All doctors and other health care professionals with direct patient contact should receive an influenza immunization every year, the Association for Professionals in Infection Control and Epidemiology said in a new position paper.

The group said hospitals, nursing homes, outpatient clinics, urgent care centers and home health agencies should implement a system of “informed declination” for health professionals.

As part of this news system, health professionals who refuse to be vaccinated for nonmedical reasons would admit in writing that they are exposing their patients to additional risk.

The Washington, D.C.-based APIC represents 12,000 members who direct infection-control programs in health care facilities.

The national health worker immunization rate has peaked at about 40% during the last decade, according to the Centers for Disease Control and Prevention.

– by Gene J. Koprowski, Editorial Director

APIC says patients are at increased risk if doctors don’t get vaccinated.

Posted: October 20th, 2008 under Diseases, Influenza.
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More kids are dying from the flu because they also have staph infections, according to a new government report.

There was also a more than a fivefold increase in hard-to-treat complications of the flu.

Public health officials reckon the numbers underscore the importance of a new recommendation that all children, from 6 months through 18 years, get routine flu shots.

More than half the children who died were between ages five and 17 and had been seen as healthy until they contracted the flu.

“It’s an important message to say even healthy children develop complications and die almost before anything much can be done for them,” said Dr. Gregory Poland, a Mayo Clinic infectious disease specialist.

Flu season is just beginning. This year’s vaccine should be widely available this month.

Though few children die from the flu virus, the disease puts about 20,000 U.S. kids in the hospital each year.

Just six percent of the children studied who died had been fully vaccinated against the flu. Two doses are recommended each flu season for children ages six months to eight years who have not been vaccinated previously; for older kids, just one dose a year is needed.

The study, appearing in the October edition of Pediatrics, released on Monday, is based on an analysis of reported flu deaths from the 2004-05 through 2006-07 seasons.

The percentage of those who also had bacterial infections jumped from six percent to almost 36 percent. Most had staph infections, and 60 percent of those involved the dangerous MRSA bug, which is resistant to antibiotics.

– by Gene J. Koprowski, Editorial Director

Flu vaccine ready for the new season.

Posted: October 6th, 2008 under Diseases, Influenza.
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Hawaiian health officials are hoping that their campaign to increase vaccinations may prevent the flu virus from creating a massive outbreak there this winter.

“When we’re talking about flu, it is not a common cold or a minor respiratory infection. … It lasts longer and has potentially more severe complications, especially for infants and the very old” and those with chronic medical conditions, said Dr. Sarah Park, chief of the Hawaii Health Department’s Disease Outbreak Control Division.

Flu monitoring begins on the mainland of the U.S. this week with the traditional start of the flu season, according to the Centers for Disease Control and Prevention (CDC) but in Hawaii the Health Department works with monitoring physicians year-round, Park said.

“Although we do see a rise (in flu) in the traditional winter time, the last few seasons have been pretty mild,” she said. “It will be interesting to see how this season shapes up. If it turns out to be mild, maybe our school vaccine program is really making a difference, which is great.”

Hawaii last year implemented the first statewide influenza program in the schools for students between ages 5 and 13. More than 340 public and private schools participated.

Clearly, more than 60,000 students, about 45 percent, and more than 9,000 faculty and staff received free vaccinations.

– by Gene J. Koprowski, Editorial Director

Sanitize your hands and countertops and doorknobs — don’t become “flu man” this season.

Posted: October 1st, 2008 under Diseases, Influenza.
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Doctors in Central Florida are reporting a surge in cases of respiratory infections at local clinics. Centra Care doctors in the Sand Lake area said there’s been a 200 percent increase in the past week. Conway’s Central Care clinic said cases at facility are up 600 percent during the last week.

Typical symptoms of respiratory infection include:

* A sore throat.

* Sneezing. * Nasal and ear congestion and watery eyes.

Posted: October 1st, 2008 under Diseases, Influenza, The Common Cold, Whooping Cough.
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The flu season is upon us once again, and the Centers for Disease Control and Prevention is warning that mutant strains of the virus are likely to emerge once again.

The flu virus has an innate ability to adapt, so new strains emerge all the time.

