News Scan for Aug 02, 2013

H3N2v in Illinois
Meningococcal vaccine for babies
Broad-spectrum antibiotic overuse

Illinois reports its first H3N2v case of the year

Illinois health officials yesterday reported the state's first variant H3N2 (H3N2v) influenza case of the summer, in a child who had contact with swine at a county fair.

The Illinois Department of Public Health (IDPH) said in a statement that the infection was mild and was confirmed in a Boone County child who helped an exhibitor at the DuPage County Fair, which was held in late July.

Illinois is the third state to report an H3N2v infection this summer, and its case raises the nation's total to 15, with 13 cases in Indiana and 1 in Ohio. So far all of the illnesses have been in people who had contact with swine.

Last year Illinois reported four H3N2v cases. The US Centers for Disease Control and Prevention (CDC) included the new Illinois cases in its latest H3N2v tally and in its weekly flu update today.
Aug 1 IDPH news release
Aug 2 CDC H3N2v case count


FDA OKs meningococcal vaccine for babies starting at 2 months

The US Food and Drug Administration (FDA) yesterday approved the use of Menveo, a meningococcal vaccine made by Novartis, in babies as young as 2 months old, making it the only quadrivalent meningococcal vaccine routinely available for children less than 2 years of age, the company announced.

Menveo has been available for use in 11- to 55-year-olds since 2010 and for 2- to 10-year-olds since 2011, Novartis said in a press release. It protects against Neiserria meningitidis groups A, C, Y, and W-135.

"With this expanded indication, pediatricians in the US can now offer a single vaccine to help protect infants, children and adolescents against four of the five most common serogroups that cause meningococcal disease," the company said. It said infants under 7 months old are most vulnerable to meningococcal disease—about seven times more vulnerable than 14- to 24-year-olds.

FDA approval was based on data from three randomized studies involving more than 8,700 infants, conducted in Australia, Canada, Latin America, Taiwan, and the United States, Novartis reported. The studies showed that Menveo generated a robust protective immune response and had a good safety profile when given along with routine pediatric vaccines.

One other quadrivalent meningococcal vaccine, Sanofi Pasteur's Menactra, can be used in children 9 to 23 months olds if they have specific certain risk factors, such as complement component deficiency, an immune system disorder, according to the CDC.

No vaccine is available in the United States for meningococcal group B, which causes about a third of all cases, according to the CDC.
Aug 1 Novartis press release
CDC information on meningococcal disease and vaccines


Antibiotic prescribing study finds broad-spectrum overuse

A study of adults in outpatient clinics and emergency departments found that 61% of antibiotic prescriptions were for broad-spectrum drugs, many of which were used to treat conditions such as respiratory infections that would have been better treated by other antibiotics less likely to cause resistance.

The study, led by a group from the University Utah, appeared in the Journal of Antimicrobial Chemotherapy.  The researchers based their findings on a sample of 238,624 visits from 2007 to 2009 that were part of a public database. Narrow-spectrum antibiotics such as amoxicillin and doxycycline made up the remaining 39% of prescriptions.

Adam Hersh, MD, PhD, senior author of the study and an infectious disease specialist at the University of Utah School of Medicine, said in a university press release yesterday that 25% of the broad-spectrum prescriptions are useless, because that percentage of infections are caused by a virus. He added that overuse of broad-spectrum antibiotics can lead to more side effects and contribute to the growth of antibiotic-resistant bacteria.

"It seems that the natural bias, when there is uncertainty about an infection's cause, is to err on the side of prescribing antibiotics," he said, adding that prescribing patterns for children is similar.

Based on their sample, the study group estimated that there were about 985 million ambulatory care visits in the United States during the study period, with antibiotics prescribed for 101 million visits—62 million of which were broad-spectrum drugs.
Jul 25 J Antimicrob Chemother abstract
Aug 1 University of Utah press release

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