News Reports for August 12, 2012

CIDRAP: Study - Children, middle-aged most vulnerable to variant H3N2

Aug 10, 2012 (CIDRAP News) - A serologic study from Canada suggests that children and middle-aged adults have little or no immunity to the swine-origin variant H3N2 influenza virus (H3N2v), but about half of adolescents and young adults have some degree of immunity as measured by antibody levels.

The researchers also found that seasonal flu vaccines used in the past two seasons did not improve participants' ability to mount an immune response to H3N2v. Their report was published this week in the Journal of Infectious Diseases.

(Snip) "A specific vaccine would be needed in the event A(H3N2)v establishes epidemic spread," says the study, which was led by Danuta M. Sowronski, MD, of the British Columbia Centre for Disease Control as first author.

The H3N2v strain, which contains the matrix gene from the 2009 H1N1 virus, emerged last summer in the United States, causing a dozen cases. But more than 150 cases of H3N2v illness have been reported in the past few weeks, most of them in children who had contact with pigs, often at county fairs. The illnesses have generally been mild and self-limiting.

A flu expert with the US Centers for Disease Control and Prevention (CDC) said today that the new findings generally agree with those of previous studies by the CDC and others, but the finding of low antibody levels in middle-aged adults emerged more clearly in the new study than in previous ones.

The CDC has prepared a candidate vaccine for the novel virus, and clinical trials are expected this fall.

The Canadian researchers looked for cross-reactive antibodies to H3N2v, using 1,116 serum samples that had been collected in 2010 from people across the age spectrum. In addition, they tested sera collected from children and adults before and after receipt of the 2010-11 seasonal flu vaccine and from elderly people before and after receipt of the 2011-12 vaccine.

Hemagglutination inhibition (HI) and, in a subset of cases, microneutralization were used to assess antibodies to H3N2v.

Overall, 25% of the 1,116 participants had an HI antibody titer of at least 40 to the H3N2v strain, the level that's believed to confer some degree of protection. But no children younger than 5 years and fewer than 20% of subjects 14 or younger or over age 40 had this seroprotective level of antibody.

Between the ages of 14 and 40, half of the subjects had a seroprotective level of antibody to the virus, the report says. The proportion peaked at about 60% in adults in their 20s but dropped to about one-third for those in their 30s. Fewer than 10% of those between ages 40 and 69 and about 20% of those older than 69 had seroprotection. 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 @ Sun Aug 12, 2012 at 06:19:08 AM UTC

CIDRAP: CDC updates novel H3N2 info for clinicians

(Snip)

(Snip) the CDC issued new information on H3N2v for clinicians, including an evaluation of rapid influenza tests that found their sensitivity varies greatly, and the agency urged clinicians not to use negative results as the basis for treatment.

(Snip)

In a joint statement with the Ohio Department of Agriculture (ODA), the ODH said the two departments are launching an outreach plan to boost H3N2v awareness at county fairs, including visits at each fair and in-person contact with swine exhibitors. The ODA has established guidance for fair boards, and the agencies have produced a YouTube video for fairgoers and exhibitors.

At a press briefing yesterday, the CDC said the surge in reports involving the swine-origin H3N2 virus that contains the matrix gene from the 2009 H1N1 virus reflects a real rise in the number of cases, as well as a change in how the cases are reported.

In an early-release edition of Morbidity and Mortality Weekly Report (MMWR) today, the CDC said state laboratories have been using the CDC Flu rT-PCR Dx Panel to detect the novel virus, and their positive findings were initially considered inconclusive until confirmed as H3N2v by the CDC. However, on Aug 7 the CDC updated the results interpretation of the test for public health labs, which allows them to report the presumptive H3N2v-positives as confirmed cases.

The CDC said 128 (93%) of the patients are younger than age 18 and the median age is 7 years. Though the infections have predominantly occurred in kids, the fact that 10 of the illnesses involved adults underscores the point that people of any age can be infected, the CDC said. It urged people with underlying health conditions that pose a high risk of complications from flu to avoid swine barns this summer, especially if sick pigs have been identified.

In initial tests on seven rapid flu diagnostic tests, four detected all of the H3N2v viruses, the CDC reported. It said the findings reinforce that negative test results shouldn't be considered conclusive for ruling out H3N2v infection. CDC added that more data are needed on the performance of the rapid tests but that both positive and negative findings should be interpreted in the broader context of circulating strains in the community, level of clinical suspicion, disease severity, and patients' underlying risk factors.

