News Scan for Oct 09, 2015

Effective rotavirus vaccines
Antibiotic stewardship for C diff
H5N6 in Laos
Cholera in Iraq

Both US rotavirus vaccines shown 80% effective in kids

Vaccine effectiveness (VE) for both US-approved rotavirus vaccines— the five-strain (RV5) and single-strain (RV1) versions—is 80% in children, according to a study published yesterday in Clinical Infectious Diseases.

Researchers from the Centers for Disease Control and Prevention and across the country enrolled children hospitalized or visiting emergency departments with acute gastroenteritis in 2012 and 2013 at seven hospitals.

Analyses for RV5 (RotaTeq) included 2,961 patients, of whom 402 (14%) had lab-confirmed rotavirus and 2,559 served as rotavirus-negative controls. Analyses for RV1 (Rotarix) included 100 rotavirus cases (11%) and 804 controls, or 904 total patients. Over the two rotavirus seasons, VE for a complete three-dose vaccine course of RV5 was 80% (95% confidence interval [CI], 74%-84%), and VE for a complete two-dose regimen with RV1 was also 80% (95% CI, 68%-88%).

The authors conclude, "In this large, geographically and demographically diverse sample of US children, we observed that RV5 and RV1 rotavirus vaccines each provided a lasting, and broadly heterologous protection against rotavirus gastroenteritis."
Oct 8 Clin Infect Dis study


Antibiotic stewardship program cuts pediatric C diff rates 70%

Children treated in a hospital that implemented an antibiotic stewardship program were three times less likely to develop a Clostridium difficile infection, according to a study presented at IDWeek in San Diego, according to a news release today from the Infectious Diseases Society of America (IDSA), a sponsor of the conference.

Investigators compared rates of C diff and antibiotic-related costs at U of California–Davis Children's Hospital in 2008 through 2010, before an antibiotic stewardship program was begun and in 2011 through 2014, when the program was in place. They found the rates of C diff dropped from 9.2 to 2.8 per 10,000 patient-days after the program was instituted, a 69.6% reduction.

"C diff infection is not always benign and can result in significant consequences for a child, including longer hospital stays, treatment with unpleasant-tasting and expensive medicines, and weight loss," said author Jean Wiedeman, MD, PhD.
Oct 9 IDSA news release


Laos reports H5N6 outbreak on farm

An outbreak of H5N6 avian flu in poultry has been reported for the first time in Laos since last September, according to a report filed by health authorities with the World Organization for Animal Health (OIE) yesterday.

The outbreak was first detected on Oct 3. It involves a farm that housed 534 ducks and chickens. Of those, 314 died from the disease and the rest were culled to prevent disease spread.

The farm is located in Xaignabouli province in the northwestern part of the country adjoining Thailand. The country's previous H5N6 outbreaks were reported on Sep 16 and Mar 31, 2014, but Vietnam has been beset by the virus this year.
Oct 8 OIE report


Cholera outbreak in Iraq tops 1,200 cases

Cholera cases in Iraq have increased 10-fold in less than 2 weeks, to 1,201 lab-confirmed infections, with a tripling of affected governorates, the World Health Organization's (WHO's) Eastern Mediterranean Regional Office (EMRO) said in a news release yesterday.

On Sep 28 the WHO reported 120 cholera cases in five of the country's governorates. Fifteen governorates are now affected, according to the release.

WHO and Iraqi officials are ramping up response efforts, according to WHO EMRO. "Comprehensive and multisectoral response activities cover the areas of coordination, surveillance, laboratory, case management, infection control, water sanitation and hygiene (WASH) promotion, risk communications, as well as oral cholera vaccine," the agency said. The WHO has supplied kits for treating 6,800 moderate and 1,700 severe cholera cases, as well as almost 1,000 rapid diagnostic tests.

The outbreak is centered in southern Iraq but appears to be spreading to northern regions, the press release said. A few cases have also been detected in neighboring Kuwait and Bahrain.

The WHO also raised concerns about an additional risk of international spread of the disease, with millions of pilgrims from throughout Iraq and other nations coming to Karbala governorate on Oct 23 for an annual religious gathering.
Oct 8 WHO EMRO news release

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