NEWS SCAN: H5N1 in Cambodia, designer flu proteins as antivirals, US West Nile cases, HFMD in Vietnam

May 29, 2012

Cambodia reports H5N1 death
Cambodia's health ministry has announced that a 10-year-old girl died from H5N1 avian influenza, the World Health Organization (WHO) said today in a statement. The girl, from Kampong Speu province in central Cambodia, got sick May 20 and was treated in her village before admission to a hospital on May 25. The Pasteur Institute in Cambodia confirmed the presence of H5N1 on May 26, and the girl died on May 27, despite intensive treatment, according to the WHO. An investigation into the source of her infection found that recent poultry deaths were reported in her village and that the girl had prepared sick chicken for food before she became ill. The girl is Cambodia's 21st H5N1 case since 2005 and its 19th death from the disease. So far this year Cambodia has reported three H5N1 infections, all involving children and all fatal. The new case pushes the WHO's global H5N1 count to 604 infections and 357 deaths.
May 29 WHO statement
May 29 WHO global H5N1 case count

Scientists develop flu proteins that may disable multiple flu strains
US researchers have developed a method for designing influenza proteins as antivirals that have proved potent against an array of flu strains, according to a preliminary study in Nature Biotechnology. The team used computer-aided design to engineer proteins that targeted vulnerable hemagglutinin sites on the flu virus, according to a news release from Michigan State University (MSU). The scientists then optimized those proteins by comprehensively mapping the mutations that gave the proteins a strong advantage when attacking the viruses' targeted areas. The team improved their proteins through a process called "DNA deep sequencing" to simultaneously sequence millions of variants of the manufactured proteins and identify and keep the beneficial mutations. "By taking only the best mutations, we can reprogram our proteins to burrow into viruses at key locations and render them harmless," said lead author Tim Whitehead, PhD, of MSU, in the release. "The most potent of these," the authors write, "a 51-residue protein, is broadly cross-reactive against all influenza group 1 hemagglutinins, including human H2, and neutralizes H1N1 viruses with a potency that rivals that of several human monoclonal antibodies." Whitehead added in the news release, "Our work demonstrates a new approach to construct therapeutic proteins, which we hope will spur development of new protein drugs by the biopharmaceutical industry."
May 27 Nature Biotech abstract
May 27 MSU news release

Researchers estimate 3 million US West Nile infections, 780,000 cases
Extrapolating from surveillance data, US researchers estimate that, from 1999 through 2010, more than 3 million Americans were infected by West Nile virus (WNV), which resulted in 780,000 illnesses and more than $800 million in medical costs. Writing in Epidemiology and Infection yesterday, researchers from the Centers for Disease Control and Prevention (CDC), Fargo, N.D., San Francisco, and Madison, Wis., noted that the nationwide ArboNET surveillance system has detected 12,823 cases of West Nile neuroinvasive disease (WNND) since 1999. They point out that a 2012 study in Emerging Infectious Diseases on blood donors in North Dakota suggested that, for every WNND case detected, 213 to 286 infections likely occurred. From these statistics, the investigators estimated that almost 2.8 million WNV infections occurred in the study period in adults. They note that estimates of infection rate vary for children, but, if they assume the rate to be similar to the adult rate, the number of US WNV infections grows to about 3.2 million. Assuming that 26% of infections lead to clinical disease, they estimated about 780,000 cases of WNF, for a total acute-care medical cost of about $832 million.
May 28 Epidemiol Infect abstract
April Emerg Infect Dis report on WNND cases

CDC alerts travelers to Vietnam of HFMD outbreak
In a May 25 update for travelers, the CDC warned of a widespread outbreak of hand, foot, and mouth disease (HFMD) in Vietnam that began in January. The agency said that, as of Apr 29, nearly 40,000 people had become ill from the HFMD virus and that 20 have died, all children younger than 5 years old. Hai Phong province in the north has reported the most cases, followed by Bac Can, Yen Bai, and Lao Cai provinces. "The Vietnam Ministry of Health is taking steps to control the outbreak," the CDC said. The agency encouraged travelers to practice healthy personal hygiene such as washing hands and to avoid contact with HFMD patients, adding that packing alcohol-based hand sanitizer might be a good idea. In a May 15 update, the WHO, using data through May 6, said that Vietnam had 43,196 cases in 2012, including 22 deaths. China has had more than 99,000 cases this year, compared with 34,709 at this time last year, the WHO reported.
May 25 CDC update
May 15 WHO update

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