POLIO [to 30 May 2015]

POLIO [to 30 May 2015]
Public Health Emergency of International Concern (PHEIC)

GPEI Update: Polio this week – As of 27 May 2015
Global Polio Eradication Initiative
[Editor’s Excerpt and text bolding]
Full report: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
:: Ministers of Health from around the world adopted a landmark resolution to end polio once and for all at the World Health Assembly in Geneva last week. The discussions were informed by a status report prepared by the Global Polio Eradication Initiative. Draft 3rd report of the Committee A , WHO news release from 22 May 2015
:: Polio staff continue to offer support to the humanitarian response to the devastating earth quakes in Nepal. Read more.
:: The 11th IMB report was published last week, reporting on progress towards polio eradication and making recommendations
Selected excerpts from Country-specific Reports
:: One new case of wild poliovirus type 1 (WPV1) has been reported in the past week in Gulestan district of Farah province. This most recent case had onset of paralysis on 5 May. The total number of WPV1 cases for 2015 is now 2, and remains 28 for 2014. Most of the cases from 2014 were linked with cross-border transmission from neighbouring Pakistan.
:: Environmental sampling in the country continues to find wild poliovirus (most recently in Hilmand). Such sampling is invaluable to improved surveillance for the virus.
:: Subnational Immunization Days (SNIDs) are planned from 14 – 16 June across the south and east using bivalent OPV. National Immunization Days are scheduled on 16 to 18 Augus
:: Two new environmental samples positive for WPV1 were reported this week from Quetta district of Balochistan and from Jacobabad district of Sindh.
:: Currently, the focus of the polio eradication programme in Pakistan is on known infected areas and on areas deemed to be high-risk but which have not reported polio cases.
:: Environmental surveillance indicates widespread circulation of polioviruses – WPV as well as VDPV – not just in known infected areas but also in areas without cases. Environmental surveillance is proving to be an instrumental supplemental surveillance tool enabling a clearer epidemiological picture.

WHO and UNICEF launch vaccination campaign to keep Iraq polio free
Baghdad | Erbil, 26 May 2015 – A mass polio vaccination campaign, aiming to target 5.7 million children under the age of 5, began in Iraq on 24 May. The campaign will be conducted in all governorates to maintain the country’s polio-free status. The last case of polio was reported on 7 April 2014; a 34-month-old girl from the Rasafa district of Baghdad.

Iraq’s response to combating polio aligns with a multi-country response plan developed following the outbreak of polio in Syria in 2013. Multiple vaccination rounds held in country since then have helped to protect Iraqi children from the paralysis caused by this incurable disease. Despite ongoing conflict, mass population displacement and a complex and unpredictable security situation, only 2 cases of polio were confirmed in Iraq during the regional outbreak in early 2014.

WHO Country Representative to Iraq Dr Syed Jaffar Hussain said, “Despite the civil unrest that engulfs over a third of the country, polio campaigns have continued to reach up to 90% of children through collaborative efforts with multiple line-ministries and local partners.” He paid tribute to polio vaccination team members and parents and appealed to the international community and partners for their continued financial and technical support over the next 12 months for an additional 4 nationwide vaccination campaigns.”Community efforts were well acknowledged by the Independent Monitoring Board for the Global Polio Eradication Initiative during their recent meeting. However, significant risks continue to exist and thus there is no room for complacency,” Dr Hussain added.

UNICEF Country Representative to Iraq Phillippe Heffinck added, “The polio effort in Iraq has been successful despite tremendous challenges. The collaboration and leadership of the Ministries of Health and strong collaboration with partners, such as WHO, have established community ownership for polio campaigns, and created a strong platform for rolling out strong routine immunization services. Both of these achievements are not only remarkable, but essential to keep Iraq polio free and improve the health of all Iraqi children.”…

WHO & Regionals [to 30 May 2015]

WHO & Regionals [to 30 May 2015]
Egypt: increase in H5N1 human and poultry cases but no change in transmission pattern of infection
May 2015 — The recent increase in the number of people affected by the avian influenza virus H5N1 in Egypt is not related to virus mutations but rather to more people becoming exposed to infected poultry. Since November 2014 to 30 April 2015, the period analysed by the international mission, a total of 165 cases, including 48 deaths were reported.

