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News Reports for November 27, 2012

by: NewsDiary

Sat Nov 24, 2012 at 15:12:16 PM EST

Reminder: Please do not post whole articles, just snippets and links, and do not post articles from the Las Vegas Review-Journal. Thanks!

• Study: Off-season flu surge in Australia not caused by genetic shift (Link)

Bird Flu Plague in Tegal (translated) (Link)

• There are health alert for outbreaks of influenza A and B in the north (translated) (Link)

United States
• First Seasonal Influenza Vaccine Produced in Cell Culture Approved in US (Link)
• TX: Warning Signs Point to Busy Flu Season (Link)

• Germany: CureVac, German scientists take aim at faster flu vaccine (Link)

• Latest coronavirus cases prompt WHO call for vigilance (Link)
• Flu starts its Northern Hemisphere rise (Link)

• Recombinomics: Curious Coronavirus Comments By Saudi Arabia MoH (Link)
• Branswell: New coronavirus cases suggest source may be more widespread, WHO says (Link)

• H(Link)

NewsDiary :: News Reports for November 27, 2012

News for November 26, 2012 is here.

Thanks to all of the newshounds!
Special thanks to the newshound volunteers who translate international stories - thanks for keeping us all informed!

Other useful links:
WHO A(H1N1) Site
WHO H5N1 human case totals, last updated August 10, 2012
Charts and Graphs on H5N1 from WHO
Google Flu Trends
CDC Weekly Influenza Summary
Map of seasonal influenza in the U.S.
CIDPC (Canada) Weekly FluWatch
UK RCGP Weekly Data on Communicable and Respiratory Diseases
Flu Wiki

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Germany: CureVac, German scientists take aim at faster flu vaccine
When it comes to flu pandemics, making and distributing vaccines quickly is of utmost importance. And now German scientists have developed an RNA vaccine that could cut flu vaccine production time from months to weeks.

Developed by Lothar Stitz of Friedrich-Loeffler-Institut and colleagues, the experimental vaccine is made only of messenger RNA (mRNA), a molecule that carries information telling cells which proteins to make. Tests in mice, ferrets and pigs with an mRNA vaccine yielded immune responses similar to or better than those found with conventional vaccines, Reuters reports. And the vaccine showed high efficacy in both very young and very old animals. (Snip)

The typical flu vaccine is made with fertilized chicken eggs, a process that can take up to 6 months. Novartis ($NVS) recently received FDA approval for a flu vaccine using cell culture technology, but that technique, while faster, only reduces manufacturing time by about 8 to 10 weeks.

Another benefit of an mRNA flu vaccine? It doesn't need to be refrigerated. This means doses can bypass the expensive and somewhat inconvenient cold-chain.

Still, a human vaccine based on the research is years away. Continued: http://www.fiercevaccines.com/...

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


First Seasonal Influenza Vaccine Produced in Cell Culture Approved in US
Novartis announced that it has received FDA approval for a seasonal influenza vaccine produced in cell culture. The vaccine, Flucelvax, is approved for use in individuals 18 years of age or older. (Snip) cell-culture technology has been successfully used to manufacture other vaccines, including those distributed during the H1N1 pandemic, as well as vaccines for polio, rubella, and hepatitis, but Flucelvax is the first seasonal vaccine produced by this method to be approved in the US. The virus for the vaccine is produced under closed, sterile conditions in a well-characterized mammalian cell line, rather than in chicken eggs.

Novartis partnered with the US Department of Health and Human Services and the Biomedical Advanced Research and Development Authority to develop the cell-culture manufacturing technology, as well as to construct a manufacturing facility in Holly Springs, NC. (Snip)

(Snip) Andrin Oswald, Division Head, Novartis Vaccines and Diagnostics, said, "Modern cell-culture technology will likely become the new standard for influenza vaccine production and we are proud to lead the way." http://www.pharmtech.com/pharm...

