H5N1

UK: Cases of pertussis continue to decrease

Via HPA: Cases of whooping cough continue to decrease. Excerpt:

Figures published by the Health Protection Agency (HPA) today show that confirmed cases of whooping cough in England and Wales have continued to decrease with 668 cases reported in January 2013, compared to 835 cases in December 2012. 

This will be the third month running that cases have decreased, however numbers remain unusually high following a sustained outbreak during 2012 which saw a record 9,741 cases. Large numbers of cases continue to be reported in those aged 15 years and older with 579 cases reported in January this year compared to 170 in the same period in 2012 and 25 in 2008, which was the last peak year. 

Dr. Gayatri Amirthalingam, consultant epidemiologist for immunisation at the HPA, said: “The January figures show a welcome continued decrease of whooping cough cases since October. However, it is very important to note that we usually see a reduction in cases of whooping cough at this time of year so this decrease is in line with normal seasonal patterns. 

“It is very encouraging to see that almost 60 per cent of pregnant women delivering in January in England had accepted the offer of a vaccination against whooping cough. We would like to remind pregnant women how serious this infection can be in young babies. The aim of vaccinating of women between 28 and 38 weeks of pregnancy is to offer babies protection against whooping cough in the first few months of life, before they receive their own vaccines. 

“It is also important for parents to ensure their children are vaccinated against whooping cough on time, even babies of women who’ve had the vaccine in pregnancy – this is to continue their baby’s protection through childhood.”

CIDRAP: Researchers find first US evidence of vaccine-resistant pertussis

Via CIDRAP, Lisa Schnirring has the least welcome news of the day: Researchers find first US evidence of vaccine-resistant pertussis. Excerpt:

Researchers in other countries have found evidence that circulating strains of Bordetella pertussis have adapted to the acellular vaccine, and researchers today reported similar findings for the first time in US kids, based on genetic analysis of isolates from hospitalized children. 

Infectious disease experts have been eyeing waning immunity from acellular pertussis vaccines as a contributor to increasing numbers of cases of pertussis (whooping cough) in several countries, and evidence is mounting that another factor fueling the outbreaks could be that the bacteria are adapting to the vaccine. 

The US researchers, including a scientist from the US Centers for Disease Control and Prevention (CDC), described their findings in a letter in the New England Journal of Medicine. 

So far, lab studies in Japan, France, and Finland have identified variants of B pertussis that are negative for pertactin, a virulence factor and an outer membrane protein that promotes adhesion to tracheal epithelial cells. Pertactin purified from B pertussis is a key component of the acellular pertussis vaccine. 

Many countries switched from the whole-cell pertussis vaccine to the acellular version in the late 1990s because of a fairly high rate of minor side effects in the whole-cell vaccine. 

However, in the face of rising pertussis levels, surveillance studies in the United States and other countries are finding a gap in protection in children who received doses of acellular vaccine. The CDC has said that pertussis cases are at their highest point since 1955.

US: Flu panic grips the fashion world

Via The New York Times: Illness Walks the Runway. Excerpt:

A top fashion designer quarantines a sneezing underling, forcing her to work in a closet. An industry P.R. executive makes colleagues douse their hands with Purell. Germ-phobic magazine editors are powerblasting offices with antiseptic wipes and Lysol. 

While all eyes are on the models, top, those behind the scenes hope to avoid being struck by sickness. Such is the dread gripping the fashion world as it prepares for New York Fashion Week, beginning Feb. 7, with a killer flu and a stomach-bug norovirus on the loose. 

The eight-day event, when fashionistas from around the world pack into small spaces to attend runway shows and parties — only to cram onto the same flights and repeat the process in London, Milan and Paris — is always an occasion for sickness paranoia. In past years, sniffles in the front row could prompt icy stares and social ostracism. 

But with this season’s flu panic, the fear is approaching hysteria. Stressed-out designers recoil in horror if someone coughs within earshot. Frail models shiver their way between fittings, terrified someone will spy their runny noses. And frenemies everywhere are reconsidering the wisdom of the double-cheek kiss, the standard greeting of the global fashion tribe. Air kissing seems safe for now. 

“This will be the season where everyone in fashion becomes mysteriously nonaffectionate,” said Laura Brown, executive editor of Harper’s Bazaar. Staff members in her West 57th Street offices, she added, have been scouring doorknobs with sanitizing wipes. “We can give a nudge and a wink instead.” 

To be fair, much of the paranoia is founded. According to the Centers for Disease Control and Prevention, deaths from the current flu season reached “epidemic” levels, in part because of an unusually severe flu strain. Adding to the flulike epidemic is a surging new strain of norovirus, which can cause sudden diarrhea and projectile vomiting, and the worst whooping cough outbreak in 60 years.

Yang: Disease outbreaks may be on rise, health officials fear

Via The Star, health reporter Jennifer Yang writes: Disease outbreaks may be on rise, health officials fear. Excerpt:

North America is in the throes of a severe flu season, but it’s not the only infectious disease that has sent public health officials scrambling over the past year. In fact, in a world of ever-increasing travel, trade and temperatures, outbreaks seem to be more frequent. 

