News Scan for May 21, 2014

News brief

One Guinea prefecture still seeing new Ebola cases

Only one prefecture in Guinea—Gueckedou—has reported continued community transmission and deaths in the Ebola virus disease (EVD) outbreak there as of May 18, says an update from the World Health Organization (WHO) Regional Office for Africa.

Gueckedou is the prefecture that has seen the most clinical cases (168, with 123 deaths) during the outbreak, which began earlier this spring. The cumulative total for clinical cases stands at 253, with 176 deaths. Confirmed cases number 144 with 97 deaths—6 and 5 more, respectively, than reported in the last WHO update May 12.

The update notes that the number of cases is subject to change because of reclassification, retrospective investigation, consolidation of cases and lab data, enhanced surveillance, and contact tracing.

Liberia and Sierra Leone reported no new EVD cases. In Liberia, which has not seen a case since Apr 9, the EVD outbreak may be declared over tomorrow (May 22), says the WHO.
May 21 WHO Ebola update

Pasteur lab shuttered in wake of missing SARS virus vials

French health officials have temporarily shuttered the Pasteur Institute lab in Paris after more than 2,000 test tubes containing parts of SARS (severe acute respiratory syndrome) coronaviruses turned up missing in January, the Associated Press (AP) reported yesterday.

After the samples were found to be missing, the lab asked France's medical safety agency to carry out inspections. A team couldn't find the tubes and identified problems with the lab's material-tracking methods. The suspension order calls on the Pasteur Institute to inventory all of its samples.

In April, the Pasteur Institute reported the loss of 2,349 tubes that contained fragments of the SARS virus, which it said does not pose an infection risk. Lab officials said the loss was an "unacceptable mistake" and that the vials may have been moved from one freezer to another in March 2013 and might have been destroyed by a staffer who forgot to document the step.
May 20 AP story
Apr 15 CIDRAP News item "Pasteur Institute loses 2,300 vials containing pieces of SARS virus"

US, Canada, Mexico agree to share health emergency communications

The US, Canadian, and Mexican governments formally agreed yesterday that during health emergencies they will share communications plans and statements with one another before releasing them to the public.

The three countries signed a declaration of intent on the subject at the 67th World Health Assembly in Geneva, according to an announcement from the Canadian government.

"Infectious diseases are not limited by countries' borders, and neither are the ways through which we receive the news," Canadian Minister of Health Rona Ambrose stated in the announcement. "This Declaration will help our countries work together on the essential task of communicating more effectively on public health issues, which will protect the health of all of our citizens."

The declaration of intent calls on the three countries to "share public communications plans, statements and other communications products related to health emergencies with each other prior to their public release." In addition, the agreement calls for conducting annual joint communications exercises to improve coordination.

The agreement aligns with the requirements of the International Health Regulations, which call for neighboring countries to cooperate on shared public health issues, the Canadian statement said. In addition, it supports the "underlying principles of the 2012 North American Plan for Animal and Pandemic Influenza (NAPAPI)."

Building on the experiences of the H1N1 influenza pandemic, the NAPAPI outlines how the three countries intend to strengthen and coordinate their emergency response capacities, including public communications, in preparation for a pandemic virus arising in or spreading to North America, the statement said.
May 20 Canadian government statement

Flu Scan for May 21, 2014

News brief

Study: School-based flu vaccination feasible but reimbursement problematic

School-based flu vaccination programs may be a good vehicle for moving toward universal coverage of children, but headaches regarding billing and reimbursement issues pose big administrative challenges, says a Colorado study published in Academic Pediatrics.

The researchers evaluated vaccination clinics held in 19 elementary schools in the Denver Public Schools from September 2010 to February 2011. Parental consent was obtained by the schools, and community health workers administered the vaccines and handled third-party billing; parents did not pay any fees.

About 30% (2,784 of 9,295) of the children in the population received at least one dose of vaccine; 39% (1,079 of the 2,784) of children needed a second dose and 80% of that group did receive both.

The cost of implementing the program, minus the cost of the vaccine itself, amounted to $24.69 per vaccination. Reimbursement from various public and private sources amounted to 62% overall for the vaccine costs and 19% overall for implementation costs. As stated by the authors, "The current program demonstrated that school-based third-party billing for both vaccine and implementation costs was feasible, but problems with reimbursement will need to be solved before it can be financially solvent."
May-Jun Acad Pediatr article on reimbursement study
May 20 University of Colorado news release

Another article in the same journal by the same authors examined parental views on the concept of school-based vaccination programs. A majority supported the programs, but some said they would want to be present when the vaccination was given.

Surveys were distributed to parents of 1,000 randomly selected elementary school students. Of the 699 (70%) who responded, 81% indicated they "would be okay" with the school-based program. Reservations about the safety of the influenza vaccine and about children receiving the vaccine without their parents present were expressed and, according to the authors, would need to be addressed.
May-Jun Acad Pediatr article on parent survey

WHO sees first sparks of Southern Hemisphere flu season

Flu has ebbed to interseasonal levels in most European and east Asian countries and in North America, though some influenza B activity is still occurring, the World Health Organization (WHO) said in its latest update May 19. In the Southern Hemisphere, flu activity is slowly picking up but is still at low levels.

In tropical countries, flu activity overall was low, but a few hot spots, such as the Caribbean territories of Guadeloupe and Guyana, reported elevated activity, and in the African country of Mauritius, high levels of the 2009 H1N1 virus were reported.

Areas in the Southern Hemisphere that are starting to see flu increases include Australia, New Zealand, some of the Pacific Islands, and South America.

In a separate report the WHO said that, of positive flu specimens at national influenza labs in late April and early May, 54.6% were influenza B and 45.4% were influenza A.

Of the subtyped influenza A viruses, 31.2% were 2009 H1N1 and 68.8% were H3N2. Nearly 90% of the characterized influenza B viruses were of the Yamagata lineage, which is recommended for inclusion in trivalent flu vaccines for upcoming seasons in both hemispheres.
May 19 WHO global flu update
May 19 WHO global flu virologic report