The CDC said that although human-to-human transmission hasn't been seen in this summer's H3N2v infections, limited spread was suspected in a few cases that were detected in households and in a child-care setting in 2011. It urged state health officials to enhance surveillance, especially in areas where infections have already been confirmed.

"The initial goal of enhanced surveillance is to detect the source and geographic spread of these viruses, but once cases are detected, particular emphasis should be placed on detection of ongoing transmission within the community through investigation of close contacts of patients with confirmed cases," the CDC wrote.

In a separate information release for clinicians, the CDC said the H3N2v infections can't be distinguished clinically from seasonal flu infections and other flulike illnesses. The key to identifying a suspected H3N2v infection is to tease out a link to swine exposure in the week before illness onset, including direct contact with pigs, indirect exposure (such as walking through a swine barn at a fair), and close contact with a sick person who had recent swine exposure.

The virus has been circulating in US pigs since 2011, has been detected in many states, and appears to be circulating widely in the nation's pig populations, the CDC said.

(Snip)

Limited serologic data show that children younger than 10 lack immunity to the virus and are most susceptible, and that while other age-groups may have cross-protective antibodies, some persons are still susceptible to the new virus, according to the CDC.

Patients with flu-like illness and an epidemiologic link to swine exposure should be considered probable H3N2v cases and local health departments should be notified as soon as possible for additional testing, the agency said.

Meanwhile, overall US flu markers remained at low summer levels (Snip), which made note of the new H3N2v infections. 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 @ Sun Aug 12, 2012 at 06:33:35 AM UTC

H3N2v Testing Halt In Champaign County Ohio

Recombinomics Commentary

The three "probable confirmed" cases are among eight Influenza A cases reported by local health care providers to the county Health District.

Hiddleson said her staff has taken calls from others with flu-like symptoms and that they have been told to treat fever and discomfort and only call a doctor if they are at high risk for flu complications.

Hiddleson said the local flu does not appear to be transmitted from person to person, but that her staff will monitor this as well as any confirmed cases in coming weeks. She said the incubation period is three to seven days, so more cases may be coming.

The above comments describe a halt in testing of mild H3N2v cases in Champaign County, Ohio, where 3 patients have tested H3N2v positive at the Ohio Department of Health (ODH) and 5 more are symptomatic with influenza-like illness (ILI).  (Snip) this is a recent outbreak and the 3 confirmed cases were not included in the ODH August 10 update which raises the confirmed cases to 36 (from 30) and counties with confirmed cases to 8 (from 6).

As noted in the CDC August 9 telebriefing, there is little seasonal flu in the United States at this time, so ILI cases are likely to be H3N2v, especially if linked to attendance at an agricultural fair.  However, claims of no human to human transmission are largely based on a lack of testing or reporting, since the CDC has emphasized swine contact for an H3N2v sub-clade that has documented human to human transmission in West Virginia where the two confirmed cases were at a day care center and had no swine contact or exposure, yet at least 22 additional contacts had ILI.

(Snip) The latest ODH has increased the number of confirmed Gallia (County) cases to six (from four).  (Snip) since 2/3 of those who were H3N2v infected tested negative, and only a subset of the influenza A positive were sent to ODH, the number confirmed will be a gross undercount, and monitoring of human to human transmission will be compromised.

The halt in testing of a novel influenza has striking parallels with the 2009 pandemic when mild cases were told to not seek medical treatment unless they were at risk.

The control reported cases in a pandemic by refusing to test is the current status throughout the country for those without swine contact.  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 @ Sun Aug 12, 2012 at 06:49:00 AM UTC

Mexico: Follow Yucatan on alert for bird flu outbreak

Translated

MERIDA, YUC. - The president of the Animal Health Committee in Yucatan, Pedro Lopez Serralta said following alerts (of) the avian influenza outbreak to prevent the entry of poultry and eggs from other parts of the country.  

"We have not dropped (our) guard, (Snip) we remain alert not only at the entrances to our state of Campeche and Quintana Roo, but also the supply center in Merida, where we review everything that comes from other parts of the Republic.

