News Reports for September 15, 2012

US: Policymakers plot next pandemic flu preparedness steps

Sep 14, 2012 (CIDRAP News) - US influenza policy experts who gathered in Washington, DC, today called for better vaccines and other steps for improving pandemic and seasonal flu preparedness, themes echoed in an action plan released by the Infectious Diseases Society of America (IDSA).

The presentations and panel discussions were streamed live in a webinar cohosted by the IDSA and the American Medical Association (AMA). The IDSA posted its 22-page report, "Pandemic and Seasonal Influenza Principles for United States Action," on its Web site today.

Two of the main themes of the discussion centered around the need for better flu vaccines and treatments and a steady stream of funding to support the many preparedness activities, such as immunizing patients and conducting flu surveillance, that take place at the state and local public health levels.

Since 2006, the Pandemic and All-Hazards Preparedness Act (PAHPA) has been the federal funding tool for filling gaps in the nation's preparedness against flu and other biologic threats. The legislation is up for reauthorization but has languished in the Senate for the past several months.

Rep. Mike Rogers, R-Mich., the lead House sponsor of the bill, told webinar participants today that the Senate's work on the bill is 90% complete, and while negotiations aren't contentious, consideration of the bill is competing with several other measures. He urged the group to give their Senators a friendly call as a nudge to send the bill to final passage.

Rogers, who also chairs the House intelligence committee, told attendees that bioterror attacks are still a threat, and that maintaining work on countermeasure development and the Strategic National Stockpile is crucial. "This is on our watch, and we've got to get it right," he said.

Nicole Lurie, MD, MPH, assistant secretary for preparedness and response (ASPR) at the Department of Health and Human Services (HHS), told participants that the next flu preparedness steps are based on several lessons that health officials learned during the 2009 H1N1 pandemic. She said the new mantra for pandemic and other flu vaccines isn't just faster production. "It's more vaccine, better vaccine, and faster vaccine."

The country still has a long way to go toward acquiring new antiviral and broad-spectrum antibiotics, she said, pointing out that during the 2009 H1N1 pandemic, 40% of children who died from pandemic flu infections were coinfected with methicillin-resistant Staphylococcus aureus (MRSA).

Another important gap that the 2009 pandemic response revealed was that the slow movement of federal funding to states in some instances limited the pace of local efforts and took away an important opportunity to do science-based research during the outbreak. Such research is crucial to help guide pandemic response and advance knowledge about the disease, Lurie said. She said discussions are under way about how to speed research money to academic institutions so they can quickly launch key studies during biological events. To boost the science-based nature of response to flu and other threats, Lurie said the ideas of an "incident commander for science" and a "science ready reserve" are options under consideration.

Andrew Pavia, MD, a pediatric infectious disease expert at the University of Utah and board member of the IDSA, said it will take an enormous effort and a great deal of coordination to support and develop a better, more adaptable, flu vaccine. However, he urged policymakers not to ignore the important distribution and dispensing steps that happens with flu vaccines and medications at the state and local levels where public health departments have been gutted by budget cuts and challenged by a lack of steady funding for preparedness activities. Continued: http://www.cidrap.umn.edu/cidr...

Sep 14 IDSA report http://www.idsociety.org/Influ...  

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 Sep 15, 2012 at 02:11:15 AM UTC

Review of the MRSA aspect (which I had forgotten)

The country still has a long way to go toward acquiring new antiviral and broad-spectrum antibiotics, she said, pointing out that during the 2009 H1N1 pandemic, 40% of children who died from pandemic flu infections were coinfected with methicillin-resistant Staphylococcus aureus (MRSA).

 from Carol's post above

Here are snips about MRSA and flu (bolding added):

Staphylococcus aureus, often referred to simply as "staph," are bacteria healthy people can carry on the skin or in the nose. Staph bacteria commonly cause skin infections, such as boils. Most of these infections are not life-threatening.
In addition to skin infections, staph bacteria can cause infections in the blood, in the bones and in the lungs (pneumonia). Most serious staph bacteria infections are treated with an antibiotic related to penicillin. However, over the past 50 years, some staph bacteria have become resistant to antibiotics, including the commonly used penicillin-related antibiotics. These resistant bacteria are called methicillin-resistant Staphylococcus aureus, or MRSA.

 http://www.cdc.gov/flu/about/q...