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


Curious Coronavirus Comments By Saudi Arabia MoH
Recombinomics Commentary

We do trust ProMED-mail's editors and moderators will remember that our Ministry of Health bears ultimate responsibility for managing contagious disease within and even outside our boundaries. We take seriously our responsibilities to our citizens and our guests. This time of year, we assume an enormous responsibility to our Hajj pilgrims visiting Mecca, and then to the world community as our guests return home. We invite our friends and colleagues to stay tuned; we invite ProMED-mail to collaborate with us to balance public health reporting. As of now, the full story has yet to be told.

The above comments are from an October 22, 2012 ProMED letter from Ziad Memish, who is Deputy Minister of Public Health for the Kingdom of Saudi Arabia (KSA) as well as Director WHO Collaborating Center for Mass Gatherings.

His letter was in response to the ProMED September 20 publication of a September 15 letter from Ali Zaki, Professor of Microbiology at the Dr Kakeeh Hospital in Jeddah, Saudi Arabi.  His letter described a Jeddah patient who was fatally infected with a novel coronavirus which was identified with a pancornavirus PCR test and subsequently sequenced in collaboration with Ron Fouchier at the Emarasus Medical Center in The Netherlands.  The patient had died in June and the novel coronavirus was reportable under International Health Regulations (IHR).

In the letter Dr Memesh complained that the reporting of the case had not gone through proper channels, which may have caused unnecessary collateral economic damage due to an over-reaction to the news.  However, the complaint was made well after the case and virus were described in multiple independent sources, along with additional case(s).

The time line of the events surrounding the curious complaint  are instructive and raise transparency and credibility concerns for the KSA Ministry of Health as well as WHO.

The Zaki letter was written almost four months after the patient died from an IHR reportable agent (a novel cornavirus). The ProMED report was on September 20, and two days later the full sequence of the coronavirus (EMC/12) was submitted to Genbank, a public sequence database.  The letter was also linked to testing of the Health Protection Agency (HPA) of a severe case who like the above fatal case had been placed on life support after renal failure.  A sample was tested with the pancornavirus PCR test described in the Zaki letter, and the case, who was a Qatari National (49M) who had traveled to Saudi Arabia.

The following day the Saudi Arabia Ministry of Health acknowledged the two confirmed cases as well as another fatal case who was a Saudi who died in England after seeking advanced medical care.  The case had similar symptoms but was not tested for the novel coronavirus.  On September 23 the WHO also acknowledged the two confirmed cases.

The following day the HPA released the sequence of the 206 BP insert from the PCR test of the Qatari case.  That sequences had 35 mismatches with the most closely related sequences at Genbank, bat sequences (Snip) from Guangdong Province in China, but there was only 1 mismatch (99.5% identity), with they EMC sequence from the fatal Saudi case from June (Snip).  The phylogenetic analysis placed the sequences in group 2c adjacet to SARS CoV sequences in group 2a.

On September 27 the full sequence from the fatal case was made public, and a revised sequence was made public on October 16, which was followed the next day by the publication of a New England Journal of Medicine report on the fatal Saudi case.

Thus, the Memesh complaint on October 22 was written after the Qatari case was confirmed in England and the two confirmed cases were described by the KSA MoH (in addition to the suspect fatal case who was not tested) as well as WHO.

The letter noted that the full story had not been told and subsequent reports by the KSA MoH and WHO raised serious concerns.

On November 4 the KSA MoH announced a third confirmed case.  The report noted that the case was treated at a Riyadh hospital and was recovering, but the age of the case, as well as associated dates (Snip) were withheld.

On November 19 the KSA MoH announced a fourth confirmed case.  Like the earlier report the case was treated at a Riyadh hospital and was recovering, but the age/gender as well as key dates were withheld.  The KSA did not describe relatives with the same symptoms, including two who had been PCR confirmed or the fact that two of the relatives had died.  (Snip)

On November 23 a fifth confirmed case was described (Snip).  This case was another Qatari who had also gone to Europe (Germany) for treatment and was recovering from an October infection.

