Rubella epidemic in Japan traced to past female-only vaccination efforts

Japan had 5,442 rubella cases in the first 4 months of this year, largely because past rubella vaccination programs did not target males, according to an article in today's Morbidity and Mortality Weekly Report.

The main aim of rubella vaccination is to prevent congenital rubella syndrome (CRS), which involves various birth defects in infants infected by their mothers, the article notes.

Japan and several other countries that in the past targeted only girls and women for rubella vaccination have had large outbreaks among adolescent boys and young men.

Rubella cases in Japan increased sharply in 2012, reaching 2,392. The increase has continued this year, with men between the ages of 20 and 39, who were not included in the initial rubella vaccination program, accounting for 68% of cases.

Vaccination efforts targeting both boys and girls were strengthened starting in 2006, with the result that children under age 15 account for only 5.6% of the cases this year.

The report says that countries using rubella vaccine should work to prevent outbreaks by aiming for high immunity in all age-groups and both sexes.
Jun 14 MMWR article

CDC reports infection findings in tainted steroid outbreak

The US Centers for Disease Control and Prevention (CDC) has reported one more suspected infection linked to tainted injectable steroids produced by Main Street Family Pharmacy and said that skin wound tests have found bacteria and fungi in 4 of the 26 patients so far, according to an update yesterday. The number of affected states stayed at four.

Most patients have had skin and soft-tissue infections following intramuscular injection of the contaminated methylprednisolone acetate. Two of the patients had Enterobacter cloacae andKlebsiella pneumoniae, one had an unidentified mixed bacterial infection, and one had a fungal finding highly suggestive of Aspergillus, according to the CDC. Further confirmation is under way.

The CDC said that though bacteria and fungi have been isolated from unopened vials, it's not possible to determine which infections are due to the contamination and which could be from other factors, such as improper handling or medication administration.

CDC reminded clinicians to use individual containers of compounded or preservative-free medicine for single patients only and to promptly report any infections that might be related to a medication or device, even outside of a recognized outbreak.
Jun 13 CDC outbreak update

Viral pneumonia sickens 21 health workers at Chinese hospital

Local health officials in China's Anhui province said today that 21 healthcare workers from the same hospital in the city of Suzhou have been hospitalized with viral pneumonia, Xinhua, China's state news agency reported.

A statement from city health officials said all worked in the hospital's respiratory care department, and none of the illnesses are critical. The first patient was a nurse who came down with a fever, cough, and headache on Jun 5. No new cases have been reported since Jun 11.

The city's disease control center is testing samples from the patients, though tests at another hospital's lab indicate that the patients have viral pneumonia.

A spokesperson from Anhui province's health bureau told Xinhua that the illness is a common pneumonia and does not pose a public health threat.
Jun 14 Xinhua story

Democratic Republic of Congo reports yellow fever outbreak

The Democratic of Congo's health ministry is launching a yellow fever vaccination campaign in response to an outbreak that has so far resulted in 51 suspected cases and 19 deaths in three of the country's health zones, the World Health Organization (WHO) said today.

So far six of the infections have been lab-confirmed. The index patient is a 16-year-old boy from the village of Kisengua in the northeast part of the country who got sick on Mar 1.

The mass vaccination campaign starts Jun 20 and will target 503,426 people in the three health zones, the WHO said. The International Coordinating Group on Yellow Fever Provision will dispense 559,000 doses to the health ministry, which will coordinate the campaign with assistance of global health partners.

The last report of yellow fever in the country was Jul 2010, according to previous WHO reports. The Republic of Congo, the DRC's neighbor to the west, reported an outbreak in December 2012.
Jun 14 WHO statement