It wasn't understood exactly why healthy children who fell ill with the H1N1 flu, during the 2009 epidemic, became critically ill. The Children's Hospital in Boston has found one key risk factor is MRSA (methicillin-resistant Staphylococcus aureus). Those carrying the bacteria had eight times the risk of mortality amongst previously healthy children.
What's more worrying is that the infections were more often than not detected and the children were treated with vancomycin, considered to be appropriate treatment for MRSA, but they died despite this treatment and it is especially alarming with the rising rates of MRSA among children in the community.
Study leader Adrienne Randolph, MD, MsC, of the Division of Critical Care Medicine at Children's Hospital Boston said :  "There's more risk for MRSA to become invasive in the presence of flu or other viruses ... These deaths in co-infected children are a warning sign."
Dr. Randolph clarifies that there is more risk of MRSA becoming invasive when the immune system is weakened fighting the flu, and goes on to raise the red flag on these MRSA / Flu deaths in children as the harbinger of worse to come.
The average age of the children in the study that had H1N1 was six. Many had respiratory failure and more than 60% needed mechanical ventilation with some requiring extracorporeal membrane oxygenation (ECMO) for advanced cardiac and respiratory support. The disease was aggressive and 75 children, around 9 percent of the study, died and of them around 50 within two weeks.

http://bakteriophag.com/home/m...

Of the children whose records the study examined, 8.9 percent died. Sixty-two percent were critically ill from H1N1 infection without there being evidence of bacterial infection when they were admitted to the PICU. Vaccination status was unknown for most of the children, largely because the H1N1 vaccine wasn't made ready until the pandemic was well underway. Many severe illnesses and deaths occurred among young people with previously existing, chronic neurological and immune-system conditions.
More than 88 percent of the children received the antiviral medication oseltamivir (Tamiflu), but only about 6 percent of them started such therapy before being admitted to the PICU. The authors speculate that earlier antiviral treatment could perhaps prove effective in reducing pediatric mortality associated with the H1N1 virus.

http://www.washingtonpost.com/...

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

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by: Jane @ Sat Sep 15, 2012 at 22:42:29 PM UTC

[ Parent ]

Bird flu continues to expand in northern, central Vietnam

HANOI, Sept. 14 (Xinhua) -- Bird flu has spread to two more provinces in northern Vietnam as of Sept. 14, making the total number of provinces infected with the disease to seven (Snip). In Tuyen Quang province, more than 17,600 infected fowls had been culled (Snip)

He said bird flu first appeared in one commune in Son Duong district on Aug. 10, and as of Sept. 7 it spread to other nine communes in this district and Tuyen Quang provincial town.

To prevent the spreading of H5N1 virus, the province's Department of Animal Health has implemented strict measures in response to the epidemics, including establishing a Steering Committee for avian influenza epidemic prevention and control at all levels from district to commune, setting up mobile checkpoints to control illegal poultry transportation, killing infected poultry and stopping all poultry slaughtering, purchasing and transporting activities in the infected areas.

So far, the local authority has supplied 10,000 liters of disinfectant and 70 tons of lime powder to clean those areas having infected poultry. In addition, the national reserve support fund has provided the province with 250,000 doses of bird flu vaccines.

(Snip)

Meanwhile, in Hoa Binh province, four hamlets in two communes in Luong Son district have 1,140 infected fowls and 848 others died (Snip). The local authority instructed the culling of all infected poultry and implemented measures to prevent the expanse of the disease.

According to the Department of Animal Health under the Vietnam' s Ministry of Agriculture and Rural Development, as of Sept. 12, bird flu has spread to seven provinces in Vietnam's northern and central regions including Ha Tinh, Ninh Binh, Nam Dinh, Bac Giang, Quang Ngai, Tuyen Quang and Hoa Binh.

