Chinese surveillance reports reveal 17 more H7N9 cases

China has reported 17 more H7N9 avian influenza cases, at least three of them fatal, according to official reports from local, state, and federal government health departments.

In a surveillance report for the month of January, the country's National Health and Family Planning Commission (NHFPC) reported 13 cases with 3 deaths that hadn’t already been reported by city or provincial officials, according to a report in Chinese translated and posted by FluTrackers, an infectious disease news message board. No details were available about the patients, locations, or type of exposure, but most of China's H7N9 cases have been linked to contact with market poultry or their environments.

The four other cases, all involving men age 52 or older, were reported over the past few days from different parts of the mainland: one from Guangdong province, two from Hunan province, and one from Shanghai.

Hong Kong's Centre for Health Protection (CHP) reported the Guangdong case yesterday. It said the patient, a 73-year-old man, had contact with poultry before he got sick on Feb 2, was hospitalized on Feb 5, and is in serious condition.

Also, a report from Hunan province described two more cases announced on Feb 3, involving a 52-year-old man from Yongzhou and a 76-year-old man from Chenzhou, according to FluTrackers. Finally, Shanghai officials on Feb 5 announced an infection in a 66-year-old man, according to a separate report.

The new cases boost the global total to 735, according to FluTrackers’ running case list. Nearly 50 cases have been reported in China's fourth wave of H7N9 infections since the virus first emerged in early 2013.
Feb 7 FluTrackers thread on NHFPC report from January
Feb 7 CHP statement
Feb 7 FluTrackers thread on two recent Hunan province cases
Feb 7 FluTrackers thread on Shanghai case
FluTrackers H7N9 case list


H1N1 and influenza B making marks on Europe's flu season

In a seasonal flu update, the European Centre for Disease Control and Prevention (ECDC) said today that the 2009 H1N1 virus is predominant in many countries and has been linked to severe infections in risk groups as well as in previously health people ages 15 to 64 years, a pattern seen in other years when the strain was common. However, it added that Victoria lineage influenza B—the strain not included in Northern Hemisphere trivalent vaccines—has predominated in four countries, which might impair the performance of the seasonal flu vaccine.

The ECDC said an estimate from New Zealand's 2015 flu season suggested that its flu vaccine, which includes the same three strains, provided modest protection, showing an overall effectiveness of 50% against flu requiring hospitalization.

The agency also warned that it's not clear if the emergence of a new 2009 H1N1 subgroup will undercut vaccine effectiveness. It said an increasing proportion of H1N1 viruses fall into a subcluster within the 6B subgroup, which is antigenically similar to the vaccine virus despite S162N and I216T amino acid substitutions in the hemagglutinin gene.

World Health Organization (WHO) vaccine advisors will meet Feb 22 through 25 to discuss recommendations for the Northern Hemisphere's 2016-17 flu vaccine.
Feb 8 ECDC flu season risk assessment update


USDA expands regulations for compensating avian flu damages

The US Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS) on Feb 5 outlined an interim rule that clarifies qualifications for indemnity payments to poultry producers affected by highly pathogenic avian influenza (HPAI).

The most significant changes to indemnity qualifications include (1) providing a mechanism and formula for owners of poultry and egg facilities to divide financial compensation for losses with contractors; (2) clarifying that losses due to HPAI-related egg destruction will be eligible for indemnity; and (3) requiring facility owners and contractors to prove that they had a biosecurity plan in place when HPAI was detected in their flocks.

Part of the interim rule's intent is to strengthen biosecurity compliance across the 18,900 US facilities required to have a plan in place. Small egg-laying, poultry, and game farms are exempt from the biosecurity plan requirement.

APHIS noted that the outbreak of HPAI in US facilities in early 2015 caused major financial losses for poultry and egg producers. The interim rule will be posted to the Federal Register this week, and APHIS is requesting comments and ideas for using indemnity regulations to build stronger accountability and biosecurity surveillance across the agricultural sector.
 Feb 5 APHIS press release

News Scan for Feb 08, 2016

News brief

Mayo researchers find new Lyme disease-causing species

A team of researchers from the Mayo Clinic and state and federal health agencies have discovered a new species of Borrelia, the tick-borne bacteria that causes Lyme borreliosis, according to findings published Feb 5 in TheLancet Infectious Diseases.

