News Scan for Jun 25, 2015

Saudi MERS case
Pneumococcal vaccine timing
Waterborne outbreaks
Rotavirus vaccine and seizures

Saudi Arabia reports another MERS case in Hofuf outbreak

Saudi Arabia’s Ministry of Health (MOH) today announced one new MERS-CoV infection, yet another case linked to an outbreak in the city of Hofuf, which has reported clusters linked to healthcare facilities and at least one family.

The patient is a 41-year-old Saudi man who is a household contact of an earlier reported case. He is not a healthcare worker and is hospitalized in stable condition.

Two day ago the MOH reported one additional MERS-CoV (Middle East respiratory syndrome coronavirus) death in a previously reported patient, a 61-year-old woman in Hofuf.

The latest illness and death lift Saudi Arabia's MERS-CoV totals to 1,039 cases and 460 fatalities. The MOH said four people are still being treated for their infections, and over the course of the outbreak 575 have recovered.
Jun 25 MOH update
Jun 23 MOH update


ACIP recommends a year between pneumococcal shots in elderly

The US Advisory Committee on Immunization Practices (ACIP) today fine-tuned its recommendation on pneumococcal vaccinations for elderly people to stipulate that there should always be a 1-year interval between the two types of immunizations.

People age 65 and older are advised to receive the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23). The current official recommendation is that those who have received neither vaccine should get PCV13 first, followed by PPSV23 between 6 and 12 months later.

The ACIP today voted to recommend that there should be at least a 1-year wait between receipt of PCV13 and PPSV23, instead of 6 to 12 months, according to Alison Albert, a spokeswoman for the Centers for Disease Control and Prevention's (CDC's) National Center for Immunization and Respiratory Diseases.

For elderly people who have received PPSV23 but not PCV13, the existing recommendation is that there should be a 1-year wait, and today's ACIP action doesn't change that, Albert said.

Today's ACIP vote "will allow the recommended interval between these vaccinations to match, regardless of which vaccine is administered first," she said.

The committee advises the CDC on immunization issues, and its recommendations routinely become official CDC policy.
CDC adult immunization schedules


Waterborne pathogens—notably Crypto—sickened 1,800 in 2 years

Disease outbreaks associated with recreational water use caused at least 1,788 infections, 95 hospitalizations, and 1 death in the United States in 2011 and 2012, with Cryptosporidium the leading culprit, federal researchers said today.

Investigators from the CDC and the Environmental Protection Agency noted 90 outbreaks during the 2 years, 69 of which (77%) occurred in treated pools, according to their summary in Morbidity and Mortality Weekly Report (MMWR).

The median number of cases in treated-water outbreaks was 7 (range, 2 to 144). Thirteen outbreaks occurred in hotels, and 10 were associated at least partly with a spa. Thirty-six (52%) were caused by Cryptosporidium, followed by Legionella, which caused 9.

In the 21 outbreaks involving untreated water bodies like lakes, the median number of cases was 16 (range, 2 to 125). Five outbreaks were caused by Escherichia coli, while only 1 was attributed to Cryptosporidium.

In all outbreaks combined, Cryptosporidium caused by far the most illnesses. It accounted for 890 cases, followed by norovirus at 175 and norovirus combined with Giardia intestinalis at 125. The parasites Cryptosporidium, Giardia, and avian schistosomes accounted entirely or in part for 1,092 of the 1,788 cases, or 61%.

Cryptosporidium can survive in water for more than 10 days at CDC-recommended chlorine and pH levels, the report says.
Jun 26 MMWR report


Rotavirus vaccine might reduce seizures in young kids

Rotavirus vaccine might reduce hospitalizations due to seizures in preschoolers, according to a study today in the Pediatric Infectious Disease Journal.

Spanish scientists looked at hospitalization rates for any kind of seizure in 6,149 children younger than 5 years from 2003 to 2013 in Spain. Rotavirus vaccine was introduced in 2007.

They found that seizure-related hospitalizations declined by rates ranging from 16% in 2007 to 34% in 2010 compared with the median rate over the pre-vaccine years. The drop in rates for convulsions (also called tonic-clonic seizures) among hospitalized preschoolers ranged from 19% in 2007 to 43% in 2012. Those declines were all statistically significant and appeared to be more marked in the youngest infants.
July Ped Infect Dis J study

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