WHO recommends 10 measurements for HIV
May 2015 — WHO released new guidelines recommending simplified indicators to measure the reach of HIV services, and the impact achieved at both the national and global levels.

Global Alert and Response (GAR) – Disease Outbreak News (DONs)
30 May 2015 – Middle East respiratory syndrome coronavirus (MERS-CoV) – China
30 May 2015 – Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea
28 May 2015 – Lassa Fever – United States of America
25 May 2015 – Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia
24 May 2015 – Middle East respiratory syndrome coronavirus (MERS-CoV) – United Arab Emirates

:: WHO Regional Offices
WHO African Region AFRO
:: Cholera crisis in Tanzania improving despite high transmission risk
Kagunga, 26 May 2015 – The ongoing cholera outbreak in western Tanzania appears to be improving thanks to intensive national and international efforts, but the risk of transmission remains high due to limited access to shelter, toilets, water and essential medical care. As of 25 May, the total number of cases diagnosed and treated was 4408 and no deaths have been reported between 21-24 May.

WHO Region of the Americas PAHO
:: PAHO urges member countries to ratify new protocol on illicit tobacco (05/29/2015)

WHO South-East Asia Region SEARO
:: Stop illicit trade of tobacco products 29 May 2015

WHO European Region EURO
:: Final day of the World Health Assembly: highlights for the European Region 28-05-2015
:: World No Tobacco Day awards 2015 27-05-2015
:: Days 5 to 7 of the World Health Assembly: highlights for the European Region 27-05-2015

WHO Eastern Mediterranean Region EMRO
:: Urgent funding needed to prevent imminent closure of health care projects in Iraq
Cairo, 27 May 2015 – If urgently needed funds are not secured by the end of June 2015, more than 84% of health care projects serving populations in need in Iraq will be forced to close. If this happens, more than 3 million refugees, internally displaced persons and host communities will not have access to the treatment and care that these projects provide. WHO is coordinating the response of health cluster partners to optimize the use of available resources and calls on donors to provide financial support to prevent further avoidable death and additional suffering for millions of the most vulnerable people in Iraq.
:: WHO statement on the situation in Yemen by WHO Director-General Dr Margaret Chan
27 May 2015
:: WHO and UNICEF launch vaccination campaign to keep Iraq polio free 26 May 2015
:: WHO partners with MENTOR Initiative to control leishmaniasis in Aleppo and Deir ez-Zor  26 May 2015

WHO Western Pacific Region
No new digest content identified.

GAVI Watch [to 30 May 2015]

GAVI Watch [to 30 May 2015]
:: Oman commits US$ 3 million to support childhood immunisation
28 May 2015
First time pledge will enable Gavi to reach children with life-saving vaccines.

Geneva, 28 May 2015 – The Government of the Sultanate of Oman today committed US$ 3 million to Gavi, the Vaccine Alliance – the first time Oman has provided funds to help Gavi reach children with vaccines in the world’s poorest countries.

“Oman is joining the global drive to protect children from potentially-fatal diseases,” said Dr Seth Berkley, Gavi CEO. “This new contribution will help us achieve our goal of supporting developing countries to immunise 300 million more children between 2016 and 2020, saving up to six million more lives.”

