Scientists report large-scale cholera vaccine campaign possible
Scientists who conducted the first large-scale cholera outbreak control campaign in Africa using oral vaccine reported yesterday in PLoS One that immunization was well accepted by the public and that high vaccination coverage is possible, even in remote settings.
Forty-three immunization teams administered 312,650 doses of the newly approved Shanchol vaccine in the West African nation of Guinea in the spring of 2012, after cases began cropping up earlier than usual. The efforts marked the first use of Shanchol in Africa.
As with previous cholera epidemics, cases were first reported on islands north and south of the capital, Conakry, in the coastal districts of Boffa and Forecariah. The islands are populated by highly mobile people in the fishing and trade industries who have limited access to healthcare, the authors said.
Everyone 1 year and older in the two districts was eligible for immunization during both rounds, which were spaced 2 to 3 weeks apart. A household survey conducted immediately after the campaign found two-dose coverage in both districts to be about 76%, and one-dose coverage to be greater than 90%.
The final outcome of the campaign will not be known until effectiveness studies are completed, the researchers said. They noted, however, that cholera activity peaked in other parts of Guinea during the rainy season but remained low in Boffa and Forecariah.
From the decision to proceed to completion of vaccinations, the campaign took about 6 weeks. It was well-received by the population, according to the investigators.
They conclude, "Oral cholera vaccines are a promising new tool in the arsenal of cholera control measures, alongside efforts to improve provision of safe water and sanitation and access to cholera treatment."
Sep 10 PLoS One report
Los Angeles reports uptick in flu cases
The Los Angeles County Department of Public Health (LACDPH) said it is receiving reports of lab-confirmed flu, which might signal an early start to the flu season for the area, according to a Sep 9 statement.
The LACDPH also said the first flu hospitalization has been reported and that the strain is H1N1, which is covered by this year's seasonal flu vaccine. Jonathan Fielding, MD, MPH, the department's director of public health and health officer, said in the statement that occasional reports and even low levels of activity can continue through summer and early fall.
He added that the recent uptick in cases should encourage people 6 months and older to get vaccinated. Despite the early flu activity, it's impossible to predict how severe or mild the flu season will be, Fielding said.
The 2012-13 flu season started about a month ahead of schedule and was dominated by the H3N2 strain, which boosted hospitalization rates, especially in seniors. The US Centers for Disease Control and Prevention says flu season timing can vary from season to season, but can begin as early as October and can continue through May.
Sep 9 LACDPH statement
Minnesota study shows less H1N1 vaccine uptake in poor
Minnesotans living in zip-code zones with lower median incomes were much less likely to receive the 2009 pandemic H1N1 (pH1N1) vaccine during the 2009-10 pandemic than those in high-income areas, researchers from the Minnesota Department of Health (MDH) found.
Writing in the September issue of Minnesota Medicine, the investigators analyzed data from the Minnesota Immunization Information Connection, which showed that overall, 23% of Minnesotans received the pH1N1 vaccine.
When subdivided by zip code, however, the data showed that only 49 of 268, or 18.3%, of zip-code zones with median income below $35,000 achieved vaccination rates greater than 25%. That compares with 69 of 163 (42.3%) for zip-code zones with a median income above $50,000.
Similarly, only 42 of 214, or 19.6%, of zip-code regions with more than 8% of people below the poverty line reached the 25% vaccination mark, compared with 76 of 207 (36.7%) in regions with less than 3% of people in poverty.
The differences were less striking by minority level but surprisingly showed that zip-code zones with more diversity had higher levels of 25%-or-better pH1N1 vaccine coverage. Of zones with less than a 1% non-Caucasian makeup, 25 of 120 (20.8%) attained that level, compared with 65 of 220 (29.5%) in zones with more than 5% non-Caucasian residents.
This is counter to the findings of most studies, the authors say, and more research is needed to determine whether the differences had to do with the make-up of the minority populations or other socioeconomic factors.
The researchers concluded, "Although a centralized system of vaccine distribution that relied heavily on the private sector worked well in Minnesota during the 2009 H1N1 influenza pandemic, work is needed to make sure the coverage gaps that existed are addressed when planning for a future pandemic."
September Minn Med study
