Flu Scan for Jan 30, 2015

News brief

Flu maintains strong grip on US

Influenza seems reluctant to release its grip on the United States, as most measures of flu activity showed little change last week, according to today's update from the Centers for Disease Control and Prevention (CDC).

The agency said 4.4% of outpatient visits to healthcare providers last week were related to flu-like illness (ILI), compared with 4.5% the week before. The number of states with geographically widespread flu activity stayed the same at 44. However, 29 states reported high ILI activity, up from 23 states a week earlier.

There was little change in the proportion of respiratory samples that tested positive for flu: 19.9% of 23,339 specimens, versus 19.5% of 26,205 the previous week.

The share of deaths attributed to flu and pneumonia was 9.1% last week, which was down slightly from 9.2% a week earlier but well above the epidemic threshold of 7.1%.

Flu-related deaths in children dropped to 5 last week, from 11 the week before. Four of the deaths were linked to influenza A/H3N2 infections, the overwhelmingly dominant strain this season, the CDC said. The other death involved a type A virus that was not subtyped.

The cumulative estimate of hospitalizations reached 40.5 per 100,000 population, up from 36.3 the week before. The CDC noted that this number is ahead of the 27.4 per 100,000 in the same week of 2013, during the last H3N2-dominated season.

The CDC also revealed that a novel flu infection was reported in Minnesota. The state reported an infection with an H1N1 variant (H1N1v) virus in a person who had been exposed to pigs before the illness. The patient has recovered, and no further transmission has been observed, the agency said.
Jan 30
FluView report
Jan 30
FluView summary

In other developments, the European Centre for Disease Prevention and Control (ECDC) said in a risk assessment this week that most European countries are likely to see medium or high levels of flu circulation the rest of this season.

Children up to the age of 4 have been the hardest-hit group so far, the agency said. "We face an influenza season that could be more severe and exert bigger pressure on health care systems than in the last few years," ECDC Director Marc Sprenger, MD, PhD, said in a press release.

As in the United States, H3N2 viruses are dominant in almost all countries, and most of them differ from the H3N2 strain in the vaccine, the ECDC said. The mismatch has been blamed for low flu vaccine effectiveness in the United States and Canada so far this season.
Jan 28 ECDC risk assessment
Jan 28 ECDC press release

 

Infection confirmed in husband of Canada's first H7N9 patient

Canadian officials confirmed that the husband of a British Columbia woman infected with H7N9 avian flu tested positive for the virus, making him the country's second H7N9 case-patient, according to a Canadian Press story yesterday.

The man and his wife returned to Canada from China on Jan 12, and both became ill several days after their return. Although the man did not seek treatment for his illness, he was tested after his wife was diagnosed with H7N9 avian flu. The National Microbiology Laboratory in Winnipeg, Man., confirmed last night that the man had been infected with H7N9.

Both people have recovered without complications, and Canadian health officials do not expect any of their contacts to become ill.
Jan 29 Canadian Press
story
Jan 27 CIDRAP News scan on potential second case
Jan 26
CIDRAP News story on woman's case

News Scan for Jan 30, 2015

News brief

MERS-CoV case count in Saudi Arabia increases by 2

Two men have been stricken with MERS-CoV in Saudi Arabia, bringing the total case count since June 2012 to 845, according to an update today from the country's ministry of health (MOH).

One case-patient is a 37-year-old expatriate in Riyadh who is in critical condition. He is not a healthcare worker, nor has he had any known animal exposure or contact with MERS-CoV (Middle East respiratory syndrome coronavirus) patients in either the community or healthcare setting. He does have preexisting disease, however.

A 76-year-old Saudi from the city of Hafoof is the other new case-patient. He has preexisting disease as well and also has a history of animal exposure. He has had no known exposure to MERS-CoV patients in the community or healthcare settings, and he is in stable condition.

No new recoveries or deaths are reported in today's update, leaving those numbers at 475 and 364, respectively.
Jan 30 MOH update

Meanwhile, a MERS-CoV situation report today in the Center for Disease Control and Prevention's (CDC's) Morbidity Mortality Weekly Report (MMWR) puts the total number of lab-confirmed cases globally as of Jan 23 at 956, with at least 351 deaths. (The CDC numbers as well as World Health Organization [WHO] numbers lag behind those in Saudi daily reports.)

The report says 504 of those cases occurred between March and May of 2014, most of them in Saudi Arabia. It notes that another rash of cases has occurred recently, with the WHO confirming 102 cases, 97 of them in Saudi Arabia, from Aug 1, 2014, through Jan 23 of this year.

The CDC warns travelers to countries in or near the Arabian Peninsula to wash hands often, avoid contact with ill persons, and seek medical care if they have a fever or respiratory symptoms after returning home.
Jan 30 MMWR report

 

European report notes link between antibiotic use, resistance

Use of certain antimicrobial drugs in both animals and humans in Europe is associated with resistance to those drugs in bacteria from both populations, and in some cases antimicrobial use in food animals is associated with resistance in people, according to the first integrated analysis of drug-resistance data from people, animals, and food, published today by European authorities.

The report stems from investigations by the European Centre for Disease Prevention and Control (ECDC), the European Food Safety Authority (EFSA) and the European Medicines Agency (EMA). Investigators analyzed data from all of 2012.

The team found that, pound-for-pound, antimicrobial use is higher in European food animals than in people. The report states, "Overall, a positive association was observed between antimicrobial consumption in food-producing animals and occurrence of resistance in bacteria from such animals for most of the [drug] combinations investigated." The strongest such associations were for Escherichia coli, while associations were also noted for Salmonella and Campylobacter.

The researchers also noted an association between people's consumption of third- and fourth-generation cephalosporins and resistance to third-generation cephalosporins in E coli from humans. And human use of fluoroquinolones likewise increased fluoroquinolone resistance in E coli in people.

For both cephalosporins and fluoroquinolones, the team found positive associations between resistance in E coli in food-producing animals and resistant in E coli in people.

The authors conclude, "These results should be interpreted with caution owing to current data limitations and the complexity of [antimicrobial resistance], which is influenced by several factors besides antimicrobial consumption. They recommend steps to address current data limitations for this type of study and stress the responsible use of antimicrobials in both humans and animals.
Jan 30 news release on the ECDC/EFSA/EMA report
Full report

 

Norway reports first BSE case

Norwegian veterinary officials detected the country's first case of bovine spongiform encephalitis (BSE, or "mad cow disease") in a 15-year-old cow that was slaughtered because of old age and injuries, according to a Norwegian Food Safety Authority report issued yesterday to the World Organization for Animal Health (OIE).

Tests conducted as part of Norway's BSE surveillance program found that the animal was positive for the atypical BSE type H of the prion disease. The cow was born in Norway and did not show signs of neurologic illness prior to slaughter.

The cow lived in a herd of 27 Scottish Highland cattle on a beef cattle farm. The carcass was destroyed after it tested positive for BSE, and no part of it entered the food system.

Norwegian health officials also plan to cull four animals deemed at risk, two of which are offspring of the affected cow and two of which are members of its birth cohort.
Jan 29 OIE
report

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