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News Reports for October 24, 2012

by: NewsDiary

Sat Oct 20, 2012 at 18:03:46 PM EDT

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

• Maharashtra: Pregnant woman dies of swine flu, toll touches 10 in Chinchwad (Link)
• Andhra Pradesh: Swine flu: Minister calls for a nodal agency (Link)

• Undiagnosed febrile illness, fatal - Sudan: (SF) RFI (Link)

United States
• MS: Harrison County patient diagnosed as one of first flu cases of season (Link)

• US: Viral research faces clampdown (Link)
• Pigs May Look Healthy but Can Test Positive for Flu at Fairs (Link)

• Threatwatch: Find the germs, don't sack the messenger (Link)

• H (Link)

NewsDiary :: News Reports for October 24, 2012

News for October 23, 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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US: Viral research faces clampdown
Federal health agencies in the United States have acted to tighten security surrounding research on two deadly pathogens. The move is intended to enhance public safety, but some fear that it may hamper research in the United States and abroad.

Earlier this month, US health agencies added the SARS virus to its list of select agents - pathogens and toxins that it deems to have the "potential to pose a severe threat to public health and safety". In addition, the agencies last week opened a public consultation about whether they should designate strains of H5N1 avian influenza virus that are transmissible between mammals as 'Tier 1' select agents - a newly created class subject to the strictest levels of biosecurity. The consultation comes after the Intragovernmental Select Agents and Toxins Technical Advisory Committee advised the agencies that the virus could "potentially overwhelm the health care system".

The listing of the SARS virus as a select agent - along with two recently discovered haemorrhagic-fever viruses, Lujo and Chapare - means that dozens of US labs holding the virus have until 3 April to either upgrade the bio­security of their labs or destroy or transfer their stocks. The US government estimates that 38 of the labs - 10 academic, 22 commercial and 6 government labs - do not currently have the extra biosecurity measures required to carry out select-agent research, including stricter lab-access rules and vetting of staff.

Shinji Makino, a SARS researcher at the University of Texas Medical Branch in Galveston, whose biosafety-level-3 (BSL-3) lab is one of the 38 affected, is "disappointed" by the move. His university owns the BSL-4 Galveston National Laboratory, which has the highest biosafety containment rating and so is select-agent compliant, and Makino is now seeking lab space there to continue his research.

The restrictions could interfere with sharing the virus or reagents between labs based in the United States or overseas, warns Michael Buchmeier, deputy director of the Pacific Southwest Center of Excellence for Bio­defense and Emerging Infectious Diseases at the University of California, Irvine. "The threat of criminal prosecution and severe penalties will have a chilling effect on the kinds of collaborative efforts that have characterized SARS work up until now," he says.

For H5N1 researchers, the proposal to add mammalian-transmissible forms of the virus to the Tier 1 list is the latest twist in a year-long international storm that erupted over experiments by Ron Fouchier at the Erasmus Medical Center in Rotterdam, the Netherlands, and Yoshihiro Kawaoka at the University of Wisconsin-Madison. Critics have questioned the benefits of the work, which showed that a few genetic tweaks allowed the avian virus to spread easily in ferrets, an animal model used for research into human flu. They say that if this virus escaped from a lab it might cause a pandemic in humans. Continued: http://www.nature.com/news/vir...

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


US: Harrison County patient diagnosed as one of first flu cases of season (Mississippi)
A Harrison County patient is one of the first diagnosed with flu for the 2012-13 season, according to the Mississippi State Department of Health. The state department has confirmed samples from two patients from Harrison and Lamar counties have been documented at the MSDH Public Health Laboratory. "We now have two confirmed flu cases in Mississippi," State Health Officer Dr. Mary Currier said. "This not only indicates that flu has been detected in the state, but it also serves as a reminder that now is the best time to get your flu shot. "The flu shot takes one to two weeks to produce immunity, and although flu season usually peaks in January through March, it sometimes reaches high levels as early as December, she said. Continued: http://www.sunherald.com/2012/...

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


India: Pregnant woman dies of swine flu, toll touches 10 in Chinchwad (Maharashtra)
A 30-year-old pregnant woman from Chinchwad died of H1N1 virus last week. With this, the swine flu death toll in Pimpri-Chinchwad has reached 10.

(Snip) the woman was in the 33rd week of pregnancy and had symptoms like fever, cough and sore throat since October 15. She was undergoing treatment at Ankur Hospital in Chinchwad following which she was referred to Niramay Hospital where the throat swab was taken for tests on October 19. The woman died on the same day.

