News Scan for Aug 12, 2016

Yellow fever in Angola, DRC
Childhood vaccine costs
MRSA in people and pigs

Yellow fever declines in Angola, but is still spreading in DRC

Yellow fever has declined in Angola, with no confirmed cases reported since June, but the disease in the Democratic Republic of the Congo (DRC) is spreading to new provinces and new parts of already affected provinces, the World Health Organization (WHO) said today in a weekly update.

Despite the drop-off in cases in Angola, the source of the DRC's outbreak, the WHO recommends maintaining a high-level of vigilance, and a mass vaccination campaign targeting 3 million people in 18 districts is expected to launch on Aug 15. Yellow fever vaccination is also scheduled to take place this month in four districts that border Namibia.

In the DRC, preventive vaccination campaigns are scheduled to start on Aug 17 in Kinshasa province using fractional dosing, a strategy the WHO recently approved for stretching limited vaccine supplies on an emergency basis. Vaccination will also target health zones that border Angola.

Since December 2015, Angola has reported 3,867 yellow fever cases, 879 of them confirmed. As of Aug 8 the DRC had reported 2,269 cases, 74 of them confirmed. Of that country's confirmed cases, 56 were imported from Angola, 12 were locally acquired, 3 were sylvatic (from wild animals), and 3 are under investigation, the WHO said.
Aug 12 WHO yellow fever update


Cost of US childhood vaccinations rose 13% per year, study finds

The cost of childhood vaccinations rose 12.6% per year from 1996 to 2014, driven largely by the introduction of new vaccines, researchers from the Centers for Disease Control and Prevention (CDC) said in a study this week in Vaccine.

The researchers used the most recent public-sector data to analyze vaccine purchase costs over the study period. They found that the cost per child of recommended non-flu vaccines climbed from about $260 in the 1990s to nearly $1,630 in 2014—a 12.6% average annual growth rate after adjusting for inflation.

The CDC team found that most of the growth was attributed to updates to existing recommendations and to additions of new vaccines, such as the seven-valent pneumococcal vaccine in 2000 and the human papillomavirus vaccine in 2007. In contrast, the annual growth rate due to price variation varied from -5% to 5%. Also, combination vaccines showed more price fluctuation and were often more expensive than component vaccines.

The investigators said that if this trend continues, the cost of vaccinating a child will more than double by 2020 compared with 2014 prices.
Aug 10 Vaccine study


Researchers identify factors that likely spread MRSA on swine farms

A study of recent human and swine cases of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in Norway noted that occupational exposure, trade of pigs, and livestock transport vehicles were common routes of transmission.

The researchers analyzed data on three outbreak clusters of LA-MRSA from 2008 through 2014 that included 26 pig farms, two slaughterhouses, and 36 people.

They wrote, "Primary introductions likely occurred by human transmission to three sow farms with secondary transmission to other pig farms mainly through animal trade and to a lesser extent via humans or livestock trucks." They also discovered that all non-cluster human MRSA isolates of the same strain as the outbreak strain—CC398—from the same period were genetically distinct, indicating limited spread of LA-MRSA to the general population.

The authors conclude, "These findings are essential for keeping pig populations MRSA-free and from a One Health perspective to prevent pig farms from becoming reservoirs for MRSA transmission to humans."
Aug 11 Clin Infect Dis abstract

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