Vaccines: The Week in Review

25 October 2010
Center for Vaccine Ethics & Policy
http://centerforvaccineethicsandpolicy.wordpress.com/
A program of
- Center for Bioethics, University of Pennsylvania
http://www.bioethics.upenn.edu/
- The Wistar Institute Vaccine Center
http://www.wistar.org/vaccinecenter/default.html
- Children’s Hospital of Philadelphia, Vaccine Education Center
http://www.chop.edu/consumer/jsp/microsite/microsite.jsp

This weekly summary targets news and events in the global vaccines field gathered
from key governmental, NGO and company announcements, key journals and
events. This summary provides support for ongoing initiatives of the Center for
Vaccine Ethics & Policy, and is not intended to be exhaustive in its coverage.
Vaccines: The Week in Review is now also posted in a blog format at
http://centerforvaccineethicsandpolicy.wordpress.com/. Each item is treated as an individual
post on the blog, allowing for more effective retrospective searching. Given email
system conventions and formats, you may find this alternative more effective. This
blog also allows for RSS feeds, etc.
Comments and suggestions should be directed to
David R. Curry, MS
Editor and
Executive Director
Center for Vaccine Ethics & Policy
david.r.curry@centerforvaccineethicsandpolicy.org

The IDSA (Infectious Disease Society of America) held its 48th

Annual Meeting in Vancouver, BC, Canada from 21 – 24 October 2010. A
video archive of media conferences with ISDA panels on a range of topics
including HIV Global Health Influenza Pediatrics Emerging infections and
more is available at:
http://www.idmeeting.org/omk.php?
sid=S20101019100441ZY45HT&pid=1697

WHO: Avian influenza – situation in Indonesia - update 4

18 October 2010 -- The Ministry of Health of Indonesia has announced two
new cases of human infection of H5N1 avian influenza. A 35-year-old male
from West Jakarta, Jakarta Province developed symptoms on 16 August, was
hospitalized on 20 August and died on 27 August. Initial investigations into
the source of his infection suggest a number of sudden chicken deaths
occurred around the case’s house a week before onset. The second case, a
40-year-old female from Kota Depok, West Java Province developed
symptoms on 9 September, was hospitalized on 12 September and died on
17 September. Initial investigations into the source of her infection suggest
exposure at a live bird market.
For both cases laboratory tests have confirmed infection with the H5N1 avian
influenza virus. Of the 170 cases confirmed to date in Indonesia, 141 have
been fatal. http://www.who.int/csr/don/2010_10_18/en/index.html

The Weekly Epidemiological Record (WER) for 22 October 2010, vol.

85, 43 (pp 425–436) includes: Health conditions for travellers to Saudi Arabia
for the pilgrimage to Mecca (Hajj); Elimination of maternal and neonatal
tetanus in Myanmar, 2010; Changing epidemiology of pneumococcal
serotypes after introduction of conjugate vaccine: July 2010 report.
http://www.who.int/entity/wer/2010/wer8543.pdf

Events/Conference Watch
[Editor’s Note]
Vaccines: The Week in Review is now monitoring key events and conferences
and will include summaries of key announcements and other content. Event
Watch is not intended to be exhaustive, but indicative of themes and
issues the Center is actively tracking. If you would like to suggest events
and conferences for coverage, please write to David Curry at
david.r.curry@centerforvaccineethicsandpolicy.org

Meeting: Advisory Committee on Immunization Practices (ACIP)

WHEN: Wednesday and Thursday, October 27-28, 2010 from 8:00am to
5:30pm ET
WHERE: Centers for Disease Control and Prevention, Atlanta
Tom Harkin Global Communications Center (Building 19)
BACKGROUND: An agenda for the meeting, which will be web-streamed, is at:
http://www.cdc.gov/vaccines/recs/acip/
http://www.cdc.gov/media/pressrel/2010/a101019.html

