Measles among vaccinated Quebec kids questioned The Canadian Press Posted: Oct 20, 2011 9:35 AM ET Last Updated: Oct 20, 2011 9:34 AM ET
http://www.cbc.ca/news/health/measles-among-vaccinated-quebec-kids-questioned-1.1086151
An unusual vaccine observation from a large measles outbreak in Quebec may raise some alarm among those who attend the annual meeting of the Infectious Diseases Society of America.
Measles cases have surged in parts of Canada and the United States this year, with cases among unvaccinated children and teens driving the high numbers, public health officials from both countries will tell a major infectious diseases conference this weekend.
An investigation into an outbreak in a high school in a town that was heavily hit by the virus found that about half of the cases were in teens who had received the recommended two doses of vaccine in childhood — in other words, teens whom authorities would have expected to have been protected from the measles virus.
It's generally assumed that the measles vaccine, when given in a two-dose schedule in early childhood, should protect against measles infection about 99 per cent of the time. So the discovery that 52 of the 98 teens who caught measles were fully vaccinated came as a shock to the researchers who conducted the investigation.
"That's the real question. How could that have happened?" said Dr. Gaston De Serres, an infectious diseases expert with Quebec's public health agency and one of the authors of the study.
In an interview before the start of the conference, De Serres would not name the highly affected town or the high school in it.
But he suggested the discovery that as many of the cases were fully vaccinated as unvaccinated raises a serious question about whether the timing of the delivery of the first dose of measles vaccine is undermining the efficacy of the prevention program.
Vaccine schedule questions: It is recommended that the first dose of measles vaccine be administered at 12 months of age, with the second coming at either 18 months or some time before a child starts school. Quebec uses the 12-month and 18-month schedule.
The vaccine can't be given earlier, because of a phenomenon that helps babies survive infancy. Children are born without a fully developed immune system — it starts to build as babies become exposed to a variety of disease threats over their first few years.
In pregnancy and after birth, through breastfeeding, babies acquire antibodies from their mothers that tide them over until they can make their own. But that means if they are given the measles vaccine — which is made from weakened live viruses — too early, their mothers' antibodies will kill the vaccine viruses, preventing protection from being induced.
It has been thought that 12 months was appropriately late for vaccination to begin, and it may still be. De Serres insisted other studies will have to confirm his group's findings before anyone starts advocating delaying the first dose of measles vaccine.
"This is the first outbreak where an investigation has shown this effect in two-dose recipients," he said.
But the study did note that teens in the school who got their first dose of measles vaccine at 15 months of age were more than three times less likely to get measles in the outbreak than teens who got their first shot at 12 months.
If other groups confirm what the Quebec investigation found, it could mean there is a lot more susceptibility to measles in the vaccinated population than is currently being assumed, De Serres admitted.
"There may be more vulnerability than we know and were planning for," he said.
Coming back with measles"The problem is: if you have a population where the disease does not enter often, you may have a pool of susceptibles that is growing up, year after year, and you will be unaware of that vulnerability."
Changing vaccine schedules is not something that is done lightly, especially at a time when little children are getting an increasing number of vaccinations.
And there's another factor one would have to consider when debating the question, noted Dr. Allison McGeer, an infectious diseases expert at Toronto's Mount Sinai Hospital.
Many measles cases seen in Canada are in the children of new Canadians who have travelled to their homelands to show off their new babies. Some of those families are travelling to places where measles viruses are still circulating.
"If you knew that a child was going to stay in Canada … a 15-month first dose [schedule], based on this experience, certainly sounds like a sensible thing to do," McGeer said.
"But measles is one of those diseases where when immigrant parents take their children home to see the grandparents, it frequently happens before or just about the age of one year. … If you shift the first dose to older, some of those kids will come back with measles."
After the Boston meeting De Serres will be travelling to Atlanta to brief the U.S. Advisory Committee on Immunization Practices of his group's findings. ACIP set vaccine policy for the U.S.
© The Canadian Press, 2011
http://www.cbc.ca/news/health/measles-among-vaccinated-quebec-kids-questioned-1.1086151
An unusual vaccine observation from a large measles outbreak in Quebec may raise some alarm among those who attend the annual meeting of the Infectious Diseases Society of America.
Measles cases have surged in parts of Canada and the United States this year, with cases among unvaccinated children and teens driving the high numbers, public health officials from both countries will tell a major infectious diseases conference this weekend.
An investigation into an outbreak in a high school in a town that was heavily hit by the virus found that about half of the cases were in teens who had received the recommended two doses of vaccine in childhood — in other words, teens whom authorities would have expected to have been protected from the measles virus.
It's generally assumed that the measles vaccine, when given in a two-dose schedule in early childhood, should protect against measles infection about 99 per cent of the time. So the discovery that 52 of the 98 teens who caught measles were fully vaccinated came as a shock to the researchers who conducted the investigation.
"That's the real question. How could that have happened?" said Dr. Gaston De Serres, an infectious diseases expert with Quebec's public health agency and one of the authors of the study.
In an interview before the start of the conference, De Serres would not name the highly affected town or the high school in it.
But he suggested the discovery that as many of the cases were fully vaccinated as unvaccinated raises a serious question about whether the timing of the delivery of the first dose of measles vaccine is undermining the efficacy of the prevention program.
Vaccine schedule questions: It is recommended that the first dose of measles vaccine be administered at 12 months of age, with the second coming at either 18 months or some time before a child starts school. Quebec uses the 12-month and 18-month schedule.
The vaccine can't be given earlier, because of a phenomenon that helps babies survive infancy. Children are born without a fully developed immune system — it starts to build as babies become exposed to a variety of disease threats over their first few years.
In pregnancy and after birth, through breastfeeding, babies acquire antibodies from their mothers that tide them over until they can make their own. But that means if they are given the measles vaccine — which is made from weakened live viruses — too early, their mothers' antibodies will kill the vaccine viruses, preventing protection from being induced.
It has been thought that 12 months was appropriately late for vaccination to begin, and it may still be. De Serres insisted other studies will have to confirm his group's findings before anyone starts advocating delaying the first dose of measles vaccine.
"This is the first outbreak where an investigation has shown this effect in two-dose recipients," he said.
But the study did note that teens in the school who got their first dose of measles vaccine at 15 months of age were more than three times less likely to get measles in the outbreak than teens who got their first shot at 12 months.
If other groups confirm what the Quebec investigation found, it could mean there is a lot more susceptibility to measles in the vaccinated population than is currently being assumed, De Serres admitted.
"There may be more vulnerability than we know and were planning for," he said.
Coming back with measles"The problem is: if you have a population where the disease does not enter often, you may have a pool of susceptibles that is growing up, year after year, and you will be unaware of that vulnerability."
Changing vaccine schedules is not something that is done lightly, especially at a time when little children are getting an increasing number of vaccinations.
And there's another factor one would have to consider when debating the question, noted Dr. Allison McGeer, an infectious diseases expert at Toronto's Mount Sinai Hospital.
Many measles cases seen in Canada are in the children of new Canadians who have travelled to their homelands to show off their new babies. Some of those families are travelling to places where measles viruses are still circulating.
"If you knew that a child was going to stay in Canada … a 15-month first dose [schedule], based on this experience, certainly sounds like a sensible thing to do," McGeer said.
"But measles is one of those diseases where when immigrant parents take their children home to see the grandparents, it frequently happens before or just about the age of one year. … If you shift the first dose to older, some of those kids will come back with measles."
After the Boston meeting De Serres will be travelling to Atlanta to brief the U.S. Advisory Committee on Immunization Practices of his group's findings. ACIP set vaccine policy for the U.S.
© The Canadian Press, 2011
More than 1,500 sickened in mumps outbreak in NY, NJ Orthodox Jewish communities
MIKE STOBBE, THE ASSOCIATED PRESS
ATLANTA - A mumps outbreak among Orthodox Jews in New York and New Jersey has now surpassed 1,500 cases and shows no sign of ending soon.
The outbreak began last summer at a boys camp in the Catskills. Nearly all the cases are in the insular Orthodox Jewish community. Health officials said most had a mumps vaccination, but the shots are not completely effective.
The Centers for Disease Control and Prevention on Thursday said the count has now reached 1,521. Nineteen people have been hospitalized, but no deaths have been reported.
300 New Mumps Cases Reported, Spotlighting the Importance of the Vaccine
February 08, 2010 02:20 PM
by Colleen Brondou
The nation's largest outbreak of mumps in years has spread, calling into question whether those afflicted had the mumps vaccine.
Mumps Outbreak Spreads Again
On Saturday, the Associated Press reported that 300 people had been diagnosed with the mumps in New York's Rockland County. Almost all of those diagnosed are Orthodox Jews. This outbreak follows an earlier outbreak that started in August 2009.
This past October, Helen Kennedy wrote for the New York Daily News that city health officials in Brooklyn, N.Y., had uncovered “an outbreak of the old-fashioned childhood disease mumps.” Health officials said they had approximately 57 confirmed cases and that “75% of the victims had the normal two doses of mumps vaccine.” The outbreak was attributed to a child who had gone to Britain, “where the illness is more common because of lower levels of vaccination,” and then infected other children at a summer camp in upstate New York.
According to Kennedy, the recommended two doses of mumps vaccine are designed to protect people against mumps 90 percent of the time. So why are we seeing a resurgence of the illness? "We know that approximately one in every 20 people who are vaccinated may not develop antibodies," Dr. Jane Zucker, assistant commissioner of immunization, told the Daily News. "If the vaccine was not effective we would have many, many more cases. "
Background: What is a vaccine?
The National Institute of Allergy and Infectious Diseases (NIAID) explains that a vaccine contains disease-causing germs, or microbes, that have been weakened or killed so that they don’t cause actual disease. When these microbes are introduced to your immune system, your body quickly clears them and usually develops a degree of immunity to them. “In other words,” according to NIAID, “vaccines trick your immune system to teach your body important lessons about how to defeat its opponents.” After your immune system has learned how to fight a disease, you are immune to it. Vaccines provide artificially acquired immunity vs. the naturally acquired immunity that sometimes comes from getting a disease.
Polio vaccine blamed for outbreaks in Nigeria
Mutation of live virus in oral doses linked to 124 cases this year, experts say
http://www.msnbc.msn.com/id/32418446/ns/health-infectious_diseases
updated 1:24 p.m. ET, Fri., Aug 14, 2009
LONDON - Polio is spreading in Nigeria and health officials say in some cases it's caused by the vaccine used to fight the paralyzing disease.
In July, the World Health Organization issued a warning that this particular virus might extend beyond Africa. So far, 124 Nigerian children have been paralyzed this year — about twice those afflicted in 2008.
Nigeria and most other poor nations use an oral polio vaccine because it's cheaper, easier, and protects entire communities. But it's made from a live polio virus which carries a small risk of causing polio. In even rarer instances, the virus in the vaccine can mutate into a deadlier version that ignites new outbreaks.
Half of school children sick from "swine flu" shot
http://www.theflucase.com/index.php?option=com_content&view=article&id=1753%3Ahalf-of-school-children-sick-from-qswine-fluq-shot&catid=1%3Alatest-news&Itemid=64&lang=de
In a school in Sweden where the students was mass vaccinated with the poisonous Pandemrix "swine flu", half of them called in sick the day after the vaccination.
Out of 233 students, 130 reported sick the day after the shot and did not show up for school. The doctor administering the shot, Richard Eitrem, was shocked and called the headmaster of the school to find out what the status was of his patients. Many of the students went back to school the second day and this "calmed him down".
The seasonal flu is also making several students ill and according to Aftonbladet, that contributed to the high number of students calling in sick.
The article then states that only 20% to 30 % of the parents in several areas surrounding the capital Stockholm agreed to have their children vaccinated with the poisonous Pandemrix vaccine.
According to a school nurse, Ingrid Scotte, that is due to hesitations towards the vaccine based on "irrelevant" information concerning side effects.
Johan Niklasson
http://www.dailytelegraph.com.au/news/whooping-cough-strain-now-immune-to-vaccine/story-e6freuy9-1225828959714
Last Updated: February 14, 2010
Whooping cough strain now immune to vaccine
By Danny Rose
From: The Daily Telegraph
February 11, 2010 12:00 AM
THE bacteria that causes whooping cough has mutated, eroding the protection provided by the vaccine now given to children, scientists warned yesterday.
University of NSW researchers have identified significant changes in the two most common strains of the bordetella pertussis bacteria, which they also traced back to events in the late 1990s. Australian children were given a broad-acting "whole cell" vaccination against whooping cough up to 1997, but this was phased out over two years and replaced with a more targeted version. Concerns over potential side-effects were behind the change to a vaccine with a narrower scope, but this now appears to have contributed to the promotion of resistant strains.
"A key issue is that the whole cell vaccine contained hundreds of antigens, which gave broad protection against many strains of pertussis," UNSW School of Biotechnology and Biomolecular Sciences associate professor Ruiting Lan said.
"But the (targeted) acellular vaccine contains only three to five antigens. Our findings suggest that the use of the acellular vaccine may be one factor contributing to these genetic changes."
The research team analysed more than 200 samples of the bacterium collected over the past 40 years in Australia and compared them with samples from Japan, Canada, USA and Finland. They found while the vaccine now in use was effective against some of the strains circulating in Australia it may no longer protect against two strains, known as MT27 and MT70.
Dr Lan said more research was needed to confirm the results but health authorities may need to modify the vaccine to broaden the protection it offered. Whooping cough cases are on the rise in Australia, with several significant outbreaks seen last year in western Sydney. Protection against whooping cough is contained in childhood vaccinations which, in NSW, are usually given to infants. Parents who opt out of this child vaccination process were thought to have contributed to the rise in cases.
If one vaccine doesn't work...they just need another...and another....and another....until when?
"In an interview with Medscape Allergy and Clinical Immunology, Dr. Vaughn said that findings among pediatric patients in his practice led to this study.
"We found that among children with recurring infections, particularly ear and nose infections, a lot of them failed to respond appropriately to their pediatric vaccinations," said Dr. Vaughn. "Also, a lot of these children were not making natural antibodies to strep pneumonia, particularly. Since that organism is found many times in those diseases, we felt that this information was clinically relevant."
The study, therefore, was designed to "evaluate the immune response to PCV-7 and HiB vaccinations in a subgroup of children who were identified suffering from 'bacterial' upper respiratory tract infections more frequently than their peers." ...
When asked about the study's take-home message, Dr. Vaughn said: "In our practice, it's been very useful to check for whether or not a child has responded to pneumococcal vaccine and to find out if they're making any natural antibodies. If they're not, clinicians need to consider the possibility that additional vaccination is the right thing to do."
http://www.medscape.com/viewarticle/713265
http://www.telegraph.co.uk/health/healthnews/5982476/Four-year-old-dies-after-being-diagnosed-with-mumps.html
Daily Telegraph
06 Aug 2009
Four-year-old dies after being diagnosed with mumps
By Rebecca Smith, Medical Editor
Lisa Pollitt, a four-year-old girl from Wythenshawe who had had the MMR vaccine, has died after being diagnosed with mumps, it has emerged.
Lisa Pollitt, aged 4, from Baguely who died suspected of mumps
The youngster had appeared to be recovering but then suddenly took a turn for the worse and doctors at a hospital in Manchester failed in their battle to save her. The exact cause of death has not yet been established, but deaths following mumps are very rare.
If confirmed, Lisa would be the first death in a mumps patient for more than nine years and over 65,000 cases.
Parents shunned the MMR vaccine followed research that linked it to bowel disorders and autism and there was a resurgence in mumps, with an epidemic in 2005. Measles cases have also risen and doctors are urging parents to ensure their children have had the full two doses of the vaccine.
It is not clear if Lisa had been given two doses of the MMR vaccine and cases of mumps in people who have been fully vaccinated are rare.
Parents Patsy and Danny, from Baguley, told of their horror at the death of their 'bright, bubbly and beautiful' daughter.
They described how their GP informed them Lisa had mumps, but the cause of death has not yet been confirmed.
Lisa was rushed to Wythenshawe Hospital where medics managed to revive her, but she died hours later.
Patsy, 24, said: "She was so full of life, bright and bubbly and into everything. She was a real tomboy and loved playing with her brothers and ourdog.. We can't believe she has gone."
Post-mortem tests have not so far established the cause of death and toxicology tests are now being carried out. The results will not be available for several weeks.
Her paretns have been told by doctors that she could have died because of a rare complication of mumps or a separate virus while her system was weakened.
Lisa had been given the MMR vaccine which should protect against mumps but in rare cases people can still catch it.
Patsy said: "She was a healthy young girl and had suffered no serious illnesses. She woke up with a swollen face and the GP said it was mumps.
"She seemed to be OK, she was eating and even had started playing again.
"Then a week later she was a bit groggy and couldn't get to sleep so I stayed downstairs on the sofa with her.
"Suddenly her lips went blue, she was all pale and was still breathing but a few minutes later she stopped.
"It all happened so quickly. It was terrifying.
"In a way it was good that I had her sleeping with me because if not we would never have known what had happened - at least we knew we had got her medical care immediately. Everyone did everything they could to save her."
Lisa had two brothers, Cameron, five, and Anthony, three, and was due to start at Baguley Hall Primary in September. She was already a pupil at the school's nursery.
Lisa was diagnosed with mumps on July 20. It is incredibly rare to die from the disease, with estimates suggesting one in 10,000 cases.
Patsy said: "It seems so unfair when Lisa had had all her injections that she would get mumps, but the doctors says it happens sometimes and there is a lot of mumps around at the moment.
"We know there are lots of children who haven't been given the injection and I hope that if their parents hear what happened to Lisa they will realise how serious it can be and they will get their children protected and stop it from spreading."
By May this year doctors had recorded 95 cases of mumps across Greater Manchester, with 31 cases in Manchester, 17 in Tameside, 13 in Trafford and 10 in the Ashton, Wigan and Leigh area.
Mumps is a virus which normally affects glands in the mouth and neck, making them swell up and become painful.
It is passed on through saliva and the incubation period is between two and three weeks.
In 30 per cent of cases there are no symptoms and complications include swelling of the ovaries and testes and, although some believe it can cause sterility, there is no evidence of this.
WESH.com
Chicken Pox Outbreak Strikes School
POSTED: 5:06 pm EST February 13, 2008
UPDATED: 11:52 am EST February 14, 2008
KISSIMMEE, Fla. -- More than 20 students at Mill Creek Elementary School in Kissimmee have been diagnosed with the Varicella virus, more commonly known as chicken pox. The students affected have all had their mandatory chicken pox vaccine, but the CDC is now recommending two doses instead of one.As of Thursday morning, the chicken pox outbreak was contained to Mill Creek Elementary. A mass immunization program began at the school.
(So if one vaccine doesn't work you just need another one....good grief.)
http://www.ncbi.nlm.nih.gov/pubmed/19155953?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
1: Obstet Gynecol. 2009 Feb;113(2 Pt 2):550-2.
Links
Cervical cancers after human papillomavirus vaccination.
Beller U, Abu-Rustum NR.
Shaare Zedek Medical Center, Jerusalem, Israel. beller@szmc.org.il
BACKGROUND: Current randomized clinical trials have shown that the quadrivalent human papillomavirus (HPV) vaccine can reduce the morbidity of precancerous lesions associated with HPV infection of vaccine-related subtypes. However, to date, there is no definite evidence showing the vaccine reduces the incidence of invasive cervical carcinoma. CASES: We present two cases--one young, vaccinated woman who developed cervical carcinoma that was unrelated to HPV and another who developed cervical carcinoma secondary to infection with an HPV subtype not covered by the vaccine. Both patients were treated successfully and remained well without evidence of cancer. CONCLUSION: Long-term follow-up data are needed to evaluate the prophylactic effectiveness of the current HPV vaccine. These cases could represent non-vaccine-related HPV infections. Young women must be thoroughly counseled about the efficacy and limitations of the vaccine and about continuing lifelong
screening even after vaccination.
PMID: 19155953 [PubMed - indexed for MEDLINE]
Warning from flu jab inventor http://ukpress.google.com/article/ALeqM5ixXz-8-OKh8FR1suzAa5dcZoWJtA
The inventor of the flu jab has warned it would do little to prevent a flu epidemic in Britain this winter, adding to fears about the vaccine's ineffectiveness. Dr Graeme Laver, who helped create the jab more than 40 years ago, believes it should not be relied upon to protect from a potentially severe flu epidemic. The Australian scientist also claims that people's lives could be saved if drugs such as Tamiflu and Relenza were used instead, once the disease has already struck.
These are both currently prescription-only in the UK but Dr Laver argues they should be sold over the counter so that they were more readily available to flu sufferers. He told the Daily Mail: "I have never been very impressed with its (the jab's) efficacy. It is better than nothing and I wouldn't want to advise people not to take it, but you can't rely on it doing any good. "If the seasonal flu is as bad as it was in Australia, you are in for a pretty bad time. You could have a really severe epidemic." An extra-bad flu season in Australia this year, which has seen the number of flu victims triple compared with last year, could herald problems for the UK as well, Dr Laver claims. His comments are set to fuel the debate about the efficacy of the flu jab, which has already come in for criticism. Last month a study by the Health Protection Agency (HPA) found the vaccine had no "protective effect" on lowering numbers of elderly people admitted to hospital with respiratory infections.
Researchers concluded that ministers should not rely solely on the flu vaccines to have a large effect on the pressure put on hospitals in winter from infections, including flu.
Despite vaccine, meningitis takes teen's life Strain of bacterial disease kills immunized Bentley freshman By Tania deLuzuriaga, Globe Staff | October 10, 2007
When Bentley College freshman Erin M. Ortiz went home sick last weekend, her mother did what any mother might do. She cooked comfort foods - corned beef, rice, and plantains - reflecting her daughter's Puerto Rican and Irish heritage.
"It was her favorite meal," said Brenda Rivera, a family friend.
But just hours after complaining of a headache and going to bed to sleep it off, Ortiz, 18, was dead of bacterial meningitis, a disease against which she had been vaccinated. Now, Ortiz's family hopes others will learn from their story.
"I'm all cried out," said her father, Raymond Ortiz. "I've got a hole in my heart. I don't think I'll ever be the same."
"We thought she'd be covered," he said. "They don't tell you that even if you get the vaccine, you're still susceptible."
Like most incoming freshmen, Ortiz was vaccinated last summer. Massachusetts law requires all college students to receive the vaccine. But it protects only about 85 percent of recipients and is not effective against all strains of the bacteria that cause infection in the brain and spinal fluid, which can result in brain damage, hearing loss, learning disability, or death.
"I wish we had a vaccine that worked 100 percent of the time," said Dr. Richard A. Moriarty, a professor of clinical pediatrics at the University of Massachusetts Medical School. "But this is certainly better than not being immunized."
Doctors aren't sure yet what strain of meningitis Ortiz contracted or if she was one of the rare people the vaccine does not protect.
Ortiz first complained of feeling sick on Friday when she arrived home in New Hampton, N.Y., to see her family for the long weekend. She went to bed early and slept until the next afternoon.
On Saturday, her mother, Cathy, cooked her favorite dinner. That night, she woke with a terrible headache and her parents decided to take her to the hospital.
"She got dressed and walked down to the car," Raymond Ortiz said. "She walked into the emergency room."
Not long after, though, Ortiz's condition went downhill and she developed a fever of nearly 105 degrees. A spinal tap revealed meningitis, something the family had thought was not possible.
"When they told us, we were like, 'How can this be?' " Raymond Ortiz said.
Though she initially appeared to respond to antibiotics, by 7 p.m. Sunday, Ortiz had taken a final turn for the worse, the pressure on her brain causing irreversible damage.
"There's a spiritual connection you have," Raymond Ortiz said. "We looked at her and we knew she wasn't there."
Doctors kept her alive until Monday morning to harvest her organs.
In response to the case, Bentley College officials have been in touch with more than 50 students who had contact with Ortiz. About 30 of them have been given preventive antibiotics, said Gerri Taylor, the director of health services at the college.
"We are working day and night to identify students who may have had contact with her," she said. "It's a health service's worst nightmare. It's a college's worst nightmare."
Bacterial meningitis is less common and more lethal than viral meningitis. The bacteria, which can live undetected in the nose or throat, are more common on college campuses, where students living in close quarters can easily spread the bacteria by sharing drinks, cigarettes, or lip gloss. Massachusetts recorded 21 cases of bacterial meningitis last year.
"It's a nasty little bug," Raymond Ortiz said. "It can take away your shining star in 36 hours, just like it did mine."
Tania deLuzuriaga can be reached at deluzuriaga@globe.com.
Possible measles outbreak hits Ann Arbor school http://www.detnews.com/apps/pbcs.dll/article?AID=/20071004/UPDATE/710040458/1409/METRO
Santiago Esparza / The Detroit News ANN ARBOR -- State health officials are looking into a possible outbreak of measles at Burns Park elementary School.
Officials have confirmed that a third-grade girl had the disease and a classmate likely has it. A fifth grader at the school also is being checked to see if she has the disease, thought to be all-but-eradicated, said Ann Arbor public schools spokeswoman Liz Margolis.
"If you even have one it definitely becomes a serious situation," Margolis said of the girls.
All three of the girls were immunized against the disease. But the girl who was confirmed as having the disease likely caught it on an overseas trip, state health officials said.
She already has recovered and was able to come back to school. Students who are not current with their vaccinations are not allowed back to school until they are caught up or 21 days has elapsed, Margolis said. About 10 students who need to do this, she said.
The district today is sending home, with all students, health information about measles and the need to be immunized, Margolis said.
In each of the past two years there only was one confirmed case of measles in the state, according to the Michigan Department of Community Health. In 2004 there were no cases.
Measles today, thanks to vaccinations, is a rare disease," said TJ Bucholz, department spokesman. "It is something we take very seriously."
The students last month began exhibiting cold-like symptoms, Margolis said. It was not until they developed rashes that doctors discovered they were suffering from measles, Margolis said.
State officials believe the school is an isolated site and are not planning to quarantine it. Margolis said the three girls are the only ones with any signs of the disease.
About 100 people annually get the disease in the United States, Margolis said.
You can reach Santiago Esparza at (313) 222-2127 or sesparza@detnews.com.
MSNBC.com
--------------------------------------------------------------------------------
Flu vaccines may not save lives of elderly
No solid proof that shots prevent seniors from dying of disease, expert says
Reuters
Updated: 8:19 p.m. ET Sept 24, 2007
WASHINGTON - Getting an annual flu vaccine may not save the lives of seniors, and health officials may want to look at other ways to protect the elderly, researchers said on Monday.
No studies have conclusively proven that influenza shots prevent flu-related deaths in people over the age of 65, and some of the arguments that have been used to support this idea are based on faulty data, the researchers argue in the Lancet medical journal.
"We need to find a way to better estimate what the true benefits are," said Dr. Lone Simonsen of George Washington University.
Simonsen stressed that the elderly should continue to get flu shots. But she said health officials should also be looking for other ways to prevent some of the 36,000 deaths that come each year from flu in the United States alone.
"We can probably do more to protect the seniors," Simonsen said in a telephone interview.
Every year, the U.S. Centers for Disease Control and Prevention launches a new flu vaccination campaign, citing the research that shows the deaths and the 200,000 hospitalizations every year from flu-related illness.
People over the age of 65 make up the majority of these cases, although some children also die every year from flu.
Less benefit
But Simonsen said that no one has actually ever shown that vaccination cuts deaths from flu among the elderly. She said there is plenty of evidence to show that, because older people have lower immune activity, they in fact get less benefit than younger people from vaccination.
"There is no question about the vaccine working in people under the age of 65," she said.
Simonsen said it may be possible to design vaccines that better protect the elderly — something the CDC is working on.
She said the CDC should also consider recommending more aggressive use of antiviral drugs that can treat and sometimes even prevent flu.
CDC flu expert Dr. Joe Bresee said his agency was considering these and other measures — including better vaccination of health care workers and recommending the widespread vaccination of schoolchildren.
"We know that school children are a big part of community transmission. They shed lots of virus. They shed it for long periods of time," Bresee said in a telephone interview.
Bresee and Simonsen said elderly people may get other benefits from the flu vaccine. Influenza shots do not always completely prevent infection, but they can make the illness less serious.
Simonsen noted that a vaccine now commonly used against several types of streptococcal bacteria, which cause pneumonia, meningitis and ear infections, did not show big effects across populations until it became a regular childhood vaccine.
Experts now agree that the vaccine not only protects children, but it protects the elderly people that the children may have been infecting before.
(c) Reuters 2007. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
URL: http://www.msnbc.msn.com/id/20962720/
The Times of India -Breaking news, views. reviews, cricket from across India
Human trials of anti-AIDS vaccine stopped
25 Sep 2007, 0120 hrs IST,Kounteya Sinha,TNN
SMS NEWS to 58888 for latest updates
NEW DELHI: The world's most promising anti-AIDS vaccine candidate has failed. Instead of protecting volunteers from the deadly virus, the vaccine actually ended up infecting numerous participants during its large scale clinical trial on humans.
The vaccine also failed to reduce the amount of HIV in the blood of those who got infected, which was a second major goal of the study. US pharmaceutical giant Merck has now halted the V520 vaccine trial called STEP. The announcement came as a major blow to international hopes of developing a HIV vaccine that could stall the spread of this deadly disease.
Earlier experiments of the vaccine on animals and smaller tests on humans had showed promising results. This led Merck to start large scale human trials in US, Australia, Latin America and the Caribbean in 2004.
Over 3,000 high risk uninfected volunteers, aged between 18 and 45 years were recruited and three doses of the vaccine were injected over six months. The final result of the vaccine's efficacy was expected by the end of 2008. But initial analysis of 1,500 volunteers by the independent Data Safety Monitoring Board, monitoring the trial, concluded that the vaccine was failing hopelessly.
Of the 741 people who received at least one dose of the vaccine, 24 cases of infection were reported in 13 months. That compared with 21 infections out of 762 people who received injections of a dummy vaccine. The search to find an anti-AIDS vaccine has involved over 20 clinical trials with tests for over 30 vaccine candidates still under way.
Since HIV was first identified in 1981, 40 million people have been infected with the virus. Annually, an estimated 4 million new infections occur, of which 90% are in developing countries. Over the last 25 years, AIDS has claimed more than 25 million lives.
Merck Research Lab's president Peter Kim said: "We share in the disappointment of the research and HIV communities today."
kounteya.sinha@timesgroup.com
Effects of chickenpox vaccine fade over time Thu Mar 15, 2007 2:02PM GMT By Gene Emery
BOSTON (Reuters) - Merck's chickenpox vaccine Varivax not only loses its effectiveness after a while, but it has also changed the profile of the disease in the population, U.S. researchers reported on Wednesday.
The study confirmed what doctors widely knew -- that the vaccine's protection does not last long.
And with fewer natural cases of the disease going around, unvaccinated children or children in whom the first dose of the vaccine fails to work have been catching the highly contagious disease later in life, when the risk of severe complications is greater, they said.
"If you're unvaccinated and you get it later in life, there's a 20-times greater risk of dying compared to a child, and a 10 to 15 times greater chance of getting hospitalized," said Jane Seward of the Centers for Disease Control and Prevention in Atlanta, who worked on the study.
The findings, reported fully for the first time in Thursday's New England Journal of Medicine, have already had an impact.
They helped prompt the CDC's Advisory Committee on Immunization Practices to recommend a booster shot between the ages of 4 and 6. The panel also said in its June 2006 report that children, adolescents and adults should be given boosters as well.
No one knows how long the effects of a second shot will last, said the research team, led by Sandra Chaves of the CDC.
http://uk.reuters.com/articlePrint?articleId=UKN1429730720070315
http://www.poughkeepsiejournal.com/apps/pbcs.dll/article?AID=/20070209/NEWS01/70209065
Friday, February 9, 2007
Chicken pox strikes Highland Elementary, 33 students ill
HIGHLAND — A chicken pox outbreak of three dozen cases has been reported at Highland Elementary School, according to the Ulster County Department of Health. Since Feb. 6, 33 students out of about 900 in the elementary school have been diagnosed with the aricella, or chickenpox, virus, said John McCarthy, district superintendent. "It's all in the elementary school right now," he said. "It seems to be contained there." According to public health director Dean Palen, an outbreak occurs when five or more cases are reported at once. The goal now, he said, is to prevent the disease's spread. "We're trying to contain it to make sure other students at the other schools don't get it," Palen said. Of the 33 students, all but two had been vaccinated for the virus.
According to a letter sent to district parents Thursday from the Department of Health, children who have already received one dose of chicken pox vaccine should receive a second dose if an appropriate amount of time has elapsed between shots. While not usually a serious illness, complications can cause pneumonia and in rare occasions can be life threatening, Palen said. Chickenpox is an infectious disease caused by a virus, which results in a blister-like rash, itching, tiredness and fever, according to the Center for Disease Control.
The county will offer a special chickenpox vaccine clinic for children 3-7 p.m. at the Health Department office, 570 Route 299, Highland. Appointments are required and the child's vaccine record must be brought to the appointment.
*If one doesn't work you just need another one...and another one....ect....
http://www.stuff.co.nz/stuff/0,2106,3753266a11,00.html
Vaccinated youngsters still vulnerable to killer disease
04 August 2006
By KIM RUSCOE
Twenty fully vaccinated under-20-year-olds have contracted the epidemic strain of meningitis since immunisation began.
The Health Ministry says though five sufferers needed intensive care, none had died.
It was possible the vaccine had lessened the severity of their symptoms and saved their lives, meningococcal programme director Jane O'Hallahan said.
New figures show that this year five people have died from meningococcal disease – all in the past five weeks – compared with 14 for the whole of last year. The deaths follow the completion of the ministry's $222 million mass vaccination of under-20-year-olds against meningococcal B.
Meningococcal B reached epidemic proportions in 1991 and peaked in 2001, when 650 cases and 26 deaths were recorded. Dr O'Hallahan said the epidemic strain was still circulating and "looking for vulnerable children". "With herd immunisation, if you vaccinate enough of the population you give protection to those who are unvaccinated," she said.
"But that doesn't appear to be happening with meningococcal B." Of the 90 cases of meningococcal disease so far this year, 38 had been confirmed as the epidemic meningococcal B strain. A further 26 were awaiting identification and the rest were attributed to other meningococcal strains. Of the five who died last month, one had the less common meningococcal C. It was not yet known which strain caused the other four deaths.
Even the fully vaccinated were not invulnerable, Dr O'Hallahan said.
"No vaccine is 100 per cent effective."
http://www.stuff.co.nz/stuff/0,2106,3537307a10,00.html
Ten vaccinated kids get disease
12 January 2006
By KELLY ANDREW and NZPA
Ten fully vaccinated children and teenagers have been infected with deadly meningococcal B disease since the immunisation programme began 18 months ago.
These "breakthrough" cases have been assessed by the Health Ministry, which is considering whether a fourth booster vaccination is needed for babies aged under six months.
Currently, three injections are given to children aged between six weeks and 20.
Of the 10 patients infected, one was a baby who began vaccinations before six months of age.
But national meningococcal vaccine strategy director Jane O'Hallahan said the decision about a fourth dose was not prompted by this case or the other meningococcal B vaccine breakthroughs. "It relates to the fact that infants frequently require four doses to get protection in relation to many different diseases," she said.
The vaccine manufacturer applied for a licence to give four doses to infants about six months ago, and Medsafe is expected to announce its decision in the next few days.
If approval is given for a fourth dose, about 50,000 babies could be affected before the vaccination programme ends in June.
Of the nine other fully vaccinated children who have contracted the disease since the programme began in July 2004, seven were over five years old and two were aged under five. Two were admitted to intensive care, and the others required treatment in hospital. All made a full recovery.
Dr O'Hallahan said the booster dose was being considered for infants under six months because their antibody response to immunisations was lower than older children, making them more vulnerable to the disease.
The ministry had no plans to introduce a fourth dose for other age groups because "there was no suggestion that it was warranted".
Ten breakthrough cases in 18 months was "relatively small" and within expected levels, Dr O'Hallahan said. No vaccine was 100 per cent effective.
She believed the programme was working.
Early results for Counties-Manukau, where vaccinations began, showed a drop in meningococcal B cases, and a national picture would emerge in the next six months.
It was possible that even though the vaccinated children had become infected, the vaccine had provided them with some protection by reducing the severity of the illness.
Since the vaccination programme began, more than 2.8 million doses have been administered. More than 1 million people have had at least one dose and more than 890,000 people have had all three doses.
There were 222 cases of meningococcal disease in the year to November last year, with 14 deaths. The average number of cases a year for the past five years was 490.
http://www.mg.co.za/Content/l3.asp?ao=16474
Mail & Guardian
Race is on to save first Aids vaccine. But does it work? 01 July 2003 07:32
What was billed as the first Aids vaccine, with potential to end a global disaster that is killing millions every year, has ended with an ignominious whimper, as a Californian biotech company arranges to pull out of Thailand before the final analysis of its clinical trials involving 2 500 Thai volunteers. Two US government health agencies and the Gates Foundation are in urgent talks about stepping into the breach.
The decision of VaxGen to cut its losses could mean the loss of invaluable data to scientists working in one of the most important research areas of our time. There are lessons to be learned even from the failures of a clinical trial, said a leading US scientist yesterday. More importantly, she said, if the western world pulled out of a trial in this abrupt way, allowing all the efforts of the Thai participants and staff to go for naught, it could wreck the chances of future clinical trials in developing countries. "Imagine going to a developing country again and asking them to roll up their sleeves for an efficacy trial if we didn't finish this one," said Peggy Johnstone, director of the vaccine and prevention research programme of the National Institute of Allergies and Infectious Diseases (NIAID), one of the government-funded bodies considering paying the bill. "We have to consider their side of it as well. The rest of the world is looking at what happens. They are going to want guarantees." VaxGen is acting entirely on commercial grounds. "What has happened is that their board of directors has said they are not interested in completing the trials," said Dr Johnstone. "The staff, having put blood, sweat and tears into the trial, are very interested in completing it. We are in discussions now to decide what it will need to complete the trial.
From a scientific perspective, it would be a tremendous loss not to complete the trial and analyse the data." VaxGen insisted it was not pulling out, but simply did not have the money to analyse all the data from the Thai trials. "The financial markets sent a loud and clear signal to us through the decline in our stock value and through conversations with members of the financial community. Their unambiguous response was, please do not spend more money than is necessary on your trials," said Lance Ignon, vice president of corporate communications.
He said the company would announce whether the vaccine had worked this winter. The vaccine, called AidsVax, was way ahead of the rest of the field in terms of its progress through the clinical trials designed to prove whether any drug is safe and whether it works. A phase three trial -- the last in the process -- was carried out in the US and another in Thailand. Few expected AidsVax to be the wonder drug everybody prays for, but even if it worked in some volunteers, it would have been of use. But on February 24 this year -- at midnight -- VaxGen released the results of the US trial. AidsVax was a failure. But, to the fury of some scientists, who accused the company of manipulation of the data, VaxGen sent a hare running, claiming that the vaccine had worked in a small minority of those who were given it, from the black and Asian communities. The most marked effect, said the company, was a 78% reduction in infection among black volunteers. However, there were only 314 of them out of a total of 5 009. One advantage of the big US health agencies, NIAID and the Centres for Disease Control (CDC), getting involved in finalising the data from Thailand might be, said Dr Johnstone, "that we maybe avoid some of the hoop-la that happened around the American trials." Ignon, from VaxGen, said it was now for NIAID and CDC to work out how significant the ethnic minority findings from the US trial were. The roller-coaster ride that VaxGen has offered the Aids research community may be inevitable from a private company that has to look to the markets to fund a risky business.
Don Francis, who formed VaxGen specifically to investigate an Aids vaccine, has his admirers for his determination to get involved. "It is overall disappointing that there aren't more private sector resources going into Aids vaccines, but it is understandable," said Johnstone. "Ninety per cent of the need is going to be in countries that can't pay for it." Hype claim Aids activists, however, point out that many scientists have argued for years that VaxGen's approach was not likely to work. "Based on the poor results from their trial here in the United States, I think they made a rational decision" to pull out of Thailand, said Gregg Gonsalves, director of treatment and prevention advocacy of Gay Men's Health Crisis in New York. "They've been hyping this vaccine for many years based on dubious data, but at some point, all the hype in the world can't salvage a product that doesn't work." NIAID several years ago declined to give VaxGen funding for its vaccine research, he pointed out. Richard Jefferys of the Treatment Action Group said that the decision on Thailand "speaks volumes about their confidence in the product to work", in spite of all the spin about ethnic groups in the US trial. "The positive thing about it is that they have shown that you can do a phase three efficacy trial [for an Aids vaccine]. It may be that there are unfortunately lessons about how careful people need to be in listening to the results of those trials." -
Mumps suspected in local child
Jul 31 2003 12:00AM By Staff Writer
Despite being properly immunized, a St. Francis child is believed to have had the first case of mumps in the city in at least a decade and a half, St. Francis Health Department officials said.
Public Health Administrator Kathy Scott said she could not disclose the gender or age of the child involved, saying only that it was a school-age child. The Health Department was notified of the possible case July 9. The parents took the child to a physician, and because of the symptoms, blood samples were drawn to test for mumps, said Jeff Berg, immunization adviser for the Wisconsin Immunization program, run by the Department of Health and Family Services, located in Madison. An antibody associated with mumps was found in the blood samples, he said. More tests are under way to determine if the child had mumps or another virus that mimics mumps, Berg said. Mumps is a viral infection and is communicable, meaning it can be passed on to other people, Berg said. Both children and adults can get it. Like the flu, there is no treatment, and the disease basically has to run its course, Berg said. The illness was common before 1967, when the mumps vaccine was licensed. Before 1967 there were about 200,000 cases of mumps nationwide each year, according to the Mayo Clinic's Web site. In 2002, there were 74 cases in the country, with one being in Wisconsin, Berg said. Scott has not had a case of mumps reported in her 16 years with the St. Francis Health Department until now. Most people who get the mumps make a full recovery. To try to minimize the public health impact, Health Department officials have notified anyone that may have been in contact with the child and told them the symptoms to watch out for, Scott said. "The parents took the child in to a doctor because the child woke up with a small lump behind the ear and was feeling really tired," Scott said. Besides having tender salivary glands along the neck, there may be swelling in the cheeks, she said. The ill person may also have a low-grade fever and headache. The incubation period for mumps is 14 to 25 days, Berg said. People with the disease are sick about two to three weeks after exposure. The mumps is most contagious in the three days before and four days after the symptoms occur, Berg said. How long a person stays sick after the symptoms appear depends on the severity of the symptoms, Scott said. The child suspected of having had the mumps had received vaccinations for measles/mumps/rubella from the Health Department at two different times in the past, Scott said. The vaccine is one distributed by the state's immunization program to all health care providers. "Vaccines are not 100 percent effective," Scott said. "It's more like 96 or 97 percent." Berg said this case is a reminder to parents with children that are about to enter school for the first time to make sure they are up-to-date on their vaccinations. The first measles/mumps/rubella vaccine should be given after a child's first birthday and a second dose should be administered before a child enters elementary school. Berg said Scott followed the correct procedure in advising parents and others about the possible mumps exposure. "You have to start from the time when the symptoms first show up, and then go backward from there to see if you can find a source," Berg said. "You have to see where the child was and what they were doing. You need to see if they were exposed to anyone with similar symptoms." Berg said the child had not gone out of the St. Francis area. No source for the child's infection has been identified. If a child that was exposed does develop symptoms that appear to be mumps, parents are advised to keep the child isolated, contact their physician and report the possibility to the Health Department and work with them. The key is to get the child checked without exposing a large number of people to the possible illness, Berg said.
ttp://www.medscape.com/viewarticle/459695_4
Pediatrics, August 2003 Journal Scan
From The Pediatric Infectious Disease Journal
July 2003 (Volume 22, Number 7)
Increase in Deaths From Pertussis Among Young Infants in the United States in
the 1990sVitek CR, Pascual FB, Baughman AL, Murphy TV
The Pediatric Infectious Disease Journal. 2003;22(7):628-634
They also noted that the current vaccination strategy does not protect the patients at highest risk for death, young infants.
Reviewer comment: I included this article in part as a reminder for all of us to aggressively screen infants for needed immunizations and administer deficient immunizations as soon as identified. The investigator's comment about finding new strategies to protect the very young demonstrates the best new information this article provides. Additionally, they suggest protecting adults around infants as a possible method of protection. I also recently heard a speaker discuss the possibility of "boosting" women of child-bearing age or even pregnant women as another potential strategy. Whatever the ultimate strategy, it almost certainly will involve efforts to reduce pertussis among the older child and adult populations, presumably the reservoirs from which these younger children are exposed.
“Last year we saw three cases among vaccinated children in the south west London area."
Sort of proves the point, doesn't it...?
Sue
http://www.thisislocallondon.co.uk/matters/currentaffairshealth/display.var.
410495.0.children_targeted_for_meningitis_booster_jabs.php
Children targeted for meningitis booster jabs
Young children across Wandsworth are to be encouraged to have a meningitis immunisation jab in a new drive by South West London Health Protection Unit. Children aged between six months and four years are being offered the Hib booster vaccine in their GP practices after recent figures show that the number of cases of meningitis has begun to rise.
The haemophilus influenza, or Hib, vaccine was first introduced in 1992, and doctors believe it is a vital tool in maintaining low instances of the disease recurring. Clinical director of South West London Health Protection Dr Barry Walsh said: “Hib meningitis is a serious condition. “Last year we saw three cases among vaccinated children in the south west London area.
