Flu Scan for Oct 27, 2016

Flu VE in older people
H5N8 in Hungary
H7N9 persistence in China

Swedish study finds good flu vaccine protection in older people

A "real-world" analysis of flu vaccine effectiveness (VE) today in Eurosurveillance that included 2 million Stockholm County, Sweden, residents each season found low flu VE in general but surprisingly robust results in two of the four seasons in adults 65 years and older who had chronic conditions.

The seasonal flu immunization program in Stockholm offers vaccination for free to people aged 65 and older, pregnant women, and anyone else with certain underlying risk factors like chronic disease. A total of 2 million to 2.2 million people were included per season from 2011-12 to 2014-15 so as to gauge VE in all people in the county who were hospitalized for influenza and pneumonia or had primary care flu cases. Flu was defined as a clinical diagnosis.

The number of patients diagnosed as having flu was highest in 2011-12 and in 2014-15, seasons dominated by the H3N2 strain, but hospitalization rates were about three times higher in 2014-15 than in 2011-12.

Protection against flu in all people studied was 19% in 2011-12, 40% in 2012-13, 37% in 2013-14, and 15% in 2014-15. For all people 65 and older it was 10%, 49%, 46%, and 18% for those seasons, respectively.

When the authors looked at only people who had chronic disease, they found that flu VE was 10%, 50%, 48%, and 15% for the four seasons, respectively, among all age-groups. For those 65 and older who had chronic conditions, the rates were 17%, 53%, 55%, and 18%. The flu VE rates below 18% were not significant.
Oct 27 Eurosurveill study


H5N8 found in Hungarian swan

A dead swan in Hungary has tested positive for H5N8, an avian flu that recently made headlines for shutting down an Indian zoo, according to the infectious disease blog Avian Flu Diary.

Hungary's Department of Animal Health and Animal Welfare reported yesterday that a dead swan in Csongrad County tested positive for the highly pathogenic avian flu strain, which has destroyed thousands of poultry worldwide in the last 2 years.

Waterfowl and migratory birds are at the greatest risk for H5N8, especially during the current fall migration season. Hungarian officials warned that European countries need to be on high alert for H5N8 in the coming weeks.
Oct 27 Avian Flu Diary post


Study: Poultry market intervention fails to deter H7N9 avian flu

A study today in Emerging Infectious Diseases shows that live-poultry market intervention failed to halt an H7N9 avian flu epidemic in Guangdong province, China.

Since March of 2013, H7N9 has caused four waves of human infections in China involving more than 800 cases and at least 320 deaths. One of the major risk factors for contracting the virus is exposure to live poultry or poultry environments. To stop disease spread, several markets were closed in epicenter cities during the outbreaks, and advanced surveillance measures were put into place.

In this retrospective study, researchers used epidemiologic and genomic data to analyze the second and third waves of human infection, to understand if heightened surveillance and poultry market control led to a disruption of the virus. They found no evidence it did, and instead concluded that "…the H7N9 circulating during the second wave probably persisted in targeted cities and/or their neighboring areas until the third epidemic wave."

Viral persistence, and not novel introduction of poultry strains, likely caused the continued epidemic in China, the authors said.
Oct 27 Emerg Infect Dis study

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