WHO Workshop: Community public health measures implemented

during the influenza A(H1N1) 2009 pandemic
Place: La Marsa-Gammarth, Tunisia
Date: 26–28 October 2010
“During the influenza A(H1N1) 2009 pandemic, in addition to
pharmaceutical interventions such as influenza vaccine or antivirals, WHO
recommended public health measures (PHM) that could be implemented to
reduce or delay the transmission of the pandemic. These public health
measures are for instance individual-level measures such as cough etiquette
and hand washing, or community-level measures such as border screening or
school closures.
“The objectives of the workshop are: to provide a forum for stakeholders to
share data and experiences on public health measures implemented during
the influenza A(H1N1) 2009 pandemic; to collect information that will inform
the updating of the WHO guidelines on public health measures during an
influenza pandemic; and to identify gaps in public health measures that
require further studies.
http://www.who.int/mediacentre/events/meetings/2010/influenza_workshop/e
n/index.html

Annual Conference: The American Public Health Association

(APHA) will convene more than 13,000 health experts for its 138th Annual
Meeting & Exposition from 6-10 November 2010 in Denver, Colorado. This
year’s conference theme – Social Justice: A Public Health Imperative –
“explores the link between social justice and public health and stresses the
importance of expanding the dialogue to include social determinants of
health equity in policy considerations.”
More information at: APHA website

Conference: Mobile Technologies Use for Public Health and Medical

Information; 8-10 November 2010: Walter E. Washington Convention
Center, Washington, DC. “Approximately 5 billion mobile telephones are in
use in the world, and use has become common even in remote villages of
developing countries. Public health and medical researchers have become
interested in the use of mobile telephones and other mobile technologies to
improve access to medical care and pharmaceuticals, facilitate responses to
public health emergencies, and conduct public health surveillance. The 2010
mHealth Summit, to be held November 8--10, will focus on how mobile
technologies can be used to improve the health of persons in underserved
communities worldwide….”
Registration details and additional information are available at:
http://www.mhealthsummit.org/

Meeting: Strategic Advisory Group of Experts (SAGE) Meeting, 9-11

November 2010, Geneva, Switzerland (Sponsor/Host: WHO)