“In order to prevent further cases we are urging parents to have their children boosted with the fourth dose of vaccine, which is safe and effective.” Parents of children within the age range are urged to contact their GP if they haven’t already been contacted to arrange an appointment. To find out more about the Hib vaccine contact the NHS Direct helpline on 0845 46 47.
http://www.reutershealth.com/archive/2003/08/08/professional/links/20030808c
lin010.html
Meningococcal C vaccine may cause relapse of nephrotic syndrome in children
Last Updated: 2003-08-08 12:33:14 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Administration of meningococcal C conjugate vaccine (MCCV) appears to increase the risk of nephrotic syndrome relapse in children, according to a research letter in the August 9th issue of The Lancet. "The risk of relapse after vaccination might be greater for this group of patients than the risk of meningococcal C infection," Dr. Richard S. Trompeter and colleagues write, "so the decision to vaccinate should be carefully considered."
Immunogenic stimuli have been associated with the syndrome, but the effect of vaccination has not been investigated, the British researchers note. Their suspicions were raised when nine children with nephrotic syndrome relapsed after receiving MCCV.
Dr. Trompeter, of Great Ormond Street Children's Hospital NHS Trust in London, and colleagues investigated the relapse rate during the year before and the year after vaccination of children with steroid-sensitive nephrotic syndrome.
Included were 106 patients who received the vaccine, among whom there were 63 relapses in the year before and 96 in the year postvaccination, a relative incidence of 1.52 (p = 0.009). The risk was markedly raised only in the first 6 months after inoculation (relative incidence = 1.84). "From 106 doses of vaccine, there was a risk of one relapse in every four doses given to this population," Dr. Trompeter and colleagues write. They suggest that conjugate vaccines stimulate T cells, "so disturbance of the cytokines by MCCV might have resulted in the cluster of relapses we recorded."
Lancet 2003;361:449-450.
Lancet 2003;
http://www.washingtonpost.com/ac2/wp-dyn/A51637-2003Sep9?language=printer
washingtonpost.com
Marines' Malaria Cases Show Protections Failed
By David Brown
Washington Post Staff Writer
Wednesday, September 10, 2003; Page A01
Despite extensive preventive measures, most of the more than 200 Marines who spent time ashore in Liberia last month apparently contracted malaria, with about 43 of them ill enough to be hospitalized. The malaria outbreak amounts to a stunning failure of standard protections against a disease that the American military is unusually keen to prevent in troops deployed to the tropics. So many Marines became sick in such a short period of time that Navy physicians for a while doubted the illnesses could all be due to the mosquito-borne infection.
Although the malaria diagnosis has been confirmed in only 15 percent of the troops, they and their officers report that nearly all who spent the two weeks ashore reported at least mild symptoms typical of malaria. Navy physicians and epidemiologists investigating the outbreak believe most of
the onshore troops may have been infected.
"We are extremely, extremely concerned about this," said Capt. Gregory J.Martin, a physician at National Naval Medical Center in Bethesda, where all but two patients are being treated. The concern is shared not only by the military's infectious diseases and preventive medicine specialists but by combat commanders, he said.
The outbreak occurred even though the troops were taking a drug to prevent the disease, were instructed to use insect repellents and were wearing uniforms treated with long-acting insecticides. How the Marines became infected despite these measures is uncertain, although failure of the drug to reach adequate concentrations in the troops' bloodstreams is a leading hypothesis.
The patients, members of the 26th Marine Expeditionary Unit except for several Navy medical corpsmen, were taking mefloquine (sold as Lariam), a standard drug used to prevent and treat malaria. West Africa is not known to be an area with high rates of mefloquine-resistant disease, although occasional cases have been reported there. U.S. troops in West Africa have since switched to an alternative medication, doxycycline.
This is the most intensive outbreak of malaria in the U.S. armed services in recent memory and the largest number of cases among Marines since the deployment to Somalia a decade ago. All of the cases were caused by Plasmodium falciparum, one of three types of malaria parasite and by far the most dangerous. The number of malaria cases in the armed services in recent years was not available yesterday. The Army, which has the most, reported 57 cases last year, 52 in 2001 and 55 in 2000.
Thirty-one patients arrived at the Bethesda hospital Sunday and 10 yesterday morning. Two others are being treated at the Army hospital in Landstuhl, Germany. No one has died in the outbreak, but two patients in the Bethesda intensive care unit have cerebral malaria, the most feared form of the disease, with a fatality rate of about 20 percent. They are conscious, improving and expected to recover fully, said Lt. Cmdr. David L. Blazes, an infectious-diseases physician treating them.
Members of the Marine unit, normally stationed at Camp Lejeune, N.C., went ashore Aug. 12-14 and returned to their two ships 10 to 12 days later. Soon afterward, many reported common symptoms of malaria, including headache, pain behind the eyes and muscle aches accompanied by cyclical fevers.
Malaria is normally diagnosed by using a microscope to look for malaria parasites inside red blood cells. Many of the Marines were diagnosed aboard ship that way. In some of the 43 people -- 40 Marines and three sailors --no parasites were seen, probably because the infection was partially treated by the mefloquine, but "virtually everyone had classical symptoms" of the disease, Blazes said.
About 30 patients who arrived at Bethesda on Sunday were put in a separate unit because physicians feared some might have some other disease; malaria rarely shows up in sudden, severe outbreaks. The possibilities included Lassa fever, which is caused by a virus; leptospirosis, caused by a bacterium; or infections arising from bacteria-like microbes called rickettsia.
"It was hard to believe that you could have almost all of a group that large develop symptoms over a four- to five-day period and have it be malaria," Martin said. Blood samples were sent to the Army's infectious diseases laboratory at Fort Detrick in Frederick, and within 12 hours those infections were ruled out.
Nearly all the Marines said they had taken their once-a-week mefloquine pills; a few said they had missed a dose or two. Many had been taking it since June. Normally, a case of malaria is considered severe if more than 3 percent of red blood cells are infected with the parasite. Several of the Marines, including one who reported never missing a dose of mefloquine, had more than 10 percent of their cells infected.
Peter B. Bloland, a malaria epidemiologist at the Centers for Disease Control and Prevention, said there are only a few possible explanations for the outbreak. "The possibilities include inadequate absorption [of the drug into the bloodstream], people not taking it correctly, poor drug quality or actual resistance" to the drug in the microbes, he said. The experience of Peace Corps volunteers in West Africa, who live in areas of intense malaria transmission for long periods of time, suggests that mefloquine-resistant infections are rare there, he added.
"Based on what we know about failures of prophylaxis in Africa, I think the most common explanation is inadequate blood levels [of the preventive drug] for some reason," he said. About 120 samples of blood taken from the Marines shortly before they became ill will be sent to CDC to measure mefloquine levels.
© 2003 The Washington Post Company
This article below indicates some top anthrax researchers found they need to revise their ideas on how anthrax works. Wonder if this has any implications for how the vaccine supposedly works? I remember from other material (GAO reports) that there was already a lack of certainty on how the shot provides "protection." And there are certainly arguments that the titer count does not equate to protection. Maybe if the researchers are going back to square one, so should the vaccine. This article would seem to lend credence to efforts being pursued to develop a new shot.
http://www.advanceformlp.com/common/editorial/PrintFriendly.aspx?CC=21648
Issue Date: 9/8/2003
Mouse Study Gives New View of Anthrax Toxin
A large-scale study of anthrax in mice has yielded new information about immune system response to anthrax bacteria, according to scientists at the National Institute of Allergy and Infectious Diseases (NIAID). The discovery that toxins released by the bacteria do not behave as previously believed should redirect approaches to anthrax drug design, notes NIAID Senior Investigator Stephen Leppla, PhD, whose research is published in today's issue of the Journal of Clinical Investigation.
In the new study, Dr. Leppla and his colleagues injected hundreds of inbred mice with anthrax lethal toxin (LT), and then took precisely timed measurements to determine how various organs and immune system processes responded. For example, they measured levels of chemicals called cytokines, which are released by immune system cells after a bacterial invasion. Dr. Leppla and his colleagues found no evidence of a persistent increase in cytokines, or of a link between cytokine increase and anthrax LT effects, contradicting earlier beliefs. The evidence suggests that current efforts to design cytokine-suppressing drugs to treat lethal toxin-mediated events in late stages of anthrax may be misguided.
"Finding effective therapies for diseases such as inhalational anthrax depends on our ability to connect basic research with clinicians' needs. This research is a perfect example of such translational research," said NIAID Director Anthony S. Fauci, MD.
In a natural infection, inhalational anthrax begins after anthrax bacteria spores enter the body, germinate and release toxins. Scientists can create artificial infection by injecting animals with anthrax LT. The accumulation of toxins precipitates events that lead to death. For more than a decade, scientists based their understanding of LT actions on the results of a few studies that employed a limited number of mice. Because of the high cost of doing anthrax toxin research and the small number of anthrax researchers, theories about LT action went largely unquestioned.
"We still do not know how LT brings about the hypoxia and shock-like death we see in mice," said the paper's first author, Mahtab Moayeri, PhD. The next important step, she adds, will be to identify the cell targets of LT and determine precisely how it initiates the chain of events leading to death.
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KERRY'S FIGHT FOR LIFE AFTER TB JAB AT SCHOOL
Date: 9/28/2003; Publication: Sunday Mirror; Author: HELEN MORGAN
No URL:
A TEENAGER has spent five months in hospital and still has to be fed through a tube after a routine TB jab given to her at school. Kerry Watson, 15, had the BCG vaccine, which protects against tuberculosis, while she was suffering from a bug. Just days after the injection, which was also given to hundreds of her school-mates, she started having attacks of vomiting and was taken to the Royal Infirmary, Aberdeen. Doctors dismissed her condition as a stomach bug and she was sent home. But her body continued to reject food and after a few days she was too weak to stand so she was re-admitted to hospital and hooked to a feeding tube.
Eventually, her weight fell to just six stone. Kerry was released from hospital in July, but she still cannot eat solid food and is being fed through a tube in her nose. It could take more than a year for her stomach to heal properly. Doctors think an allergic reaction to the jab, plus the bug, led to her illness. Her mother Karen, a 37-year-old careworker, said: "It was a terrible time for us all. The doctors had no idea what was wrong with Kerry. "We were all sick with worry and scared for her. She couldn't eat anything. It was heartbreaking to see her like that, because she is normally so fit and healthy and raring to go." Kerry was given the BCG injection at Portlethen Academy, Aberdeen, in February. Kerry's dad, 41-year-old garage owner Alan, said: "There were a few times when we thought we were going to lose Kerry. It was horrible. At one point they were on the verge of sending her to intensive care. "It has helped us to grow closer as a family. We realise what we could have lost and how lucky we are." Kelly longed to get out of her hospital bed and get back to her passion - dancing.
But as soon as she was taken off the feeding tubes she was ill again. Her parents are angry. Mr Watson said: "This has ruined her life. She is not the same girl any more. "She dances seven days a week and practises all the time, but it's not as easy as it was before. It's just not fair." Kerry is now back at school - and dancing again. She won 10 trophies at a recent contest in Aberdeen. A spokeswoman from NHS Grampian said: "We can't comment on individual cases but would state that the BCG is a very safe vaccination."
HELEN MORGAN, KERRY'S FIGHT FOR LIFE AFTER TB JAB AT SCHOOL. , Sunday Mirror, 09-28-2003, pp 35.
http://www.wfsb.com/Global/story.asp?S=1025686
COLCHESTER -- State health experts are investigating an outbreak of chicken pox in Colchester.
65 students at the Jack Jackter Elementary School got chicken pox last year. It was one of the largest outbreaks in the state. The Centers for Disease Control is also involved in the investigation. That's because some of the students who got sick were vaccinated against chicken pox. The chicken pox vaccine has a 20-percent failure rate.
http://www.nytimes.com/2002/12/12/national/12BRFS6.html?tntemail1
December 12, 2002
National Briefing: Washington
New York Times
STUDY OF CHICKEN POX VACCINE
A chicken pox outbreak two years ago found vaccinations surprisingly ineffective and may suggest that children should get two shots instead of one, some researchers say.
http://www.knoxnews.com/kns/health_and_fitness/article/0,1406,KNS_310_2395537,00.html
Whooping cough not shot down, but vaccinations up
By JANE E. ALLEN, Los Angeles Times
November 3, 2003
Doctors and public health officials are stumped. Even though vaccination rates are at record highs for whooping cough, cases of the highly contagious respiratory illness have been on the rise nationwide for more than two decades. In recent weeks, outbreaks have taken hold in parts of New York, Pennsylvania, Texas and Illinois. Nationally, cases reached 9,771 last year, the most since 1964.
The disease can be deadly, especially in babies, with 22 deaths nationwide last year. Whooping cough, or pertussis, takes its name from the sound that infected infants make as they struggle to inhale. It's caused by a rugged and wily bacterium, "Bordetella pertussis," that evades much of the body's disease-fighting system while wreaking havoc in the lungs, creating paroxysms of coughing powerful enough to break ribs. In adults, the illness typically is less severe, producing a cough that lasts weeks to months. Vaccination begun in the 1940s was considered to have vanquished the bacterium. It slashed rates from 150 reported cases per 100,000 Americans to less than 1 case per 100,000. But that rate has bounced back to 2.7 reported cases for every 100,000 Americans, although "there may be as many as 10 times as many cases," said Kris Bisgard, a medical epidemiologist with the federal Centers for Disease Control and Prevention in Atlanta. The illness is likely to be missed in teenagers and adults, who account for 50 percent of reported cases, because few doctors are trained to think about pertussis in anyone but babies. Although a simple blood test could help ensure that cases are properly treated, such a test remains elusive. Nor is there a vaccine for people older than 7.
http://www.kron4.com/Global/story.asp?S=1617203
U.S. to Begin 1st Tuberculosis Vaccine Trial in 60 Years
A new vaccine -- made with several proteins from the bacterium that causes tuberculosis -- will soon begin initial testing in humans, U.S. health officials announced Monday.
"This candidate vaccine, as well as other novel products emerging from the TB research and development pipeline, offers hope for reducing the burden of a disease that claims approximately two million lives each year," said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.
The vaccine combines two tuberculosis proteins known to stimulate strong immune responses in humans. The proteins were initially identified by screening blood taken from volunteers who never became ill with tuberculosis despite long-term infection with Mycobacterium tuberculosis bacteria, health officials said.
The Phase I trial will include 20 volunteers at a single site in the United States and will assess the vaccine's safety. If the vaccine proves safe in this initial trial, it will be tested further in larger clinical trials. The trial will be conducted by Seattle biotechnology company Corixa and GlaxoSmithKline Biologicals, a vaccine manufacturer based in Belgium, officials said.
The current TB vaccine, called BCG, offers some protection against the form of TB most often contracted by very young children. But the vaccine's effectiveness wears off over time. Also, BCG isn't very effective against pulmonary TB, the most contagious form of the disease, officials said.
http://www.thelancet.com/journal/vol363/iss9408/full/llan.363.9408.correspondence.28727.1
MMR immunisation after contact with measles virus
Sir--A single case of measles occurred recently at a children's nursery in the UK. A 17-month-old boy who had not received the measles, mumps, and rubella (MMR) vaccine presented to the Accident and Emergency department in the morning with an erythematous maculopapular rash on his face and upper body. He had been unwell for 72 h with coryza, cough, conjunctivitis, and diarrhoea. Measles was laboratory-confirmed within 3 h by virus-specific immunofluorescence of a nasopharyngeal aspirate. However, since the history and rash were virtually pathognomonic of measles, the nursery was contacted as soon as a clinical diagnosis was made.
The child had been in close contact with six other children (ages 15-24 months) during the entire coryzal period. None of these children had received MMR despite all being eligible. Since current advice indicates that MMR given within 3 days of exposure might modify or abort an attack of measles,1-3 we advised the parents to have their children immunised immediately. The severity of the illness in the index case ensured that four of the six sets of parents had their children immunised with MMR the same day. Despite doing so, all six children developed prodromal symptoms of measles, on average 8 days after the onset of such symptoms in the index case. 2-3 days later, they all developed a typical measles rash.
Measles-specific IgM was detected in oral fluids from all six secondary cases and viral nucleic acid was detected by PCR in the index case and from two secondary cases (one of whom had been immunised after exposure). Sequencing showed all three isolates to be genotype D8, the strain circulating currently in south London, UK.
We have shown that, despite rapid diagnosis, measles transmission and clinical infection was not preventable by post-exposure immunisation. This finding contrasts with accepted guidance in this area. Only two studies have shown that live measles vaccine alone can prevent secondary cases after exposure: Watson2 was able to prevent infection in a single household when vaccine was given to family contacts one day after appearance of the rash and 96 h after onset of coryzal symptoms in the index case, and Ruuskanen and colleagues3 reported protection from vaccination in children vaccinated after exposure in a school setting. However, the first study was conducted with a very early vaccine that contained a high dose of a different measles virus strain (Edmonston). Subsequently, all monovalent measles and MMR vaccines used in the UK have contained lower doses of Schwartz or Moraten strains. The lack of efficacy we saw might have been due to delay in administration or to differences in the vaccine formulation. Alternatively, the interpretation of the original observations made on small numbers of cases might have been incorrect.
If parents continue to decline MMR immunisation, once measles is introduced into a home, nursery, school, or hospital ward, our observations suggest that administration of MMR vaccine as early as possible might not prevent infection in those children already exposed. The only reliable way to prevent measles is to maintain high MMR uptake rates in the community.
*Philip Rice, Yvonne Young, Bernard Cohen, Mary Ramsay
http://www.oregonlive.com/metro/oregonian/index.ssf?/base/news/1078146023173
820.xml
Chickenpox flare in Lake Oswego indicates vaccine may wear off
Many of the children who got the illness had been inoculated, raising the question of whether booster shots will be needed
03/01/04
DON COLBURN
A new study of a 2001 chickenpox outbreak in a Lake Oswego elementary school suggests that a booster shot for the disease may be needed after five years. Health investigators were surprised to find an outbreak of chickenpox in a school in which 97 percent of students had already had the disease or had been vaccinated. The 21 chickenpox cases at Forest Hills Elementary included
18 students who had received shots. Most of them had been vaccinated more than five years earlier.
If larger studies bear out the Lake Oswego findings, "routine booster vaccination for children might be warranted," concluded a team of researchers from Oregon and the federal Centers for Disease Control and Prevention. The findings are reported today in the medical journal Pediatrics.
The study does not show that the chickenpox vaccine is ineffective, said Dr. Paul Cieslak, a communicable disease specialist with the Oregon Department of Human Services and co-author of the study. "You're still better off with the vaccine," Cieslak said. Inoculated children rarely get chickenpox, and if they do, their cases are milder. In the Lake Oswego school outbreak, 43 percent of the small number of unvaccinated children came down with chickenpox, compared with 12 percent of those who had received shots.
But researchers were surprised by the difference in risk between kids recently vaccinated and those vaccinated years earlier. A separate study at Yale Medical School, reported last month in the Journal of the American Medical Association, found a slight loss of immunity -- from 97 percent to 84 percent -- after one year.
In the Oregon study, the big jump in cases among vaccinated children came after five years. Nearly one in four students exposed to chickenpox more than five years after immunization got the disease.
For public health officials, "outbreaks are natural experiments," Cieslak said. Because it is ethically taboo to expose children intentionally to disease, "our approach is that when an outbreak happens, let's learn something from it."
The Lake Oswego elementary school provided "a perfect place to study how well the vaccine works," he said. Of the 218 students who had not gained immunity by having the disease, all but seven had been vaccinated.
The culprit: rare cases
"So we're thinking: How come there's chickenpox there?" Cieslak said.
The culprit: a small number of what disease-trackers call "breakthrough cases" -- rare cases that allow an outbreak to occur even among a heavily inoculated population.
"No vaccine is 100 percent effective," cautioned Peggy Lou Hillman, immunization coordinator for Multnomah County.
But before health officials add a chickenpox booster to the immunization schedule, she said, researchers must make sure the breakthrough cases result from dwindling immunity over time. Other factors, such as improper storage or exposure to heat, also can impair the vaccine's effectiveness.
A total of 422 students in 16 classrooms attended the Lake Oswego school in 2001. They were fairly evenly divided between those who had already had chickenpox and those who hadn't. Most who hadn't had the disease had gotten the shots. Only seven students appeared susceptible to the disease because they had had neither the shots nor the disease. Nevertheless, 21 cases
occurred among students in nine classrooms.
The findings suggest but do not prove that the immunity conferred by the vaccine wanes over time, Cieslak said. That would not be surprising, but the magnitude of the difference was striking, he said. The numbers in the Oregon study are small, and they do not justify calling for a chickenpox booster shot until they are corroborated by research in larger, more diverse populations, Cieslak said. The study was based on health records from the school, a questionnaire and phone calls to the parents of each child involved in the outbreak.
Developed in 1970s
The chickenpox vaccine, developed in Japan during the 1970s, uses a live virus that is weakened. It is potent enough to trigger a protective reaction by the body's immune system but not strong enough to cause illness.
The vaccine was approved in the United States in 1995, and Oregon schools began to phase in a required shot in 2000 for children who had not had the disease.
Chickenpox is not a reportable disease -- meaning doctors are not required to report cases to local or state health departments, The reason is that before the vaccine became available, virtually every child got chickenpox. Reporting is limited to rarer and more dangerous infections, such as
tuberculosis, HIV/AIDS and salmonella.
Tracking chickenpox cases, Cieslak said, would have been "like battling an ocean."
Don Colburn: 503-294-5124; doncolburn@news.oregonian.com
http://www.medicalposting.ca/children/article.jsp?content=20040311_082809_63
68&topStory=y
2004-03-11
Vaccine-in-a-patch linked to diabetes and multiple sclerosis
Ingredients called accelerants trigger immune system diseases in mice
Adhesive patches -- proposed as an easy way to vaccinate children -- may increase the risk of developing diabetes and multiple sclerosis, Australian researchers suggest. The method is being tested in the United States, where its developers contend seven in 10 immunizations will be done this way within five years because the method offers lower cost, less pain and greater hygiene.
But research by Alan Baxter at James Cook University in Townsville, Australia, and Tony Basten of the University of Sydney raises doubts about the safety of the technique. The patches contain components of either a virus or bacteria, as do existing vaccines. But they also use accelerants that increase the body's response to the vaccine.
"We've found that the accelerant also accelerates other ongoing tissue damage which may be occurring in the person," Baxter says. Their research showed that multiple sclerosis and type 1 diabetes appeared at an earlier stage in mice treated with the accelerant than in other mice. In type 1 diabetes, the body's immune system mistakenly attacks the cells in the pancreas that produce insulin. In multiple sclerosis, it attacks the myelin sheath covering nerves in the brain and spinal cord.
"We found that the way this accelerant increases a person's immune response to the vaccine appears to be exactly the same as the mechanism by which it increases the reaction to your own tissue, and this effect cannot be separated." Baxter says the findings mean patch vaccines will need to be tested much more extensively than planned.
PERSONAL HEALTH
Even With Vaccination, the 'Whoop' Is Back
By JANE E. BRODY
Published: March 2, 2004
http://www.nytimes.com/2004/03/02/health/02BROD.html
Get used to it. Pertussis, whooping cough, is here to stay. . "Pertussis is the only vaccine-preventable disease that is still increasing in this country.
Testimony by Jerri Johnson
Health and Human Services Policy Committee
January 27, 2003
Childcare providers enforce immunization requirements, state licensers of childcare providers, and the public schools. This enforcement costs money for staff to do record keeping and follow-up. Much of this cost is borne by the state. A study in 1998 estimated that enforcing the immunization
requirements cost the state at that time around $5 million per year.
Will adding new vaccines to the list increase costs to schools? It will, because many more follow-up contacts will be needed for these particular vaccines. Currently, 35 percent of parents are not vaccinating their children for chickenpox. Minneapolis Public Schools estimated that each parent follow-up contact cost $18 in staff time.
Minneapolis Public Schools wrote to the Department of Health asking that no immunization requirements be added until funding is in place to enforce them. In addition to the state costs of enforcing vaccine requirements, these vaccines cost money in health care dollars. I have included a handout in your package with medical cost analyses of pneumococcal and chickenpox vaccines. Chickenpox and pneumococcal vaccine programs actually cost more money than they save from preventing disease. The pneumococcal vaccine, for example, costs around $60 per dose, or $240 per child for the four-dose series. The chickenpox vaccine also does not recover costs when looking at the cost of the vaccine compared to the cost of the disease. Only by factoring in indirect costs, such as lost wages for a parent to stay home with a child sick with chickenpox, is this vaccine deemed to be cost-effective.
But these assessments of indirect costs did not include the cost of caring for vaccine-injured children. Hospitalization and medical costs for these children are extremely high. During school years, they require special education services, costs borne by the state. These children may later be
cared for in group homes the rest of their lives, incurring huge costs to the state. Twelve percent of our children now have chronic disease of some sort, and many medical experts believe that the rapid increase in diseases such as autism, ADD, juvenile diabetes and asthma is partially attributable
to the increase in required vaccines.
A parent who stays home for five days when her child has chickenpox may use vacation days or may lose some income. But parents of children disabled by vaccines often must quit work permanently to stay home with their child, losing years of income, and the vaccine-injured child may never grow up to
earn a productive income.
But ultimately, the question before us is not about dollars and cents. When we are preventing communicable disease, and when we are preventing vaccine injuries, the real issue is the value in human life that can't be quantified. You can't put a price on the joy of having a healthy baby, and you can't quantify the grief of a parent who loses a baby, no matter what the cause.
And so the Minnesota Natural Health Coalition is calling for the following:
1. Safer vaccines. Pharmaceutical companies need to be held accountable to produce vaccines that have fewer serious side effects.
2. The State of Minnesota should not require new vaccines if we do not know whether they are safe for our children. In the case of the pneumococcal vaccine, during the pre-licensure study where 17,000 healthy infants with no acute or underlying chronic disease were given Prevnar, 162 infants required emergency room care, 24 were hospitalized within 72 hours of receiving the vaccine and eight infants who had never had seizures before had seizures within 72 hours. Forty infants who had never had asthma before required doctor's care for asthma, wheezing, shortness of breath or breath-holding within 72 hours of the vaccine.
One previously healthy child developed congestive heart failure within 72 hours of the vaccine and three children developed hypotonic/hyporesponsive episodes. Were these serious situations caused by the vaccine? There is no way to determine this without following the time-honored scientific process of comparing the test group with a control group that did not receive a vaccine. This was not done. One variable, the test vaccine, was compared with another variable, another experimental vaccine.
Yet the physicians who conducted the study concluded at the end, this test "did not reveal any severe adverse events related to vaccination that resulted in hospitalization, emergency room visits or clinic visits." The Vaccine Information Sheet on Prevnar given to parents at their clinics says, "So far, no serious reactions have been associated with this vaccine." Given the structure of the clinical study, it is not scientifically possible to say that these reactions were caused by the vaccine, nor is it possible to say that they were not.
3. If it is inherently impossible to produce a vaccine without a significant risk of serious adverse effects or death, then we need to be clear about that. If the pneumococcal vaccine effectively reduces pneumococcal disease, but at the price of death or disability to a few babies, we need to know those numbers. Our research needs to be science-based, with control groups, and parents need to know the risks so they can make an informed decision.
We are having a good debate in this country on the smallpox vaccine. This could be a great model for our infant vaccination programs. Public health officials are doing a good job of articulating the risks of smallpox and the risks of the vaccine. One or two deaths per million from the vaccine is being taken very seriously. Adults are weighing the risks and benefits. We should afford the same courtesy to infants and their parents in the routine vaccine program.
4. Parents should be educated that if their child is ill, vaccination should be postponed. They should be told that if their child suffered a seizure or bad reaction to a previous vaccine, she is at risk for an even greater reaction to the next one. If parents have a family history of a severe vaccine reaction, they should know that their child might be at risk.
The CDC already has guidelines on this, and they are printed on the sheets given to parents when the child receives a vaccine. If parents knew this before making their appointments with the doctor, perhaps many vaccine injuries could be avoided. Again, the smallpox discussion is a good model on this--people are being informed that if you have eczema, you are at risk from the vaccine; if you are on corticosteroids you are at risk. Similarly, parents of infants could be advised on this at an early date.
5. If new vaccines being produced cannot be safer, then perhaps we need to rethink the model that vaccinates the entire population for a disease. This model was developed in response to overwhelming epidemics like polio. However, in the case of invasive pneumococcal disease, which affects only 0.2 percent of Minnesota children, this may not be an appropriate model.
6. Finally, parents who believe that their child was harmed or killed by a vaccine need to be heard and taken seriously. They should not be brushed off by being told it was not related to the vaccine. Their experience should be studied for clues to how we can have safer vaccine programs.
http://asia.reuters.com/newsArticle.jhtml?&storyID=4740126
Stress May Weaken Flu Shot Protection
Fri Apr 2, 2004 02:37 PM ET
By Merritt McKinney
If the vaccine doesn't work blame stress.
http://thestar.com.my/news/story.asp?file=/2004/4/9/nation/7728525&sec=nation
The Star, Malaysia
April 9, 2004
CAP: Mass measles vaccination may not be wise move
KUALA LUMPUR: The Consumers Association of Penang has urged the Health Ministry to conduct a proper evaluation before carrying out mass measles vaccination to immunise 4.5 million children nationwide. CAP president S.M. Mohd Idris claimed in a statement that the ministry had made the decision based merely on the fact that it expected an outbreak of the disease in 2005 or 2006.
He was commenting on a recent ministry announcement that it aimed to immunise children aged between seven and 15 against measles through its National Measles Immunisation Campaign. The immunisation programme will be carried out in schools by a health team. Mohd Idris said the plan was to use a combination vaccine against three diseases, namely mumps, measles and rubella (German measles), or what is better known as MMR vaccine. He said that studies overseas had shown that measles continued to occur even in children who had been fully vaccinated.
Previously, he said, those who contacted measles were usually below the age of 10, but now, following years of vaccinations, more adults were being infected. He also pointed out that soon after the measles vaccine was in use, a new problem arose where children were contracting a condition known as atypical measles, a more serious form of measles that may not respond to treatment. "Many children already receive a dose of MMR vaccine when they are around one year old, with a booster a few years later. "The health authorities have informed one parent that, although her child
has received her booster jab the year before, the vaccination under this programme is still necessary.
"Is there any guarantee that there will be no adverse effects on the child following these repeated jabs?" Mohd Idris called on the Health Ministry to put the measles immunisation plan on hold pending a proper review, as "there is much evidence against the need for mass vaccinations as much as there is for them." - Bernama
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&
dopt=Abstract&list_uids=15121300
Vaccine. 2004 May 7;22(15-16):1892-8. Related Articles,Links
Efficacies of whole cell and acellular pertussis vaccines against Bordetella parapertussis in a mouse model.
David S, Van Furth R, Mooi FR.
Research Laboratory for Infectious Diseases, National Institute Of Public Health and the Environment, P.O. Box 1, 3720 Bilthoven, The Netherlands.
Pertussis vaccine development has mainly focused on Bordetella pertussis, and consequently these vaccines contain B. pertussis antigens only. However, the related species Bordetella parapertussis can also cause pertussis, although symptoms associated with the disease are generally considered to be milder. Recent field studies have shown that in some outbreaks B. parapertussis can prevail. Using a mouse model we compared the efficacy against B. parapertussis of two commercially available acellular vaccines and two whole cell vaccines, used in The Netherlands and Finland, respectively. The efficacies of the two whole cell vaccines against B. parapertussis were similar, but much lower compared to the efficacy against B. pertussis. Although, the acellular vaccines conferred some protection against B. parapertussis early in infection, the values were not significant. Later in infection, a highly significant enhancement of colonisation by B. parapertussis was observed in mice vaccinated with acellular vaccines. The whole cell vaccines protected significantly better than the acellular vaccines against B. parapertussis. The possible consequences of a switch from whole cell to acellular vaccines was discussed in the light of our findings.
PMID: 15121300 [PubMed]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&
dopt=Abstract&list_uids=15155223
Antimicrob Agents Chemother. 2004 Jun;48(6):2206-13. Related Articles,
Links
Short- and long-term effects of pneumococcal conjugate vaccination of
children on penicillin resistance.
Temime L, Guillemot D, Boelle PY.
INSERM U444-27, rue Chaligny, 75571 Paris Cedex 12, France. laura.tem
ime@sat.ap-hop-paris.fr
Recent observations have shown that wide-scale vaccination with pneumococcal conjugate vaccines was associated with a reduction in invasive disease, supporting the expectation that vaccination could help reduce carriage of Streptococcus pneumoniae and control the spread of resistant strains. However, it is too early to assess whether these effects can be sustained in the long term. Here, we used mathematical modeling to investigate time changes in pneumococcal colonization and resistance induced by conjugate vaccination in an environment where antibiotic exposure is high and resistance is widespread. According to model predictions, vaccination induced a decrease in carriage of vaccine-type pneumococci to very low levels, typically in 10 to 15 years under epidemiologically realistic conditions. Almost simultaneously, non-vaccine-type pneumococci spread in the community. Consequently, while there was a short-term decrease in the overall carriage rate, it was followed after a few years by a renewed, although limited, increase. Vaccination with a heptavalent vaccine did not affect the extent to which antibiotic resistance was selected: in all cases, the distribution of resistance levels peaked at high levels (MIC > 2 microg/ml) after 20 years. With a vaccine optimally designed to include all serotypes currently exhibiting decreased susceptibility to penicillin G, the selection of resistance was slowed down, although not prevented. These results suggest that because of serotype replacement, the effects of vaccination observed today may not be sustained in the long term. As a consequence, vaccination alone may not be successful in controlling selection for resistance in S. pneumoniae.
PMID: 15155223 [PubMed - in process]
[When a religion (eg, Vaccines are miraculously wonderful) interferes with scientific findings (eg, research showing the vaccines can bias immunity in unnatural ways, even prompt lingering infections), then the scientific findings should be ignored so that vaccine orthodoxy is preserved. -Teresa Binstock]
Vaccine failure puzzles biologists
By The Associated Press - 5/31/04
http://www.helenair.com/articles/2004/05/31/montana/a06053104_04.txt
JACKSON, Wyo. (AP) — Biologists are puzzled why brucellosis exposure rates have spiked among some vaccinated elk. Disease rates at the Greys River elk feedground have even exceeded the high rates of the 1970s, before the state began vaccinating elk against brucellosis, according to Brandon Scurlock, a biologist with the Wyoming Game and Fish Department.
To be honest, I have no way of explaining this,'' Scurlock told a recent forum in Pinedale on elk feedgrounds. Controlling the disease, which can cause animals to abort, is important because it can be transmitted to cattle. The detection of the disease in cattle caused Wyoming to lose its federal brucellosis-free status earlier this year. That in turn has led to laborious and costly testing requirements.
While feedgrounds help keep elk away from cattle by encouraging them to congregate, the same congregation helps spread disease. About 25 percent of elk on all feedgrounds test positive for exposure to the disease ; compared to less than 3 percent of other elk. Vaccination at the Greys River feedground began in 1985. Brucellosis exposure dropped below 10 percent in the mid-1990s, down from 54 percent in the 1970s. In 2000, however, rates jumped to 26 percent before hitting 54 percent the following year. This year, 59 percent of elk tested positive.
Biologists originally thought that a weak batch of vaccine given to some elk in 1998 was to blame for the brucellosis rates at the Greys River feedground. But Scurlock said that theory is no longer plausible because disease rates should have dropped among the elk that have been vaccinated with the correct dosage since then.
He said more tests are needed to find out what is happening.
[Of course, if "more tests" generate data that is too damning of the
vaccinations, then the Elk version of the IOM will decree, No More Study!]
http://www.nature.com/nsu/040621/040621-3.html
Vaccines may increase virulence
Pursue additional defences, urge malaria experts.
22 June 2004
HELEN PEARSON
Vaccines against malaria could cause the parasite to develop more vicious strains. But experts warn that the finding should not detract from the urgent hunt for a jab.
Malaria is caused by the parasite Plasmodium falciparum, which is injected into humans by mosquitoes. Over a dozen clinical trials are in progress for possible vaccines against the deadly disease. Most of these jabs create conditions in which, although the parasites can still infect people, the immune system slows their multiplication so they do not cause disease.
To investigate whether surviving parasites change with time, Margaret Mackinnon and Andrew Read at the University of Edinburgh, UK, infected a mouse with a type of Plasmodium and then passed blood carrying the parasite on to another animal seven days later. They repeated this process 20 times, to mimic the ailment passing from person to person.
Parasites that moved from one vaccinated animal to another evolved into nastier strains than those grown in non-vaccinated animals, the researchers show in PLoS Biology1. The vaccinated animals stayed healthy, but when the parasite they carried was transferred into other mice, it killed more red
blood cells and made them lose more weight than the original malaria strain. Mackinnon and Read believe that malaria vaccines could have the same effect in people. Perhaps over decades, P. falciparum might evolve into a more deadly form in vaccinated people, which would pose a greater threat than ever to those unprotected by a jab.
No magic bullet
Malaria vaccines are still vital, stresses Read, because people who are immunized will be protected from the disease. But he urges public health officials to pursue other methods to eliminate malaria, such as distributing nets and developing new drugs, even as jabs are developed. "You shouldn't think of vaccines as a magic bullet," he says.
Researchers might also avoid types of vaccine that allow the parasite to survive at low levels, he suggests. Instead, they could focus on classes of vaccine that hobble the parasite before it infects red blood cells or which cripple it in the mosquito and so stop it passing from one person to another.
Many of the vaccines under trial already take the latter approach. In fact experts predict that an effective malaria vaccine will probably trigger the immune system into attacking the parasite at several different stages of its life cycle.
But some experts are concerned that the new finding will undermine their efforts to stem a disease that kills 2 million to 3 million people each year. "It has no relevance to vaccine development," says Adrian Hill who is working on malaria jabs at the University of Oxford, UK.
Read disagrees: "The big question is, would the same thing happen with another virus?" If so, jabs against other diseases, such as measles, might also have promoted the emergence of more virulent strains. It is hard to tell whether this has happened, because improved medical practices make it difficult to compare death rates at a time before vaccination with those today.
References
Mackinnon, M .J. & Read, A. F. . PloS Biology, published online, doi:10.1371/journal.pbio.0020230 (2004).|Article|
Search for AIDS vaccine falters
Tue Jul 13, 6:45 AM ET Add Top Stories - USATODAY.com to My Yahoo!
By Steve Sternberg, USA TODAY
The two-decade search for an AIDS (news - web sites) vaccine, the only way to end the global crisis, is all but starting over, researchers here said Monday. The only vaccine to complete two large-scale clinical trials, AIDSVAX, proved a flop. A major Thai trial now enrolling patients and using a two-vaccine approach has drawn criticism for including the failed vaccine. Most of the 30 vaccine candidates now in the pipeline are relatively untested, and they're so similar that if one fails, they all may fail.
If that isn't discouraging enough, the next wave of large-scale human trials will be especially challenging because countries with the biggest epidemics lack the resources needed to study thousands of patients. "This is a global disgrace," says Seth Berkley, director of the non-profit International AIDS Vaccine Initiative. "There hasn't been a serious effort, and until there is a serious effort, we'll never get there." Four years ago, the initiative called for tripling annual research money to $1.1 billion. Funding now totals $650 million; $100 million comes from drug companies, which is 1% of what the companies spend on health product development, says Scientific Blueprint 2004, the initiative's report released Monday.
A separate report by the Joint United Nations (news - web sites) Programme on HIV (news - web sites)/AIDS, UNAIDS (news - web sites), shows that there were more than 13,000 new HIV infections a day last year, almost all in low- and middle-income countries.
The search for an AIDS vaccine has long been overshadowed by the search for new AIDS drugs, which are far more profitable because patients must take them for life. But that cost already is beyond the means of most poor countries. Considering there are roughly 5 million new infections a year, "we won't be able to be keep pace with the demand for treatment," Helene Gayle of the Bill & Melinda Gates Foundation told the 15th International AIDS Conference here.
Gayle is a co-chair of the Global HIV Vaccine Enterprise, a consortium of research agencies launched by the Gates Foundation last year to jump-start vaccine research. In June, G-8 nations endorsed the strategy, and the USA promised $15 million.
Two major trials of vaccine candidates are still in the works. The first pairs AIDSVAX with a dose of Alvac, a vaccine made by Aventis Pasteur. Now getting started in Thailand, it will involve about 16,000 people. But critics say the trial is a waste of time because AIDSVAX has been proven not to work. John McNeill of the National Institute of Allergy and Infectious Diseases (news - web sites) says researchers believe the two vaccines might work better together than by themselves.
[Like usual, they don't have any idea what vaccines REALLY do to the body. Brain shrinkage and atrophy may explain some decisions by CDC and ACIP on vaccine policy. On the plus side, at least they are just giving this to people already with the disease and not trying to develop one for all babies ..yet.]
http://www.dfw.com/mld/dfw/news/nation/9214343.htm?1c Alzheimer's vaccine made brains shrink
Posted on Thu, Jul. 22, 2004
By John Fauber
Milwaukee Journal Sentinel
PHILADELPHIA - The brains of some of the people who received an experimental vaccine against Alzheimer's disease have shrunk.
Virology. 2004 Aug 15;326(1):20-8.
The nonresponse to hepatitis B vaccination is associated with impaired lymphocyte activation.
Goncalves L, Albarran B, Salmen S, Borges L, Fields H, Montes H, Soyano A, Diaz Y, Berrueta L.
Institute of Clinical Immunology, University of Los Andes, Merida,Venezuela.
Nonresponsiveness against hepatitis B vaccination has been described in 4-10% of immunized subjects. We have explored the specific cell response to hepatitis B surface antigen by analyzing: PBMC proliferation, cytokine production (Th1, Th2 profiles, and TGF-beta), and activation molecules on Th cells. A poor proliferative response was demonstrated in nonresponders (P < 0.05). T cells from responders produced all tested cytokines (P < 0.01), in contrast with nonresponders subjects (P < 0.05). Expression of CD69 and CD25 was diminished in T cells from nonresponders (P < 0.01). A reduced expression of CD40L was also detected in T cells from nonresponders (P < 0.01). An elevated correlation coefficient was observed between CD40L on CD4+ cells and antibody production. These results suggest an overall inability of T cells to be activated which could be consistent with potential differences in antigen presentation. In conclusion, our results suggest that an altered Th response may be a consequence of inappropriate early activation events.
PMID: 15262491 [PubMed - in process]
Posted on Thu, Aug. 19, 2004
Student better after close call with meningitis
UK SOPHOMORE'S FATHER EXPECTS FULL RECOVERY
By Barbara Isaacs
HERALD-LEADER STAFF WRITER
A University of Kentucky student with bacterial meningitis is improving, but still in serious condition at UK Hospital. The illness of Charles "Tripp" Eckerline III, 19, a UK sophomore and former Lexington Catholic High School football player, has raised awareness on campus about the risks of meningitis and vaccinating against the disease. However, Eckerline's illness also shows that the meningitis vaccine is not foolproof. Eckerline was vaccinated against meningitis a year ago, before he entered UK as a freshman, said his father, Dr. Charles Eckerline Jr., who is an emergency room physician at UK.
Eckerline's strain of meningococcal meningitis is usually covered by the vaccine, but the vaccination is only about 80 percent effective, Dr. Eckerline said. Tripp Eckerline was first ill at 9 p.m. Saturday. When his parents went to his home to check on him Sunday afternoon, Dr. Eckerline took him immediately to UK's emergency room.
By the evening, Tripp Eckerline was in septic shock and on large doses of three antibiotics. He required a ventilator. "I've practiced emergency medicine for 26 years, and it's the scaredest I've ever been," Dr. Eckerline said yesterday. "What's so scary is that everything was done quickly and appropriately -- and he still got worse and worse for six hours. He came as close to dying as anyone possibly could."
Dr. Eckerline said his son might be hospitalized for at least a week, but he could be off the ventilator today. He expects his son to make a complete recovery. Dr. Gregory Moore said the University Health Service has been receiving calls from students now interested in the vaccine. Moore is director of the service, which provides medical care for the 35,000 students at UK and Lexington Community College.
This year, the Kentucky General Assembly began requiring that Kentucky colleges inform incoming students who live in residence halls about meningitis risks and the vaccine that can prevent the disease. UK had already been giving that information to incoming students for several years, Moore said.
The legislature stopped short of requiring the vaccine, which costs $75 through the University Health Service. Connecticut and New Jersey require the vaccination for all college students. Some colleges around the country also require it for their students, but UK does not. College students can benefit from the vaccine because communal living increases the risks of getting the illness, Moore said. Eckerline lives off campus with two other students, his father said, not in a residence hall. "They're a population that tend to share cups, kisses, toothbrushes and everything," Moore said, though he noted that the disease is most commonly seen in the very young and the very old.
Close contact is required to transmit the bacteria. Only a tiny percentage of those who come into contact with the bacteria develop an infection of the fluid surrounding the brain and spinal cord. The meningitis bacteria is fairly common and lives in the throats of about 15 percent of the population at any given time, Moore said. "You no doubt meet people every day who carry this," he said.
What to watch forCommon symptoms of meningitis are high fever, stiff neck and headache. Other signs can be rash, nausea and vomiting.
www.kentucky.com/mld/heraldleader/news/legislature/9438114.htm
Kenneth M. Petersen, MD; Lisa R. Bulkow, MS; Brian J. McMahon, MD; Carolyn
Zanis, BS; Marilyn Getty, RN; Helen Peters, RN; Alan J. Parkinson, PhD
Pediatr Infect Dis J 23(7):650-655, 2004.
Abstract
Background: The duration of protection after hepatitis B vaccination of infants is unknown. Methods: We determined antibody to hepatitis B surface antigen (anti-HBs) at 4-13 years of age in 363 low risk children who had been vaccinated starting at birth with hepatitis B vaccine. Those with nonprotective titers (<10 mIU/mL) received a booster dose. We similarly followed 16 children of hepatitis B surface antigen (HBsAg)-positive mothers.