“Every year has its share of outbreaks but I wouldn’t be surprised if, just like climate change, we’re seeing an overall increase over time,” said Dr. Larry Madoff, editor of ProMed, an international disease surveillance and reporting website.

Clock through to read Yang's summary of present and impending hazards.

Nearly half of US children late receiving vaccines

Via Yahoo!News, a Reuters report: Nearly half of U.S. children late receiving vaccines. Excerpt:

Nearly half of babies and toddlers in the United States aren't getting recommended vaccines on time, according to a study - and if enough skip vaccines, whole schools or communities could be vulnerable to diseases such as whooping cough and measles. 

"What we're worried about is if (undervaccination) becomes more and more common, is it possible this places children at an increased risk of vaccine-preventable diseases?" said study leader Jason Glanz, with Kaiser Permanente Colorado in Denver. 

"It's possible that some of these diseases that we worked so hard to eliminate (could) come back." 

Glanz and his colleagues analyzed data from eight managed care organizations, including immunization records for about 323,000 children. 

During the study period, the number of children who were late on at least one vaccine - including their measles, mumps and rubella (MMR) and diphtheria, tetanus and pertussis (DTaP) shots - rose from 42 percent to more than 54 percent. 

Babies born towards the end of the study were late on their vaccines for more days, on average, than those born earlier. 

"When that happens, it can create this critical mass of susceptible individuals," said Saad Omer, from the Emory Vaccine Center in Atlanta, who wasn't involved in the new study.

Just over one in eight children went undervaccinated due to parents' choices. For the rest, it wasn't clear why they were late getting their shots. Some could have bounced in and out of insurance coverage, Glanz suggested, or were sick during their well-child visits, so doctors postponed vaccines. 

Undervaccinated kids also tended to have fewer doctors' appointments and emergency room visits than those who got their shots on time, according to findings published in the journal JAMA Pediatrics.

Vietnam: WHO says Quinvaxem vaccine safe for children

Via Saigon Giai Phong: Quinvaxem vaccine safe for children: WHO. 

After seven deaths and three serious allergy cases attributed to Quinvaxem vaccine injections in the last two months, the Ministry of Health and the World Health Organization jointly conducted tests of the vaccine to assess the properties of the vaccine and assert cause of deaths. 

WHO sent five samples to an independent international organization for testing and the test results showed that the vaccine was safe for children. 

Before, the ministry had also announced test results of the vaccine, declaring it safe for children and conforming to the country’s standards as well as international WHO standards. 

In addition, the transportation and preservation conditions of the vaccine were also done in the right manner under hygienic conditions. Medical staff also had followed correct procedures while injecting the children. 

Quinvaxem is a vaccine used to fight five serious child diseases, namely, diphtheria (D), tetanus (T), pertussis (P, whooping cough), hepatitis B (HepB), and Haemophilus influenzae type b (Hib). 

So far, around 427 million doses of Quinvaxem vaccine have been used in more than 91 nations since 2006. Since June 2010, Vietnam has been using the Quinvaxem vaccine and consumes 4.5 million free doses in children from 2-4 months old.

US: Hospitals turn away visitors with flu symptoms

Via The New York Times, a January 14 report: Hospitals Turn Away Visitors With Flu Symptoms. Excerpt:

People who wish to visit loved ones in the hospital take heed: At some medical centers, a cough or a sneeze will probably get you turned away. 

As public health officials struggle to contain the spread of influenza, pertussis and norovirus, a growing number of hospitals around the country are placing restrictions on visitors to protect their patients from infection. Hospitals in at least 10 states have asked visitors with flulike symptoms not to visit patients. Some are placing outright bans on children and teenagers, fearing they may be most likely to infect patients. 

Most hospitals, though, are also making exceptions — for instance, in cases where a loved one is critically or terminally ill. 

Hospitals in Boston, the first place in the country to declare a flu emergency last week, were among the first to start asking visitors with signs of illness to wear masks and avoid certain wards. 

On Monday, several hospitals in Western Michigan asked anyone with a fever, cough, runny nose or other signs of the flu to refrain from visiting. Jersey City Medical Center said that any visitor under age 18 or with signs of flulike illness will not be allowed to see patients. 

And four hospitals in the Peoria, Ill., area said that they would start enforcing new guidelines barring children and would allow staff to ask anyone who coughs or sneezes in the patient-care area to leave. The hospitals said they were following guidelines by the state department of public health. 

“More than anything, we’re just trying to keep the environment safe for patients,” said Dr. Ryan Walsh, the medical director for employee health at Methodist Medical Center in Peoria. 

Dr. Walsh said that the hospital was not motivated by any particular incident, but by the rate of flu activity in the area. At this time last year, Methodist Medical Center had seen eight confirmed cases of flu in its emergency room. The number of confirmed cases so far this year is up to 68.

Mexico: Looking for an answer to the Yajalón deaths

Via La Jornada: En Yajalón, analizan qué causó muerte de 5 bebés. [In Yajalón, identifying what caused the deaths of 5 babies] Excerpt, with my translation:

El director del Centro Nacional para la Salud de la Infancia y la Adolescencia (Censia), Ignacio Villaseñor, informó que luego que se realicen los cultivos para la identificación del virus o la bacteria, se conocerá la causa del fallecimiento de cinco niños del municipio de Yajalón, Chiapas. 