Journal Watch
[Editor’s Note]
Vaccines: The Week in Review continues its weekly scanning of key journals
to identify and cite articles, commentary and editorials, books reviews and
other content supporting our focus on vaccine ethics and policy. Journal
Watch is not intended to be exhaustive, but indicative of themes and
issues the Center is actively tracking. We selectively provide full text of
some editorial and comment articles that are specifically relevant to our
work. Successful access to some of the links provided may require
subscription or other access arrangement unique to the publisher. Our initial
scan list includes the journals below. If you would like to suggest other titles,
please write to David Curry at
david.r.curry@centerforvaccineethicsandpolicy.org
Clinical Infectious Diseases
15 November 2010 Volume 51, Number 10
http://www.journals.uchicago.edu/toc/cid/current
Major Article
The Infection Attack Rate and Severity of 2009 Pandemic H1N1
Influenza in Hong Kong
Joseph T. Wu, Edward S. K. Ma, Cheuk Kwong Lee, Daniel K. W. Chu, Po-
Lai Ho, Angela L. Shen, Andrew Ho, Ivan F. N. Hung, Steven Riley,
Lai Ming Ho, Che Kit Lin, Thomas Tsang, Su-Vui Lo, Yu-Lung Lau,
Gabriel M. Leung, Benjamin J. Cowling, and J. S. Malik Peiris
[Free full text]
Abstract
Background. Serial cross-sectional data on antibody levels to the 2009
pandemic H1N1 influenza A virus from a population can be used to estimate
the infection attack rates and immunity against future infection in the
community.
Methods. From April through December 2009, we obtained 12,217 serum
specimens from blood donors (aged 16–59 years), 2520 specimens from
hospital outpatients (aged 5–59 years), and 917 specimens from subjects
involved in a community pediatric cohort study (aged 5–14 years). We
estimated infection attack rates by comparing the proportions of specimens
with antibody titers 1:40 by viral microneutralization before and after the
first wave of the pandemic. Estimates were validated using paired serum
samples from 324 individuals that spanned the first wave. Combining these
estimates with epidemiologic surveillance data, we calculated the proportion
of infections that led to hospitalization, admission to the intensive care unit
(ICU), and death.
Results. We found that 3.3% and 14% of persons aged 5–59 years had
antibody titers 1:40 before and after the first wave, respectively. The overall
attack rate was 10.7%, with age stratification as follows: 43.4% in persons
aged 5–14 years, 15.8% in persons aged 15–19 years, 11.8% in persons aged
20–29 years, and 4%–4.6% in persons aged 30–59 years. Case-hospitalization
rates were 0.47%–0.87% among persons aged 5–59 years. Case-ICU rates
were 7.9 cases per 100,000 infections in persons aged 5–14 years and 75
cases per 100,000 infections in persons aged 50–59 years, respectively.
Case-fatality rates were 0.4 cases per 100,000 infections in persons aged 5–
14 years and 26.5 cases per 100,000 infections in persons aged 50–59 years,
respectively.
Conclusions. Almost half of all school-aged children in Hong Kong were
infected during the first wave. Compared with school children aged 5–14
years, older adults aged 50–59 years had 9.5 and 66 times higher risks of ICU
admission and death if infected, respectively.
Review Article
Transfusion-Transmitted Malaria in Countries Where Malaria Is
Endemic: A Review of the Literature from Sub-Saharan Africa
Alex K. Owusu-Ofori, Christopher Parry, and Imelda Bates
Abstract
Although international policies recommend that blood for transfusion should
be screened for transfusion-transmitted infections, malaria screening is not
performed in most malaria-endemic countries in sub‐Saharan Africa. Our
literature review identified 17 relevant studies from the period 1980–2009
and indicated that the median prevalence of malaria among 33,029 blood
donors was 10.2% (range, 0.7% in Kenya to 55.0% in Nigeria). Malaria
screening methods, including microscopy (used in 16 of 17 studies), are
either insensitive or impractical for donor screening in resource-poor
countries. Even if a suitable screening method were available, rejection of
malaria-positive donors would jeopardize the blood supply. Only 1 study
established the prevalence of parasitemia among transfusion recipients. This
review highlights the need for more evidence about the clinical impact of
transfusion-transmitted malaria to justify the policy of screening for blood for
malaria in areas of endemicity and for a critical analysis of the feasibility of
implementing such a policy and its effect on blood supply.
Editorial Commentary: Malaria and Transfusion: A Neglected Subject
Coming Back to the Forefront
Jean-Pierre Allain