Results: Of low risk infants receiving a plasma-derived vaccine, 41% (42 of 102) of those whose primary response was unknown and 24% (4 of 17) who had initially responded retained protective titers (>/=10 mIU/mL) of anti-HBs at 9 and 13 years, respectively. Of those who did not have protective antibody titers, 61% (33 of 54) and 67% (8 of 12), respectively, responded to a booster dose. In children of HBsAg-positive mothers, 31% retained protective anti-HBs at 12 years, and 90% (9 of 10) with nonprotective titers responded to a booster. In low risk children initially receiving a recombinant vaccine, 12.5% (26 of 208) and none (0 of 36) retained protective anti-HBs titers at 5 and 7 years of age, respectively. Of those who did not have protective titers, 90% (120 of 134) and 91% (32 of 35), respectively, responded to a booster.
Conclusions: Anti-HBs disappeared by 5 years of age in most children who were vaccinated with hepatitis B vaccine from birth. Although most children showed immunologic memory, one-third failed to demonstrate an anamnestic response to a booster dose. Additional long term studies of low risk infants are needed to determine duration of protection and the necessity for or timing of booster doses.
Subject: HIB infections on the rise in adults despite child vaccination programme
BMJ 2004;329:655-658 (18 September)
Trends in Haemophilus influenzae type b infections in adults in England and
Wales: surveillance study
Jodie McVernon, specialist registrar, Caroline L Trotter, scientist (epidemiology), Mary P E Slack, consultant microbiologist, Mary E Ramsay, consultant epidemiologist
Full original article can be found here:
http://bmj.bmjjournals.com/cgi/content/full/329/7467/655
http://www.medicalnewstoday.com/medicalnews.php?newsid=13566 HIB infections on the rise in adults despite child vaccination programme 17 Sep 2004
Cases of the Hib infection (haemophilus influenzae type b) among children and adults have risen in recent years, despite a vaccination programme which initially proved successful, say researchers in this week's BMJ (British Medical Journal).
The Hib vaccine became part of the routine immunisation programme for babies in 1992, cutting deaths from the disease amongst children significantly and reducing infection rates. In 1992 for instance 21.91 cases per 100,000 children were reported, dropping to 0.65 by 1998.
Adults-most of whom were not immunised-also benefited, with Hib infections in the population at large also dropping-from 0.17 cases per 100,000 to 0.03 in the same period. Although infection in adults is rare, infection rates are higher among the age groups in regular contact with children, suggesting that adults usually catch infection from these young children, say the authors.
From 1998 however Hib cases in children started to rise significantly, mostly among those who were immunised in the programme as babies-though infection rates remain well below those seen before vaccination was introduced. Among adults rates have now reached levels higher than before the vaccination programme was introduced (0.27 cases per 100,000 in 2003, compared with 0.17 in 1992.)
The apparent fall in the effectiveness of the initial vaccination programme for children may be due to several factors, say the researchers, including issues with the vaccine used, which has now been changed. For adults the situation was more complex. They had initially benefited from 'herd immunity' say the authors, where the drop in infection rates among children resulted in reduced exposure to the disease for adults, and consequently fewer infections. But adults' reduced exposure to the disease also meant their antibody levels-or 'natural' immunity - was no longer being boosted. When the disease began to rise once again amongst children, some adults found themselves less equipped than before to fight the infection.
Monitoring the Hib immunisation strategy quickly exposed trends and problems with the programme, say the authors, prompting swift corrective action-in this case resulting in the implementation of a national booster vaccination programme for children younger than four years, which should once again benefit adults. Such high quality surveillance systems are vital, say the authors, in the fight against immunisable diseases.
http://www.thecouriermail.news.com.au/common/story_page/0,5936,11008696%255E
421,00.html
Pneumococcal jab fails to stop disease
08oct04
TWO children developed the deadly pneumococcal disease despite receiving very expensive vaccinations meant to prevent it. Another 41 children have reported minor reactions to the vaccine which will become available free to all children aged under two from January next year.
And an elderly woman has died from septic shock after she and 14 others developed serious blood problems after using the oral antifungal drug Lamisil used to treat tinea. The cases were reported in the Adverse Drug Reactions Bulletin yesterday. Drug company Novartis, which makes Lamisil, yesterday refused to comment on the death.
A spokesman said the adverse blood reactions, which leave a person vulnerable to infection, were detailed on its patient information sheet and occurred in just 0.1 per cent of cases. The company was negotiating with the Therapeutic Goods Administration about whether any changes were needed to the drug's labelling, he said. The bulletin reported that of the two children affected by the pneumococcal vaccine, one, a two-year-old girl, developed pneumococcal pneumonia two months after being given a single dose of the product. A seven-month-old baby also developed a pneumococcal infection four months after being given the vaccine.
Both recovered from the infections.
Drug company Wyeth, which manufacturers the vaccine, said it appeared from the case notes that the vaccine had not been properly administered to the baby. Official guidelines recommend children be vaccinated at two, four and six months but this child appeared to have received three doses in her first three months of life. The two-year-old child had developed a less serious form of the disease, a Wyeth spokesman said.
Infection rising despite vaccine
More people are contracting Hib infection despite a child vaccination programme, government advisors warn. Rates of the meningitis-causing bacteria among adults have reached levels higher than before 1992, when routine vaccination of babies started. Rates in children are also rising, mainly among those immunised as babies, according to Health Protection Agency (HPA) experts. Booster jabs should reduce rates they told the British Medical Journal.
http://news.bbc.co.uk/1/hi/health/3660660.stm
http://www.cdc.gov/ncidod/EID/vol9no10/03-0180.htm
We studied eight children who had measles at 6 to 10 months of age during the 1998 Argentine measles outbreak and in whom subacute sclerosing panencephalitis developed 4 years later. We report the genetic characterization of brain tissue–associated measles virus samples from three patients. Phylogenetic relationships clustered these viruses with the wild-type D6 genotype isolated during the 1998 outbreak. The children received measles vaccine; however, vaccinal strains were not found.
The measles vaccine was included in the regular immunization schedule in Argentina in 1978. Despite vaccination, several disease outbreaks have occurred (12). Although we had previously performed a thorough molecular description of acute measles outbreaks, genetic characterization of SSPE has not yet been reported in Argentina (9).
Failure of Inactivated Influenza A Vaccine To Protect Healthy Children Aged 6–24 Months
[Not yet available online.]
Pediatrics International (2004) 46 , 122–125
Taro Maeda, Yukihiro Shintani, Kanako Nakano, Kazuhiro Terashima And Yoshiyasu Yamada
Department of Pediatrics, Public Shisou General Hospital, Shisou and
Department of Pediatrics, Rokko Island Hospital, Kobe, Japan
Abstract
Background: The efficacy of inactivated influenza vaccine in healthy infants and children younger than 24 months has not been confirmed. The aim of the present study was to determine the prophylactic effect of inactivated influenza vaccine against influenza A in healthy children aged 6–24 months.
Methods: Healthy infants and young children (6–24 months old) were immunized by subcutaneous injection of inactivated influenza vaccine before influenza seasons. Age matched children were randomly assigned as the control. These children were followed up from January to April in each year (2000, 2001 and 2002). The attack rates of influenza A infection was compared and statistically assessed.
Results: The attack rate of influenza A virus infection in the vaccine group and the control group were 14.8% ( n = 27) vs 12.5% ( n = 32) in 2000 ( P = 0.526); 2.8% ( n = 72) vs 7.2% ( n = 69) in 2001 ( P = 0.203); and 3.4% ( n = 52) vs 8.9% ( n = 56) in 2002 ( P = 0.205). The attack rates of influenza A between the two groups were not significantly different.
Conclusion: Inactivated influenza vaccine did not reduce the attack rate of influenza A infection in 6–24 month old children. Key words influenza, vaccine, children, infant. Different countries have selected a range of different programs for influenza vaccine recommendations. In the United States, inactivated influenza vaccine is recommended for any person aged greater than 6 months
old who is at increased risk for complications.
http://www.nbc17.com/health/3875137/detail.html
Orange County health officials said late Friday that lab tests show Davis has the second most common strain of bacterial meningitis, but it is one that isn't covered by a meningococcal vaccine. Exposed individuals who have received the vaccine still need preventive treatment, they said.
Davis himself had been vaccinated against meningitis in April. Officials haven't determined when or where he contracted the disease.
http://home.hamptonroads.com/stories/story.cfm?story=79266&ran=144526
EVMS research aims to help elderly fight flu
By KATRICE HARDY, The Virginian-Pilot
© December 13, 2004
Last updated: 11:37 PM
When the nationwide flu vaccine shortage hit, doctors at Eastern Virginia Medical School initially found themselves, like many others in Hampton Roads, without any vaccine for their patients. But a small team of EVMS scientists had vaccine to give. Now, the patients who rolled up their sleeves for them are on the front line of research that could boost the effectiveness of flu shots – and better guard the nation against a bioterror threat. The federally funded research is aimed at improving elderly people’s ability to fight off the virus.
In the flu battle, that’s no small matter. Nine out of every 10 Americans who die of flu complications are 65 or older. That adds up to more than 30,000 deaths in an average year, and the number could well climb as the population ages. Some die even after receiving flu vaccinations. With age, immune systems degrade; older people are particularly susceptible to flu strains that may not be included in the vaccine in circulation at the time. The EVMS research, paid for by a $487,000 grant from the National Institutes of Health, is being conducted by scientists in a biodefense center the medical school established two years ago.
All eight of the biochemists, physicians and protein specialists who are part of the center have won government and private grants for bioterrorism protection research.
Flu is one concern of anti-terror officials . A hard-to-combat strain spread by terrorists could cause an epidemic, said Dr. George Curlin, acting branch chief of the National Institute of Allergy and Infectious Diseases, which awarded EVMS the flu-vaccine research grant.
Vaccinations are still the best protection against flu for adults of any age. But Curlin said his agency has been concerned that as more people have made it a priority to be vaccinated, the number of elderly dying from the virus has not declined.
EVMS’ work focuses on one particular type of cell in the immune system. Known as T-cells, they have been proven critical in fighting off diseases, said Yuping Deng, who is leading EVMS’ latest influenza research. The cells help keep infections from spreading to other cells in the body.
Deng, 41, hopes her work will help scientists better understand how well elderly people’s T-cells work against the flu.
In a nation of flu vaccine shortages, Deng had no problem finding volunteers.
Nearly 175 people were recruited.
The associate professor of EVMS’ Glennan Center for Geriatrics and Gerontology recently laughed about her good fortune. She ordered her vaccine from a company other than Chiron Corp., whose factory shutdown in Liverpool, England, by British regulators triggered the U.S. vaccine shortage.
“Otherwise, I wouldn’t have any,” Deng said in an interview in EVMS’ Hofheimer Hall.
The medical school’s practicing doctors had relied on Chiron instead. Later, they received a limited amount of vaccine from other local health providers. In Deng’s project, flu vaccine was given to two groups. “The young,” as she describes them, are 58 volunteers between the ages of 21 and 40. About 115 people over 65 make up the other group.
After she completes drawing the volunteers’ blood, she plans to examine the effectiveness of each age group’s T-cells. Next flu season, she plans to administer new variations and versions of the vaccine to elderly volunteers in an attempt to boost their T-cells.
Deng will give some volunteers a vaccine and then a second shot of a liquid chemical which consists of pieces of DNA found in bacteria. The chemical, which is effective in boosting the immune system against cancers, is produced by Coley Pharmaceutical Group of Wellesley, Mass.
The company has given EVMS the drug for free. Previous studies have shown that mixing the DNA-laced liquid with vaccine could likely help health officials protect more people. The mixture might be the nation’s answer to future vaccine shortages, Deng said, noting that at least two people might be able to get flu shots with just one vial of vaccine, instead of one person. With a separate group of volunteers, Deng will give two shots within one week to see if the added amount helps boost their immune systems.
Officials at the national institute will monitor Deng’s volunteers. Her research will be published at the end of the two-year study. EVMS scientists said the potential for improving the immune system of the elderly is great. It’s not unreasonable, Deng said, to expect that someday an elderly person’s immune system would be as robust as that of a 20-year-old.
Reach Katrice Hardy at 222-5857 or katrice.franklin@pilotonline.com
© 2004 HamptonRoads.com/PilotOnline.com
Clin Infect Dis. 2004 Dec 1;39(11):1715-8. Epub 2004 Dec 1. Related Articles, Links
Prevalence of antibody to Bordetella pertussis antigens in serum specimens obtained from 1793 adolescents and adults.
Cherry JD, Chang SJ, Klein D, Lee M, Barenkamp S, Bernstein D, Edelman R, Decker MD, Greenberg DP, Keitel W, Treanor J, Ward JI.
University of CaliforniaLos Angeles Center for Vaccine Research, Research and Education Institute, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, USA. jcherry@mednet.ucla.edu <jcherry@mednet.ucla.edu>
Serum specimens were obtained from all subjects in the adolescent and adult acellular pertussis (aP) vaccine efficacy trial before and after immunization to study the prevalence of IgG and IgA antibody and geometric mean titers to 4 Bordetella pertussis antigens. Of 1793 adolescents and adult subjects who received aP vaccine, only 20%, 68%, 59%, and 39% had concentrations of IgG antibodies to pertussis toxin, filamentous hemagglutinin, pertactin, and fimbriae types 2 and 3, respectively, that were greater than or equal to the limit of quantitation of the enzyme-linked immunosorbent assay used in the analysis. There was minimal variation in antibody prevalence with respect to geographic area, age, sex, or race.
PMID: 15578376 [PubMed - in process]
Chicken-Pox vaccine not totally effective
25 Dec 2004 <http://www.medicalnewstoday.com/images/blanktab.gif>
http://www.medicalnewstoday.com/medicalnews.php?newsid=18313
<http://www.medicalnewstoday.com/medicalnews.php?newsid=18313&nfid=rssfe
eds> &nfid=rssfeeds
For over five years, doctors in India have been recommending chicken pox vaccination for children, even though it does not figure in the list of mandatory vaccinations, and no comparative study has ever been conducted. Now they may have to do a rethink, after new studies in the US have raised
doubts about its effectiveness. According to the study, published last week in The Journal of the American Medical Association, found the effectiveness of the vaccine is found to fade substantially a year after it is administered.
In children below 15 months, the vaccine appears to have less immunity. Experts are now questioning whether the vaccine - for long a topic of debate in the US - should be used at all, as immunisation just pushes the disease into adulthood when it could take a more severe form. Adults whose childhood immunity has worn off could be in trouble later age as it increases their vulnerability to the disease, say experts. ''The findings do raise some pertinent questions. It is a matter of concern.'' says Dr Anupal Sibal, senior child specialist, Indraprastha Apollo Hospitals.
The study, carried out over several years by researchers at Yale Medical School, further found that in children above 15 months, protection was 99 per cent in the first year, and only 73 per cent in those below 15 months. However, those who got chicken pox after receiving the shots had only mild
symptoms.
What's the solution for this then? Sibal suggests administering a second dose, "Even now, children beyond 15 years are recommended two doses." The catch: it's very expensive.
http://www.medindia.net/News/view_news_main.asp?t=gn
<http://www.medindia.net/News/view_news_main.asp?t=gn&x=3166> &x=3166
(rather than admit vaccines don't work they just recommend another dose! )
Flu Shots for Elderly May Not Save Lives
2 hours, 38 minutes ago Health - AP
By CARLA K. JOHNSON, Associated Press Writer
CHICAGO - A new study based on more than three decades of U.S. data suggests that giving flu shots to the elderly has not saved any lives.
Led by National Institutes of Health (news - web sites) researchers, the study challenges standard government dogma and is bound to confuse senior citizens. During last fall's flu vaccine shortage, thousands of older Americans, heeding the government's public health message, stood in long lines to get their shots. "There is a sense that we're all going to die if we don't get the flu shot," said the study's lead author, Lone Simonsen, a senior epidemiologist at the National Institute of Allergy and Infectious Diseases (news - web sites) in Bethesda, Md. "Maybe that's a little much."
The study should influence the nation's flu prevention strategy, Simonsen said, perhaps by expanding vaccination to schoolchildren, the biggest spreaders of the virus. However, the U.S. Centers for Disease Control and Prevention (news - web sites) in Atlanta plans no change in its advice on who should get flu shots, saying the NIH research isn't enough to shift gears. "We think the best way to help the elderly is to vaccinate them," said CDC epidemiologist William Thompson. "These results don't contribute to changing vaccine policy."
The CDC currently recommends flu shots for people age 50 and over, nursing home residents, children 6-23 months, pregnant women, people with chronic health problems and certain health care and day care workers. When vaccine was scarce a few months ago, healthy adults under 65 were urged to forgo the shot. Although the study, published Monday in the Archives of Internal Medicine (news - web sites), looks at data from the whole U.S. elderly population over time, it doesn't directly compare vaccinated vs. unvaccinated elderly, Thompson said. Previous studies that made that comparison found the vaccine decreased the rate of all winter deaths.
It's also unlikely that a single study would trigger a change in policy, said CDC spokesman Glen Nowak. But the former head of the nation's vaccine strategy, Dr. Walter Orenstein, said Simonsen's work "should make us think twice about our current strategy and (about) potentially enhancing it." Orenstein is former director of the CDC's National Immunization Program and now leads a program for vaccine policy development at Emory University. A shift to vaccinating schoolchildren, the age group most likely to spread the flu virus, is advocated by colleagues of Orenstein's at Emory in a separate report to be published Tuesday in the American Journal of Epidemiology.
The NIH and Emory papers, one a highly technical statistical analysis of death data and the other a commentary based on field studies and mathematical modeling, come during a season that focused the nation's attention on vaccine supplies. As a vaccine shortage loomed last fall, the CDC urged shots only for the highest-risk groups. Most of the 36,000 people who die each year of flu-related causes are elderly and the nation's strategy has focused on getting shots to them, as well as other high-risk groups. Last week the CDC reported that about 59 percent of older Americans got shots in 2004, down from 65 percent in 2003. Based on her research, Simonsen doesn't expect to see a corresponding increase in flu-related deaths this year, something that "can be seen as good news."
The flu vaccine is less effective in the elderly than in younger people. It works, but not very well, said Ira Longini, a biostatistics professor at Emory University's Rollins School of Public Health and a proponent of vaccinating schoolchildren. While it's smart for senior citizens to get their yearly flu shots because it can decrease their risk of getting sick, he said, a smarter government strategy would emphasize shots for children, ages 5 to 18. His statistical models show that strategy could save more elderly Americans from hospital visits and death. "If we really want to make a difference and control influenza, we simply have to change the policy. We have to vaccinate large numbers of children," Longini said.
He and his colleague Dr. Elizabeth Halloran write that if 70 percent of schoolchildren were vaccinated, the elderly would be protected without flu shots. The strategy would require 42 million doses of flu vaccine. Even during this season's shortage, there were 57 million doses available, their report says. Yearly flu shots have been recommended for people 65 and older since the 1960s and for those 50 and older since 2000. Vaccination rates have risen among seniors from 20 percent before 1980 to 65 percent in 2001, according to the NIH study.
Simonsen and her team of researchers could find no corresponding decrease in death rates. Their analysis took into account the fact that people are living longer and that more virulent strains of flu dominated the 1990s. The CDC's Thompson said Simonsen didn't take into account the effect of a gradual lengthening of the average flu season over the decades. But Simonsen said that no matter what model she used to define a flu season, she came to the same result. Older Americans should keep their risk in perspective, said Dr. Lisa Schwartz and Dr. Steven Woloshin, senior researchers at the VA Outcomes Group, a small group of researchers trying to promote the straightforward presentation of medical information.
For the average senior citizen, the annual risk of dying from the flu is low: about 1 in 1,000. They said senior citizens still should try to get flu shots, but shouldn't panic if vaccine isn't available.
New strain of child-killing influenza feared
http://www.yomiuri.co.jp/newse/20050224wo72.htm
Yomiuri Shimbun
Six children who died in Osaka Prefecture two years ago during an influenza outbreak were victims of a new strain of influenza encephalopathy, a disease affecting the central nervous system caused by the influenza virus, a Health, Labor and Welfare Ministry team has discovered.
The team also attributed several deaths in other locations that occurred during the outbreak and at least one last winter to the new strain. Five cases of children dying suddenly while sleeping were also reported in the Untied States during the same period.
The disease can kill children suddenly--often while they are sleeping--without the children exhibiting the classical symptoms of convulsions or impaired consciousness seen in regular influenza encephalopathy.
The team said it had been unable to find common causes in the deaths and said a detailed investigation was needed.
Some experts on drug-induced diseases said the new strain of encephalopathy may have been caused by drugs prescribed to the victims.
Team member Masashi Shiomi, who is director of emergency medical care for children at the Osaka City Central Hospital, said that between December 2002 and February 2003 six young boys died in their sleep one or two days after they contracted influenza. The boys, aged 1 to 8, lived in Osaka, Suita and other parts of the prefecture.
None of the boys showed specific symptoms. Autopsies on three of the boys showed severe brain swelling and deformed astrocytes, brain cells that support the brain's nervous tissue. As such deformation is not observed in ordinary influenza encephalopathy, Shiomi and other team members concluded the disease was a new strain of the disease.
The findings of the team, headed by Prof. Tsuneo Morishima of Okayama University, prompted it to ask medical institutions across the nation to provide any information they have that might be pertinent to the disease.
In response, the team received notification of several other cases of sudden deaths of children while they were sleeping or being sent to hospital.
Of the six children in Osaka Prefecture, four had been prescribed oseltamivir, an antiviral drug sold under the trade name of Tamiflu, and a fifth was on Amantadine, an antiviral drug.
The Swiss pharmaceutical company Roche, which manufactures Tamiflu, warned in January last year that medical institutions should observe the recommendation not to prescribe the drug to children less than 1 year old. The advisory was issued following experiments in which young laboratory rats dosed with large quantities of the drug died and high concentrations of the drug were detected in their brains.
Rokuro Hama, director of the Osaka-based nonprofit organization Japan Institute of Pharmacovigilance for Evidence-based Healthcare, said, "Drugs may have entered the children's brains, in which the function to block foreign substances has yet to develop, suppressed their respiratory centers and killed them suddenly."
Prof. Morishima said: "Four children in Osaka Prefecture took Tamiflu only once. Of the other children, some died of the new strain of the disease although they had not taken the drug. Others who had taken the drug suffered regular encephalopathy. It is difficult to explain the influence of drugs. It may depend on their constitution."
Influenza encephalopathy is a disease that causes the brain to swell as well as rapid progressing nervous symptoms, such as impaired consciousness and convulsions.
The disease often affects children aged 6 or younger. Hundreds of children come down with the disease every year, of whom 10 percent to 30 percent die, while 25 percent suffer serious after effects.
Last winter, 103 children developed the disease and 10 died.
Some experts have pointed to a relation with two nonsteroidal fever reducers, the use of which the central government banned in the autumn of 2000 for treating influenza. The causes of influenza encephalopathy, however, have yet to be determined.
The ministry team said that influenza encephalopathy cannot always be prevented by vaccination.
Commun Dis Public Health. 2004 Dec;7(4):272-7. Related Articles, Links
Outbreak of influenza A (H3N2) in a highly-vaccinated religious community: a retrospective cohort study.
Nicholls S, Carroll K, Crofts J, Ben-Eliezer E, Paul J, Zambon M, Joseph CA, Verlander NQ, Goddard NL, Watson JM.
Brighton and Hove City Primary Care Trust.
An outbreak of influenza occurred at the end of the 2001-2 winter season in a highly-vaccinated, semi-enclosed, religious community. On the basis of retrospective self reporting, 43% met the case definition (151/350) and 81% (25/31) of throat swabs from cases were polymerase chain reaction (PCR) -positive for influenza A (H3N2). The risk of developing influenza in people aged 65 or more was lower than that of children aged 2 years and under (odds ratio 0.1, 95% confidence interval 0.02 to 0.38). The risk of developing symptoms of influenza was not significantly different between people who had been vaccinated in the United Kingdom and those who had not been vaccinated (OR 1.14, CI 0.41 to 3.14). Chronic disease was an independent risk factor for developing symptoms of influenza (OR 1.9, CI 1 to 3.63). Timing of the outbreak, the age structure and mode of communal living may have influenced the efficacy of the influenza vaccine, which was well matched to circulating strains at the time of the outbreak. It is important to consider the diagnosis of influenza even in a highly-vaccinated community.
PMID: 15779788 [PubMed - in process]
US flu vaccine trials may be effort wasted
12:30 25 March 2005
Exclusive from New Scientist Print Edition
Debora MacKenzie
The first human trials of a vaccine against H5N1 bird flu are likely to be a waste of time and money.
The formulations that the US plans to test are thought likely to be ineffective - and even if they do work it will take far too long to manufacture enough doses to prevent a pandemic strain wreaking havoc. Other countries are following more promising approaches, but they are not ready to start trials.
Fears that the H5N1 virus might mutate into a form capable of triggering a human pandemic have persuaded several countries to change strategy. Instead of waiting for a pandemic strain to emerge, health authorities are creating human vaccines against the current strain. Although these vaccines might not be perfect, the hope is that they will make the difference between life and death.
The sooner prototype vaccines are tested, the sooner vaccine makers can prepare to manufacture the vast quantities that might be needed. But so far the US is the only country to have ordered enough prototype vaccine to do clinical trials - and there are two major problems with its formulations.
No immunising effectThe key ingredient in any flu vaccine is the viral protein haemagglutinin, or HA. Vaccines against ordinary flu contain 15 micrograms each of three varieties of HA. The clinical trials planned by the US National Institute of Allergy and Infectious Diseases will test doses of 15 and 45 micrograms of H5 - the HA of the H5N1 virus killing people in Vietnam. The aim is to make the vaccine as similar to ordinary flu vaccines as possible, to ease approval by the FDA.
But several studies have shown that with HAs that people have not been exposed to before, such as H5, even doses higher than 15 micrograms have little or no immunising effect. "I predict they won't get much immune response at all," says Tony Colegate of the vaccine company Chiron in the UK, head of the industry's pandemic task force.
For this reason, other countries planning to test prototype vaccines - like Japan, Canada and Australia - will all add a chemical such as alum to boost the immune system reaction. This adjuvant is used in many childhood vaccines.
Another important benefit of adding an adjuvant is that far less HA will be needed in each dose. That is crucial because vaccine production capacity is limited.
Worldwide capacityThe single flu vaccine factory in the US would take six months to produce 180 million doses of 15 micrograms of H5, according to calculations by flu expert David Fedson in the latest issue of the Journal of Public Health Policy. And since past studies suggest people need two shots three weeks apart to develop immunity to novel strains, that is enough for only 90 million people. All vaccine plants worldwide could produce only enough for 450 million people.
In 2001, however, scientists in the UK found that with an adjuvant, two doses of just 7.5 micrograms of H5 were enough to induce immunity in previously unexposed people. And last year scientists at GlaxoSmithKline Biologicals found that two doses each of 1.9 micrograms of another novel HA were enough.
If a vaccine could be made with just 1.9 micrograms per dose, the world's vaccine plants could churn out 7.2 billion doses in six months, enough for 3.6 billion people, Fedson says. "That's probably more than the world's combined healthcare services can vaccinate."
Bruce Gellin, head of the US National Vaccine Programme Office, says the trials now being planned "are only the first in a long series". Last week his department asked for proposals to find ways to make vaccines stretch farther, he says. "We are taking this very seriously."
Journal reference: Journal of Public Health Policy
EPediatric News
May 2005 . Volume 39 . Number 5*
*
Combo Vaccine Counters Effect Of Other Vaccines
Pnc9-MenC less effective than MenC alone.
Alicia Ault*
/Contributing Writer/
An experimental vaccine that combines coverage for nine strains of pneumococcus and a single meningococcal strain appears to be less effective than a meningitis vaccine alone, and also decreases the immunogenicity of some other vaccinations given concomitantly, according to a recent report.
The study results provide a cautionary tale for vaccine makers and pediatricians, said John Bradley, M.D., director of the division of infectious disease at Children's Hospital, San Diego, who was asked to comment on the findings. "It is not easy to put together a vaccine that has all these components," he said. "When you mix them all together you don't get the nice brisk responses you expect when you administer each separately, and we're probably further off from a single vaccine than we were all
hoping," added Dr. Bradley, who is a member of the American Academy of Pediatrics Committee on Infectious Diseases.
Lead author Jim P. Buttery, M.D., agreed that the study showed the technical difficulty of building a single-shot package. "Each new antigen is successively more difficult," he said in an interview. The phase II trial compared Wyeth's Pnc9-MenC vaccine with the company's MenC vaccine alone (JAMA 2005;293:1751-8). MenC (Meningitec) is not used in the United States, and it's not likely that the Pnc9-MenC combination would ever be sold in the United States, as the strains it covers are not as prevalent here.
There is great interest in having more combination vaccines. Dr. Buttery and his colleagues noted that if a combination meningococcal/pneumococcal vaccine was adopted, it could spare U.S. infants up to four extra injections by 18 months, and United Kingdom infants two to three injections at each visit. Dr. Buttery led the study while at Churchill Hospital in Oxford, England. He is now with Murdoch Children's Research Institute, the University of Melbourne (Australia).
In the trial, Dr. Buttery and his colleagues enrolled 240 healthy infants aged 7-11 weeks at two United Kingdom hospitals from August 2000 to January 2002. Children who had known immunosuppression, previous vaccination, or confirmed invasive meningococcal or pneumococcal disease were excluded from the study.
They were divided into two groups: 120 received the Pnc9-MenC vaccine, and 120 received MenC, a monovalent group C meningococcal conjugate vaccine. MenC is the standard in the United Kingdom. There is no separate pneumococcal injection. Both groups also were given diphtheria and tetanus toxoids and whole-cell pertussis, /Haemophilus influenzae/ type b (Hib), polyribosylribitol phosphate-tetanus toxoid protein conjugate, and oral polio vaccine.
Vaccinations were given at ages 2, 3, and 4 months--an accelerated schedule, compared with the United States. Home follow-up visits were conducted at 2, 3, 4, and 5 months of age. At 5 months, serum samples indicated that the combination vaccine was less immunogenic than the MenC vaccine. Antibody concentrations for Hib and diphtheria were lower for infants who received the combination. Dr. Buttery and his colleagues said the effect on diphtheria was unexpected, but he noted that the antibodies were still in the protective range. There was no difference between the groups for tetanus antibodies.
More children in the combination group had to forego second or third vaccinations because of prolonged crying or fever.
The study might not be applicable to U.S. practice because of the accelerated schedule--because there is only a month of separation between each dose--and because of the different vaccinations used. For instance, whole-cell pertussis and oral polio are not usually given in the United States; acellular pertussis and injectable polio are used, Dr. Bradley said. But he said it was important the study was published, especially since it was sponsored by a drug company and was published despite its negative findings.
http://www.newstarget.com/008146.html
NewsTarget
June 1, 2005
A teenage boy in New Zealand contracted a deadly disease known as meningococcal B, despite having been vaccinated against the disease. Investigators are examining the boy to try and understand why the vaccine was not fully effective in his case. Because it does not contain live bacteria, it is not possible that the teen caught the disease from the vaccine.
New Zealand authorities assured the public that this incident does not mean that the nationwide vaccination campaign has been ineffective. According to Dr. Jane O'Hallahan, "No vaccine is 100 percent effective." The teenage boy has made a complete recovery. To learn more on this topic, be sure to also read the related article, Obesity follows Western culture's influence around the world.
He had received three injections of the vaccine being given to under-20-year-olds to combat the meningococcal B epidemic strain responsible for most meningococcal cases in New Zealand. "The youth appears to have had a less severe case of the disease. It is possible that the vaccine provided partial protection for this person and lessened the severity of the disease," meningococcal B immunisation programme director Jane O'Hallahan said.
The boy could not have contracted the disease from the vaccine because it does not contain live bacteria. Dr O'Hallahan said with any vaccine there was a small proportion of the population who did not develop full immunity. The breakthrough case involving the South Auckland teenager, the first since the campaign began in July, was being investigated by the ministry to find out why it had happened.
Possible causes included the patient's immune system being compromised or the vaccine not being stored properly. The review was likely to take some time. The case would not dent the credibility of the $200 million vaccination campaign, she said. More than 170,000 children have so far been immunised against the deadly disease. The campaign was launched in Wellington this week.
To be fully immunised a person needs to have three doses, and it can take upto 28 days after the third dose for immunity to fully develop. Ron Law, a risk analyst who has publicly questioned the vaccination campaign, said be believed there were other cases that had not been made public where children had contracted meningococcal disease after being vaccinated. The effectiveness of the campaign was unknown and it should be halted till it could be investigated by a commission of inquiry, he said.
U. Iowa Finding Speeds Up Immunization Booster Schedule
6/12/2005
Source: University of Iowa
Parents often wonder why it takes a year or more and multiple shots to fully immunize their children against diseases like diphtheria and pertussis. The reason is twofold. First, a single vaccination generates only a small amount of immunity and booster shots are needed to build up immunity to protective levels. The second reason is due to the fact that a substantial "lag time" is required by the immune system between initial immunization and subsequent booster shots to maximize the size of each boost.
Researchers at the University of Iowa Roy J. and Lucille A Carver College of Medicine have discovered that a different vaccination strategy, called dendritic cell vaccination, can dramatically speed up the immunization process by greatly reducing the required "lag time" between the initial vaccination and the booster shots. The finding has important implications for immunotherapy -- using vaccines to treat cancer -- where developing immunity fast is critical.
In the UI study, mice treated with a dendritic cell vaccine and a booster shot were protected against a bacterial infection in a matter of days compared to the several weeks required by normal vaccination to generate immunity. The study results appeared in Nature Medicine advance online publication (AOP) at the journal's Web site
(http://www.nature.com/nm/index.html) on June 12.
"People should not be concerned that vaccines don't work -- if you have plenty of time, current vaccine and booster regimens work very well," said John Harty, Ph.D., UI professor of microbiology in the Carver College of Medicine, and senior author of the study. "But there are circumstances, such as using a vaccine to treat a fast-growing cancer, where the immune response might be needed much more rapidly. With the dendritic cell vaccinations, we really speed up the booster schedule and also speed up the time it takes to achieve protective immunity."
Harty, who also is the Carver College of Medicine Endowed Professor in Microbial Immunology, noted that there already are DC vaccines in clinical trials for cancer, and if the new information from the UI study can be applied in humans, then the findings might provide a way to greatly speed up the booster schedule for immunotherapies and shorten the time needed to generate protective immunity.
Dendritic cells (DCs) are an important component of the immune system. They act like scouts, monitoring the body for foreign invaders such as bacteria or viruses. Contact with the invading microbe "arms" the dendritic cells, which then travel from the infection site to the lymph nodes where they activate specific T cells. These stimulated T cells proliferate and go through a transformation process, first becoming effector cells that can fight the infection and then developing memory characteristics, which are the basis of long-term immunity against that infection.
This T cell transformation process takes time, and only memory T cells can proliferate in response to a booster vaccination or a second infection. Thus it is necessary to allow for this "lag time," in which the memory T cell population develops, before giving a booster shot designed to bump up immunity.
The DC vaccination strategy used by Harty and his colleagues involved "arming" dendritic cells against a specific bacterium in a petri dish and then immunizing mice with the altered dendritic cells. The UI team found that these DC vaccinations cause an accelerated production of memory T cells.
"Six days after infection or conventional immunization those memory cells are not yet available to be expanded by the booster shot. But six days after a DC vaccination they are," Harty said. "An initial DC vaccination followed very quickly by booster shots allowed us to rapidly generate tremendous numbers of T cells."
Further experiments suggested that inflammation, which is a normal part of infection or current vaccine regimens, plays an important role in controlling the normally slow development of memory T cells. In contrast, DC vaccinations do not produce inflammation and the memory T cells develop very quickly.
"Provoking a T cell response in the absence of inflammation gives you early memory, which allows us to boost the response quickly," Harty said. "If results in humans are similar to what we see in animal models, this could represent a large step forward in vaccine efficiency, especially for situations were speedy protection is important."
In addition to Harty, the UI team included Vladimir Badovinac, Ph.D., an associate research scientist, and Kelly Messingham, Ph.D., a postdoctoral researcher, who were co-first authors of the study. Ali Jabbari and Jodie Haring, Ph.D., also were part of the research group. The study was funded by the National Institutes of Health.
Contact: Jennifer Brown
jennifer-l-brown@uiowa.edu
319-335-9917
University of Iowa
July 2005 12:45
http://news.independent.co.uk/uk/health_medical/article297165.ece
'Ineffective' tuberculosis vaccinations in schools to be dropped
By Jeremy Laurance
Published: 06 July 2005
The Government is to abandon the schools vaccination programme against tuberculosis despite the growth in cases of the disease.
Professor Liam Donaldson, the Government's chief medical officer, will announce today that the BCG vaccination offered to all children between the ages of 10 and 14 is to be dropped because it is ineffective. Evidence shows that tuberculosis is falling among the white population and that schoolchildren are at lowest risk, but it remains a risk among immigrant groups. The vaccination will continue to be offered to babies from high-risk groups whose parents were born abroad.
The move has the backing of specialists in the field who are lobbying for the £10m cost of the vaccination scheme to be ploughed back into services to improve TB control. Cases of tuberculosis have grown from 5,000 in 1987 to almost 7,000 last year, but they are concentrated among the homeless and communities with close links to parts of the world where tuberculosis is rife, especially in Africa and the Indian subcontinent.
Professor Peter Ormerod, of the British Thoracic Society, said: "All the scientific evidence shows that the schools BCG programme is given to people at extremely low risk of TB. Children born abroad or with parents born abroad are at higher risk and they are offered vaccination at birth, which will continue. If you are not in one of those groups, the chances of getting TB are one in 100,000." Professor Ormerod, professor of respiratory medicine at Blackburn Royal Infirmary, said the BCG vaccine was only 75 per cent effective and gave protection for 10 to 15 years. For every 5,000 children vaccinated, one case of TB would be prevented over the following 15 years.
Some children suffered adverse reactions, including a BCG abscess which required treatment with anti- tuberculosis drugs, or a keloid scar - an unsightly disfigurement at the site of the injection. Professor Ormerod said: "It is hugely cost-ineffective. If you are having to give 5,000 injections to prevent one case of disease, that is madness. The British Thoracic Society fully supports the decision to stop the school BCG programme, but we will lobby to have the money saved invested in TB services." Tuberculosis is a global killer, claiming more than two million lives a year. In Britain, after decades of decline, the number of cases started to rise again in the mid-1980s. Although it is curable with drugs, the development of drug-resistant strains of TB in recent years has caused alarm. These cases are extremely difficult and costly to treat.
TB is not easy to catch, and in most cases requires prolonged close contact with an infected person. Once infected, the disease can lie dormant and may not emerge until years or decades later.
Professor Ormerod said most white victims of the disease were in their fifties or older who became infected decades ago. The proportion of the white population infected had fallen year on year. The Government is to abandon the schools vaccination programme against tuberculosis despite the growth in cases of the disease.
Professor Liam Donaldson, the Government's chief medical officer, will announce today that the BCG vaccination offered to all children between the ages of 10 and 14 is to be dropped because it is ineffective. Evidence shows that tuberculosis is falling among the white population and that schoolchildren are at lowest risk, but it remains a risk among immigrant groups. The vaccination will continue to be offered to babies from high-risk groups whose parents were born abroad.
The move has the backing of specialists in the field who are lobbying for the £10m cost of the vaccination scheme to be ploughed back into services to improve TB control. Cases of tuberculosis have grown from 5,000 in 1987 to almost 7,000 last year, but they are concentrated among the homeless and communities with close links to parts of the world where tuberculosis is rife, especially in Africa and the Indian subcontinent. Professor Peter Ormerod, of the British Thoracic Society, said: "All the scientific evidence shows that the schools BCG programme is given to people at extremely low risk of TB. Children born abroad or with parents born abroad are at higher risk and they are offered vaccination at birth, which
will continue. If you are not in one of those groups, the chances of getting TB are one in 100,000."
Professor Ormerod, professor of respiratory medicine at Blackburn Royal Infirmary, said the BCG vaccine was only 75 per cent effective and gave protection for 10 to 15 years. For every 5,000 children vaccinated, one case of TB would be prevented over the following 15 years. Some children suffered adverse reactions, including a BCG abscess which required treatment with anti- tuberculosis drugs, or a keloid scar - an unsightly disfigurement at the site of the injection.
Professor Ormerod said: "It is hugely cost-ineffective. If you are having to give 5,000 injections to prevent one case of disease, that is madness. The British Thoracic Society fully supports the decision to stop the school BCG programme, but we will lobby to have the money saved invested in TB services." Tuberculosis is a global killer, claiming more than two million lives a year. In Britain, after decades of decline, the number of cases started to rise again in the mid-1980s. Although it is curable with drugs, the development of drug-resistant strains of TB in recent years has caused alarm. These cases are extremely difficult and costly to treat.
TB is not easy to catch, and in most cases requires prolonged close contact with an infected person. Once infected, the disease can lie dormant and may not emerge until years or decades later. Professor Ormerod said most white victims of the disease were in their fifties or older who became infected decades ago. The proportion of the white population infected had fallen year on year.
Failure of hepatitis B vaccination in patients receiving lamivudine
Failure of hepatitis B vaccination in patients receiving lamivudine prophylaxis after liver transplantation for chronic hepatitis B
Chung Mau Loa, , , Chi Leung Liua, See Ching Chana, George K. Laub and
Sheung Tat Fana aCentre for the Study of Liver Disease, Department of Surgery, The
University of Hong Kong, Pokfulam, Hong Kong, China bCentre for the Study of Liver Disease, Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
Received 26 January 2005; revised 25 February 2005; accepted 23 March 2005. See Editorial, pages 203–206. Available online 17 May 2005.
Background/Aims
Lamivudine prophylaxis against hepatitis B virus (HBV) reinfection after liver transplantation is associated with recurrence due to escape mutants.
Methods
Fifty-two patients on lamivudine prophylaxis at a median of 412 days (median, 370–2040 days) after transplantation for chronic HBV-related liver disease received two courses of an accelerated schedule of double-dose recombinant HBV vaccine. Before vaccination, all patients were seronegative for HBsAg, anti-HBs and HBV DNA (by qPCR). Three intramuscular doses of vaccine (40 ìg each) were administered monthly and another identical
course was repeated after 3 months. Lamivudine (100 mg/day) was continued throughout the study.
Results
After the first course, two patients developed a weak response (anti-HBs titre of 12 mIU/mL) that disappeared rapidly. One early responder developed anti-HBs (27 mIU/mL) again after the second course but the other did not. Two other patients developed response (anti-HBs titre of 17 and 103 mIU/mL, respectively) giving an overall response rate of 7.7%. The antibody level declined rapidly. At the end of the study, one patient who did not respond had developed viral breakthrough which was treated with adefovir dipivoxil therapy.
Conclusions
Active immunization with two courses of double-dose recombinant HBV vaccine has limited efficacy in patients receiving lamividine prophylaxis after liver transplantation.
Keywords: Active immunization; Immunity; Recurrence; Antibody against hepatitis B surface antigen The authors who have taken part in this study have declared that they do not have a relationship with the manufacturers of the drugs involved either in the past or present and did not receive funding from the manufacturers to carry out their research.
Corresponding author. Tel.: +852 2855 4761; fax: +852 2817 5475.
Journal of Hepatology
Volume 43, Issue 2 , August 2005, Pages 283-287
http://today.reuters.co.uk/news/newsArticle.aspx?&storyID=2005-08-01T171034Z_01_N01380986_RTRIDST_0_SCIENCE-TUBERCULOSIS-DC.XML New TB vaccine design called for in poor nations
Mon Aug 1, 2005 6:11 PM BST
By Patricia Reaney
LONDON (Reuters) - Tuberculosis vaccines being tested in developed countries will not protect people living in parts of the developing world where they are most needed because they trigger a different body response, researchers said on Monday. Scientists at University College London (UCL), who looked at variations in immune system responses around the globe, found that in countries near the equator the tuberculosis bacteria turn the body's normal protective response into a harmful one.
So like the BCG, or bacille Calmette-Guerin vaccine, used against TB in some countries, the latest vaccines which use the same approach will not work in developing countries, according to the researchers. "What we have done is identify the mechanisms that we think lead to the fact that BCG vaccine does not work close to the equator, where the problem really is," Professor Graham Rook, an immunologist at UCL, said in an interview.
"We realized that the vaccine candidates going into clinical trials at the cost of hundreds of millions of dollars haven't in any way answered that particular problem," he added. In countries in the northern hemisphere, the immune system protects the body against TB with TH1 cells. BCG and new candidate TB vaccines are designed to boost the TH1 cells.
But in people living near the equator, the TH1 cells are already on alert, so the protective mechanism is switched on but does not work because another inappropriate response is also turned on which undermines it. "What is needed, in our opinion, is not a vaccine that turns on the protective mechanism because that is already there but rather a vaccine that turns off the subversive mechanism that shouldn't be there," said Rook, who reported the findings in the journal Nature Reviews Immunology.
TB is a contagious airborne disease that affects about 9 million people each year and kills 2 million. The World Health Organization has warned that TB has reached alarming proportions in Africa where co-infection with HIV makes a lethal combination.
"We are not saying that funding for TB vaccination in developing countries should be stopped -- quite the contrary, given that TB kills between 2 and 3 million people every year. But we are concerned that the BCG vaccine is failing these countries and that TB vaccines currently on trial are likely to go the same way," Rook added. The researchers believe a new vaccine approach -- turning off the damaging immune response -- could be used to develop vaccines to combat other infections including HIV.
© Reuters 2005. All Rights Reserved
Vaccinated children have developed meningitis
Dr Muiris Houston, Medical Correspondent
http://www.ireland.com/newspaper/front/2005/0920/4116665085HM1MUIRIS.html
A number of children have developed meningitis caused by the bacterium haemophilus influenzae, despite having been vaccinated against the disease, it has emerged. A recommendation, made last July, to offer a booster vaccine against the infection has yet to be implemented.
Medical sources have confirmed that at least three children under the age of four have been hospitalised with haemophilus meningitis this year. It has also emerged that a number of children have suffered neurological damage from the disease in the last number of years, with one child at Our Lady's Hospital for Sick Children, Crumlin, left with serious neurological complications following invasive haemophilus infection.
