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News Reports for July 8, 2013

by: NewsDiary

Sat Jul 06, 2013 at 22:33:53 PM EDT

Reminder: Please do not post whole articles, just snippets and links. Thanks!

• Alberta: Flu vaccination rates worry health officials (Link)

• Undiagnosed febrile illness - India (TN): RFI  (Link)

Saudi Arabia
• WHO update: Middle East respiratory syndrome coronavirus (MERS-CoV) - update (Link)

United States
• IN: Swine flu surfaces again (Link)
• MERS-CoV vigilance rises in US (Link)

• 80 years ago today: MRC researchers discover viral cause of flu (Link)

• WHO Emergency Committee To Meet (plus coverage of Fukuda's recent press conference) (Link)

• Helen Branswell: Progress to understand MERS coronavirus frustratingly slow (Link)

• H (Link)

NewsDiary :: News Reports for July 8, 2013

News for July 7, 2013 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 H7N9 web page WHO A(H1N1) Site WHO H5N1 human case totals
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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Canada: Flu vaccination rates worry health officials (Alberta)
EDMONTON - Less than a quarter of Albertans were immunized from the flu last winter, raising questions for health authorities as to whether a more aggressive approach is required to get people taking the annual vaccine.

The 23-per-cent take-up rate, while actually a minor improvement from past years, still represents minimal progress in a year in which the province launched an enhanced awareness campaign and gave people more options for taking the vaccine - including making it available from pharmacists and offering it in a nasal mist.

Also, the province fell substantially short of its goal for immunizing high-risk groups for whom flu can be life threatening. Thirty per cent of children under two were vaccinated, a slight rise from the past few years but well below the target of 75 per cent. The same target was set for seniors, 60 per cent of whom got the vaccine.

Even health-care workers are not being immunized in the numbers the province wants.

But while the problem is clear, experts say solutions are elusive.

"I hate to be a pessimist about this, but I'm not sure a lot else can be done with general public immunization rates," says Monika Naus, a medical director at the Centre for Disease Control in B.C., which has similar vaccination struggles to Alberta. "What we've learned from surveys is that the people who get vaccinated are the ones who tend to get vaccinated year after year. And the ones who don't are the ones who don't year after year. Continued:  http://www.edmontonjournal.com...

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


80 years ago today: MRC researchers discover viral cause of flu
Forget bird flu and swine flu, it was ferret flu and The Field magazine that helped MRC scientists discover the influenza virus, after eleven years of dedicated research.

In the spring of 1933 a team of Medical Research Council (MRC) staff gathered nasal fluids and throat garglings from a sick researcher, filtered them, and dripped them into ferrets. Within forty-eight hours the ferrets would start sneezing and displaying signs of an influenza-like disease. This research formed the basis of an extraordinarily important Lancet paper by Wilson Smith, Christopher H Andrewes and Patrick Laidlaw, published on 8 July 1933, identifying a 'virus' as the primary causative agent for influenza. This was no serendipitous finding, but the result of a sustained campaign of funding and research.

The 1918-9 influenza pandemic and virus research

The 1918-19 influenza pandemic challenged ideas about influenza, as at the time most microbiologists believed that influenza was caused by a bacteria. But during the pandemic, pathologists failed to consistently find the bacillus. This undermined claims about its primary role and jeopardised the prospect of producing a vaccine.

Walter Morley Fletcher, Secretary of the MRC, suggested to the War Office and Army Medical Services that attention should be turned to the possible role of a so-called 'filter-passing virus', and in November 1918 the search for the virus began. The first British investigations into the role of a virus in influenza were carried out by two teams in France and within weeks both claimed they had identified a filterable agent from sick servicemen.

These findings were controversial - there was no test for a virus, so its presence had to be inferred: it could not be seen with light microscopes, retained by bacterial filters or studied using culture methods. Only the presence of symptoms, and traces in serological tests suggested any 'thing' was present in infected people (and animals).

