Flu Scan for Jun 03, 2016

News brief

Flu episode may yield years of future protection against same virus subtype

A study from Spain suggests that people who are infected by the influenza A viruses H3N2 or H1N1 may have better than 60% protection against new infections by the same subtype for several years afterward, according to a report in yesterday's issue of Eurosurveillance.

The researchers aimed to learn the extent to which (1) flu episodes within the past 5 years and (2) current trivalent influenza vaccine (TIV) prevented lab-confirmed flu cases in Navarre, Spain, in the 2013-14 flu season.

They enrolled 1,170 patients with medically attended flu-like illness (MA-ILI), including 645 in hospitals and 525 in primary care clinics. Of those, 589 tested positive for flu, all of them for type A viruses, and 581 served as negative controls.

The team defined MA-ILI due to a specific virus subtype in the previous five seasons as a laboratory-confirmed flu infection with the same subtype or MA-ILI during weeks when more than 25% of samples were positive for this subtype. It was possible to use the second criterion, they said, because one subtype was clearly dominant in Navarre in each of the five preceding seasons.

The researchers found that patients previously infected with the 2009 H1N1 virus had 63% protection (95% confidence interval [CI], 16%-84%) against infection with H1N1 in the 2013-14 season, and those who had a previous H3N2 infection had 65% protection (95% CI, 13%-86%) against another H3N2 illness.

Protection provided by the vaccine was considerably lower, the analysis showed. Overall adjusted vaccine effectiveness (VE) was 31% (95% CI, 5%-50%). By subtype, VE was 45% (95% CI, 12%-65%) for H1N1 and 20% (95% CI, −16%-44%) for H3N2.

"Our results suggest low to moderate influenza VE in the 2013/14 season," the authors wrote. "While not entirely satisfactory, this result is important in terms of individual and public health.

"Previous influenza episodes were highly effective against new influenza illness by the same virus subtype, and this effect seemed to persist over various seasons, which may point to possible avenues of obtaining better vaccines against influenza," they added. "In any case, annual influenza vaccination remains the principal preventive option in persons at high risk of developing complications if they contract influenza."
Jun 2 Eurosurveill report

 

US flu activity stays low, but 4 deaths in kids reported

US influenza activity stayed at low levels typical for this time of year, the Centers for Disease Control and Prevention (CDC) said today in its weekly update, though four new flu-related deaths in children were reported.

Just 1.5% of visits to sentinel clinics were prompted by influenza-like illnesses last week, up a bit from 1.3% a week earlier and well below the national baseline of 2.1%, the CDC said. Deaths attributed to pneumonia and flu, as reported by the 122 Cities Mortality Reporting system, also inched up a bit to 6.3% last week from 6.0% the previous week. The epidemic threshold for the week is 6.5%.

The 4 flu-related deaths in children compared with 2 the previous week and raised the season total to 74. Two deaths were tied to the 2009 H1N1 virus and occurred in late April and early May. Another one, from March, was attributed to an influenza A virus that was not subtyped. The fourth was caused by type B in late March or early April.

The 74 pediatric deaths compare with 171, 111, and 148 in the previous flu seasons.

The CDC has switched to an abbreviated version of FluView for its weekly report, an indication that the country is between flu seasons.
Jun 3 CDC FluView update

 

Avian flu outbreaks reported in Mexico, Niger

In separate reports to the World Organization for Animal Health (OIE) on Jun 1 and 2, government officials confirmed an outbreak of highly pathogenic avian influenza (HPAI) H7N3 in Mexico and an outbreak of HPAI H5N1 in Niger.

In Mexico, H7N3 was detected on May 11 on a farm containing 151,000 commercial layers in the town of Sayula, Jalisco. Cases were identified in 15 birds as a result of active surveillance, agriculture officials said, noting that the birds showed no clinical signs of illness. Depopulation of the affected farm is currently under way.

In Niger, an outbreak of H5N1 began Feb 21 on a farm of layers in the country's capital city of Niamey, located in the southwestern Tillaberi region. All 86,000 chickens on the farm were sickened and died, officials said. Potential sources of infection reported to the OIE include "introduction of new live animals" and "fomites (humans, vehicles, feed, etc.)."
Jun 1 OIE report on H7N3 outbreak
Jun 2 OIE
report on H5N1 outbreak

News Scan for Jun 03, 2016

News brief

Saudi Arabia reports first new MERS case since May 15

After 18 days with no new cases, Saudi Arabia's Ministry of Health (MOH) today reported a MERS infection in an elderly woman.

