News Scan for May 19, 2014

Fluzone and seizures
WHA begins in Geneva
Legionella and wiper fluid

FDA: 2010-11 flu vaccine not associated with childhood febrile seizures

Although early reports during the 2010-11 flu season suggested possible safety concerns over febrile seizures in kids with the trivalent inactivated influenza vaccine (TIV) Fluzone, just-released epidemiologic findings show no statistically significant association, according to the US Food and Drug Administration (FDA).

The FDA, through its Postlicensure Rapid Immunization Safety Monitoring (PRISM) program, studied 842,325 children enrolled in one of three health plans during that flu season who met eligibility requirements. Sixty-eight of them experienced confirmed febrile seizures within 20 days of receiving TIV, rendering any association not statistically significant.

On the basis of these findings, no changes to the prescribing information for Fluzone or other flu vaccines have been requested by the FDA.

In its notice, the FDA points out that any childhood illness that induces fever can result in a febrile seizure and that about 1 in 25 young children (4%) will have at least one such seizure by 5 years of age, most commonly between 14 and 18 months of age.

Most affected children recover quickly with no long-term sequelae, the agency said. It stressed that young children are at increased risk of severe influenza and recommended that all persons 6 months of age or older receive flu vaccine each year.
May 16 FDA update


WHA begins with new TB strategy approval

The World Health Assembly (WHA) opened in Geneva today, highlighted by an opening address from World Health Organization (WHO Director-General Margaret Chan, MD, MPH, and the group approving a resolution endorsing a new global strategy for addressing tuberculosis (TB) after 2015.

Infectious disease topics were prominent in Chan's speech today, and she began her address using a recent spike in polio spread from travelers as an example of universal, concerning trends that are shaping world health, such as armed conflict, civil unrest, weak border control, and poor immunization coverage.

She said social inequalities are fueling a host of disruptions that threaten future prosperity and that a recent expert panel on climate change raised major concerns about the impact on human health. "Changes in the way humanity inhabits the planet have given the volatile microbial world multiple new opportunities to exploit," Chan said, adding that West Africa's Ebola outbreak adds to the number of severe emerging viruses that are circulating, including H5N1 and H7N9 avian influenza and Middle East respiratory syndrome coronavirus (MERS-CoV).

Afterward, a committee discussion on communicable diseases took up the TB strategy discussion, which has a goal of ending the TB epidemic with targets to reduce deaths by 95% and cut new cases by 90% by 2035, the WHO said in a statement today. The strategy also includes interim milestones for 2020, 2025, and 2030.

The TB resolution asks governments to support the strategy with high-level containment and financing and to focus on vulnerable groups, such as migrants, who have little access to healthcare. It also underscores the importance of addressing multidrug-resistant TB. The new strategy asks the WHO to monitor implementation and progress toward the new targets.

The WHA, the decision-making group of the WHO, is held each year in Geneva. About 3,000 participants help set policy decisions on issues such as disease prevention, monitoring health improvement progress, and the WHO's budget. The meeting goes through May 24.
May 19 WHO press release
May 19 text of Chan WHA address


Study: Legionella can grow in and spread from windshield washer fluid

Legionella bacteria, the cause of legionellosis or Legionnaires' disease and of the milder Pontiac fever, can grow in high levels in windshield washer fluid and may be released in "potentially dangerous numbers" into the air, says research presented yesterday at the American Society for Microbiology (ASM) annual meeting in Boston.

The studies, presented by doctoral student Otto Schwake of Arizona State University, were done in the summer of 2012. Several kinds of washer fluid were tested as growth media for Legionella, according to an ASM press release. Bacterial concentrations were found to increase over time, with stable populations maintained for up to 14 months.

In a second study, washer fluid from the school buses in a central Arizona district was tested. Culturable Legionella was found in about 75% of the samples.

Said Schwake, "While potential transmission of a deadly respiratory disease from a source as common as automobile windshield washing systems is significant, the study also points to the fact people can be exposed to pathogens—particularly those occurring naturally in the environment—in previously unknown and unusual ways."

Legionella, which usually exists in water, has most commonly been associated with large air-conditioner cooling towers and hot tubs.
May 18 ASM press release

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