Emerging Infectious Diseases

Volume 16, Number 11–November 2010
http://www.cdc.gov/ncidod/EID/index.htm
Research
Outbreaks of Pandemic (H1N1) 2009 and Seasonal Influenza A
(H3N2) on Cruise Ship
Kate A. Ward, Paul Armstrong, Jeremy M. McAnulty, Jenna M. Iwasenko, and
Dominic E. Dwyer
Author affiliations: New South Wales Health, Sydney, New South Wales,
Australia (K.A. Ward, J.M. McAnulty); Western Australian Department of
Health, Perth, Western Australia, Australia (P. Armstrong); South Eastern Area
Laboratory Services, Sydney (J.M. Iwasenko); and Institute of Clinical
Pathology and Medical Research, Sydney (D.E. Dwyer)
Abstract
To determine the extent and pattern of influenza transmission and
effectiveness of containment measures, we investigated dual outbreaks of
pandemic (H1N1) 2009 and influenza A (H3N2) that had occurred on a cruise
ship in May 2009. Of 1,970 passengers and 734 crew members, 82 (3.0%)
were infected with pandemic (H1N1) 2009 virus, 98 (3.6%) with influenza A
(H3N2) virus, and 2 (0.1%) with both. Among 45 children who visited the
ship's childcare center, infection rate for pandemic (H1N1) 2009 was higher
than that for influenza A (H3N2) viruses. Disembarked passengers reported a
high level of compliance with isolation and quarantine recommendations. We
found 4 subsequent cases epidemiologically linked to passengers but no
evidence of sustained transmission to the community or passengers on the
next cruise. Among this population of generally healthy passengers, children
seemed more susceptible to pandemic (H1N1) 2009 than to influenza (H3N2)
viruses. Intensive disease control measures successfully contained these
outbreaks.
Conference Summary
International Conference on Emerging Infectious Diseases, 2010
Nina Marano, Theresa L. Smith, Rana A. Hajjeh, Marian McDonald, Carolyn B.
Bridges, Sharon A. Martin, and Terence Chorba
Author affiliation: Centers for Disease Control and Prevention, Atlanta,
Georgia, USA
“The seventh International Conference on Emerging Infectious Diseases
(ICEID) was held in Atlanta, Georgia, USA, July 11–14, 2010. The conference
goal was to bring together public health professionals to encourage exchange
of scientific and public health information on global emerging infectious
disease issues. The conference was organized by the Centers for Disease
Control and Prevention (CDC), American Society for Microbiology, the Council
of State and Territorial Epidemiologists, the Association of Public Health
Laboratories, and the World Health Organization; additional support was
provided by 40 other multidisciplinary public health partners.
“The conference schedule was built around 20 plenary speakers, 31 panel
sessions, 110 scientific oral presentations, and 445 posters from 6 continents.
Topics included relevant infectious diseases issues from the past 2 years and
updates on a variety of new findings and approaches, including social
determinants of health, lessons learned from the recent pandemic (H1N1)
2009, zoonotic diseases, viral hepatitis, prevention challenges of respiratory
diseases, travelers' health, new developments in vaccines, and vaccine-
preventable diseases. Rima Khabbaz, Deputy Director for Infectious Diseases
at CDC, and Center directors Kevin Fenton, Thomas Hearn, and Anne
Schuchat conducted tours of outstanding posters that addressed emergence,
prevention, and control of infectious diseases in the international and
domestic arenas…” The full agenda and list of speakers can be found at the
conference website (www.iceid.org).

Human Vaccines
Volume 6, Issue 10 October 2010
http://www.landesbioscience.com/journals/vaccines/toc/volume/6/issue/10/
[Reviewed earlier]

JAMA
Vol. 304 No. 15, pp. 1639-1736, October 20, 2010
http://jama.ama-assn.org/current.dtl
[No relevant content]