On November 23 WHO also issued an update, with 4 confirmed cases including two who were epidemiologically linked, increasing the total number of confirmed cases to six.  The description of three of the cases matches those disclosed by the KSA MoH or RKI, while the sixth case was the confirmed fatal case.  The two epidemiologically linked cases were from the same family and lived in the same house.  However, there were two additional family members who were symptomatic, including one who had died.  The surviving symptomatic family member tested negative for the novel coronavirus. Like the KSA MoH reports, the WHO update gave no age or gender for the six confirmed or suspect cases and also failed to give any dates.

Subsequent media reports contained additional information, which raised serious concerns.  All six cases were male, and the unconfirmed fatal case (who died from renal failure complications) was 70 years of age and the father of the other fatal case (who died from complications linked to multi-organ failure) in the cluster, which developed in October, but reported on November 23. (Snip). the fatally infected son was hospitalized four days after his father died, suggesting a significant time gap in disease onset dates for the father and son, which would strongly support human to human transmission.  

Another media report quoted a WHO spokesperson, who also alluded to the time gap in disease onset dates for the cluster, which supported H2H transmission.

(Snip)  Media reports suggested that all 6 of the recently described confirmed and suspect cases were from October, but reported in November, including the November 23rd report which announced the cluster, which including a failure to detect the novel coronavirus in one of the surviving symptomatic family members.

These recent reports raise serious questions regarding the delays in reporting these cases as well as the withholding key information including age and disease onset dates supporting human to human transmission.  The cases were active in October during peak Hajj activity, and now the WHO is suggesting more widespread testing. 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


CIDRAP: Latest coronavirus cases prompt WHO call for vigilance
Nov 26, 2012 (CIDRAP News) - The reporting of four more novel coronavirus infections in recent weeks, raising the total to six, has prompted the World Health Organization (WHO) to suggest that governments consider a major escalation of testing for the virus, a potentially burdensome undertaking.

In a Nov 23 statement, the WHO reported three new cases, with one death, in Saudi Arabia and one new case in Qatar. The latest Saudi Arabian cases included two in the same household, but it was not known if person-to-person transmission was involved.

The global case count since the virus emerged in June has reached six, of which two were fatal. (Snip).

(Snip) "It is prudent to consider that the virus is likely more widely distributed than just the two countries which have identified cases. Member States should consider testing of patients with unexplained pneumonias for the new coronavirus even in the absence of travel or other associations with the two affected countries."

The European Centre for Disease Prevention and Control (ECDC), in a risk assessment released today, said it was considering the implications of the WHO recommendation and commented that increasing testing to that extent would probably be burdensome for European countries.


The first case was in a 60-year-old Saudi Arabian man who died in a Jeddah hospital Jun 24. The second case struck a Qatari man who fell ill in early September and was flown to London, where he apparently remains hospitalized. Both patients had pneumonia and acute renal failure.

A Saudi health official reported the third case on Nov 4, in a Saudi man in Riyadh who had been critically ill but was recovering. The fourth case, as reported Nov 21 by a Saudi newspaper quoting government sources, involved another Saudi man who was hospitalized in Riyadh and was said to be improving.

The Nov 23 WHO statement gave few details on the latest four cases, but it said two of the patients came from the same family and household and had similar symptoms. One of the patients died and the other recovered (Snip).

Further, two more members of the same family were sick with similar symptoms, and one of them died, the WHO said. Test results for the deceased family member are pending, and the other patient, who is recovering, tested negative. Investigations concerning the source of infection, the route of exposure, and the possibility of human-to-human transmission are ongoing, the WHO said.

The latest Qatari patient got sick in October and was flown to Germany, where he was hospitalized and received intensive care but eventually recovered and was discharged this week (Snip). In a Nov 23 statement, the institute said the patient was treated for 4 weeks at a hospital in North Rhine-Westfalia. No illnesses have been reported among hospital personnel, though an investigation of the patient's contacts is ongoing. The institute said samples taken while the patient was still in Qatar were (Snip) found to be positive.

