News Scan for Nov 12, 2014

2 new Saudi MERS cases
Tdap vaccine in pregnancy

Saudi Arabia reports 2 new MERS cases

Saudi Arabia's Ministry of Health (MOH) today reported two new MERS-CoV cases and one recovery in a previously reported patient. Both new cases occurred in Taif, and the MOH says that both patients are in critical condition.

The first patient is a 22-year-old male expatriate who had contact with a suspected or confirmed MERS-CoV (Middle East respiratory syndrome coronavirus) case-patient in a community setting. He is not a healthcare worker, had no contact with MERS-CoV patients in healthcare settings, and had no preexisting disease or exposure to animals.

The second case-patient is a 70-year-old Saudi woman with preexisting disease. The MOH is investigating whether or not she had contact with animals or other MERS patients.

The MOH also reported that a 36-year-old man from Taif has recovered from the disease. He had an underlying medical condition and is not a healthcare worker.

Of the 802 Saudi MERS cases that the MOH has confirmed, 15 are active, and 340 have been fatal.
Nov 12 MOH update
Nov 11
CIDRAP News scan on Saudi Arabia's 800th MERS case


Study: Tdap vaccination deemed safe in pregnancy

The administration of Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccine to women during pregnancy causes no ill effects, say results of a study in today's issue of the Journal of the American Medical Association (JAMA).

Tdap was licensed in 2005 for use in nonpregnant adolescents and adults but is now recommended by the Advisory Committee on Immunization Practices (ACIP) for all pregnant women, preferably between 27 and 36 weeks' gestation. The change stemmed from outbreaks of pertussis and neonatal deaths. California, in 2010, was the first state to recommend the vaccine for pregnant women.

The authors retrospectively analyzed data from two Vaccine Safety Datalink sites in California to determine whether administration of the vaccine during pregnancy increased the risk of adverse obstetric or birth outcomes. Records of 123,494 women pregnant from Jan 1, 2010, through Nov 15, 2012 were included. Of the group, 26,229 (21%) received Tdap during pregnancy and 97,265 did not.

The authors found that 8.4% of women receiving Tdap delivered small-for-gestational-age (< 10th percentile) infants, compared with 8.3% of women who did not get the vaccine. They also found the rate of preterm (< 37 weeks) delivery to be 6.3% in the Tdap group and 7.8% in the non-Tdap group. The incidence of hypertensive disorders of pregnancy was not increased in the Tdap group.

A small but significant increased risk of chorioamnionitis was observed in the Tdap group—6.1% versus 5.5% overall; the risk in women vaccinated late in pregnancy (27 to 36 week) was slightly elevated but even less so than in the women overall.
Nov 12 JAMA abstract

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