New estimate puts current flu vaccine's effectiveness a bit lower
The latest estimate of the overall effectiveness of this year's seasonal influenza vaccine puts it at just 19% (95% confidence interval [CI], 7%-29%), slightly lower than the 23% reported in mid-January, the Centers for Disease Control and Prevention (CDC) reported yesterday.
The CDC said the updated estimate of vaccine effectiveness (VE) against H3N2 viruses, the heavily dominant subtype this winter, is 18% (95% CI, 6%-29%). This is similar to the earlier estimate (22%) and confirms reduced protection against H3N2 viruses this season, the agency added.
About two thirds of circulating H3N2 viruses have not been well matched to the H3N2 in the vaccine this winter. The CDC said the estimated VE is about a third of what is expected when the vaccine is well matched to the dominant circulating viruses, though a number of other factors also influence VE.
The estimate of VE against influenza B this winter is 45% (95% CI, 14%-65%), which is similar to the VE seen when vaccine and circulating viruses are well matched, the CDC said. The earlier VE estimate did not include a separate estimate for type B because of low numbers of cases.
In practical terms, the overall VE of 19% means "the flu vaccine reduced a person’s risk of having to seek medical care at a doctor's office for flu illness by 19%," the CDC observed.
Mar 2 CDC statement on flu VE
Jan 15 CIDRAP News story on earlier CDC estimate
Fever as proxy for flu in HCWs ill-advised, study suggests
The common practice of excluding healthcare workers (HCWs) with respiratory symptoms from patient contact only if they are febrile may not be appropriate, say results of a study from the University of Chicago that found only about half of flu-positive HCWs to be febrile.
The study, published yesterday in Clinical Infectious Diseases, was carried out after influenza in a hospitalized patient was linked with an HCW who had respiratory symptoms but no fever.
Mandatory polymerase chain reaction testing of flocked nasopharyngeal swabs for influenza and other respiratory pathogens was carried out from Jan 3 through Feb 28, 2014, on 449 HCWs with respiratory symptoms (cough, sore throat, runny nose, congestion). Temperature was also measured and vaccination status reported for each.
Positive results for any respiratory pathogen were found in 243 (54%) of the HWCs, including influenza in 34 (7.6%); 7 additional HCWs were diagnosed with influenza outside of the employee-screening program, for a total of 41 with flu. Of these, only 21 (51.2%) had a history of fever or were febrile during evaluation.
Among the flu-positive HCWs, 20 had received flu vaccine, 18 had declined vaccine, and 3 had an unknown vaccine status. Although there was a trend toward fever being more common among the flu-positive HCWs who had not had flu vaccination compared with those who had, the difference was not significant (11/18 [61%] vs 9/20 [45%], P = 0.32).
The authors express the hope that their findings "can inform infection control practices and sick leave policies during the influenza season."
Mar 3 Clin Infect Dis study abstract
Two Chinese provinces report new H7N9 cases
Two of China's provinces—Anhui and Guangdong—reported new H7N9 avian influenza infections today, according to official reports translated and posted by FluTrackers, and infectious disease news message board.
Anhui province's patient is a 50-year-old man from Chaohu who had contact with live poultry before he got sick. His H7N9 infection was confirmed yesterday, and he is being treated in the hospital.
Guangdong province's latest case-patient is a 36-year-old woman from Chaozhou whose illness was confirmed yesterday. She is hospitalized in critical condition.
FluTrackers said two Mar 1 H7N9 cases from Zhejiang province reported yesterday by Macau's health department, both involving children, have been retracted. Given that development, the new cases reported today keep the global total from H7N9 at 622, according to a case list maintained by FluTrackers.
Mar 3 FluTrackers thread on Anhui case
Mar 3 FluTrackers thread on Guangdong case
FluTrackers H7N9 case list
H5N1 strikes poultry in Nigeria again
A series of H5N1 avian influenza outbreaks in Nigeria was renewed with a recent hit on a layer chicken farm in Ogun state in the far southwestern part of the country, Nigerian authorities have told the World Organization for Animal Health (OIE).
The Mar 2 report said the virus killed 2,148 of 30,046 chickens on a cluster of farms in the Ado-Odo settlement, prompting culling of the rest of the birds to stop the virus's spread. The outbreak started Feb 14.
The source of the virus was unknown. In addition to culling the chickens, authorities have quarantined and disinfected the outbreak site and restricted poultry movements in the area, the report said.
H5N1 resurfaced in Nigeria in late December, after an absence of reported outbreaks for several years, according to OIE reports.
Mar 2 OIE report from Nigeria