NEWS SCAN: US flu patterns, H5N1 in Vietnam, polio eradication, plague warning in China

Apr 16, 2010

Study says peaks in US flu activity move from west to east
Researchers from Tufts University School of Medicine report that peaks in US seasonal flu activity, as indicated by peaks in hospital cases among the elderly, tend to occur first in the West and then move eastward, hitting the New England states last. The researchers studied the seasonality and intensity of flu by extracting 248,889 Medicare and Medicaid hospitalization records from 1991 through 2004, according to their report in PLoS One. They determined that on average, flu activity peaked first in Nevada and last in Maine. The wave of peak activity crossed the country within 4 weeks, and the average peak occurred in the third week in January. The study also showed that flu seasons that peaked early involved larger epidemics. In a Tufts news release, senior author Eleva Naumova, PhD, said that 10.5% of the 9.7 million hospitalizations in elderly patients that occurred annually were due to pneumonia and influenza.
Full text of PLoS One study

Vietnam confirms two more H5N1 cases in suspected case cluster
Health officials in Vietnam have confirmed two more H5N1 infections in a suspected case cluster in the country's Bac Kan province, Saigon Daily, Vietnam's Communist Party newspaper, reported today. The two patients were hospitalized in serious condition. Both are from the same village where other H5N1 cases were reported earlier, in a 22-year-old man and a 27-month-old girl. Earlier reports said 11 other patients with similar symptoms were isolated and treated with oseltamivir (Tamiflu). Clusters of H5N1 cases raise fears of person-to-person transmission, which raises the risk of the virus becoming a pandemic flu strain. Dr Tran Nhu Duong of the Institute of Hygiene and Epidemiology, part of the Vietnam's health ministry in Hanoi, told the Daily that two groups recently appointed to conduct an epidemiologic investigation of the village found that the first two patients both had contact with infected poultry, with no evidence of person-to-person spread.
Apr 16 Saigon Daily story

Commentators say seeking polio eradication is ethical obligation
Two Canadian public health experts writing in The Lancet argue that there is an ethical obligation to continue to try to eradicate polio, rather than settling for an "effective control" strategy, meaning limiting cases to 500 per year. Claudia Emerson and Peter A. Singer of the McLaughlin-Rotman Centre for Global Health in Toronto write that discussions of polio eradication in recent years have largely focused on economic and technical feasibility. They argue that the obligation to push for eradication comes under the moral duty to rescue someone in distress if one has the ability and the act does not require excessive sacrifice. The World Health Organization (WHO) has estimated, they say, that using the "effective control" strategy would lead to 4 million polio cases in children over the next 20 years. They note that the benefits of disease eradication have been demonstrated in the case of smallpox, whose extermination in the 1970s has prevented an estimated 10 million to 15 million cases per year and saved up to 2 million lives annually. Though polio cases have already been reduced by 99%, the disease remains endemic in India, Pakistan, Afghanistan, and Nigeria. Polio eradication may depend on switching from oral vaccines to the more costly inactivated vaccine, which developing countries can't afford. Rich countries have strong moral reasons to subsidize this switch, particularly since diseases can easily cross borders, the authors write. "We are on the last kilometre of a marathon; surely it is worth crossing the finish line?" they conclude.
Apr 17 Lancet editorial

China warns of plague risk in earthquake zone
China's health ministry today warned of a pneumonic plague risk in the area recently hit by an earthquake, Yushu prefecture in Qinghai province, according to a report from China's state media that was picked up by Agence France-Presse (AFP). Health officials cautioned that the earthquake could have roused marmots, which can spread pneumonic plague, from hibernation earlier than usual. Feng Zijian of the Chinese Center of Disease Prevention and Control said the health ministry has asked rescue workers to monitor the disease situation and report suspected cases as soon as possible. He also asked rescue workers and survivors to avoid contact with dead animals. Last year another plague outbreak in a different part of Qinghai province caused three fatalities. Pneumonic plague, the most virulent but least common form of plague, can represent a primary infection caused by inhalation of droplets or can result from secondary spread from an advanced bubonic plague infection, according to the WHO. Patients typically experience flu-like symptoms after a 3- to 7-day incubation period. Rapid diagnosis and treatment are essential to avoid complications and death.
Apr 16 AFP story

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