News Scan for Feb 28, 2019

No flu shot link to miscarriage
Saudi MERS case
Measles and vaccine exemptions
New malaria approach

Study presented to ACIP finds no link between flu shots and miscarriage

A larger follow-up on a 2017 study that found an association between repeated doses of flu vaccine containing the 2009 H1N1 strain and miscarriage in pregnant women ruled out the association, researchers reported to federal vaccine advisors yesterday.

The group that presented the findings to the Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP) was from the Marshfield Clinic Research Institute — the same team that published the 2017 report on a potential safety signal. At the time they said the findings called for deeper investigation but cautioned that there was no biological basis for the phenomenon and that the data didn't show the vaccine causes miscarriages.

The new findings include data from three more flu seasons—2012-13, 2013-14, and 2014-15—and include 1,236 pairs of women, 627 who had been vaccinated and 609 who had not, CNN reported yesterday.

When the investigators looked at data from each flu season and all of the seasons combined, researchers found no increased miscarriage risk during the 28 days following flu vaccination or any other time period they examined. They said the odds ratio of having a miscarriage were less than or close to one and that minor variations could be explained by chance, concluding that the findings provided a high level of reassurance, according to the report.

In other ACIP developments, the group voted to recommend for anthrax pre-exposure prevention a booster dose of anthrax vaccine adsorbed (AVA), which can be given every 3 years to maintain protection, Healio, a medical news service, reported yesterday. AVA, also known as BioThrax, is the only licensed vaccine against disease caused by Bacillus anthracis, the bacterium that causes anthrax. Also, ACIP members approved a shorter duration between the first and second doses of Japanese encephalitis vaccine for travelers.
Feb 27 CNN story
Sep 13, 2017, CIDRAP News story "
Study signals association between flu vaccine, miscarriage"
Feb 28 Healio report


New MERS case recorded in Saudi Arabia

The Saudi Arabian Ministry of Health (MOH) announced one new MERS-CoV case today, recorded in epidemiologic week 9, in Sajir in the central part of the country. The case does not appear to be part of an ongoing outbreak of the virus in Wadi ad-Dawasir, more than 300 miles to the south.

A 43-year-old man from Sajir is hospitalized for his MERS-CoV (Middle East respiratory syndrome coronavirus) infection. The MOH said the man had camel contact prior to illness.

The new case raises the total number of MERS cases reported in Saudi Arabia so far this year to 82. Fifty-one of those cases have occurred in a hospital-based outbreak in Wadi ad-Dawasir, which has featured both human and zoonotic transmission.

The MOH confirmed two MERS cases in Sajir in December 2018, both involving camel contact.
Feb 28 MOH


2018 measles cluster shows stricter vaccine exemptions can be dodged

Today in the CDC's Morbidity and Mortality Weekly Report (MMWR), California public health officials describe a cluster of seven measles cases in 2018 involving minors who were able to evade the state's stricter vaccine exemption requirements.

Five of the seven cases, including the index case, were teenage boys who were unvaccinated because of parental beliefs, despite that fact that in 2016 California passed Senate Bill 277, which stated children entering school in California may no longer receive exemptions from immunization requirements based on parental personal beliefs.

"Medical exemptions for reasons determined by individual physicians, including family medical history, rather than a uniform standard (i.e., a medical contraindication to vaccination), remain permitted," the authors wrote. "Interviews with local health authorities suggest that some students without contraindications to vaccination have received medical exemptions."

The index case, a 15-year-old boy, contracted measles while traveling to England and Wales in early 2018. He spread the disease to other unvaccinated contacts during scouting events.

The MMR (measles, mumps, rubella) vaccine, is recommended for all Americans born after 1957 who do not have a medical contraindication.
Mar 1 MMWR


Study: Common malaria drug on bed nets kills parasite in mosquitoes

In an effort to combat growing insecticide resistance, researchers writing in Nature yesterday said exposing mosquitoes to the malaria drug atovaquone (ATQ) killed the parasite in the mosquitoes.

ATQ, in combination with proguanil, is used extensively under the name Malarone for prophylaxis in travelers. Insecticides effectively kill mosquitoes and have helped combat malaria, but resistance to these chemicals is increasing.

The authors said atovaquone could be paired with insecticides to treat mosquito bed nets, and demonstrated that after just 6 minutes of contact with the medicine, Plasmodium falciparum was eliminated in a sample of Anopheles misquotes, the most common vectors of malaria in Africa.

"Parasite development was also completely aborted when mosquitoes were exposed to ATQ 24 h before or 12 h after infection," the authors said.

"These findings indicate that ATQ-like antimalarials could be incorporated into control interventions other than treated nets, such as attractive toxic sugar baits, in which female mosquitoes become exposed to chemicals while feeding on sugar, or indoor residual-insecticide spraying, in which contact occurs while female mosquitoes are resting before or after blood feeding."
Feb 27 Nature study

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