News Scan for Sep 19, 2014

Review finds more Saudi MERS cases
Food safety rules
Tainted vaccine in Syria
Premature-death targets
Business and flu

Saudi audit finds 16 earlier MERS cases; 1 new case reported

An independent audit of MERS-CoV data in Saudi Arabia yesterday identified 16 more infections with illness onsets before Jun 3 and has reclassified a handful of previously reported cases, the country's Ministry of Health (MOH) announced yesterday.

It said the review is part of an ongoing effort to ensure that MERS-CoV (Middle East respiratory syndrome coronavirus) data are accurate.

Many of the new cases were found during a review of patient records at hospitals that conduct on-site lab testing, and all but three of the cases are from Jeddah. The health ministry said it has shared the new data with the World Health Organization (WHO).

In addition, among the previously reported cases, one duplicate was found and deleted and two cases reported on Jun 9 and Aug 26 were identified as false-positives and have been deleted from the case total.

Records were updated for 21 cases, with 18 changed from active to recovered and 3 changed from active to deceased.
Sep 18 MOH statement

In a related development, the Saudi MOH today reported one new MERS case, in a 65-year-old man from Taif who is hospitalized with symptoms and is in stable condition. It said the man had animal exposure and has an underlying health condition. The MOH said he is not a healthcare worker.

The health ministry has confirmed seven MERS cases since Sep 8, five of which involved intensive care.

The new case, plus the 16 retrospective cases and deaths, push Saudi Arabia's number of MERS-CoV infections to 749 and its death total to 316.
Sep 19 MOH update
Sep 17 CIDRAP News Scan on previous case


FSMA revisions aim to give flexibility to producers and suppliers

Revised provisions to four proposed rules that fall within the Food Safety Modernization Act (FSMA) were announced today by the US Food and Drug Administration (FDA) in a news release.

Taking comments on revised proposals before arriving at final rules is "a very unusual step" that shows the agency's "determination to get the rules right," a Food Safety News (FSN) story quoted FDA deputy commissioner for foods and veterinary medicine Michael Taylor as saying.

FSMA focuses on preventing food-related problems rather than responding to them after the fact, the FDA said. Today's revisions address rules on produce safety, preventive controls for both human and animal food, and foreign-supplier verification. The revisions were developed in response to thousands of comments from farmers, consumers, the food industry, and academic experts after the rules' initial issuance.

Specifically, the changes address:

  • Water quality testing rules so they account for natural variations in water sources
  • Adjustments in regulations about the use of manure and compost
  • The definition of which farms are subject to produce-safety rules
  • Use of spent grains, which are byproducts of brewing and distilling that are fed to animals
  • More flexibility in foreign-supplier verification based on risk and history

The changes in the proposed rules are open for comment for 75 days. Comments can be made beginning Sep 29 at
Sep 19 FDA news release with links to proposed revisions
Sep 19 FSN article


WHO: Mixing error in measles vaccine that killed Syrian children

The WHO announced today that 15 Syrian children died this week after being vaccinated with measles vaccine that mistakenly contained a muscle relaxant, according to a Reuters story. A measles vaccination campaign that began Monday in war-torn northern Syria with support from the WHO and the UN Children's Fund (UNICEF) was promptly halted while the event is investigated.

The vaccine, from an unnamed manufacturer, was reportedly shipped in powder form along with a dilutant to a hub in Syria where the two ingredients were refrigerated before shipment to vaccine sites. The refrigerator apparently also contained the muscle relaxant Atracurium, said WHO spokesperson Christian Lindmeier said at a news briefing in Geneva, according to the story.

The vaccine powder appears to have been packed with ampules of Atracurium instead of the dilutant for delivery to vaccination facilities in the Zor and Idliv provinces, where the two were then mixed for use within 6 hours.

Some 50,000 children received the incorrectly mixed vaccine. Lindmeier is quoted as saying, "Both at the packing and at the unpacking there had to be gross negligence."

Atracurium is normally administered as an anesthetic for surgery with the dosage calculated by weight. The children who died were all under age 2, and older children, who presumably weighed more, experienced vomiting, diarrhea, and anaphylactic shock.

It is not clear yet whether the error occurred inadvertently or by intent. "It seems very clear that it was not the manufacturer's fault, not that the vaccine is contaminated, but it's a fault on the ground . . . whether it's human error or deliberate," said Lindmeier. Reports earlier this week raised the possibility of sabotage in relation to vaccine contamination in northern Syria.
Sep 19 Reuters story
Sep 17 CIDRAP News scan on reports of vaccine contamination


International group suggests premature death targets

With the United Nations (UN) planning later this month to discuss replacing Millennium Development Goals (MDGs), which expire next year, a global group of researchers today proposed a more specific health goal, one involving infectious diseases. The team published its findings in The Lancet.

The UN will be looking at 17 "Sustainable Development Goals," effective between 2016 and 2030. The new health goal is to "ensure healthy lives and promote well-being for all ages."

To come up with their more specific goals, experts looked at death patterns from various causes over the past decades. The more specific goals they call for include targets for each country geared toward reducing premature deaths before age 70 by 40%. The goal would build on causes already targeted by MDGs, as well as other noncommunicable disease and injury causes of early death.

Looking back at death patterns, they found that the risk of premature deaths has been dropping in all countries, except those carrying high HIV and political disturbance burdens. The most striking change from 2000 to 2010 they found was a drop in childhood deaths from vaccine-preventable diseases.

Their proposed targets include a two-thirds reduction in child and maternal deaths from HIV, tuberculosis, and malaria. They predicted that moderately accelerating the overall achievements seen from 2000 to 2010 would achieve 2030 disease-specific reductions, at least in areas not affected by war, political conflict, or new epidemics.
Sep 19 Lancet study


CDC business publication focuses on coming flu season

The latest edition of the CDC Foundation's quarterly Business Pulse publication focuses on influenza, offering employers and workers resources and information on the upcoming flu season, said a news release yesterday from the Centers for Disease Control and Prevention (CDC).

Challenges faced by businesses in relation to influenza are addressed, and a Q and A feature and an interactive infographic are offered.

Through Business Pulse, CDC intends to help businesses and workers protect themselves against both chronic and emergency health threats that could lessen productivity, says the release. Each issue focuses on a different topic.
Sep 18 CDC news release
Business Pulse flu prevention issue

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