Flu Scan for May 16, 2017

H9N2 case in China
Immune plasma for severe flu
Southern Hemisphere flu rise

China reports second H9N2 case of the year

Tests have confirmed another H9N2 avian influenza infection, in a 32-year-old Beijing man who had symptoms such as fever, cough, and sore throat but has since recovered, according to a notice from the Beijing Centers for Disease Control (Beijing CDC) translated and posted by FluTrackers, an infectious disease news message board.

The man is an outdoor worker. His illness marks China's second H9N2 case of the year. The first involved an 11-month-old boy from Gansu province who was sick in early February. Most H9N2 illnesses have been seen in children, unlike H7N9, which is primarily detected in adults.

In its report, Beijing CDC also said it has reported 19 H7N9 cases in the city this year, 11 of them local and 8 imported. The city and adjacent areas in northern China have seen a late-season increase in H7N9 cases over the past few weeks.
May 16 FluTrackers post
Apr 26 CIDRAP News scan "H9N2 avian flu infects baby in China"


Phase 2 trial show promise for immune plasma in treating severe flu

Using immune plasma—a blood product that contains antibodies against flu—might be a tool to combat severe cases of influenza, according to the first randomized controlled trial of its kind, published yesterday in The Lancet Respiratory Medicine.

The study, which was funded by the US National Institutes of Health, involved 113 patients (including children and pregnant women) in 29 academic medical centers across the country. The patients, who had severe influenza A or B, were randomly assigned standard therapy plus immune plasma (which contained antibody titers of 1:80 or more of the infecting strain) or standard therapy alone.

The researchers found no significant difference between the groups in achieving the primary end point of the phase 2 trial, which was normalization of breathing, but the treatment was found to be safe and well tolerated. The team also reported significant improvement in clinical status at 7 days in the immune plasma patients and non-significant improvements in other clinical end points, including reduced death rates (2% vs10%).

In an accompanying commentary, US scientists not involved in the study, including two from the Food and Drug Administration, wrote, "Severe zoonotic influenza A virus infections, like the ongoing A(H7N9) outbreak in China, urgently need improved therapies and are events in which survivors as potential plasma donors should be easy to identify."

But they added, "The logistical hurdles to collection of large amounts of convalescent plasma and the scarcity of experience of most blood collection centres with using plasma as an immunotherapeutic raises concerns about the feasibility of obtaining therapeutic plasma for large numbers of patients, particularly in less well-resourced settings."
May 15 Lancet Respir Med study
May 15 Lancet Respir Med commentary


Flu starts to pick up in Southern Hemisphere

Though flu activity in the Southern Hemisphere is still low, levels have reached seasonal thresholds in some countries, as disease activity in the Northern Hemisphere continued to ebb in many regions, such as North America and Europe, the World Health Organization (WHO) said yesterday in an update.

Bolivia has reported a rise in flu over the past few weeks, with H3N2 as the dominant strain. Chile's flulike illness activity continued to increase and has now passed the country's seasonal threshold.

In India, 2009 H1N1 activities continues to be reported, but other parts of South Asia such as Iran and Sri Lanka are reporting low flu activity, with influenza B predominant. Most of Southeast Asia reported low flu activity, except for Singapore, which noted increases over recent weeks.

West Africa's flu activity continued, with a mix of 2009 H1N1 and influenza B.

At the global level, influenza B is the dominant strain, making up 65.3% of positive specimens tested in the last half of April. The subtyped B viruses were nearly evenly split between Yamagata and Victoria lineages. Of the subtyped influenza A viruses from recent sampling, 54.9% were H3N2 and 45.1% were 2009 H1N1.
May 15 WHO global flu update

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