Flu Scan for Oct 08, 2015

News brief

Coadministering Tdap, flu vaccine during pregnancy found safe

Administering tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine together with the flu vaccine during pregnancy was found as safe as administering them sequentially, according to a retrospective cohort study published this week in Obstetrics & Gynecology.

The study included 36,844 US girls and women 14 to 49 who received both vaccines while pregnant at any point between Jan 1, 2007, and Nov 15, 2013. Of the participants, 8,464 (23%) received the vaccines during the same appointment, while 28,380 (77%) received them sequentially.

The researchers found no differences in preterm delivery, low birth weight, or small-for-gestational-age neonates between the two groups.
Oct 5 Obstet Gynecol study

Ferret study shows live flu viruses in breast tissue, milk

Influenza might be transmitted via infected mammary cells from mothers to breastfeeding infants, according to a ferret study today in PLoS Pathogens.

Toronto researchers nasally inoculated either mother or infant ferrets—known to be a good model for human infection—with 2009 H1N1 and noted that both infants and mothers became infected after one of the two were inoculated. The secondary infections followed illnesses in the animals that were first infected by a few days.

Wanting to explore the role of breastfeeding in flu infections, the team then examined virus presence in mammary tissue and in the mothers' milk. The mammary cells of all six mothers tested contained live flu virus, as did their nipples and milk.

And when the scientists directly inoculated the ferrets' mammary glands, they found their cells could be directly infected by flu virus and were able to produce live virus. They noted that infants nursed by these mothers then became infected, likely through the breast because the transmitted virus was found in the infants before it was detectable in their mothers' nasal fluid.

The researchers noted, however, that transmission unrelated to breastfeeding cannot be ruled out, and the results don't necessarily translate to humans.
Oct 8 PLoS Pathogens study
Oct 8 PLoS Pathogens news release

Nigeria reports 5 more H5N1 outbreaks

Five new H5N1 avian flu outbreaks in Nigeria have affected more than 9,000 poultry, the latest in a string of incursions caused by the disease this year, according to a report posted Oct 6 by the World Organization for Animal Health (OIE).

The outbreaks, which began from Sep 27 to Oct 1, are all in Rivers state in southern Nigeria, the hardest-hit region of the country. All told, 1,822 chickens and turkeys died from the disease out of 9,238 birds total.

Flocks ranged in size from 600 to 3,818 farm poultry. Samples tested positive for H5N1 on Oct 4 at the National Veterinary Research Institute in Vom, Plateau state. Disinfection and other response measures have been implemented.

Nigeria has now confirmed 89 outbreaks caused by H5N1 in 2015.
Oct 6 OIE report

News Scan for Oct 08, 2015

News brief

Gaps in measles vaccination rates places 1 in 8 US kids at risk

Inadequate measles vaccination coverage places one in eight US kids at risk for contracting the disease and one in four of those 3 years old or younger, according to data presented today at IDWeek in San Diego, the Infectious Diseases Society of America (IDSA), a sponsor of the conference, reported today in a press release.

Emory University researchers determined that 8.7 million children, or 12.5%, are not fully protected from measles because they haven't received the measles, mumps and rubella (MMR) vaccine or have received only one of the two recommended doses. That figure jumped to 24.7% for kids 3 and younger.

The team also found that 4.6% of 17-year-olds have received no MMR doses. They also estimate that if the US vaccination rate drops to just 98% of current levels, 14.2% of children (one in seven) will be vulnerable to measles.

Lead author Robert Bednarczyk, PhD, of Emory, said, "While we currently have overall immunity in the population that should prevent sustained measles transmission, if the virus is introduced, there is the potential for large outbreaks. This is because there are clusters of unvaccinated children in some communities, which could allow a large outbreak to occur with spread to similar communities."
Oct 8 IDSA press release

Special issue spells out invasive Salmonella problems in Africa

The high burden of invasive Salmonella infections in African children and the rise of antibiotic resistant strains of nontyphoidal Salmonella are among the findings in a special Clinical Infectious Diseases issue on the disease in Africa published today.

The supplement is a follow-up to an expert meeting held in Malawai in late 2014 sponsored by the Bill and Melinda Gates Foundation and Wellcome Trust. The global burden of invasive nontyphoidal Salmonella (iNTS) disease was published in 2010, and efforts have been under way to gauge the burden in Africa.

In an introduction to the collection, editors wrote that the gradually increasing availability of blood cultures in Africa is shedding new light on patterns there. The experts are John Crump, MBChB, MD, director of the Centre for International Health at the University of Otago in New Zealand, and Robert Heyderman, MBBS, PhD, an infectious disease specialist at University College London.

The issue contains 19 studies that profile iNTS in 16 African countries, along with reports that describe genetic fingerprinting and mathematical modeling to better clarify the disease and its sources.

Researchers found that NTS occurs in infants and young children, especially those with malaria and malnutrition. HIV-infected adults are also at risk for contracting the disease, which kills 20% of those with Salmonella blood poisoning. A report from Kenya notes that the majority of NTS strains are resistant to most antibiotics that are available in Africa.

In a University of Otago press release, Crump said that currently Salmonella deaths linked to diarrhea are counted, but not ones linked to sepsis. "In global health there is a great risk that the uncounted will be ignored: this body of work will help to focus much needed attention and justification for investment in a major neglected disease that carries an unacceptably high burden of death."
Nov 1 Clin Infect Dis special issue
Oct 8 University of Otago press release