Control of an outbreak of human parainfluenza virus 3 in hematopoietic stem cell transplant recipients.

Human parainfluenza virus 3 (HPIV3) infection can cause significant morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). There are no standard guidelines for the prevention and control of HPIV3 in the outpatient setting. After 2 HSCT inpatients diagnosed with HPIV3 were noted to have had multiple recent HSCT outpatient clinic (OPC) visits, an investigation of policy and procedures in the HSCT OPC was undertaken, and active surveillance for respiratory viral illness was instituted in the at-risk HSCT population. Between July 19 and August 30, 2005, 13 patients were diagnosed with HPIV3 infection. Morbidity in affected patients was significant, and mortality was high (38.5%) and not affected by antiviral therapy. Molecular typing identified several genetically distinct groups of the hemagglutinin-neuraminidase gene of the 11 available isolates. Based on sequence relatedness among the isolates and the demographic and exposure history of the patients, in many of these cases HPIV3 infection likely was acquired in the HSCT OPC. The major infection control interventions were introduced between August 20 and August 24. An epidemic curve revealed that HPIV3 infection frequency peaked between August 17 and August 26, with no cases identified after August 30. Prompt attention and focus on infection control interventions were associated with a rapid decrease in the number of incident cases. Policies and procedures regarding patients with respiratory viral illnesses in HSCT OPC populations should be formulated and universally reinforced with HSCT clinic staff to prevent the spread of these infections.

International science at the annual meeting of the American Academy of Neurology.

The annual meeting of the American Academy of Neurology (AAN) is a major venue for presentation of the latest disease-related clinical and basic neurologic research and is attended by a large number of neurologists from countries outside the United States and Canada. One-third of annual meeting attendees and abstract submissions are international in origin, with wide variations between countries and world regions, and this proportion has remained stable for the past 5 years. By comparison, international neurologists constitute 12% (n = 2,485) of AAN membership, and international membership has declined slightly over the past 5 years compared to a 15% increase from the United States and Canada. The scientific topics covered by international abstracts are similar to those from the United States and Canada. Abstract acceptance rates are 15% lower for international submissions than for those from the United States and Canada although variations between countries are seen. Three times more European neurologists attend the annual meeting than are AAN members whereas Asian neurologists are more likely to be AAN members than to attend the annual meeting. The AAN is working to understand and address the issues that affect international physicians' decisions to participate in the annual meeting.