Children are vaccinated against haemophilus influenzae type b (Hib) at two, four and six months as part of the national childhood vaccination programme. However, medical experts are now concerned that immunity from these vaccinations does not continue for the main risk period of infection, which lasts until five years of age.
Despite the rising incidence of late Hib infection, a recommendation to offer a booster vaccine made by the National Immunisation Advisory Committee (NIAC) to the Department of Health in July has yet to be implemented. Paediatricians and infection control experts have expressed concern a booster programme has not started in advance of the winter period when haemophilus infection is at its peak.
Dr Kevin Connolly, a consultant paediatrician at Portiuncula Hospital, Ballinasloe, and a member of the advisory committee, said: "I am disappointed that the implementation of a booster programme was not advanced quicker. The NIAC scheduled extra meetings specifically to discuss whether a booster was necessary. We made a decision in July in the hope that a booster dose would be introduced before the winter period. I am very disappointed that nothing definite has been decided thus far".
Dr Karina Butler, a consultant in infectious diseases at Our Lady's Hospital for Sick Children, confirmed last night that she had seen "a small number of cases of invasive Hib disease. The numbers are small but the trend is up and is similar to that seen in the UK. It is now recognised that Hib vaccine given in the first year of life is not strong enough to last through the risk period".
She added: "We need a booster vaccine to protect children up to five years of age. Among the types of infection we have seen is meningitis and some children have developed septic arthritis in their joints as a result of Hib infection".
A source in the Health Service Executive said it is actively planning a booster Hib programme. He estimated it could be December before additional vaccinations would begin. Asked about the budgetary implications of the programme, the source said both the cost of the vaccine and a fee for family doctors would have to be included. He said that, for logistical reasons, it would be the end of the year before a programme could begin. It is estimated the cost of the "catch-up" programme for the 200,000 children involved is about €8 million.
Haemophilus influenza type B is known to cause invasive blood-borne infection such as meningitis, septic arthritis (joint infection) and epiglottisis (a potentially fatal infection of a part of the voice box). A vaccine against the bacterium was introduced in 1992, resulting in a decline in Hib disease. But in 2003, 14 Hib cases were reported, the highest number since 1994.
© The Irish Times
Posted on Sun, Oct. 02, 2005
http://www.twincities.com/mld/pioneerpress/12795127.htm?template=
contentModules/printstory.jsp
Infant found to have polio
Risk to general public is nil, state health officials say
BY TIM HUBER
Pioneer Press
Minnesota health officials said Saturday they are investigating the first case of polio reported in the state since 2000, but dismissed the potential for an outbreak of the crippling disease.
The case involves an infant from central Minnesota who already was hospitalized with a weakened immune system when the infection was discovered, the Minnesota Health Department said. The agency stressed that there is no risk to the general public.
Only people who have not been vaccinated and who had direct contact with the infant would be at risk because the disease is transmitted through stools or oral secretions, said Health Department spokesman Buddy Ferguson. The vast majority of Minnesotans — approximately 93 percent — have been vaccinated, most as infants.
"If you didn't have that kind of contact, you're not at risk," Ferguson said. "We're talking about health care workers who might have cared for the infant. We're talking about family members. We are going to be contacting people in those groups individually."
In the vast majority of cases, polio has no symptoms, but it can cause sore throats, vomiting, abdominal pain and flulike symptoms, according to the Centers for Disease Control. In less than 2 percent of cases, the virus causes minor stiffness in the neck, back or legs, and in less than 1 percent of cases, it attacks the central nervous system and results in permanent paralysis, muscular atrophy and even death. The disease usually affects young children.
Before the 1960s, the disease left hundreds of thousands of victims paralyzed across the United States. Outbreaks created panic. Many people became afraid of large public gatherings. In 1946, the Minnesota State Fair was canceled as state health officials were recording as many as 50 new cases a day.
Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the most recent case has been managed well by state officials.
"This is not a public health situation of any concern," he said.
Health officials would not name the child, give an age or even which town or hospital the infant is in, citing state and federal privacy laws.
The infant apparently contracted polio from someone infected with a mutated form of the polio strain used in oral vaccines, officials said. Even though the child is infected with the virus, he did not show any signs of paralysis, health officials said.
The United States stopped using polio vaccines that contain weakened strains of the live virus in 2000. The live-virus vaccine still can cause polio, and about eight people in the U.S. developed the disease annually before the country switched to using vaccine without the live virus. The last reported polio case in the U.S. occurred the final year that the live vaccine was in use.
Live-virus vaccine remains in use elsewhere in the world, in part because it helps expand protection in areas where not everyone receives the vaccine, Osterholm said. In essence, health officials rely on poor hygiene and inadequate sanitation in these areas to expose more people to the weakened form of the virus and thus give them protection.
At times, the weakened virus reverts to an infectious strain, which apparently is what happened to the infant in Minnesota, Osterholm said.
Polio ceased to be a major threat in the United States decades ago and largely has been eliminated in the Western Hemisphere since Dr. Jonas Salk developed the first vaccine in 1955. Yet the disease remains a serious health threat in the developing world and retains a terrifying reputation in the United States. By one estimate, polio paralyzed 254,000 Americans, many of them children. Vaccination gradually eliminated U.S. outbreaks. In 1960, there were 2,525 paralytic polio cases in the country, but by 1965 the number had dropped to 61, according to the Centers for Disease Control in Atlanta.
The last U.S. outbreak — and naturally occurring cases — occurred in 1979, when Amish in several Midwestern states contracted the disease from a strain of the virus brought in from the Netherlands, according to the CDC.
The last reported case of polio in Minnesota was caused by a vaccine in 1992.
In parts of Africa and Asia, however, polio remains a threat. In Indonesia, for instance, more than 230 children younger than 5 have been infected this year.
The Associated Press contributed to this report.
Tim Huber can be reached at thuber@pioneerpress.com or 651-228-5580.
http://www.tallahassee.com/mld/tallahassee/news/12895605.htm
Four children in Minnesota contract polio
MARTIGA LOHN
Associated Press
ST. PAUL, Minn. - Four children in an Amish community in Minnesota have contracted the polio virus - the first known infections in the U.S. in five years, state health officials said Thursday. Dr. Harry Hull, the state epidemiologist, said the cases do not pose a threat to the general public because most people have been vaccinated against polio and are unlikely to have contact with Amish people. But he said he expects to find more infections within the Amish community because some of its members refuse immunizations on religious grounds.
None of the children have shown any symptoms of the paralyzing disease. About one in 200 people who contract the polio virus suffer paralysis because of it; others typically rid themselves the virus after weeks or months.
None of the four children had been vaccinated. Three are siblings; the fourth is a baby from another family. The infection came to light when the baby was hospitalized for various health problems and underwent tests. Authorities then began testing other members of the community for the virus. Officials would not identify the Amish community but said it consisted of 100 to 200 people. Hull said the infections were traced to an oral vaccine that was administered in another country, probably within the past three years.
The use of oral polio vaccine containing the live virus was stopped in the United States in 2000. The live-virus vaccine caused an average of eight cases of polio a year in the United States. The U.S. and Canada now use an injected vaccine made from the killed virus. State and federal officials are investigating how an infection from a vaccine given in another country reached Minnesota. Stool or saliva from an infected person can transmit the virus. Health officials said they are working with the Amish community to determine who may have been exposed to the virus, and to encourage immunizations.
"We have been going house to house, talking with them about the risk, offering the vaccine and attempting to collect specimens to see if the virus has been spreading," Hull said. "Some families have said, `No, thank you, we do not want to interact with you at all.' Other families have said, `Sure, we'll get vaccinated. We'll provide specimens.'"
Without the community's cooperation, Hull said, there is a chance of an outbreak similar to one that occurred in 1979 in Amish communities in Iowa, Wisconsin, Missouri and Pennsylvania. Ten people were left paralyzed by the disease, according to the Centers for Disease Control and Prevention.
The last naturally occurring case of polio in the United States was in 1979, and health officials consider the disease eliminated in the Western Hemisphere. It persists in other parts of the world, with the vast majority of cases concentrated in India, Nigeria and Pakistan, according to the World Health Organization.
According to the CDC, more than 95 percent of U.S. children are vaccinated against polio by the time they enter school.
2-year-old dies despite vaccination
http://www.irishhealth.com/?level=4&id=8217%3E%20&id=8217
[Posted: Thu 22/09/2005]
A two-year-old boy from Co Louth has died as a result of contracting Haemophilus influenzae type B (Hib), despite being vaccinated against it.
Hib can cause bacterial meningitis in young children. The death of the boy comes just days after the Health Service Executive (HSE) approved plans to offer a Hib booster vaccine to further protect children already vaccinated.
The child had been brought to the A&E department at Our Lady of Lourdes Hospital in Drogheda a number of days ago, but was eventually discharged. The family then went on holiday abroad, where the boy became ill and died.
He had developed septicaemia, as a result of contracting Hib.
The Government is now coming under increasing pressure to explain why a recommendation to provide the booster vaccine has still not been implemented. The recommendation was made in July by the National Immunisation Advisory Committee, after a small number of children developed meningitis despite being vaccinated against the disease.
Earlier this week, the HSE said that it had been planning a campaign to offer the booster vaccine since it was notified about the committee's recommendation in July. It said that the target date for this campaign was this coming November, continuing over the winter months. However according to Fine Gael health spokesperson, Dr Liam Twomey, this case highlights an overall lack of Government understanding of the importance of vaccination.
"In light of this tragic death, it is clear that the provision of a booster for all of the children at risk is an emergency. However it is deeply worrying that the programme is not targeted to start until November, when it should have started before the end of September", Dr Twomey said.
A statement from the HSE meanwhile said that as the death of the boy had occurred abroad, 'complete information is not yet available'. It added that an initial review of the case has been conducted by Our Lady of Lourdes Hospital and a final review will be completed when all the relevant information is obtained.
Chickenpox Outbreak in School District
http://www.wqow.com/news/articles/article_5778.shtml
Galesville
Jan 20, 2006
The chickenpox vaccine is supposed to be at least 85-percent effective. You wouldn't think that by looking at a western Wisconsin school.
An outbreak of chickenpox has affected 44 children at Gale-Ettrick-Trempealeau. All but two had been vaccinated against it.
The outbreak started in November when 36 kindergartners developed chickenpox. The Wisconsin Department of Health and Family Services says it's trying to figure out why so many vaccinated students became sick.
The school nurse says the students received vaccinations from a number of different providers and no manufacturer has reported a bad batch. Only one of the cases cannot be traced back to the kindergarten building and that student was not vaccinated.
[PROVE Note: An American woman traveling abroad has caught vaccine strain polio from a vaccinated baby in another country. The CDC has warped this into a recommendation that adults traveling abroad should be vaccinated against polio to protect them from catching vaccine strain polio. I promise you I did not make this up.]
http://www.reutershealth.com/en/index.html
Vaccine-associated polio reported in US traveler
Last Updated: 2006-02-07 15:30:36 -0400 (Reuters Health)
NEW YORK (Reuters Health) - In a new report, researchers from the Centers for Disease Control and Prevention in Atlanta describe what appears to be the first case of vaccine-associated paralytic poliomyelitis in a US adult who traveled abroad.
Although polio is rare in the US, it is endemic in other parts of the world and for this reason, vaccination is recommended for residents traveling to at risk areas, the researchers note in the February 2nd issue of the Morbidity and Mortality Weekly Report.
The present case involves a young, unvaccinated woman from Arizona who traveled to Central and South America in early 2005 as part of a study-abroad program. She appears to have become infected with poliovirus through exposure to her host family's infant grandson who had recently been given a live, attenuated oral polio vaccine (OPV).
The women experienced fever, general malaise, and progressive muscle weakness. Her condition worsened and she was eventually admitted to the hospital and intubated for respiratory failure. Testing revealed infection with Sabin-strain poliovirus and although the patient eventually recovered, she still had some weakness in the legs 60 days after disease onset.
"Healthcare providers assessing vaccine needs for unvaccinated adults traveling to countries that use OPV should be aware of the risk that OPV might pose to such travelers and should consider offering them polio vaccination," the report suggests.
Mor Mortal Wkly Rep CDC Surveill Summ 2006;55:97-99
http://news.yahoo.com/s/ap/20060401/ap_on_he_me/mumps_outbreak
Mumps Cases Reach Epidemic Level in Iowa By MELANIE S. WELTE, Associated Press Writer
Fri Mar 31, 10:22 PM ET
A mumps epidemic is sweeping across Iowa in the nation's biggest outbreak in at least 17 years, baffling health officials and worrying parents.
As of Thursday, 245 confirmed, probable or suspected cases of mumps had been reported to the Iowa Department of Public Health since mid-January.
The federal Centers for Disease Control and Prevention said it is the nation's only outbreak, which the CDC defines as five or more cases in a concentrated area.
"We are calling this an epidemic," said Iowa state epidemiologist Dr. Patricia Quinlisk, explaining that mumps has spread to more than one-third of the state and does not appear to be confined to certain age groups or other sectors of the population.
Quinlisk said Iowa has had about five cases of mumps a year in recent years, and this is its first large outbreak in nearly 20 years.
"We're trying to figure out why is it happening, why is it happening in Iowa and why is it happening right now. We don't know," she said.
CDC spokeswoman Lola Russell said the federal agency has no answers yet. But Quinlisk said one theory is that the infection was brought over from England — perhaps by a college student — because the strain seen in Iowa has been identified by the CDC as the same one that has caused tens of thousands of cases of the mumps in a major outbreak in Britain over the past two years.
"It may have been a college student, since we did see the first activities on college campuses, but we can't prove that," Quinlisk said. The Public Health Department said 23 percent of the 245 reported patients are in college.
The CDC said it is the nation's biggest epidemic of mumps since 269 cases were reported in Douglas County, Kan., from October 1988 to April 1989.
Mumps is a viral infection of the salivary glands. Symptoms include fever, headache, muscle aches and swelling of the glands close to the jaw. It can cause serious complications, including meningitis, damage to the testicles and deafness.
A mumps vaccine was introduced in 1967. Iowa law requires schoolchildren to be vaccinated against measles and rubella, and the mumps vaccine is included in the same shot. The state's last major outbreak was in 1987, when 476 people were infected.
Of the 245 patients this year, at least 66 percent had had the recommended two-shot vaccination, while 14 percent had received one dose, the Public Health Department said.
"The vaccine is working," Quinlisk said. "The vaccine certainly was made to cover this particular strain, because it's a fairly common strain of mumps." Quinlisk said the vaccine overall is considered about 95 percent effective.
Quinlisk said the mumps outbreak started in eastern Iowa and is spreading statewide and possibly into the neighboring states of Illinois, Minnesota and Nebraska. Those states may have one or two cases, she said.
When 11-year-old Will Hean of Davenport starting feeling sick in mid-January, his family thought he had a bad case of the flu. But his face and throat swelled and his temperature climbed to 103. His parents took him to the doctor, and he was diagnosed to their surprise with full-blown mumps.
About two weeks later, the Heans' daughter, Kate, 21, came down with the mumps, too.
Both children had gotten the measles, mumps and rubella vaccine, or MMR. So had their other son, 13-year-old Jimmy, who did not get the mumps.
"He had all the shots and everything. You don't think you're going to get the mumps after you've been inoculated," said Will's father, Wayne Hean
Health Officials Scramble To Contain Mumps Outbreak In U.S. Midwest
Posted on Wednesday, April 12 2006 20:05:35 PDT by Intellpuke
Read 15 times
Local, state and federal health experts are urgently trying to contain a large mumps outbreak raging across Iowa that has now spread to at least eight other Midwestern states. At least 515 cases have been reported in Iowa this year, far outpacing the five cases the state usually sees in a year and the 200 to 300 that typically occur nationally. The epidemic, the largest since a 1988 outbreak in Kansas, shows no sign of slowing, with at least 100 more cases in Nebraska, Kansas, Minnesota, Wisconsin, Indiana, Michigan, Missouri and Illinois.
Among other steps, the effort to stem the outbreak has led investigators to hunt down passengers on a flight to Washington, D.C., last month that carried a woman who later developed mumps, and to vaccinate more than a dozen people she visited on Capitol Hill.
As health officials work to break the chain of transmission of the viral infection, disease detectives are trying to puzzle out what is causing it. Cases appear concentrated among young, otherwise healthy adults. "Why Iowa and why now? We really don't know," said William Bellini of the federal Centers for Disease Control and Prevention in Atlanta, which has sent investigators to help control and investigate it. "There are a lot of unknowns."
Among them: Does the mumps vaccine fail to take hold in more people than had been thought? Does its protection wane? Is the virus that is causing this outbreak less susceptible to the vaccine for some reason, or more infectious? The outbreak has underscored that old infectious diseases that most people rarely think about - and doctors do not often encounter - can suddenly reemerge. "This shows us once again that the world is a very small place," said William Schaffner, an infectious-disease expert at Vanderbilt University. "We have to remain on guard, even about diseases we usually rarely see anymore in this country."
To try to keep the outbreak from widening further, the CDC announced Wednesday that officials are working to track down 222 airline passengers who sat near two people from Iowa who developed the mumps after traveling on nine flights from March 26 to April 2. One flew from Tucson to Cedar Rapids, Iowa, stopping in Arkansas and St. Louis. The second, a 51-year-old woman on a trip to lobby the Iowa congressional delegation, flew from Waterloo, Iowa, to Washington and back, stopping in Detroit and Minneapolis. About 17 people who came in contact with her on Capitol Hill have been given vaccine shots as a precaution, health officials said. "The states where these passengers traveled and landed we'll be watching closely and putting prevention and control activities in place if they start to see some cases," said Jane Seward of the CDC.
In the states that have cases, officials are alerting the public to the symptoms in hopes that anyone who has been infected can be identified quickly and isolated. They are also trying to identify and inoculate unvaccinated adults. "We're doing everything we can to get out in front of this outbreak and try to get it stopped," said Patricia Quinlisk, Iowa's state epidemiologist. "Mumps can produce severe complications, and we're trying to do whatever we can to prevent them from happening." About a dozen patients in Iowa have been hospitalized so far, including one who was treated for encephalitis, but all have recovered, officials said.
Much of the effort has been focused at colleges, where many of the cases are occurring.
"We give the student the choice: If they want to go home, we think that's the best bet," said Lois Noel, who runs the health center in Dubuque, Iowa, which, with at least 151 cases, has been hit hardest. "If they stay in the residence halls, we make arrangements to make sure their needs are being met."
Sara Breitbach was stunned when a doctor told her to leave her sorority, go home and hide behind a surgical mask whenever she went near her parents. "I couldn't believe it," said the 20-year-old University of Iowa sophomore, who spent a week in isolation before the infection passed. "Nobody ever talks about the mumps. It was very weird." "I've never been so miserable in my life," said Christopher J. O'Brion, 22, a University of Iowa senior who holed up in his apartment for two weeks after his chin swelled up. "I couldn't eat. I couldn't sleep. It was just miserable." The reason colleges have had so many mumps cases remains unclear, but the virus could simply have arrived there first.
"You know what dorms are like. If it gets hold there it can keep transmitting for a while," Seward said. "We suspect that's the situation we're in now." Officials speculate that the epidemic might have been sparked by someone from Britain, which has been experiencing a large mumps outbreak for several years. Last summer, a much smaller outbreak at a summer camp in New York was started by an unvaccinated British counselor. "We suspect that there was some importation into Iowa, and initially perhaps it wasn't recognized immediately because physicians don't see mumps much anymore," Seward said. "That's how these things can get going."
The virus in the Iowa outbreak is the same strain as the one in the United Kingdom, but officials have not identified the first Iowa case. "We're not looking back right now," Quinlisk said. "We're focused on stopping the transmission." Experts hope the relatively high U.S. vaccination rates will contain the outbreak. The tens of thousands of cases in Britain have been blamed on problems with the vaccination program there, and concerns among some parents that childhood vaccines may increase the risk of autism, which left a significant proportion of the population unvaccinated.
"The United States, fortunately, generally has good vaccine coverage," said Stanley Plotkin, an infectious-disease expert from the University of Pennsylvania.
The vaccine is believed to be about 95 percent effective, meaning that five in 100 fully vaccinated people would still be vulnerable, enough to allow an outbreak to occur.
The size of the episode has experts wondering whether the vaccine is less effective than that, and whether the immunity wanes over time. About 68 percent of the cases have occurred among people who received the two recommended doses of vaccine as part of their routine childhood immunizations.
"That's a very pregnant question in this outbreak, because such a large proportion of the individuals affected have a history of having had two immunizations," Schaffner said.
Investigators are gathering information about how many shots the infected people got and how far apart they got them. "Does it last a lifetime? As far as we're aware it does. But that's something we're interested in studying," Seward said of the vaccine. Scientists are also analyzing the virus, deciphering its genetic code to see how closely it matches the one circulating in Britain and the one used in the vaccine, as well as doing tests with cells to assess whether it is unusually infectious. "That will give us some idea how aggressive it will be," said Bellini, adding that researchers are also testing how well antibodies produced in response to the vaccine neutralize the virus. "We think vaccine should be fully protective, but we certainly will investigate that."
http://www.canada.com/nationalpost/news/story.html?id=a3febc68-8863-4a2c-802
f-f414d0876e86&k=20268
Free flu vaccine fails to reduce cases study: 'Rates haven't decreased and there's been lots of money spent'
Tom Blackwell
National Post
Tuesday, May 02, 2006
Canada's first experiment in universal, free flu vaccine has cost Ontario taxpayers more than $200-million, but appears to have done nothing to cut the spread of influenza, a new study suggests. Per-capita flu rates in the province have not fallen at all since the program was introduced in 2000, concluded the University of Ottawa research, published in the journal Vaccine. In fact, the average monthly incidence of the virus jumped over the first five years of the program, though researchers say it is too early to say that numbers are really on the rise.
"All we do know is rates haven't decreased, and there has been a lot of money spent," said Dianne Groll, the University of Ottawa professor who led the study. "The program was designed to reduce the incidence of flu, and this hasn't yet happened." The heavily publicized offer of free flu shots to all 12 million Ontarians was launched in 2000 to try to ease pressure on emergency wards from flu patients, and cut the incidence and severity of the illness.
Dr. Groll said it might be wise to focus on better targeting the vaccine at high-risk groups -- the very young, the elderly and the chronically ill -- perhaps by giving shots to anyone who comes into an emergency ward. She also said the province failed to collect detailed "baseline" information on vaccination patterns before the plan started or similar data since then to compare, making it difficult to thoroughly evaluate the program. Some infectious disease specialists warned yesterday the study is seriously limited, partly because it compares the rates of laboratory-diagnosed flu before and after the program started. Cases that are confirmed by a lab test represent a small fraction of the total amount of flu and may not give a true picture of the situation, said Dr. Allison McGeer, one of the country's leading influenza experts.
The Ottawa research correctly and interestingly analyzed the data available but is "irrelevant," concluded Dr. McGeer, infection-control officer at Toronto's Mount Sinai Hospital and a strong proponent of universal immunization. She acknowledged there is simply very little evidence with which to evaluate the program.
"That we would publish this study is a marker of desperation."
Dr. McGeer said there is other research, not yet published, suggesting the campaign has resulted in more chronically ill seniors being vaccinated and has reduced the seriousness of some illness. The Ontario initiative, the world's first universal flu campaign, distributes about five million vaccine doses a year at a current cost of $50- to $55-million, including promotion, according to the Health Ministry. Dr. Groll looked at the number of cases of laboratory-diagnosed flu reported to Health Canada between 1990 and 2005.
She found that the rate between 1990 and 2000, when the program started, was 109 per 100,000 Ontarians. After the campaign's launch, it jumped to 164. The data was analyzed by Queen's University statistician David Thomson, who concluded there are not enough statistics yet to prove the numbers are on the rise.
The researchers also found the Ontario flu rates did not change relative to other provinces. And, though the number of laboratory tests conducted has gone up, it has not increased compared with the rest of Canada. Dr. Michael Gardam, infection-control specialist at Toronto General Hospital, also stressed the limitations of the study, noting the vaccine in one of the years after the program started did not match the strains circulating in Ontario.
Still, he admitted that emergency rooms at his hospital are no less busy and that "Ontario still gets flu outbreaks like anybody else." "The most we can say from this study is that clearly this program is not a home-run success," he said. "If there is success, it's subtle. If the results are that subtle, should the money be spent elsewhere? That is a very good question."
Dr. Groll noted the campaign was instituted in 2000 without any "baseline" data -- information on what sort of people were getting vaccinated before, how many of those got the flu and whether flu patients used hospital emergency wards.
Nor has such information been gathered since, making it very difficult to effectively evaluate the global vaccination plan, she said. "The program just lacks the baseline information you would need -- that anybody would need -- before anybody put this kind of multi-million-dollar proposal together," Dr. Groll said. John Letherby, a spokesman for the Ontario Health Ministry, defended the flu program, though, saying it does have many "ancillary benefits" apart from the impact on overall rates. Those benefits include less emergency-room crowding and less absenteeism, but Mr. Letherby said the ministry does not itself collect such statistics.
tblackwell@nationalpost.com
Friday, June 02, 2006
Harmful effects: PHC moved against polio vaccination
By Akhtar Amin
PESHAWAR: The Peshawar High Court (PHC) was on Thursday moved to stop the WHO-backed polio vaccination drive in Pakistan with the petitioner arguing that the anti-polio vaccine contains ingredients which weaken the male reproductive system and trigger the onset of puberty in females.
The petitioner, Ghulam Ali, has made the government of Pakistan and Dr Ibrahim, the WHO country head, respondents. The petition alleges that after testing polio vaccine in Karachi and Peshawar, two ingredients Estrogen and Estradoil were found which do not create immunity against the polio virus. They “weaken the male reproductive system and accelerate puberty in females” and also weaken resistance to disease, it added.
The petitioner has requested the court to stop the polio vaccination drive and order a first information report against people involved in “playing with the lives of the country’s children”.
The petitioner had also submitted a report by Dr Haroona Kiata, a Nigerian doctor, who tested the WHO’s polio vaccine administered to Nigerian children. The tests were conducted in India with the assistance of Indian doctors as the facility was not available in Nigeria. According to the petitioner, the tests confirmed the presence of additional ingredients in the vaccine that have no relevance to treating polio and instead weaken the male reproductive system and quicken the onset of puberty in females. Ali has also attached an Americans Doctor’s Association study which found that children who were administered the polio vaccine were 78 percent more vulnerable to other diseases than those who were not administered the vaccine.
Courtesy http://www.DailyTimes.com.pk
Mostly women getting mumps
By Aaron Kessler
Daily Progress staff writer
Saturday, November 4, 2006
University of Virginia health officials are a bit puzzled why the ongoing outbreak of mumps has struck almost entirely women. Of the 31 cases of probable or confirmed mumps at UVa, 28 have been in women. "There is a curiosity in that most of our cases are in females," said Dr. James C. Turner, executive director of Student Health. "We can't really say for sure why it's happened that way."
One theory is that young female students, particularly first-year undergraduates living in residence halls, have a tendency to, well, cuddle. "Apparently it's popular for first-year women to push their beds together and have movie nights and such, where they'll share pillows, that kind of thing," Turner said.
The resulting cuddling might explain the larger percentage of women contracting mumps, Turner said. But he was quick to point out that the cuddle theory is but one possible explanation for the gender disparity.
Dr. Lilian Peake, health director for the Thomas Jefferson Health District, said one partial explanation could be that women tend to seek health care more than men, so more cases have been picked up among women. "The truth is, we simply don't know. But it has been very interesting," Peake said. As of Friday, UVa reported 28 cases of mumps among undergraduates, although the Health District was still unsure about one of those cases.
Turner said an undergraduate has also developed viral meningitis, but is expected to recover. She is being treated for the pain associated with the condition, which about 1 percent of mumps patients can
develop. "Usually, it's something that's very painful, but not life-threatening," he said of the virus, which is much less severe, in general, than its potentially deadly bacterial counterpart. The student is recovering at her apartment in the Charlottesville area.
In addition, for the first time the virus has been diagnosed in graduate students as well - two now have probable mumps. Turner would not say which graduate or professional programs the students are involved in, but the two students are not in the same program. Also, a member of the UVa staff who works at Student Health contracted mumps, Turner said, bringing the total at the university to 31.
All of those infected had been vaccinated. The vaccine, however, is not 100 percent effective.
At this point, most local sufferers have fully recovered and are no longer contagious. As of Friday, three students were still in isolation. The student with viral meningitis was also still recovering. Turner said with three students found to have mumps this week, compared with nine last week, he hopes the outbreak may be slowing down. "It would appear it may be [slowing,] I hope that turns out to be right," Turner said. "At this point, we're basically collectively holding our breath."
Peake said there have been five cases of mumps diagnosed outside of UVa in the larger Charlottesville community, but those cases have been only sporadic.
"We're still really talking about a UVa outbreak, and in particular an undergraduate outbreak," she said.
Mumps is a virus that can cause fever, aches and swelling of the glands close to the jaw. Symptoms usually appear between 12 and 25 days after exposure to the virus, and mumps is contagious for three
days before the onset of swelling.
Contact Aaron Kessler at (434) 964-5476 or akessler@dailyprogress.com.
http://www.ashleycountyledger.com/articles/2006/11/08/news/h16f103t.txt
Health Department, CDC Looking at Chicken Pox Outbreak in County
Representatives from the Centers for Disease Control in Atlanta have been in Ashley County in connection with an outbreak of chicken pox among highly-immunized groups.
Ann Wright of the Arkansas Department of Heath said that as Monday morning that there have been 118 cases of chicken pox in Ashley County, but could not provide additional details as to the location.
Hamburg Superintendent of Schools Keith Alexander said Friday that the Hamburg School District had some cases at the high school. He also noted that earlier, there had been three to four cases at Noble Elementary. Tracy Streeter, the Noble principal, said that no students were out with chicken pox as of Monday. She also noted that CDC officials had done environmental scans at the school, but did not find anything.
Hamburg High School Principal Jeff Senn said Monday night that the high school has 28 students out with chicken pox.
Wright termed the situation a "very large outbreak." She also noted that the issue is of concern because it has been in a population that has been "highly vaccinated." "Because of that," she said, "the CDC is assisting with the investigation." She said that the CDC had two people in Ashley County this past week, but that they have since left the county.
The first cases were reported on September 4, and they were in the elementary grades. Now, however, the disease is in all ages. Wright noted that for students now in grades 10-12, the vaccine was not available when they went through the childhood vaccination series. Young children who are now in that age group were not mandated to get the shots when they were small.
Chicken pox is a very infectious disease, she said, caused by the varicella-zoster virus. "When you contract it," Wright said, "you have a blister-like rash, itching, tiredness and fever."
Wright said that the disease is usually visible first on the trunk of the body or the face, but can spread all over the body. She said that most cases are in children under 15 years old.
The disease is spread person to person by direct contact or thorough the air by coughs or sneezes. Wright said that people are contagious for a day or two before the rash appears, and they remain contagious until all the blisters form scabs. When a person who has not been vaccinated is exposed, it can take ten to 21 days for the disease to develop, she said.
Wright said that when a person gets chicken pox, they are usually sick for five to ten days, and kids usually miss five to six days to school. They should stay home for a week after the blisters erupt or until the blisters are dry and crusted. "That is really important," she said.
Wright said that the health department recommends that a person go to a physician when they are first exposed. She said that if a person already has had one vaccination then a second dose may be administered to those exposed. "If someone in the family is sick," she said, "the others need vaccination."
Wright noted that the symptoms can be very serious, with about one in ten having complications. The possible complications include infected skin lesions and dehydration. The disease can make asthma worse, she said, and can even develop into pneumonia. She also added that some people can even die from chicken pox. "It is nothing to play around with," she said.
The CDC is investigating the outbreak to help determine the reason for the spread of the disease in groups which have been vaccinated. She said that the CDC has determined that the local sickness is definitely varicella and that the problem was not the efficacy of the vaccine. The CDC is now looking at the issue of transmission.
Wright noted that the CDC and health department have worked with the schools for education and sent home letters with parents. "The schools in the county have been very cooperative," she said.
Asked if there was a possible new strain which the vaccine does not prevent, Wright said that would not be known until the investigation is completed.
In regard to preventing the spread of the disease, Wright said that people that are sick need to stay home and avoid exposing others. Those who are sick should stay home until one week after the blisters erupt, she said, "and everyone needs to be vaccinated."
Wright noted that the health department policy had been to have one dose of vaccine at 12 months of age. Now however, the CDC and the health department are recommending two doses, but the health department has not been funded to administer a second dose. "If a child is 13 or above and has not been vaccinated, give them two doses," she advised.
She also noted that if a person is exposed, a second dose of the vaccine within five days can help prevent a person from developing the disease.
She suggested that any person who is worried can get a second shot, but the health department is not routinely giving two vaccinations.
The CDC web site notes that people can contract the disease more than one time, though one infection normally gives lifetime immunity.
Just because a person has had the shot, does not mean he or she is always protected. According to the CDC, for chickenpox vaccine, about 8 to 9 out of every 10 people who are vaccinated are completely protected from chickenpox. The vaccine almost always prevents against severe disease. If a vaccinated person does get chickenpox, it is usually a very mild case with fewer skin lesions (usually less than 50) lasting only a few days, no fever or a low fever, and few other symptoms.
Locally, the number of cases in those who have had shots is the major item of concern.
Bharat Biotech launches anti rabies vaccine
Tuesday, December 26, 2006 18:00 IST
Our Bureau, Mumbai
Bharat Biotech International Ltd. (BBIL) announced the launch of chromatographically purified vero cell vaccine, Rabirix for the treatment of rabies.
Dr Julie Gerberding, director, Centres for Disease Control and Prevention (CDC) along with Dr Krishna M Ella, Chairman and Managing Director, Bharat Biotech, did the launch of the vaccine in Hyderabad.
Rabirix has been indigenously developed by BBIL and can be used for both prophylactic (vaccine-pre bite) and therapeutic (post bite) treatments. Rabirix is manufactured in a state of the art manufacturing facility conforming to the current good manufacturing practices established by Regulatory agencies such as the Drug Controller General of India (DCGI), World Health Organisation (WHO), United States Food and Drug Administration (USFDA), European Medical Evaluation Agency (EMEA).
Rabirix is a Purified Vero cell based Rabies Vaccine (PVRV), which has been extensively evaluated clinically for pre-bite and post-bite applications, and has proven to be well tolerated with minimal or no side effects. The immune sera samples from phase III clinical trials have been analysed at the National Institute of Virology, Pune and the efficacy of the product has thus been established.
According to Dr Krishna M. Ella, chairman and managing director BBIL said, "The rabies vaccines contribute approximately 50 per cent of the vaccine market in India in terms of value. Currently, the market size of rabies vaccines is estimated to be around Rs 250 crores. To promote vaccines exclusively, we have created a dedicated marketing division christened Immutika (Immunisation and Tika)." He also added that Rabirix is yet another effort towards our commitment to providing affordable, safe and effective health care solutions."
Four million people are exposed to the rabies virus, worldwide every year and 60,000 people fall victim to it. In India 3 million people under go anti-rabies treatment and 30,000 deaths are reported annually which accounts for 50 per cent of mortality from rabies worldwide. The WHO estimates between 35,000 to 50,000 human rabies cases worldwide, and approximately 30,000 cases from India. Human rabies is most common in people younger than 15 years. 90 per cent of these deaths are due to bite of rabid dogs. Even a vaccinated dog could transmit the rabies virus.
Then why get your dog vaccinated if they don't work?
Date: Sun, 11 Feb 2007 19:10:12 -0000
Chicken pox strikes Highland Elementary, 33 students ill
HIGHLAND — A chicken pox outbreak of three dozen cases has been reported at Highland Elementary School, according to the Ulster County Department of Health. Since Feb. 6, 33 students out of about 900 in the elementary school have been diagnosed with the aricella, or chickenpox, virus, said John McCarthy, district superintendent. "It's all in the elementary school right now," he said. "It seems to be contained there."
According to public health director Dean Palen, an outbreak occurs when five or more cases are reported at once. The goal now, he said, is to prevent the disease's spread. "We're trying to contain it to make sure other students at the other schools don't get it," Palen said. Of the 33 students, all but two had been vaccinated for the virus. According to a letter sent to district parents Thursday from the Department of Health, children who have already received one dose of chicken pox vaccine should receive a second dose if an appropriate amount of time has elapsed between shots.
While not usually a serious illness, complications can cause pneumonia and in rare occasions can be life threatening, Palen said. Chickenpox is an infectious disease caused by a virus, which results in a blister-like rash, itching, tiredness and fever, according to the Center for Disease Control. The county will offer a special chickenpox vaccine clinic for children 3-7 p.m. at the Health Department office, 570 Route 299, Highland. Appointments are required and the child's vaccine record must be brought to the appointment.
http://cities.expressindia.com/fullstory.php?newsid=243704
THE SPECIAL REPORT LUCKNOW: POLIO RESURGENCE
ALARMING : 55 OUT OF 56 CONFIRMED POLIO VICTIMS HAVE BEEN ADMINISTERED SEVERAL DOSES OF VACCINE
No resistance, yet polio strikes again
Maulshree Seth
Lucknow, June 30: The Uttar Pradesh Health Department can no longer put the blame on the resistance among a particular community for spiralling polio cases. It can, however, take credit for tackling resistance successfully. For, of the 56 confirmed polio cases — out of a total 82 detected in the country — 55 have been found to have taken at least four rounds of polio drops. And, 40 children, in fact, took seven rounds of polio drops. The health department has now sent the samples of these cases to National Institute of Virology, Pune, to check the efficacy of the vaccine.
Meanwhile, the Department claims that lack of immunity and sanitation could be reasons behind ineffectiveness of the vaccine in some cases. It has now prepared a proposal worth Rs 34 crore to launch ‘Child Survival Project’.
The proposal would be sent to the Centre to start the project under the National Rural Health Mission.
The bad news for the Health Department does not end here. While it might have been able to control P1 virus in Mooradabad division, it has failed to do so in Devipatan division that has seven P-1 cases out of the 15 P-1 cases reported in the state so far. The remaining 41 cases in the state are of P-3, with 17 of them being reported from Mooradabad division.
“It is a matter of satisfaction that Mooradabad division, which has been a reservoir of P-1 virus, has not reported a single P-1 case so far. It is a success for us. Even the fact that out of 56 polio cases, 55 did take vaccine shows there has been no lacunae in vaccination drives. Our coverage has been up to 95 per cent, and in the coming drive we plan to increase it further,” said Dr L B Prasad, Director General, Family Welfare.
Meanwhile, the officials who are to undertake the pulse polio drive starting from July 1 fear facing people in localities where children have contracted the virus despite taking several rounds of vaccine.
A P Dixit, State officer for Universal Immunisation Programme, however, said, “In the coming drive, there will be an increased stress on counselling. People would be informed about the importance of administering drop in each drive.”
Significantly, no P-1 virus has been reported in the five traditional high-risk districts of western Uttar Pradesh (Moradabad, JP Nagar, Bareilly, Rampur and Badaun).
Bahraich district in Deviatan division, however, has reported three P-1 cases whereas sporadic cases have been reported from Allahabad, Faizabad, Bareilly and Saharanpur.
CDC says whooping cough over-diagnosed
Published: Aug. 24, 2007 at 11:58 AM
ATLANTA, Aug. 24 (UPI) -- The U.S. Centers for Disease Control says outbreaks of respiratory illness were mistakenly attributed to whooping cough.
Two hospital outbreaks and one community outbreak of respiratory illness between 2004 and 2006 in New Hampshire, Massachusetts, and Tennessee were attributed initially to pertussis, or whooping cough. Subsequent investigations, however, suggested pertussis was not the cause of these outbreaks, the CDC said Friday.
Researchers said thorough epidemiologic and laboratory investigation of suspected pertussis outbreaks are necessary when considering extensive control measures. Diagnosis of pertussis is complicated by nonspecific signs and symptoms, particularly in the early stage of disease.
The CDC said reported cases of whooping cough have tripled in the United States since 2001. The increase is attributed to increased exposure to the virus, waning vaccine immunity among adults and adolescents, heightened awareness of pertussis among healthcare providers, increased public health reporting, and increased use of polymerase chain reaction (PCR) testing for diagnosis.
http://www.upi.com/NewsTrack/Science/2007/08/24/cdc_says_whooping_cough_overdiagnosed/2085/
Could this be an example of hypervaccinated people demonstrating inadaquate antibody response to vaccines? Or just a general reflection of how useless these shots can be? I don't understand why they're saying that, on the one hand, the vax was ineffective against a new strain yet, on the other, the vax proved effective in states which didn't have an outbreak. Call me stupid but, uh, how's that work?
http://news.yahoo.com/s/ap/20080409/ap_on_he_me/mumps_vaccine
By LINDA A. JOHNSON, Associated Press Writer
49 minutes ago
Most of the college students who got the mumps in a big outbreak in 2006 had received the recommended two vaccine shots, according to a study that raises questions about whether a new vaccine or another booster shot is needed. The outbreak was the biggest in the U.S. since shortly before states began requiring a second shot for youngsters in 1990.
Nearly 6,600 people became sick with the mumps, mostly in eight Midwest states, and the hardest-hit group was college students ages 18 to 24. Of those in that group who knew whether they had been vaccinated, 84 percent had had two mumps shots, according to the study by the Centers for Disease Control and Prevention and state health departments. That "two-dose vaccine failure" startled public health experts, who hadn't expected immunity to wane so soon — if at all.
The mumps virus involved was a relatively new strain in the U.S., not the one targeted by the vaccine, although there's evidence from outbreaks elsewhere the shots work well against the new strain. The researchers, reporting in Thursday's New England Journal of Medicine, note the virus likely came from travelers or students from the United Kingdom, where mumps shots are voluntary and there was a much larger mumps outbreak of the same strain. Many countries don't vaccinate against mumps, so future cases brought from overseas are likely.
"If there's another outbreak, we would evaluate the potential benefit of a third dose to control the outbreak," said researcher Dr. Jane Seward, deputy director of the CDC's viral diseases division. Mumps is spread by respiratory secretions and saliva among people in close contact, making college students particularly susceptible. Students' sharing of drinks and utensils, and sexual activity, probably increased their exposure. Mumps causes fever and swollen salivary glands in the cheeks. Before the vaccine, complications such as deafness, viral meningitis and testicle inflammation, which can cause sterility, were common and there were a couple million U.S. cases a year.
The only U.S. vaccine, made by Whitehouse Station, N.J.-based Merck & Co., hasn't been changed since its introduction in 1967 and there are no plans to change it, said Barbara Kuter, Merck's executive director of pediatric affairs. Over 500 million doses have been sold since the 1970s, when it was put in the combination measles-mumps-rubella shot. Dr. John Bradley, a member of the American Academy of Pediatrics committee on infectious diseases, said his group is talking about possible changes to the vaccine recommendations schedule with CDC and other health agencies. Now two shots are recommended, one at 12 to 15 months and the other at age 4 to 6. It might not be cost effective to give everyone a third shot, but it should be considered for college students, said Dr. Stephen Marcella, an epidemiologist at University of Medicine and Dentistry of New Jersey's School of Public Health.
Dr. William Schaffner, head of preventive medicine at Vanderbilt University School of Medicine, said what's need is a longer-lasting shot. "It's clear that over time, immunity wanes somewhat," he said. "We need a better vaccine." Seward said other CDC studies on the 2006 outbreak found two mumps shots protected about 85 percent of people from the new strain — not quite enough to prevent spread even with the nearly 90 percent vaccination rate at the time. The outbreak was in Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, South Dakota and Wisconsin.
http://newsmax.com/health/vaccine_pneumonia/2009/01/06/168223.html
Vaccine Doesn’t Protect Against Pneumonia
Tuesday, January 6, 2009 10:16 AM
Commonly used pneumococcal polysaccharide vaccines do not appear to be effective for preventing pneumonia, found a study by a team of researchers from Switzerland and the United Kingdom. In many industrialized countries, polysaccharide pneumococcal vaccines (PPVs) are currently recommended to help prevent pneumococcal disease in people aged 65 and over and for younger people with increased risk due to conditions like HIV. Studies have shown conflicting results regarding the efficacy of PPV. The study, a systematic review and meta-analysis, looked at 22 clinical trials, reviews and meta-analyses and more than 100,000 participants from countries in North America as well as India, Africa, Latin America and the Caribbean. Unlike other similar studies the authors examined the reasons why different clinical trials produced different results. They found that the quality of the studies substantially affected the results. When only high quality trials were included, there was no evidence that PPVs could prevent pneumonia. The study adds to the ongoing debate around effectiveness of the vaccine.
"Policy makers may therefore wish to reconsider their current recommendations for PPV, especially where routine pneumococcal conjugate immunization has been introduced," conclude Dr. Matthias Egger from the University of Bern, Switzerland and coauthors. However, in a related commentary http://www.cmaj.ca/press/pg18.pdf, Dr. Ross Andrews and coauthor from the Menzies School of Health Research, Darwin, Australia state that the researchers' conclusions exceed the evidence presented. They caution that there should be no change in vaccine policy in countries that recommend PPV to prevent invasive pneumococcal disease.
China orders probe after unsafe vaccine report http://www.google.com/hostednews/afp/article/ALeqM5it0tVezpvN6k03MYeQCWZ9_-Y9FQ (AFP) – 3 days ago
BEIJING — China has ordered an investigation after a report that unsafe vaccines led to the deaths of four children and sickened 74 others in the country's latest product-quality scare. The order by the Ministry of Health came after the China Economic Times on Wednesday reported unsafe vaccines for encephalitis, hepatitis B, rabies and other illnesses were being used in the northern province of Shanxi.
