NEWS SCAN: H1N1 vaccine and pregnancy, Campylobacter in chicken, fungal meningitis, measles & rubella in Europe, polio in Pakistan, infectious imports

Feb 4, 2013

Two studies find H1N1 vaccine safe during pregnancy
Two recent studies found no adverse effects of the 2009 H1N1 (pH1N1) flu vaccine on women's fetuses, adding to the growing ledger of studies demonstrating the safety of the vaccine during pregnancy. In the first study, published Feb 1 in Clinical Infectious Diseases, US researchers retrospectively analyzed data from 3,327 live births within the Kaiser Permanente Georgia and Mid-Atlantic States system during the 2009-10 pandemic. Of the expectant moms, 1,125 had been vaccinated. Among the 3,327 births there were 327 (9.8%) preterm births, 236 (7.4%) babies with low birth weight, and 267 (8.4%) babies who were small for gestational age. The researchers found no statistically significant association between receipt of the vaccine and these adverse outcomes, and in fact vaccinated moms were less likely to have preterm births.
Feb 1 Clin Infect Dis abstract
The second study involved 30 ,448 pregnant Argentinean women who gave birth in 1 of 49 major urban hospitals from September 2010 to May 2011. Of the women, 7,293 had received the pH1N1 vaccine with Sanofi's proprietary MF59 adjuvant (an immune booster) during pregancy. In today's BMJ the researchers reported that the vaccinated moms had a lower risk for three key health measures: Adjusted odds ratios for vaccinated women were 0.74 (95% confidence interval [CI], 0.65-0.83) for low birth weight babies, 0.79 (95% CI, 0.69-0.90) for preterm delivery, and 0.68 (95% CI, 0.42-1.06) for fetal or infant death up to 7 days postpartum.
Feb 4 BMJ study

Study: Organic chicken in Denmark far more often contaminated with Campylobacter
Contamination with Campylobacter species was nearly three times as common in chilled organic broiler chicken carcasses than in chilled conventional broiler carcasses, and the relative risk of becoming ill from exposure to the bacteria in organic carcasses was 1.7 times higher, says a Danish study in the International Journal of Food Microbiology. The researchers sampled 208 carcasses representing 52 organic flocks and 228 carcasses representing 228 conventionally raised flocks. Sampling was done over 1 year and was done after chilling. They found the yearly mean prevalence of Campylobacter to be 54.1% (confidence interval [CI], 40.9-67.5) in organic versus 19.7% (CI, 14.8-24.7) in conventional broiler meat. C jejuni was the species most frequently isolated. In contaminated samples, the mean concentration of Campylobacter did not differ appreciably between the two groups. Contamination was more common in both types of meat in warmer weather, with the peak beginning earlier in the year for organic carcasses. Broilers raised organically are exposed to the outdoors, while those raised conventionally are kept indoors. In addition, organic broilers are slaughtered at an older age (63-70 versus 36-42 days), according to the authors. Conventionally raised broilers comprise 99% of broiler production in Denmark. The authors conclude that "Interventions in the organic broiler production are clearly needed."
Feb 1 Int J Food Microbiol abstract

New cases of fungal infections from contaminated steroids few
The number of fungal infections linked to contaminated injectable steroids that began to appear last fall has climbed by 3 over the past week, to 696 total cases, the US Centers for Disease Control and Prevention (CDC) reported today. The death toll has stayed at 45, and the number of affected states has increased by 1 (West Virginia ,with two cases) to 20. Indiana also reported 2 new cases, but North Carolina's total was changed from 17 to 16 in the latest report, netting the 3 additional cases. Of the total cases, 247 were meningitis only, 130 involved spinal or paraspinal infections with meningitis, 6 involved stroke without lumbar puncture, 282 were paraspinal or spinal infections only, 30 were peripheral joint infections only, and 1 involved a paraspinal or spinal infection along with a peripheral joint injection. Michigan has had the most cases, with 243, followed by Tennessee with 147. Contaminated methylprednisolone acetate from New England Compounding Center in Framingham, Mass., has been implicated as the causal agent.
Feb 4 CDC updated case count

Europe sees drop in measles, rise in rubella
Disease surveillance reports covering most of 2012 for European countries show a decline in measles compared with the previous year but a rise in rubella, according to a report today from the European Centre for Disease Prevention and Control (ECDC). Among 8,326 measles cases reported by 29 countries, 5 countries accounted for 87% of cases: France, Italy, Romania, Spain, and the United Kingdom. For case-patients with known vaccination status, 82% were unvaccinated. No measles-related deaths were reported, but seven cases were complicated by acute measles encephalitis. The ECDC said that although measles transmission continues and exceeds elimination targets, no new large outbreaks have been reported since the last report. Meanwhile, 28,536 measles cases were reported during the same 12-month period by 26 countries that conduct enhanced surveillance for the disease, the ECDC said. Poland and Romania reported 99% of the cases. The highest rubella infection levels were in adolescents aged 15 to 19 years.
Feb 4 ECDC statement

Security concerns scrap Karachi polio vaccine campaign
Deteriorating security conditions have scuttled a 3-day polio vaccination campaign that was slated to begin today in Karachi, says a Feb 2 report in Dawn, an English-language newspaper based in Pakistan. Dr. Imdadullah Siddiqui said that security personnel are busy assisting with voter verification activities so aren't available to protect vaccination teams. The report also noted a shortage of vaccination workers, who often receive death threats from militant groups.
Feb 2 Dawn story
In other developments, Pakistan reported its first polio case of 2013, according to a Feb 2 report from The Nation, another English language newspaper in Pakistan. The patient is a 2-year-old boy from Bin Qasim Town, located in the southeastern part of Karachi, whose parents had refused vaccine for him.
Feb 2 Nation story

Final HHS rule on import of infectious materials
The Centers for Disease Control and Prevention (CDC), under the Department of Health and Human Services (HHS), has issued the final rule amending regulations on the importation of infectious biological agents, infectious substances, and vectors intended to prevent the introduction, transmission, or spread of communicable diseases into the United States. The proposed rule was published Oct 14, 2011, with a public comment period ending Dec 13, 2011. The final rule appears in today's Federal Register.The purposes of the rule are to clarify regulatory definitions, ensure adequate biosafety measures, increase oversight through inspection, address permit exemptions and transportation requirements, and describe an appeal process. It contains provisions applying to entities including academic institutions and biomedical centers; commercial manufacturing facilities; federal, state, and local laboratories; and research, exhibition, and educational facilities. The rule will go into effect on Apr 5.
Feb 4 Federal Register final rule

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