FLU NEWS SCAN: Effects of school closure, secondary H1N1 infection, liquid Tamiflu shortage, H5N1 in Hong Kong

Jan 21, 2011

School closure during H1N1 pandemic had economic, social impact
Two new studies showed that because of school closure about a quarter of households reported missing work, one-fifth lost wages, and contacts with people outside the home declined but were still fairly frequent during the 2009 H1N1 influenza pandemic. In the first study, in the Journal of Infection, researchers surveyed 232 Taiwanese households after a 1-week elementary school closure in May 2009 and found that 61 (27%) reported workplace absenteeism and 42 (18%) reported wage loss (totaling 194 working days or $6,433 US). Also, 29 households (13%) went to public places or gathering during the week. In spite of the lost work, 169 families (73%) were at least moderately supportive of the school closure.
Jan 20 J Infection abstract
In the second study, published today in Emerging Infectious Diseases, researchers studied survey data from 107 students after a 2-week closure of a UK middle school in the summer of 2009. As opposed to the Taiwanese study, the number of visits to public places did not decrease by much. The researchers found these drops in students' weekly visits from days when school was open to when it was closed: shops, from 94 to 78; park or playing field, 81 to 59; place of worship, 66 to 46; public transportation, 58 to 43; cafe, 50 to 37; and recreation center, 42 to 28. Visits to a movie theater stayed the same, at 17, while party-going actually increased, from 22 to 26. In addition, students reported a decline in the number of face-to-face contacts with other people, from 70.3 to 24.8, which meant a reduction of 45.5% in the daily number of contacts, or a relative reduction of 65%.
Jan 21 Emerg Infect Dis study

Study: One fourth of affected households saw secondary H1N1 infection
More than one fourth of Australian households experienced secondary 2009 H1N1 infection after a family member had contracted the virus, according to a report published yesterday. Researchers studied 595 Western Australia households in which the index case was the home's first 2009 H1N1 flu case from late May to early August 2009. Flu-like illness developed in 231 of 1,589 household contacts, for a secondary attack rate of 14.5%. At least one secondary case occurred in 166 of the 595 households, for a household transmission rate of 27.9%. Of the households with secondary cases, 76.5% had one case and 23.5% had two or more cases. In addition, the researchers determined that prophylactic (preventive) antiviral therapy led to reduced H1N1 transmission. They wrote that the secondary attack rate in this study is comparable to that reported for seasonal flu.
Jan 20 Eurosurveillance report

FDA reports shortage of Tamiflu pediatric suspension
The US Food and Drug Administration (FDA) on Jan 19 posted a notice about a shortage of oral oseltamivir (Tamiflu) suspension, due to increased demand. The liquid suspension is often a better option when a child or adult can't swallow pills. It said Genentech, which through its San Francisco facility serves as US headquarters for Roche, notified the FDA that Tamiflu oral suspension is on backorder, but wholesales and pharmacies still have some remaining supplies. The FDA reminded healthcare professionals about the agency's approved emergency compounding instructions for making an oral suspension from 75-mg Tamiflu capsules. It also said the 75-mg, 45-mg, and 30-mg capsules remain available and that they can be mixed into sweetened liquids such as chocolate syrup, as directed by a healthcare professional, for patients who have difficulty swallowing. Supplies of oral suspension Tamiflu were also scarce during the 2009 H1N1 pandemic. At the time Roche said it takes 25 times more production capacity to make the liquid suspension and was focusing on boosting production of pediatric-dose capsules.
Jan 19 FDA current drug shortage notice

Hong Kong finds H5N1 in two wild birds
Hong Kong's agriculture department announced today that tests have confirmed the H5N1 avian influenza virus in two wild birds found dead recently. In a press release, the Agriculture Fisheries, and Conservation Department (AFCD) said one was a crow found on Jan 18 and the other was an Oriental magpie robin found near a garbage collection point in a park on Jan 17. The AFCD has warned poultry farmers to step up their biosecurity measures and has advised other bird owners to take precautions. It said it would continue inspecting and monitoring poultry farms and wholesale bird markets. In a report today to the World Organization for Animal Health (OIE), the AFCD said its last H5N1 finding in birds was Dec 18, 2010. It said the source of the virus was inconclusive and that the testing was done as part of ongoing surveillance. The department added that no spread of the disease is evident.
Jan 21 AFCD statement
Jan 21 OIE report

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