoS One. Toronto public health professionals analyzed serum data from 3,375 samples collected by Ontario public health labs and from 1,024 recruited cohort adults taken before, at several points during, and after the 2009-10 pandemic. They found that the prepandemic seroprevalence of 2009 H1N1 antibodies ranged from 2% to 12% across age-groups and that those numbers jumped to 10% to 19% after the spring pandemic wave and to 32% to 41% at the end of the 2009-10 flu season. Younger populations had higher seroprevalence rates. By season's end, the rates were as follows for the various age-groups as measured by hemagglutination inhibition: under 18, 62% to 83%; 18 to 29, 30% to 45%; 30 to 64, 28% to 44%; and 65 and older, 33% to 35%. The researchers found that geometric mean antibody titers were significantly higher among those who received the H1N1 vaccine. After teasing out those data, the team estimated that 20% to 30% of the population was infected.
Nov 14 PLoS One study

Study links pig exposure to MRSA in veterinarians
Veterinarians who work with swine have a significantly elevated risk of contracting methicillin-resistant Staphylococcus aureus (MRSA), according to a study published today by Belgian and Danish researchers. The team found that, among 146 Danish vets, 14 (9.6%) tested positive for MRSA, including 11 (7.5%) for livestock-associated MRSA (LA-MRSA). Among Belgian vets, the carriage rate was 1.4% (2/143), and both isolates were LA-MRSA. All LA-MRSA isolates were resistant to tetracycline, and 53.4% (7/13) were of a multi-drug-resistant phenotype. Multivariate analysis showed that working with small animals in a clinic appeared to be negatively associated with LA-MRSA (odds ratio [OR], 0.15; 95% confidence interval [CI], 0-1.0, P = 0.05) but that exposure to live pigs was strongly associated with LA-MRSA (OR, 12.1; 95% CI, 1.6-548.5, P = 0·01). The authors conclude, "Since carriage of MRSA ST398 may increase the risk of complications during hospitalization, our results underline that preventive measures may need to be developed for veterinary professionals, particularly for livestock veterinarians."
Nov 15 Epidemiol Infect abstract

US uptake of 3 adolescent vaccines on the rise
Vaccination coverage for three vaccines added to the US adolescent vaccination schedule from 2005 through 2007 have increased, but further strides could be made, according to a study published online yesterday in Pediatrics. Scientists from the Centers for Disease Control and Prevention analyzed the 2006 through 2009 National Immunization Survey–Teen, an annual provider-verified survey of vaccination coverage among 13- to 17-year-olds, for data on coverage of the tetanus-diphtheria-acellular pertussis (TdaP), meningococcal conjugate (MenACWY), and human papillomavirus (HPV) vaccines, the latter for girls only. From 2006 to 2009, those receiving one or more doses of TdaP and MenACWY increased from 11% to 56% and from 12% to 54%, respectively. From 2007 to 2009, the proportion of girls who received one or more HPV doses increased from 25% to 44%, and from 2008 to 2009 coverage with three or more HPV doses increased from 18% to 27%. The investigators also estimated that vaccination coverage in 2009 could have been higher than 80% for TdaP and MenACWY and as high as 74% for the first HPV dose if providers had administered all recommended vaccine doses during the same vaccination visit. The authors conclude, "Strategies are needed to increase parental knowledge about adolescent vaccines and improve provider recommendation and administration of all vaccines during the same visit."
Nov 14 Pediatrics abstract

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