NEWS SCAN: EU rule on pandemic vaccines, shorter regimen for latent TB, skewed infection-control efforts, gastroenteritis outbreak

Dec 8, 2011

EU seeks leverage to negotiate pandemic flu vaccine contracts
In a proposed draft rule, the European Union is seeking power to negotiate the price of vaccines on behalf of EU countries in future influenza pandemics, according to the EU's health chief in a Reuters story today. Discussing the 2009 H1N1 flu pandemic, when some EU nations were unable to buy much vaccine while others had surpluses, EU health chief John Dalli said, "We all know that the conditions that were imposed by the pharma industry on member states sometimes were not the best of conditions that one would hope." Under the plan, EU countries could have the option to ask the European Commission to negotiate contracts with vaccine makers. The proposed rule, part of wider legislative proposals to improve EU responses to major health threats, must be approved by a majority of EU member states, which may take more than a year. Dalli said he did not foresee major obstacles to its passage.
Dec 8 Reuters report

New CDC-approved option pares latent TB treatment from 9 months to 3
US healthcare providers have a new option for treating latent tuberculosis (TB) that cuts treatment time from 9 months to 3, according to recommendations released today by the Centers for Disease Control and Prevention (CDC) in Morbidity and Mortality Weekly Report (MMWR). The recommendations follow a large clinical trial, described yesterday in the New England Journal of Medicine, that showed that a once-weekly regimen of rifapentine and isoniazid taken for 12 weeks was as effective in preventing TB disease as the standard 9-month daily regimen of isoniazid alone. It cuts the number of doses required from 270 to 12 and is recommended in otherwise healthy patients 12 years old and older. Latent TB occurs when a person is infected with TB bacteria but does not have symptoms and cannot transmit the bacteria to others, the CDC said in a press release today. "This regimen has the potential to be a game-changer in the United States when it comes to fighting TB," said CDC Director Thomas R. Frieden, MD, MPH, in the release.
Dec 9 MMWR report
Dec 8 N Engl J Med study
Dec 8 CDC press release

Study sees skewed approach in fight against hospital-acquired infections
US hospitals are working harder to prevent hospital-acquired infections (HAIs), but they aren't focusing as much on the most common HAI—catheter-associated urinary tract infections (CAUTIs)—as on other kinds of infections, according to a new survey study. Researchers from the University of Michigan Health System (UMHS) and the Veterans Affairs Ann Arbor Healthcare Center surveyed infection preventionists at nonfederal and VA hospitals in 2005 and 2009 to examine practice trends. They found that both types of hospitals reported increases in the use of most practices to prevent central line–associated bloodstream infections (CLABSIs), ventilator-associated pneumonia (VAP), and CAUTIs in 2009, with 90% or more using certain measures to prevent CLABSIs and VAP. Still, only one practice to prevent CAUTIs was used by at least 50% of hospitals in 2009, the study says. It notes that in 2008 Medicare stopped paying non-federal hospitals for the extra costs of treating infections that are considered preventable. "The actual impact of the no-payment rule appears limited given the fact that hospitals not affected by the rule change, such as VA hospitals, also increased their use of infection practices," lead author Sarah L. Krein, PhD, RN, said in a UMHS press release. She said other factors, such as the introduction of practice guidelines, may have contributed as much as the non-payment rule to the increased use of infection prevention practices.
Dec 6 J Gen Intern Med abstract
Dec 8 UMHS release

Workers may have spread gastroenteritis between long-term care facilities
A suspected norovirus outbreak in eight long-term care facilities in southern Nevada in 2010 may have been facilitated by the movement of staff members between facilities, according to a report today in Epidemiology and Infection. The report, by Las Vegas epidemiologists, said that 299 (31%) of 954 residents and 95 (11%) of 843 staff members had gastroenteritis beginning in February 2010, with the epidemiologic curve showing staggered starts of the outbreak in the different facilities. Of the case-patients, 2.5% required hospitalization. Of 62 stool samples tested, 32 (52%) were positive for norovirus. Eight staff members were employed in multiple facilities, and four of these had gastroenteritis and may have facilitated disease spread to at least three facilities. None of the outbreaks was preceded by illness in food service staffers. The authors emphasize the importance of diagnostic testing of sick residents, as the testing also uncovered a Clostridium difficile outbreak in one facility that otherwise would have gone undetected.
Dec 8 Epidemiol Infect abstract

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