In early September, the ministry released news that a new bird flu strain was developing unexpectedly in Vietnam and caused a big concern to the government and public. (Snip) the new strain of bird flu virus, which is suspected to have higher risk of causing human death than previously known ones, appeared in July and strongly spread in August in Vietnam's central and northern provinces. The new strain was thought to belong to H5N1 - Clade 2.3.2.1, which is different from the two strains of A and B that appeared in Vietnam in 2011, due to its higher pathogenic risk.

Apart from the newly-found strain of the virus, the bird flu has developed unexpectedly in the country so far this year. Normally, avian influenza appears shortly before or after the traditional lunar Tet holidays, which often falls in late January and early February. However, it has appeared since July this year and fast spread with unexpected signs. According to local experts, the epidemic would become more complicated once it reaches its peak in the coming months.

As of mid-September, four cases of A/H5N1 infection had been recorded with two deaths in Vietnam, but the new strain of bird flu virus has not yet been found in humans, reported the Ministry of Agriculture and Rural Development. http://news.xinhuanet.com/engl...

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 Sep 15, 2012 at 06:57:44 AM UTC

Missouri H1N1v Case Raises Concerns

Recombinomics Commentary

As a result of enhanced surveillance activities for H3N2v, one infection with an influenza A (H1N1) variant (H1N1v) virus has been detected in Missouri in a patient who became ill after contact with swine.

Confirmatory testing at CDC identified H1N1v with the matrix (M) gene from the 2009 H1N1 influenza virus in specimens collected from this patient.

The above comments from the CDC's week 36 FluView describe a Missouri patient infected with H1N1v with an H1N1pdm09 M gene.  This result is similar to reports at the end of 2011 of a Wisconsin case, (Snip) which also was infected with H1N1v with an H1N1pdm09 M gene.  These are the only cases since the 2009 H1N1pdm09 pandemic.

This case follows recent reports of 4 H1N2v cases in Minnesota, which also saw an H1N2v case, (Snip) at the end of 2011.  However, the (H1N2v) 2012 cases have the H1N1pdm09 M gene.

The detection of three different serotypes with the H1N1pdm09 gene (Snip) is without precedent and raises concerns that the spread of H1N1pdm09 in swine populations has led to a number of constellations with an H1N1pdm09 M gene. Continued: http://www.recombinomics.com/N...

(Note: Human infections by three different swine flu variants (H1N1v, H1N2v, and H3N2v), all containing a gene from the H1N1 swine flu virus that resulted in a pandemic in 2009, is very worrisome, IMO.)

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 Sep 15, 2012 at 07:32:41 AM UTC

US: Latest variant flu cases include rare H1N1 strain

Sep 14, 2012 (CIDRAP News) - The number of swine-origin H3N2 (variant H3N2, or H3N2v) influenza cases in the United States has climbed by 9 in the past week, to 305, and another rare swine-origin variant, H1N1v, has cropped up in Missouri, the Centers for Disease Control and Prevention (CDC) reported today.

The case in Missouri involves an H1N1v virus carrying the M (matrix) gene from the pandemic 2009 H1N1 (pH1N1) virus, marking only the second finding of such an isolate (Snip) The previous case was reported in Wisconsin in December 2011; 12 other H1N1v cases (without the pH1N1 M gene) have been reported since 2005 (Snip).

The Missouri case was found because of increased surveillance for H3N2v cases, the CDC said in its weekly flu update. The patient got sick after contact with pigs and has since recovered. (Snip)

The CDC's report on the H1N1v case in Wisconsin in December 2011 said similar viruses had been found in US swine since 2010 and that the strain was susceptible to antiviral drugs.

The CDC said the total number of variant flu cases detected since July has now reached 309. That includes the 305 H3N2v cases, the Missouri H1N1v case, and three H1N2v cases that were recently reported in Minnesota. All three strains contain the pH1N1 M gene.

