Regional survey supports national initiative for 'water-only' schools in New Zealand.

OBJECTIVE: To support a national initiative to remove sugary drinks from schools and limit drinks to water or unflavoured milk ('water-only'). METHODS: We emailed all 201 schools with primary school aged children in the Greater Wellington region with a survey on (1) current status of, (2) support needs for, and (3) barriers to or lessons learned from, a 'water-only' school policy. RESULTS: Only 78 (39%) of schools responded. Most supported 'water-only': 22 (28%) had implemented a policy; 10 (13%) in process of doing so; 22 (28%) were considering it; and 12 (15%) were 'water-only', but did not have a policy. Only 12 (15%) were not considering a 'water-only' policy. The main barrier reported was lack of community and/or family support. Many schools did not see any barriers beyond the time needed for consultation. Monitoring and communication were identified as key to success. A quarter of schools requested public health nurse support for a 'water-only' policy. CONCLUSIONS: The survey elicited a range of views on 'water-only' policies for schools, but suggests that 'water-only' may be an emerging norm for schools. Implications for public health: Our survey shows how local assessment can support a national initiative by providing a baseline, identifying schools that want support, and sharing lessons. Making schools 'water-only' could be a first step in changing our children's environment to prevent obesity.

Should hepatitis B vaccine be used for infants?

Chronic hepatitis B virus infection causes nearly all the deaths from this virus. As the initial infection occurs without symptoms and decades prior to the onset of cirrhosis and liver cancer, these consequences are rarely recognized as being caused by the virus. Consequently, its public health importance is under-recognized. Safe and effective vaccines have now been available for over 20 years. Concerns have been raised regarding the mercury preservative in vaccines leading to potential toxicity. But the evidence to date does not support any association of hepatitis B vaccine with serious adverse consequences. Protecting infants through immunization is the most effective control strategy. By 2005, over 80% of countries had implemented routine infant immunization. In countries with relatively low rates of hepatitis B virus infection, some have argued to defer immunization until later life. However, these arguments focus on the more visible acute infection. The possible future cost from a single infant infection argues for universal infant hepatitis B immunization--given the very high costs of treating its consequences (e.g., liver transplant) and the very low price of the vaccine.

Accelerated measles control in the Western Pacific region.

By the 1990s, an immunization program in the western Pacific had dramatically reduced measles morbidity and mortality. Building on the region's successful elimination of polio, several countries and areas achieved or are close to measles elimination, thus showing the potential for global eradication. The diverse challenges for measles control in different parts of the region have produced lessons that will help with future control, including the need for surveillance of sufficient standard to guide and monitor progress. A group of experts recognized both the potential and the challenges of the measles immunization program and proposed regional elimination as the appropriate disease control target for the region. No date was recommended for its achievement. If progress continues at the present rate, the western Pacific region should soon be able to set a target date for measles elimination.