Flu Scan for Apr 11, 2014

News brief

China reports H7N9 illness, another death

China reported one additional H7N9 influenza case and another death from the virus today, according to health officials in Guangdong province.

The latest case-patient is a 79-year-old man from the Guangzhou, the province's capital, according to a health department statement translated and posted by FluTrackers, an infectious disease news message board. He is hospitalized in critical condition.

The province also reported another death from H7N9, in a patient from Guangzhou whose illness was confirmed on Feb 11 and who died on Apr 5.

Today's developments edge the outbreak's overall total to 419, according to a case listing maintained by FluTrackers. The new death raises the unofficial fatality count to 127. So far 283 infections have been reported in the second wave of disease activity, which began in October, compared with 136 in the first wave last spring.
Apr 11 FluTrackers thread
FluTrackers human H7N9 case count

In related developments, the World Health Organization (WHO) acknowledged reports of two additional H7N9 infections, one received by Hong Kong on Apr 9 and the other from China on Apr 10.

The case from Hong Kong involves an 82-year-old woman from Guangzhou who got sick in Guangdong province on Apr 7, a day before she traveled to Hong Kong. She is hospitalized in stable condition. The patient from China is a 69-year-old man from Anhui province who got sick on Apr 1, was hospitalized 4 days later, and is listed in critical condition.
Apr 11 WHO statement


US flu activity rolls along at low levels

Flu activity in the United States continued at relatively low levels last week, much the same as in previous weeks, with some markers even showing a slight rise, the Centers for Disease Control and Prevention (CDC) reported today.

Five states— Connecticut, Delaware, Massachusetts, New Jersey, and New York—reported geographically widespread flu activity last week, the same states at that level the week before. In addition, New York City reported high flu-like illness (ILI) activity last week, which also mirrors the previous week. New York was the only state reporting moderate ILI activity

The share of outpatient medical visits for ILI, at 1.6%, stayed the same as the previous 2 weeks and is well below the national baseline of 2.0%.

The proportion of respiratory specimens that tested positive for flu, however, increased, to 13.4% of 5,127 samples last week from 12.5% of 5,206 samples the week before. Also, the proportion of deaths attributed to pneumonia and influenza rose to 6.8%, up from 6.5% in the previous week.

The CDC reported three more flu-related deaths in children, the same as in the previous week, bringing the season's total to 85. Two of the deaths were attributed to influenza B and the other to an influenza A strain that wasn't subtyped.

As typically happens late in the flu season, the share of influenza B circulating continues to increase. Of the 685 flu-positive tests reported to the CDC, 383 (56%) were influenza B and 302 (44%) were influenza A. Of the "A" viruses that were subtyped, 69% were H3 viruses and 31% were 2009 H1N1.
Apr 11 CDC FluView report
Apr 11 CDC weekly FluView summary

In related news, the Boston Public Health Commission (BPHC) issued an influenza advisory yesterday because of a late-season spike in cases.

From Mar 30 to Apr, the BPHC confirmed 116 new flu cases, bringing the total reported in the city this year to 1,237, the Boston Globe reported yesterday. On Jan 10 the city had confirmed only 158 cases.

In addition, 27% of Boston flu cases this year have required hospitalization, the story said, and 11 patients have died. That compares with 22 flu-related deaths last season, but they had all occurred before this point in the season.
Apr 10 Boston Globe story


NIH funds five centers of excellence in flu research for 7 years

Researchers will receive funding for advancing the study of influenza viruses via five US centers of excellence from the National Institute of Allergy and Infectious Diseases (NIAID), the agency said in a news release yesterday from the National Institutes of Health (NIH), which houses the NIAID.

The funding is for 7 years. In addition to basic research, investigators in the Centers of Excellence for Influenza Research and Surveillance (CEIRS) network also conduct flu surveillance studies with an emphasis on rapid characterization of viruses that have the potential to cause pandemics. The first CEIRS network was launched in 2007 by the NIAID.

The centers include four established in 2007, at Emory University in Atlanta, Icahn School of Medicine at Mount Sinai in New York City, St. Jude Children’s Research Hospital, Memphis, Tenn., and the University of Rochester (N.Y.) Medical Center.

In addition, Johns Hopkins University in Baltimore will join the network. The University of Minnesota, which staffed one of the original CEIRS sites, did not receive continued NIAID funding and closed its center last month.

"The CEIRS network exemplifies NIAID's dual mission of conducting basic and applied influenza research, while maintaining the ability to respond rapidly in the event of an emerging public health threat," said NIAID Director Anthony S. Fauci, MD, in the release.
Apr 10 NIH news release

News Scan for Apr 11, 2014

News brief

MSF resumes treatment center work at Ebola protest site

Doctors without Borders (Medecins Sans Fronteires, or MSF) said it resumed treating patients with Ebola infections at a center in the Guinea city of Macenta yesterday, following protests last week by some of the local people.

In a statement today, MSF said several days of negotiations with local authorities, youth leaders, and village elders led to reassurance that the group could continue its work safely. During the interim, patients at the Macenta center were treated by the health ministry staff.

Corrine Benazech, who heads the MSF mission in Guinea, said in the statement that the group understands the local people's fears and has seen similar reactions during outbreaks in Uganda and Gabon.

"There had been no Ebola cases in Guinea before the current outbreak and seeing our workers in the protective dress must be quite shocking for people who are not used to it," she said. Benazech added that MSF and other health groups working in the area need to ensure that the people know about and understand the disease and to keep dialogues going with local communities.

The Macenta treatment center is one of three that MSF is staffing as part of the outbreak response. Four patients are currently being treated at a newly expanded site in Conakry, the country's capital, three are being cared for in Macenta, and three are at a site in Gueckedou. MSF said a team arrived yesterday in Liberia to help the health ministry respond to the recent identification of Ebola virus cases in the northern part of that country.
Apr 11 MSF statement


FDA OK's ionizing radiation for crustaceans

In response to a petition from the National Fisheries Institute, the US Food and Drug Administration (FDA) said today that it is allowing ionizing radiation on crustaceans like crab, shrimp, lobster, and crayfish to control foodborne pathogens and extend shelf life.

The agency said it based its decision on a "rigorous safety assessment" that considered potential toxicity, the effect of irradiation on nutrients, and the potential microbiological risk. It also factored in previous evaluations of the safety of irradiating other foods, including poultry, meat, mollusks, lettuce, and spinach.

The rule covers raw, frozen, cooked, partially cooked, shelled, and dried crustaceans, as well as cooked or ready-to-cook crustaceans processed with spices or small amounts of other food ingredients.

"At the maximum permitted dose of 6.0 kiloGray, this new use of ionizing radiation will reduce, but not entirely eliminate, the number of pathogenic (illness causing) microorganisms in or on crustaceans," the FDA said in a constituent update. "The maximum dosage of irradiation approved is capable of reducing a number of pathogens that may be found in crustaceans, including Listeria, Vibrio,and E coli."

The agency said the technique is not a substitute for proper food handling. All foods that undergo ionizing irradiation must be labeled with the international symbol for irradiation (called the radura) and the statement "Treated with radiation" or "Treated by irradiation."

According to a notice that will be published in the Federal Register on Apr 14, the FDA is taking comments on the rule till May 15.
Apr 11 FDA constituent update
Apr 14 Federal Register notice

This week's top reads