The new vaccine, created for this year, covers the A/Brisbane strain that wasn’t covered by last year’s vaccine, said Michael Shaw, associate director for laboratory science in the CDC’s influenza division.

CDC officials knew the A/Brisbane strain was mutating quickly last year. However, at the time the vaccine was made, fertile hen eggs used to develop vaccines wouldn’t accept the first isolates of the strain, so last year’s vaccine didn’t cover A/Brisbane, Shaw added.

A new solution: cell-based vaccines, which might include late-developing strains of influenza because they accept isolates of viruses faster than eggs. Cell-based vaccines might be available in two or three flu seasons.

Several pharmaceutical companies are close to applying for licenses with the Food and Drug Administration to develop cell-based vaccines, Shaw said. Then the virus could be inserted into a mammalian cell for cultures to grow so vaccines could be developed, he added.

– by Gene J. Koprowski, Editorial Director

CDC warns that flu season is now upon us again.

Posted: September 29th, 2008 under Avian Flu, Developing Diseases, Diseases, Influenza.
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Pregnant women can protect their newborns against deadly influenza infections by getting a flu shot, a new study has found.

Infants are particularly vulnerable to the disease because they’re too young to get the annual vaccine or the drugs used to treat influenza, the researchers said. While public health officials have suggested the immunization for pregnant women for years, few mothers actually receive them, particularly in poorer countries.

The study of 340 women in Bangladesh found the shot slashed the number of proven cases of influenza by 63 percent in infants under 6 months and prevented about one in three respiratory illnesses in them and their mothers, according to the report in the New England Journal of Medicine. The protection lasted for five to six months and was similar to the benefit from the shot seen in older children.

“There’s never been evidence before that immunizing the mother provides a big benefit to the baby,” said Mark Steinhoff, a professor of pediatric and international medicine at Johns Hopkins University in Baltimore. “That’s what this study is about. More people should consider doing it,” he said in a telephone interview yesterday.

The shots are made by Paris-based Sanofi-Aventis SA, Novartis AG, of Basel, Switzerland, GlaxoSmithKline, Plc, of London, and the Australian drugmaker, CSL, Ltd. The Centers for Disease Conrol ein Atlanta has steadily widened recommendations for annual shots to include more Americans, which now covers all children aged 6 months to 18 years.

Posted: September 17th, 2008 under Diseases, Influenza.
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A new study by researchers at Yale School of Medicine explains why the cold and flu virus symptoms that are often transient in non-smokers, but seriously sicken smokers. The research also pinpointed the mechanism through which viruses and cigarette smoke interact to “increase lung inflammation and damage.”Scientists historically haven’t been able to explain why smokers have more exaggerated responses to viral infections. Those who smoke cigarettes have been more likely than non-smokers to die during previous influenza epidemics and are more susceptible to chronic obstructive pulmonary disease (COPD). What’s more, kids who are exposed to second-hand smoke get sicker, faster, when infected with respiratory synctial virus.

The conventional wisdom has been that cigarette smoke decreases anti-viral responses. But the Yale researchers— Dr. Jack A. Elias, MD, the Waldermar Von Zedtwitz Professor of Medicine and chair of internal medicine at Yale School of Medicine, and Dr. Min-Jong Kang, MD, associate research scientist—found the exact opposite to be true.

Their studies showed that the immune systems of mice exposed to cigarette smoke from as little as two cigarettes a day for two weeks overreacted when they were also exposed to a mimic of the flu virus. The rodent’s immune systems cleared the virus normally but the exaggerated inflammation caused dramatically increased levels of tissue damage.

“The anti-viral responses in the cigarette smoke exposed mice were not only not defective, but were hyperactive,” said Elias. “These findings suggest that smokers do not get in trouble because they can’t clear or fight off the virus; they get in trouble because they overreact.”

– by Gene J. Koprowski, Editorial Director

Smokers more prone to viral infections than non-smokers.

Posted: August 5th, 2008 under Avian Flu, Developing Diseases, Diseases, Impaired Immunity, Influenza, SARS, The Common Cold.
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A new concern is emerging in medicine — infection protection and control in dental office waiting rooms.

The Organization for Safety and Asepsis Procedures addresses the topic in its May issue in a feature entitled, “The Reception Room” is a feature in the May issue of the OSAP’s association publication Infection Control in Practice.

