NEWS SCAN: Adenovirus vaccination, Salmonella from salmon & turtles, Marburg in Uganda, antimicrobial stewardship

Oct 19, 2012

Adenovirus vaccination in military trainees has slashed respiratory illnesses
More than 200,000 US military recruits have been vaccinated since adenovirus immunizations were revived in the US military a year ago, and the incidence of febrile respiratory illnesses has sharply declined, according to an Oct 18 press release from Teva North America, maker of the vaccine. A vaccine against adenovirus types 4 and 7 was reintroduced in the military in October 2011 after a 12-year hiatus. "Since the program began last year, combined data from the training installations indicates that the vaccine has reduced the incidence of febrile respiratory illness by over 75% and essentially eliminated the threat posed by adenovirus types 4 and 7,” said Clifford E. Snyder Jr, JD, PhD, adenovirus vaccine product manager at the US Army Medical Materiel Development Activity, as quoted in the Teva release. In a May article in Medical Surveillance Monthly Report (MSMR), a Department of Defense publication, Snyder and colleagues gave an initial assessment of the effects of the vaccine in basic trainees. They said the overall rate of febrile respiratory illnesses dropped from 0.6 to 0.15 cases per 100 trainees per week after the immunization program was launched.
Oct 18 Teva press release
May 2012 MSMR with report on adenovirus immunization impact
Related Feb 1 CIDRAP News item

Salmon-related salmonellosis outbreak widens in Netherlands
The outbreak of Salmonella Thompson in the Netherlands caused by eating contaminated salmon from Dutch fish processor Foppen has increased rapidly to at least 950 cases with three deaths, says an Agence France-Presse (AFP) story today. Foppen, headquartered in Harderwijk, traced the contamination to a production line in a company facility in Greece. All Dutch markets were advised in early October to pull the salmon off their shelves. In the United States, infection with Salmonella Thompson having the same genetic fingerprint as the Dutch cases has been reported in about 100 people but does not appear to be associated with eating smoked salmon, according to a Centers for Disease Control and Prevention (CDC) official quoted in an article today in Food Safety News. Costco carries Foppen salmon in the United States and recalled the product early this month; no cases of illness have been reported to Costco.
Oct 19 AFP story
Oct 19 Food Safety News article
Oct 3 CIDRAP News story on Dutch Salmonella link in US

US salmonellosis cases tied to pet turtles reach 219
The count of cases in six Salmonella outbreaks related to pet turtles has reached 219, the CDC reported today, which is 23 more than reported in an Oct 2 update. The number of hospitalizations remained at 36, and no one has died in the outbreaks. The number of affected states climbed to 34, three more than previously reported. The outbreaks have mainly affected children; 66% of patients have been no more than 10 years old, and 30% have been 1 year or younger, according to the CDC. Seventy-three percent of those affected reported they had contact with pet turtles before they got sick. The Food and Drug Administration has banned the sale and distribution of small turtles as pets since 1975.
Oct 19 CDC update

Marburg virus outbreak reported in Uganda
Uganda's Ministry of Health warned today of a deadly Marburg virus outbreak in the Kabale district, the same district hit by an Ebola outbreak a few months ago, according to media reports from the country. The ministry said tests at the Uganda Virus Research Institute today confirmed three cases of Marburg infection, according to The Independent. Preliminary reports from the district said that four other people had died of a strange disease since Oct 4. Investigators have found that all the cases occurred in the same family in Kitumba sub-country, according to a report from New Vision, another Ugandan media outlet. The story said the health ministry has taken several steps to respond to the outbreak, including sending experts to the area to support the clinical and public health investigations. The Marburg and Ebola viruses are related and cause similar illnesses. At least 17 people died in an Ebola outbreak in Kabale district in July and August, according to earlier reports.
Oct 19 Independent story
Oct 19 New Vision story

Prescription monitoring in pediatric clinics improved antimicrobial stewardship
A program of quarterly monitoring of and feedback on prescribing patterns cut the inappropriate use of antibiotics nearly 50% in a large network of pediatrics practices, according to a report presented at the IDWeek infectious disease conference in San Diego yesterday. The study is one of the first trials of an antimicrobial stewardship program in an outpatient setting, the Society for Healthcare Epidemiology of America (SHEA) said in a press release. Eighteen pediatrics practices linked with Children's Hospital of Philadelphia participated in the study. In nine practices, clinicians received a short presentation on the latest prescribing guidelines, followed by quarterly updates on their individual prescribing habits and how those compared with the guidelines. The study focused on prescribing for sinusitis, Group A strep throat, and pneumonia. The other nine practices served as a control group and were simply told the study was going on. Baseline data showed that about 28% of all children received an inappropriate broad-spectrum antibiotic for a targeted condition. But in the first year of the program, clinicians in the intervention group cut their off-guideline use to 14%. The control group rate also declined, but only to 23%. The biggest impact was on inappropriate use of antibiotics for pneumonia, which dropped from 16% to 4%. "The impact in the intervention group was much better than we thought it would be," lead author Jeffrey Gerber, MD, said in the press release. The IDWeek meeting is billed as the first joint annual meeting of SHEA, the Infectious Diseases Society of America, the HIV Medical Association, and the Pediatric Infectious Diseases Society.
Oct 18 SHEA press release via EurekAlert

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