FLU NEWS SCAN: H5N1 in Egypt, swine-origin H3N2 hybrid, H1N1 mutation

Nov 2, 2011

Egyptian boy recovering from H5N1 infection
Egypt's health ministry has reported that a 1-year-old boy is recovering from an H5N1 avian influenza, the World Health Organization (WHO) said today in a statement. The boy, from Gharbia governorate, got sick on Sep 17 and was hospitalized 4 days later. He improved after completing a course of oseltamivir (Tamiflu) and was discharged on Sep 25. The boy's infection pushes Egypt's H5N1 total to 152 cases, which includes 52 deaths. An investigation revealed that the boy had contact with neighborhood poultry. The case was confirmed by the Egyptian Central Public Health Laboratory, which is a National Influenza Center of the WHO Global Influenza Surveillance Network. This latest case, after adding two recent H5N1 deaths in Indonesia not yet tallied on the WHO's official chart, raises the global H5N1 count to 569 cases, including 334 fatalities.
Nov 2 WHO statement
WHO H5N1 case count

Maine confirms 2nd case of hybrid H3N2 flu
Maine has confirmed a second case of swine-origin novel H3N2 flu virus with genetic material from the 2009 H1N1 virus, according to the state's Center for Disease Control and Prevention (Maine CDC) yesterday, bringing the national total of such cases to six. The state's first case was confirmed Oct 17, and the most recent one on Oct 31. Both patients had multiple exposures to pigs. The US CDC confirmed the four other cases—three in Pennsylvania and one in Indiana—in September.
Nov 1 Maine CDC report
Oct 19 Maine CDC alert

Severe disease reported in 3 patients with mutated H1N1
Two cases of pandemic 2009 H1N1 flu with a mutation in the virus's hemagglutinin (HA) earlier this year indicate the mutation may be associated with more severe disease, according to a study in the Journal of Clinical Virology. US researchers reported on two patients from Ecuador and one from Washington, DC, who were infected by a 2009 H1N1 variant with a mutation within the primary HA receptor-binding site. All required mechanical ventilation, and one died. The D222N mutation was confirmed in two of the patients, but all the isolates were found to be from a subclade phylogenetically homologous with strains associated with recent deaths in Chihuahua, Mexico. The authors conclude, "Previously, enhanced virulence associated with the change, D222G, has been clinically linked to severe morbidity and mortality. Initial observations of the prevalence of a novel sub-clade of strains in the Americas suggest that viruses with a re-emergent D222N mutation may too correlate with severe clinical manifestations."
Oct 28 J Clin Virol abstract

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