News Scan for Aug 01, 2013

US kindergarten vaccination
NDM-1 in France
H5N1 in Nepal
Rabies in Taiwan

Vaccination rates high among US kindergartners

Vaccination rates among US kindergarteners remain at high levels, with coverage near or exceeding the Healthy People 2020 target rate of 95% in most states, and exemption rates are holding steady, the Centers for Disease Control and Prevention (CDC) reported today.

In it yearly update in Morbidity and Mortality Weekly Report (MMWR), the CDC said that, among 48 states and the District of Columbia (DC) that reported 2012-13 school vaccination coverage, median two-dose measles, mumps, and rubella (MMR) vaccination coverage was 94.5%, with 20 states reporting coverage of 95% or above. The lowest uptake was in Colorado, with 85.7%, while the highest was in Mississippi, with almost 100% uptake.

Median diphtheria, tetanus, and acellular pertussis (DTaP) vaccination coverage was 95.1%, with 25 states reporting 95% or higher uptake. Colorado again reported the lowest coverage, at 82.9%, while Mississippi again reported near-100% uptake.

Median two-dose varicella (chicken pox) vaccination coverage in 36 states and DC was 93.8%, with a low of 84.6% in Colorado and a high of nearly 100% in Mississippi. Fourteen states reported coverage of 95% or better.

The CDC said an estimated 91,453 exemptions were granted among an estimated 4,242,558 US kindergarteners, which was similar to 2011-12 levels. Mississippi, which, along with West Virginia, does not allow immunization exemptions, had the lowest exemption rate, at less than 0.1%. Oregon had the highest rate of exemptions, at 6.5%.
Aug 2 MMWR report


France reports first A baumannii NDM-1 cases in Europe

Scientists writing in Eurosurvellance today detailed the first outbreak of carbapenem-resistant New Delhi metallo-beta-lactamase 1 (NDM-1)–producing Acinetobacter baumannii in Europe, in a French intensive care unit (ICU) from January to May. Bacteria that produce NDM-1 are usually resistant to most antibiotics.

The index patient was a woman in her 80s who was transferred from Algeria for care of end-stage cirrhosis. On Jan 18 she was admitted to a Paris hospital and, in line with guidance, was screened for carriage of multidrug-resistant (MDR) bacteria, which turned up the NDM-1 A baumannii.

From then to Feb 2 an additional three patients in that ICU were confirmed to have the same drug-resistant strain. Meanwhile, another woman in her 80s arrived from the same region in Algeria and was found to be NDM-positive with the same strain on admission to the same ICU.

Two months after this first cluster of five patients, two additional patients who were free of MDR bacteria on admission to the ICU also acquired the NDM-1–producing A baumannii outbreak strain during their stay in this unit.

The authors conclude, "Taking in account the relationship between North African countries and many European countries, it is possible that the spread of NDM-1 carbapenemase may occur rapidly, mostly through A baumannii rather than Enterobacteriacae, since A baumannii may become much more difficult to eradicate."
Aug 1 Eurosurveillance report


Nepal bans chicken sales after H5N1 outbreaks

Nepal today instituted a week-long ban on the sale of chickens after officials identified several new outbreaks of H5N1 avian flu on farms on the outskirts of Kathmandu, the nation's capital, Agence-France Presse (AFP) reported.

"We have taken this decision to save both human lives as well as the industry," said Bolraj Acharya, director of the Kathmandu District Animal Health Office. If the virus is not under control in a week, the ban will be extended, he added. Surveillance teams will enforce the ban.

Since the latest H5N1 outbreak in the country 2 weeks ago, workers have culled 20,000 chickens and destroyed more than 12,000 eggs at 30 affected farms, another official said, calling it Nepal's biggest outbreak yet.

The country experienced its first H5N1 outbreak in poultry in January 2009. Since then, 200,000 chickens and more than 400,000 eggs have been destroyed to curb the disease, the official said.
Aug 1 AFP story


Taiwan has first animal rabies outbreak in 50 years

Taiwan has ordered tens of thousands of doses of human rabies vaccine after the island's first rabies outbreak in animals in more than 50 years, the Associated Press (AP) reported today.

In the past 2 weeks 17 ferret badgers have tested positive for rabies by direct fluorescent antibody tests, and yesterday an Asian house shrew was confirmed to be rabid, according to the AP and the World Organization for Animal Health (OIE)

No humans or dogs have yet been involved in the outbreak, the AP said. Health Minister Chiu-Wen-ta said new doses of human vaccine are expected to arrive tomorrow and will supplement about 3,000 in stock.

Health workers have been vaccinating animals throughout Taiwan, the AP reported. The island has about 40,000 animal vaccine doses in stock, with a half million more expected in the next 3 weeks.
Aug 1 AP article
Aug 1 OIE report on most recent animal cases

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