The report said the problem vaccines had been sold in the province since 2006. Neither the media report nor the ministry's order made it clear whether the vaccines themselves were dangerous or whether they had failed to protect children from illness. Xinhua news agency quoted a top official with the Shanxi Health Department as denying the allegations made in the report. In a statement posted on its website Wednesday announcing the investigation order, the health ministry said it had investigated earlier reports of bad vaccines in 2008, finding no problems. China's huge food and drug industries are notoriously scandal-prone, with regular reports of dangerous products on the market, leading to health problems and even deaths among consumers.
In 2008, China's dairy sector was rocked by the widespread contamination of milk supplies with the industrial chemical melamine, which was added to give the appearance of higher protein content. Six babies died and 300,000 others fell ill after being fed tainted baby formula, according to government figures.
Copyright © 2010 AFP. All rights reserved
MIKE STOBBE, THE ASSOCIATED PRESS
ATLANTA - A mumps outbreak among Orthodox Jews in New York and New Jersey has now surpassed 1,500 cases and shows no sign of ending soon.
The outbreak began last summer at a boys camp in the Catskills. Nearly all the cases are in the insular Orthodox Jewish community. Health officials said most had a mumps vaccination, but the shots are not completely effective.
The Centers for Disease Control and Prevention on Thursday said the count has now reached 1,521. Nineteen people have been hospitalized, but no deaths have been reported.
300 New Mumps Cases Reported, Spotlighting the Importance of the Vaccine
February 08, 2010 02:20 PM
by Colleen Brondou
The nation's largest outbreak of mumps in years has spread, calling into question whether those afflicted had the mumps vaccine.
Mumps Outbreak Spreads Again
On Saturday, the Associated Press reported that 300 people had been diagnosed with the mumps in New York's Rockland County. Almost all of those diagnosed are Orthodox Jews. This outbreak follows an earlier outbreak that started in August 2009.
This past October, Helen Kennedy wrote for the New York Daily News that city health officials in Brooklyn, N.Y., had uncovered “an outbreak of the old-fashioned childhood disease mumps.” Health officials said they had approximately 57 confirmed cases and that “75% of the victims had the normal two doses of mumps vaccine.” The outbreak was attributed to a child who had gone to Britain, “where the illness is more common because of lower levels of vaccination,” and then infected other children at a summer camp in upstate New York.
According to Kennedy, the recommended two doses of mumps vaccine are designed to protect people against mumps 90 percent of the time. So why are we seeing a resurgence of the illness? "We know that approximately one in every 20 people who are vaccinated may not develop antibodies," Dr. Jane Zucker, assistant commissioner of immunization, told the Daily News. "If the vaccine was not effective we would have many, many more cases. "
Background: What is a vaccine?
The National Institute of Allergy and Infectious Diseases (NIAID) explains that a vaccine contains disease-causing germs, or microbes, that have been weakened or killed so that they don’t cause actual disease. When these microbes are introduced to your immune system, your body quickly clears them and usually develops a degree of immunity to them. “In other words,” according to NIAID, “vaccines trick your immune system to teach your body important lessons about how to defeat its opponents.” After your immune system has learned how to fight a disease, you are immune to it. Vaccines provide artificially acquired immunity vs. the naturally acquired immunity that sometimes comes from getting a disease.
Polio vaccine blamed for outbreaks in Nigeria
Mutation of live virus in oral doses linked to 124 cases this year, experts say
http://www.msnbc.msn.com/id/32418446/ns/health-infectious_diseases
updated 1:24 p.m. ET, Fri., Aug 14, 2009
LONDON - Polio is spreading in Nigeria and health officials say in some cases it's caused by the vaccine used to fight the paralyzing disease.
In July, the World Health Organization issued a warning that this particular virus might extend beyond Africa. So far, 124 Nigerian children have been paralyzed this year — about twice those afflicted in 2008.
Nigeria and most other poor nations use an oral polio vaccine because it's cheaper, easier, and protects entire communities. But it's made from a live polio virus which carries a small risk of causing polio. In even rarer instances, the virus in the vaccine can mutate into a deadlier version that ignites new outbreaks.
Half of school children sick from "swine flu" shot
http://www.theflucase.com/index.php?option=com_content&view=article&id=1753%3Ahalf-of-school-children-sick-from-qswine-fluq-shot&catid=1%3Alatest-news&Itemid=64&lang=de
In a school in Sweden where the students was mass vaccinated with the poisonous Pandemrix "swine flu", half of them called in sick the day after the vaccination.
Out of 233 students, 130 reported sick the day after the shot and did not show up for school. The doctor administering the shot, Richard Eitrem, was shocked and called the headmaster of the school to find out what the status was of his patients. Many of the students went back to school the second day and this "calmed him down".
The seasonal flu is also making several students ill and according to Aftonbladet, that contributed to the high number of students calling in sick.
The article then states that only 20% to 30 % of the parents in several areas surrounding the capital Stockholm agreed to have their children vaccinated with the poisonous Pandemrix vaccine.
According to a school nurse, Ingrid Scotte, that is due to hesitations towards the vaccine based on "irrelevant" information concerning side effects.
Johan Niklasson
http://www.dailytelegraph.com.au/news/whooping-cough-strain-now-immune-to-vaccine/story-e6freuy9-1225828959714
Last Updated: February 14, 2010
Whooping cough strain now immune to vaccine
By Danny Rose
From: The Daily Telegraph
February 11, 2010 12:00 AM
THE bacteria that causes whooping cough has mutated, eroding the protection provided by the vaccine now given to children, scientists warned yesterday.
University of NSW researchers have identified significant changes in the two most common strains of the bordetella pertussis bacteria, which they also traced back to events in the late 1990s. Australian children were given a broad-acting "whole cell" vaccination against whooping cough up to 1997, but this was phased out over two years and replaced with a more targeted version. Concerns over potential side-effects were behind the change to a vaccine with a narrower scope, but this now appears to have contributed to the promotion of resistant strains.
"A key issue is that the whole cell vaccine contained hundreds of antigens, which gave broad protection against many strains of pertussis," UNSW School of Biotechnology and Biomolecular Sciences associate professor Ruiting Lan said.
"But the (targeted) acellular vaccine contains only three to five antigens. Our findings suggest that the use of the acellular vaccine may be one factor contributing to these genetic changes."
The research team analysed more than 200 samples of the bacterium collected over the past 40 years in Australia and compared them with samples from Japan, Canada, USA and Finland. They found while the vaccine now in use was effective against some of the strains circulating in Australia it may no longer protect against two strains, known as MT27 and MT70.
Dr Lan said more research was needed to confirm the results but health authorities may need to modify the vaccine to broaden the protection it offered. Whooping cough cases are on the rise in Australia, with several significant outbreaks seen last year in western Sydney. Protection against whooping cough is contained in childhood vaccinations which, in NSW, are usually given to infants. Parents who opt out of this child vaccination process were thought to have contributed to the rise in cases.
If one vaccine doesn't work...they just need another...and another....and another....until when?
"In an interview with Medscape Allergy and Clinical Immunology, Dr. Vaughn said that findings among pediatric patients in his practice led to this study.
"We found that among children with recurring infections, particularly ear and nose infections, a lot of them failed to respond appropriately to their pediatric vaccinations," said Dr. Vaughn. "Also, a lot of these children were not making natural antibodies to strep pneumonia, particularly. Since that organism is found many times in those diseases, we felt that this information was clinically relevant."
The study, therefore, was designed to "evaluate the immune response to PCV-7 and HiB vaccinations in a subgroup of children who were identified suffering from 'bacterial' upper respiratory tract infections more frequently than their peers." ...
When asked about the study's take-home message, Dr. Vaughn said: "In our practice, it's been very useful to check for whether or not a child has responded to pneumococcal vaccine and to find out if they're making any natural antibodies. If they're not, clinicians need to consider the possibility that additional vaccination is the right thing to do."
http://www.medscape.com/viewarticle/713265
http://www.telegraph.co.uk/health/healthnews/5982476/Four-year-old-dies-after-being-diagnosed-with-mumps.html
Daily Telegraph
06 Aug 2009
Four-year-old dies after being diagnosed with mumps
By Rebecca Smith, Medical Editor
Lisa Pollitt, a four-year-old girl from Wythenshawe who had had the MMR vaccine, has died after being diagnosed with mumps, it has emerged.
Lisa Pollitt, aged 4, from Baguely who died suspected of mumps
The youngster had appeared to be recovering but then suddenly took a turn for the worse and doctors at a hospital in Manchester failed in their battle to save her. The exact cause of death has not yet been established, but deaths following mumps are very rare.
If confirmed, Lisa would be the first death in a mumps patient for more than nine years and over 65,000 cases.
Parents shunned the MMR vaccine followed research that linked it to bowel disorders and autism and there was a resurgence in mumps, with an epidemic in 2005. Measles cases have also risen and doctors are urging parents to ensure their children have had the full two doses of the vaccine.
It is not clear if Lisa had been given two doses of the MMR vaccine and cases of mumps in people who have been fully vaccinated are rare.
Parents Patsy and Danny, from Baguley, told of their horror at the death of their 'bright, bubbly and beautiful' daughter.
They described how their GP informed them Lisa had mumps, but the cause of death has not yet been confirmed.
Lisa was rushed to Wythenshawe Hospital where medics managed to revive her, but she died hours later.
Patsy, 24, said: "She was so full of life, bright and bubbly and into everything. She was a real tomboy and loved playing with her brothers and ourdog.. We can't believe she has gone."
Post-mortem tests have not so far established the cause of death and toxicology tests are now being carried out. The results will not be available for several weeks.
Her paretns have been told by doctors that she could have died because of a rare complication of mumps or a separate virus while her system was weakened.
Lisa had been given the MMR vaccine which should protect against mumps but in rare cases people can still catch it.
Patsy said: "She was a healthy young girl and had suffered no serious illnesses. She woke up with a swollen face and the GP said it was mumps.
"She seemed to be OK, she was eating and even had started playing again.
"Then a week later she was a bit groggy and couldn't get to sleep so I stayed downstairs on the sofa with her.
"Suddenly her lips went blue, she was all pale and was still breathing but a few minutes later she stopped.
"It all happened so quickly. It was terrifying.
"In a way it was good that I had her sleeping with me because if not we would never have known what had happened - at least we knew we had got her medical care immediately. Everyone did everything they could to save her."
Lisa had two brothers, Cameron, five, and Anthony, three, and was due to start at Baguley Hall Primary in September. She was already a pupil at the school's nursery.
Lisa was diagnosed with mumps on July 20. It is incredibly rare to die from the disease, with estimates suggesting one in 10,000 cases.
Patsy said: "It seems so unfair when Lisa had had all her injections that she would get mumps, but the doctors says it happens sometimes and there is a lot of mumps around at the moment.
"We know there are lots of children who haven't been given the injection and I hope that if their parents hear what happened to Lisa they will realise how serious it can be and they will get their children protected and stop it from spreading."
By May this year doctors had recorded 95 cases of mumps across Greater Manchester, with 31 cases in Manchester, 17 in Tameside, 13 in Trafford and 10 in the Ashton, Wigan and Leigh area.
Mumps is a virus which normally affects glands in the mouth and neck, making them swell up and become painful.
It is passed on through saliva and the incubation period is between two and three weeks.
In 30 per cent of cases there are no symptoms and complications include swelling of the ovaries and testes and, although some believe it can cause sterility, there is no evidence of this.
WESH.com
Chicken Pox Outbreak Strikes School
POSTED: 5:06 pm EST February 13, 2008
UPDATED: 11:52 am EST February 14, 2008
KISSIMMEE, Fla. -- More than 20 students at Mill Creek Elementary School in Kissimmee have been diagnosed with the Varicella virus, more commonly known as chicken pox. The students affected have all had their mandatory chicken pox vaccine, but the CDC is now recommending two doses instead of one.As of Thursday morning, the chicken pox outbreak was contained to Mill Creek Elementary. A mass immunization program began at the school.
(So if one vaccine doesn't work you just need another one....good grief.)
http://www.ncbi.nlm.nih.gov/pubmed/19155953?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
1: Obstet Gynecol. 2009 Feb;113(2 Pt 2):550-2.
Links
Cervical cancers after human papillomavirus vaccination.
Beller U, Abu-Rustum NR.
Shaare Zedek Medical Center, Jerusalem, Israel. beller@szmc.org.il
BACKGROUND: Current randomized clinical trials have shown that the quadrivalent human papillomavirus (HPV) vaccine can reduce the morbidity of precancerous lesions associated with HPV infection of vaccine-related subtypes. However, to date, there is no definite evidence showing the vaccine reduces the incidence of invasive cervical carcinoma. CASES: We present two cases--one young, vaccinated woman who developed cervical carcinoma that was unrelated to HPV and another who developed cervical carcinoma secondary to infection with an HPV subtype not covered by the vaccine. Both patients were treated successfully and remained well without evidence of cancer. CONCLUSION: Long-term follow-up data are needed to evaluate the prophylactic effectiveness of the current HPV vaccine. These cases could represent non-vaccine-related HPV infections. Young women must be thoroughly counseled about the efficacy and limitations of the vaccine and about continuing lifelong
screening even after vaccination.
PMID: 19155953 [PubMed - indexed for MEDLINE]
Warning from flu jab inventor http://ukpress.google.com/article/ALeqM5ixXz-8-OKh8FR1suzAa5dcZoWJtA
The inventor of the flu jab has warned it would do little to prevent a flu epidemic in Britain this winter, adding to fears about the vaccine's ineffectiveness. Dr Graeme Laver, who helped create the jab more than 40 years ago, believes it should not be relied upon to protect from a potentially severe flu epidemic. The Australian scientist also claims that people's lives could be saved if drugs such as Tamiflu and Relenza were used instead, once the disease has already struck.
These are both currently prescription-only in the UK but Dr Laver argues they should be sold over the counter so that they were more readily available to flu sufferers. He told the Daily Mail: "I have never been very impressed with its (the jab's) efficacy. It is better than nothing and I wouldn't want to advise people not to take it, but you can't rely on it doing any good. "If the seasonal flu is as bad as it was in Australia, you are in for a pretty bad time. You could have a really severe epidemic." An extra-bad flu season in Australia this year, which has seen the number of flu victims triple compared with last year, could herald problems for the UK as well, Dr Laver claims. His comments are set to fuel the debate about the efficacy of the flu jab, which has already come in for criticism. Last month a study by the Health Protection Agency (HPA) found the vaccine had no "protective effect" on lowering numbers of elderly people admitted to hospital with respiratory infections.
Researchers concluded that ministers should not rely solely on the flu vaccines to have a large effect on the pressure put on hospitals in winter from infections, including flu.
Despite vaccine, meningitis takes teen's life Strain of bacterial disease kills immunized Bentley freshman By Tania deLuzuriaga, Globe Staff | October 10, 2007
When Bentley College freshman Erin M. Ortiz went home sick last weekend, her mother did what any mother might do. She cooked comfort foods - corned beef, rice, and plantains - reflecting her daughter's Puerto Rican and Irish heritage.
"It was her favorite meal," said Brenda Rivera, a family friend.
But just hours after complaining of a headache and going to bed to sleep it off, Ortiz, 18, was dead of bacterial meningitis, a disease against which she had been vaccinated. Now, Ortiz's family hopes others will learn from their story.
"I'm all cried out," said her father, Raymond Ortiz. "I've got a hole in my heart. I don't think I'll ever be the same."
"We thought she'd be covered," he said. "They don't tell you that even if you get the vaccine, you're still susceptible."
Like most incoming freshmen, Ortiz was vaccinated last summer. Massachusetts law requires all college students to receive the vaccine. But it protects only about 85 percent of recipients and is not effective against all strains of the bacteria that cause infection in the brain and spinal fluid, which can result in brain damage, hearing loss, learning disability, or death.
"I wish we had a vaccine that worked 100 percent of the time," said Dr. Richard A. Moriarty, a professor of clinical pediatrics at the University of Massachusetts Medical School. "But this is certainly better than not being immunized."
Doctors aren't sure yet what strain of meningitis Ortiz contracted or if she was one of the rare people the vaccine does not protect.
Ortiz first complained of feeling sick on Friday when she arrived home in New Hampton, N.Y., to see her family for the long weekend. She went to bed early and slept until the next afternoon.
On Saturday, her mother, Cathy, cooked her favorite dinner. That night, she woke with a terrible headache and her parents decided to take her to the hospital.
"She got dressed and walked down to the car," Raymond Ortiz said. "She walked into the emergency room."
Not long after, though, Ortiz's condition went downhill and she developed a fever of nearly 105 degrees. A spinal tap revealed meningitis, something the family had thought was not possible.
"When they told us, we were like, 'How can this be?' " Raymond Ortiz said.
Though she initially appeared to respond to antibiotics, by 7 p.m. Sunday, Ortiz had taken a final turn for the worse, the pressure on her brain causing irreversible damage.
"There's a spiritual connection you have," Raymond Ortiz said. "We looked at her and we knew she wasn't there."
Doctors kept her alive until Monday morning to harvest her organs.
In response to the case, Bentley College officials have been in touch with more than 50 students who had contact with Ortiz. About 30 of them have been given preventive antibiotics, said Gerri Taylor, the director of health services at the college.
"We are working day and night to identify students who may have had contact with her," she said. "It's a health service's worst nightmare. It's a college's worst nightmare."
Bacterial meningitis is less common and more lethal than viral meningitis. The bacteria, which can live undetected in the nose or throat, are more common on college campuses, where students living in close quarters can easily spread the bacteria by sharing drinks, cigarettes, or lip gloss. Massachusetts recorded 21 cases of bacterial meningitis last year.
"It's a nasty little bug," Raymond Ortiz said. "It can take away your shining star in 36 hours, just like it did mine."
Tania deLuzuriaga can be reached at deluzuriaga@globe.com.
Possible measles outbreak hits Ann Arbor school http://www.detnews.com/apps/pbcs.dll/article?AID=/20071004/UPDATE/710040458/1409/METRO
Santiago Esparza / The Detroit News ANN ARBOR -- State health officials are looking into a possible outbreak of measles at Burns Park elementary School.
Officials have confirmed that a third-grade girl had the disease and a classmate likely has it. A fifth grader at the school also is being checked to see if she has the disease, thought to be all-but-eradicated, said Ann Arbor public schools spokeswoman Liz Margolis.
"If you even have one it definitely becomes a serious situation," Margolis said of the girls.
All three of the girls were immunized against the disease. But the girl who was confirmed as having the disease likely caught it on an overseas trip, state health officials said.
She already has recovered and was able to come back to school. Students who are not current with their vaccinations are not allowed back to school until they are caught up or 21 days has elapsed, Margolis said. About 10 students who need to do this, she said.
The district today is sending home, with all students, health information about measles and the need to be immunized, Margolis said.
In each of the past two years there only was one confirmed case of measles in the state, according to the Michigan Department of Community Health. In 2004 there were no cases.
Measles today, thanks to vaccinations, is a rare disease," said TJ Bucholz, department spokesman. "It is something we take very seriously."
The students last month began exhibiting cold-like symptoms, Margolis said. It was not until they developed rashes that doctors discovered they were suffering from measles, Margolis said.
State officials believe the school is an isolated site and are not planning to quarantine it. Margolis said the three girls are the only ones with any signs of the disease.
About 100 people annually get the disease in the United States, Margolis said.
You can reach Santiago Esparza at (313) 222-2127 or sesparza@detnews.com.
MSNBC.com
--------------------------------------------------------------------------------
Flu vaccines may not save lives of elderly
No solid proof that shots prevent seniors from dying of disease, expert says
Reuters
Updated: 8:19 p.m. ET Sept 24, 2007
WASHINGTON - Getting an annual flu vaccine may not save the lives of seniors, and health officials may want to look at other ways to protect the elderly, researchers said on Monday.
No studies have conclusively proven that influenza shots prevent flu-related deaths in people over the age of 65, and some of the arguments that have been used to support this idea are based on faulty data, the researchers argue in the Lancet medical journal.
"We need to find a way to better estimate what the true benefits are," said Dr. Lone Simonsen of George Washington University.
Simonsen stressed that the elderly should continue to get flu shots. But she said health officials should also be looking for other ways to prevent some of the 36,000 deaths that come each year from flu in the United States alone.
"We can probably do more to protect the seniors," Simonsen said in a telephone interview.
Every year, the U.S. Centers for Disease Control and Prevention launches a new flu vaccination campaign, citing the research that shows the deaths and the 200,000 hospitalizations every year from flu-related illness.
People over the age of 65 make up the majority of these cases, although some children also die every year from flu.
Less benefit
But Simonsen said that no one has actually ever shown that vaccination cuts deaths from flu among the elderly. She said there is plenty of evidence to show that, because older people have lower immune activity, they in fact get less benefit than younger people from vaccination.
"There is no question about the vaccine working in people under the age of 65," she said.
Simonsen said it may be possible to design vaccines that better protect the elderly — something the CDC is working on.
She said the CDC should also consider recommending more aggressive use of antiviral drugs that can treat and sometimes even prevent flu.
CDC flu expert Dr. Joe Bresee said his agency was considering these and other measures — including better vaccination of health care workers and recommending the widespread vaccination of schoolchildren.
"We know that school children are a big part of community transmission. They shed lots of virus. They shed it for long periods of time," Bresee said in a telephone interview.
Bresee and Simonsen said elderly people may get other benefits from the flu vaccine. Influenza shots do not always completely prevent infection, but they can make the illness less serious.
Simonsen noted that a vaccine now commonly used against several types of streptococcal bacteria, which cause pneumonia, meningitis and ear infections, did not show big effects across populations until it became a regular childhood vaccine.
Experts now agree that the vaccine not only protects children, but it protects the elderly people that the children may have been infecting before.
(c) Reuters 2007. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
URL: http://www.msnbc.msn.com/id/20962720/
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Human trials of anti-AIDS vaccine stopped
25 Sep 2007, 0120 hrs IST,Kounteya Sinha,TNN
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NEW DELHI: The world's most promising anti-AIDS vaccine candidate has failed. Instead of protecting volunteers from the deadly virus, the vaccine actually ended up infecting numerous participants during its large scale clinical trial on humans.
The vaccine also failed to reduce the amount of HIV in the blood of those who got infected, which was a second major goal of the study. US pharmaceutical giant Merck has now halted the V520 vaccine trial called STEP. The announcement came as a major blow to international hopes of developing a HIV vaccine that could stall the spread of this deadly disease.
Earlier experiments of the vaccine on animals and smaller tests on humans had showed promising results. This led Merck to start large scale human trials in US, Australia, Latin America and the Caribbean in 2004.
Over 3,000 high risk uninfected volunteers, aged between 18 and 45 years were recruited and three doses of the vaccine were injected over six months. The final result of the vaccine's efficacy was expected by the end of 2008. But initial analysis of 1,500 volunteers by the independent Data Safety Monitoring Board, monitoring the trial, concluded that the vaccine was failing hopelessly.
Of the 741 people who received at least one dose of the vaccine, 24 cases of infection were reported in 13 months. That compared with 21 infections out of 762 people who received injections of a dummy vaccine. The search to find an anti-AIDS vaccine has involved over 20 clinical trials with tests for over 30 vaccine candidates still under way.
Since HIV was first identified in 1981, 40 million people have been infected with the virus. Annually, an estimated 4 million new infections occur, of which 90% are in developing countries. Over the last 25 years, AIDS has claimed more than 25 million lives.
Merck Research Lab's president Peter Kim said: "We share in the disappointment of the research and HIV communities today."
kounteya.sinha@timesgroup.com
Effects of chickenpox vaccine fade over time Thu Mar 15, 2007 2:02PM GMT By Gene Emery
BOSTON (Reuters) - Merck's chickenpox vaccine Varivax not only loses its effectiveness after a while, but it has also changed the profile of the disease in the population, U.S. researchers reported on Wednesday.
The study confirmed what doctors widely knew -- that the vaccine's protection does not last long.
And with fewer natural cases of the disease going around, unvaccinated children or children in whom the first dose of the vaccine fails to work have been catching the highly contagious disease later in life, when the risk of severe complications is greater, they said.
"If you're unvaccinated and you get it later in life, there's a 20-times greater risk of dying compared to a child, and a 10 to 15 times greater chance of getting hospitalized," said Jane Seward of the Centers for Disease Control and Prevention in Atlanta, who worked on the study.
The findings, reported fully for the first time in Thursday's New England Journal of Medicine, have already had an impact.
They helped prompt the CDC's Advisory Committee on Immunization Practices to recommend a booster shot between the ages of 4 and 6. The panel also said in its June 2006 report that children, adolescents and adults should be given boosters as well.
No one knows how long the effects of a second shot will last, said the research team, led by Sandra Chaves of the CDC.
http://uk.reuters.com/articlePrint?articleId=UKN1429730720070315
http://www.poughkeepsiejournal.com/apps/pbcs.dll/article?AID=/20070209/NEWS01/70209065
Friday, February 9, 2007
Chicken pox strikes Highland Elementary, 33 students ill
HIGHLAND — A chicken pox outbreak of three dozen cases has been reported at Highland Elementary School, according to the Ulster County Department of Health. Since Feb. 6, 33 students out of about 900 in the elementary school have been diagnosed with the aricella, or chickenpox, virus, said John McCarthy, district superintendent. "It's all in the elementary school right now," he said. "It seems to be contained there." According to public health director Dean Palen, an outbreak occurs when five or more cases are reported at once. The goal now, he said, is to prevent the disease's spread. "We're trying to contain it to make sure other students at the other schools don't get it," Palen said. Of the 33 students, all but two had been vaccinated for the virus.
According to a letter sent to district parents Thursday from the Department of Health, children who have already received one dose of chicken pox vaccine should receive a second dose if an appropriate amount of time has elapsed between shots. While not usually a serious illness, complications can cause pneumonia and in rare occasions can be life threatening, Palen said. Chickenpox is an infectious disease caused by a virus, which results in a blister-like rash, itching, tiredness and fever, according to the Center for Disease Control.
The county will offer a special chickenpox vaccine clinic for children 3-7 p.m. at the Health Department office, 570 Route 299, Highland. Appointments are required and the child's vaccine record must be brought to the appointment.
*If one doesn't work you just need another one...and another one....ect....
http://www.stuff.co.nz/stuff/0,2106,3753266a11,00.html
Vaccinated youngsters still vulnerable to killer disease
04 August 2006
By KIM RUSCOE
Twenty fully vaccinated under-20-year-olds have contracted the epidemic strain of meningitis since immunisation began.
The Health Ministry says though five sufferers needed intensive care, none had died.
It was possible the vaccine had lessened the severity of their symptoms and saved their lives, meningococcal programme director Jane O'Hallahan said.
New figures show that this year five people have died from meningococcal disease – all in the past five weeks – compared with 14 for the whole of last year. The deaths follow the completion of the ministry's $222 million mass vaccination of under-20-year-olds against meningococcal B.
Meningococcal B reached epidemic proportions in 1991 and peaked in 2001, when 650 cases and 26 deaths were recorded. Dr O'Hallahan said the epidemic strain was still circulating and "looking for vulnerable children". "With herd immunisation, if you vaccinate enough of the population you give protection to those who are unvaccinated," she said.
"But that doesn't appear to be happening with meningococcal B." Of the 90 cases of meningococcal disease so far this year, 38 had been confirmed as the epidemic meningococcal B strain. A further 26 were awaiting identification and the rest were attributed to other meningococcal strains. Of the five who died last month, one had the less common meningococcal C. It was not yet known which strain caused the other four deaths.
Even the fully vaccinated were not invulnerable, Dr O'Hallahan said.
"No vaccine is 100 per cent effective."
http://www.stuff.co.nz/stuff/0,2106,3537307a10,00.html
Ten vaccinated kids get disease
12 January 2006
By KELLY ANDREW and NZPA
Ten fully vaccinated children and teenagers have been infected with deadly meningococcal B disease since the immunisation programme began 18 months ago.
These "breakthrough" cases have been assessed by the Health Ministry, which is considering whether a fourth booster vaccination is needed for babies aged under six months.
Currently, three injections are given to children aged between six weeks and 20.
Of the 10 patients infected, one was a baby who began vaccinations before six months of age.
But national meningococcal vaccine strategy director Jane O'Hallahan said the decision about a fourth dose was not prompted by this case or the other meningococcal B vaccine breakthroughs. "It relates to the fact that infants frequently require four doses to get protection in relation to many different diseases," she said.
The vaccine manufacturer applied for a licence to give four doses to infants about six months ago, and Medsafe is expected to announce its decision in the next few days.
If approval is given for a fourth dose, about 50,000 babies could be affected before the vaccination programme ends in June.
Of the nine other fully vaccinated children who have contracted the disease since the programme began in July 2004, seven were over five years old and two were aged under five. Two were admitted to intensive care, and the others required treatment in hospital. All made a full recovery.
Dr O'Hallahan said the booster dose was being considered for infants under six months because their antibody response to immunisations was lower than older children, making them more vulnerable to the disease.
The ministry had no plans to introduce a fourth dose for other age groups because "there was no suggestion that it was warranted".
Ten breakthrough cases in 18 months was "relatively small" and within expected levels, Dr O'Hallahan said. No vaccine was 100 per cent effective.
She believed the programme was working.
Early results for Counties-Manukau, where vaccinations began, showed a drop in meningococcal B cases, and a national picture would emerge in the next six months.
It was possible that even though the vaccinated children had become infected, the vaccine had provided them with some protection by reducing the severity of the illness.
Since the vaccination programme began, more than 2.8 million doses have been administered. More than 1 million people have had at least one dose and more than 890,000 people have had all three doses.
There were 222 cases of meningococcal disease in the year to November last year, with 14 deaths. The average number of cases a year for the past five years was 490.
http://www.mg.co.za/Content/l3.asp?ao=16474
Mail & Guardian
Race is on to save first Aids vaccine. But does it work? 01 July 2003 07:32
What was billed as the first Aids vaccine, with potential to end a global disaster that is killing millions every year, has ended with an ignominious whimper, as a Californian biotech company arranges to pull out of Thailand before the final analysis of its clinical trials involving 2 500 Thai volunteers. Two US government health agencies and the Gates Foundation are in urgent talks about stepping into the breach.
The decision of VaxGen to cut its losses could mean the loss of invaluable data to scientists working in one of the most important research areas of our time. There are lessons to be learned even from the failures of a clinical trial, said a leading US scientist yesterday. More importantly, she said, if the western world pulled out of a trial in this abrupt way, allowing all the efforts of the Thai participants and staff to go for naught, it could wreck the chances of future clinical trials in developing countries. "Imagine going to a developing country again and asking them to roll up their sleeves for an efficacy trial if we didn't finish this one," said Peggy Johnstone, director of the vaccine and prevention research programme of the National Institute of Allergies and Infectious Diseases (NIAID), one of the government-funded bodies considering paying the bill. "We have to consider their side of it as well. The rest of the world is looking at what happens. They are going to want guarantees." VaxGen is acting entirely on commercial grounds. "What has happened is that their board of directors has said they are not interested in completing the trials," said Dr Johnstone. "The staff, having put blood, sweat and tears into the trial, are very interested in completing it. We are in discussions now to decide what it will need to complete the trial.
From a scientific perspective, it would be a tremendous loss not to complete the trial and analyse the data." VaxGen insisted it was not pulling out, but simply did not have the money to analyse all the data from the Thai trials. "The financial markets sent a loud and clear signal to us through the decline in our stock value and through conversations with members of the financial community. Their unambiguous response was, please do not spend more money than is necessary on your trials," said Lance Ignon, vice president of corporate communications.
He said the company would announce whether the vaccine had worked this winter. The vaccine, called AidsVax, was way ahead of the rest of the field in terms of its progress through the clinical trials designed to prove whether any drug is safe and whether it works. A phase three trial -- the last in the process -- was carried out in the US and another in Thailand. Few expected AidsVax to be the wonder drug everybody prays for, but even if it worked in some volunteers, it would have been of use. But on February 24 this year -- at midnight -- VaxGen released the results of the US trial. AidsVax was a failure. But, to the fury of some scientists, who accused the company of manipulation of the data, VaxGen sent a hare running, claiming that the vaccine had worked in a small minority of those who were given it, from the black and Asian communities. The most marked effect, said the company, was a 78% reduction in infection among black volunteers. However, there were only 314 of them out of a total of 5 009. One advantage of the big US health agencies, NIAID and the Centres for Disease Control (CDC), getting involved in finalising the data from Thailand might be, said Dr Johnstone, "that we maybe avoid some of the hoop-la that happened around the American trials." Ignon, from VaxGen, said it was now for NIAID and CDC to work out how significant the ethnic minority findings from the US trial were. The roller-coaster ride that VaxGen has offered the Aids research community may be inevitable from a private company that has to look to the markets to fund a risky business.
Don Francis, who formed VaxGen specifically to investigate an Aids vaccine, has his admirers for his determination to get involved. "It is overall disappointing that there aren't more private sector resources going into Aids vaccines, but it is understandable," said Johnstone. "Ninety per cent of the need is going to be in countries that can't pay for it." Hype claim Aids activists, however, point out that many scientists have argued for years that VaxGen's approach was not likely to work. "Based on the poor results from their trial here in the United States, I think they made a rational decision" to pull out of Thailand, said Gregg Gonsalves, director of treatment and prevention advocacy of Gay Men's Health Crisis in New York. "They've been hyping this vaccine for many years based on dubious data, but at some point, all the hype in the world can't salvage a product that doesn't work." NIAID several years ago declined to give VaxGen funding for its vaccine research, he pointed out. Richard Jefferys of the Treatment Action Group said that the decision on Thailand "speaks volumes about their confidence in the product to work", in spite of all the spin about ethnic groups in the US trial. "The positive thing about it is that they have shown that you can do a phase three efficacy trial [for an Aids vaccine]. It may be that there are unfortunately lessons about how careful people need to be in listening to the results of those trials." -
Mumps suspected in local child
Jul 31 2003 12:00AM By Staff Writer
Despite being properly immunized, a St. Francis child is believed to have had the first case of mumps in the city in at least a decade and a half, St. Francis Health Department officials said.
Public Health Administrator Kathy Scott said she could not disclose the gender or age of the child involved, saying only that it was a school-age child. The Health Department was notified of the possible case July 9. The parents took the child to a physician, and because of the symptoms, blood samples were drawn to test for mumps, said Jeff Berg, immunization adviser for the Wisconsin Immunization program, run by the Department of Health and Family Services, located in Madison. An antibody associated with mumps was found in the blood samples, he said. More tests are under way to determine if the child had mumps or another virus that mimics mumps, Berg said. Mumps is a viral infection and is communicable, meaning it can be passed on to other people, Berg said. Both children and adults can get it. Like the flu, there is no treatment, and the disease basically has to run its course, Berg said. The illness was common before 1967, when the mumps vaccine was licensed. Before 1967 there were about 200,000 cases of mumps nationwide each year, according to the Mayo Clinic's Web site. In 2002, there were 74 cases in the country, with one being in Wisconsin, Berg said. Scott has not had a case of mumps reported in her 16 years with the St. Francis Health Department until now. Most people who get the mumps make a full recovery. To try to minimize the public health impact, Health Department officials have notified anyone that may have been in contact with the child and told them the symptoms to watch out for, Scott said. "The parents took the child in to a doctor because the child woke up with a small lump behind the ear and was feeling really tired," Scott said. Besides having tender salivary glands along the neck, there may be swelling in the cheeks, she said. The ill person may also have a low-grade fever and headache. The incubation period for mumps is 14 to 25 days, Berg said. People with the disease are sick about two to three weeks after exposure. The mumps is most contagious in the three days before and four days after the symptoms occur, Berg said. How long a person stays sick after the symptoms appear depends on the severity of the symptoms, Scott said. The child suspected of having had the mumps had received vaccinations for measles/mumps/rubella from the Health Department at two different times in the past, Scott said. The vaccine is one distributed by the state's immunization program to all health care providers. "Vaccines are not 100 percent effective," Scott said. "It's more like 96 or 97 percent." Berg said this case is a reminder to parents with children that are about to enter school for the first time to make sure they are up-to-date on their vaccinations. The first measles/mumps/rubella vaccine should be given after a child's first birthday and a second dose should be administered before a child enters elementary school. Berg said Scott followed the correct procedure in advising parents and others about the possible mumps exposure. "You have to start from the time when the symptoms first show up, and then go backward from there to see if you can find a source," Berg said. "You have to see where the child was and what they were doing. You need to see if they were exposed to anyone with similar symptoms." Berg said the child had not gone out of the St. Francis area. No source for the child's infection has been identified. If a child that was exposed does develop symptoms that appear to be mumps, parents are advised to keep the child isolated, contact their physician and report the possibility to the Health Department and work with them. The key is to get the child checked without exposing a large number of people to the possible illness, Berg said.
ttp://www.medscape.com/viewarticle/459695_4
Pediatrics, August 2003 Journal Scan
From The Pediatric Infectious Disease Journal
July 2003 (Volume 22, Number 7)
Increase in Deaths From Pertussis Among Young Infants in the United States in
the 1990sVitek CR, Pascual FB, Baughman AL, Murphy TV
The Pediatric Infectious Disease Journal. 2003;22(7):628-634
They also noted that the current vaccination strategy does not protect the patients at highest risk for death, young infants.
Reviewer comment: I included this article in part as a reminder for all of us to aggressively screen infants for needed immunizations and administer deficient immunizations as soon as identified. The investigator's comment about finding new strategies to protect the very young demonstrates the best new information this article provides. Additionally, they suggest protecting adults around infants as a possible method of protection. I also recently heard a speaker discuss the possibility of "boosting" women of child-bearing age or even pregnant women as another potential strategy. Whatever the ultimate strategy, it almost certainly will involve efforts to reduce pertussis among the older child and adult populations, presumably the reservoirs from which these younger children are exposed.
“Last year we saw three cases among vaccinated children in the south west London area."
Sort of proves the point, doesn't it...?
Sue
http://www.thisislocallondon.co.uk/matters/currentaffairshealth/display.var.
410495.0.children_targeted_for_meningitis_booster_jabs.php
Children targeted for meningitis booster jabs
Young children across Wandsworth are to be encouraged to have a meningitis immunisation jab in a new drive by South West London Health Protection Unit. Children aged between six months and four years are being offered the Hib booster vaccine in their GP practices after recent figures show that the number of cases of meningitis has begun to rise.
The haemophilus influenza, or Hib, vaccine was first introduced in 1992, and doctors believe it is a vital tool in maintaining low instances of the disease recurring. Clinical director of South West London Health Protection Dr Barry Walsh said: “Hib meningitis is a serious condition. “Last year we saw three cases among vaccinated children in the south west London area.
“In order to prevent further cases we are urging parents to have their children boosted with the fourth dose of vaccine, which is safe and effective.” Parents of children within the age range are urged to contact their GP if they haven’t already been contacted to arrange an appointment. To find out more about the Hib vaccine contact the NHS Direct helpline on 0845 46 47.
http://www.reutershealth.com/archive/2003/08/08/professional/links/20030808c
lin010.html
Meningococcal C vaccine may cause relapse of nephrotic syndrome in children
Last Updated: 2003-08-08 12:33:14 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Administration of meningococcal C conjugate vaccine (MCCV) appears to increase the risk of nephrotic syndrome relapse in children, according to a research letter in the August 9th issue of The Lancet. "The risk of relapse after vaccination might be greater for this group of patients than the risk of meningococcal C infection," Dr. Richard S. Trompeter and colleagues write, "so the decision to vaccinate should be carefully considered."
Immunogenic stimuli have been associated with the syndrome, but the effect of vaccination has not been investigated, the British researchers note. Their suspicions were raised when nine children with nephrotic syndrome relapsed after receiving MCCV.
Dr. Trompeter, of Great Ormond Street Children's Hospital NHS Trust in London, and colleagues investigated the relapse rate during the year before and the year after vaccination of children with steroid-sensitive nephrotic syndrome.
Included were 106 patients who received the vaccine, among whom there were 63 relapses in the year before and 96 in the year postvaccination, a relative incidence of 1.52 (p = 0.009). The risk was markedly raised only in the first 6 months after inoculation (relative incidence = 1.84). "From 106 doses of vaccine, there was a risk of one relapse in every four doses given to this population," Dr. Trompeter and colleagues write. They suggest that conjugate vaccines stimulate T cells, "so disturbance of the cytokines by MCCV might have resulted in the cluster of relapses we recorded."
Lancet 2003;361:449-450.
Lancet 2003;
http://www.washingtonpost.com/ac2/wp-dyn/A51637-2003Sep9?language=printer
washingtonpost.com
Marines' Malaria Cases Show Protections Failed
By David Brown
Washington Post Staff Writer
Wednesday, September 10, 2003; Page A01
Despite extensive preventive measures, most of the more than 200 Marines who spent time ashore in Liberia last month apparently contracted malaria, with about 43 of them ill enough to be hospitalized. The malaria outbreak amounts to a stunning failure of standard protections against a disease that the American military is unusually keen to prevent in troops deployed to the tropics. So many Marines became sick in such a short period of time that Navy physicians for a while doubted the illnesses could all be due to the mosquito-borne infection.
Although the malaria diagnosis has been confirmed in only 15 percent of the troops, they and their officers report that nearly all who spent the two weeks ashore reported at least mild symptoms typical of malaria. Navy physicians and epidemiologists investigating the outbreak believe most of
the onshore troops may have been infected.
"We are extremely, extremely concerned about this," said Capt. Gregory J.Martin, a physician at National Naval Medical Center in Bethesda, where all but two patients are being treated. The concern is shared not only by the military's infectious diseases and preventive medicine specialists but by combat commanders, he said.
The outbreak occurred even though the troops were taking a drug to prevent the disease, were instructed to use insect repellents and were wearing uniforms treated with long-acting insecticides. How the Marines became infected despite these measures is uncertain, although failure of the drug to reach adequate concentrations in the troops' bloodstreams is a leading hypothesis.
The patients, members of the 26th Marine Expeditionary Unit except for several Navy medical corpsmen, were taking mefloquine (sold as Lariam), a standard drug used to prevent and treat malaria. West Africa is not known to be an area with high rates of mefloquine-resistant disease, although occasional cases have been reported there. U.S. troops in West Africa have since switched to an alternative medication, doxycycline.
This is the most intensive outbreak of malaria in the U.S. armed services in recent memory and the largest number of cases among Marines since the deployment to Somalia a decade ago. All of the cases were caused by Plasmodium falciparum, one of three types of malaria parasite and by far the most dangerous. The number of malaria cases in the armed services in recent years was not available yesterday. The Army, which has the most, reported 57 cases last year, 52 in 2001 and 55 in 2000.
Thirty-one patients arrived at the Bethesda hospital Sunday and 10 yesterday morning. Two others are being treated at the Army hospital in Landstuhl, Germany. No one has died in the outbreak, but two patients in the Bethesda intensive care unit have cerebral malaria, the most feared form of the disease, with a fatality rate of about 20 percent. They are conscious, improving and expected to recover fully, said Lt. Cmdr. David L. Blazes, an infectious-diseases physician treating them.
Members of the Marine unit, normally stationed at Camp Lejeune, N.C., went ashore Aug. 12-14 and returned to their two ships 10 to 12 days later. Soon afterward, many reported common symptoms of malaria, including headache, pain behind the eyes and muscle aches accompanied by cyclical fevers.
Malaria is normally diagnosed by using a microscope to look for malaria parasites inside red blood cells. Many of the Marines were diagnosed aboard ship that way. In some of the 43 people -- 40 Marines and three sailors --no parasites were seen, probably because the infection was partially treated by the mefloquine, but "virtually everyone had classical symptoms" of the disease, Blazes said.
About 30 patients who arrived at Bethesda on Sunday were put in a separate unit because physicians feared some might have some other disease; malaria rarely shows up in sudden, severe outbreaks. The possibilities included Lassa fever, which is caused by a virus; leptospirosis, caused by a bacterium; or infections arising from bacteria-like microbes called rickettsia.
"It was hard to believe that you could have almost all of a group that large develop symptoms over a four- to five-day period and have it be malaria," Martin said. Blood samples were sent to the Army's infectious diseases laboratory at Fort Detrick in Frederick, and within 12 hours those infections were ruled out.
Nearly all the Marines said they had taken their once-a-week mefloquine pills; a few said they had missed a dose or two. Many had been taking it since June. Normally, a case of malaria is considered severe if more than 3 percent of red blood cells are infected with the parasite. Several of the Marines, including one who reported never missing a dose of mefloquine, had more than 10 percent of their cells infected.
Peter B. Bloland, a malaria epidemiologist at the Centers for Disease Control and Prevention, said there are only a few possible explanations for the outbreak. "The possibilities include inadequate absorption [of the drug into the bloodstream], people not taking it correctly, poor drug quality or actual resistance" to the drug in the microbes, he said. The experience of Peace Corps volunteers in West Africa, who live in areas of intense malaria transmission for long periods of time, suggests that mefloquine-resistant infections are rare there, he added.
"Based on what we know about failures of prophylaxis in Africa, I think the most common explanation is inadequate blood levels [of the preventive drug] for some reason," he said. About 120 samples of blood taken from the Marines shortly before they became ill will be sent to CDC to measure mefloquine levels.
© 2003 The Washington Post Company
This article below indicates some top anthrax researchers found they need to revise their ideas on how anthrax works. Wonder if this has any implications for how the vaccine supposedly works? I remember from other material (GAO reports) that there was already a lack of certainty on how the shot provides "protection." And there are certainly arguments that the titer count does not equate to protection. Maybe if the researchers are going back to square one, so should the vaccine. This article would seem to lend credence to efforts being pursued to develop a new shot.
http://www.advanceformlp.com/common/editorial/PrintFriendly.aspx?CC=21648
Issue Date: 9/8/2003
Mouse Study Gives New View of Anthrax Toxin
A large-scale study of anthrax in mice has yielded new information about immune system response to anthrax bacteria, according to scientists at the National Institute of Allergy and Infectious Diseases (NIAID). The discovery that toxins released by the bacteria do not behave as previously believed should redirect approaches to anthrax drug design, notes NIAID Senior Investigator Stephen Leppla, PhD, whose research is published in today's issue of the Journal of Clinical Investigation.
