News Scan for Oct 07, 2013

H5N1 death in Indonesia
Bomb attack on polio workers
Hand sanitizer benefits in schools
Resistance monitoring in India
Health disparities in Europe

Indonesia confirms H5N1 death

Indonesia's Ministry of Health has confirmed the country's second H5N1 case this year, in a 28-year-old man from Bekasi.

The man died from the disease, according to a machine-translated health ministry statement today on FluTrackers, the Web-based infectious disease message board. The health ministry statement is dated Oct 3.

The man, a truck driver, developed a fever, aches, and back pain on Sep16 and received outpatient treatment on Sep 18 at a private hospital in Bekasi, which is on the outskirts of Jakarta. He was admitted to the hospital on Sep 20. He died at a different hospital on Sep 27 of suspected avian flu.

Tests by the Center for Biomedical and Healthcare Technology Association later confirmed H5N1 avian flu, the statement said. Indonesia has now had 194 H5N1 cases, including 162 deaths, since 2005, the Ministry of Health said.
Oct 7 FluTrackers post


Two killed in Pakistan polio-vaccine-related bombing

Two people were killed and 12 were wounded today when a bomb exploded near a clinic where polio vaccines were being administered outside of Peshawar, Pakistan, Agence France-Presse (AFP) reported.

The bomb, fashioned from a pressure cooker, detonated as a police van arrived to escort an immunization team in a Peshawar suburb. The two killed were a police officer and a volunteer from a village policing unit.

"It was an IED [improvised explosive devise] blast and the target was policemen," Najeebur Rehman, a senior police official, told AFP. Officials said most, if not all, of the wounded were police officers.

The Pakistani Taliban has claimed responsibility for the bombing, Al Jazeera reported.

Officials said 54 polio workers were in the clinic when the bomb exploded, according to the AFP story. "A second bomb with five kilograms of explosives has been defused. We have suspended the campaign for time being," Zahurul Islam, a senior government official in Peshawar, told AFP.

Pakistan's polio vaccination teams have been targeted for months by Islamic militants, some of whom accuse the workers of spying for the West. Peshawar is the capital of the northern Khyber Pakhtunkhwa province, site of multiple attacks. Pakistan is one of three countries in which polio is endemic; the others are Afghanistan and Nigeria.
Oct 7AFP report
Oct 7 Al Jazeera


Sanitizer plus hand washing may cut GI illness in school kids

Adding hand sanitizer to a hand washing regimen can cut school absences from gastrointestinal illnesses compared with hand washing alone, according to a new study in the Pediatric Infectious Disease Journal.

The randomized controlled trial included 1,341 children ages 4 to 12 years at five schools in Spain's Almeria state from October 2009 through May 2010.

Children in the experimental group attended hand-washing workshops and were told to also use hand sanitizer certain circumstances, such as before and after lunch and after coughing, sneezing, or blowing their noses. Teachers supervised hand sanitizer use, and researchers checked hand washing technique. Those in the control group followed usual hand washing procedures without recommendations or reinforcements.

Parent- and school-reported absences related to gastrointestinal illness increased in both groups in the winter and spring, but the level was significantly lower in the hand sanitizer group in February, March, and May. The researchers found a 36% reduction in absenteeism in the intervention group. Kids in the hand sanitizer group had 0.27 absenteeism episodes per child per school year compared with 0.40 in the control group.

The researchers said that hand sanitizers have the potential to more reliably kill pathogens such as rotavirus, compared with regular hand washing.
Oct 3Pediatr Infect Dis J abstract


India to set up 30 labs to monitor antimicrobial resistance

India's health ministry announced plans to establish 30 laboratories to monitor antimicrobial resistance, the Times of India reported on Oct 5.

The program will be launched in Delhi and will be expanded to other states in phases, the story said. Plans call for training microbiologists, lab technicians, clinicians, pharmacists, and others involved.

A health ministry official said each lab would be provided 1.5 to 2 million rupees, or about $24,000 to $32,000, per year for equipment, reagents, and staffing.

The National Centre for Disease Control will monitor and review the program and will also establish national hospital infection control guidelines that will be disseminated to hospitals for implementation, according to the story.

The report also said that India has not yet implemented a national antibiotic policy that was drafted in 2011 after emergence of the resistance enzyme known as New Delhi metallo beta-lactamase 1 (NDM-1). The enzyme renders gram-negative bacteria resistant to nearly all antibiotics.

A study published in August 2010 said that 136 NDM-1-producing bacterial isolates had been found in Indian and Pakistan.
Oct 5 Times of India story
Aug 20, 2010,
CIDRAP News story on NDM-1 resistance enzyme


ECDC report: Social inequalities affect infectious disease profile

Socioeconomic disparities between various European populations can affect infectious disease spread and control, and public health officials need to address the issue, according to a report today from the European Centre for Disease Prevention and Control (ECDC).

The report cites several examples of health inequalities, such as socioeconomic factors being associated with tickborne encephalitis in central and eastern Europe, immigrant women in Greece having a higher prevalence of hepatitis B, and economically deprived populations in England having a higher risk of methicillin-resistant Staphylococcus aureus and lower flu vaccine uptake compared with wealthier populations.

"The financial crisis continues to influence many of the key social determinants of health in Europe, both through changes to living conditions and to public spending," according to a ECDC news release on the report.

The report recommends several steps, including reviewing best practices, defining vulnerable groups, promoting evidence-based action, and expanding and engaging various relevant networks.

In conjunction with the report, ECDC is hosting a meeting in Stockholm this week that will cover the importance of health inequalities to infectious disease prevention and control. European and international experts are scheduled to attend.
Oct 7 ECDC report
Oct 7 ECDC
news release
meeting information

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