Continued with much more: http://www.guardian.co.uk/scie...

(Note: And 80 years later, people (like me) are sitting at computers at 3 AM and searching a huge source of information called the "Internet" for articles from around the world on that tiny but deadly virus called "influenza"! Why? Because we are all worried about another 1918 type (or worse) flu virus outbreak. With all the progress made, we still are in danger when it comes to influenza viruses. JMO)

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


US: Swine flu surfaces again (Indiana)
VIGO COUNTY, Ind. (WTHI) - The swine influenza is back! Last year, Indiana had 138 confirmed cases of this disease.

Already this year, 12 cases of swine flu have been confirmed. At least 10 of those swine flue cases started with county fair animals, our sister station WTHI reports.

Vigo County's fair opens Sunday. So what's being done to keep people safe in the Wabash Valley?

98 percent. That's how many 4-H'ers took advantage of an early swine flu vaccination in May. "We got the influenza vaccinations and made those available for all our 4-H families to purchase and vaccinate their animals," said Julie Hart, extension educator. Hart said they're locking down on the swine flu early this year.

The Indiana State Department of Health says at least 10 out of the 12 people in Indiana got the disease because of exposure at county fairs. So Hart said they're amping up preventive measures to keep fair-goers safe. Continued: http://www.wishtv.com/dpp/news...  

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


ProMED: Undiagnosed febrile illness - India (TN): RFI
In the past few weeks, many hospitals have been seeing several cases of undiagnosed fever with patients showing symptoms similar to those of malaria, dengue, Japanese encephalitis and typhoid. However, physicians are in a spot as the infectious diseases test results turn out to be negative, making it difficult for them to understand the ailment and prescribe medicines.

Doctors said the symptoms could not be brushed aside as common flu, as most antibiotics proved ineffective [sic, antibiotics are ineffective against viral illnesses], but said the disease was self-limiting. The fever takes a week to 10 days to disappear and has the patient running high temperature, cold, sore throat and body pain.

"It seems to target the gastric area, causing nausea and vomiting. This results in severe dehydration and weakness, and patients need to be admitted without delay for IV fluid administration," said a senior gastroenterologist at the GH, adding that he saw about 5 patients daily with symptoms of typhoid.

Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka

The etiology of these cases has not been determined. Although some pathogens have apparently been ruled out, the limited information provided does not permit reasonable speculation concerning which agents might be involved in these cases. An earlier series of cases of undiagnosed febrile disease were reported in Tamil Nadu state in December 2012. No further reports indicating the etiology of the disease in that outbreak were received. Continued: http://www.promedmail.org/

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


Virology Down Under: MERS: US CDC takes your clinical questions.

Ian Mackay PhD.
July 8, 2013

[snip info on Hendra virus)

CIDRAP ( http://www.cidrap.umn.edu/news... ) has a nice summary of the recent US Centers for Disease Control and Prevention (CDC)'s Clinician Outreach and Communication Activity (COCA) conference call call on the Middle East respiratory syndrome coronavirus (MERS-CoV), listing some interesting comments:

   Most MERS cases have been severe and the US is focussing on surveillance for severe acute respiratory infections - no US cases yet despite 30 cases having been tested by the CDC

   Co-morbidities have included kidney transplantation, malignancy, steroid therapy and kidney failure

   A validated serologic assay was not yet part of the armamentarium

   There are no good data on how long MERS-CoV can survive in the environment.

   The animal source of the virus remains unknown, but investigations are ongoing.

   There is no evidence so far that people can transmit the virus before they have symptoms, but information is limited [Ed. non that they cannot?].

   The virus has been found in the blood of sick patients [viraemia], but it is unknown whether viremia can occur before onset of symptom

   While one patient, the index patient in France, had diarrhea before any respiratory symptoms, the information on initial signs and symptoms remains very incomplete.  

In memory of pogge: Peace, order and good government, eh?
[If we want it, we'll have to work at it.]