Journal of Infectious Diseases

15 November 2010 Volume 202, Number 10
http://www.journals.uchicago.edu/toc/jid/current
Major Article
A 2009 Varicella Outbreak in a Connecticut Residential Facility for
Adults with Intellectual Disability
Jessica Leung, Kathy Kudish, Chengbin Wang, Latetia Moore, Paul Gacek,
Kay Radford, Adriana Lopez, Lynn Sosa, D. Scott Schmid, Matthew Cartter,
and Stephanie Bialek
[Free full text]
Abstract
We investigated a varicella outbreak in a residential facility for adults with
intellectual disabilities. A case of varicella was defined as a generalized
maculopapular rash that developed in a facility resident or employee.
Immunoglobulin M testing was conducted on serologic samples, and
polymerase chain reaction testing was performed on environmental and skin
lesion samples. Eleven cases were identified among 70 residents and 2
among 145 staff. An unrecognized case of herpes zoster was the likely
source. Case patients first entered any residential facility at a younger age
than non‐case residents (9.5 vs 15.0 years; ). Varicella zoster virus
DNA was detected 2 months after the outbreak in environmental samples
obtained from case patients’ residences. This outbreak exemplifies the
potential for at‐risk pockets of varicella‐susceptible adults, especially among
those who have lived in residential facilities from a young age. Evidence of
immunity should be verified for all adults and healthcare staff in similar
residential settings.
Major Article
Measles in the United States during the Postelimination Era
Amy Parker Fiebelkorn, Susan B. Redd, Kathleen Gallagher, Paul A. Rota,
Jennifer Rota,
William Bellini, and Jane Seward
Division of Viral Diseases, National Center for Immunization and Respiratory
Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Abstract
Background. Measles affected entire birth cohorts in the prevaccine era but
was declared eliminated in the United States in 2000 because of a successful
measles vaccination program.
Methods. We reviewed US surveillance data on confirmed measles cases
reported to the Centers for Disease Control and Prevention and data on
national measles-mumps-rubella (MMR) vaccination coverage during
postelimination years 2001−2008.
Results. During 2001−2008, a total of 557 confirmed cases of measles
(annual median no. of cases, 56) and 38 outbreaks (annual median no. of
outbreaks, 4) were reported in the United States; 232 (42%) of the cases
were imported from 44 countries, including European countries. Among case-
patients who were US residents, the highest incidences of measles were
among infants 6–11 months of age and children 12–15 months of age (3.5
and 2.6 cases/1 million person-years, respectively). From 2001 through 2008,
national 1-dose MMR vaccine coverage among children 19–35 months of age
ranged from 91% to 93%. From 2001 through 2008, a total of 285 US-
resident case-patients (65%) were considered to have preventable measles
(ie, the patients were eligible for vaccination but unvaccinated). During 2004–
2008, a total of 68% of vaccine-eligible US-resident case-patients claimed
exemptions for personal beliefs.
Conclusions. The United States maintained measles elimination from 2001
through 2008 because of sustained high vaccination coverage. Challenges to
maintaining elimination include large outbreaks of measles in highly traveled
developed countries, frequent international travel, and clusters of US
residents who remain unvaccinated because of personal belief exemptions.
The Lancet
Oct 23, 2010 Volume 376 Number 9750 Pages 1363 - 1436
http://www.thelancet.com/journals/lancet/issue/current
Comment
Global Health Metrics and Evaluation—a call for abstracts
GHME Conference Organizing Committee
The Institute for Health Metrics and Evaluation (Seattle, WA, USA), The
Lancet, the London School of Hygiene & Tropical Medicine, the Harvard
School of Public Health, and the University of Queensland School of
Population Health invite submission of abstracts for oral or poster
presentation at their conference called Global Health Metrics and Evaluation:
Controversies, Innovation, Accountability, to be held on March 14–16, 2011 in
Seattle, WA, USA.
Article
Equity and adequacy of international donor assistance for global
malaria control: an analysis of populations at risk and external
funding commitments
Robert W Snow, Emelda A Okiro, Peter W Gething, Rifat Atun, Simon I Hay
Preview
Funding for malaria control worldwide is 60% lower than the US$4·9 billion
needed for comprehensive control in 2010; this includes funding shortfalls for
a wide range of countries with different numbers of people at risk and
different levels of domestic income. More efficient targeting of financial
resources against biological need and national income should create a more
equitable investment portfolio that with increased commitments will
guarantee sustained financing of control in countries most at risk and least
able to support themselves.

The Lancet Infectious Disease

Oct 2010 Volume 10 Number 10 Pages 653 - 736
http://www.thelancet.com/journals/laninf/issue/current
[Reviewed earlier]

Nature
Volume 467 Number 7318 pp883-934 21 October 2010
http://www.nature.com/nature/current_issue.html
[No relevant content]

Nature Medicine
October 2010, Volume 16 No 10
http://www.nature.com/nm/index.html
[No relevant content]

New England Journal of Medicine

October 21, 2010 Vol. 363 No. 17
http://content.nejm.org/current.shtml
[No relevant content]

The Pediatric Infectious Disease Journal

October 2010 - Volume 29 - Issue 10
http://journals.lww.com/pidj/pages/currenttoc.aspx
[Reviewed earlier]

Pediatrics
October 2010 / VOLUME 126 / ISSUE 4
http://pediatrics.aappublications.org/current.shtml
[Reviewed earlier]

PLoS Medicine
(Accessed 25 October 2010)
http://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-
1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1
&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1
c2a2501181c#results
[No relevant content]

Science
22 October 2010 Vol 330, Issue 6003, Pages 413-546
http://www.sciencemag.org/current.dtl

Science Translational Medicine

20 October 2010 vol 2, issue 54
http://stm.sciencemag.org/content/current
[No relevant content]

Vaccine
http://www.sciencedirect.com/science/journal/0264410X

Volume 28, Issue 47 pp. 7453-7576 (3 November 2010)