In the new study, Dr. Leppla and his colleagues injected hundreds of inbred mice with anthrax lethal toxin (LT), and then took precisely timed measurements to determine how various organs and immune system processes responded. For example, they measured levels of chemicals called cytokines, which are released by immune system cells after a bacterial invasion. Dr. Leppla and his colleagues found no evidence of a persistent increase in cytokines, or of a link between cytokine increase and anthrax LT effects, contradicting earlier beliefs. The evidence suggests that current efforts to design cytokine-suppressing drugs to treat lethal toxin-mediated events in late stages of anthrax may be misguided.
"Finding effective therapies for diseases such as inhalational anthrax depends on our ability to connect basic research with clinicians' needs. This research is a perfect example of such translational research," said NIAID Director Anthony S. Fauci, MD.
In a natural infection, inhalational anthrax begins after anthrax bacteria spores enter the body, germinate and release toxins. Scientists can create artificial infection by injecting animals with anthrax LT. The accumulation of toxins precipitates events that lead to death. For more than a decade, scientists based their understanding of LT actions on the results of a few studies that employed a limited number of mice. Because of the high cost of doing anthrax toxin research and the small number of anthrax researchers, theories about LT action went largely unquestioned.
"We still do not know how LT brings about the hypoxia and shock-like death we see in mice," said the paper's first author, Mahtab Moayeri, PhD. The next important step, she adds, will be to identify the cell targets of LT and determine precisely how it initiates the chain of events leading to death.
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KERRY'S FIGHT FOR LIFE AFTER TB JAB AT SCHOOL
Date: 9/28/2003; Publication: Sunday Mirror; Author: HELEN MORGAN
No URL:
A TEENAGER has spent five months in hospital and still has to be fed through a tube after a routine TB jab given to her at school. Kerry Watson, 15, had the BCG vaccine, which protects against tuberculosis, while she was suffering from a bug. Just days after the injection, which was also given to hundreds of her school-mates, she started having attacks of vomiting and was taken to the Royal Infirmary, Aberdeen. Doctors dismissed her condition as a stomach bug and she was sent home. But her body continued to reject food and after a few days she was too weak to stand so she was re-admitted to hospital and hooked to a feeding tube.
Eventually, her weight fell to just six stone. Kerry was released from hospital in July, but she still cannot eat solid food and is being fed through a tube in her nose. It could take more than a year for her stomach to heal properly. Doctors think an allergic reaction to the jab, plus the bug, led to her illness. Her mother Karen, a 37-year-old careworker, said: "It was a terrible time for us all. The doctors had no idea what was wrong with Kerry. "We were all sick with worry and scared for her. She couldn't eat anything. It was heartbreaking to see her like that, because she is normally so fit and healthy and raring to go." Kerry was given the BCG injection at Portlethen Academy, Aberdeen, in February. Kerry's dad, 41-year-old garage owner Alan, said: "There were a few times when we thought we were going to lose Kerry. It was horrible. At one point they were on the verge of sending her to intensive care. "It has helped us to grow closer as a family. We realise what we could have lost and how lucky we are." Kelly longed to get out of her hospital bed and get back to her passion - dancing.
But as soon as she was taken off the feeding tubes she was ill again. Her parents are angry. Mr Watson said: "This has ruined her life. She is not the same girl any more. "She dances seven days a week and practises all the time, but it's not as easy as it was before. It's just not fair." Kerry is now back at school - and dancing again. She won 10 trophies at a recent contest in Aberdeen. A spokeswoman from NHS Grampian said: "We can't comment on individual cases but would state that the BCG is a very safe vaccination."
HELEN MORGAN, KERRY'S FIGHT FOR LIFE AFTER TB JAB AT SCHOOL. , Sunday Mirror, 09-28-2003, pp 35.
http://www.wfsb.com/Global/story.asp?S=1025686
COLCHESTER -- State health experts are investigating an outbreak of chicken pox in Colchester.
65 students at the Jack Jackter Elementary School got chicken pox last year. It was one of the largest outbreaks in the state. The Centers for Disease Control is also involved in the investigation. That's because some of the students who got sick were vaccinated against chicken pox. The chicken pox vaccine has a 20-percent failure rate.
http://www.nytimes.com/2002/12/12/national/12BRFS6.html?tntemail1
December 12, 2002
National Briefing: Washington
New York Times
STUDY OF CHICKEN POX VACCINE
A chicken pox outbreak two years ago found vaccinations surprisingly ineffective and may suggest that children should get two shots instead of one, some researchers say.
http://www.knoxnews.com/kns/health_and_fitness/article/0,1406,KNS_310_2395537,00.html
Whooping cough not shot down, but vaccinations up
By JANE E. ALLEN, Los Angeles Times
November 3, 2003
Doctors and public health officials are stumped. Even though vaccination rates are at record highs for whooping cough, cases of the highly contagious respiratory illness have been on the rise nationwide for more than two decades. In recent weeks, outbreaks have taken hold in parts of New York, Pennsylvania, Texas and Illinois. Nationally, cases reached 9,771 last year, the most since 1964.
The disease can be deadly, especially in babies, with 22 deaths nationwide last year. Whooping cough, or pertussis, takes its name from the sound that infected infants make as they struggle to inhale. It's caused by a rugged and wily bacterium, "Bordetella pertussis," that evades much of the body's disease-fighting system while wreaking havoc in the lungs, creating paroxysms of coughing powerful enough to break ribs. In adults, the illness typically is less severe, producing a cough that lasts weeks to months. Vaccination begun in the 1940s was considered to have vanquished the bacterium. It slashed rates from 150 reported cases per 100,000 Americans to less than 1 case per 100,000. But that rate has bounced back to 2.7 reported cases for every 100,000 Americans, although "there may be as many as 10 times as many cases," said Kris Bisgard, a medical epidemiologist with the federal Centers for Disease Control and Prevention in Atlanta. The illness is likely to be missed in teenagers and adults, who account for 50 percent of reported cases, because few doctors are trained to think about pertussis in anyone but babies. Although a simple blood test could help ensure that cases are properly treated, such a test remains elusive. Nor is there a vaccine for people older than 7.
http://www.kron4.com/Global/story.asp?S=1617203
U.S. to Begin 1st Tuberculosis Vaccine Trial in 60 Years
A new vaccine -- made with several proteins from the bacterium that causes tuberculosis -- will soon begin initial testing in humans, U.S. health officials announced Monday.
"This candidate vaccine, as well as other novel products emerging from the TB research and development pipeline, offers hope for reducing the burden of a disease that claims approximately two million lives each year," said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.
The vaccine combines two tuberculosis proteins known to stimulate strong immune responses in humans. The proteins were initially identified by screening blood taken from volunteers who never became ill with tuberculosis despite long-term infection with Mycobacterium tuberculosis bacteria, health officials said.
The Phase I trial will include 20 volunteers at a single site in the United States and will assess the vaccine's safety. If the vaccine proves safe in this initial trial, it will be tested further in larger clinical trials. The trial will be conducted by Seattle biotechnology company Corixa and GlaxoSmithKline Biologicals, a vaccine manufacturer based in Belgium, officials said.
The current TB vaccine, called BCG, offers some protection against the form of TB most often contracted by very young children. But the vaccine's effectiveness wears off over time. Also, BCG isn't very effective against pulmonary TB, the most contagious form of the disease, officials said.
http://www.thelancet.com/journal/vol363/iss9408/full/llan.363.9408.correspondence.28727.1
MMR immunisation after contact with measles virus
Sir--A single case of measles occurred recently at a children's nursery in the UK. A 17-month-old boy who had not received the measles, mumps, and rubella (MMR) vaccine presented to the Accident and Emergency department in the morning with an erythematous maculopapular rash on his face and upper body. He had been unwell for 72 h with coryza, cough, conjunctivitis, and diarrhoea. Measles was laboratory-confirmed within 3 h by virus-specific immunofluorescence of a nasopharyngeal aspirate. However, since the history and rash were virtually pathognomonic of measles, the nursery was contacted as soon as a clinical diagnosis was made.
The child had been in close contact with six other children (ages 15-24 months) during the entire coryzal period. None of these children had received MMR despite all being eligible. Since current advice indicates that MMR given within 3 days of exposure might modify or abort an attack of measles,1-3 we advised the parents to have their children immunised immediately. The severity of the illness in the index case ensured that four of the six sets of parents had their children immunised with MMR the same day. Despite doing so, all six children developed prodromal symptoms of measles, on average 8 days after the onset of such symptoms in the index case. 2-3 days later, they all developed a typical measles rash.
Measles-specific IgM was detected in oral fluids from all six secondary cases and viral nucleic acid was detected by PCR in the index case and from two secondary cases (one of whom had been immunised after exposure). Sequencing showed all three isolates to be genotype D8, the strain circulating currently in south London, UK.
We have shown that, despite rapid diagnosis, measles transmission and clinical infection was not preventable by post-exposure immunisation. This finding contrasts with accepted guidance in this area. Only two studies have shown that live measles vaccine alone can prevent secondary cases after exposure: Watson2 was able to prevent infection in a single household when vaccine was given to family contacts one day after appearance of the rash and 96 h after onset of coryzal symptoms in the index case, and Ruuskanen and colleagues3 reported protection from vaccination in children vaccinated after exposure in a school setting. However, the first study was conducted with a very early vaccine that contained a high dose of a different measles virus strain (Edmonston). Subsequently, all monovalent measles and MMR vaccines used in the UK have contained lower doses of Schwartz or Moraten strains. The lack of efficacy we saw might have been due to delay in administration or to differences in the vaccine formulation. Alternatively, the interpretation of the original observations made on small numbers of cases might have been incorrect.
If parents continue to decline MMR immunisation, once measles is introduced into a home, nursery, school, or hospital ward, our observations suggest that administration of MMR vaccine as early as possible might not prevent infection in those children already exposed. The only reliable way to prevent measles is to maintain high MMR uptake rates in the community.
*Philip Rice, Yvonne Young, Bernard Cohen, Mary Ramsay
http://www.oregonlive.com/metro/oregonian/index.ssf?/base/news/1078146023173
820.xml
Chickenpox flare in Lake Oswego indicates vaccine may wear off
Many of the children who got the illness had been inoculated, raising the question of whether booster shots will be needed
03/01/04
DON COLBURN
A new study of a 2001 chickenpox outbreak in a Lake Oswego elementary school suggests that a booster shot for the disease may be needed after five years. Health investigators were surprised to find an outbreak of chickenpox in a school in which 97 percent of students had already had the disease or had been vaccinated. The 21 chickenpox cases at Forest Hills Elementary included
18 students who had received shots. Most of them had been vaccinated more than five years earlier.
If larger studies bear out the Lake Oswego findings, "routine booster vaccination for children might be warranted," concluded a team of researchers from Oregon and the federal Centers for Disease Control and Prevention. The findings are reported today in the medical journal Pediatrics.
The study does not show that the chickenpox vaccine is ineffective, said Dr. Paul Cieslak, a communicable disease specialist with the Oregon Department of Human Services and co-author of the study. "You're still better off with the vaccine," Cieslak said. Inoculated children rarely get chickenpox, and if they do, their cases are milder. In the Lake Oswego school outbreak, 43 percent of the small number of unvaccinated children came down with chickenpox, compared with 12 percent of those who had received shots.
But researchers were surprised by the difference in risk between kids recently vaccinated and those vaccinated years earlier. A separate study at Yale Medical School, reported last month in the Journal of the American Medical Association, found a slight loss of immunity -- from 97 percent to 84 percent -- after one year.
In the Oregon study, the big jump in cases among vaccinated children came after five years. Nearly one in four students exposed to chickenpox more than five years after immunization got the disease.
For public health officials, "outbreaks are natural experiments," Cieslak said. Because it is ethically taboo to expose children intentionally to disease, "our approach is that when an outbreak happens, let's learn something from it."
The Lake Oswego elementary school provided "a perfect place to study how well the vaccine works," he said. Of the 218 students who had not gained immunity by having the disease, all but seven had been vaccinated.
The culprit: rare cases
"So we're thinking: How come there's chickenpox there?" Cieslak said.
The culprit: a small number of what disease-trackers call "breakthrough cases" -- rare cases that allow an outbreak to occur even among a heavily inoculated population.
"No vaccine is 100 percent effective," cautioned Peggy Lou Hillman, immunization coordinator for Multnomah County.
But before health officials add a chickenpox booster to the immunization schedule, she said, researchers must make sure the breakthrough cases result from dwindling immunity over time. Other factors, such as improper storage or exposure to heat, also can impair the vaccine's effectiveness.
A total of 422 students in 16 classrooms attended the Lake Oswego school in 2001. They were fairly evenly divided between those who had already had chickenpox and those who hadn't. Most who hadn't had the disease had gotten the shots. Only seven students appeared susceptible to the disease because they had had neither the shots nor the disease. Nevertheless, 21 cases
occurred among students in nine classrooms.
The findings suggest but do not prove that the immunity conferred by the vaccine wanes over time, Cieslak said. That would not be surprising, but the magnitude of the difference was striking, he said. The numbers in the Oregon study are small, and they do not justify calling for a chickenpox booster shot until they are corroborated by research in larger, more diverse populations, Cieslak said. The study was based on health records from the school, a questionnaire and phone calls to the parents of each child involved in the outbreak.
Developed in 1970s
The chickenpox vaccine, developed in Japan during the 1970s, uses a live virus that is weakened. It is potent enough to trigger a protective reaction by the body's immune system but not strong enough to cause illness.
The vaccine was approved in the United States in 1995, and Oregon schools began to phase in a required shot in 2000 for children who had not had the disease.
Chickenpox is not a reportable disease -- meaning doctors are not required to report cases to local or state health departments, The reason is that before the vaccine became available, virtually every child got chickenpox. Reporting is limited to rarer and more dangerous infections, such as
tuberculosis, HIV/AIDS and salmonella.
Tracking chickenpox cases, Cieslak said, would have been "like battling an ocean."
Don Colburn: 503-294-5124; doncolburn@news.oregonian.com
http://www.medicalposting.ca/children/article.jsp?content=20040311_082809_63
68&topStory=y
2004-03-11
Vaccine-in-a-patch linked to diabetes and multiple sclerosis
Ingredients called accelerants trigger immune system diseases in mice
Adhesive patches -- proposed as an easy way to vaccinate children -- may increase the risk of developing diabetes and multiple sclerosis, Australian researchers suggest. The method is being tested in the United States, where its developers contend seven in 10 immunizations will be done this way within five years because the method offers lower cost, less pain and greater hygiene.
But research by Alan Baxter at James Cook University in Townsville, Australia, and Tony Basten of the University of Sydney raises doubts about the safety of the technique. The patches contain components of either a virus or bacteria, as do existing vaccines. But they also use accelerants that increase the body's response to the vaccine.
"We've found that the accelerant also accelerates other ongoing tissue damage which may be occurring in the person," Baxter says. Their research showed that multiple sclerosis and type 1 diabetes appeared at an earlier stage in mice treated with the accelerant than in other mice. In type 1 diabetes, the body's immune system mistakenly attacks the cells in the pancreas that produce insulin. In multiple sclerosis, it attacks the myelin sheath covering nerves in the brain and spinal cord.
"We found that the way this accelerant increases a person's immune response to the vaccine appears to be exactly the same as the mechanism by which it increases the reaction to your own tissue, and this effect cannot be separated." Baxter says the findings mean patch vaccines will need to be tested much more extensively than planned.
PERSONAL HEALTH
Even With Vaccination, the 'Whoop' Is Back
By JANE E. BRODY
Published: March 2, 2004
http://www.nytimes.com/2004/03/02/health/02BROD.html
Get used to it. Pertussis, whooping cough, is here to stay. . "Pertussis is the only vaccine-preventable disease that is still increasing in this country.
Testimony by Jerri Johnson
Health and Human Services Policy Committee
January 27, 2003
Childcare providers enforce immunization requirements, state licensers of childcare providers, and the public schools. This enforcement costs money for staff to do record keeping and follow-up. Much of this cost is borne by the state. A study in 1998 estimated that enforcing the immunization
requirements cost the state at that time around $5 million per year.
Will adding new vaccines to the list increase costs to schools? It will, because many more follow-up contacts will be needed for these particular vaccines. Currently, 35 percent of parents are not vaccinating their children for chickenpox. Minneapolis Public Schools estimated that each parent follow-up contact cost $18 in staff time.
Minneapolis Public Schools wrote to the Department of Health asking that no immunization requirements be added until funding is in place to enforce them. In addition to the state costs of enforcing vaccine requirements, these vaccines cost money in health care dollars. I have included a handout in your package with medical cost analyses of pneumococcal and chickenpox vaccines. Chickenpox and pneumococcal vaccine programs actually cost more money than they save from preventing disease. The pneumococcal vaccine, for example, costs around $60 per dose, or $240 per child for the four-dose series. The chickenpox vaccine also does not recover costs when looking at the cost of the vaccine compared to the cost of the disease. Only by factoring in indirect costs, such as lost wages for a parent to stay home with a child sick with chickenpox, is this vaccine deemed to be cost-effective.
But these assessments of indirect costs did not include the cost of caring for vaccine-injured children. Hospitalization and medical costs for these children are extremely high. During school years, they require special education services, costs borne by the state. These children may later be
cared for in group homes the rest of their lives, incurring huge costs to the state. Twelve percent of our children now have chronic disease of some sort, and many medical experts believe that the rapid increase in diseases such as autism, ADD, juvenile diabetes and asthma is partially attributable
to the increase in required vaccines.
A parent who stays home for five days when her child has chickenpox may use vacation days or may lose some income. But parents of children disabled by vaccines often must quit work permanently to stay home with their child, losing years of income, and the vaccine-injured child may never grow up to
earn a productive income.
But ultimately, the question before us is not about dollars and cents. When we are preventing communicable disease, and when we are preventing vaccine injuries, the real issue is the value in human life that can't be quantified. You can't put a price on the joy of having a healthy baby, and you can't quantify the grief of a parent who loses a baby, no matter what the cause.
And so the Minnesota Natural Health Coalition is calling for the following:
1. Safer vaccines. Pharmaceutical companies need to be held accountable to produce vaccines that have fewer serious side effects.
2. The State of Minnesota should not require new vaccines if we do not know whether they are safe for our children. In the case of the pneumococcal vaccine, during the pre-licensure study where 17,000 healthy infants with no acute or underlying chronic disease were given Prevnar, 162 infants required emergency room care, 24 were hospitalized within 72 hours of receiving the vaccine and eight infants who had never had seizures before had seizures within 72 hours. Forty infants who had never had asthma before required doctor's care for asthma, wheezing, shortness of breath or breath-holding within 72 hours of the vaccine.
One previously healthy child developed congestive heart failure within 72 hours of the vaccine and three children developed hypotonic/hyporesponsive episodes. Were these serious situations caused by the vaccine? There is no way to determine this without following the time-honored scientific process of comparing the test group with a control group that did not receive a vaccine. This was not done. One variable, the test vaccine, was compared with another variable, another experimental vaccine.
Yet the physicians who conducted the study concluded at the end, this test "did not reveal any severe adverse events related to vaccination that resulted in hospitalization, emergency room visits or clinic visits." The Vaccine Information Sheet on Prevnar given to parents at their clinics says, "So far, no serious reactions have been associated with this vaccine." Given the structure of the clinical study, it is not scientifically possible to say that these reactions were caused by the vaccine, nor is it possible to say that they were not.
3. If it is inherently impossible to produce a vaccine without a significant risk of serious adverse effects or death, then we need to be clear about that. If the pneumococcal vaccine effectively reduces pneumococcal disease, but at the price of death or disability to a few babies, we need to know those numbers. Our research needs to be science-based, with control groups, and parents need to know the risks so they can make an informed decision.
We are having a good debate in this country on the smallpox vaccine. This could be a great model for our infant vaccination programs. Public health officials are doing a good job of articulating the risks of smallpox and the risks of the vaccine. One or two deaths per million from the vaccine is being taken very seriously. Adults are weighing the risks and benefits. We should afford the same courtesy to infants and their parents in the routine vaccine program.
4. Parents should be educated that if their child is ill, vaccination should be postponed. They should be told that if their child suffered a seizure or bad reaction to a previous vaccine, she is at risk for an even greater reaction to the next one. If parents have a family history of a severe vaccine reaction, they should know that their child might be at risk.
The CDC already has guidelines on this, and they are printed on the sheets given to parents when the child receives a vaccine. If parents knew this before making their appointments with the doctor, perhaps many vaccine injuries could be avoided. Again, the smallpox discussion is a good model on this--people are being informed that if you have eczema, you are at risk from the vaccine; if you are on corticosteroids you are at risk. Similarly, parents of infants could be advised on this at an early date.
5. If new vaccines being produced cannot be safer, then perhaps we need to rethink the model that vaccinates the entire population for a disease. This model was developed in response to overwhelming epidemics like polio. However, in the case of invasive pneumococcal disease, which affects only 0.2 percent of Minnesota children, this may not be an appropriate model.
6. Finally, parents who believe that their child was harmed or killed by a vaccine need to be heard and taken seriously. They should not be brushed off by being told it was not related to the vaccine. Their experience should be studied for clues to how we can have safer vaccine programs.
http://asia.reuters.com/newsArticle.jhtml?&storyID=4740126
Stress May Weaken Flu Shot Protection
Fri Apr 2, 2004 02:37 PM ET
By Merritt McKinney
If the vaccine doesn't work blame stress.
http://thestar.com.my/news/story.asp?file=/2004/4/9/nation/7728525&sec=nation
The Star, Malaysia
April 9, 2004
CAP: Mass measles vaccination may not be wise move
KUALA LUMPUR: The Consumers Association of Penang has urged the Health Ministry to conduct a proper evaluation before carrying out mass measles vaccination to immunise 4.5 million children nationwide. CAP president S.M. Mohd Idris claimed in a statement that the ministry had made the decision based merely on the fact that it expected an outbreak of the disease in 2005 or 2006.
He was commenting on a recent ministry announcement that it aimed to immunise children aged between seven and 15 against measles through its National Measles Immunisation Campaign. The immunisation programme will be carried out in schools by a health team. Mohd Idris said the plan was to use a combination vaccine against three diseases, namely mumps, measles and rubella (German measles), or what is better known as MMR vaccine. He said that studies overseas had shown that measles continued to occur even in children who had been fully vaccinated.
Previously, he said, those who contacted measles were usually below the age of 10, but now, following years of vaccinations, more adults were being infected. He also pointed out that soon after the measles vaccine was in use, a new problem arose where children were contracting a condition known as atypical measles, a more serious form of measles that may not respond to treatment. "Many children already receive a dose of MMR vaccine when they are around one year old, with a booster a few years later. "The health authorities have informed one parent that, although her child
has received her booster jab the year before, the vaccination under this programme is still necessary.
"Is there any guarantee that there will be no adverse effects on the child following these repeated jabs?" Mohd Idris called on the Health Ministry to put the measles immunisation plan on hold pending a proper review, as "there is much evidence against the need for mass vaccinations as much as there is for them." - Bernama
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&
dopt=Abstract&list_uids=15121300
Vaccine. 2004 May 7;22(15-16):1892-8. Related Articles,Links
Efficacies of whole cell and acellular pertussis vaccines against Bordetella parapertussis in a mouse model.
David S, Van Furth R, Mooi FR.
Research Laboratory for Infectious Diseases, National Institute Of Public Health and the Environment, P.O. Box 1, 3720 Bilthoven, The Netherlands.
Pertussis vaccine development has mainly focused on Bordetella pertussis, and consequently these vaccines contain B. pertussis antigens only. However, the related species Bordetella parapertussis can also cause pertussis, although symptoms associated with the disease are generally considered to be milder. Recent field studies have shown that in some outbreaks B. parapertussis can prevail. Using a mouse model we compared the efficacy against B. parapertussis of two commercially available acellular vaccines and two whole cell vaccines, used in The Netherlands and Finland, respectively. The efficacies of the two whole cell vaccines against B. parapertussis were similar, but much lower compared to the efficacy against B. pertussis. Although, the acellular vaccines conferred some protection against B. parapertussis early in infection, the values were not significant. Later in infection, a highly significant enhancement of colonisation by B. parapertussis was observed in mice vaccinated with acellular vaccines. The whole cell vaccines protected significantly better than the acellular vaccines against B. parapertussis. The possible consequences of a switch from whole cell to acellular vaccines was discussed in the light of our findings.
PMID: 15121300 [PubMed]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&
dopt=Abstract&list_uids=15155223
Antimicrob Agents Chemother. 2004 Jun;48(6):2206-13. Related Articles,
Links
Short- and long-term effects of pneumococcal conjugate vaccination of
children on penicillin resistance.
Temime L, Guillemot D, Boelle PY.
INSERM U444-27, rue Chaligny, 75571 Paris Cedex 12, France. laura.tem
ime@sat.ap-hop-paris.fr
Recent observations have shown that wide-scale vaccination with pneumococcal conjugate vaccines was associated with a reduction in invasive disease, supporting the expectation that vaccination could help reduce carriage of Streptococcus pneumoniae and control the spread of resistant strains. However, it is too early to assess whether these effects can be sustained in the long term. Here, we used mathematical modeling to investigate time changes in pneumococcal colonization and resistance induced by conjugate vaccination in an environment where antibiotic exposure is high and resistance is widespread. According to model predictions, vaccination induced a decrease in carriage of vaccine-type pneumococci to very low levels, typically in 10 to 15 years under epidemiologically realistic conditions. Almost simultaneously, non-vaccine-type pneumococci spread in the community. Consequently, while there was a short-term decrease in the overall carriage rate, it was followed after a few years by a renewed, although limited, increase. Vaccination with a heptavalent vaccine did not affect the extent to which antibiotic resistance was selected: in all cases, the distribution of resistance levels peaked at high levels (MIC > 2 microg/ml) after 20 years. With a vaccine optimally designed to include all serotypes currently exhibiting decreased susceptibility to penicillin G, the selection of resistance was slowed down, although not prevented. These results suggest that because of serotype replacement, the effects of vaccination observed today may not be sustained in the long term. As a consequence, vaccination alone may not be successful in controlling selection for resistance in S. pneumoniae.
PMID: 15155223 [PubMed - in process]
[When a religion (eg, Vaccines are miraculously wonderful) interferes with scientific findings (eg, research showing the vaccines can bias immunity in unnatural ways, even prompt lingering infections), then the scientific findings should be ignored so that vaccine orthodoxy is preserved. -Teresa Binstock]
Vaccine failure puzzles biologists
By The Associated Press - 5/31/04
http://www.helenair.com/articles/2004/05/31/montana/a06053104_04.txt
JACKSON, Wyo. (AP) — Biologists are puzzled why brucellosis exposure rates have spiked among some vaccinated elk. Disease rates at the Greys River elk feedground have even exceeded the high rates of the 1970s, before the state began vaccinating elk against brucellosis, according to Brandon Scurlock, a biologist with the Wyoming Game and Fish Department.
To be honest, I have no way of explaining this,'' Scurlock told a recent forum in Pinedale on elk feedgrounds. Controlling the disease, which can cause animals to abort, is important because it can be transmitted to cattle. The detection of the disease in cattle caused Wyoming to lose its federal brucellosis-free status earlier this year. That in turn has led to laborious and costly testing requirements.
While feedgrounds help keep elk away from cattle by encouraging them to congregate, the same congregation helps spread disease. About 25 percent of elk on all feedgrounds test positive for exposure to the disease ; compared to less than 3 percent of other elk. Vaccination at the Greys River feedground began in 1985. Brucellosis exposure dropped below 10 percent in the mid-1990s, down from 54 percent in the 1970s. In 2000, however, rates jumped to 26 percent before hitting 54 percent the following year. This year, 59 percent of elk tested positive.
Biologists originally thought that a weak batch of vaccine given to some elk in 1998 was to blame for the brucellosis rates at the Greys River feedground. But Scurlock said that theory is no longer plausible because disease rates should have dropped among the elk that have been vaccinated with the correct dosage since then.
He said more tests are needed to find out what is happening.
[Of course, if "more tests" generate data that is too damning of the
vaccinations, then the Elk version of the IOM will decree, No More Study!]
http://www.nature.com/nsu/040621/040621-3.html
Vaccines may increase virulence
Pursue additional defences, urge malaria experts.
22 June 2004
HELEN PEARSON
Vaccines against malaria could cause the parasite to develop more vicious strains. But experts warn that the finding should not detract from the urgent hunt for a jab.
Malaria is caused by the parasite Plasmodium falciparum, which is injected into humans by mosquitoes. Over a dozen clinical trials are in progress for possible vaccines against the deadly disease. Most of these jabs create conditions in which, although the parasites can still infect people, the immune system slows their multiplication so they do not cause disease.
To investigate whether surviving parasites change with time, Margaret Mackinnon and Andrew Read at the University of Edinburgh, UK, infected a mouse with a type of Plasmodium and then passed blood carrying the parasite on to another animal seven days later. They repeated this process 20 times, to mimic the ailment passing from person to person.
Parasites that moved from one vaccinated animal to another evolved into nastier strains than those grown in non-vaccinated animals, the researchers show in PLoS Biology1. The vaccinated animals stayed healthy, but when the parasite they carried was transferred into other mice, it killed more red
blood cells and made them lose more weight than the original malaria strain. Mackinnon and Read believe that malaria vaccines could have the same effect in people. Perhaps over decades, P. falciparum might evolve into a more deadly form in vaccinated people, which would pose a greater threat than ever to those unprotected by a jab.
No magic bullet
Malaria vaccines are still vital, stresses Read, because people who are immunized will be protected from the disease. But he urges public health officials to pursue other methods to eliminate malaria, such as distributing nets and developing new drugs, even as jabs are developed. "You shouldn't think of vaccines as a magic bullet," he says.
Researchers might also avoid types of vaccine that allow the parasite to survive at low levels, he suggests. Instead, they could focus on classes of vaccine that hobble the parasite before it infects red blood cells or which cripple it in the mosquito and so stop it passing from one person to another.
Many of the vaccines under trial already take the latter approach. In fact experts predict that an effective malaria vaccine will probably trigger the immune system into attacking the parasite at several different stages of its life cycle.
But some experts are concerned that the new finding will undermine their efforts to stem a disease that kills 2 million to 3 million people each year. "It has no relevance to vaccine development," says Adrian Hill who is working on malaria jabs at the University of Oxford, UK.
Read disagrees: "The big question is, would the same thing happen with another virus?" If so, jabs against other diseases, such as measles, might also have promoted the emergence of more virulent strains. It is hard to tell whether this has happened, because improved medical practices make it difficult to compare death rates at a time before vaccination with those today.
References
Mackinnon, M .J. & Read, A. F. . PloS Biology, published online, doi:10.1371/journal.pbio.0020230 (2004).|Article|
Search for AIDS vaccine falters
Tue Jul 13, 6:45 AM ET Add Top Stories - USATODAY.com to My Yahoo!
By Steve Sternberg, USA TODAY
The two-decade search for an AIDS (news - web sites) vaccine, the only way to end the global crisis, is all but starting over, researchers here said Monday. The only vaccine to complete two large-scale clinical trials, AIDSVAX, proved a flop. A major Thai trial now enrolling patients and using a two-vaccine approach has drawn criticism for including the failed vaccine. Most of the 30 vaccine candidates now in the pipeline are relatively untested, and they're so similar that if one fails, they all may fail.
If that isn't discouraging enough, the next wave of large-scale human trials will be especially challenging because countries with the biggest epidemics lack the resources needed to study thousands of patients. "This is a global disgrace," says Seth Berkley, director of the non-profit International AIDS Vaccine Initiative. "There hasn't been a serious effort, and until there is a serious effort, we'll never get there." Four years ago, the initiative called for tripling annual research money to $1.1 billion. Funding now totals $650 million; $100 million comes from drug companies, which is 1% of what the companies spend on health product development, says Scientific Blueprint 2004, the initiative's report released Monday.
A separate report by the Joint United Nations (news - web sites) Programme on HIV (news - web sites)/AIDS, UNAIDS (news - web sites), shows that there were more than 13,000 new HIV infections a day last year, almost all in low- and middle-income countries.
The search for an AIDS vaccine has long been overshadowed by the search for new AIDS drugs, which are far more profitable because patients must take them for life. But that cost already is beyond the means of most poor countries. Considering there are roughly 5 million new infections a year, "we won't be able to be keep pace with the demand for treatment," Helene Gayle of the Bill & Melinda Gates Foundation told the 15th International AIDS Conference here.
Gayle is a co-chair of the Global HIV Vaccine Enterprise, a consortium of research agencies launched by the Gates Foundation last year to jump-start vaccine research. In June, G-8 nations endorsed the strategy, and the USA promised $15 million.
Two major trials of vaccine candidates are still in the works. The first pairs AIDSVAX with a dose of Alvac, a vaccine made by Aventis Pasteur. Now getting started in Thailand, it will involve about 16,000 people. But critics say the trial is a waste of time because AIDSVAX has been proven not to work. John McNeill of the National Institute of Allergy and Infectious Diseases (news - web sites) says researchers believe the two vaccines might work better together than by themselves.
[Like usual, they don't have any idea what vaccines REALLY do to the body. Brain shrinkage and atrophy may explain some decisions by CDC and ACIP on vaccine policy. On the plus side, at least they are just giving this to people already with the disease and not trying to develop one for all babies ..yet.]
http://www.dfw.com/mld/dfw/news/nation/9214343.htm?1c Alzheimer's vaccine made brains shrink
Posted on Thu, Jul. 22, 2004
By John Fauber
Milwaukee Journal Sentinel
PHILADELPHIA - The brains of some of the people who received an experimental vaccine against Alzheimer's disease have shrunk.
Virology. 2004 Aug 15;326(1):20-8.
The nonresponse to hepatitis B vaccination is associated with impaired lymphocyte activation.
Goncalves L, Albarran B, Salmen S, Borges L, Fields H, Montes H, Soyano A, Diaz Y, Berrueta L.
Institute of Clinical Immunology, University of Los Andes, Merida,Venezuela.
Nonresponsiveness against hepatitis B vaccination has been described in 4-10% of immunized subjects. We have explored the specific cell response to hepatitis B surface antigen by analyzing: PBMC proliferation, cytokine production (Th1, Th2 profiles, and TGF-beta), and activation molecules on Th cells. A poor proliferative response was demonstrated in nonresponders (P < 0.05). T cells from responders produced all tested cytokines (P < 0.01), in contrast with nonresponders subjects (P < 0.05). Expression of CD69 and CD25 was diminished in T cells from nonresponders (P < 0.01). A reduced expression of CD40L was also detected in T cells from nonresponders (P < 0.01). An elevated correlation coefficient was observed between CD40L on CD4+ cells and antibody production. These results suggest an overall inability of T cells to be activated which could be consistent with potential differences in antigen presentation. In conclusion, our results suggest that an altered Th response may be a consequence of inappropriate early activation events.
PMID: 15262491 [PubMed - in process]
Posted on Thu, Aug. 19, 2004
Student better after close call with meningitis
UK SOPHOMORE'S FATHER EXPECTS FULL RECOVERY
By Barbara Isaacs
HERALD-LEADER STAFF WRITER
A University of Kentucky student with bacterial meningitis is improving, but still in serious condition at UK Hospital. The illness of Charles "Tripp" Eckerline III, 19, a UK sophomore and former Lexington Catholic High School football player, has raised awareness on campus about the risks of meningitis and vaccinating against the disease. However, Eckerline's illness also shows that the meningitis vaccine is not foolproof. Eckerline was vaccinated against meningitis a year ago, before he entered UK as a freshman, said his father, Dr. Charles Eckerline Jr., who is an emergency room physician at UK.
Eckerline's strain of meningococcal meningitis is usually covered by the vaccine, but the vaccination is only about 80 percent effective, Dr. Eckerline said. Tripp Eckerline was first ill at 9 p.m. Saturday. When his parents went to his home to check on him Sunday afternoon, Dr. Eckerline took him immediately to UK's emergency room.
By the evening, Tripp Eckerline was in septic shock and on large doses of three antibiotics. He required a ventilator. "I've practiced emergency medicine for 26 years, and it's the scaredest I've ever been," Dr. Eckerline said yesterday. "What's so scary is that everything was done quickly and appropriately -- and he still got worse and worse for six hours. He came as close to dying as anyone possibly could."
Dr. Eckerline said his son might be hospitalized for at least a week, but he could be off the ventilator today. He expects his son to make a complete recovery. Dr. Gregory Moore said the University Health Service has been receiving calls from students now interested in the vaccine. Moore is director of the service, which provides medical care for the 35,000 students at UK and Lexington Community College.
This year, the Kentucky General Assembly began requiring that Kentucky colleges inform incoming students who live in residence halls about meningitis risks and the vaccine that can prevent the disease. UK had already been giving that information to incoming students for several years, Moore said.
The legislature stopped short of requiring the vaccine, which costs $75 through the University Health Service. Connecticut and New Jersey require the vaccination for all college students. Some colleges around the country also require it for their students, but UK does not. College students can benefit from the vaccine because communal living increases the risks of getting the illness, Moore said. Eckerline lives off campus with two other students, his father said, not in a residence hall. "They're a population that tend to share cups, kisses, toothbrushes and everything," Moore said, though he noted that the disease is most commonly seen in the very young and the very old.
Close contact is required to transmit the bacteria. Only a tiny percentage of those who come into contact with the bacteria develop an infection of the fluid surrounding the brain and spinal cord. The meningitis bacteria is fairly common and lives in the throats of about 15 percent of the population at any given time, Moore said. "You no doubt meet people every day who carry this," he said.
What to watch forCommon symptoms of meningitis are high fever, stiff neck and headache. Other signs can be rash, nausea and vomiting.
www.kentucky.com/mld/heraldleader/news/legislature/9438114.htm
Kenneth M. Petersen, MD; Lisa R. Bulkow, MS; Brian J. McMahon, MD; Carolyn
Zanis, BS; Marilyn Getty, RN; Helen Peters, RN; Alan J. Parkinson, PhD
Pediatr Infect Dis J 23(7):650-655, 2004.
Abstract
Background: The duration of protection after hepatitis B vaccination of infants is unknown. Methods: We determined antibody to hepatitis B surface antigen (anti-HBs) at 4-13 years of age in 363 low risk children who had been vaccinated starting at birth with hepatitis B vaccine. Those with nonprotective titers (<10 mIU/mL) received a booster dose. We similarly followed 16 children of hepatitis B surface antigen (HBsAg)-positive mothers.
Results: Of low risk infants receiving a plasma-derived vaccine, 41% (42 of 102) of those whose primary response was unknown and 24% (4 of 17) who had initially responded retained protective titers (>/=10 mIU/mL) of anti-HBs at 9 and 13 years, respectively. Of those who did not have protective antibody titers, 61% (33 of 54) and 67% (8 of 12), respectively, responded to a booster dose. In children of HBsAg-positive mothers, 31% retained protective anti-HBs at 12 years, and 90% (9 of 10) with nonprotective titers responded to a booster. In low risk children initially receiving a recombinant vaccine, 12.5% (26 of 208) and none (0 of 36) retained protective anti-HBs titers at 5 and 7 years of age, respectively. Of those who did not have protective titers, 90% (120 of 134) and 91% (32 of 35), respectively, responded to a booster.
Conclusions: Anti-HBs disappeared by 5 years of age in most children who were vaccinated with hepatitis B vaccine from birth. Although most children showed immunologic memory, one-third failed to demonstrate an anamnestic response to a booster dose. Additional long term studies of low risk infants are needed to determine duration of protection and the necessity for or timing of booster doses.
Subject: HIB infections on the rise in adults despite child vaccination programme
BMJ 2004;329:655-658 (18 September)
Trends in Haemophilus influenzae type b infections in adults in England and
Wales: surveillance study
Jodie McVernon, specialist registrar, Caroline L Trotter, scientist (epidemiology), Mary P E Slack, consultant microbiologist, Mary E Ramsay, consultant epidemiologist
Full original article can be found here:
http://bmj.bmjjournals.com/cgi/content/full/329/7467/655
http://www.medicalnewstoday.com/medicalnews.php?newsid=13566 HIB infections on the rise in adults despite child vaccination programme 17 Sep 2004
Cases of the Hib infection (haemophilus influenzae type b) among children and adults have risen in recent years, despite a vaccination programme which initially proved successful, say researchers in this week's BMJ (British Medical Journal).
The Hib vaccine became part of the routine immunisation programme for babies in 1992, cutting deaths from the disease amongst children significantly and reducing infection rates. In 1992 for instance 21.91 cases per 100,000 children were reported, dropping to 0.65 by 1998.
Adults-most of whom were not immunised-also benefited, with Hib infections in the population at large also dropping-from 0.17 cases per 100,000 to 0.03 in the same period. Although infection in adults is rare, infection rates are higher among the age groups in regular contact with children, suggesting that adults usually catch infection from these young children, say the authors.
From 1998 however Hib cases in children started to rise significantly, mostly among those who were immunised in the programme as babies-though infection rates remain well below those seen before vaccination was introduced. Among adults rates have now reached levels higher than before the vaccination programme was introduced (0.27 cases per 100,000 in 2003, compared with 0.17 in 1992.)
The apparent fall in the effectiveness of the initial vaccination programme for children may be due to several factors, say the researchers, including issues with the vaccine used, which has now been changed. For adults the situation was more complex. They had initially benefited from 'herd immunity' say the authors, where the drop in infection rates among children resulted in reduced exposure to the disease for adults, and consequently fewer infections. But adults' reduced exposure to the disease also meant their antibody levels-or 'natural' immunity - was no longer being boosted. When the disease began to rise once again amongst children, some adults found themselves less equipped than before to fight the infection.
Monitoring the Hib immunisation strategy quickly exposed trends and problems with the programme, say the authors, prompting swift corrective action-in this case resulting in the implementation of a national booster vaccination programme for children younger than four years, which should once again benefit adults. Such high quality surveillance systems are vital, say the authors, in the fight against immunisable diseases.
http://www.thecouriermail.news.com.au/common/story_page/0,5936,11008696%255E
421,00.html
Pneumococcal jab fails to stop disease
08oct04
TWO children developed the deadly pneumococcal disease despite receiving very expensive vaccinations meant to prevent it. Another 41 children have reported minor reactions to the vaccine which will become available free to all children aged under two from January next year.
And an elderly woman has died from septic shock after she and 14 others developed serious blood problems after using the oral antifungal drug Lamisil used to treat tinea. The cases were reported in the Adverse Drug Reactions Bulletin yesterday. Drug company Novartis, which makes Lamisil, yesterday refused to comment on the death.
A spokesman said the adverse blood reactions, which leave a person vulnerable to infection, were detailed on its patient information sheet and occurred in just 0.1 per cent of cases. The company was negotiating with the Therapeutic Goods Administration about whether any changes were needed to the drug's labelling, he said. The bulletin reported that of the two children affected by the pneumococcal vaccine, one, a two-year-old girl, developed pneumococcal pneumonia two months after being given a single dose of the product. A seven-month-old baby also developed a pneumococcal infection four months after being given the vaccine.
Both recovered from the infections.
Drug company Wyeth, which manufacturers the vaccine, said it appeared from the case notes that the vaccine had not been properly administered to the baby. Official guidelines recommend children be vaccinated at two, four and six months but this child appeared to have received three doses in her first three months of life. The two-year-old child had developed a less serious form of the disease, a Wyeth spokesman said.
Infection rising despite vaccine
More people are contracting Hib infection despite a child vaccination programme, government advisors warn. Rates of the meningitis-causing bacteria among adults have reached levels higher than before 1992, when routine vaccination of babies started. Rates in children are also rising, mainly among those immunised as babies, according to Health Protection Agency (HPA) experts. Booster jabs should reduce rates they told the British Medical Journal.
http://news.bbc.co.uk/1/hi/health/3660660.stm
http://www.cdc.gov/ncidod/EID/vol9no10/03-0180.htm
We studied eight children who had measles at 6 to 10 months of age during the 1998 Argentine measles outbreak and in whom subacute sclerosing panencephalitis developed 4 years later. We report the genetic characterization of brain tissue–associated measles virus samples from three patients. Phylogenetic relationships clustered these viruses with the wild-type D6 genotype isolated during the 1998 outbreak. The children received measles vaccine; however, vaccinal strains were not found.
The measles vaccine was included in the regular immunization schedule in Argentina in 1978. Despite vaccination, several disease outbreaks have occurred (12). Although we had previously performed a thorough molecular description of acute measles outbreaks, genetic characterization of SSPE has not yet been reported in Argentina (9).
Failure of Inactivated Influenza A Vaccine To Protect Healthy Children Aged 6–24 Months
[Not yet available online.]
Pediatrics International (2004) 46 , 122–125
Taro Maeda, Yukihiro Shintani, Kanako Nakano, Kazuhiro Terashima And Yoshiyasu Yamada
Department of Pediatrics, Public Shisou General Hospital, Shisou and
Department of Pediatrics, Rokko Island Hospital, Kobe, Japan
Abstract
Background: The efficacy of inactivated influenza vaccine in healthy infants and children younger than 24 months has not been confirmed. The aim of the present study was to determine the prophylactic effect of inactivated influenza vaccine against influenza A in healthy children aged 6–24 months.
Methods: Healthy infants and young children (6–24 months old) were immunized by subcutaneous injection of inactivated influenza vaccine before influenza seasons. Age matched children were randomly assigned as the control. These children were followed up from January to April in each year (2000, 2001 and 2002). The attack rates of influenza A infection was compared and statistically assessed.
Results: The attack rate of influenza A virus infection in the vaccine group and the control group were 14.8% ( n = 27) vs 12.5% ( n = 32) in 2000 ( P = 0.526); 2.8% ( n = 72) vs 7.2% ( n = 69) in 2001 ( P = 0.203); and 3.4% ( n = 52) vs 8.9% ( n = 56) in 2002 ( P = 0.205). The attack rates of influenza A between the two groups were not significantly different.
