News Scan for Jun 11, 2019

FluMist and asthma
Legionnaires' in New Zealand
Rotary polio funding

Large study affirms inhaled flu vaccine safety in kids with asthma

A large study to assess if a new guideline recommending live attenuated influenza vaccine (LAIV, or FluMist) for children over age 2 years with asthma found no increase in lower respiratory events following vaccination. A research team from HealthPartners, a Minnesota-based healthcare and insurance provider, published its findings yesterday in Vaccine.

Little data are available on wheezing after LAIV in children with asthma, and the team's goal was to help fill the gap by studying kids ages 2 to 17 years who were vaccinated in two large medical groups from 2007 to 2016. In 2010, one of the groups implemented the new clinical guideline recommending LAIV for all children, including those with asthma. In comparing outcomes in the two groups, the researchers examined a cohort of 7,851 vaccinations in 4,771 children with asthma.

Of patients in the LAIV group, the proportion of kids receiving the formulation increased from 23% to 68% after guideline implementation, compared with a rise from 7% to 11% in the group that didn't implement the guideline.

After adjusting for age and baseline asthma severity, the researchers found no increase in lower respiratory events, including asthma exacerbations, within 21 days and 42 days of vaccination, even in the youngest subset of kids.

They concluded that the findings strengthen existing data that suggest LAIV is safe for children with asthma who are older than 2 years and that guidelines for flu vaccination in children with asthma over age 2 should allow use of either LAIV or inactivated vaccine (flu shots) and be based on vaccine effectiveness.
Jun 10 Vaccine abstract


Study shows increasing rates of Legionnaires' disease in New Zealand

Rates of Legionnaires' disease are increasing in New Zealand, with cases in 2015 and 2016 triple the average of the preceding 3 years, according to new data published in The Lancet Infectious Diseases.

The data come from the first nationwide study of routine systematic polymerase chain reaction (PCR) testing to assess the incidence of Legionnaires' disease in hospitals in New Zealand. From May 2015 through May 2016, 5,622 eligible respiratory specimens from 4,862 patients were tested for Legionnaires'. Through the specimens and notification systems, the authors detected 238 cases.

"The overall incidence of Legionnaires' disease cases in hospital in the study area was 5.4 per 100 000 people per year, and Legionella longbeachae was the predominant cause, found in 150 (63%) of 238 cases," the authors said.

The increase in incidence occurred because PCR testing found more cases than culture-based testing, the authors noted.

In a commentary on the study, Mathias Pletz, PhD, and colleagues from Jena University Hospital in Jena, Germany, said the research shows "that the real burden of Legionnaires' disease seems to have been underestimated. This finding might have implications for community-acquired pneumonia treatment guidelines."
Jun 10 Lancet Infect Dis
Jun 10 Lancet Infect Dis


Rotary pledges $100 million to support polio eradication

As Africa nears polio-free status, the Rotary organization has pledged $100 million US to address the final challenges to ending poliovirus transmission.

"We have the wild poliovirus cornered in the smallest geographic area in history, and now there are just two countries that continue to report cases of the wild virus," said Michael K. McGovern, chair of Rotary's International PolioPlus Committee in a press release. "Rotary is doubling down on our commitment to end polio for good."

Nigeria is approaching 3 years since the last detection of a wild poliovirus case, while Afghanistan and Pakistan are still detecting wild poliovirus cases.

Rotary funding will be split among Pakistan ($25.2 million), Afghanistan ($13.6 million), and Nigeria ($10.2 million). The remaining funds will be given to 10 countries that are polio-free but still vulnerable to the virus.

Last year saw 33 cases of wild poliovirus, Rotary said. So far in 2019 the Global Polio Eradication Initiative has tracked 29 wild poliovirus cases, 21 in Pakistan and 8 in Afghanistan.
Jun 10 Rotary press release

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