Infectious Diseases News Brief - June 5, 2009

[Current Issue -Table of contents]

Cost-Effective Measures Could Stop Child Pneumonia Deaths

Implementing measures to improve nutrition, indoor air pollution, immunization coverage and the management of pneumonia cases could be cost-effective and significantly reduce child mortality from pneumonia, according to a recent study.  Researchers found that these strategies combined could reduce total child mortality by 17 percent and could reduce pneumonia deaths by more than 90 percent. Pneumonia is a leading cause of death of infants in many developing countries, resulting in 2.2 million deaths each year.  The study, conducted in collaboration with the World Health Organization (WHO) and other public health schools, assessed economic aspects of existing child interventions and identified the most efficient pneumonia control strategies. Programs to promote better community-based treatment of pneumonia, promotion of exclusive breastfeeding, zinc supplementation and vaccination for Hib and S. pneumoniae were found to be the most cost-effective interventions. The burning of solid fuels like wood, for cooking and heating, was found to contribute at least 20 percent to the burden of childhood pneumonia. 
Source: Medical News Today 3 June 2009
http://www.medicalnewstoday.com/articles/152275.php

Human Papilloma Virus Vaccine Effective in Women Aged 24-45 Not Previously Exposed

An article published Online First and in an upcoming edition of The Lancet reports that women aged between 24 and 45 can be protected by the human papilloma virus (HPV) vaccine, if they have not been already infected by the virus. The report is the work of Dr Nubia Muñoz, from the National Institute of Cancer, Bogotá, Colombia, and collaborators.  The women who participated in the randomized trial did not have a history of cervical disease or cancer or genital warts, caused by HPV types 6, 11, 16 and 18. The first group of women received the quadrivalent HPV vaccine and the second group received placebo (at day 1 and months 2 and 6).  There were a total of 1911 women in the first group and 1908 in the second group. The first endpoint for assessment was infection for six months or more, and cervical and external genital disease due to HPV 6, 11, 16, 18. The second was the same but genital disease was due to HPV 16 and 18 only. The average of follow-up time was of 2.2 years. No further data was analyzed at the end of the four year trial. Among the women, specific populations were analyzed.  The per-protocol population of ideal participants included 1615 women who were given the vaccine and 1607 receiving placebo. From day 1 and up to month seven, they all tested negative for the appropriate vaccine HPV type. Within one year, they all had to receive three vaccine doses. They were required to have one or more follow-up visits after month seven. Research showed that there were four cases of infection or disease in the vaccine group compared to forty one in the placebo group. Researchers observed the vaccine proved to have 91 percent effectiveness against all four virus strains (the percent reduction in incidence rate in the vaccine group compared to the placebo group). In the evaluation of the HPV 16 and 18 only, four cases occurred in the vaccine group compared with 23 in the placebo group (vaccine efficiency of 83 percent). When women who had not been completely vaccinated and had already existing HPV infection were included in the analysis, vaccine efficacy against all four HPV types was lower (31 percent). Effectiveness was of 24 percent when it was specifically against types HPV 16 and 18. Although there were two target outcomes of the trial, the researchers observed that in general, the women reaching the endpoint had infections, rather than cervical or genital disease. As a result, the high vaccine efficacy in the intention-to-treat population was mostly as a result of efficacy against infection.                   
Source: Medical News Today 2 June 2009
http://www.medicalnewstoday.com/articles/152137.php

Case-based Surveillance of Influenza Hospitalizations during 2004–2008, Colorado, USA

Colorado became the first state to make laboratory-confirmed influenza-associated hospitalizations a case-based reportable condition in 2004. The researchers summarized surveillance for influenza hospitalizations in Colorado during the first 4 recorded influenza seasons (2004–2008). They highlighted the similarities and differences among influenza seasons; no 2 seasons were entirely the same. The 2005–06 influenza season had 2 distinct waves of activity (types A and B), the 2006–07 season was substantially later and milder, and 2007–08 had substantially greater influenza B activity. The case-based surveillance for influenza hospitalizations provided information regarding the time course of seasonal influenza activity, reported case numbers and population-based rates by age group and influenza virus type, and a measure of relative severity. Influenza hospitalization surveillance provided more information about seasonal influenza activity than any other surveillance measure (e.g., surveillance for influenza-like illness) currently in widespread use among states. More states should consider implementing case-based surveillance for influenza hospitalizations.
Source: Emerging Infectious Diseases Journal, volume 15 number 6, June 2009