Impact of unfounded vaccine safety concerns on the nationwide measles-rubella immunization campaign, Georgia, 2008.

Vaccine safety fears following media reports of adverse events led to low (50.3%) coverage in a supplementary measles-rubella immunization campaign in Georgia in 2008. Review of adverse events associated with the campaign identified 432 reports (<0.1% of ∼ 493,000 vaccinees) including 338 (78.2%) cases of syncope. There were no deaths. Causality assessment was performed for 79 cases perceived by providers as severe and with clinical details available. Conditions likely caused by the vaccine were identified in 13 (16.5%) cases (allergic and local reactions, thrombocytopenia). Thirty-seven (46.8%) cases had symptoms consistent with syncope or anxiety attack; 36 (97.3%) of them were initially misdiagnosed as anaphylactic shock/allergies/"postvaccinal reactions". Twenty-nine (36.7%) cases had coincidental illnesses. Safety fears were unfounded and exaggerated by media reports and providers' difficulties in recognizing syncope/anxiety attacks. Risk communication strategies to address perceived vaccine safety concerns are urgently needed to ensure that the goal of measles and rubella elimination in the European Region of the World Health Organization is met.

Rabies control and prevention in Georgia: current status and perspectives.

The incidence of rabies post-exposure prophylaxis (PEP) is very high in Georgia, at 876/100,000 persons in 2006. Data from the National Centre for Disease Control on rabies surveillance for 2004, 2005 and 2006 was analysed, with the objective of improving postexposure policy and practice, as well as identifying priorities for national surveillance and control. For the base period 1986-1995, a total of 40 rabies cases in humans were reported in Georgia. In 2004, 2005 and 2006 there were 12, 10 and 7 reported cases, respectively, representing a significant increase in overall incidence for this period. Ninety-three percent (93%) of cases were caused by dog bites. The large population of stray dogs and unvaccinated pets in Georgia is recognized as the main risk factor. In 2006, 38,569 patients received PEP following bites by an animal with suspected rabies, compared to 23,712 in 2004, and 30,254 in 2005 (representing a 1/3 increase annually). Of the total number of PEP treatments initiated in 2004, 16,568(69.9%) were discontinued due to the fact that the biting animal remained healthy during the observation period; 23,106 (76.4%) were discontinued in 2005; and 30,254 (78.4%) were discontinued in 2006. Concerns regarding the safety of available immunoglobulins, uncertainty regarding the use of vaccines and immunoglobulins from different manufacturers, and the inconsistency of national guidelines with international recommendations are cited as obstacles to an improved delivery of PEP. For the effective control of rabies, the national veterinary programmes need to be improved, stray dog population control measures need to be updated according to international standards, and clear national guidelines regarding the use of rabies vaccines and immunoglobulins for PEP should be developed and implemented.

Investigation of an outbreak of amoebiasis in Georgia.

Entamoeba histolytica, a protozoan parasite, occurs worldwide and 12% of the world's population are estimated to be infected. The prevalence of infection varies between 1% in industrialised countries to between 50% and 80% in tropical countries, where tra

[The frequency of detection of markers of hepatitis virus B infection among the inhabitants of Rustavi, the Georgian SSR]. / Chastota vyiavleniia markerov infitsirovaniia virusom gepatita B sredi zhitelei Rustavi Gruzinskoi SSR.

Blood serum samples from 1,087 patients with acute viral hepatitis were studied. HBsAg was detected in 36.6% of cases. The study of anti-HBc IgM made it possible to diagnose hepatitis B in 6.6% of cases. The study of blood serum samples from 362 donors, 2,356 pregnant women and 163 medical workers in Rustavi for the presence of the markers of hepatitis B infection revealed a wide spread of hepatitis B in Rustavi.