Conclusion: Inactivated influenza vaccine did not reduce the attack rate of influenza A infection in 6–24 month old children. Key words influenza, vaccine, children, infant. Different countries have selected a range of different programs for influenza vaccine recommendations. In the United States, inactivated influenza vaccine is recommended for any person aged greater than 6 months
old who is at increased risk for complications.
http://www.nbc17.com/health/3875137/detail.html
Orange County health officials said late Friday that lab tests show Davis has the second most common strain of bacterial meningitis, but it is one that isn't covered by a meningococcal vaccine. Exposed individuals who have received the vaccine still need preventive treatment, they said.
Davis himself had been vaccinated against meningitis in April. Officials haven't determined when or where he contracted the disease.
http://home.hamptonroads.com/stories/story.cfm?story=79266&ran=144526
EVMS research aims to help elderly fight flu
By KATRICE HARDY, The Virginian-Pilot
© December 13, 2004
Last updated: 11:37 PM
When the nationwide flu vaccine shortage hit, doctors at Eastern Virginia Medical School initially found themselves, like many others in Hampton Roads, without any vaccine for their patients. But a small team of EVMS scientists had vaccine to give. Now, the patients who rolled up their sleeves for them are on the front line of research that could boost the effectiveness of flu shots – and better guard the nation against a bioterror threat. The federally funded research is aimed at improving elderly people’s ability to fight off the virus.
In the flu battle, that’s no small matter. Nine out of every 10 Americans who die of flu complications are 65 or older. That adds up to more than 30,000 deaths in an average year, and the number could well climb as the population ages. Some die even after receiving flu vaccinations. With age, immune systems degrade; older people are particularly susceptible to flu strains that may not be included in the vaccine in circulation at the time. The EVMS research, paid for by a $487,000 grant from the National Institutes of Health, is being conducted by scientists in a biodefense center the medical school established two years ago.
All eight of the biochemists, physicians and protein specialists who are part of the center have won government and private grants for bioterrorism protection research.
Flu is one concern of anti-terror officials . A hard-to-combat strain spread by terrorists could cause an epidemic, said Dr. George Curlin, acting branch chief of the National Institute of Allergy and Infectious Diseases, which awarded EVMS the flu-vaccine research grant.
Vaccinations are still the best protection against flu for adults of any age. But Curlin said his agency has been concerned that as more people have made it a priority to be vaccinated, the number of elderly dying from the virus has not declined.
EVMS’ work focuses on one particular type of cell in the immune system. Known as T-cells, they have been proven critical in fighting off diseases, said Yuping Deng, who is leading EVMS’ latest influenza research. The cells help keep infections from spreading to other cells in the body.
Deng, 41, hopes her work will help scientists better understand how well elderly people’s T-cells work against the flu.
In a nation of flu vaccine shortages, Deng had no problem finding volunteers.
Nearly 175 people were recruited.
The associate professor of EVMS’ Glennan Center for Geriatrics and Gerontology recently laughed about her good fortune. She ordered her vaccine from a company other than Chiron Corp., whose factory shutdown in Liverpool, England, by British regulators triggered the U.S. vaccine shortage.
“Otherwise, I wouldn’t have any,” Deng said in an interview in EVMS’ Hofheimer Hall.
The medical school’s practicing doctors had relied on Chiron instead. Later, they received a limited amount of vaccine from other local health providers. In Deng’s project, flu vaccine was given to two groups. “The young,” as she describes them, are 58 volunteers between the ages of 21 and 40. About 115 people over 65 make up the other group.
After she completes drawing the volunteers’ blood, she plans to examine the effectiveness of each age group’s T-cells. Next flu season, she plans to administer new variations and versions of the vaccine to elderly volunteers in an attempt to boost their T-cells.
Deng will give some volunteers a vaccine and then a second shot of a liquid chemical which consists of pieces of DNA found in bacteria. The chemical, which is effective in boosting the immune system against cancers, is produced by Coley Pharmaceutical Group of Wellesley, Mass.
The company has given EVMS the drug for free. Previous studies have shown that mixing the DNA-laced liquid with vaccine could likely help health officials protect more people. The mixture might be the nation’s answer to future vaccine shortages, Deng said, noting that at least two people might be able to get flu shots with just one vial of vaccine, instead of one person. With a separate group of volunteers, Deng will give two shots within one week to see if the added amount helps boost their immune systems.
Officials at the national institute will monitor Deng’s volunteers. Her research will be published at the end of the two-year study. EVMS scientists said the potential for improving the immune system of the elderly is great. It’s not unreasonable, Deng said, to expect that someday an elderly person’s immune system would be as robust as that of a 20-year-old.
Reach Katrice Hardy at 222-5857 or katrice.franklin@pilotonline.com
© 2004 HamptonRoads.com/PilotOnline.com
Clin Infect Dis. 2004 Dec 1;39(11):1715-8. Epub 2004 Dec 1. Related Articles, Links
Prevalence of antibody to Bordetella pertussis antigens in serum specimens obtained from 1793 adolescents and adults.
Cherry JD, Chang SJ, Klein D, Lee M, Barenkamp S, Bernstein D, Edelman R, Decker MD, Greenberg DP, Keitel W, Treanor J, Ward JI.
University of CaliforniaLos Angeles Center for Vaccine Research, Research and Education Institute, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, USA. jcherry@mednet.ucla.edu <jcherry@mednet.ucla.edu>
Serum specimens were obtained from all subjects in the adolescent and adult acellular pertussis (aP) vaccine efficacy trial before and after immunization to study the prevalence of IgG and IgA antibody and geometric mean titers to 4 Bordetella pertussis antigens. Of 1793 adolescents and adult subjects who received aP vaccine, only 20%, 68%, 59%, and 39% had concentrations of IgG antibodies to pertussis toxin, filamentous hemagglutinin, pertactin, and fimbriae types 2 and 3, respectively, that were greater than or equal to the limit of quantitation of the enzyme-linked immunosorbent assay used in the analysis. There was minimal variation in antibody prevalence with respect to geographic area, age, sex, or race.
PMID: 15578376 [PubMed - in process]
Chicken-Pox vaccine not totally effective
25 Dec 2004 <http://www.medicalnewstoday.com/images/blanktab.gif>
http://www.medicalnewstoday.com/medicalnews.php?newsid=18313
<http://www.medicalnewstoday.com/medicalnews.php?newsid=18313&nfid=rssfe
eds> &nfid=rssfeeds
For over five years, doctors in India have been recommending chicken pox vaccination for children, even though it does not figure in the list of mandatory vaccinations, and no comparative study has ever been conducted. Now they may have to do a rethink, after new studies in the US have raised
doubts about its effectiveness. According to the study, published last week in The Journal of the American Medical Association, found the effectiveness of the vaccine is found to fade substantially a year after it is administered.
In children below 15 months, the vaccine appears to have less immunity. Experts are now questioning whether the vaccine - for long a topic of debate in the US - should be used at all, as immunisation just pushes the disease into adulthood when it could take a more severe form. Adults whose childhood immunity has worn off could be in trouble later age as it increases their vulnerability to the disease, say experts. ''The findings do raise some pertinent questions. It is a matter of concern.'' says Dr Anupal Sibal, senior child specialist, Indraprastha Apollo Hospitals.
The study, carried out over several years by researchers at Yale Medical School, further found that in children above 15 months, protection was 99 per cent in the first year, and only 73 per cent in those below 15 months. However, those who got chicken pox after receiving the shots had only mild
symptoms.
What's the solution for this then? Sibal suggests administering a second dose, "Even now, children beyond 15 years are recommended two doses." The catch: it's very expensive.
http://www.medindia.net/News/view_news_main.asp?t=gn
<http://www.medindia.net/News/view_news_main.asp?t=gn&x=3166> &x=3166
(rather than admit vaccines don't work they just recommend another dose! )
Flu Shots for Elderly May Not Save Lives
2 hours, 38 minutes ago Health - AP
By CARLA K. JOHNSON, Associated Press Writer
CHICAGO - A new study based on more than three decades of U.S. data suggests that giving flu shots to the elderly has not saved any lives.
Led by National Institutes of Health (news - web sites) researchers, the study challenges standard government dogma and is bound to confuse senior citizens. During last fall's flu vaccine shortage, thousands of older Americans, heeding the government's public health message, stood in long lines to get their shots. "There is a sense that we're all going to die if we don't get the flu shot," said the study's lead author, Lone Simonsen, a senior epidemiologist at the National Institute of Allergy and Infectious Diseases (news - web sites) in Bethesda, Md. "Maybe that's a little much."
The study should influence the nation's flu prevention strategy, Simonsen said, perhaps by expanding vaccination to schoolchildren, the biggest spreaders of the virus. However, the U.S. Centers for Disease Control and Prevention (news - web sites) in Atlanta plans no change in its advice on who should get flu shots, saying the NIH research isn't enough to shift gears. "We think the best way to help the elderly is to vaccinate them," said CDC epidemiologist William Thompson. "These results don't contribute to changing vaccine policy."
The CDC currently recommends flu shots for people age 50 and over, nursing home residents, children 6-23 months, pregnant women, people with chronic health problems and certain health care and day care workers. When vaccine was scarce a few months ago, healthy adults under 65 were urged to forgo the shot. Although the study, published Monday in the Archives of Internal Medicine (news - web sites), looks at data from the whole U.S. elderly population over time, it doesn't directly compare vaccinated vs. unvaccinated elderly, Thompson said. Previous studies that made that comparison found the vaccine decreased the rate of all winter deaths.
It's also unlikely that a single study would trigger a change in policy, said CDC spokesman Glen Nowak. But the former head of the nation's vaccine strategy, Dr. Walter Orenstein, said Simonsen's work "should make us think twice about our current strategy and (about) potentially enhancing it." Orenstein is former director of the CDC's National Immunization Program and now leads a program for vaccine policy development at Emory University. A shift to vaccinating schoolchildren, the age group most likely to spread the flu virus, is advocated by colleagues of Orenstein's at Emory in a separate report to be published Tuesday in the American Journal of Epidemiology.
The NIH and Emory papers, one a highly technical statistical analysis of death data and the other a commentary based on field studies and mathematical modeling, come during a season that focused the nation's attention on vaccine supplies. As a vaccine shortage loomed last fall, the CDC urged shots only for the highest-risk groups. Most of the 36,000 people who die each year of flu-related causes are elderly and the nation's strategy has focused on getting shots to them, as well as other high-risk groups. Last week the CDC reported that about 59 percent of older Americans got shots in 2004, down from 65 percent in 2003. Based on her research, Simonsen doesn't expect to see a corresponding increase in flu-related deaths this year, something that "can be seen as good news."
The flu vaccine is less effective in the elderly than in younger people. It works, but not very well, said Ira Longini, a biostatistics professor at Emory University's Rollins School of Public Health and a proponent of vaccinating schoolchildren. While it's smart for senior citizens to get their yearly flu shots because it can decrease their risk of getting sick, he said, a smarter government strategy would emphasize shots for children, ages 5 to 18. His statistical models show that strategy could save more elderly Americans from hospital visits and death. "If we really want to make a difference and control influenza, we simply have to change the policy. We have to vaccinate large numbers of children," Longini said.
He and his colleague Dr. Elizabeth Halloran write that if 70 percent of schoolchildren were vaccinated, the elderly would be protected without flu shots. The strategy would require 42 million doses of flu vaccine. Even during this season's shortage, there were 57 million doses available, their report says. Yearly flu shots have been recommended for people 65 and older since the 1960s and for those 50 and older since 2000. Vaccination rates have risen among seniors from 20 percent before 1980 to 65 percent in 2001, according to the NIH study.
Simonsen and her team of researchers could find no corresponding decrease in death rates. Their analysis took into account the fact that people are living longer and that more virulent strains of flu dominated the 1990s. The CDC's Thompson said Simonsen didn't take into account the effect of a gradual lengthening of the average flu season over the decades. But Simonsen said that no matter what model she used to define a flu season, she came to the same result. Older Americans should keep their risk in perspective, said Dr. Lisa Schwartz and Dr. Steven Woloshin, senior researchers at the VA Outcomes Group, a small group of researchers trying to promote the straightforward presentation of medical information.
For the average senior citizen, the annual risk of dying from the flu is low: about 1 in 1,000. They said senior citizens still should try to get flu shots, but shouldn't panic if vaccine isn't available.
New strain of child-killing influenza feared
http://www.yomiuri.co.jp/newse/20050224wo72.htm
Yomiuri Shimbun
Six children who died in Osaka Prefecture two years ago during an influenza outbreak were victims of a new strain of influenza encephalopathy, a disease affecting the central nervous system caused by the influenza virus, a Health, Labor and Welfare Ministry team has discovered.
The team also attributed several deaths in other locations that occurred during the outbreak and at least one last winter to the new strain. Five cases of children dying suddenly while sleeping were also reported in the Untied States during the same period.
The disease can kill children suddenly--often while they are sleeping--without the children exhibiting the classical symptoms of convulsions or impaired consciousness seen in regular influenza encephalopathy.
The team said it had been unable to find common causes in the deaths and said a detailed investigation was needed.
Some experts on drug-induced diseases said the new strain of encephalopathy may have been caused by drugs prescribed to the victims.
Team member Masashi Shiomi, who is director of emergency medical care for children at the Osaka City Central Hospital, said that between December 2002 and February 2003 six young boys died in their sleep one or two days after they contracted influenza. The boys, aged 1 to 8, lived in Osaka, Suita and other parts of the prefecture.
None of the boys showed specific symptoms. Autopsies on three of the boys showed severe brain swelling and deformed astrocytes, brain cells that support the brain's nervous tissue. As such deformation is not observed in ordinary influenza encephalopathy, Shiomi and other team members concluded the disease was a new strain of the disease.
The findings of the team, headed by Prof. Tsuneo Morishima of Okayama University, prompted it to ask medical institutions across the nation to provide any information they have that might be pertinent to the disease.
In response, the team received notification of several other cases of sudden deaths of children while they were sleeping or being sent to hospital.
Of the six children in Osaka Prefecture, four had been prescribed oseltamivir, an antiviral drug sold under the trade name of Tamiflu, and a fifth was on Amantadine, an antiviral drug.
The Swiss pharmaceutical company Roche, which manufactures Tamiflu, warned in January last year that medical institutions should observe the recommendation not to prescribe the drug to children less than 1 year old. The advisory was issued following experiments in which young laboratory rats dosed with large quantities of the drug died and high concentrations of the drug were detected in their brains.
Rokuro Hama, director of the Osaka-based nonprofit organization Japan Institute of Pharmacovigilance for Evidence-based Healthcare, said, "Drugs may have entered the children's brains, in which the function to block foreign substances has yet to develop, suppressed their respiratory centers and killed them suddenly."
Prof. Morishima said: "Four children in Osaka Prefecture took Tamiflu only once. Of the other children, some died of the new strain of the disease although they had not taken the drug. Others who had taken the drug suffered regular encephalopathy. It is difficult to explain the influence of drugs. It may depend on their constitution."
Influenza encephalopathy is a disease that causes the brain to swell as well as rapid progressing nervous symptoms, such as impaired consciousness and convulsions.
The disease often affects children aged 6 or younger. Hundreds of children come down with the disease every year, of whom 10 percent to 30 percent die, while 25 percent suffer serious after effects.
Last winter, 103 children developed the disease and 10 died.
Some experts have pointed to a relation with two nonsteroidal fever reducers, the use of which the central government banned in the autumn of 2000 for treating influenza. The causes of influenza encephalopathy, however, have yet to be determined.
The ministry team said that influenza encephalopathy cannot always be prevented by vaccination.
Commun Dis Public Health. 2004 Dec;7(4):272-7. Related Articles, Links
Outbreak of influenza A (H3N2) in a highly-vaccinated religious community: a retrospective cohort study.
Nicholls S, Carroll K, Crofts J, Ben-Eliezer E, Paul J, Zambon M, Joseph CA, Verlander NQ, Goddard NL, Watson JM.
Brighton and Hove City Primary Care Trust.
An outbreak of influenza occurred at the end of the 2001-2 winter season in a highly-vaccinated, semi-enclosed, religious community. On the basis of retrospective self reporting, 43% met the case definition (151/350) and 81% (25/31) of throat swabs from cases were polymerase chain reaction (PCR) -positive for influenza A (H3N2). The risk of developing influenza in people aged 65 or more was lower than that of children aged 2 years and under (odds ratio 0.1, 95% confidence interval 0.02 to 0.38). The risk of developing symptoms of influenza was not significantly different between people who had been vaccinated in the United Kingdom and those who had not been vaccinated (OR 1.14, CI 0.41 to 3.14). Chronic disease was an independent risk factor for developing symptoms of influenza (OR 1.9, CI 1 to 3.63). Timing of the outbreak, the age structure and mode of communal living may have influenced the efficacy of the influenza vaccine, which was well matched to circulating strains at the time of the outbreak. It is important to consider the diagnosis of influenza even in a highly-vaccinated community.
PMID: 15779788 [PubMed - in process]
US flu vaccine trials may be effort wasted
12:30 25 March 2005
Exclusive from New Scientist Print Edition
Debora MacKenzie
The first human trials of a vaccine against H5N1 bird flu are likely to be a waste of time and money.
The formulations that the US plans to test are thought likely to be ineffective - and even if they do work it will take far too long to manufacture enough doses to prevent a pandemic strain wreaking havoc. Other countries are following more promising approaches, but they are not ready to start trials.
Fears that the H5N1 virus might mutate into a form capable of triggering a human pandemic have persuaded several countries to change strategy. Instead of waiting for a pandemic strain to emerge, health authorities are creating human vaccines against the current strain. Although these vaccines might not be perfect, the hope is that they will make the difference between life and death.
The sooner prototype vaccines are tested, the sooner vaccine makers can prepare to manufacture the vast quantities that might be needed. But so far the US is the only country to have ordered enough prototype vaccine to do clinical trials - and there are two major problems with its formulations.
No immunising effectThe key ingredient in any flu vaccine is the viral protein haemagglutinin, or HA. Vaccines against ordinary flu contain 15 micrograms each of three varieties of HA. The clinical trials planned by the US National Institute of Allergy and Infectious Diseases will test doses of 15 and 45 micrograms of H5 - the HA of the H5N1 virus killing people in Vietnam. The aim is to make the vaccine as similar to ordinary flu vaccines as possible, to ease approval by the FDA.
But several studies have shown that with HAs that people have not been exposed to before, such as H5, even doses higher than 15 micrograms have little or no immunising effect. "I predict they won't get much immune response at all," says Tony Colegate of the vaccine company Chiron in the UK, head of the industry's pandemic task force.
For this reason, other countries planning to test prototype vaccines - like Japan, Canada and Australia - will all add a chemical such as alum to boost the immune system reaction. This adjuvant is used in many childhood vaccines.
Another important benefit of adding an adjuvant is that far less HA will be needed in each dose. That is crucial because vaccine production capacity is limited.
Worldwide capacityThe single flu vaccine factory in the US would take six months to produce 180 million doses of 15 micrograms of H5, according to calculations by flu expert David Fedson in the latest issue of the Journal of Public Health Policy. And since past studies suggest people need two shots three weeks apart to develop immunity to novel strains, that is enough for only 90 million people. All vaccine plants worldwide could produce only enough for 450 million people.
In 2001, however, scientists in the UK found that with an adjuvant, two doses of just 7.5 micrograms of H5 were enough to induce immunity in previously unexposed people. And last year scientists at GlaxoSmithKline Biologicals found that two doses each of 1.9 micrograms of another novel HA were enough.
If a vaccine could be made with just 1.9 micrograms per dose, the world's vaccine plants could churn out 7.2 billion doses in six months, enough for 3.6 billion people, Fedson says. "That's probably more than the world's combined healthcare services can vaccinate."
Bruce Gellin, head of the US National Vaccine Programme Office, says the trials now being planned "are only the first in a long series". Last week his department asked for proposals to find ways to make vaccines stretch farther, he says. "We are taking this very seriously."
Journal reference: Journal of Public Health Policy
EPediatric News
May 2005 . Volume 39 . Number 5*
*
Combo Vaccine Counters Effect Of Other Vaccines
Pnc9-MenC less effective than MenC alone.
Alicia Ault*
/Contributing Writer/
An experimental vaccine that combines coverage for nine strains of pneumococcus and a single meningococcal strain appears to be less effective than a meningitis vaccine alone, and also decreases the immunogenicity of some other vaccinations given concomitantly, according to a recent report.
The study results provide a cautionary tale for vaccine makers and pediatricians, said John Bradley, M.D., director of the division of infectious disease at Children's Hospital, San Diego, who was asked to comment on the findings. "It is not easy to put together a vaccine that has all these components," he said. "When you mix them all together you don't get the nice brisk responses you expect when you administer each separately, and we're probably further off from a single vaccine than we were all
hoping," added Dr. Bradley, who is a member of the American Academy of Pediatrics Committee on Infectious Diseases.
Lead author Jim P. Buttery, M.D., agreed that the study showed the technical difficulty of building a single-shot package. "Each new antigen is successively more difficult," he said in an interview. The phase II trial compared Wyeth's Pnc9-MenC vaccine with the company's MenC vaccine alone (JAMA 2005;293:1751-8). MenC (Meningitec) is not used in the United States, and it's not likely that the Pnc9-MenC combination would ever be sold in the United States, as the strains it covers are not as prevalent here.
There is great interest in having more combination vaccines. Dr. Buttery and his colleagues noted that if a combination meningococcal/pneumococcal vaccine was adopted, it could spare U.S. infants up to four extra injections by 18 months, and United Kingdom infants two to three injections at each visit. Dr. Buttery led the study while at Churchill Hospital in Oxford, England. He is now with Murdoch Children's Research Institute, the University of Melbourne (Australia).
In the trial, Dr. Buttery and his colleagues enrolled 240 healthy infants aged 7-11 weeks at two United Kingdom hospitals from August 2000 to January 2002. Children who had known immunosuppression, previous vaccination, or confirmed invasive meningococcal or pneumococcal disease were excluded from the study.
They were divided into two groups: 120 received the Pnc9-MenC vaccine, and 120 received MenC, a monovalent group C meningococcal conjugate vaccine. MenC is the standard in the United Kingdom. There is no separate pneumococcal injection. Both groups also were given diphtheria and tetanus toxoids and whole-cell pertussis, /Haemophilus influenzae/ type b (Hib), polyribosylribitol phosphate-tetanus toxoid protein conjugate, and oral polio vaccine.
Vaccinations were given at ages 2, 3, and 4 months--an accelerated schedule, compared with the United States. Home follow-up visits were conducted at 2, 3, 4, and 5 months of age. At 5 months, serum samples indicated that the combination vaccine was less immunogenic than the MenC vaccine. Antibody concentrations for Hib and diphtheria were lower for infants who received the combination. Dr. Buttery and his colleagues said the effect on diphtheria was unexpected, but he noted that the antibodies were still in the protective range. There was no difference between the groups for tetanus antibodies.
More children in the combination group had to forego second or third vaccinations because of prolonged crying or fever.
The study might not be applicable to U.S. practice because of the accelerated schedule--because there is only a month of separation between each dose--and because of the different vaccinations used. For instance, whole-cell pertussis and oral polio are not usually given in the United States; acellular pertussis and injectable polio are used, Dr. Bradley said. But he said it was important the study was published, especially since it was sponsored by a drug company and was published despite its negative findings.
http://www.newstarget.com/008146.html
NewsTarget
June 1, 2005
A teenage boy in New Zealand contracted a deadly disease known as meningococcal B, despite having been vaccinated against the disease. Investigators are examining the boy to try and understand why the vaccine was not fully effective in his case. Because it does not contain live bacteria, it is not possible that the teen caught the disease from the vaccine.
New Zealand authorities assured the public that this incident does not mean that the nationwide vaccination campaign has been ineffective. According to Dr. Jane O'Hallahan, "No vaccine is 100 percent effective." The teenage boy has made a complete recovery. To learn more on this topic, be sure to also read the related article, Obesity follows Western culture's influence around the world.
He had received three injections of the vaccine being given to under-20-year-olds to combat the meningococcal B epidemic strain responsible for most meningococcal cases in New Zealand. "The youth appears to have had a less severe case of the disease. It is possible that the vaccine provided partial protection for this person and lessened the severity of the disease," meningococcal B immunisation programme director Jane O'Hallahan said.
The boy could not have contracted the disease from the vaccine because it does not contain live bacteria. Dr O'Hallahan said with any vaccine there was a small proportion of the population who did not develop full immunity. The breakthrough case involving the South Auckland teenager, the first since the campaign began in July, was being investigated by the ministry to find out why it had happened.
Possible causes included the patient's immune system being compromised or the vaccine not being stored properly. The review was likely to take some time. The case would not dent the credibility of the $200 million vaccination campaign, she said. More than 170,000 children have so far been immunised against the deadly disease. The campaign was launched in Wellington this week.
To be fully immunised a person needs to have three doses, and it can take upto 28 days after the third dose for immunity to fully develop. Ron Law, a risk analyst who has publicly questioned the vaccination campaign, said be believed there were other cases that had not been made public where children had contracted meningococcal disease after being vaccinated. The effectiveness of the campaign was unknown and it should be halted till it could be investigated by a commission of inquiry, he said.
U. Iowa Finding Speeds Up Immunization Booster Schedule
6/12/2005
Source: University of Iowa
Parents often wonder why it takes a year or more and multiple shots to fully immunize their children against diseases like diphtheria and pertussis. The reason is twofold. First, a single vaccination generates only a small amount of immunity and booster shots are needed to build up immunity to protective levels. The second reason is due to the fact that a substantial "lag time" is required by the immune system between initial immunization and subsequent booster shots to maximize the size of each boost.
Researchers at the University of Iowa Roy J. and Lucille A Carver College of Medicine have discovered that a different vaccination strategy, called dendritic cell vaccination, can dramatically speed up the immunization process by greatly reducing the required "lag time" between the initial vaccination and the booster shots. The finding has important implications for immunotherapy -- using vaccines to treat cancer -- where developing immunity fast is critical.
In the UI study, mice treated with a dendritic cell vaccine and a booster shot were protected against a bacterial infection in a matter of days compared to the several weeks required by normal vaccination to generate immunity. The study results appeared in Nature Medicine advance online publication (AOP) at the journal's Web site
(http://www.nature.com/nm/index.html) on June 12.
"People should not be concerned that vaccines don't work -- if you have plenty of time, current vaccine and booster regimens work very well," said John Harty, Ph.D., UI professor of microbiology in the Carver College of Medicine, and senior author of the study. "But there are circumstances, such as using a vaccine to treat a fast-growing cancer, where the immune response might be needed much more rapidly. With the dendritic cell vaccinations, we really speed up the booster schedule and also speed up the time it takes to achieve protective immunity."
Harty, who also is the Carver College of Medicine Endowed Professor in Microbial Immunology, noted that there already are DC vaccines in clinical trials for cancer, and if the new information from the UI study can be applied in humans, then the findings might provide a way to greatly speed up the booster schedule for immunotherapies and shorten the time needed to generate protective immunity.
Dendritic cells (DCs) are an important component of the immune system. They act like scouts, monitoring the body for foreign invaders such as bacteria or viruses. Contact with the invading microbe "arms" the dendritic cells, which then travel from the infection site to the lymph nodes where they activate specific T cells. These stimulated T cells proliferate and go through a transformation process, first becoming effector cells that can fight the infection and then developing memory characteristics, which are the basis of long-term immunity against that infection.
This T cell transformation process takes time, and only memory T cells can proliferate in response to a booster vaccination or a second infection. Thus it is necessary to allow for this "lag time," in which the memory T cell population develops, before giving a booster shot designed to bump up immunity.
The DC vaccination strategy used by Harty and his colleagues involved "arming" dendritic cells against a specific bacterium in a petri dish and then immunizing mice with the altered dendritic cells. The UI team found that these DC vaccinations cause an accelerated production of memory T cells.
"Six days after infection or conventional immunization those memory cells are not yet available to be expanded by the booster shot. But six days after a DC vaccination they are," Harty said. "An initial DC vaccination followed very quickly by booster shots allowed us to rapidly generate tremendous numbers of T cells."
Further experiments suggested that inflammation, which is a normal part of infection or current vaccine regimens, plays an important role in controlling the normally slow development of memory T cells. In contrast, DC vaccinations do not produce inflammation and the memory T cells develop very quickly.
"Provoking a T cell response in the absence of inflammation gives you early memory, which allows us to boost the response quickly," Harty said. "If results in humans are similar to what we see in animal models, this could represent a large step forward in vaccine efficiency, especially for situations were speedy protection is important."
In addition to Harty, the UI team included Vladimir Badovinac, Ph.D., an associate research scientist, and Kelly Messingham, Ph.D., a postdoctoral researcher, who were co-first authors of the study. Ali Jabbari and Jodie Haring, Ph.D., also were part of the research group. The study was funded by the National Institutes of Health.
Contact: Jennifer Brown
jennifer-l-brown@uiowa.edu
319-335-9917
University of Iowa
July 2005 12:45
http://news.independent.co.uk/uk/health_medical/article297165.ece
'Ineffective' tuberculosis vaccinations in schools to be dropped
By Jeremy Laurance
Published: 06 July 2005
The Government is to abandon the schools vaccination programme against tuberculosis despite the growth in cases of the disease.
Professor Liam Donaldson, the Government's chief medical officer, will announce today that the BCG vaccination offered to all children between the ages of 10 and 14 is to be dropped because it is ineffective. Evidence shows that tuberculosis is falling among the white population and that schoolchildren are at lowest risk, but it remains a risk among immigrant groups. The vaccination will continue to be offered to babies from high-risk groups whose parents were born abroad.
The move has the backing of specialists in the field who are lobbying for the £10m cost of the vaccination scheme to be ploughed back into services to improve TB control. Cases of tuberculosis have grown from 5,000 in 1987 to almost 7,000 last year, but they are concentrated among the homeless and communities with close links to parts of the world where tuberculosis is rife, especially in Africa and the Indian subcontinent.
Professor Peter Ormerod, of the British Thoracic Society, said: "All the scientific evidence shows that the schools BCG programme is given to people at extremely low risk of TB. Children born abroad or with parents born abroad are at higher risk and they are offered vaccination at birth, which will continue. If you are not in one of those groups, the chances of getting TB are one in 100,000." Professor Ormerod, professor of respiratory medicine at Blackburn Royal Infirmary, said the BCG vaccine was only 75 per cent effective and gave protection for 10 to 15 years. For every 5,000 children vaccinated, one case of TB would be prevented over the following 15 years.
Some children suffered adverse reactions, including a BCG abscess which required treatment with anti- tuberculosis drugs, or a keloid scar - an unsightly disfigurement at the site of the injection. Professor Ormerod said: "It is hugely cost-ineffective. If you are having to give 5,000 injections to prevent one case of disease, that is madness. The British Thoracic Society fully supports the decision to stop the school BCG programme, but we will lobby to have the money saved invested in TB services." Tuberculosis is a global killer, claiming more than two million lives a year. In Britain, after decades of decline, the number of cases started to rise again in the mid-1980s. Although it is curable with drugs, the development of drug-resistant strains of TB in recent years has caused alarm. These cases are extremely difficult and costly to treat.
TB is not easy to catch, and in most cases requires prolonged close contact with an infected person. Once infected, the disease can lie dormant and may not emerge until years or decades later.
Professor Ormerod said most white victims of the disease were in their fifties or older who became infected decades ago. The proportion of the white population infected had fallen year on year. The Government is to abandon the schools vaccination programme against tuberculosis despite the growth in cases of the disease.
Professor Liam Donaldson, the Government's chief medical officer, will announce today that the BCG vaccination offered to all children between the ages of 10 and 14 is to be dropped because it is ineffective. Evidence shows that tuberculosis is falling among the white population and that schoolchildren are at lowest risk, but it remains a risk among immigrant groups. The vaccination will continue to be offered to babies from high-risk groups whose parents were born abroad.
The move has the backing of specialists in the field who are lobbying for the £10m cost of the vaccination scheme to be ploughed back into services to improve TB control. Cases of tuberculosis have grown from 5,000 in 1987 to almost 7,000 last year, but they are concentrated among the homeless and communities with close links to parts of the world where tuberculosis is rife, especially in Africa and the Indian subcontinent. Professor Peter Ormerod, of the British Thoracic Society, said: "All the scientific evidence shows that the schools BCG programme is given to people at extremely low risk of TB. Children born abroad or with parents born abroad are at higher risk and they are offered vaccination at birth, which
will continue. If you are not in one of those groups, the chances of getting TB are one in 100,000."
Professor Ormerod, professor of respiratory medicine at Blackburn Royal Infirmary, said the BCG vaccine was only 75 per cent effective and gave protection for 10 to 15 years. For every 5,000 children vaccinated, one case of TB would be prevented over the following 15 years. Some children suffered adverse reactions, including a BCG abscess which required treatment with anti- tuberculosis drugs, or a keloid scar - an unsightly disfigurement at the site of the injection.
Professor Ormerod said: "It is hugely cost-ineffective. If you are having to give 5,000 injections to prevent one case of disease, that is madness. The British Thoracic Society fully supports the decision to stop the school BCG programme, but we will lobby to have the money saved invested in TB services." Tuberculosis is a global killer, claiming more than two million lives a year. In Britain, after decades of decline, the number of cases started to rise again in the mid-1980s. Although it is curable with drugs, the development of drug-resistant strains of TB in recent years has caused alarm. These cases are extremely difficult and costly to treat.
TB is not easy to catch, and in most cases requires prolonged close contact with an infected person. Once infected, the disease can lie dormant and may not emerge until years or decades later. Professor Ormerod said most white victims of the disease were in their fifties or older who became infected decades ago. The proportion of the white population infected had fallen year on year.
Failure of hepatitis B vaccination in patients receiving lamivudine
Failure of hepatitis B vaccination in patients receiving lamivudine prophylaxis after liver transplantation for chronic hepatitis B
Chung Mau Loa, , , Chi Leung Liua, See Ching Chana, George K. Laub and
Sheung Tat Fana aCentre for the Study of Liver Disease, Department of Surgery, The
University of Hong Kong, Pokfulam, Hong Kong, China bCentre for the Study of Liver Disease, Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
Received 26 January 2005; revised 25 February 2005; accepted 23 March 2005. See Editorial, pages 203–206. Available online 17 May 2005.
Background/Aims
Lamivudine prophylaxis against hepatitis B virus (HBV) reinfection after liver transplantation is associated with recurrence due to escape mutants.
Methods
Fifty-two patients on lamivudine prophylaxis at a median of 412 days (median, 370–2040 days) after transplantation for chronic HBV-related liver disease received two courses of an accelerated schedule of double-dose recombinant HBV vaccine. Before vaccination, all patients were seronegative for HBsAg, anti-HBs and HBV DNA (by qPCR). Three intramuscular doses of vaccine (40 ìg each) were administered monthly and another identical
course was repeated after 3 months. Lamivudine (100 mg/day) was continued throughout the study.
Results
After the first course, two patients developed a weak response (anti-HBs titre of 12 mIU/mL) that disappeared rapidly. One early responder developed anti-HBs (27 mIU/mL) again after the second course but the other did not. Two other patients developed response (anti-HBs titre of 17 and 103 mIU/mL, respectively) giving an overall response rate of 7.7%. The antibody level declined rapidly. At the end of the study, one patient who did not respond had developed viral breakthrough which was treated with adefovir dipivoxil therapy.
Conclusions
Active immunization with two courses of double-dose recombinant HBV vaccine has limited efficacy in patients receiving lamividine prophylaxis after liver transplantation.
Keywords: Active immunization; Immunity; Recurrence; Antibody against hepatitis B surface antigen The authors who have taken part in this study have declared that they do not have a relationship with the manufacturers of the drugs involved either in the past or present and did not receive funding from the manufacturers to carry out their research.
Corresponding author. Tel.: +852 2855 4761; fax: +852 2817 5475.
Journal of Hepatology
Volume 43, Issue 2 , August 2005, Pages 283-287
http://today.reuters.co.uk/news/newsArticle.aspx?&storyID=2005-08-01T171034Z_01_N01380986_RTRIDST_0_SCIENCE-TUBERCULOSIS-DC.XML New TB vaccine design called for in poor nations
Mon Aug 1, 2005 6:11 PM BST
By Patricia Reaney
LONDON (Reuters) - Tuberculosis vaccines being tested in developed countries will not protect people living in parts of the developing world where they are most needed because they trigger a different body response, researchers said on Monday. Scientists at University College London (UCL), who looked at variations in immune system responses around the globe, found that in countries near the equator the tuberculosis bacteria turn the body's normal protective response into a harmful one.
So like the BCG, or bacille Calmette-Guerin vaccine, used against TB in some countries, the latest vaccines which use the same approach will not work in developing countries, according to the researchers. "What we have done is identify the mechanisms that we think lead to the fact that BCG vaccine does not work close to the equator, where the problem really is," Professor Graham Rook, an immunologist at UCL, said in an interview.
"We realized that the vaccine candidates going into clinical trials at the cost of hundreds of millions of dollars haven't in any way answered that particular problem," he added. In countries in the northern hemisphere, the immune system protects the body against TB with TH1 cells. BCG and new candidate TB vaccines are designed to boost the TH1 cells.
But in people living near the equator, the TH1 cells are already on alert, so the protective mechanism is switched on but does not work because another inappropriate response is also turned on which undermines it. "What is needed, in our opinion, is not a vaccine that turns on the protective mechanism because that is already there but rather a vaccine that turns off the subversive mechanism that shouldn't be there," said Rook, who reported the findings in the journal Nature Reviews Immunology.
TB is a contagious airborne disease that affects about 9 million people each year and kills 2 million. The World Health Organization has warned that TB has reached alarming proportions in Africa where co-infection with HIV makes a lethal combination.
"We are not saying that funding for TB vaccination in developing countries should be stopped -- quite the contrary, given that TB kills between 2 and 3 million people every year. But we are concerned that the BCG vaccine is failing these countries and that TB vaccines currently on trial are likely to go the same way," Rook added. The researchers believe a new vaccine approach -- turning off the damaging immune response -- could be used to develop vaccines to combat other infections including HIV.
© Reuters 2005. All Rights Reserved
Vaccinated children have developed meningitis
Dr Muiris Houston, Medical Correspondent
http://www.ireland.com/newspaper/front/2005/0920/4116665085HM1MUIRIS.html
A number of children have developed meningitis caused by the bacterium haemophilus influenzae, despite having been vaccinated against the disease, it has emerged. A recommendation, made last July, to offer a booster vaccine against the infection has yet to be implemented.
Medical sources have confirmed that at least three children under the age of four have been hospitalised with haemophilus meningitis this year. It has also emerged that a number of children have suffered neurological damage from the disease in the last number of years, with one child at Our Lady's Hospital for Sick Children, Crumlin, left with serious neurological complications following invasive haemophilus infection.
Children are vaccinated against haemophilus influenzae type b (Hib) at two, four and six months as part of the national childhood vaccination programme. However, medical experts are now concerned that immunity from these vaccinations does not continue for the main risk period of infection, which lasts until five years of age.
Despite the rising incidence of late Hib infection, a recommendation to offer a booster vaccine made by the National Immunisation Advisory Committee (NIAC) to the Department of Health in July has yet to be implemented. Paediatricians and infection control experts have expressed concern a booster programme has not started in advance of the winter period when haemophilus infection is at its peak.
Dr Kevin Connolly, a consultant paediatrician at Portiuncula Hospital, Ballinasloe, and a member of the advisory committee, said: "I am disappointed that the implementation of a booster programme was not advanced quicker. The NIAC scheduled extra meetings specifically to discuss whether a booster was necessary. We made a decision in July in the hope that a booster dose would be introduced before the winter period. I am very disappointed that nothing definite has been decided thus far".
Dr Karina Butler, a consultant in infectious diseases at Our Lady's Hospital for Sick Children, confirmed last night that she had seen "a small number of cases of invasive Hib disease. The numbers are small but the trend is up and is similar to that seen in the UK. It is now recognised that Hib vaccine given in the first year of life is not strong enough to last through the risk period".
She added: "We need a booster vaccine to protect children up to five years of age. Among the types of infection we have seen is meningitis and some children have developed septic arthritis in their joints as a result of Hib infection".
A source in the Health Service Executive said it is actively planning a booster Hib programme. He estimated it could be December before additional vaccinations would begin. Asked about the budgetary implications of the programme, the source said both the cost of the vaccine and a fee for family doctors would have to be included. He said that, for logistical reasons, it would be the end of the year before a programme could begin. It is estimated the cost of the "catch-up" programme for the 200,000 children involved is about €8 million.
Haemophilus influenza type B is known to cause invasive blood-borne infection such as meningitis, septic arthritis (joint infection) and epiglottisis (a potentially fatal infection of a part of the voice box). A vaccine against the bacterium was introduced in 1992, resulting in a decline in Hib disease. But in 2003, 14 Hib cases were reported, the highest number since 1994.
© The Irish Times
Posted on Sun, Oct. 02, 2005
http://www.twincities.com/mld/pioneerpress/12795127.htm?template=
contentModules/printstory.jsp
Infant found to have polio
Risk to general public is nil, state health officials say
BY TIM HUBER
Pioneer Press
Minnesota health officials said Saturday they are investigating the first case of polio reported in the state since 2000, but dismissed the potential for an outbreak of the crippling disease.
The case involves an infant from central Minnesota who already was hospitalized with a weakened immune system when the infection was discovered, the Minnesota Health Department said. The agency stressed that there is no risk to the general public.
Only people who have not been vaccinated and who had direct contact with the infant would be at risk because the disease is transmitted through stools or oral secretions, said Health Department spokesman Buddy Ferguson. The vast majority of Minnesotans — approximately 93 percent — have been vaccinated, most as infants.
"If you didn't have that kind of contact, you're not at risk," Ferguson said. "We're talking about health care workers who might have cared for the infant. We're talking about family members. We are going to be contacting people in those groups individually."
In the vast majority of cases, polio has no symptoms, but it can cause sore throats, vomiting, abdominal pain and flulike symptoms, according to the Centers for Disease Control. In less than 2 percent of cases, the virus causes minor stiffness in the neck, back or legs, and in less than 1 percent of cases, it attacks the central nervous system and results in permanent paralysis, muscular atrophy and even death. The disease usually affects young children.
Before the 1960s, the disease left hundreds of thousands of victims paralyzed across the United States. Outbreaks created panic. Many people became afraid of large public gatherings. In 1946, the Minnesota State Fair was canceled as state health officials were recording as many as 50 new cases a day.
Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the most recent case has been managed well by state officials.
"This is not a public health situation of any concern," he said.
Health officials would not name the child, give an age or even which town or hospital the infant is in, citing state and federal privacy laws.
The infant apparently contracted polio from someone infected with a mutated form of the polio strain used in oral vaccines, officials said. Even though the child is infected with the virus, he did not show any signs of paralysis, health officials said.
The United States stopped using polio vaccines that contain weakened strains of the live virus in 2000. The live-virus vaccine still can cause polio, and about eight people in the U.S. developed the disease annually before the country switched to using vaccine without the live virus. The last reported polio case in the U.S. occurred the final year that the live vaccine was in use.
Live-virus vaccine remains in use elsewhere in the world, in part because it helps expand protection in areas where not everyone receives the vaccine, Osterholm said. In essence, health officials rely on poor hygiene and inadequate sanitation in these areas to expose more people to the weakened form of the virus and thus give them protection.
At times, the weakened virus reverts to an infectious strain, which apparently is what happened to the infant in Minnesota, Osterholm said.
Polio ceased to be a major threat in the United States decades ago and largely has been eliminated in the Western Hemisphere since Dr. Jonas Salk developed the first vaccine in 1955. Yet the disease remains a serious health threat in the developing world and retains a terrifying reputation in the United States. By one estimate, polio paralyzed 254,000 Americans, many of them children. Vaccination gradually eliminated U.S. outbreaks. In 1960, there were 2,525 paralytic polio cases in the country, but by 1965 the number had dropped to 61, according to the Centers for Disease Control in Atlanta.
The last U.S. outbreak — and naturally occurring cases — occurred in 1979, when Amish in several Midwestern states contracted the disease from a strain of the virus brought in from the Netherlands, according to the CDC.
The last reported case of polio in Minnesota was caused by a vaccine in 1992.
In parts of Africa and Asia, however, polio remains a threat. In Indonesia, for instance, more than 230 children younger than 5 have been infected this year.
The Associated Press contributed to this report.
Tim Huber can be reached at thuber@pioneerpress.com or 651-228-5580.
http://www.tallahassee.com/mld/tallahassee/news/12895605.htm
Four children in Minnesota contract polio
MARTIGA LOHN
Associated Press
ST. PAUL, Minn. - Four children in an Amish community in Minnesota have contracted the polio virus - the first known infections in the U.S. in five years, state health officials said Thursday. Dr. Harry Hull, the state epidemiologist, said the cases do not pose a threat to the general public because most people have been vaccinated against polio and are unlikely to have contact with Amish people. But he said he expects to find more infections within the Amish community because some of its members refuse immunizations on religious grounds.
None of the children have shown any symptoms of the paralyzing disease. About one in 200 people who contract the polio virus suffer paralysis because of it; others typically rid themselves the virus after weeks or months.
None of the four children had been vaccinated. Three are siblings; the fourth is a baby from another family. The infection came to light when the baby was hospitalized for various health problems and underwent tests. Authorities then began testing other members of the community for the virus. Officials would not identify the Amish community but said it consisted of 100 to 200 people. Hull said the infections were traced to an oral vaccine that was administered in another country, probably within the past three years.