Letters to the Editor
An update to “The cost-effectiveness of rotavirus vaccination:
Comparative analyses for five European countries and transferability
in Europe”
Pages 7457-7459
Mark Jit, Marie-Josée J. Mangen, Hugues Melliez, Yazdan Yazdanpanah, Joke
Bilcke, Heini Salo, W. John Edmunds, Philippe Beutels
Abstract
A cost-effectiveness analysis of rotavirus vaccination in Belgium, England and
Wales, Finland, France and the Netherlands published in 2009 was updated
based on recent studies on rotavirus burden of disease and vaccine efficacy.
All the qualitative conclusions in the previous study were found to remain
valid. Vaccination remains cost-effective in Finland only when using plausible
tender prices.
Regular Papers
Acceptability of HPV vaccination among young adults aged 18–30
years–a population based survey in Sweden
Original Research Article
Pages 7492-7500
Karin Sundström, Trung Nam Tran, Cecilia Lundholm, Cecilia Young, Pär
Sparén, Lisen Arnheim Dahlström
Preview
Acceptability of human papillomavirus (HPV) vaccination seems to be high in
the Western world but fewer data are available for men than for women.
There are also concerns that HPV vaccination might lead young people to
change their healthcare-related behaviours. We investigated these issues in a
population-based survey performed in Sweden during January-May, 2007, just
after HPV vaccination had been licensed. A total of 10 567 men and women
aged 18 to 30 years participated. The intention to accept HPV vaccination
among these young adults was relatively high but could likely be improved
with higher awareness of HPV-related diseases as well as of the safety and
efficacy of vaccines in general. Also, the cost of the vaccine needs to be
affordable. Even though few young adults stated their healthcare-related
behaviours would change after HPV vaccination, a significant number were
uncertain, suggesting a need for continued educational efforts when HPV-
vaccinating this group.
A measles and rubella (MR) catch-up vaccination campaign in an
Egyptian University: Vaccine uptake and knowledge and attitudes of
students
Original Research Article
Pages 7563-7568
Khaled M. Abd Elaziz, Sahar M. Sabbour, Sahar A. Dewedar
Abstract
Introduction
In 2008, following a rubella epidemic, the Egyptian Ministry of Health
implemented a Measles Rubella (MR) catch-up campaign, based on WHO
recommendations for supplementary immunization activities to eliminate
measles by 2010. The age group targeted was 10–20 years. This campaign
was unique in Egypt as it was the first national vaccination campaign which
included university students.
Aim
To report uptake of MR vaccine and reasons for declining the vaccine among
medical and non-medical students in the campaign and to assess the
knowledge about the vaccine and the diseases.
Methods
The study was conducted in two stages. In the first stage during the
vaccination sessions, medical and other students (N = 310) were given a
questionnaire to assess their knowledge of the campaign and the vaccine.
The second stage (N = 341) was carried out when the campaign was
completed to assess vaccine uptake among medical students.
Results
Posters displayed inside the university were reported to be the main source
of information about the campaign. Students were generally poorly informed
about both vaccine adverse effects, and contraindications although medical
students tended to be better informed than other students. Overall 64.8%
medical students accepted the vaccine with higher uptake among females
than males (85.9 and 58.3% respectively). Non-compliant students had a
significantly higher mean age. Almost half of students who did not accept the
vaccine gave their reason as having little information about the vaccine
(43.3%).
Conclusion
The MR campaign in Ain Shams University may have been more successful
with better use of health education messages.
Knowledge of vaccination of allergic children among Italian primary
care pediatricians, hospital pediatricians and pediatric residents
Original Research Article
Pages 7569-7575
Susanna Esposito, Chiara Azzari, Giorgio Bartolozzi, Gaetano Maria Fara,
Franco Giovanetti, Milena Lo Giudice, Carlotta Galeone, Marta Ciofi degli Atti
and for the Italian Society of Pediatric Allergy and Immunology
Abstract
A cross-sectional survey of Italian pediatricians and pediatric residents was
carried out between 15 September and 18 October 2008 in order to evaluate
their knowledge concerning the administration of vaccines to children with
suspected or proved allergies. Of the 750 physicians who accepted to
participate (620 pediatricians and 130 residents), 630 (84.0%; 407 females;
mean age 43.5 ± 11.2 years) returned completed questionnaires: 268
primary care pediatricians (42.5%), 244 hospital pediatricians (38.8%), and
118 pediatric residents (18.7%). Knowledge concerning the vaccination of
children with suspected or proved allergies was far from optimal, with the
poorest knowledge being shown by the pediatric residents and no difference
between the primary care and hospital pediatricians. Since pediatricians are
the main parents’ advisors regarding vaccinations, these results indicate an
urgent need for educational programmes (especially for residents) and
evidence-based guidelines concerning vaccinations in children with
suspected or proved allergies.