The article is aimed at helping dental professionals recognize sites in the reception room that need constant attention with regard to cleanliness and infection control, and is the second installment of a new series on compartmentalizing infection control policies and procedures.

Patients, caregivers and the the dental team are all at risk of infection in the waiting room. The article reports that there are new guidelines from the Centers for Disease Control (CDC) as to how to control infection in the reception area, and provide disease prevention information for patients.

– by The Editors

The dental office — next place where MRSA will flourish?

Posted: June 4th, 2008 under Diseases, Herpes-Cold Sores, Influenza, Meningitis, Mumps, Norwalk-Like Viruses, Pneumonia, Rubella.
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On March 17, the Massachusetts Department of Public Health, confirmed the state’s fourth pediatric death from influenza. “This has been a very difficult flu season for the residents of Massachusetts,” Dr. Alfred DeMaria, DPH’s director of communicable disease control, indicated. The number of flu cases which have been severe enough to be tested at hospitals and doctors’ offices was more than three times the number for last season as of March 13, Donna Rheaume, a spokesperson for the department, tells Infection Protection. 

According to the state, “this year’s flu shot was not the best match for some of the flu strains circulating this year.” That problem is not unique to Massachusetts, the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), which have to predict what flu strains to cover, missed on two out of three this year. “That guess is made by mid-summer in the Northern Hemisphere and vaccine production is based on these projections. Flu mutates frequently and as new strains emerge we must prepare new vaccines,” says Dr. Jim Wilde, professor of pediatrics and emergency medicine at the Medical College of Georgia. Dr. Wilde, who has a long standing interest in influenza and has published numerous articles based on his research, tells Infection Protection, “there is a worldwide network of people who monitor for the emergence of new strains of flu. Wrong guesses occur every few years. This year they guessed wrong on the B strain and on one of the A strains.”

The flu vaccine is reformulated every year from three viral strains including two types A strains and one type B strain. In view of this year’s mismatch, the FDA advisory committee, following the lead of the WHO, is recommending that all three strains be changed for next year. Ms. Rheaume, of the Massachusetts DPH, tells Infection Protection that they have already received the 2008-09 recommendations. Changing all three strains is “unprecedented” and raises the question of whether the flu strains are drifting and shifting too quickly for accurate predictions.

Professor Sheldon Jacobson, Willett faculty scholar at the University of Illinois, is an operations researcher with expertise in supply chain management issues for vaccine distribution and stockpiling. “The key question is whether this represents a onetime aberration or the beginning of a new trend. Additional research and data collection will be needed to address this question,” he tells Infection Protection.

One of the possible problems in growing three new strains for next year’s vaccine is that some flu strains grow slowly in the laboratory.  Dr. Nancy Cox, director of the CDC influenza division notes that, “One of the great limiting factors is how well the virus strains grow, and of course when you change strains, the growth properties are inherently unpredictable.” Professor Jacobson comments that, “vaccine manufacturers have already expressed concerns about the time frame to produce the 100 million plus doses needed for the 2008-2009 flu season. Given the time frame involved, and the nature of the new strains, it would not be a surprise to see flu vaccine supply chain problems and delays next year.”

– by Dr. Chris Iliades, MD, Boston Correspondent 

Nurse prepares a flu shot. Will it help? Image source: The Johns Hopkins University School of Public Health.

Posted: April 9th, 2008 under Diseases, Influenza.
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Nearly 1 million people in Britain could die if a flu pandemic struck there, a government report indicates.

A National Security Strategy created by the Cabinet Office says such an outbreak is the biggest danger to the country, alongside nuclear attack by Al-Qaeda, the terrorist group.

The document says: “We assess that the highest risk is an influenza-type pandemic like the outbreak in 1918, which killed 228,000 people in the UK.

Further, the report says, “experts agree there is a high risk of a pandemic occurring and the speed at which it could spread has increased because of globalisation We estimate that a pandemic could cause fatalities in the UK from 50,000 to 750,000, although both the timing and the impact are impossible to predict exactly.”

– by the Editors

A flu pandemic could kill more in the U.K. than this villian.

Posted: March 21st, 2008 under Influenza.
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