The use of oral polio vaccine containing the live virus was stopped in the United States in 2000. The live-virus vaccine caused an average of eight cases of polio a year in the United States. The U.S. and Canada now use an injected vaccine made from the killed virus. State and federal officials are investigating how an infection from a vaccine given in another country reached Minnesota. Stool or saliva from an infected person can transmit the virus. Health officials said they are working with the Amish community to determine who may have been exposed to the virus, and to encourage immunizations.
"We have been going house to house, talking with them about the risk, offering the vaccine and attempting to collect specimens to see if the virus has been spreading," Hull said. "Some families have said, `No, thank you, we do not want to interact with you at all.' Other families have said, `Sure, we'll get vaccinated. We'll provide specimens.'"
Without the community's cooperation, Hull said, there is a chance of an outbreak similar to one that occurred in 1979 in Amish communities in Iowa, Wisconsin, Missouri and Pennsylvania. Ten people were left paralyzed by the disease, according to the Centers for Disease Control and Prevention.
The last naturally occurring case of polio in the United States was in 1979, and health officials consider the disease eliminated in the Western Hemisphere. It persists in other parts of the world, with the vast majority of cases concentrated in India, Nigeria and Pakistan, according to the World Health Organization.
According to the CDC, more than 95 percent of U.S. children are vaccinated against polio by the time they enter school.
2-year-old dies despite vaccination
http://www.irishhealth.com/?level=4&id=8217%3E%20&id=8217
[Posted: Thu 22/09/2005]
A two-year-old boy from Co Louth has died as a result of contracting Haemophilus influenzae type B (Hib), despite being vaccinated against it.
Hib can cause bacterial meningitis in young children. The death of the boy comes just days after the Health Service Executive (HSE) approved plans to offer a Hib booster vaccine to further protect children already vaccinated.
The child had been brought to the A&E department at Our Lady of Lourdes Hospital in Drogheda a number of days ago, but was eventually discharged. The family then went on holiday abroad, where the boy became ill and died.
He had developed septicaemia, as a result of contracting Hib.
The Government is now coming under increasing pressure to explain why a recommendation to provide the booster vaccine has still not been implemented. The recommendation was made in July by the National Immunisation Advisory Committee, after a small number of children developed meningitis despite being vaccinated against the disease.
Earlier this week, the HSE said that it had been planning a campaign to offer the booster vaccine since it was notified about the committee's recommendation in July. It said that the target date for this campaign was this coming November, continuing over the winter months. However according to Fine Gael health spokesperson, Dr Liam Twomey, this case highlights an overall lack of Government understanding of the importance of vaccination.
"In light of this tragic death, it is clear that the provision of a booster for all of the children at risk is an emergency. However it is deeply worrying that the programme is not targeted to start until November, when it should have started before the end of September", Dr Twomey said.
A statement from the HSE meanwhile said that as the death of the boy had occurred abroad, 'complete information is not yet available'. It added that an initial review of the case has been conducted by Our Lady of Lourdes Hospital and a final review will be completed when all the relevant information is obtained.
Chickenpox Outbreak in School District
http://www.wqow.com/news/articles/article_5778.shtml
Galesville
Jan 20, 2006
The chickenpox vaccine is supposed to be at least 85-percent effective. You wouldn't think that by looking at a western Wisconsin school.
An outbreak of chickenpox has affected 44 children at Gale-Ettrick-Trempealeau. All but two had been vaccinated against it.
The outbreak started in November when 36 kindergartners developed chickenpox. The Wisconsin Department of Health and Family Services says it's trying to figure out why so many vaccinated students became sick.
The school nurse says the students received vaccinations from a number of different providers and no manufacturer has reported a bad batch. Only one of the cases cannot be traced back to the kindergarten building and that student was not vaccinated.
[PROVE Note: An American woman traveling abroad has caught vaccine strain polio from a vaccinated baby in another country. The CDC has warped this into a recommendation that adults traveling abroad should be vaccinated against polio to protect them from catching vaccine strain polio. I promise you I did not make this up.]
http://www.reutershealth.com/en/index.html
Vaccine-associated polio reported in US traveler
Last Updated: 2006-02-07 15:30:36 -0400 (Reuters Health)
NEW YORK (Reuters Health) - In a new report, researchers from the Centers for Disease Control and Prevention in Atlanta describe what appears to be the first case of vaccine-associated paralytic poliomyelitis in a US adult who traveled abroad.
Although polio is rare in the US, it is endemic in other parts of the world and for this reason, vaccination is recommended for residents traveling to at risk areas, the researchers note in the February 2nd issue of the Morbidity and Mortality Weekly Report.
The present case involves a young, unvaccinated woman from Arizona who traveled to Central and South America in early 2005 as part of a study-abroad program. She appears to have become infected with poliovirus through exposure to her host family's infant grandson who had recently been given a live, attenuated oral polio vaccine (OPV).
The women experienced fever, general malaise, and progressive muscle weakness. Her condition worsened and she was eventually admitted to the hospital and intubated for respiratory failure. Testing revealed infection with Sabin-strain poliovirus and although the patient eventually recovered, she still had some weakness in the legs 60 days after disease onset.
"Healthcare providers assessing vaccine needs for unvaccinated adults traveling to countries that use OPV should be aware of the risk that OPV might pose to such travelers and should consider offering them polio vaccination," the report suggests.
Mor Mortal Wkly Rep CDC Surveill Summ 2006;55:97-99
http://news.yahoo.com/s/ap/20060401/ap_on_he_me/mumps_outbreak
Mumps Cases Reach Epidemic Level in Iowa By MELANIE S. WELTE, Associated Press Writer
Fri Mar 31, 10:22 PM ET
A mumps epidemic is sweeping across Iowa in the nation's biggest outbreak in at least 17 years, baffling health officials and worrying parents.
As of Thursday, 245 confirmed, probable or suspected cases of mumps had been reported to the Iowa Department of Public Health since mid-January.
The federal Centers for Disease Control and Prevention said it is the nation's only outbreak, which the CDC defines as five or more cases in a concentrated area.
"We are calling this an epidemic," said Iowa state epidemiologist Dr. Patricia Quinlisk, explaining that mumps has spread to more than one-third of the state and does not appear to be confined to certain age groups or other sectors of the population.
Quinlisk said Iowa has had about five cases of mumps a year in recent years, and this is its first large outbreak in nearly 20 years.
"We're trying to figure out why is it happening, why is it happening in Iowa and why is it happening right now. We don't know," she said.
CDC spokeswoman Lola Russell said the federal agency has no answers yet. But Quinlisk said one theory is that the infection was brought over from England — perhaps by a college student — because the strain seen in Iowa has been identified by the CDC as the same one that has caused tens of thousands of cases of the mumps in a major outbreak in Britain over the past two years.
"It may have been a college student, since we did see the first activities on college campuses, but we can't prove that," Quinlisk said. The Public Health Department said 23 percent of the 245 reported patients are in college.
The CDC said it is the nation's biggest epidemic of mumps since 269 cases were reported in Douglas County, Kan., from October 1988 to April 1989.
Mumps is a viral infection of the salivary glands. Symptoms include fever, headache, muscle aches and swelling of the glands close to the jaw. It can cause serious complications, including meningitis, damage to the testicles and deafness.
A mumps vaccine was introduced in 1967. Iowa law requires schoolchildren to be vaccinated against measles and rubella, and the mumps vaccine is included in the same shot. The state's last major outbreak was in 1987, when 476 people were infected.
Of the 245 patients this year, at least 66 percent had had the recommended two-shot vaccination, while 14 percent had received one dose, the Public Health Department said.
"The vaccine is working," Quinlisk said. "The vaccine certainly was made to cover this particular strain, because it's a fairly common strain of mumps." Quinlisk said the vaccine overall is considered about 95 percent effective.
Quinlisk said the mumps outbreak started in eastern Iowa and is spreading statewide and possibly into the neighboring states of Illinois, Minnesota and Nebraska. Those states may have one or two cases, she said.
When 11-year-old Will Hean of Davenport starting feeling sick in mid-January, his family thought he had a bad case of the flu. But his face and throat swelled and his temperature climbed to 103. His parents took him to the doctor, and he was diagnosed to their surprise with full-blown mumps.
About two weeks later, the Heans' daughter, Kate, 21, came down with the mumps, too.
Both children had gotten the measles, mumps and rubella vaccine, or MMR. So had their other son, 13-year-old Jimmy, who did not get the mumps.
"He had all the shots and everything. You don't think you're going to get the mumps after you've been inoculated," said Will's father, Wayne Hean
Health Officials Scramble To Contain Mumps Outbreak In U.S. Midwest
Posted on Wednesday, April 12 2006 20:05:35 PDT by Intellpuke
Read 15 times
Local, state and federal health experts are urgently trying to contain a large mumps outbreak raging across Iowa that has now spread to at least eight other Midwestern states. At least 515 cases have been reported in Iowa this year, far outpacing the five cases the state usually sees in a year and the 200 to 300 that typically occur nationally. The epidemic, the largest since a 1988 outbreak in Kansas, shows no sign of slowing, with at least 100 more cases in Nebraska, Kansas, Minnesota, Wisconsin, Indiana, Michigan, Missouri and Illinois.
Among other steps, the effort to stem the outbreak has led investigators to hunt down passengers on a flight to Washington, D.C., last month that carried a woman who later developed mumps, and to vaccinate more than a dozen people she visited on Capitol Hill.
As health officials work to break the chain of transmission of the viral infection, disease detectives are trying to puzzle out what is causing it. Cases appear concentrated among young, otherwise healthy adults. "Why Iowa and why now? We really don't know," said William Bellini of the federal Centers for Disease Control and Prevention in Atlanta, which has sent investigators to help control and investigate it. "There are a lot of unknowns."
Among them: Does the mumps vaccine fail to take hold in more people than had been thought? Does its protection wane? Is the virus that is causing this outbreak less susceptible to the vaccine for some reason, or more infectious? The outbreak has underscored that old infectious diseases that most people rarely think about - and doctors do not often encounter - can suddenly reemerge. "This shows us once again that the world is a very small place," said William Schaffner, an infectious-disease expert at Vanderbilt University. "We have to remain on guard, even about diseases we usually rarely see anymore in this country."
To try to keep the outbreak from widening further, the CDC announced Wednesday that officials are working to track down 222 airline passengers who sat near two people from Iowa who developed the mumps after traveling on nine flights from March 26 to April 2. One flew from Tucson to Cedar Rapids, Iowa, stopping in Arkansas and St. Louis. The second, a 51-year-old woman on a trip to lobby the Iowa congressional delegation, flew from Waterloo, Iowa, to Washington and back, stopping in Detroit and Minneapolis. About 17 people who came in contact with her on Capitol Hill have been given vaccine shots as a precaution, health officials said. "The states where these passengers traveled and landed we'll be watching closely and putting prevention and control activities in place if they start to see some cases," said Jane Seward of the CDC.
In the states that have cases, officials are alerting the public to the symptoms in hopes that anyone who has been infected can be identified quickly and isolated. They are also trying to identify and inoculate unvaccinated adults. "We're doing everything we can to get out in front of this outbreak and try to get it stopped," said Patricia Quinlisk, Iowa's state epidemiologist. "Mumps can produce severe complications, and we're trying to do whatever we can to prevent them from happening." About a dozen patients in Iowa have been hospitalized so far, including one who was treated for encephalitis, but all have recovered, officials said.
Much of the effort has been focused at colleges, where many of the cases are occurring.
"We give the student the choice: If they want to go home, we think that's the best bet," said Lois Noel, who runs the health center in Dubuque, Iowa, which, with at least 151 cases, has been hit hardest. "If they stay in the residence halls, we make arrangements to make sure their needs are being met."
Sara Breitbach was stunned when a doctor told her to leave her sorority, go home and hide behind a surgical mask whenever she went near her parents. "I couldn't believe it," said the 20-year-old University of Iowa sophomore, who spent a week in isolation before the infection passed. "Nobody ever talks about the mumps. It was very weird." "I've never been so miserable in my life," said Christopher J. O'Brion, 22, a University of Iowa senior who holed up in his apartment for two weeks after his chin swelled up. "I couldn't eat. I couldn't sleep. It was just miserable." The reason colleges have had so many mumps cases remains unclear, but the virus could simply have arrived there first.
"You know what dorms are like. If it gets hold there it can keep transmitting for a while," Seward said. "We suspect that's the situation we're in now." Officials speculate that the epidemic might have been sparked by someone from Britain, which has been experiencing a large mumps outbreak for several years. Last summer, a much smaller outbreak at a summer camp in New York was started by an unvaccinated British counselor. "We suspect that there was some importation into Iowa, and initially perhaps it wasn't recognized immediately because physicians don't see mumps much anymore," Seward said. "That's how these things can get going."
The virus in the Iowa outbreak is the same strain as the one in the United Kingdom, but officials have not identified the first Iowa case. "We're not looking back right now," Quinlisk said. "We're focused on stopping the transmission." Experts hope the relatively high U.S. vaccination rates will contain the outbreak. The tens of thousands of cases in Britain have been blamed on problems with the vaccination program there, and concerns among some parents that childhood vaccines may increase the risk of autism, which left a significant proportion of the population unvaccinated.
"The United States, fortunately, generally has good vaccine coverage," said Stanley Plotkin, an infectious-disease expert from the University of Pennsylvania.
The vaccine is believed to be about 95 percent effective, meaning that five in 100 fully vaccinated people would still be vulnerable, enough to allow an outbreak to occur.
The size of the episode has experts wondering whether the vaccine is less effective than that, and whether the immunity wanes over time. About 68 percent of the cases have occurred among people who received the two recommended doses of vaccine as part of their routine childhood immunizations.
"That's a very pregnant question in this outbreak, because such a large proportion of the individuals affected have a history of having had two immunizations," Schaffner said.
Investigators are gathering information about how many shots the infected people got and how far apart they got them. "Does it last a lifetime? As far as we're aware it does. But that's something we're interested in studying," Seward said of the vaccine. Scientists are also analyzing the virus, deciphering its genetic code to see how closely it matches the one circulating in Britain and the one used in the vaccine, as well as doing tests with cells to assess whether it is unusually infectious. "That will give us some idea how aggressive it will be," said Bellini, adding that researchers are also testing how well antibodies produced in response to the vaccine neutralize the virus. "We think vaccine should be fully protective, but we certainly will investigate that."
http://www.canada.com/nationalpost/news/story.html?id=a3febc68-8863-4a2c-802
f-f414d0876e86&k=20268
Free flu vaccine fails to reduce cases study: 'Rates haven't decreased and there's been lots of money spent'
Tom Blackwell
National Post
Tuesday, May 02, 2006
Canada's first experiment in universal, free flu vaccine has cost Ontario taxpayers more than $200-million, but appears to have done nothing to cut the spread of influenza, a new study suggests. Per-capita flu rates in the province have not fallen at all since the program was introduced in 2000, concluded the University of Ottawa research, published in the journal Vaccine. In fact, the average monthly incidence of the virus jumped over the first five years of the program, though researchers say it is too early to say that numbers are really on the rise.
"All we do know is rates haven't decreased, and there has been a lot of money spent," said Dianne Groll, the University of Ottawa professor who led the study. "The program was designed to reduce the incidence of flu, and this hasn't yet happened." The heavily publicized offer of free flu shots to all 12 million Ontarians was launched in 2000 to try to ease pressure on emergency wards from flu patients, and cut the incidence and severity of the illness.
Dr. Groll said it might be wise to focus on better targeting the vaccine at high-risk groups -- the very young, the elderly and the chronically ill -- perhaps by giving shots to anyone who comes into an emergency ward. She also said the province failed to collect detailed "baseline" information on vaccination patterns before the plan started or similar data since then to compare, making it difficult to thoroughly evaluate the program. Some infectious disease specialists warned yesterday the study is seriously limited, partly because it compares the rates of laboratory-diagnosed flu before and after the program started. Cases that are confirmed by a lab test represent a small fraction of the total amount of flu and may not give a true picture of the situation, said Dr. Allison McGeer, one of the country's leading influenza experts.
The Ottawa research correctly and interestingly analyzed the data available but is "irrelevant," concluded Dr. McGeer, infection-control officer at Toronto's Mount Sinai Hospital and a strong proponent of universal immunization. She acknowledged there is simply very little evidence with which to evaluate the program.
"That we would publish this study is a marker of desperation."
Dr. McGeer said there is other research, not yet published, suggesting the campaign has resulted in more chronically ill seniors being vaccinated and has reduced the seriousness of some illness. The Ontario initiative, the world's first universal flu campaign, distributes about five million vaccine doses a year at a current cost of $50- to $55-million, including promotion, according to the Health Ministry. Dr. Groll looked at the number of cases of laboratory-diagnosed flu reported to Health Canada between 1990 and 2005.
She found that the rate between 1990 and 2000, when the program started, was 109 per 100,000 Ontarians. After the campaign's launch, it jumped to 164. The data was analyzed by Queen's University statistician David Thomson, who concluded there are not enough statistics yet to prove the numbers are on the rise.
The researchers also found the Ontario flu rates did not change relative to other provinces. And, though the number of laboratory tests conducted has gone up, it has not increased compared with the rest of Canada. Dr. Michael Gardam, infection-control specialist at Toronto General Hospital, also stressed the limitations of the study, noting the vaccine in one of the years after the program started did not match the strains circulating in Ontario.
Still, he admitted that emergency rooms at his hospital are no less busy and that "Ontario still gets flu outbreaks like anybody else." "The most we can say from this study is that clearly this program is not a home-run success," he said. "If there is success, it's subtle. If the results are that subtle, should the money be spent elsewhere? That is a very good question."
Dr. Groll noted the campaign was instituted in 2000 without any "baseline" data -- information on what sort of people were getting vaccinated before, how many of those got the flu and whether flu patients used hospital emergency wards.
Nor has such information been gathered since, making it very difficult to effectively evaluate the global vaccination plan, she said. "The program just lacks the baseline information you would need -- that anybody would need -- before anybody put this kind of multi-million-dollar proposal together," Dr. Groll said. John Letherby, a spokesman for the Ontario Health Ministry, defended the flu program, though, saying it does have many "ancillary benefits" apart from the impact on overall rates. Those benefits include less emergency-room crowding and less absenteeism, but Mr. Letherby said the ministry does not itself collect such statistics.
tblackwell@nationalpost.com
Friday, June 02, 2006
Harmful effects: PHC moved against polio vaccination
By Akhtar Amin
PESHAWAR: The Peshawar High Court (PHC) was on Thursday moved to stop the WHO-backed polio vaccination drive in Pakistan with the petitioner arguing that the anti-polio vaccine contains ingredients which weaken the male reproductive system and trigger the onset of puberty in females.
The petitioner, Ghulam Ali, has made the government of Pakistan and Dr Ibrahim, the WHO country head, respondents. The petition alleges that after testing polio vaccine in Karachi and Peshawar, two ingredients Estrogen and Estradoil were found which do not create immunity against the polio virus. They “weaken the male reproductive system and accelerate puberty in females” and also weaken resistance to disease, it added.
The petitioner has requested the court to stop the polio vaccination drive and order a first information report against people involved in “playing with the lives of the country’s children”.
The petitioner had also submitted a report by Dr Haroona Kiata, a Nigerian doctor, who tested the WHO’s polio vaccine administered to Nigerian children. The tests were conducted in India with the assistance of Indian doctors as the facility was not available in Nigeria. According to the petitioner, the tests confirmed the presence of additional ingredients in the vaccine that have no relevance to treating polio and instead weaken the male reproductive system and quicken the onset of puberty in females. Ali has also attached an Americans Doctor’s Association study which found that children who were administered the polio vaccine were 78 percent more vulnerable to other diseases than those who were not administered the vaccine.
Courtesy http://www.DailyTimes.com.pk
Mostly women getting mumps
By Aaron Kessler
Daily Progress staff writer
Saturday, November 4, 2006
University of Virginia health officials are a bit puzzled why the ongoing outbreak of mumps has struck almost entirely women. Of the 31 cases of probable or confirmed mumps at UVa, 28 have been in women. "There is a curiosity in that most of our cases are in females," said Dr. James C. Turner, executive director of Student Health. "We can't really say for sure why it's happened that way."
One theory is that young female students, particularly first-year undergraduates living in residence halls, have a tendency to, well, cuddle. "Apparently it's popular for first-year women to push their beds together and have movie nights and such, where they'll share pillows, that kind of thing," Turner said.
The resulting cuddling might explain the larger percentage of women contracting mumps, Turner said. But he was quick to point out that the cuddle theory is but one possible explanation for the gender disparity.
Dr. Lilian Peake, health director for the Thomas Jefferson Health District, said one partial explanation could be that women tend to seek health care more than men, so more cases have been picked up among women. "The truth is, we simply don't know. But it has been very interesting," Peake said. As of Friday, UVa reported 28 cases of mumps among undergraduates, although the Health District was still unsure about one of those cases.
Turner said an undergraduate has also developed viral meningitis, but is expected to recover. She is being treated for the pain associated with the condition, which about 1 percent of mumps patients can
develop. "Usually, it's something that's very painful, but not life-threatening," he said of the virus, which is much less severe, in general, than its potentially deadly bacterial counterpart. The student is recovering at her apartment in the Charlottesville area.
In addition, for the first time the virus has been diagnosed in graduate students as well - two now have probable mumps. Turner would not say which graduate or professional programs the students are involved in, but the two students are not in the same program. Also, a member of the UVa staff who works at Student Health contracted mumps, Turner said, bringing the total at the university to 31.
All of those infected had been vaccinated. The vaccine, however, is not 100 percent effective.
At this point, most local sufferers have fully recovered and are no longer contagious. As of Friday, three students were still in isolation. The student with viral meningitis was also still recovering. Turner said with three students found to have mumps this week, compared with nine last week, he hopes the outbreak may be slowing down. "It would appear it may be [slowing,] I hope that turns out to be right," Turner said. "At this point, we're basically collectively holding our breath."
Peake said there have been five cases of mumps diagnosed outside of UVa in the larger Charlottesville community, but those cases have been only sporadic.
"We're still really talking about a UVa outbreak, and in particular an undergraduate outbreak," she said.
Mumps is a virus that can cause fever, aches and swelling of the glands close to the jaw. Symptoms usually appear between 12 and 25 days after exposure to the virus, and mumps is contagious for three
days before the onset of swelling.
Contact Aaron Kessler at (434) 964-5476 or akessler@dailyprogress.com.
http://www.ashleycountyledger.com/articles/2006/11/08/news/h16f103t.txt
Health Department, CDC Looking at Chicken Pox Outbreak in County
Representatives from the Centers for Disease Control in Atlanta have been in Ashley County in connection with an outbreak of chicken pox among highly-immunized groups.
Ann Wright of the Arkansas Department of Heath said that as Monday morning that there have been 118 cases of chicken pox in Ashley County, but could not provide additional details as to the location.
Hamburg Superintendent of Schools Keith Alexander said Friday that the Hamburg School District had some cases at the high school. He also noted that earlier, there had been three to four cases at Noble Elementary. Tracy Streeter, the Noble principal, said that no students were out with chicken pox as of Monday. She also noted that CDC officials had done environmental scans at the school, but did not find anything.
Hamburg High School Principal Jeff Senn said Monday night that the high school has 28 students out with chicken pox.
Wright termed the situation a "very large outbreak." She also noted that the issue is of concern because it has been in a population that has been "highly vaccinated." "Because of that," she said, "the CDC is assisting with the investigation." She said that the CDC had two people in Ashley County this past week, but that they have since left the county.
The first cases were reported on September 4, and they were in the elementary grades. Now, however, the disease is in all ages. Wright noted that for students now in grades 10-12, the vaccine was not available when they went through the childhood vaccination series. Young children who are now in that age group were not mandated to get the shots when they were small.
Chicken pox is a very infectious disease, she said, caused by the varicella-zoster virus. "When you contract it," Wright said, "you have a blister-like rash, itching, tiredness and fever."
Wright said that the disease is usually visible first on the trunk of the body or the face, but can spread all over the body. She said that most cases are in children under 15 years old.
The disease is spread person to person by direct contact or thorough the air by coughs or sneezes. Wright said that people are contagious for a day or two before the rash appears, and they remain contagious until all the blisters form scabs. When a person who has not been vaccinated is exposed, it can take ten to 21 days for the disease to develop, she said.
Wright said that when a person gets chicken pox, they are usually sick for five to ten days, and kids usually miss five to six days to school. They should stay home for a week after the blisters erupt or until the blisters are dry and crusted. "That is really important," she said.
Wright said that the health department recommends that a person go to a physician when they are first exposed. She said that if a person already has had one vaccination then a second dose may be administered to those exposed. "If someone in the family is sick," she said, "the others need vaccination."
Wright noted that the symptoms can be very serious, with about one in ten having complications. The possible complications include infected skin lesions and dehydration. The disease can make asthma worse, she said, and can even develop into pneumonia. She also added that some people can even die from chicken pox. "It is nothing to play around with," she said.
The CDC is investigating the outbreak to help determine the reason for the spread of the disease in groups which have been vaccinated. She said that the CDC has determined that the local sickness is definitely varicella and that the problem was not the efficacy of the vaccine. The CDC is now looking at the issue of transmission.
Wright noted that the CDC and health department have worked with the schools for education and sent home letters with parents. "The schools in the county have been very cooperative," she said.
Asked if there was a possible new strain which the vaccine does not prevent, Wright said that would not be known until the investigation is completed.
In regard to preventing the spread of the disease, Wright said that people that are sick need to stay home and avoid exposing others. Those who are sick should stay home until one week after the blisters erupt, she said, "and everyone needs to be vaccinated."
Wright noted that the health department policy had been to have one dose of vaccine at 12 months of age. Now however, the CDC and the health department are recommending two doses, but the health department has not been funded to administer a second dose. "If a child is 13 or above and has not been vaccinated, give them two doses," she advised.
She also noted that if a person is exposed, a second dose of the vaccine within five days can help prevent a person from developing the disease.
She suggested that any person who is worried can get a second shot, but the health department is not routinely giving two vaccinations.
The CDC web site notes that people can contract the disease more than one time, though one infection normally gives lifetime immunity.
Just because a person has had the shot, does not mean he or she is always protected. According to the CDC, for chickenpox vaccine, about 8 to 9 out of every 10 people who are vaccinated are completely protected from chickenpox. The vaccine almost always prevents against severe disease. If a vaccinated person does get chickenpox, it is usually a very mild case with fewer skin lesions (usually less than 50) lasting only a few days, no fever or a low fever, and few other symptoms.
Locally, the number of cases in those who have had shots is the major item of concern.
Bharat Biotech launches anti rabies vaccine
Tuesday, December 26, 2006 18:00 IST
Our Bureau, Mumbai
Bharat Biotech International Ltd. (BBIL) announced the launch of chromatographically purified vero cell vaccine, Rabirix for the treatment of rabies.
Dr Julie Gerberding, director, Centres for Disease Control and Prevention (CDC) along with Dr Krishna M Ella, Chairman and Managing Director, Bharat Biotech, did the launch of the vaccine in Hyderabad.
Rabirix has been indigenously developed by BBIL and can be used for both prophylactic (vaccine-pre bite) and therapeutic (post bite) treatments. Rabirix is manufactured in a state of the art manufacturing facility conforming to the current good manufacturing practices established by Regulatory agencies such as the Drug Controller General of India (DCGI), World Health Organisation (WHO), United States Food and Drug Administration (USFDA), European Medical Evaluation Agency (EMEA).
Rabirix is a Purified Vero cell based Rabies Vaccine (PVRV), which has been extensively evaluated clinically for pre-bite and post-bite applications, and has proven to be well tolerated with minimal or no side effects. The immune sera samples from phase III clinical trials have been analysed at the National Institute of Virology, Pune and the efficacy of the product has thus been established.
According to Dr Krishna M. Ella, chairman and managing director BBIL said, "The rabies vaccines contribute approximately 50 per cent of the vaccine market in India in terms of value. Currently, the market size of rabies vaccines is estimated to be around Rs 250 crores. To promote vaccines exclusively, we have created a dedicated marketing division christened Immutika (Immunisation and Tika)." He also added that Rabirix is yet another effort towards our commitment to providing affordable, safe and effective health care solutions."
Four million people are exposed to the rabies virus, worldwide every year and 60,000 people fall victim to it. In India 3 million people under go anti-rabies treatment and 30,000 deaths are reported annually which accounts for 50 per cent of mortality from rabies worldwide. The WHO estimates between 35,000 to 50,000 human rabies cases worldwide, and approximately 30,000 cases from India. Human rabies is most common in people younger than 15 years. 90 per cent of these deaths are due to bite of rabid dogs. Even a vaccinated dog could transmit the rabies virus.
Then why get your dog vaccinated if they don't work?
Date: Sun, 11 Feb 2007 19:10:12 -0000
Chicken pox strikes Highland Elementary, 33 students ill
HIGHLAND — A chicken pox outbreak of three dozen cases has been reported at Highland Elementary School, according to the Ulster County Department of Health. Since Feb. 6, 33 students out of about 900 in the elementary school have been diagnosed with the aricella, or chickenpox, virus, said John McCarthy, district superintendent. "It's all in the elementary school right now," he said. "It seems to be contained there."
According to public health director Dean Palen, an outbreak occurs when five or more cases are reported at once. The goal now, he said, is to prevent the disease's spread. "We're trying to contain it to make sure other students at the other schools don't get it," Palen said. Of the 33 students, all but two had been vaccinated for the virus. According to a letter sent to district parents Thursday from the Department of Health, children who have already received one dose of chicken pox vaccine should receive a second dose if an appropriate amount of time has elapsed between shots.
While not usually a serious illness, complications can cause pneumonia and in rare occasions can be life threatening, Palen said. Chickenpox is an infectious disease caused by a virus, which results in a blister-like rash, itching, tiredness and fever, according to the Center for Disease Control. The county will offer a special chickenpox vaccine clinic for children 3-7 p.m. at the Health Department office, 570 Route 299, Highland. Appointments are required and the child's vaccine record must be brought to the appointment.
http://cities.expressindia.com/fullstory.php?newsid=243704
THE SPECIAL REPORT LUCKNOW: POLIO RESURGENCE
ALARMING : 55 OUT OF 56 CONFIRMED POLIO VICTIMS HAVE BEEN ADMINISTERED SEVERAL DOSES OF VACCINE
No resistance, yet polio strikes again
Maulshree Seth
Lucknow, June 30: The Uttar Pradesh Health Department can no longer put the blame on the resistance among a particular community for spiralling polio cases. It can, however, take credit for tackling resistance successfully. For, of the 56 confirmed polio cases — out of a total 82 detected in the country — 55 have been found to have taken at least four rounds of polio drops. And, 40 children, in fact, took seven rounds of polio drops. The health department has now sent the samples of these cases to National Institute of Virology, Pune, to check the efficacy of the vaccine.
Meanwhile, the Department claims that lack of immunity and sanitation could be reasons behind ineffectiveness of the vaccine in some cases. It has now prepared a proposal worth Rs 34 crore to launch ‘Child Survival Project’.
The proposal would be sent to the Centre to start the project under the National Rural Health Mission.
The bad news for the Health Department does not end here. While it might have been able to control P1 virus in Mooradabad division, it has failed to do so in Devipatan division that has seven P-1 cases out of the 15 P-1 cases reported in the state so far. The remaining 41 cases in the state are of P-3, with 17 of them being reported from Mooradabad division.
“It is a matter of satisfaction that Mooradabad division, which has been a reservoir of P-1 virus, has not reported a single P-1 case so far. It is a success for us. Even the fact that out of 56 polio cases, 55 did take vaccine shows there has been no lacunae in vaccination drives. Our coverage has been up to 95 per cent, and in the coming drive we plan to increase it further,” said Dr L B Prasad, Director General, Family Welfare.
Meanwhile, the officials who are to undertake the pulse polio drive starting from July 1 fear facing people in localities where children have contracted the virus despite taking several rounds of vaccine.
A P Dixit, State officer for Universal Immunisation Programme, however, said, “In the coming drive, there will be an increased stress on counselling. People would be informed about the importance of administering drop in each drive.”
Significantly, no P-1 virus has been reported in the five traditional high-risk districts of western Uttar Pradesh (Moradabad, JP Nagar, Bareilly, Rampur and Badaun).
Bahraich district in Deviatan division, however, has reported three P-1 cases whereas sporadic cases have been reported from Allahabad, Faizabad, Bareilly and Saharanpur.
CDC says whooping cough over-diagnosed
Published: Aug. 24, 2007 at 11:58 AM
ATLANTA, Aug. 24 (UPI) -- The U.S. Centers for Disease Control says outbreaks of respiratory illness were mistakenly attributed to whooping cough.
Two hospital outbreaks and one community outbreak of respiratory illness between 2004 and 2006 in New Hampshire, Massachusetts, and Tennessee were attributed initially to pertussis, or whooping cough. Subsequent investigations, however, suggested pertussis was not the cause of these outbreaks, the CDC said Friday.
Researchers said thorough epidemiologic and laboratory investigation of suspected pertussis outbreaks are necessary when considering extensive control measures. Diagnosis of pertussis is complicated by nonspecific signs and symptoms, particularly in the early stage of disease.
The CDC said reported cases of whooping cough have tripled in the United States since 2001. The increase is attributed to increased exposure to the virus, waning vaccine immunity among adults and adolescents, heightened awareness of pertussis among healthcare providers, increased public health reporting, and increased use of polymerase chain reaction (PCR) testing for diagnosis.
http://www.upi.com/NewsTrack/Science/2007/08/24/cdc_says_whooping_cough_overdiagnosed/2085/
Could this be an example of hypervaccinated people demonstrating inadaquate antibody response to vaccines? Or just a general reflection of how useless these shots can be? I don't understand why they're saying that, on the one hand, the vax was ineffective against a new strain yet, on the other, the vax proved effective in states which didn't have an outbreak. Call me stupid but, uh, how's that work?
http://news.yahoo.com/s/ap/20080409/ap_on_he_me/mumps_vaccine
By LINDA A. JOHNSON, Associated Press Writer
49 minutes ago
Most of the college students who got the mumps in a big outbreak in 2006 had received the recommended two vaccine shots, according to a study that raises questions about whether a new vaccine or another booster shot is needed. The outbreak was the biggest in the U.S. since shortly before states began requiring a second shot for youngsters in 1990.
Nearly 6,600 people became sick with the mumps, mostly in eight Midwest states, and the hardest-hit group was college students ages 18 to 24. Of those in that group who knew whether they had been vaccinated, 84 percent had had two mumps shots, according to the study by the Centers for Disease Control and Prevention and state health departments. That "two-dose vaccine failure" startled public health experts, who hadn't expected immunity to wane so soon — if at all.
The mumps virus involved was a relatively new strain in the U.S., not the one targeted by the vaccine, although there's evidence from outbreaks elsewhere the shots work well against the new strain. The researchers, reporting in Thursday's New England Journal of Medicine, note the virus likely came from travelers or students from the United Kingdom, where mumps shots are voluntary and there was a much larger mumps outbreak of the same strain. Many countries don't vaccinate against mumps, so future cases brought from overseas are likely.
"If there's another outbreak, we would evaluate the potential benefit of a third dose to control the outbreak," said researcher Dr. Jane Seward, deputy director of the CDC's viral diseases division. Mumps is spread by respiratory secretions and saliva among people in close contact, making college students particularly susceptible. Students' sharing of drinks and utensils, and sexual activity, probably increased their exposure. Mumps causes fever and swollen salivary glands in the cheeks. Before the vaccine, complications such as deafness, viral meningitis and testicle inflammation, which can cause sterility, were common and there were a couple million U.S. cases a year.
The only U.S. vaccine, made by Whitehouse Station, N.J.-based Merck & Co., hasn't been changed since its introduction in 1967 and there are no plans to change it, said Barbara Kuter, Merck's executive director of pediatric affairs. Over 500 million doses have been sold since the 1970s, when it was put in the combination measles-mumps-rubella shot. Dr. John Bradley, a member of the American Academy of Pediatrics committee on infectious diseases, said his group is talking about possible changes to the vaccine recommendations schedule with CDC and other health agencies. Now two shots are recommended, one at 12 to 15 months and the other at age 4 to 6. It might not be cost effective to give everyone a third shot, but it should be considered for college students, said Dr. Stephen Marcella, an epidemiologist at University of Medicine and Dentistry of New Jersey's School of Public Health.
Dr. William Schaffner, head of preventive medicine at Vanderbilt University School of Medicine, said what's need is a longer-lasting shot. "It's clear that over time, immunity wanes somewhat," he said. "We need a better vaccine." Seward said other CDC studies on the 2006 outbreak found two mumps shots protected about 85 percent of people from the new strain — not quite enough to prevent spread even with the nearly 90 percent vaccination rate at the time. The outbreak was in Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, South Dakota and Wisconsin.
http://newsmax.com/health/vaccine_pneumonia/2009/01/06/168223.html
Vaccine Doesn’t Protect Against Pneumonia
Tuesday, January 6, 2009 10:16 AM
Commonly used pneumococcal polysaccharide vaccines do not appear to be effective for preventing pneumonia, found a study by a team of researchers from Switzerland and the United Kingdom. In many industrialized countries, polysaccharide pneumococcal vaccines (PPVs) are currently recommended to help prevent pneumococcal disease in people aged 65 and over and for younger people with increased risk due to conditions like HIV. Studies have shown conflicting results regarding the efficacy of PPV. The study, a systematic review and meta-analysis, looked at 22 clinical trials, reviews and meta-analyses and more than 100,000 participants from countries in North America as well as India, Africa, Latin America and the Caribbean. Unlike other similar studies the authors examined the reasons why different clinical trials produced different results. They found that the quality of the studies substantially affected the results. When only high quality trials were included, there was no evidence that PPVs could prevent pneumonia. The study adds to the ongoing debate around effectiveness of the vaccine.
"Policy makers may therefore wish to reconsider their current recommendations for PPV, especially where routine pneumococcal conjugate immunization has been introduced," conclude Dr. Matthias Egger from the University of Bern, Switzerland and coauthors. However, in a related commentary http://www.cmaj.ca/press/pg18.pdf, Dr. Ross Andrews and coauthor from the Menzies School of Health Research, Darwin, Australia state that the researchers' conclusions exceed the evidence presented. They caution that there should be no change in vaccine policy in countries that recommend PPV to prevent invasive pneumococcal disease.
China orders probe after unsafe vaccine report http://www.google.com/hostednews/afp/article/ALeqM5it0tVezpvN6k03MYeQCWZ9_-Y9FQ (AFP) – 3 days ago
BEIJING — China has ordered an investigation after a report that unsafe vaccines led to the deaths of four children and sickened 74 others in the country's latest product-quality scare. The order by the Ministry of Health came after the China Economic Times on Wednesday reported unsafe vaccines for encephalitis, hepatitis B, rabies and other illnesses were being used in the northern province of Shanxi.
The report said the problem vaccines had been sold in the province since 2006. Neither the media report nor the ministry's order made it clear whether the vaccines themselves were dangerous or whether they had failed to protect children from illness. Xinhua news agency quoted a top official with the Shanxi Health Department as denying the allegations made in the report. In a statement posted on its website Wednesday announcing the investigation order, the health ministry said it had investigated earlier reports of bad vaccines in 2008, finding no problems. China's huge food and drug industries are notoriously scandal-prone, with regular reports of dangerous products on the market, leading to health problems and even deaths among consumers.
In 2008, China's dairy sector was rocked by the widespread contamination of milk supplies with the industrial chemical melamine, which was added to give the appearance of higher protein content. Six babies died and 300,000 others fell ill after being fed tainted baby formula, according to government figures.
Copyright © 2010 AFP. All rights reserved
Oral Vaccines
'Fail Tests'
LONDON, Friday (A.A.P.-Reuter). — All available evidence indicated that live oral polio vaccine could be dangerous, a doctor claimed yesterday.
The doctor, Margaret Agerholm, writing in the medical weekly. Lancet, said oral vaccines had proved "disappointing" in human trials.
The vaccine the British Ministry of Health decid ed to make available for routine vaccination was prepared from strains de veloped by the American scientist. Dr. Albert Sabin, Dr. Agerholm said.
Tests showed repeatedly in Britain, America and Russia that the attenuated Sabin strains recover ed their neuropathogenicity (capability of developing disease of the nervous system) in the passage through the human intestine.
Therefore, the person who swallowed the harm less vaccine soon was infecting others with viruses which had recovered their neuropathogenicity.
"In the recent medical research council trials in this country at least three of the towns which took part in the trial suffered epidemics of paralytic poliomyelitis afterwards," she said.
"The whole concept of oral vaccines is alien to medical and lay through in this country," she said.
http://trove.nla.gov.au/ndp/del/article/104301517
3/25/2016
Strength of MMR vaccine questioned amid mumps outbreak - KOAA.com
| Continuous News | Colorado Springs and Pueblo http://www.koaa.com/story/31320886/strength-of-mmr-vaccine-questioned-amid-mumps-outbreak 1/1
By Kelsey Kennedy COLORADO SPRINGS - Posted: Feb 25, 2016 8:38 PM EST Updated: Feb 25, 2016 8:38 PM EST
Strength of MMR vaccine questioned amid mumps outbreak Colorado health officials are asking hospitals across the state to watch out for cases of the mumps. Six people in Denver have come down with the disease so far in 2016, and officials are calling it an outbreak. Mumps is usually mild disease, but it's been very uncommon for years now. New information seems to indicate the vaccination you got as a child could be wearing o× over time. The MMR vaccine is given to children in two phases. Doctors believe it has about an 88 percent immunity rate. All six people that contracted mumps in Denver had been vaccinated. "What we're finding out now is that after 15 to 20 years, the immunity fades," said Dr. James Terbush, the Interim Medical Director of El Paso County Public Health. The CDC isn't recommending a booster shot just yet. "We're waiting for additional information on that," Dr. Terbush said. A titer test can measure the level of antibodies in your blood. The El Paso County Public Health lab can do the test with orders from your doctor. Every year, more Colorado children aren't getting vaccinated. "The opt out provision in Colorado allows parents, for a variety of reasons, choose not to vaccinate their kids," Dr. Terbush said. According to the CDC, Colorado comes in 3rd in the country for highest rates of vaccination exemptions. 5.4 percent of Colorado kindergartners are "opted out" of getting vaccinated. "Parents get those kids vaccinated," Dr. Terbush said. "It's absolutely essential." 14 percent of Colorado kids haven't gotten immunized. That's the highest unvaccinated rate in the country. Mumps is now so uncommon that six cases does constitute an outbreak. "Denver usually sees about 2.5 cases per year," said Dr. Terbush said. "Our last case in El Paso County was in April of 2010. It's a very rare disease here." While most cases are mild, mumps can cause complications like meningitis and deafness. The most recognizable symptom is swelling of glands in the neck. The first Denver person to contract mumps had recently moved to Colorado from Iowa.
'Fail Tests'
LONDON, Friday (A.A.P.-Reuter). — All available evidence indicated that live oral polio vaccine could be dangerous, a doctor claimed yesterday.
The doctor, Margaret Agerholm, writing in the medical weekly. Lancet, said oral vaccines had proved "disappointing" in human trials.
The vaccine the British Ministry of Health decid ed to make available for routine vaccination was prepared from strains de veloped by the American scientist. Dr. Albert Sabin, Dr. Agerholm said.
Tests showed repeatedly in Britain, America and Russia that the attenuated Sabin strains recover ed their neuropathogenicity (capability of developing disease of the nervous system) in the passage through the human intestine.
Therefore, the person who swallowed the harm less vaccine soon was infecting others with viruses which had recovered their neuropathogenicity.
"In the recent medical research council trials in this country at least three of the towns which took part in the trial suffered epidemics of paralytic poliomyelitis afterwards," she said.
"The whole concept of oral vaccines is alien to medical and lay through in this country," she said.
http://trove.nla.gov.au/ndp/del/article/104301517
3/25/2016
Strength of MMR vaccine questioned amid mumps outbreak - KOAA.com
| Continuous News | Colorado Springs and Pueblo http://www.koaa.com/story/31320886/strength-of-mmr-vaccine-questioned-amid-mumps-outbreak 1/1
By Kelsey Kennedy COLORADO SPRINGS - Posted: Feb 25, 2016 8:38 PM EST Updated: Feb 25, 2016 8:38 PM EST
Strength of MMR vaccine questioned amid mumps outbreak Colorado health officials are asking hospitals across the state to watch out for cases of the mumps. Six people in Denver have come down with the disease so far in 2016, and officials are calling it an outbreak. Mumps is usually mild disease, but it's been very uncommon for years now. New information seems to indicate the vaccination you got as a child could be wearing o× over time. The MMR vaccine is given to children in two phases. Doctors believe it has about an 88 percent immunity rate. All six people that contracted mumps in Denver had been vaccinated. "What we're finding out now is that after 15 to 20 years, the immunity fades," said Dr. James Terbush, the Interim Medical Director of El Paso County Public Health. The CDC isn't recommending a booster shot just yet. "We're waiting for additional information on that," Dr. Terbush said. A titer test can measure the level of antibodies in your blood. The El Paso County Public Health lab can do the test with orders from your doctor. Every year, more Colorado children aren't getting vaccinated. "The opt out provision in Colorado allows parents, for a variety of reasons, choose not to vaccinate their kids," Dr. Terbush said. According to the CDC, Colorado comes in 3rd in the country for highest rates of vaccination exemptions. 5.4 percent of Colorado kindergartners are "opted out" of getting vaccinated. "Parents get those kids vaccinated," Dr. Terbush said. "It's absolutely essential." 14 percent of Colorado kids haven't gotten immunized. That's the highest unvaccinated rate in the country. Mumps is now so uncommon that six cases does constitute an outbreak. "Denver usually sees about 2.5 cases per year," said Dr. Terbush said. "Our last case in El Paso County was in April of 2010. It's a very rare disease here." While most cases are mild, mumps can cause complications like meningitis and deafness. The most recognizable symptom is swelling of glands in the neck. The first Denver person to contract mumps had recently moved to Colorado from Iowa.