(Snip) authorities declared the woman died of swine flu. (Snip) http://www.indianexpress.com/n...  

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


India: Swine flu - Minister calls for a nodal agency (Andhra Pradesh)
The district administration has been directed to set up a nodal agency to deal with the spread of swine flu.

Minister for Tribal Welfare P. Balaraju reviewed the subject with officials (Snip). He directed them to work in tandem and ensure that there were enough facilities for treating patients in the district.

He directed the officials to ensure that all the area hospitals at Aganampudi, Anakapalli, Narsipatnam and Paderu had adequate stock of medicines to treat the infectious disease.

The Minister wanted 20 beds in Chest Hospital and eight beds in KGH to be dedicated to treating patients suffering from swine flu. He asked the Collector to issue a direction to private hospitals to report any patient showing symptoms of swine flu. Continued: http://www.thehindu.com/news/c...

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, fatal - Sudan: (SF) RFI
Khartoum's Al-Sudani daily newspaper reported Tuesday [23 Oct 2012] that 6 people died of and 10 others are infected with unknown fever in various areas in Sudan's South Darfur state.

"Unknown fever appeared in various areas of the state and infected 16 people on Saturday and Sunday [20-21 Oct 2012], and 6 of them died," (Snip). "As soon as we received reports on the cases, we have contacted the federal Ministry of Health," he said, noting that medical teams have been sent to these areas to investigate the cause of the fever and provide treatment for the infected people. The local official further said that samples have been taken from the infected people and sent to Khartoum but that the test results have not come out yet.


Communicated by: ProMED-mail

In the absence of additional information on the clinical presentation of the cases other than fatalities from a febrile illness it is hazardous to attempt to speculate a differential diagnosis at this time. The range of possible diagnoses includes diseases of viral, bacterial, and parasitic origin. With the current ongoing outbreaks of Marburg virus disease in Uganda and Ebola virus disease in the Democratic Republic of the Congo, it is tempting to consider a viral hemorrhagic fever as the etiology of a fatal febrile disease outbreak in Sudan, but not casting the diagnostic net further at this point seems potentially hazardous at best.

Earlier this month (October 2012), ProMED-mail carried a report of an undiagnosed fatal illness outbreak occurring in Zalingei, Central Darfur state. In that report, the description was "most of the victims of the unknown fever are Arab nomads and gold excavation workers. ...the patients suffer from headaches, vomiting, and fatigue". A similar report on that same outbreak carried a few days later on ReliefWeb mentioned there were 7 deaths, and attributed them to poor access to good health care and medications in the region. There was mention of specimens having been sent to Khartoum for testing as well. (http://reliefweb.int/report/sudan/seven-die-unknown-fever).

Searching maps for locations, the 1st report above refers to deaths occurring "in various areas of the state [South Darfur]." The earlier report refers to the deaths occurring in the "area of Korley, south of Zalingei." Looking at a March 2012 map of Sudan available on Relief Web (http://www.un.org/Depts/Cartographic/map/profile/sudan.pdf) and looking at a map showing the location of Zalingei, the capital of Central Darfur state http://www.myweather2.com/City... one sees the proximity of the states, it is tempting to wonder whether the 2 outbreak reports might be related events, as the descriptions on both news reports seem similar. Again, this may well be a hazardous speculation as transportation is significantly challenged in these areas. (Snip) http://www.promedmail.org/dire...  

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


Threatwatch: Find the germs, don't sack the messenger
Threatwatch is your early warning system for global dangers, from nuclear peril to deadly viral outbreaks. Debora MacKenzie highlights the threats to civilisation - and suggests solutions.

Governments have a holy horror of being associated with germs - and this suits the germs just fine. Official denial about BSE, SARS and H5N1 bird flu exacerbated their spread, while India's main concern about a worrying antibiotic resistance gene seems to be that it was named for where it was discovered - New Delhi.

In all those cases scientists have been intimidated and stopped from working on the microbe the government deems bad PR. Now Saudi Arabia has sacked its top virus-hunter for discovering a virus that hardly threatens anyone.

This is all the more sad because the Saudis know better than most how vital it is to share surveillance on infectious disease. They host the largest annual human gathering on earth: the Hajj, the annual pilgrimage to Mecca taking place this week that attracts three million Muslims, 1.8 million from abroad.

