News Scan for Aug 23, 2019

Polio in 3 nations
H3N2 flu and antiviral susceptibility

Three new polio cases noted as WHO details Myanmar outbreak

Afghanistan has one more wild poliovirus (WPV) case, and Angola and Ghana each have one more vaccine-derived polio case, according to the latest weekly update today from the Global Polio Eradication Initiate (GPEI).

The three new cases come during the same week Nigeria reached the 3-year mark of no WPV transmission.

"Because Nigeria is the last polio-endemic country in Africa, this milestone opens the door for the potential WPV-free certification of the entire WHO [World Health Organization] AFRO region after the Africa Regional Certification Commission (ARCC) evaluation as early as mid-2020," the GPEI said.

In Afghanistan, the new case came from Uruzgan province, and the patient experienced an onset of paralysis on Jul 16. This is the 13th wild poliovirus case recorded in Afghanistan in 2019; in 2018, the country reported 21 cases.

Angola's new case is its sixth case in 2019. The patient experienced an onset of paralysis on Jul 12. Ghana's case was from the  Chereponi district, Northern province, and the isolates are linked to the Jigawa circulating vaccine-derived polio outbreak in Nigeria.

In other polio news, the WHO offered new details on four cases of circulating vaccine-derived polio type 1 (cVDPV1) in Myanmar. The cases represent the country's first outbreak of cVDPV1 since 2007. The patients experienced an onset of symptoms from May 23 to Jul 23, and neighboring countries have been notified of the outbreak.
Aug 23 GPEI report
Aug 22 WHO report


Human-to-human H3N2 flu spread with low susceptibility to baloxavir noted

A study today in Emerging Infectious Diseases describes how a Japanese infant with no baloxavir exposure contracted an H3N2 strain of influenza with reduced susceptibility to baloxavir.

Baloxavir, or Xofluza, is an antiviral approved for use in Japan in children and adults over the age of 12, as well as in younger children who weigh more than 10 kilograms (22 pounds).

The infant was identified in a family cluster of influenza in February 2019. Though the infant was treated with oseltamivir, his or her 10 year-old sibling was treated with baloxavir. Genetic sequencing from samples collected from the siblings showed identical strains of H3N2, indicating human-to-human transmission.

The researchers said that, during the 2018-19 influenza season in Japan, they detected 32 mutant influenza A(H3N2) viruses the conferred reduced susceptibility to baloxavir, 4 of which were isolated from children under the age of 12 without prior baloxavir exposure.

"Baloxavir susceptibility of influenza viruses, especially among infected children <12 years of age, should be closely monitored for public health planning purposes and for making clinical," the authors concluded.
Aug 23 Emerg Infect Dis study

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