The MERS-CoV (Middle East respiratory syndrome coronavirus) case involves an 85-year-old Saudi woman from Riyadh who is in stable condition, the MOH said. She is not a healthcare worker, and the source of her infection is listed as "primary," meaning she did not contract the disease from another person. Her history of exposure to camels is unknown, the MOH said.

The woman's illness lifts Saudi Arabia's MERS total since 2012 to 1,384 cases, 592 of them fatal. Two people are still receiving treatment for their illnesses, the MOH said.
Jun 3 MOH update

 

Report notes more breaches at high-containment CDC labs

Failures of a chemical decontamination shower, exit door gasket seal, and a door into the high-containment lab to remain closed were the latest examples of mishaps at a biosafety-level 4 (BSL-4) lab at the US Centers for Disease Control and Prevention (CDC), USA Today said yesterday in its latest in a series of exposes on US biolab safety.

The incident happened in 2009 but details were just released, more than 3 years after the newspaper filed a Freedom of Information Act request. The records also show that some within the agency at the time tried to avoid reporting the incident to lab regulators in another CDC division, though it was eventually reported.

"Overall, the incident shows that failures—even cascading, compounding, catastrophic failures of BSL-4 biocontainment labs—occur," said Richard Ebright, PhD, a Rutgers University biosafety expert who has testified before Congress about CDC lab safety issues. "And the attempted cover-up within the CDC makes it clear that the CDC cannot be relied upon to police its own, much less other institutions."

CDC officials countered that there was no risk posed by the equipment failures, which were traced to a software problem. Other issues noted in the story included a 2011 incident in which a worker in an enhanced BSL-3 lab was unable to shower before leaving the lab, and a 2008 instance in which an unvaccinated repair worker might have been exposed to an unidentified pathogen when an autoclave door malfunctioned.
Jun 2 USA Today story

 

FDA grants emergency use authorization for Ebola Zaire blood test

The US Food and Drug Administration has granted an emergency use authorization (EUA) for a blood test designed for rapid preliminary detection of the Ebola Zaire virus, the strain that caused West Africa's epidemic, the pharmaceutical company Johnson & Johnson announced this week.

The Idylla Ebola Virus Triage Test is a real-time reverse transcription polymerase chain reaction (rRT–PCR) test intended to detect Ebola Zaire virus RNA in venous whole blood from individuals with signs and symptoms of Ebola disease in conjunction with epidemiologic risk factors, Johnson & Johnson said in a Jun 1 press release.

The company said the test yields results within 100 minutes. The blood sample is placed into a sealed cartridge and requires no further manipulation, and the test does not require cold chain reagent storage. "It is highly standardized, automated, and requires minimal training to interpret the results."

The test was jointly developed by Janssen Diagnostics, a division of Janssen Pharmaceutica, Biocartis NV (Biocartis), and the Belgium Institute of Tropical Medicine, the release said.

The company said the test is intended for the "presumptive identification of Ebola virus RNA. The definitive identification of Ebola virus RNA requires additional testing and confirmation procedures in consultation with public health or other authorities for whom reporting is required." It added that negative results do not preclude the virus's presence and should not be used as the sole basis for medical decisions.
Jun 1 Johnson & Johnson press release

 

Rutgers urges meningitis B vaccination for all students and high-risk staff

After two students on the Rutgers University–New Brunswick campus were infected with meningitis B this past spring, campus officials on Jun 1 recommended that all students and at-risk members of the university's community receive serogroup B meningococcal (MenB) vaccine before the start of the fall semester.

The two students who were hospitalized with meningitis B during the spring 2016 semester have since recovered. The infections were genetically similar, yet the students had no history of close or prolonged contact. "This suggests that the strain is present among the Rutgers University–New Brunswick student population," university health officials concluded.

All Rutgers–New Brunswick students are urged to get two doses of the MenB vaccine Trumenba before the start of the academic year, followed by a third dose 6 months later, health officials said. The meningitis vaccination currently required for all students living in on-campus housing does not protect against meningitis B.

Additionally, health officials recommended vaccination for members of the university community with conditions that increase their risk for meningitis B infection, including functional and anatomic asplenia and persistent complement component deficiencies. Vaccination is also urged for people receiving Soliris drug therapy for atypical hemolytic uremic syndrome or paroxysmal nocturnal hemoglobinuria, along with university microbiologists who work with Neisseria meningitidis.

All undergraduate students will be required to submit proof or declination of MenB vaccination before the school year begins, officials said. Students and at-risk people affiliated with the New Brunswick campus should confirm availability of the vaccine through their healthcare provider or pharmacy.
Jun 1 Rutgers Health Services update

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