WHO update: Middle East respiratory syndrome coronavirus (MERS-CoV) - update

Middle East respiratory syndrome coronavirus (MERS-CoV) - update

7 July 2013 - The Ministry of Health (MoH) in Saudi Arabia has announced one additional laboratory-confirmed case and two deaths in previously confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia.

The new case is a 56 year-old female from Hafr Al- Batin city, North-eastern region. She is a health care worker with contact of a previously reported laboratory confirmed MERS-CoV case who subsequently recovered and was discharged.

In addition, the two deaths in previously confirmed cases are a 53 year-old citizen from the Eastern Region and a two year-old male from Jeddah.

Globally, from September 2012 to date, WHO has been informed of a total of 80 laboratory-confirmed cases of infection with MERS-CoV, including 44 deaths.  

In memory of pogge: Peace, order and good government, eh?
[If we want it, we'll have to work at it.]

The first two paragraphs should have been bolded.

In memory of pogge: Peace, order and good government, eh?
[If we want it, we'll have to work at it.]

[ Parent ]
Branswell: Progress to understand MERS coronavirus frustratingly slow

[I don't like the design of this study. You have to trust Memish to give a truthful report of the result. Since we know a lot of his previous statements have been questionable how to we know he isn't going to give the report his  own spin.]

Helen Branswell, The Canadian Press
Published Monday, July 8, 2013 8:19AM EDT

[Snip of bulk of article...please, read at site]

In addition to the research aimed at identifying the virus's reservoir, Lipkin's team is trying to help answer another key MERS question: Are there mild or symptom-free cases that are evading detection?

Most diseases have a spectrum of illness, with severe cases making up the tip of the iceberg. So far with MERS, only the tip has been visible. More than half of known cases have died.

But there have been a few mild cases spotted, giving experts hope there may be more that aren't being picked up by existing surveillance systems, which are set up to look for the virus in people who are critically ill.

One way to answer this question is by looking for antibodies in the blood of people who may have been exposed to the virus. Antibodies are proof of prior infection.

Lipkin's laboratory has been testing blood samples from more than 200 individuals from Saudi Arabia. Some of the samples were taken from known cases, others from contacts of cases.

The team doesn't know which is which, but they've studied the samples using a variety of assays and have reported the results to the Saudi deputy health minister, Dr. Ziad Memish. Memish has the code which outlines the source of each sample.

Comparing the lab's results to Memish's master list should start to give a clearer picture of whether the infection is more common than has been seen to date.

"I don't know which samples are people who had active disease, which people recovered from disease, which people were contacts," he says. "And until I have the code cracked, I can't really be certain of what we've learned."


In memory of pogge: Peace, order and good government, eh?
[If we want it, we'll have to work at it.]

WHO Emergency Committee To Meet (plus coverage of Fukuda's recent press conference)

[good article...best read at site]

MERS-CoV - WHO Emergency Committee To Meet
Editor's Choice
Viruses;  Respiratory / Asthma;  Public Health
Article Date: 08 Jul 2013 - 0:00 PDT

[big snip}
Fukuda mentioned that it is interesting that MERS-CoV is much less human transmissible than the SARS-CoV virus of a decade ago. Significantly fewer healthcare workers who care for MERS-CoV infected patients are becoming ill compared to their counterparts who nursed SARS-CoV patients. Nobody is certain why this is the case. One possible explanation might be that infection control practices improved during and after the SARS epidemic. Researchers from Johns Hopkins University, however, said in June 2013 that MERS-CoV is easily transmitted in a healthcare setting.

Dr. Fukuda said "I think importantly, however, in terms of this person to person transmission, we are not seeing it sweep through communities and so it's important to understand this is a kind of local limited person to person transmission in certain instances but we don't see it sweeping through communities in big outbreaks. So, if we summarise what we are seeing in the Middle East, it's kind of a combination of where we have these community cases and then we have some local person to person transmission."


In memory of pogge: Peace, order and good government, eh?
[If we want it, we'll have to work at it.]

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