Flu Scan for Feb 17, 2016

Flu antivirals in Europe
H5N1 outbreaks in Nigeria

ECDC expert panel says stay course on flu antiviral drugs

An expert panel convened by the European Centre for Disease Prevention and Control (ECDC) said today it has found no significant new scientific evidence to change current indications for the use of antiviral drugs to treat influenza.

The 11-member expert group, in an ECDC report, said, "This ECDC Expert Opinion confirms earlier assessments by ECDC and national authorities that there is no significant new evidence from [randomized controlled trials] to support any changes to the approved indications and recommended use of neuraminidase inhibitors in EU/EEA Member States."

The experts focused on the neuraminidase inhibitors oseltamivir (Tamiflu) and zanamivir (Relenza), which are currently authorized for treating flu in the European Union. Their literature review included the most recent meta-analyses.

Current ECDC guidelines recommend the drugs for patients with severe influenza and those at high risk for complications, as well as to prevent the flu in vulnerable family members. The report notes that these guidelines mesh with those of the World Health Organization and a number of countries.

The experts note that all three recent meta-analyses point to the importance of initiating treatment early, ideally within 48 hours of symptom onset (and within 36 hours in the case of zanamivir for children). They add, however, that observational studies indicate some benefit in reducing mortality if the drugs are started even 4 to 5days after symptom onset in hospitalized patients.

The panel concluded, "While the reviews considered for this Expert Opinion add to the evidence on the beneficial and adverse impacts of neuraminidase inhibitors, it is clear that further studies are needed to strengthen the evidence base overall, in particular for severe clinical end points and for individual risk groups."

The ECDC welcomes feedback on the document till Mar 16.
Feb 17 ECDC report landing page, with instructions on providing comments
Feb 17 commentary on the report in Influenza and Other Respiratory Viruses

Nigeria reports two more H5N1 avian flu outbreaks

Nigeria responded to two more H5N1 avian influenza outbreaks in the past week, according to a report today from Nigerian officials to the World Organization for Animal Health (OIE), adding to multiple recent H5N1 outbreaks since the virus reappeared in Nigeria last year.

The first outbreak occurred on a farm in the town of Batagarawa in Nigeria's northwestern Katsina state. Of the 5,000 birds on the farm, 60 became ill and died, and 4,940 were culled to prevent further spread of the virus.

The second H5N1 outbreak occurred on a farm in the large city of Jos in Nigeria's Plateau state. Of 6,200 birds on the affected farm, 100 birds sickened and died, and the remaining 6,100 were destroyed.

The OIE report cites "poor farm biosecurity" as a factor in the outbreaks.
Feb 17 OIE report

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