Flu Scan for Nov 01, 2013

News brief

CDC sees little movement in US flu indicators

US flu activity increased only slightly last week, though markers stayed well below thresholds, the Centers for Disease Control and Prevention (CDC) said today in its weekly update.

The number of respiratory samples that tested positive for flu edged up slightly, from 3.8% to 4.5%, and the percentage of clinic visits for flu remained at the 1.2% seen the previous week.

Among the few positive samples, 93% were influenza A, and the 2009 H1N1 virus was more common than H3N2 in the few samples that were subtyped. Deaths from flu and pneumonia stayed below the seasonal threshold, and no pediatric fatalities from the disease were reported.

Alabama became the first state this season to report regional geographic spread of flu, and four reported local spread: Mississippi, Nevada, South Carolina, and Texas.

Elsewhere, flu in Canada remained low, while in Mexico respiratory virus and flu activity indicators showed slightly increasing trends, according to an Oct 30 update from the Pan American Health Organization (PAHO).

In Europe, all 27 countries that reported last week had only low-intensity flu activity, according to an update today from the European Centre for Disease Prevention and Control (ECDC). Only 1% of sentinel specimens were positive for flu, and so far the ECDC has detected no sign of sustained activity.
Nov 1 CDC weekly flu update
Oct 30 PAHO flu update
Nov 1 ECDC influenza update

Erasmus appeals Dutch court export ruling on H5N1 studies

Researchers from the Erasmus Medical Center in the Netherlands have appealed a Sep 20 Dutch court ruling that requires Erasmus to request and export permit before submitting research on lab-modified H5N1 avian flu viruses for publication, according to Nature's news blog.

Erasmus's Ron Fouchier, PhD, led a study in 2011 involving mammalian-transmissible H5N1 that sparked bioterror concerns, and the US National Science Advisory Board for Biosecurity at first blocked publication of the findings but then allowed it in March 2012.

Last month's ruling said that all future such work requires an export license, which is what Fouchier's group needed to obtain in 2012 before their work could be published in Science. Such controls are meant to prevent the export of technology or information that could be used in chemical or biological weapons.

The Erasmus group filed its appeal just before a 6-week deadline, the blog post said. An Erasmus spokesman said the center's staff may not discuss the issue with the media while the case is under appeal.
Nov 1 Nature blog post
Sep 26 CIDRAP News story "Dutch court affirms limit on publishing H5N1 findings"

Study: Hospital-onset flu cases more likely to be severe

Patients who are infected with the flu in hospitals are more likely to be admitted to the intensive care unit (ICU) or die from the disease compared with those who catch the flu in community settings, CDC researchers reported today in the American Journal of Infection Control.

The authors identified 172 hospital-onset (HO) cases among 6,171 flu-positive hospitalized patients. They found that chronic medical conditions were more common in HO cases (89%) compared with community-onset (CO) cases (78%) (P < .01).

They also found that 42% of HO cases and 17% of CO cases were admitted to the ICU. The median length of stay after flu diagnosis was 7.5 days for HO cases and 3 days for CO cases (P < .01).

Results are based on hospitalizations during the 2010-11 flu season flagged by FluSurv-NET, a population-based network that covers 16 states.
Nov 1 Am J Infect Control abstract

News Scan for Nov 01, 2013

News brief

FDA announces progress on steps for avoiding drug shortages

The US Food and Drug Administration (FDA) yesterday announced the release of a strategic plan and expansion of early notification requirements aimed at further enhancing its efforts to avoid drug shortages and to solve them quickly when they do occur.

The strategic plan, called for by the FDA Safety and Innovation Act of 2012, outlines improvements in the agency's response to imminent or existing shortages, such as better communications about shortages and encouraging manufacturers to engage in practices to avoid shortages, the agency said in a news release. The plan also lays out approaches to address the manufacturing and quality issues that most often cause shortages, such as providing incentives for high-quality manufacturing.

A proposed rule on early notification requires manufacturers of drugs and biologic products considered medically important to report to the FDA any planned permanent discontinuation of an agent or foreseeable interruption in manufacturing that could affect supply. Early notification will give the agency time to work with manufacturers to correct problems, find other manufacturers to help fill needs, and speed up processing of other drugs that could mitigate the shortage, the FDA said.

Following an Oct 31, 2011, Executive Order to reduce drug shortages, the FDA helped prevent 195 shortages in 2011 and 282 in 2012, reducing the number of shortages from 251 in 2011 to 117 in 2012, according to the release.

Said Janet Woodcock, MD, director of the FDA's Center for Drug Evaluation and Research, said, "The FDA continues to take all steps it can within its authority, but the FDA alone cannot solve shortages. Success depends upon a commitment from all stakeholders."
Oct 31 FDA news release
Proposed early notification rule

Florida county confirms state's 22nd dengue case

The Rio and Jensen Beach area on Florida's Atlantic coast has undergone the first-ever community survey for dengue fever in that state's Martin County and remains under a health advisory for the disease after 22 residents have had confirmed cases recently, according to reports yesterday.

More than 400 blood samples were drawn from residents. One case was confirmed during that testing, adding to the 21 cases confirmed earlier. An employee of an area business in which 4 of 6 employees had dengue has been hospitalized and may be the 23rd case.

Forty blood samples had inconclusive test results and are undergoing further evaluation, officials said. Results are expected in January. Questionnaires administered during the survey are being analyzed by the Florida Department of Health in Martin County, with results expected in March.

Residents are being told to drain standing water from potential mosquito breeding areas, cover their skin with clothing, use insect repellants outdoors, and make sure window screens are not damaged.
Oct 31 Martin County Department of Health press release
Oct 31 CBS12 News report