Oman’s contribution comes days after the World Health Assembly agreed on a resolution to improve access to sustainable supplies of affordable vaccines and highlighted the important role immunisation plays in reducing child deaths while also being a highly cost-effective public health intervention…

DoD Launches Review of Lab Procedures Involving Anthrax

DoD Launches Review of Lab Procedures Involving Anthrax
WASHINGTON, May 29, 2015 – The Defense Department is launching a comprehensive review of its laboratory procedures, processes, and protocols associated with inactivating spore-forming anthrax…Deputy Defense Secretary Bob Work today ordered the review after consulting with Defense Secretary Ash Carter…

No Risk to the General Public
There is no known risk to the general public and an extremely low risk to lab workers from the department’s inadvertent shipments of inactivated samples containing small numbers of live anthrax to several laboratories, according to the release.

As of now, 24 laboratories in 11 states and two foreign countries are believed to have received suspect samples, the release said.

The department is working closely with the Centers for Disease Control and Prevention, who is leading the ongoing investigation pursuit to its statutory authorities, the release said.

Monitoring the Situation
The department will continue to monitor the situation and provide updates to the public, the release said.

In addition to the CDC review, Work ordered all DoD laboratories that have these materials to test all previously inactivated spore-forming anthrax in the inventory, the release said.

DoD also is advising labs that received inactive anthrax from the department to stop working with those samples until further instruction from the DoD and CDC…

CDC/MMWR/ACIP Watch [to 30 May 2015]

CDC/MMWR/ACIP Watch [to 30 May 2015]

CDC investigating unintentional DoD shipment of anthrax
Media Statement
CDC is investigating the unintentional transfer of anthrax from the U.S. Department of Defense (DOD) to labs in multiple states and overseas. At this time we do not suspect any risk to the general public.

The CDC investigation was started after a request for technical consultation from a private commercial lab. The lab was working as part of a DOD effort to develop a new diagnostic test to identify biological threats. Although an inactivated agent was expected, the lab reported they were able to grow live Bacillus anthracis.

CDC is working in conjunction with DoD and other federal and state partners to conduct an investigation with all the labs that received samples from the DoD. The ongoing investigation includes determining if the labs also received other live samples, epidemiologic consultation, worker safety review, laboratory analysis, and handling of laboratory waste.

All samples involved in the investigation are being securely transferred to CDC or Laboratory Response Network (LRN) laboratories for further testing. CDC has sent officials from the CDC Federal Select Agent Program to the DOD labs to conduct onsite investigations.

Updates will continue to be provided as the investigation progresses.


:: February 2015 ACIP Minutes [2.16 MB, 72 pages]
:: Next ACIP Meeting – June 24-25, 2015
ACIP June 2015 Draft Meeting Agenda [2 pages]
Register for upcoming June ACIP meeting
(Wednesday – Thursday)
Deadline for registration:
– Non-US Citizens: June 3, 2015
– US Citizens: June 10, 2015

American Journal of Infection Control – June 2015

American Journal of Infection Control
June 2015 Volume 43, Issue 6, p547-662

What can we learn about the Ebola outbreak from tweets?
Michelle Odlum, Sunmoo Yoon
Twitter can address the challenges of the current Ebola outbreak surveillance. The aims of this study are to demonstrate the use of Twitter as a real-time method of Ebola outbreak surveillance to monitor information spread, capture early epidemic detection, and examine content of public knowledge and attitudes.

