News Scan for Nov 04, 2013

WHO confirms fatal MERS case
H5N1 death in Cambodia
Final BSE import rule
2-dose HPV vaccine response
Childhood vaccine acceptance
Powassan virus cases

WHO confirms fatal MERS-CoV case in Saudi Arabia

The World Health Organization (WHO) today confirmed a fatal case of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia, adding to information in an Oct 31 statement from the Saudi government about the death of a 56-year-old.

The WHO said the patient was a 56-year-old woman who lived in the Eastern region and had underlying medical conditions. She became ill on Oct 26 and died Oct 31. She had no contact with animals before her illness, but she did have contact with another MERS case-patient, the agency said.

With this case, the WHO has confirmed 150 MERS-CoV cases, including 64 fatal ones. The Saudi Ministry of Health (MOH) currently lists a MERS count of 125 Saudi cases with 53 deaths.
Nov 4 WHO statement
Oct 31 Saudi MOH statement


Cambodian toddler dies from H5N1 avian flu

A 2-year-old Cambodian girl died of H5N1 avian flu recently, bringing the country's total this year to 23 cases and 12 deaths, according to Xinhua, China's state news agency.

The girl, from the west-central province of Pursat, which borders Thailand, was admitted to Jayavarman VII Hospital in Siem Reap province on Oct 25 with fever, lethargy, cough, and difficulty breathing. She died the next day, Xinhua said, citing a joint statement from the WHO and the Cambodian Ministry of Health.

About 2 months before the girl became ill, chickens had died suddenly at her grandparents' house, where she often stayed, the two agencies said. Officials are investigating whether the girl had contact with sick or dead poultry.

Since 2005 Cambodia has confirmed 44 cases, 31 of them fatal, according to WHO data and media reports. The vast majority have been in children.
Nov 4 Xinhua story


Final USDA rule on BSE eases imports

The US Department of Agriculture (USDA) on Nov 1 announced a final rule that wraps up its efforts to modernize import regulations related to bovine spongiform encephalopathy (BSE).

John Clifford, DVM, deputy administrator and chief veterinary officer for the USDA's Animal and Plant Health Inspection Service (APHIS) said in a statement that the rule change brings US BSE import regulations in line with international standards that are based on the risk of animals or products harboring the disease.

He said the changes will show trading partners that the United States is committed to international standards and sound science. "And we are hopeful it will help open new markets and remove remaining restrictions on US products," Clifford said.

APHIS said the new rules are based on internationally accepted scientific literature and standards set by the World Organization for Animal Health (OIE). However, it said the regulation change doesn't affect other steps that are in place to protect US consumers against BSE, such as a ruminant-to-ruminant feed ban and a cattle surveillance program.

The rule was first proposed in March 2012. The USDA's release of the final rule follows an OIE change in May that placed the United States in the lowest risk category for BSE.

The US cattle industry welcomed the new rule as a key step for boosting international beef trade, Food Safety News (FSN) reported today. However, it noted that a rancher trade group called R-CALF criticized the move as relaxing import restrictions for areas where BSE persists.
Nov 1 APHIS news release
Mar 9, 2012, APHIS press release
May 30 CIDRAP News scan "OIE puts US in lowest risk category for BSE"
Nov 4 FSN report


Study: Two Cervarix doses may protect against HPV

Two or possibly even one dose of human papillomavirus (HPV) vaccine may induce an immune response sufficiently robust and long-lasting to protect against HPV infections and cervical cancer, according to a study today in Cancer Prevention Research. Three doses are recommended for the vaccine.

The study did not, however, involve Gardasil, the quadrivalent (four-strain) HPV vaccine most widely used in the United States.

A group of international researchers, including scientists from the US National Cancer Institute (NCI), studied blood from Costa Rican women who either received the bivalent Cervarix vaccine—which protects against the HPV 16 and 18 strains—or had become infected with HPV.

They studied 4 years of data on those who received one dose (78 women), two doses 1 month apart (140), two doses 6 months apart (52), and three scheduled doses (120). They also analyzed sera from 113 women who were positive for either HPV16 or 18.

At four years, geometric mean titers (GMTs) of antibodies to the two vaccine strains were comparable among those who received three doses and those who received two doses 1 month apart. For HPV 16, GMTs were 24 times higher with two doses and 9 times higher with one dose compared with the naturally infected group. For HPV 18, GMTs were 14 and 5 times higher, respectively.

"Our findings suggest promise for simplified vaccine administration schedules that might be cheaper, simpler, and more likely to be implemented around the world," said first author Mahboobeh Safaeian, PhD, an NCI investigator, in a news release from the American Association for Cancer Research (AACR), which publishes the journal.

"Vaccination with two doses, or even one dose, could simplify the logistics and reduce the cost of vaccination, which could be especially important in the developing world," Safaeian added.
Nov 4 Cancer Prev Res abstract
Nov 4 AACR press release


Provider's approach may affect acceptance of childhood vaccines

How vaccination questions are phrased and providers' persistence appear to affect how often hesitant parents have their children vaccinated, according to a study today in Pediatrics.

US investigators observed 111 vaccine discussions involving 16 healthcare providers from nine practices. Half of the discussions involved parents who were hesitant about having their children vaccinated and thus significantly more likely to resist vaccination.

The researchers found that 74% of providers initiated vaccine recommendations using a presumptive (eg, "Well, we have to do some shots") rather than a participatory (eg, "What do you want to do about shots?") approach. But parents had significantly higher odds of resisting vaccine recommendations if the provider used a participatory rather than a presumptive approach (adjusted odds ratio: 17.5, 95% confidence interval: 1.2–253.5).

When parents resisted, half of the providers pursued their original recommendations, and, when they did, 47% of initially resistant parents accepted immunization for their children.
Nov 4 Pediatrics abstract


New York reports two Powassan virus infections

New York state health officials have confirmed two infections, both in Putnam County, with Powassan virus, a tickborne disease that can lead to encephalitis, according to a Nov 1 statement from the Putnam County Department of Health (PCDH). Both patients are recovering at home.

The disease is most common in the northeastern Great Lakes regions, and 5 of the 16 cases reported in New York so far have occurred in Putnam County, the PCDH said. A recent study of ticks in seven Hudson Valley counties revealed that Putnam County had the highest rate of ticks infected with Powassan virus, though the level was still low at 3.84% of ticks.

Powassan virus is unusual, because it can be transmitted in 15 minutes, much quicker than bacterial Lyme disease, which generally requires that the tick be attached for 36 to 48 hours for transmission to occur. Powassan symptoms include fever, headache, vomiting, and other neurologic symptoms, which can be severe and require hospitalization.

A US Geological Survey (USGS) map of human Powassan virus infections so far this year notes that only two other states have reported cases: New Hampshire (1) and Wisconsin (4).
Nov 1 PCDH statement
USGS Powassan virus map for 2013

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