Archive for July, 2012

Zero TB

Monday, July 30th, 2012 (last updated)

The Stop TB Partnership is leading the way to a world without tuberculosis (TB), a disease that is curable but still kills three people every minute. Founded in 2001, the Partnership’s mission is to serve every person who is vulnerable to TB and ensure that high-quality treatment is available to all who need it.

Together our nearly 1000 partners are a collective force that is transforming the fight against TB in more than 100 countries. They include international and technical organizations, government programmes, research and funding agencies, foundations, NGOs, civil society and community groups and the private sector.

Tuberculosis Vaccines: A Strategic Blueprint for the Next Decade is a comprehensive strategy to introduce the safest and most effective TB vaccines that reduce tuberculosis worldwide, through partnership, innovative strategies and creative mechanisms. The blueprint, developed through an international collaboration coordinated by the Stop TB Partnership Working Group on New TB Vaccines, is a valuable tool to foster unity in the field and a more comprehensive approach to developing new vaccines to prevent tuberculosis.

Stop TB Partnership

Nasal flu vaccine to be given to all UK children

Friday, July 27th, 2012 (last updated)

All children are to be given the flu vaccination after experts said it could save up to 2,000 lives a year. The scheme, which is expected to be rolled out in 2014, will see all children aged two to 17 given the vaccination through a nasal spray. Younger children will be given the spray by their GP and schoolchildren will receive it at school.

The Joint Committee on Vaccination and Immunisation, which advises the government on vaccination policy, said the flu programme should be extended to children because it could reduce the rate of infection by 40%.

The health secretary, Andrew Lansley, has accepted the recommendation, a Department of Health spokesman said.

At present, over-65s, pregnant women and people with a serious medical condition, including children, are eligible for a seasonal flu jab.

The UK will become the first country to offer the flu vaccine to healthy children free of charge, with the measure expected to cost £100m a year.

Healthy children are among those least likely to develop complications from being infected by flu, but their close contact with each other means they are more likely to transmit the virus to one another and other vulnerable people.

The mass immunisation programme is estimated to lead to 11,000 fewer hospital admissions and 2,000 fewer deaths every year.

The Department of Health said it needed to examine a number of issues before the programme can be rolled out.

Masses of the vaccine, which will be used on about 9 million children, need to be sourced and a decision needs to be made on who will deliver the vaccine – whether it should be school nurses or other healthcare workers.

Health experts also need to decide how the programme will be delivered in a six- to eight-week period ahead of the flu season.

The chief medical officer, Professor Dame Sally Davies, said: “Severe winter flu and its complications can make people really ill and can kill, particularly those who are weak and frail, which is why we already offer vaccinations to the most at risk groups.

“We accept the advice of our expert committee that rolling out a wider programme could further protect children, with even a modest takeup helping to protect our most vulnerable.

“There are significant challenges to delivering a programme that requires up to 9 million children to be vaccinated during a six-week period and we will look at the recommendations in detail to decide how best to develop and deliver the programme.”

Professor Adam Finn, professor of paediatrics at the University of Bristol, said: “I think vaccination of healthy schoolchildren with the new nasal flu vaccine is a good idea as we know it’s effective and safe and flu can be a serious illness in childhood, not just in old age.

“There should be time to do some more research before we introduce the vaccine to help us predict how well such a programme would be accepted and would work.

“Although children don’t die of flu as often as old people do, they can get sick enough to require hospitalisation. Many others are ill enough to require time off school, which is disruptive for them and their families.

“Children also spread flu to other children and to adults including school staff and their families. Preventing flu in children should benefit all children and others too.”

The Guardian

Will Olympics spread measles?

Thursday, July 26th, 2012 (last updated)

A worrying number of European measles cases — and parents not vaccinating kids — has some doctors extra-concerned.

In our post 9/11 world, events like the Olympics carry the extra burden of keeping spectators safe from acts of violence. Visitors to London will no doubt see police toting submachine guns and be captured by surveillance cameras at every turn. While anti-terrorism has dominated conversations on the eve of the games, there’s a less-discussed hazard for travelers — and the rest of us. In 2011, Europe reported over 30,000 cases of measles. Third-world levels of infection on a first-world continent are worrisome. It’s worth considering whether folks stepping foot in Great Britain should carry a copy of their vaccine records with their passport to earn safe passage into the country.

We don’t know how many measles cases were due to parents who refused to vaccinate their kids. We do know that the cases can be attributed to broad swaths of people who are not vaccinated against measles. We also know that the bogus claim that the measles-mumps-rubella vaccine (MMR) causes autism got its start in Europe. Most important, we know that the world is flat: 2011 also saw the largest outbreak of measles in the U.S. since the mid-1990s. Over 90 percent of our cases were imported here from locations around the world. Some of those cases were, unfortunately, kids who were too young to receive either one or both doses of the MMR vaccine. But of those infected kids who could get the vaccine, three out of four did not because their parents refused it.