Ignacio Villaseñor, director of the National Centre for Child and Adolescent Health, says that after tests have been completed to identify the virus or bacteria, we will know what caused the deaths of five children in the municipality of Yajalón, Chiapas.

Ratificó que, de los primeros análisis clínicos de 22 muestras de exudado faríngeo que se tomaron a un total de 40 menores con infección de vías respiratorias en aquella localidad –de menos de 14 años–, el laboratorio estatal de Chiapas descartó que fuera tosferina. 

He said that after the first clinical tests of 22 samples taken from 40 children with respiratory infections, the Chiapas state laboratory excluded the possibility of whooping cough.

Agregó que el siguiente paso es iniciar nuevos estudios en búsqueda del agente causal de la enfermedad, entre otros, influenza. En entrevista, el funcionario designado al frente del Censia el pasado 18 de diciembre comentó que los niños menores de un año, como los fallecidos, tienen mayor riesgo de presentar complicaciones graves de alguna enfermedad y más aún si viven en comunidades de alta marginación como Yajalón.

He added that the next step is to begin new studies in search of the cause of the disease, including the possibility of influenza. In an interview, the director (appointed on December 18) commented that children under the age of one year, like the victims, are under greater risk of serious complications from any disease, and even more so when they live in highly marginalized communities like Yajalón.

Mexico: Chiapas outbreak gets strong political response

Via Expreso Chiapas, a story on the remarkable political response to the mysterious respiratory outbreak: Supervisa Manuel Velasco Coello atención a pobladores de Emiliano Zapata. [Manuel Velasco Coello supervises attention to the residents of Emiliano Zapata] Velasco is the governor of Chiapas state. Excerpt, with my translation:

El Secretario de Salud, Carlos Eugenio Ruiz Hernández, explicó que a la fecha ninguno de los 41 menores afectados ameritó traslado para tratamiento hospitalario y como medida preventiva, dijo, se reforzará la vigilancia en seis comunidades más.   

Health Secretary Carlos Eugenio Ruiz Hernández said that to date none of the 41 affected children required hospitalization, adding that as a preventive measure surveillance will be strengthened in six more communities.

El jefe del Ejecutivo recorrió las instalaciones del Hospital de Especialidades Pediátricas “Manuel Velasco Suárez”, en Tuxtla Gutiérrez. 

The chief executive toured the installations of Manuel Velasco Suárez Pediatric Hospital in Tuxtla Gutiérrez.

Para atender a los pobladores de la comunidad Emiliano Zapata, municipio de Yajalón y explicar que el Gobierno del Estado coordina esfuerzos con las autoridades federales y municipales para atender la situación que se presenta en el lugar, así como en seis comunidades más, el Gobernador del Estado, Manuel Velasco Coello, supervisó personalmente las acciones que se están llevando a cabo con el propósito de proteger la salud de los habitantes de la zona.  

To attend to the residents of Emiliano Zapata community in Yajalón municipality and to explain that the state government is coordinating efforts with the federal and local authorities, state governor Manuel Velasco Coello personally supervised actions being carried out to protect the health of people living in the region.

El titular del Poder Ejecutivo constató que las brigadas médicas trabajan de manera permanentemente con cada familia, y luego de presentar sus condolencias a quienes perdieron a sus menores hijos por enfermedades a causa del intenso frío, enfatizó que la autoridad estatal no escatimará recursos humanos y materiales para apoyar a las familias de esta comunidad situada a más de 1400 metros de altura, por lo que instruyó al Secretario de Salud a intensificar la vigilancia sanitaria.

The head of the executive said that the medical brigades are working permanently with each family, and later presented his condolences to those who lost their children due to the intense cold. He emphasized that the state will not withhold human and material resources to support the families of this community, situated at an altitude of over 1400 meters, and instructed the health secretary to intensify sanitary surveillance.

The report goes on to say that the local residents can't recall any earlier visits from the state governor. 

Mexico: More on the Yajalón cases

I've found a bit more about the cases mentioned just below in this January 6 report in Expreso Chiapas: Se mantiene vigilancia epidemiológica en Yajalón. [Epidemiological surveillance maintained in Yajalón] Rather than translate word for word, here's a rough summary:

The state secretariat of health is running a lot of tests among the 550 people living in the small neighbourhood of Emiliano Zapata. The health brigades have visited a lot of households and checked 60 persons—55 for respiratory problems. They've taken 52 samples for lab tests, apparently to check for pertussis, though the cases they've seen aren't clinically compatible with pertussis.

The brigades have paid special attention to 41 children under 14 who are dealing with respiratory problems. Since November 14 the municipality of Yajalón has recorded five deaths of children under one year of age; two have died in week 1 of 2013. All they can say about the dead children's symptoms is "cough and unquantified fever."

A January 7 report, in Milenio.com, says the state governor is personally directing the surveillance teams and handing out 2 blankets per family, as well as donating an electrical generator.