FLU NEWS SCAN: Flu guide for fairs, Ohio H3N2 cases, seasonal flu vaccines approved, H5N1 vaccine response

Aug 14, 2012

CDC issues flu prevention guide for fairs
The US Centers for Disease Control and Prevention (CDC) today released a planning guide for fair organizers to help protect visitors and animals from disease threats, especially in light of a variant swine-origin H3N2 influenza virus (H3N2v) that had been detected in pigs and people at fairs in a handful of states this summer. The guide suggests basic precautions such as warning visitors and exhibitors, especially in animal barns, about disease risks and taking steps to minimize human-animal contact. The CDC also listed more specific steps that relate to the facilities and animal areas, such as advising visitors not to eat, drink, or place objects in their mouths while in areas with pigs, providing good ventilation in the buildings, and keeping soiled animal bedding away from nonanimal areas. Animal health recommendations include monitoring animals daily for any signs of illness and isolating and sending home sick animals. To prevent infections in susceptible people, the CDC advised that people younger than 5 years, people age 65 and older, pregnant women, and those with certain underlying medical conditions avoid exposure to pigs at fairs this summer, especially if sick pigs have been identified.
Aug 14 CDC resources for fair organizers

New H3N2v cases reported in Ohio
Ohio has confirmed 18 more cases of H3N2v flu since its last update on Aug 10, bringing the state's total to 54, the Ohio Department of Health (ODH) reported today. The counties citing new cases are Butler (1), Champaign (8), Franklin (2) Gallia (5), Ross (1), and Morrow (1), with Champaign, Franklin, Ross, and Morrow counties reporting their first cases. Case-patients are between 6 months and 36 years old, the ODH said, and five have been hospitalized but are now released. Officials said people do not need to avoid state and county fairs but should use precautions around pigs shown at fairs, such as frequent hand washing.
Aug 14 ODH update

FDA completes approval of flu vaccines for 2012-13 season
The US Food and Drug Administration (FDA) announced yesterday its approval of the influenza vaccine formulations from all six manufacturers that are licensed to market their vaccines in the United States in the 2012-13 flu season. This year two of the three flu strains in the vaccine—A/H3N2 and B—were changed. Some of the vaccines were approved earlier, but the FDA waits to make a general announcement until all the products have been approved, FDA spokeswoman Heidi Rebello told CIDRAP News. For example, MedImmune's FluMist was approved on Feb 29, she said. Some of the manufacturers began shipping their doses in July, as reported previously. Besides FluMist, the vaccines and their manufacturers are Afluria, CSL Limited; Fluarix, GlaxoSmithKline; FluLaval, ID Biomedical Corp.; Fluvirin, Novartis Vaccines and Diagnostics; and Fluzone, Fluzone High-Dose, and Fluzone Intradermal, Sanofi Pasteur. Each manufacturer must file a supplemental application for its flu vaccine each year, and the FDA also tests each lot of vaccine before it can be released, noted Donna Cary, a Sanofi spokeswoman. Manufacturers have said they expect to make up to 149 million doses for the upcoming season.
Aug 13 FDA statement
FDA information on flu vaccine lot releases

H5N1 vaccine trial shows low immune response, regardless of delivery
A subvirion inactivated H5N1 avian flu vaccine produced a weak immune response after two high-antigen doses, regardless of whether volunteers received the vaccine intramuscularly (IM, or standard injection) or intradermally (ID) via the Mantoux technique. US researchers immunized 227 adults 18 to 49 years old with a Sanofi Pasteur H5N1 vaccine that was produced using methods similar to those used to manufacture Fluzone, a seasonal flu vaccine. The volunteers were randomly chosen to receive two doses 28 days apart either IM or ID. Although the vaccine contained 38.7 micrograms (mcg) of antigen (compared with 7.5 mcg for each of the three strains in Fluzone), immune responses were low: Only 25.4% in the IM group and 23.0% in the ID group achieved a fourfold or greater increase in antibody titer (measured by hemagglutination inhibition) 28 days after the first dose, and those percentages climbed to only 35.4% and 42.5%, respectively, after 56 days. Both delivery methods were well tolerated. The authors conclude, "Evaluation of higher dosages, alternative intradermal delivery methods, and the addition of adjuvants will be needed to enhance the immunogenicity of inactivated influenza A/H5N1 vaccines by the intradermal route."
Aug 13 J Infect Dis abstract

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