All of this makes us ask, yet again: Despite the breadth of medical, legal and ethical evidence speaking to the safety of vaccines, why does the anti-vaccine movement continue to wield so much influence over parents?

But before getting to that, it’s worth putting the problem in perspective. Anti-vaccinationists have been around since the birth of immunizations. What’s striking is how little has changed in their attempts to damage the reputation of vaccines. Paul Offit shows this in his book “Deadly Choices: How the Anti-Vaccine Movement Threatens Us All.” After the discovery of the smallpox vaccine during the 1880s, anti-vaccinationists seized upon the fears of a less secular society by claiming the vaccine contained the “poison of adders, the blood, entrails and excretions of bats, toads and suckling whelps.” Today, in a society more accustomed to clinical jargon, they focus fear tactics on the real compounds used to keep us safe and known to be effective, like thimerosal.


Families Fighting Flu

Thursday, July 26th, 2012 (last updated)

Families Fighting Flu ( is a nonprofit, volunteer-based advocacy organization dedicated to protecting the lives of children. Our members include families whose children have suffered serious medical complications or died from influenza, as well as health care practitioners and advocates committed to flu prevention. In honor of our children, we work to increase awareness about the seriousness of the disease and to reduce the number of childhood hospitalizations and deaths caused by the flu each year by increasing vaccination rates.

This powerful six and half-minute video, created by the U.S. Centers for Disease Control and Prevention (CDC) in collaboration with Families Fighting Flu (FFF), features the personal stories of parents who have tragically lost or nearly lost a child to the flu. Why Flu Vaccination Matters: Personal Stories from Families Affected by Flu intertwines the stories of these parents with the facts about influenza as explained by Dr. Jeanne Santoli, Deputy Director of the National Center for Immunization and Respiratory Diseases at the CDC.

Families Fighting Flu & CDS

Whooping cough in an adult

Wednesday, July 25th, 2012 (last updated)

A 64-year-old man was admitted to the medical service with a presumed asthma exacerbation. His symptoms had worsened during the preceding 3 weeks despite treatment with oral glucocorticoids, leading him to present to the emergency department multiple times with a progressive cough. He also reporting having associated chest tightness and difficulty eating and sleeping, without any post-tussive emesis. Shortly after his admission, the medical team heard a characteristic “whooping” cough (see video). He was given azithromycin, and samples were obtained for serologic testing and for nasopharyngeal culture of Bordetella pertussis. The patient’s cough abated and his respiratory status improved during the next 5 days. Approximately 1 week after discharge, test results were returned that were positive for B. pertussis. Further questioning revealed that the patient had never been vaccinated against pertussis. He received a diphtheria–tetanus–acellular pertussis (DTaP) vaccine approximately 1 month after discharge.

The New England Journal of Medicine

What did Hannah bring back from vacation?

Wednesday, July 25th, 2012 (last updated)

Every Child By Two

Not vaccinated? No Kisses

Tuesday, July 24th, 2012 (last updated)

Every Child By Two

Anti-vaccine movement causes the worst whooping cough epidemic in 70 years

Monday, July 23rd, 2012 (last updated)

The great northwest of the U.S. is known for its natural beauty.  It’s also a high-tech region with a highly educated public – not exactly the kind of place one would expect to fall for the anti-science rhetoric of the anti-vaccine movement.

But it has.  The anti-vaxxers have convinced a frighteningly high number of parents in Washington State to withhold vaccines from their children.  A story in The Seattle Times last year reported that:

“Washington [state] parents are choosing not to vaccinate their kindergartners at a rate higher than anywhere else in the country.”

This despite the fact that the Bill & Melinda Gates Foundation (formed by the founder of Microsoft, which is headquartered in Seattle) is one of the world’s leading sponsors of vaccine research.

When the vaccination rates drop, everyone becomes more vulnerable to infectious diseases.  When more than 90% of the population is vaccinated, we have “herd immunity” – this means the disease can’t spread because there aren’t enough susceptible people in the community.  So the high rate of vaccine refusal in Washington makes it easier for whooping cough (and other diseases) to spread.

The media has been complicit in spreading some of anti-vaccine misinformation.  Sometimes it comes straight from the media itself, such as the credulous, anti-science, anti-vax CBS reporter Sharyl Attkisson. Other times it comes from talk shows, magazines, or even airline advertisements that provide a platform for anti-vax celebrity doctors such as Jay Gordon (who gained fame as Jenny McCarthy’s son’s doctor) and “Dr. Bob” Sears, who has published his own “alternative” vaccine schedule in a book filled with anti-vaccine nonsense.  These characters continue to claim, at every chance they get, that vaccines cause autism (as Gordon has said, repeatedly), or that they cause other harms, despite overwhelming evidence to the contrary.  They use their medical degrees and their faux concern “for the children” to frighten parents into keeping their kids unvaccinated.