Meanwhile, the Minnesota Department of Health reports that the number of H1N2v cases has increased to four, as one case previously listed as probable has been confirmed. The CDC says that when state and CDC case counts disagree, the state numbers should be considered more accurate.

The 305 H3N2v cases, most of which involved people exposed to pigs at county and state fairs, were scattered across 10 states. New cases were reported this week in Michigan, 1 (6 total); Minnesota, 2 (4); Ohio, 4 (106); and Wisconsin, 2 (20). Indiana continues to lead the list with 138 cases.

The numbers of H3N2v-related hospitalizations and deaths stayed the same, at 16 and 1, respectively.

The CDC said today, as it has previously, that a few cases of likely human-to-human transmission of H3N2v have been identified, but no ongoing human transmission.

Aside from the variant cases, flu remained at seasonably low levels in the United States last week, according to the CDC. The percentage of outpatient visits for flu-like illness stayed below the national baseline, and the percentage of deaths attributed to pneumonia and flu was under the epidemic threshold. No flu-related pediatric deaths were reported.

Globally, flu activity was low or decreasing in most regions, the World Health Organization (WHO) said in its biweekly flu update, covering the last 2 weeks of August.

Most countries in northern temperate regions have not started their seasonal flu reporting, but available data indicate that seasonal flu transmission has not begun in those areas, the WHO said.  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 @ Sat Sep 15, 2012 at 07:46:35 AM UTC

H3N2v Community Transmission In Michigan?

Recombinomics Commentary

Clinton 1
Ingham 1
Shiawassee 2
Washtenaw 2

The first five cases have had mild illness and have had either direct or indirect swine exposure at county fairs in Michigan; an investigation is underway for the sixth case.

The above comments are from the week 36 H3N2v report by the Michigan Department of Community Health.  The first five H3N2v cases were from August, but the latest case, from Ingham County, is under investigation.

The report shows an increase in ILI cases in week 36, and the detection of the H3N2v cases raises concerns that this is a case without swine exposure. (Snip) 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 @ Sat Sep 15, 2012 at 14:16:34 PM UTC

Canada: Flu forces Mooseheads to cancel pre-season game (Nova Scotia)

The Halifax Mooseheads had to call off their last home game of the pre-season on Friday after a flu bug took down close to half the team.

(Snip)

"We already had (Marty) Frk suspended and (Max) Lindsay day-to-day with headaches so it was tough once all the guys started getting sick," said Mooseheads general manager Cam Russell. "It's some kind of flu and everybody started coming down with it at the same time. Last time I checked there were seven guys who had it.

"It was just a whole body kind of thing. They've all got chest pains, aches, headaches, sweats and fevers so it's pretty nasty." Continued: http://thechronicleherald.ca/s...

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 Sep 15, 2012 at 14:24:15 PM UTC

CIDRAP: Mexico reports two H7 avian flu infections

Two relatives who worked on the same poultry farm in Jalisco state in Mexico contracted avian flu during the outbreak of H7N3 this summer (Snip). The first worker, a 32-year-old woman, had symptoms of conjunctivitis, and, because she collected eggs on an outbreak farm, was swabbed for avian flu. Ocular swab samples tested positive for H7N3 closely matching the outbreak strain. The second patient, a 52-year-old male relative of the first worker who also had conjunctivitis symptoms, tested positive for an H7 strain.

Both cases "likely represent HPAI (Snip) A (H7N3) virus transmission from infected poultry to humans through direct contact," (Snip). http://www.cidrap.umn.edu/cidr...

Sep 14 MMWR report on H7N3 http://www.cdc.gov/mmwr/previe...

(Note: The first report on these two H7N3 humane infections was posted by AlohaOR in the Sept. 13th News Diary. 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 @ Sat Sep 15, 2012 at 15:51:45 PM UTC

Please post new news stories to...

News Reports for September 16, 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 @ Sun Sep 16, 2012 at 07:48:19 AM UTC