FLU NEWS SCAN: WHO dual-use meeting, H5N1 death in Vietnam, CDC's antiviral advice

Feb 8, 2012

WHO announces meeting next week on dual-use H5N1 studies
The World Health Organization (WHO) yesterday posted a notice about its Feb 16-17 invitation-only "technical meeting" about two studies involving lab-generated, transmissible H5N1 flu viruses that the US government recommend not be published in full. The agency said it will facilitate discussion on "urgent questions related to the two studies, as well as broader concerns related to the balance between scientific research and public concerns about safety." It said invitees "will be people who have direct involvement or knowledge about these two studies, their review or oversight, or potential dissemination of results." The aim is to reach consensus on the most urgent issues, especially related to access to and dissemination of the full results of the studies. The WHO said it intends to seek wider input at an unspecified later date. In December the National Science Advisory Board for Biosecurity recommended that Science and Nature publish versions of the studies with key details withheld over bioterrorism concerns, and the US government agreed. The studies were led by Ron Fouchier, PhD, of the Netherlands and Yoshihiro Kawaoka, DVM, PhD, of the University of Wisconsin.
Feb 7 WHO notice

WHO confirms H5N1 in death of pregnant Vietnamese woman
The WHO, citing Vietnam's Ministry of Health, today confirmed H5N1 avian flu in the death of a 26-year-old pregnant woman from Soc Trang province. She developed symptoms Jan 23, was hospitalized Jan 25, given oseltamivir (Tamiflu) Jan 27, and died the next day, the WHO said. Her newborn tested negative for the virus. The woman's case was first reported in the media last week. She had slaughtered and eaten sick chickens, according to the WHO report. Hers is Vietnam's 121st WHO-confirmed H5N1 case since 2003, of which 61 were fatal. Both cases in the country this year have been fatal. The official global H5N1 count now stands at 584, including 345 deaths.
Feb 8 WHO report
Feb 8 WHO global H5N1 case count

Cochrane review won't change CDC advice on flu antivirals
The US Centers for Disease Control and Prevention (CDC) said yesterday it won't change its guidance on the use of antiviral drugs for influenza in the wake of a recent report by the Cochrane Collaboration that raised questions about the effectiveness of oseltamivir. After analyzing unpublished and published clinical trial data, the Cochrane authors concluded that the drug shortens flu symptoms by about a day, but they couldn't determine if it reduces flu complications. In a statement yesterday, the CDC said, "After careful consideration of all available evidence, CDC guidance on the use of antiviral medications remains unchanged," meaning the agency will continue recommending the use of oral oseltamivir and inhaled zanamivir (Relenza) to help prevent and treat flu. The Cochrane review focused on randomized controlled trials. The CDC said such a review may not fully resolve whether antiviral treatment reduces severe flu complications in generally healthy persons, "because enormous numbers of participants are needed." Also, noting that the Cochrane study excluded uncontrolled observational studies, the CDC said such studies have value and have consistently shown that early treatment with oseltamivir reduces the risk of hospitalizations and severe outcomes in flu patients.
Feb 7 CDC "Have you heard?" item
Jan 19 CIDRAP News story about Cochrane review

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