Healthcare worker influenza declination form program
Sherri L. LaVela, PhD, MPH, MBA, Jennifer N. Hill, MA, Bridget M. Smith, PhD, Charlesnika T. Evans, PhD, MPH, Barry Goldstein, MD, PhD, Richard Martinello, MD
Published Online: March 20, 2015
DOI: http://dx.doi.org/10.1016/j.ajic.2015.02.013
:: The declination form program was compatible, flexible, easy to use, and supported by leadership.
:: Declination form program facilitators included complementary ongoing strategies and leadership engagement.
:: One-on-one attention and education at the time of vaccination led to health care worker accountability.
:: An influenza declination form program is of minimal cost, but it requires some dedicated staff and resources.
:: Vaccination rate improved from 53.5% to 77.4% pre- to postdeclination form program implementation.
Health care worker (HCW) vaccination rates have been low for many years (approximately 50%). Our goal was to implement an influenza declination form program (DFP) to assess feasibility, participation, HCW vaccination, and costs.
This was a prospective interventional pilot study using mixed methods to evaluate the DFP implementation processes and outcomes. We conducted a formative evaluation and interviews; data were transcribed and coded into themes. Secondary outcomes included self-reported HCW influenza vaccine uptake (pre-/postsurvey) and program costs; data were evaluated using descriptive and bivariate analyses.
The DFP was compatible with ongoing strategies and unit culture. Barriers included multiple hospital shifts and competing demands. Facilitators included complementary ongoing strategies and leadership engagement. HCW vaccination rates were higher post- versus preimplementation (77.4% vs 53.5%, P =.01). To implement the DFP at site 1, using a mobile flu cart, 100% of declination forms were completed in 42.5 staff hours over <2 months. At site 2, using a vaccination table on all staff meeting days, 49% of forms were completed in 26.5 staff hours over 4.5 months. Average cost of staff time was $2,093 per site.
DFP implementation required limited resources and resulted in increased HCW influenza vaccine rates; this may have positive clinical implications for influenza infection control/prevention.
Increased reports of measles in a low endemic region during a rubella outbreak in adult populations
Takako Kurata, Daiki Kanbayashi, Hiroshi Nishimura, Jun Komano, Tetsuo Kase, Kazuo Takahashi
Published online: April 1, 2015
In 2013, a rubella outbreak was observed in Japan, Romania, and Poland. The outbreak in Japan was accompanied by an increase of measles reports, especially from a region where measles is highly controlled. This was attributed to the adult populations affected by this rubella outbreak, similarity of clinical signs between rubella and measles, sufficiently small impact of measles outbreaks from neighboring nations, and elimination levels of measles endemicity. Current and future concerns for measles control are discussed.

Impact of Health Insurance Status on Vaccination Coverage Among Adult Populations

American Journal of Preventive Medicine
June 2015 Volume 48, Issue 6, p647-770, e11-e30

Impact of Health Insurance Status on Vaccination Coverage Among Adult Populations
Peng-jun Lu, MD, PhD, Alissa O’Halloran, MSPH, Walter W. Williams, MD, MPH
Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia
Published Online: April 15, 2015
DOI: http://dx.doi.org/10.1016/j.amepre.2014.12.008
Underinsurance is a barrier to vaccination among children. Information on vaccination among adults aged ≥18 years by insurance status is limited. This study assesses vaccination coverage among adults aged ≥18 years in the U.S. in 2012 by health insurance status and access to care characteristics.
The 2012 National Health Interview Survey data were analyzed in 2014 to estimate vaccination coverage among adults aged ≥18 years by health insurance status for seven routinely recommended vaccines.
Influenza vaccination coverage among adults aged ≥18 years without or with health insurance was 14.4% versus 44.3%, respectively; pneumococcal vaccination coverage among adults aged 18–64 years with high-risk conditions was 9.8% versus 23.0%; tetanus and diphtheria toxoid (Td) coverage (age ≥18 years) was 53.2% versus 64.5%; tetanus, diphtheria, and acellular pertussis (Tdap) coverage (age ≥18 years) was 8.4% versus 15.7%; hepatitis A (HepA) coverage (age 18–49 years) was 16.6% versus 19.8%; hepatitis B (HepB) coverage (age 18–49 years) was 27.5% versus 38.0%; shingles coverage (age ≥60 years) was 6.1% versus 20.8%; and human papillomavirus (HPV) coverage (women aged 18–26 years) was 20.9% versus 39.8%. In addition, vaccination coverage differed by insurance type, whether respondents had a regular physician, and number of physician contacts.
Overall, vaccination coverage among adults aged ≥18 years is lower among uninsured populations. Implementation of effective strategies is needed to help improve vaccination coverage among adults aged ≥18 years, especially those without health insurance