Flu Scan for Jan 27, 2017

More H7N9 in China
Nasal-spray vaccine and severe flu

H7N9 avian flu sickens 2 more in China

On the eve of Lunar New Year in China, ringing in the year of the rooster, two of the country's provinces reported new H7N9 avian flu cases, Hunan and Guizhou, according to provincial health department statements translated and posted by FluTrackers, an infectious disease news message board.

The patient from Hunan is a 67-year-old man who had contact with poultry and is hospitalized in critical condition. Guizhou province didn't list the patient's age or gender but said he or she is hospitalized.

China is in the midst of its fifth wave of H7N9 since the virus emerged in humans in early 2013. Officials reported a large, early spike in activity in December, with the illness level in January so far trending even higher. Except for two small clusters this year, most cases involve contact with poultry and their environments, especially at live markets, and Chinese researchers said recently that the rise in human cases is likely to reflect a rising disease levels in birds.
Jan 27 FluTrackers thread on Hunan case
Jan 27 FluTrackers thread on Guizhou case


Study in UK kids shows modest LAIV protection against severe flu

The nasal-spray flu vaccine showed moderate protection against flu severe enough to require hospitalization in young English children during the 2015-16 flu seasons, in line with earlier estimates for flu in kids who had mild disease in Europe, researchers reported yesterday in Eurosurveillance.

The United Kingdom is in its fourth year of rolling out a universal flu vaccination recommendation for children ages 2 through 16, offering healthy kids a single dose of live-attenuated influenza vaccine (LAIV). The children received quadrivalent LAIV during the 2015-16 season.

Researchers have published reports showing protection in primary care settings over the last three seasons, but the new study is the first to measure protection against more severe disease. Last summer US vaccine advisors recommended against using LAIV this season because of problems with vaccine effectiveness over the past three seasons, a pattern not seen in Europe. Scientists from Medimmune, the maker of FluMist, are still investigating the reasons for the lack of effectiveness, but in November they said reduced fitness of the H1N1 vaccine viruses are a likely culprit.

For the UK study, researchers looked at 176 children ages 2 to 6 whose lab-confirmed flu infections were reported to the UK Severe Influenza Surveillance System. Vaccine effectiveness (VE) for all flu types was 54.5% (95% confidence interval [CI], 31.5%-68.4%). Against H1N1, the dominant strain that season, VE was 48.3% (95% CI, 16.9%-68.4%), and against influenza B VE was 70.6% (95% CI, 33.2%-87.1%).

For comparison, VE for the same season for UK children with mild disease was 57.6%. The investigators said the findings support the continued rollout of the flu vaccination program for children and that ongoing monitoring is needed, especially given US patterns.
Jan 26 Eurosurveill report

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