News Reports for May 18, 2012

US: Federal plan emphasizes resilience in national preparedness

May 17, 2012 (CIDRAP News) - The federal agency tasked with shoring up the nation's preparedness against a host of public health emergencies released a plan yesterday to help it and other partners focus and coordinate steps to meet national preparedness objectives.

The plan, authored by the US Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR), is a detailed roadmap for implementing the National Health Security Strategy (NHSS), which was released in December 2009 and required in the 2006 Pandemic and All Hazards Preparedness Act.

ASPR said the NHSS is an overarching vision of national health security that contains two main goals: building community resilience and strengthening and sustaining health and emergency response systems. The strategy describes 10 key objectives for meeting the goals:

- Foster informed and empowered individuals and communities
- Develop and maintain the workforce needed for national health security
- Ensure situational awareness
- Foster integrated, scalable healthcare delivery systems
- Ensure timely and effective communications
- Promote effective countermeasures
- Ensure prevention or mitigation of environmental and other emerging health threats
- Incorporate post-incident health recovery into planning and response
- Work with cross-border and global partners to enhance national, regional, and global health security
- Ensure that all systems are based on the best available science, evaluation, and quality improvement methods

ASPR emphasized in background materials on its Web site that the implementation plan is a national one that incorporates input from stakeholders outside of federal government, including academia, private industry, and community organizations. "While many of the actions in the plan are federal and will be led by federal agencies, these actions are meant to serve as models and catalysts for action in communities across the country," it said.

Many of the actions are under way, and all will have started by the end of 2014, according to ASPR.

In the introduction to the plan, ASPR recognized that the goals must be reached amid widespread budgeting challenges. "The activities in this plan are priorities intended to be executed with existing resources," it said. "It is assumed that there will be no significant additional public funds available for national health security for several years."

It added that the plan helps groups identify high-priority activities during times of limited resources. Continued: http://www.cidrap.umn.edu/cidr...  
 

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Fri May 18, 2012 at 06:15:47 AM UTC

US: Annual economic impacts of seasonal influenza on US counties - Spatial heterogeneity and patterns

Economic impacts of seasonal influenza vary across US counties, but little estimation has been conducted at the county level.

The computing model modified existing methods for national level estimation, and further emphasized spatial variations between counties, in terms of population size, age structure, influenza activity, and income level. Upon such a model, four vaccination strategies that prioritize different types of counties were simulated and their net returns were examined.

The results indicate that the annual economic costs of influenza varied from $13.9 thousand to $957.5 million among US counties, with a median of $2.47 million. Prioritizing vaccines to counties with high influenza attack rates produces the lowest influenza cases and highest net returns. Continued: http://7thspace.com/headlines/...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Fri May 18, 2012 at 06:39:39 AM UTC

Egypt A242T Raises H5N1 Transmission Concerns

Recombinomics Commentary

Three of the residues identified here (N224, Q226 and T318) have been strictly conserved among H5 HA proteins isolated since 2003. However, as H5N1 viruses continue to evolve and infect people, receptor-binding variants of H5N1 viruses, including avian-human reassortant viruses as tested here, may emerge. One of the four mutations we identified in our transmissible virus, the N158D mutation, results in loss of a glycosylation site. Many H5N1 viruses isolated in the Middle East, Africa, Asia and Europe do not have this glycosylation site. Therefore, only three nucleotide changes are needed for the HA of these viruses to support efficient transmission in ferrets. In addition, the H5N1 viruses circulating in these geographic areas also possess a glutamic-acid-to-lysine mutation at position 627 in the PB2 protein, which promotes viral replication in certain mammals, including humans40, 45. Therefore, these viruses may be several steps closer to those capable of efficient transmission in humans and are of concern.

The above discussion is from the revised Kawaoka Nature paper.  The comments discount the natural circulation of three of the four changes described in the paper and claim that only N158D is commonly identified.  However, 2 of the 3 which are said to be "strictly conserved" since 2003 have been reported in Egypt (N224K), Vietnam (N224K), and China (T318I).

The absence of any discussion of the acquired glycosylation site at position 240 due to A242T or A242S is glaring.  Sequencing of H5N1 from ferrets infected with N224K, Q226L and N158D identified A242S in 5 of the 6 pairs.  One pair had T318I and that acquisition was added to the three changes cited above to directly or indirectly infect additional ferrets.  9 of the 10 isolates from those ferrets had A242T (Snip).  Both changes at position 242 created a glycosylation site at position 240, which is common in clade 2.2.1 F isolates collected since 2009 in Egypt or Israel.

