Avian Flu Scan for Feb 12, 2015

News brief

China reports three H7N9 infections, one fatal

Three more H7N9 infections from China, one of them fatal, were reported yesterday and today, one in Shanghai and two in Guangdong province, according to official sources.

The patient from Shanghai is a 53-year-old man who is hospitalized in critical condition, according to a city health commission statement yesterday that was translated and posted by FluTrackers, an infectious disease news message board. The case is Shanghai's fourth to be reported in the third wave of infections, which began in September.

Meanwhile, the two patients from Guangdong province include a 61-year-old man from Guangzhou who died from his illness and a 60-year-old man from Shantou who is hospitalized in critical condition, according to a provincial health department notice today that was translated by FluTrackers.

Hong Kong's Centre for Health Protection (CHP) today also reported the three new H7N9 cases and the death.

The trio of new cases lifts the global H7N9 case tally to 588, according to a running list maintained by FluTrackers.
Feb 11 FluTrackers thread on Shanghai case
Feb 12 FluTrackers thread on Guangdong province cases
Feb 12 CHP statement
FluTrackers H7N9 case list

Egypt reports 2 more H5N1 cases

Egyptian officials reported two H5N1 avian flu infections in recent days in Asyut governorate, continuing the country’s spate of cases in recent weeks, according to two Egyptian media reports translated by FluTrackers.

On Feb 10 the country's Ministry of Health reported H5N1 in a two-and-a-half–year-old child who is hospitalized. Today provincial authorities said that a 42-year-old woman with pneumonia and breathing difficulties tested positive for the disease, according to the second FluTrackers post. No other details were provided.

Asyut is in central Egypt along the Nile River. The country has reported 40 H5N1 cases already this year, 15 of which have proved fatal, according to a case list maintained by FluTrackers.
Feb 10 FluTrackers post
Feb 12 FluTrackers post
FluTrackers case listing

News Scan for Feb 12, 2015

News brief

Proposal: Pay docs for counseling parents on childhood vaccines

Amid a widespread measles outbreak, the National Vaccine Advisory Committee (NVAC) is considering recommending that physicians be compensated for counseling parents about the importance of childhood vaccines, Bloomberg News reported yesterday.

The committee is also looking at a recommendation that would set a minimum vaccination coverage goal for clinicians, the story said.

It said the proposals were presented at an NVAC meeting yesterday by the co-chairs of a vaccine acceptance working group, Vish Viswanath, PhD, of the Harvard School of Public Health and Charles Mouton, MD, MS, of Meharry Medical College.

The panel will meet again in June to vote on its recommendations to the National Vaccine Program Office of the Department of Health and Human Services.

The report said the US government has vowed to reduce the number of measles infections acquired within the country to 30 or fewer within 5 years, compared with more than 600 last year.
Feb 11 Bloomberg News story

In related news, California added three more measles cases late yesterday to its count for an ongoing outbreak related to exposures at Disneyland, raising the total to 110 cases. That includes 39 people who visited Disneyland between Dec 17 and 20, and 37 with unknown sources of exposure.

Most of the patients were unvaccinated, the California Department of Public Health (CDPH) said in the update. Of 84 patients with available information, 17 (20%) were hospitalized.

Elsewhere, a measles outbreak in the Chicago area has increased to 11 cases with the addition of another case involving an infant who attends a day care center in the suburb of Palatine, according to an Associated Press (AP) report last night. Eight other infants and one adult also have measles linked to the center.
Feb 11 CDPH measles update
Feb 11 AP story

Study: More focus on marginalized may cut TB outbreaks in US

Initial source case-patients in tuberculosis (TB) outbreaks in the United States most commonly have a long infectious period and are part of marginalized populations, according to a study yesterday in Emerging Infectious Diseases.

The results underscore the importance of prompt diagnosis and improved contact investigations, particularly in these populations, in reducing the risk of outbreaks, the authors said.

Researchers from the Centers for Disease Prevention and Control (CDC) studied 26 TB outbreaks among the 65 that the CDC helped investigate in the United States from 2002 through 2011 that met selection criteria that included three or more culture-confirmed cases with epidemiologic links and matching Mycobacterium tuberculosis genotypes as well as an identifiable source case-patient.

Source patients were the first case-patients to come to the attention of public health authorities in 20 of the 26 selected outbreaks. The source patients had a median infectious period, defined as 3 months before symptom onset to start of treatment, of 10 months (range, 3 to 36 months). The predominant reason for the prolonged infectious periods was delayed diagnosis after seeking care in 15 (58%), with less common reasons being a delay in seeking care after symptom onset in 8 (31%) and noncompliance with treatment in 7 (27%).

Most source patients were male (23, or 88%) and US-born (19, or 79%), and black non-Hispanics outnumbered other racial/ethnic groups at 13 (50%). Excess alcohol use was present in 16 (62%) of source patients, as were illicit drug use in 14 (54%), homelessness in the previous year in 11 (42%), and a history of incarceration in 13 (50%).

The authors conclude that "Public health departments should work with local health care providers to address barriers to accessing care faced by marginalized populations and in recognizing and diagnosing TB once symptomatic patients seek medical attention."
Feb 11 Emerg Infect Dis dispatch