The WHO in its statement did not list specific reasons for its suggestion that the novel virus may exist in countries other than just Saudi Arabia and neighboring Qatar. In response to a query on the topic today, WHO spokesman Glenn Thomas told CIDRAP News via e-mail, "This is based on the fact that the cases confirmed to date are geographically far apart, and that investigations are still ongoing into the characteristics of this novel coronavirus."

The ECDC, in its statement today, noted that the possibility of person-to-person transmission in the Saudi Arabian family case cluster has not been excluded. (Snip) "There is indication that some cases had a history of visits to farms prior to illness, but no details are available concerning the kind of farms or related animal contact."

The agency said healthcare workers who treat people from the Middle East who have severe respiratory infections may be at risk for infection with the novel virus. It's possible, though, that the infections are more widespread, as suggested by the WHO, and seroepidemiologic studies are needed to investigate the possibility of mild and asymptomatic cases, the EU agency said. "The fact that there have not been any expanding clusters of cases indicates that currently the risk for EU citizens to acquire these infections has not increased and remains very low, based on the current information," the ECDC said.

The ECDC statement evidenced some wariness about the WHO suggestion to consider testing patients with unexplained pneumonia even if they have no ties to Saudi Arabia or Qatar. The ECDC said it is considering the recommendation in relation to the potential burden of testing and the possibility of false-positive results. (Snip) It estimated that EU countries have roughly 750,000 cases of community-acquired pneumonia of unknown cause each year.

Continued with links to various reports: 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


Flu starts its Northern Hemisphere rise
Flu detections are increasing in some Northern Hemisphere countries, but so far levels haven't exceeded seasonal thresholds or marked the beginning of flu season (Snip). Areas seeing increased activity include southern regions of the United States and Canada's Ontario province.

In Europe, flu detections are still low, but sporadic activity has been reported in Austria, Belgium, the Czech Republic, Finland, France, Germany, Norway, and the United Kingdom.

(Snip) Cambodia has reported rising flu activity, and some circulation has been noted in Middle Eastern countries, with 2009 H1N1 as the most commonly detected virus. (Snip)

Globally, H3N2 remains the dominant flu strain, followed by influenza B and the 2009 H1N1 virus (Snip).

Continued with links to WHO reports:  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


CIDRAP: Study - Off-season flu surge in Australia not caused by genetic shift
An increase in out-of-season influenza cases in Australia's spring and summer of 2010-11 was not caused by genetic differences in viruses but probably reflected a "natural variation" in virus circulation, (Snip).

Australian investigators analyzed nationwide data from the WHO FluNet surveillance tool, state notifications, and Google FluTrends. For the state of Victoria, they used lab-confirmed flu cases and influenza-like illness proportions.

They noted that the increase in notifications about flu were most pronounced in tropical and subtropical Australia. They also noted that out-of-season notifications in temperate Victoria were more than five times the average of the previous three years even though ILI proportions in the spring and summer were similar to the those in the previous years. (Snip) all out-of-season viruses tested were antigenically and genetically similar to those tested during the 2010 and 2011 flu seasons. 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


Mexico: There are health alert for outbreaks of influenza A and B in the north

They recommend extreme hygiene and avoid crowds. They are treating patients and their families.

The northern province is on alert to outbreaks of influenza AH3N2 (and) B ​​and recorded in Colonia Santa Rosa and Hipolito Yrigoyen, (Snip). The alert was issued by the Ministry of Health of the Province and applies to all areas of the north, (Snip).


"It is a different strain to the dreaded influenza A. The risk groups are the most exposed. We attended several cases with fever. It is noteworthy that a flu that usually appears in a fall or winter flow at this time, "said Medina.


"There is an outbreak of influenza B and do not rule out the type A, which are given to patients and their families a selective antiviral drug against influenza viruses A and B," said Dr. Marcelo Quipildor, infectious disease department of Oran.

Professionals recommended that people avoid crowded places and assist the physician with symptoms such as body aches, fever and gastrointestinal distress. http://news.google.com/news/ur...

