FLU NEWS SCAN: H5N1 in Egypt, Japan; ILI rates in pandemic; seasonal flu vaccine and H1N1; pandemic media impact

Jan 20, 2011

Egyptian boy hospitalized with H5N1
Egypt's health ministry announced an H5N1 infection in a 1-year-old boy from Alexandria governorate, the World Health Organization (WHO) said today. He got sick on Jan 12 and was hospitalized the next day, where he is in stable condition. An investigation into the source of his infection suggests he was exposed to poultry. His illness pushes Egypt's H5N1 case count to 121, of which 40 were fatal. This latest H5N1 confirmation raises the global tally to 518 cases, including 306 deaths.
Jan 20 WHO statement
Japan finds H5N1 in wild ducks
Animal health authorities in Japan have confirmed the H5N1 avian influenza virus in two tufted wild ducks found dead near a water reservoir in Fukushima prefecture, according to a report yesterday from the World Organization for Animal Health (OIE). The birds were found on Jan 4 and Jan 5. The isolates were sent to Hokkaido University, which confirmed the H5N1 virus with gene sequencing and virus isolation. In December Japan reported finding H5N1 in four captive wild birds at a zoo and in six hooded cranes at a bird sanctuary. The incidents were the country's first H5N1 outbreaks since April 2009.
Jan 19 OIE report

Flu-like illness rates during pandemic were highest in children
Telephone surveys by the US Centers for Disease Control and Prevention (CDC) during the second wave of the 2009 H1N1 flu pandemic showed that self-reported influenza-like illness (ILI) was highest among children and lowest among elderly people, a finding consistent with results from other flu surveillance systems. The CDC used the Behavioral Risk Factor Surveillance System to question 216,431 adults and 43,511 children from September 2009 through March 2010, according to an article in Morbidity and Mortality Weekly Report (MMWR). The average monthly percentage of adults reporting an ILI in the preceding 30 days was 8.1% for adults and 28.4% for children. The highest rates were reported in November interviews: 9.5% for adults and 35.9% for children. The levels declined with age, from 32.7% for children under 5 to 3.2% in adults 65 and older. Compared with rates in whites, rates were significantly higher in American Indians and Alaska natives and significantly lower among blacks. The surveys showed that 40% of adults and 56% of children with an ILI sought medical care.
Jan 21 MMWR article

Previous seasonal flu vaccination had no effect on 2009 H1N1 in kids
Receiving a seasonal flu vaccine in the year before the 2009 H1N1 pandemic did not protect children from contracting 2009 H1N1 flu, nor did it increase the risk, according to a recent study. Researchers noted the seasonal influenza vaccination status of 165 Colorado children 18 months and older who had a lab-confirmed novel H1N1 infection and 660 matched controls. After adjusting for chronic medical conditions and health-seeking behavior, the scientists determined that the H1N1 patients were neither more nor less likely than the controls to have received the 2008-09 seasonal flu vaccine.
Jan 18 Ped Infect Dis J abstract

Media may have helped UK patients seek care during pandemic
Researchers found that the first wave of pandemic flu in Wales in 2009 saw a high rate of general practitioner (GP) consultations but a low rate of test results positive for 2009 H1N1 flu. The second wave, in contrast, had a lower rate of GP consultations for ILI but a much higher positivity rate, and the study's authors attribute the difference to intense media coverage during the first wave. After assessing data from GP surveillance, community virology surveillance, hospital admissions and deaths, and media enquiry monitoring, the researchers found that during the first wave, which peaked in July 2009, there were 100 ILI consultations per 100,000 GPs. The first-wave H1N1 positivity rate did not exceed 25%, and 44 hospitalizations and 1 death were confirmed. The consultation rate fell to 65 consultations per 100,000 GPs in the second wave, which peaked in late October, but the positivity rate climbed to 60%, and 379 hospitalizations and 26 deaths were confirmed. The authors conclude, "The large number of ILI-related consultations during the first wave in Wales probably reflected the intensive media activity rather than influenza virus circulating in the community. Data from community surveillance schemes may therefore have considerably overestimated the true incidence of influenza."
Jan 20 Eurosurveill study

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