Clade 2.2.1 F was identified in vaccinated flocks in Egypt and one human case (Snip) has been identified.  That case was one of the first isolates with A242T and it also had Q196K, which is closely related to one of the receptor binding domain changes, Q196R, which was used in the CDC H5N1 transmission paper. Q196K is frequently detected in recent clade 2.2.1 F sequences.

The other major clade currently circulating in Egypt is clade 2.2.1 G, which has N158D, which abolishes the glycosylation site at position 158.  This change was also present in the egret H5 (Snip) used by the CDC and as noted above, is widespread in clade 2.2.  There are currently more than 100 public H5 sequences from clade 2.2 cases (in Turkey, Azerbaijan, Iraq, Egypt, and Bangladesh) and all but one have abolished the glycosylation site at position 158 (either via N158D, S160A, or both).  The one case with glycosylated 158 is clade 2.2.1 F, which also has glycosylated 240.

Thus, while the ferrets transmitting H5 in the Kawaoka study have lost the 158 glycosylation site and gained the 240 glycosylation site, all human clade 2.2 cases either have lost glycosylation at both sites, or gained glycosylation at both site.

However, recently released sequences from clade 2.2.1 F poultry isolates in Egypt have acquired H1N1pdm09 sequences in PB1 and/or PB2 via recombination, raising concerns of additional acquisitions from H1N1pdm09, such as the two changes linked to variant cases in the United States.  All 21 US cases since 2010 (19 H3N2v, 1 H1N2v, 1 H1N1v) have either PB1 E618D or MP from H1N1pdm09, which is linked to human transmission.  (Snip) recombination between co-circulating H5 could generate the 158/240 glycoylation pattern identified in H5 transmitting in ferrets. Continued: http://www.recombinomics.com/N...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Fri May 18, 2012 at 06:51:18 AM UTC

China: Cluster of Influenza A cases in Castle Peak Hospital (Hong Kong)

(Snip) The spokesperson of Castle Peak Hospital (CPH) made the following announcement today (May 18):

Four patients (aged 19 to 63) in a female ward for intellectual disability had presented with flu symptoms since May 17. Appropriate viral tests had been arranged for the patients and the test results of three patients were positive for Influenza A. The patients concerned have been transferred to Tuen Mun Hospital for treatment under isolation and are in stable condition.

Admission to the ward has been suspended and restricted visiting to the ward has been imposed.

Infection control measures have already been stepped (Snip) All other patients in the ward concerned are under close surveillance. (Snip) http://7thspace.com/headlines/...  

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Fri May 18, 2012 at 19:50:49 PM UTC

China: FEHD releases results of regular influenza virus surveillance in pigs from February to April (Hong Kong)

Hong Kong (HKSAR) - The Centre for Food Safety (CFS) of the Food and Environmental Hygiene Department today (May 18) announced results of the regular influenza virus surveillance programme on pigs at the Sheung Shui Slaughterhouse conducted by the University of Hong Kong (HKU) for February to April this year.

Among some 1,100 samples tested, no human swine influenza virus (pandemic H1N1) was detected. A total of eight samples were found to contain viruses that were essentially swine influenza viruses but had picked up some genes of the human swine influenza virus.

According to Professor J S M Peiris, the HKU expert in charge of the surveillance programme, such viruses are unlikely to pose any major human health risks or cause problems in food safety.

Under the programme, the CFS has been helping HKU researchers to collect blood and tracheal and nasal swabs from pigs at the Sheung Shui Slaughterhouse twice a month to monitor influenza virus activity in pigs.

"Starting from the next cycle (covering results for May to July), regular reports and relevant data of the surveillance programme will be uploaded to the CFS website ( http://www.cfs.gov.hk/eindex.html ) on a quarterly basis for public information. Results of the surveillance programme will be announced immediately if findings have significant impact on food safety and public health," a spokesman for the CFS said. Continued: http://7thspace.com/headlines/...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Fri May 18, 2012 at 19:56:23 PM UTC

UK: MLHU reports four local flu cases

The Middlesex-London Health Unit has found a total of four new cases of laboratory-confirmed influenza B cases in the area.

From May 8 to 14, three cases were derived from the community, while another was institutional-based. (Snip) there have been no deaths during this time.

(Snip) there have been a total of 33 influenza A and 66 influenza B cases found during the Middlesex-London Health Unit's 2011-12 surveillance season. http://metronews.ca/news/londo...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Fri May 18, 2012 at 20:00:53 PM UTC

Bronco Bill, it's Friday joke time!

The flu news my be sparse but you at least have "Carol's corny jokes" to read! LOL http://www.newfluwiki2.com/dia...  

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Fri May 18, 2012 at 20:36:00 PM UTC

Please post new news stories to...

News Reports for May 19, 2012

Thank you!

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Sat May 19, 2012 at 05:34:18 AM UTC