FLU NEWS SCAN: Flu in Europe, peramivir contract, WHO on Cambodian H5N1 deaths, H5N1 on poultry farms

Feb 25, 2011

Flu levels declining in many European countries
Flu activity in is still widespread in many European countries, but 17 countries reported decreasing indicators, the European Centre for Disease Prevention and Control (ECDC) reported today. with The proportion of positive respiratory specimens dropped to 40% last week, down from 43% the week before and the peak of 57% seen at the end of 2010. Increasing flu activity was reported by only three countries: Austria, Iceland, and Romania. The number of severe flu infections has decreased across western Europe, except for Greece, but the severe illness picture is uncertain in central and eastern Europe, where hospital surveillance is limited. Most of the severe flu infections have been linked to the 2009 H1N1 virus. About 67% of flu viruses are influenza A, nearly all of them the 2009 H1N1 strain, in contrast to the mix of H1N1 and H3N2 viruses in North America.
Feb 25 ECDC flu surveillance report

BioCryst gets more HHS funds to complete peramivir trial
The US government is awarding BioCryst Pharmaceuticals Inc. another $55 million to enable the company to enlarge and complete a phase 3 clinical trial of its intravenous (IV) influenza drug, peramivir, the company announced today. The contract modification awarded by the Department of Health and Human Services (HHS) brings the company's total award to $234.8 million. The firm was originally awarded $102 million in 2007 to test intramuscular peramivir in outpatients and the IV form in hospital patients. In 2009 the development program shifted to focus only on IV use in hospital patients, and HHS awarded a $77.2 million contract increase, the company said. The latest contract increase will support several changes in the company's multicountry phase 3 trial. The firm said it has modified the trial's primary efficacy analysis to evaluate IV peramivir plus "standard of care" versus standard of care alone in hospitalized flu patients. The company aims to enroll a total of 600 patients, up from a previous target of 445, and to add 45 more clinical sites. Investigators hope to include in their efficacy analysis 160 patients not treated with neuraminidase inhibitors—which at some sites may not be part of standard care—"in order to provide the greatest opportunity to demonstrate a statistically significant peramivir treatment effect," BioCryst officials said. The contract change extends the pact through 2013, but the time needed to complete the trial will depend on the prevalence and severity of flu and the ability of the more than 265 trial sites to enroll patients, officials said. After completing the trial, BioCryst plans to apply for US approval of the drug. Peramivir, which is already licensed in Japan, was used in critically ill US patients under an emergency authorization during the 2009 flu pandemic.
Feb 25 BioCryst press release
Jan 14 CIDRAP News item on peramivir trial results

WHO reports details in Cambodian H5N1 deaths
The World Health Organization (WHO) offered a few new details today in a statement on the recent H5N1 influenza deaths of a 19-year-old Cambodian woman and her 11-month-old son. It said the two had multiple exposures to sick and dead poultry during the second half of January and early February while visiting Prey Veng province. The mother and son were originally from Banteay Meanchey province and made the trip with the woman's husband, her mother-in-law, and her sister-in-law. Respiratory samples were collected at the hospital on the days the mother and son died, the mother on Feb 12 and her son on Feb 17. The H5N1 virus in the specimens was confirmed on Feb 20 and 22 at the Pasteur Institute in Phnom Penh. The WHO said it was coordinating response activities with Cambodia's health ministry, and so far no symptomatic contacts of the two victims have been identified. The new cases raise Cambodia's count of H5N1 cases to 13, of which 11 were fatal. They raise the global H5N1 total to 522, including 309 fatalities.
Feb 25 WHO statement

H5N1 strikes more poultry in South Korea. Vietnam
South Korea's agriculture ministry today said the H5N1 virus has hit another poultry farm, this one about 62 miles outside of Seoul, according to Xinhua, China's state news agency. The farm's 30,000 birds were culled to control the outbreak. The ministry said H5N1 outbreaks in South Korea now seem to be declining. A series of outbreaks that began in December has led to the culling of 5.5 million birds. Elsewhere, Vietnam News Agency reported today that the virus has been detected again in five provinces, Thai Nguyen, Vinh Phuc, Lang Son, Nam Dinh, and Kon Tum, according to another Xinhua report. In other developments, Dr Subhash Morzaria, regional manager of the United Nations Emergency Center for Transboundary Animal Diseases, said high-density farming systems, high human population, and deforestation are making people more vulnerable to zoonotic diseases, the Australian Broadcasting Corporation (ABC) reported today. Morzaria said Japan is emerging as a new hot spot for zoonotic disease risk—joining countries such as Indonesia, Vietnam, and Bangladesh—and that wild birds appear to be playing a role in spreading the disease to Japan's poultry flocks. Most transmission is still related to poultry farming and trading, which is where most disease-fighting resources should remain focused, he added.
Feb 25 Xinhua story
Feb 25 Xinhua story on Vietnamese H5N1 outbreaks
Feb 25 ABC news story

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