Volume 28, Issue 46 pp. 7345-7452 (28 October 2010)

Vaccine preventable diseases in returned international travelers:
Results from the GeoSentinel Surveillance Network
Original Research Article
Pages 7389-7395
Andrea K. Boggild, Francesco Castelli, Philippe Gautret, Joseph Torresi, Frank
von Sonnenburg, Elizabeth D. Barnett, Christina A. Greenaway, Poh-Lian Lim,
Eli Schwartz, Annelies Wilder-Smith, Mary E. Wilson and for the GeoSentinel
Surveillance Network
Abstract
Vaccine preventable diseases (VPDs) threaten international travelers, but
little is known about their epidemiology in this group. We analyzed records of
37,542 ill returned travelers entered into the GeoSentinel Surveillance
Network database. Among 580 (1.5%) with VPDs, common diagnoses
included enteric fever (n = 276), acute viral hepatitis (n = 148), and influenza
(n = 70). Factors associated with S. typhi included VFR travel (p < 0.016) to
South Central Asia (p < 0.001). Business travel was associated with influenza
(p < 0.001), and longer travel with hepatitis A virus (p = 0.02). 29% of those
with VPDs had pre-travel consultations. At least 55% of those with VPDs were
managed as inpatients, compared to 9.5% of those with non-VPDs. Three
deaths occurred; one each due to pneumococcal meningitis, S. typhi, and
rabies. VPDs are significant contributors to morbidity and potential mortality
in travelers. High rates of hospitalization make them an attractive target for
pre-travel intervention.
Healthy young and middle age adults: What will it take to vaccinate
them for influenza?
Original Research Article
Pages 7420-7422
Lori Uscher-Pines, Jurgen Maurer, Arthur Kellerman, Katherine M. Harris
Abstract
Starting in 2010, healthy adults age 19–49 will be recommended for annual
influenza vaccination. Because they were not previously targeted, little is
known about their vaccine-related attitudes and behaviors. Using nationally
representative survey data from 2009 to 2010, we found that adults newly
recommended for influenza vaccination (as compared to previously
recommended groups) are less likely to believe flu vaccines are safe (44% vs.
63%), to have ever been vaccinated (36% vs. 64%), to be vaccinated
following a healthcare provider recommendation (44% vs. 52%), and to visit a
doctor's office during vaccination season (41% vs. 69%). To boost rates of
influenza vaccination in this population, new and untraditional strategies
aimed at encouraging first-time vaccination are needed.
Racial disparities in diarrhea-associated hospitalizations among
children in five US States, before and after introduction of rotavirus
vaccine
Original Research Article
Pages 7423-7426
Catherine Yen, Claudia A. Steiner, Marguerite Barrett, Aaron T. Curns,
Katherine Hunter, Emily Wilson, Umesh D. Parashar
Abstract
Racial differences in diarrheal disease have not been systematically
examined, and the impact of rotavirus vaccine on these differences has not
been assessed. We compared diarrhea-associated hospitalizations by
race/ethnicity among children <5 years pre- (2000–2006) and post- (2007
and 2008) rotavirus vaccine introduction in five US states. Pre-vaccine
hospitalization rates were greater among whites versus blacks and Hispanics.
However, black (versus non-black) infants <6 months and white (versus non-
white) children ≥1 year had higher rates. In 2008, racial disparities for
children 12–35 months resolved, but higher hospitalization rates among black
infants <6 months persisted, highlighting the need for timely vaccination.