(Snip) the operation was extended to municipalities Oxkutzcab, Valladolid, Tizimin and Progress, a lot of sites for produce from other states, "there are also reviewed to prevent shipments (of) eggs or chickens." "This action is going to hold until full recovery Jalisco avian influenza that has cost millions of chickens, and to be sure that the disease has not spread to other states," he added.

(Snip) the official said that with the few resources they have remained good health status of animals, especially chickens, hens and turkeys for the disease (has not reached the) Yucatan.

He said the poultry farmers and poultry producers when they detect that an animal has symptoms, they are separated from the rest and were sacrificed to prevent mass contagion.

(Snip) self-sufficiency Yucatan (for) chicken and egg, so there is no need to import the product to meet local demand, "and above all we have certified quality animal that can be marketed in the country and abroad without any problems." http://www.expreso.com.mx/inde...

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 Aug 12, 2012 at 07:06:58 AM UTC

Mexico Slaughters 8 Million H7N3 Influenza-Infected Chickens

(Note: This is a repeat of a story that circulated several days ago but it shows how serious the outbreak of H7N3 is in Mexico.)

Mexico is embroiled in an effort to contain an outbreak of a strain of bird flu in the west of the country.

Agriculture ministry officials announced last Tuesday that they have already vaccinated 66 million chickens and killed 8 million infected chickens in the egg-producing Los Altos region. Mexico plans a two-phase vaccination program that would vaccinate 80 million more chickens in the first phase. The second phase would be conducted after an evaluation of the first.

The outbreak of the H7N3 bird flu strain was first detected in Los Altos on June 20. At the beginning of July, Mexico declared an animal health emergency. Subsequently, prices of eggs and chickens increased sharply. The Mexican poultry industry has already lost $50 million since June.

Even though the disease is so far confined to the Los Altos region, the ramifications of this outbreak reach beyond Mexico's borders. Authorities in neighboring Guatemala have beefed up checks on its border to prevent the spreading of the virus strain.

According to the United Nations, the H7N3 virus rarely infects humans and is not known to be easily transmittable between humans. However, viruses are prone to mutations, and other strains like H5N1 and H1N1 have already been fatal to humans. Former World Health Organization Director-General Dr LEE Jong-wook, warned back in 2005: "It is only a matter of time before an avian flu virus - most likely H5N1 - acquires the ability to be transmitted from human to human, sparking the outbreak of human pandemic influenza." Continued: http://www.thetrumpet.com/arti...

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 Aug 12, 2012 at 07:17:57 AM UTC

[ Parent ]

Bird Flu Case Report to 191

http://medicalzone.org/2012/08...
August 9, 2012, Translated Article
Jakarta, Indonesia:  Ministry of Health, "Directorate General of Disease Control and Environmental Health" announced one new case of H5N1 that has been confirmed by the Center for Biomedical and Health Technology base, Balitbangkes.  The case on behalf of AW (Female, 37 years) who is from Prambanan, Sleman District, Yogyakarta Special Province, is self-employed.  On July 24, 2012 she had symptoms of high fever, and the following day the case received treatment at a hospital outpatient PR.  Because of persistent high fever and starting to cough, on July 27, 2012 the case went to the hospital again and was finally treated at PR.  During hospital care hospital public relations, the case had more elevated fever accompanied by cough and shortness of breath, so that on July 29, 2012 the case was referred to Hospital B and put on a ventilator.  Circumstances of the case gets worse and she finally died on July 30, 2012 at 12:05 pm.

Epidemiological investigations have been carried into the homes of people and the environment by the Integrated Ministry of Health Team, the local Health Department, Animal Husbandry Department and Officer PDSR Kab.Sleman DIY Province, the Provincial Agriculture Department DIY.  There are acquired risk factors, namely the possibility of contact with the environment in the workplace and ornamental birds around 50 meters from the house.  There are cases where there are chicken, quail and duck cutting farms and there is also the case in the home environment.
(snip)

Director General of Disease Control and Environmental Health Yoga Aditama Prof.dr.Tjandra as the focal point of the International Health Regulations (IHR) has been informed about the case to the WHO.


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

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by: History Lover @ Sun Aug 12, 2012 at 14:30:24 PM UTC

Please post new news stories to...

News Reports for August 13, 2012

Thank you!

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by: AlohaOR @ Mon Aug 13, 2012 at 04:05:00 AM UTC