The bacterium, provisionally named Borrelia mayonii, was identified in six specimens (five blood and one synovial fluid) out of 100,545 routine diagnostic samples obtained at the Mayo Clinic in Rochester, Minn., from 2003 to 2014. All six specimens that tested positive for B mayonii were taken in or after 2012.

Researchers initially observed an unusually high number of bacteria (85,000 spirochetes per milliliter) in one blood sample. Spirochetemia in patients with Lyme disease caused by Borrelia burgdorferi is typically low.

A polymerase chain reaction analysis targeting the oppA1 gene of B burgdorferi confirmed that spirochetes in the six specimens were not identical to other Borrelia species.

All six patients who tested positive for B mayonii were residents of Minnesota, Wisconsin, or North Dakota. Signs and symptoms included diffuse rash (without or in addition to erythema migrans, or the bullseye rash), nausea and vomiting, high fever, and neurologic problems with vision or speech, all of which are atypical effects of B burgdorferi.

B mayonii is likely transmitted by Ixodes scapularis (the deer or black-legged tick) and was found in ticks located near probable patient exposure sites in the Upper Midwest.

Results from the six cases suggest that infections with the new Borrelia species are detectable with available Lyme disease tests approved by the Food and Drug Administration, said the Centers for Disease Control and Prevention (CDC), which was involved in the study. In a press release, the CDC also said the patients described in the study were treated successfully with antibiotics commonly used against Lyme disease.

Lyme borreliosis is the most common tick-borne disease in the Northern Hemisphere, and B burgdorferi was previously the only bacterium responsible for causing Lyme disease in the United States.
Feb 5 Lancet Infect Dis abstract
Feb 8 CDC press release


PAHO adds almost 5,000 cases to 2015, 2016 chikungunya totals

The Pan American Health Organization (PAHO) late last week added almost 5,000 new chikungunya cases to its outbreak totals as it tallied reports from countries both this year and last.

Outbreak totals now include 3,582 new 2016 cases and 1,342 cases from 2015 as countries and territories catch up on reporting, for a combined total of 4,924 newly reported infections. Cases so far this year total 6,421; in 2015 they added up to 697,756. When combined with the 2013-14 total of 1,147,626, the more recent cases bring the overall outbreak total to 1,851,803 chikungunya infections.

Nicaragua accounted for the largest increase of 2016 cases and added all the newly logged 1,342 cases from 2015, according to PAHO's Feb 5 update. It has recorded 1,778 cases this year, all of them new. Its total for 2015 has now reached 75,404 cases, the third hardest-hit nation last year.

Colombia reported 1,292 cases, for a total of 3,178 this year. Guatemala reported its first cases of the year, 243 of them. And Venezuela added 256 cases, for 1,046 total for the year.

In the previous week, which ended Jan 29, the only country that reported new cases was Paraguay, which had 5, PAHO's Teresa Villegas Moreno told CIDRAP News.

No deaths have yet been reported for 2016. Last year saw 71 deaths, and 194 fatalities were reported in 2013 and 2014. The outbreak began in December 2013 on St. Martin in the Caribbean with the first recorded cases of chikungunya in the Americas.
Feb 5 PAHO update
PAHO 2015 chikungunya numbers


Last Ebola patient in Sierra Leone released from hospital

Sierra Leone's last remaining Ebola patient was recently discharged from a hospital, according to reports from BBC/Reuters correspondent Umaru Fofana on his social media accounts.

The 38-year-old woman was confirmed to be infected with Ebola virus on Jan 22. She contracted the virus while caring for her niece, now deceased, and the two women's illnesses ended Sierra Leone's Ebola-free status.

Fofena also said that 10 missing contacts of the 22-year-old deceased woman have been located in Kambia, in Sierra Leone's northern province. Previous reports had mentioned that authorities were struggling to locate 18 high-risk and 32 low-risk contacts.

The 38-year-old patient's recovery and release starts the 42-day countdown to declaring Sierra Leone free of Ebola virus.
Umaru Fofana Facebook account
Jan 20 CIDRAP News story on Sierra Leone case



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