News Scan for Nov 19, 2013

Dengue outbreak in Texas
Compounding-pharmacy bill
Princeton meningitis steps
World Toilet Day

Southern Texas counties report 18 dengue cases

Texas health officials last week confirmed 18 dengue cases in the southern part of the state, 7 of which are believed to be locally acquired and not contracted during travel to a dengue-endemic area, Scientific American reported yesterday.

The cases are in adjoining Cameron and Hidalgo counties, the same area affected 10 years ago by dengue fever. The new cases follow an increase in dengue cases in Tamaulipas, Mexico, directly across the border from Texas, the story said. Texas had not had an outbreak of locally acquired dengue since 2005.

"We've seen in Cameron County over the last several weeks more dengue cases than we would expect," said Chris Van Deusen, a spokesman for the Texas Department of State Health Services, after the county logged 14 cases in the past few weeks. That compares with 27 dengue cases in the county over the past decade.

So far this year 23 locally acquired dengue cases have been reported in Martin and Miami-Dade counties in southern Florida, the story said, in the only other US dengue outbreak this year.
Nov 18 Scientific American report


Bill to tighten reins on compounding pharmacies heading to Obama

Prompted by last year's big fungal meningitis outbreak, a bill to increase federal oversight of large compounding pharmacies passed the Senate yesterday and is on its way to President Obama's desk, according to media reports yesterday.

The Drug Quality and Security Act was approved by the House in September and cleared the Senate on a voice vote yesterday, a Politico story said. It also sets up a system to trace drugs from the manufacturer to the dispensing pharmacy.

The legislation originated from the multistate fungal disease outbreak blamed on a contaminated injectable steroid from the New England Compounding Center in Framingham, Mass. The outbreak involved 751 cases and 64 deaths, according to the Centers for Disease Control and Prevention (CDC).

A New York Times report noted that drug compounding has expanded rapidly in recent years and that some pharmacies went beyond mixing medications for individual patients to become small manufacturers. Compounders are subject to state laws, but the Food and Drug Administration (FDA) has had little authority over them.

The new bill encourages, but does not require, compounding pharmacies that mass-produce drugs to register with the FDA, the Times reported. FDA approval is expected to give pharmacies a marketing advantage, since hospitals and other providers want assurance that they are buying safe drugs. The FDA registration system will be launched in 2014, according to Politico.

Under the legislation, companies that don’t' want to register with the FDA can continue mixing medicines for individual patients on the basis of a prescription, or making limited quantities ahead of a prescription, the Times reported. Those companies would not be subject to any new federal oversight.
Nov 18 Politico story
Nov 18 Times story


Princeton offers non–US-approved meningococcal vaccine

Officials at Princeton University said yesterday that they will make available a meningococcal vaccine that hasn't been approved in the United States to address a meningitis outbreak caused by a strain not included in the US-licensed vaccine, the Associated Press (AP) reported today.

Doses of the Bexsero vaccine, which contains the outbreak strain, Neisseria meningitidis type B, will be available in December to students living in dorms and employees who have medical conditions that place them at higher risk. Last week the FDA approved importing Bexsero in response to the outbreak after campus officials confirmed the university's seventh meningitis case. The vaccine is approved for use in Europe and Australia.

Two doses of the vaccine are recommended, and the second dose will be available in February, the story said. Princeton is acting in response to recommendations by the CDC.
Nov 19 AP story
Nov 18 CIDRAP News item "Feds to import meningococcal vaccine after Princeton outbreak"


World Toilet Day shines light on sanitation and public health

Today the world celebrates its first World Toilet Day, declared earlier this year by the United Nations to emphasize the importance of sanitation and hygiene to battle disease.

The fact that 2 billion people lack access to toilet facilities poses a particular health risk to women and children, the World Health Organization's (WHO's) Southeast Asia Regional Office (SEARO) said today in a news release. Half of those people live in Southeast Asia.

The situation has improved in the past 20 years, but much still needs to be done, according to SEARO. In 1990, 60% of Southeast Asians defecated in the open, but the number dropped to 39% in 2010.

Research suggests that every dollar invested in sanitation yields a return of about $5.50, SEARO said in the release.
Nov 19 WHO/SEARO news release

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