Flu Scan for Oct 18, 2013

News brief

Flu surveillance comparison finds flaws in Google tool

A comparison of traditional surveillance and Google Flu Trends (GFT) over the past decade found that GFT isn't a reliable tool for tracking seasonal and pandemic influenza, having missed the first 2009 H1N1 pandemic wave and overestimated the 2012-13 H3N2 epidemic, according to a study released yesterday.

A research team from New York, the National Institutes of Health, and George Washington University published the findings in PLoS Computational Biology. GFT monitors Internet searches for flu information as a way to estimate flu activity.

The team's comparison of weekly flu-like illness and GFT data spanned 10 flu seasons, from Jun 1, 2003, through Mar 30, 2013. GFT officially launched in November 2008. For the weekly flu surveillance component the group used national and regional data from the US Centers for Disease Control and Prevention (CDC). The local data they used came from New York City's emergency department syndromic surveillance system.

The traditional surveillance and GFT estimates showed similar seasonal and epidemic patterns over the three geographic scales, but the group found notable differences between the retrospective and prospective periods. They found that the original GFT model severely underestimated the first pandemic wave, and the updated GFT model greatly exaggerated the intensity of the 2012-13 season, which suggested substantial flaws in the tool.

The researchers noted that their study isn't the first to flag problems with GFT estimates, but their work is the first to compare the system across a decade of flu activity. They wrote that the shortcomings are serious, given that an initial pandemic wave is a time when accurate data are most needed.

The team concluded that there is a place for search query monitoring in disease surveillance and that it could benefit from integrating near real-term surveillance data and improved computational and modeling methods. Such improvements could make the systems more useful for public health decision-making, they wrote.
Oct 17 PLoS Comput Biol study

CDC flu report shows little activity, one H3N2v infection

The US CDC today resumed its weekly flu surveillance reports, noting little flu activity so far but reporting another variant H3N2 (H3N2v) case, in a patient from Iowa who had contact with pigs.

Weekly flu reports were suspended during the 16-day government shutdown, which ended the night of Oct 16. The CDC originally had planned to issue its first full flu surveillance report of the 2013-14 season today, but the agency said today's report is an abbreviated version. The next report, on Oct 25, will be a full version

So far flu markers are below epidemic thresholds. For example, the CDC said the percentage of doctor's visits for flulike illness was 1.1% last week, putting it below the national baseline of 2.0% and only slightly higher than the 1.0% reported in the CDC's last report before the shutdown. It said all 10 regions are below their baselines.

Puerto Rico is the only area reporting regional spread of flu, while Alabama, South Carolina, and Texas reported local activity. Roughly half of the states, plus the District of Columbia, Guam, and the US Virgin Islands, reported sporadic flu cases.

The additional H3N2v case was reported in a patient who had contact with swine the week before he or she got sick. The patient has recovered, and no further cases were detected during follow-up of close contacts. The CDC said the case will be reported as the first H3N2v case of the 2013-14 season. For the season that just ended, 18 cases were reported.
Oct 18 CDC weekly flu update

News Scan for Oct 18, 2013

News brief

WHO says Qatari MERS patient had contact with camels

The 61-year-old Qatari man who has Middle East respiratory syndrome coronavirus (MERS-CoV) had contact with farm animals, including camels, before his illness, the World Health Organization (WHO) said today in confirming his case.

"The patient owns a farm and has had significant contact with the animals, including camels, sheep and hens," the WHO statement said. "Some of the animals in his farm have been tested and were negative for MERS-CoV. Further investigations into the case and the animals in the farm are ongoing."

The agency didn't specify which animals were tested. Recent studies showed that camels in Egypt, Oman, and the Canary Islands carried antibodies to MERS-CoV or a closely related virus, which stoked the suspicion that camels may have spread the virus to humans.

The WHO said the Qatari patient is hospitalized and in stable condition. The man had not traveled outside Qatar in the 2 weeks before he got sick, the agency said. His case is the sixth reported in Qatar.

With the new case, the WHO raised its MERS-CoV count to 139 cases and 60 deaths. Other groups, such as the FluTrackers online infectious disease message board, show slightly higher counts.
Oct 18 WHO statement

CDC says chicken-related Salmonella outbreak has reached 338 cases

A Salmonella Heidelberg outbreak associated with Foster Farms brand chicken has expanded to 338 cases, the Centers for Disease Control and Prevention said today, marking an increase of 21 cases since the last update on Oct 11.

Three quarters of the cases have occurred in California, but the outbreak now includes cases in 20 states and Puerto Rico, the CDC said. Forty percent of the patients have been hospitalized, but none have died.

The update notes that Costco's El Camino Real store in South San Francisco, Calif., issued a second recall of chicken products yesterday. The recall involves 14,093 "units" of ready-to-eat rotisserie chicken because of potential Salmonella contamination after cooking, the agency said. On Oct 12 the store had recalled 9,000 units, or about 40,000 pounds, of rotisserie chicken because of possible Salmonella Heidelberg contamination.

The Salmonella strains involved in the outbreak are resistant to several commonly prescribed antibiotics, the CDC noted.
Oct 18 CDC update

Sudan to halt hostilities to allow polio vaccination

Following a recent call from the United Nation's Security Council for warring Sudanese groups to pave the way for an urgent polio vaccination campaign, Sudan's government has unilaterally agreed to halt hostilities in South Kordofan for the first 2 weeks of November, the Sudan Tribune reported yesterday.

Ali Al-Zatari, the UN's humanitarian coordinator in Sudan, said he hopes the Sudan People's Liberation Movement–North will also cease activities to allow the campaign to move forward, according to the Tribune. South Kordofan, the only oil-producing state in Sudan, has been the site of civil unrest due to many factors, including South Sudan's transition to independence in 2011.

Besides stopping hostilities, the two groups would need to agree on how the vaccines will be transported and which humanitarian workers will participate in the campaign, the story said.

In view of the recent wild poliovirus 1 (WPV 1) outbreak in the Horn of Africa, the World Health Organization (WHO) considers South Sudan at high risk for reinfection, and immunization campaigns are under way in the area to help protect the region's children.
Oct 17 Sudan Tribune story

Gene-silencing DNA analogs look promising for treating Acinetobacter

Synthetic molecules that can "silence" bacterial genes improved the survival of mice infected with two Acinetobacter species, which often cause nosocomial infections, according to a report published online this week by the Journal of Infectious Diseases.

The trial by scientists at Oregon State University involved PPMOs (peptide-conjugated phosphorodiamidate morpholino oligomers), described as synthetic oligomers that mimic the structure of DNA and RNA but are resistant to enzymes that disrupt nucleic acids.

The report says the team developed PPMOs that target essential genes in A baumannii, the most common cause of nosocomial infections, and A lwoffii, an emerging opportunistic pathogen. Both pathogens often have an "impressive" number of antibiotic- and toxin-resistance genes, the authors say.

The PPMOs were tested in vitro and in mice with lung infections. In vitro, a "clinically relevant" dose of the most promising PPMO reduced the viability of both pathogens by more than 1,000 colony-forming units per milliliter. Mice that were treated intranasally with this same PPMO survived longer and had less bacterial lung burden than mice that were treated with a scrambled-sequence PPMO or saline solution, even when initial treatment was delayed up to 18 hours.

"Given the dramatically increasing rate of multidrug resistance in Acinetobacter throughout the world, urgent new approaches to therapeutics are needed, the authors write. "PPMOs and their gene-specific silencing attributes could be a viable approach to developing novel antibacterials for these emerging pathogens."
Oct 14 JID abstract