Flu Scan for Jan 02, 2014

News brief

Study suggests preschool kids, non-elderly adults most susceptible to H1N1

A serologic survey from British Columbia suggests that preschool children and working-age adults are the groups most susceptible to the pandemic 2009 H1N1 influenza virus, by far the most common strain in North America so far this flu season.

The survey, conducted in the Vancouver, B.C., area last spring, showed that fewer than 20% of children under 5 years old had H1N1 antibody titers suggesting protection, according to findings presented on ProMED-mail by Danuta Skowronski, MD, of the British Columbia Centre for Disease Control.

Protective antibody levels (titers of 40 or higher) were found in 45% to 50% of adults of ages 20 to 39 years and in 35% to 40% of those ages 40 to 69, Skowronski wrote. Seroprotection was most prevalent—60% or higher—in school-age children and in adults 70 and older.

"Our age-related observations for the spring 2013 suggest pre-school children and young or middle-aged adults are currently the most susceptible" to 2009 H1N1 infection, she wrote.

She noted that more than 80% of flu viruses subtyped in British Columbia this season have been 2009 H1N1, and serious outcomes have been reported in some young and middle-aged adults. This has come amid "a striking absence of other more typical early warning signals of influenza circulation such as school or long-term care facility (LTCF) outbreaks."

The seroprotection findings "may help put current surveillance trends into context," Skowronski wrote. "Given the greater seroprotection identified in school children and the elderly, it could be speculated that A(H1N1)pdm09 is propagating more surreptitiously through adult contact networks without the usual school or LTCF outbreaks as expected surveillance signals and with dampened activity levels overall at the community level."

The overall prevalence of H1N1 antibodies found in the serologic survey approached 50%, which was similar to findings in the spring of 2010, following the 2009 pandemic, but age-specific findings were slightly different, she reported.
Jan 1 ProMED-mail post
Related Dec 20 CIDRAP News story

H9N2 confirmed in Chinese child

Health officials in China yesterday announced an H9N2 avian influenza infection in a 7-year-old boy from Hunan province, marking the second H9N2 case reported in China this week.

Hong Kong's Centre for Health Protection (CHP) said today that the boy, from the city of Yongzhou, had a fever and runny nose on Nov 19 and was treated at a hospital the next day. The CHP said Chinese health officials confirmed the case yesterday and reported that the boy had a history of contact with poultry.

Human infections with H9N2 influenza are sporadically reported and usually cause mild respiratory symptoms. On Dec 30 the CHP reported the virus in an 86-year-old Hong Kong man who currently lives in Shenzhen, across the border from Hong Kong. The man's H9N2 infection was the first reported in the area in 4 years.
Jan 2 CHP statement
Dec 30 CIDRAP News item "Hong Kong reports H9N2 flu case"

News Scan for Jan 02, 2014

News brief

WHO steps up disease prevention in African conflict zones

The World Health Organization (WHO) is taking steps to curb infectious disease threats at refugee camps in two African nations struck by violent political unrest, South Sudan and the Central African Republic (CAR).

In a statement today the WHO said it and its health partners will launch an emergency measles vaccination campaign tomorrow at two camps in the CAR, following the detection of cases at a camp near the Bangui airport (3 cases) and the Don Bosco Centre in Damala (5 cases). The effort will target 60,000 children between the ages of 6 months and 15 years.

Health officials are worried that overcrowding and lack of sanitary facilities could spark rapid spread of the disease. For example, the camp in Damala has 50,000 people who fled violent clashes in the capital that began on Dec 5. The camp near the Bangui airport is even more densely populated, with 100,000 displaced people.

Elsewhere, the WHO in a Dec 31 statement warned about a growing threat of infectious diseases in South Sudan, where more than 195,000 people have been displaced by violence that began Dec 15. About 75,000 have taken shelter at United Nations peacekeeping bases in Juba, Bor, Malakal, and Bentiu. The WHO estimated that 58,000 others are displaced in Aweriel County Lakes state.

Poor water, sanitation, and hygiene conditions, coupled with crowding and a shortage of health workers, pose risks to the people at the camps, especially in the form of waterborne diseases, a WHO official said.

The WHO and partners are identifying health workers who can help at the camps, and it has provided emergency health kits to clinics and other providers in four states. Diarrhea and malaria are the most common illnesses reported at the camps.
Jan 2 WHO news release
Dec 31 WHO news release

Fatal MERS-CoV case reported in Oman

An Omani man died Dec 30 of a Middle East respiratory syndrome coronavirus (MERS-CoV) infection, marking the country's second case, The Times of Oman reported yesterday.

The Ministry of Health said the patient was a 59-year-old and had "lung failure and pneumonia," according to the story. It gave no information on the man's possible exposures to the virus or the course of his illness.

The report said Oman's first MERS case-patient died of the illness on Nov 10. Earlier reports said he was a 68-year-old who had diabetes.

Another Omani, a 75-year-old man, was diagnosed with MERS while visiting in the neighboring United Arab Emirates and died there on Nov 10, the World Health Organization reported on Nov 15.

The MERS count of the WHO, which has not yet noted the new Oman case, stands at 176 cases and 74 deaths.
Jan 1 Times of Oman story
Oct 30 CIDRAP News story on first Oman case
Nov 15 CIDRAP News story noting case in 75-year-old Omani

Bald eagle deaths in Utah blamed on West Nile

Tests have confirmed that the recent deaths of 27 bald eagles in Utah were caused by West Nile virus, possibly acquired from eared grebes, the Utah Division of Wildlife Resources (DWR) announced Dec 31.

Testing has ruled out many other possible causes of death, including toxic chemicals, lead poisoning, bacterial infections, and several other viruses, including avian influenza and avian vacuolar myelinopathy, the agency said in a press release. Tests were conducted at the Utah Veterinary Diagnostic Laboratory in Logan and the National Wildlife Health Center in Madison, Wis.

West Nile typically affects birds and humans when mosquitoes that carry the virus are active. The DWR said officials aren't sure how the eagles contracted the virus, but think they might have eaten infected eared grebes that died recently on Great Salt Lake.

About 2 million eared grebes stop at the lake during their migration each winter, and about 1% of them die, usually of avian cholera, said Lesle McFarlane, DWR wildlife disease coordinator. Lab tests on dead grebes this year were inconclusive, but additional tests suggested that their cause of death is "consistent with what's going on in the eagles," she said.

The DWR said 21 of the 27 eagles were found dead in the wild and the rest died while being treated in rehab centers. West Nile virus can live for a few days in the carcass of a bird, according to the agency.

Dec 31 DWR statement