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


Branswell: New coronavirus cases suggest source may be more widespread, WHO says
New coronavirus cases suggest source may be more widespread, WHO says
Clues gleaned from the most recent infections with the new coronavirus are behind the World Health Organization's decision to warn countries to broaden their surveillance for cases, an expert with the agency says.

The Geneva-based global health body now believes the risk of exposure to the new virus may exist beyond Saudi Arabia and Qatar, so telling countries they need only look for sick people with travel or residency links to those countries may be misleading and counterproductive.

It's not that the WHO has proof of infections from elsewhere. The issue is rather that its disease experts can think of no reason why a virus that has popped up in different parts of Saudi Arabia and in Qatar would be limited to those two countries.

Warning Signs Point to Busy Flu Season
November 27, 2012
The Hidalgo County Health Department is encouraging everyone to get their flu vaccination with all signs pointing to a busy flu season.  This year the health department is using a more advanced system to track illnesses and what they see is an indication of an increase in flu cases this year.
Confirming a flu case takes time, time the health department doesn't have.  Instead of waiting for lab results, the health department has partnered with the area hospitals to track emergency room admissions.

"We will see the information earlier through ER Admins than if we wait for lab results so it's an early indicator that will help out staff be ready and investigate sooner," Hidalgo County Health & Human Services Epidemiologist Belinda Medrano said.  Medrano tracks any trends that may cause the public to take extra precautions.  "We can see if there is an increase in certain illnesses that may be due to an outbreak," Medrano said.

When it comes to the flu, the health department looks for any influenza like illnesses.

"Influenza illnesses have been more prominent in the elementary schools of some of the school districts where the person shows up with fever, body aches, chills, the classic symptoms of the flu," Chief Administrative Officer for Hidalgo County Health Department Eddie Olivarez said.
Olivarez says the school districts have been instrumental in forecasting an increase in flu cases, but with the hospitals now on board they can narrow in on any epidemic.  "We can track ER admissions by fever, abdominal pain, and we see a trend of a pattern," Olivarez said.

"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson

This is Texas

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


[ Parent ]
Bird Flu Plague in Tegal
November 27, 2012
Tegal, Indonesia:  The bird flu virus lately is endemic in some areas of Tegal.  As a result, thousands of ducks and chickens owned by communities have died suddenly.  These events, among other things, are in Pesurungan Lor Village and Village Kalinyamat Kulon, District Margadana.  One duck farmer, Darkoni (31) in the village Pesurungan Lor on Tuesday (27/11) said that the incidents are estimated to have taken place since the last month.  

"Initially ducks would not eat, then they became limp and dead.  Consequently egg production declined and farmers suffered considerable losses," he said.

It is also delivered by another breeder, Aris (30).  According to him, this time the breeder said there was social unrest.  Various attempts were made to address the farmers' virus attacks, namely by using drugs and separating ducks that have been infected.  However, the efforts have not been successful because there are a lot of dead ducks.  

"For dead ducks, then they were burned and dumped," he said.

Another breeder Bambang (28) added that in addition to attacking ducks, the virus also attacked chickens owned by residents.  Currently, about one-third of 400 of his ducks had contracted it. To avoid greater losses most farmers choose to sell ducks and some will move to diborokan ducks in the rice fields.

"We hope the relevant agencies will have addressed this soon with checks and provide medical aid to prevent this.  If left alone, farmers will be threatened with bankruptcy," he said.

Head of Kalinyamat Kulon Urban Governance Ari Wibowo said the accident occurred in the region.  Hundreds of chickens belonging to the residents died suddenly due to bird flu virus.  

"We are also demanding immediate solutions and the best effort," he said.

Acting Head of Department of the Marine and Agriculture, Ir hariyana, confirmed the issue saying that they were taking samples and testing in the laboratory in Yogyakarta.  But the result was positive for the bird flu virus.  Therefore, efforts are now made for prevention.

"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson

Please post new news stories to...

News Reports for November 28, 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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