With crowded, stressed people all carrying different germs, contagion is inevitable - "Hajj cough" is common - and a serious outbreak could be dire. So in a military-scale operation, Saudi health authorities screen and treat arriving pilgrims for conditions from food poisoning to plague, and require vaccination for meningitis and other maladies. This year they refused pilgrims from Uganda and the Democratic Republic of Congo, for fear they were infected by recent outbreaks of Ebola.

Mystery pneumonia case
Ziad Memish, deputy Saudi minister for public health and head of the WHO Collaborating Centre for Mass Gathering Medicine in Riyadh, knows the need for science in all this. He helped found an exemplary international collaboration to study health at the Hajj, and wrote recently that "sharing of information and research findings are critically important elements of the programme".

So you'd think he'd appreciate Ali Zaki, a virologist at the Dr. Soliman Fakeeh Hospital in Jeddah, already the first to identify dengue fever and a new tick-borne flavivirus in Saudi Arabia. In June Zaki sent samples from a mysterious, fatal case of pneumonia to Ron Fouchier, a virologist in Rotterdam, the Netherlands - and, he says, to the Saudi ministry of health.

Fouchier discovered a novel coronavirus in it. Zaki posted this on ProMed, the internet mailing list for emerging disease. Within days, a UK hospital discovered an identical case who had also been in Saudi Arabia.

Also within days, "an investigation team from the Saudi ministry of health arrived at the hospital to investigate me aggressively, threatening me about what I had done," Zaki told New Scientist. Shaken, he took emergency leave in Cairo - and, he says, was told it was not safe to come back. His employment has been terminated.

Pilgrims assured
You can almost understand officials being upset about news of a novel virus a few weeks before millions of visitors arrive. But because of the prompt action, it was quickly established that the virus probably doesn't transmit among humans. In October Memish could assure pilgrims that it posed little risk. Continued: http://www.newscientist.com/ar...

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


Pigs May Look Healthy but Can Test Positive for Flu at Fairs
ScienceDaily (Oct. 24, 2012) - More than 80 percent of pigs that tested positive for influenza A virus at Ohio county fairs between 2009 and 2011 showed no signs of illness, according to a new study.

Ohio State University researchers tested 20 pigs each at 53 fair events over those three summers and found at least one flu-positive pig at 12 fairs -- almost a quarter of fairs tested.

The influenza strains identified in pigs in this study include H1N2 and H3N2 viruses -- strains that have been circulating in pigs since 1998. In 2011, all of the H3N2 and H1N2 isolates found in pigs at the fairs contained a gene from the 2009 pandemic strain of H1N1, which is similar to the H3N2v strain causing human illness this year.

Though this finding alone is no cause for panic, it does show how quickly influenza viruses can change, said Andrew Bowman, lead author of the study and a Ph.D. candidate in veterinary preventive medicine at Ohio State.

In a second study led by Bowman, researchers compared the genomic sequences of influenza A viruses recovered in July 2012 from pigs and people. The analysis, showing a greater than 99 percent genetic similarity among the viruses, confirms that pigs and humans were infected with the same virus, indicating interspecies transmission.

As of Sept. 25 this year, the Centers for Disease Control and Prevention (CDC) had confirmed 107 human cases of H3N2v influenza in Ohio since July 2012, with the majority linked to exposure to pigs at agricultural fairs. While most of the human illness caused by H3N2v has been mild, one person, who had a compromised immune system, has died.

The more often that flu viruses are transmitted, the better their chances are of evolving into a strain to which humans are not immune, which is the big-picture concern among scientists monitoring these viral infections.

"Pigs can be infected with human-, avian- and swine-origin influenza viruses, making it possible for these viruses to easily swap their genetic material, which could allow for a new strain to emerge," Bowman said. "The potential is there for newly emerged strains to be the next pandemic we never saw coming."

Bowman and colleagues will continue to investigate strategies to protect swine and public health. In the meantime, the research group has offered potential risk mitigation strategies for fairs with swine competitions to consider: shortening the pig exhibition period, avoiding movement of pigs from one fair to the next, and vaccinating exhibition swine for appropriate influenza A viruses. In addition, the CDC recommends that people with compromised immune systems avoid pig displays at fairs.

Both studies appear online and are scheduled for later print publication. The three-year surveillance at Ohio fairs is published in the journal Emerging Infectious Diseases, and the analysis of human and pig viruses appears in Emerging Microbes & Infections. Continued: http://www.sciencedaily.com/re...

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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