May 17, 2013
Some Chinese provinces step down H7N9 emergency levels
Health authorities in two Chinese provinces—Jiangsu and Shandong—have stepped down their emergency response activities, since no human H7N9 influenza infections have been reported there in the past 21 days, Xinhua, China's state news agency, reported today. Provincial authorities said they are also ending medical observation of close contacts of the confirmed H7N9 patients. Zhejiang province lowered its emergency yesterday; the city of Shanghai took a similar step on May 10, according to the report. The World Health Organization (WHO) said in an update today that no new cases have been reported since May 8, keeping the H7N9 outbreak total at 131 cases. The WHO also acknowledged four deaths that were reported by provincial officials earlier, which brings the fatality count to 36. The WHO said it expects more human cases to be reported until the source of the virus is identified.
May 17 Xinhua story
May 17 WHO update
H7N7 avian flu outbreak prompts poultry culling in Germany
Detection of a low-pathogenicity H7N7 avian flu virus in Germany has prompted the culling of 13,000 poultry, according to a report that German officials filed with the World Organization for Animal Health (OIE) yesterday. The report said a subclinical infection affected 10 birds in Lower Saxony (Niedersachsen) in northwestern Germany, and the rest of the birds on the farm were destroyed to stop the outbreak. The report didn't specify the kind of poultry involved. The virus was detected in tests by the Friedrich Loeffler Institute. The source of the virus is unknown.
May 16 OIE report
Only 7 rigorous studies identified on non-antiviral interventions during 2009 pandemic
Researchers found only 7 rigorous studies out of more than 2,000 assessed that were conducted during the 2009 H1N1 flu pandemic and addressed non-antiviral clinical interventions, and none of the 7 was a randomized, controlled trial (RCT), according to a meta-analysis in Critical Care Medicine. The team identified 2,452 RCTs, prospective cohort studies, or meta-analyses in English from March 2009 through January 2012. They read 36 of them that were potentially relevant, and found that 7—all observational studies—met the inclusion criteria. One study found benefit of convalescent plasma infusion, three studies found no benefit of corticosteroids, and three studies found mixed results on the benefit of extracorporeal lung support. No study dealt with healthcare delivery with few resources. "Our investigation underscores the need for the development of outbreak-ready research capacity in both high- and low-resource settings," the authors conclude.
May Crit Care Med abstract
US flu activity continues to decline
US flu activity continued its downward pattern last week, the Centers for Disease Control and Prevention (CDC) reported today in its weekly update. Of 2,416 respiratory specimens tested, 124 (5.1%) were positive for influenza, which was up from 4.1% the week before. Other indicator, however, fell. For example, only one state—Hawaii—reported regional flu activity, down from five the week before. And 6.4% of all deaths were attributed to pneumonia and flu, down from 7.0% the week before and below the epidemic threshold of 7.1%. The proportion of outpatient visits for influenza-like illness was 0.9%, the same as the week before but well below the national baseline of 2.2% One new pediatric flu death was confirmed, bringing the seasonal total to 139.
May 17 CDC update