And now we learn that the U.S. is in the midst of the worst whooping cough epidemic in 70 years.  One of the most hard-hit states is Washington, which the CDC just announced (on 20 July) has suffered 2,520 cases so far this year, a 1300% increase over last year.  This is the highest number of cases reported in Washington since 1942.  This plot of the number of cases this year compared to last year shows the dramatic rise in infections:

Making things worse, it seems, is an increase in cases among children aged 13-14.  Children get a booster shot at age 11-12, but the new outbreak indicates that the effectiveness of the booster may not last very long.  The dramatic increase in whooping cough this year also suggests that the bacterium that causes it, Bordetella pertussis, is mutating to make the vaccine less effective.  Nevertheless, the CDC emphasizes:

“Vaccination continues to be the single most effective strategy to reduce morbidity and mortality caused by pertussis. Vaccination of pregnant women and contacts of infants is recommended to protect infants too young to be vaccinated.”

This good advice is seriously undermined when misinformed doctors such as “Dr. Bob” Sears directly advise pregnant women not to get the whooping cough vaccine, as he did in the Huffington Post. (Hint: it’s a good rule to be very skeptical of celebrity doctors who go by their first name.)

I should also point out that whooping cough is a national problem, not just Washington State’s.  The U.S. has had over 17,000 cases this year, putting it on track for the worst year since 1959.  The highest rate of infection in the nation is in Wisconsin (which has also been hit hard by anti-vaccine effects), followed by Washington and Montana. 10 deaths have been reported, mostly in infants who were too young to be vaccinated.  For all this, we can thank the anti-vaccination movement.


CDC says US pertussis outbreak could be worst in 50 years

Sunday, July 22nd, 2012 (last updated)

The number of U.S. whooping cough cases has risen to around 18,000 in an outbreak that is on track to become the most severe in over a half century and could in part stem from possible waning vaccine protection, health officials said on Thursday.

Washington state, which declared an epidemic in April, and Wisconsin were particularly hard hit, with each reporting more than 3,000 cases, according to the U.S. Centers for Disease Control and Prevention.

Nine people have died overall and the number of cases was already more than double than at the same time last year.

Whooping cough, also known as pertussis, causes severe, almost uncontrollable coughing. In the United States, most children are immunized with a DTaP five-dose series vaccine that is given as a series of shots, starting at two months.

All adults, including pregnant women, should get a booster shot because the contagious illness is especially dangerous for children under a year old who have yet to complete a cycle of vaccinations, Dr. Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases, told a media briefing.

“It’s most dangerous for babies,” Schuchat said, adding that the current outbreak at its existing pace could become the most severe since 1959, when 40,000 cases were reported. “Preventing infant deaths from the disease is our primary national goal,” she said.

A spike in whooping cough cases among 10-year-olds and adolescents who are 13 and 14 was a concern, perhaps an indicator that the pertussis vaccine may be wearing off earlier than anticipated, Washington Health Secretary Mary Selecky said.

The U.S. groups of 10-, 13- and 14-year-olds who are experiencing a high illness rate had DTaP vaccinations, which were introduced in 1997 at the same time that the prior DTP vaccine was discontinued.

The earlier vaccine used whole cell parts made of killed pertussis bacteria, while DTaP uses only small acellular bacteria pieces, not the whole bacteria cell, said Donn Moyer, Washington state Health Department spokesman

CDC officials will begin an investigation in Washington state later this month “to analyze our data for cases among 13- to 14-year-olds to see what can be learned about disease rates and vaccination status,” Moyer told Reuters.

The number of cases in Washington, with no deaths, has tripled since April, with 1,132 cases reported by the end of that month.

Moyer said the CDC also plans a similar study in California, where a 2010 epidemic counted more than 9,000 cases, including 10 infant deaths.

Whooping cough typically begins with cold-like symptoms such as a fever, runny nose and sneezing and is accompanied by a mild cough that grows more severe by the first or second week. A high-pitched whoop, giving the illness its name, can follow violent coughing fits.


Parental consent for HPV vaccination should not be waived, poll says

Friday, July 20th, 2012 (last updated)

Most adults say teenagers should be able to freely access treatment for sexually transmitted diseases, but most say parental consent should be required for the human papillomavirus (HPV) vaccine.

Researchers surveyed 2,131 adults and found that 45 percent supported allowing teens to receive the HPV vaccine without parental consent, but 57 percent said teens should be able to get STD prevention measures. The poll found that55 percent said teens should be able get STD treatments without parental consent, just not the HPV vaccine.

“These poll results show the majority of adults view HPV vaccination as distinct from sexually transmitted infection prevention, and are reluctant to support taking away parental consent,” said study author Sarah Clark, of the University of Michigan and the National Poll on Children’s Health.

My Health News Daily & UM Health System