Flu Scan for Aug 18, 2014

News brief

FDA approves first flu vaccine for jet-injector use

The US Food and Drug Administration (FDA) announced on Aug 15 that it had approved the administration of bioCSL's Afluria inactivated influenza vaccine for use with ajet-injector device, the PharmaJet Stratis. The approval applies to intramuscular injection only in adults ages 18 through 64 years, the FDA said in its statement.

The action marks the first flu vaccine to be approved for use in a jet injector. The FDA said over the past few years it has received several questions about the use of jet injectors for giving inactivated flu vaccines. In October 2011, some pharmacy chains and other health providers said they had plans to use needle-free injectors to administer flu vaccines, but the FDA advised them to stop because it had not approved any flu vaccines for use in the devices.

At the time, the Centers for Disease Control and Prevention (CDC) weighed in and said people who had been immunized through the off-label practice didn't need to be revaccinated with a standard needle syringe.

In May, a study involving Afluria given with a jet injector found that the immune response was similar to that resulting from administration by syringe and that the vaccine–jet injector combination met non-inferiority criteria for all six endpoints. Researchers found that the device had an acceptable safety profile, though the frequency of injection-site reactions was higher than for needle and syringe administration.

The FDA said Afluria is the only inactivated flu vaccine approved for use in a jet injector and that jet injectors approved by the FDA should only be used to deliver medications and vaccines that have been approved and labeled for use in the devices.
Aug 15 FDA statement
May 30 CIDRAP news scan "Needle-free vaccine produces 'non-inferior' immune response"

More H7N9 detected in bird market, farm samples in China

In its ongoing surveillance for H7N9 avian influenza in poultry, China's agriculture ministry recently reported 14 positive serum samples from two provinces, according to an Aug 15 update from the World Health Organization's (WHO's) Western Pacific Region.

The monitoring results cover much of July and the first third of August and included 23,516 serum samples and 12,755 virologic samples from Guangdong and Shandong provinces.

Nine samples from Guangdong were positive, all from live bird markets, and five from Shandong, two from breeder farms and three from layer farms. All of the positive tests were in serum samples.

H7N9 avian flu has been circulating in Chinese poultry and began spreading in humans in the spring of 2013. Although human cases have slowed, over 450 have occurred.
Aug 15 WHO update
Jul 8 CIDRAP News scan on previous poultry testing

News Scan for Aug 18, 2014

News brief

Chikungunya cases appear to slow, outbreak total passes 585,000

The number of newly reported chikungunya cases in the Caribbean region was down dramatically last week, but it's not clear if the drop was related to delays in reporting or a downturn in disease transmission. According to an Aug 15 update from the Pan American Health Organization (PAHO), the region reported 9,798 new cases, accounting for an increase of only 1.7%. For comparison, the previous 2 weeks' totals were up 8% and 12%, respectively.

Newly reported cases lift the overall outbreak total to 585,798. Some countries are behind in reporting cases. For example, Haiti, one of the hot spots over the past few months, hasn't reported new numbers in 5 weeks. The number of new cases in the neighboring Dominican Republic did not appear to increase from the previous week.

Areas reporting most of the new cases include El Salvador, Guadaloupe, Martinique, and Puerto Rico.

Meanwhile, the number of imported chikungunya cases in the PAHO region increased by 112 to put that total at 758. The United States mainland continues to report most of the travel-linked cases.

Five more deaths were reported, bringing the outbreak's overall fatality count to 37.
Aug 15 PAHO update
Aug 11 CIDRAP News scan "Chikungunya outbreak expands by 12%, to 576,000 cases"
Aug 4 CIDRAP News scan "Chikungunya cases climb 8%, top 500,000"

Saudi man died of MERS-CoV

A 72-year-old Saudi Arabian man with MERS-CoV (Middle East respiratory syndrome coronavirus) has died, according to an update from the country's ministry of health (MOH) yesterday.

The man, who died in Riyadh and whose case had been reported earlier, was not a healthcare worker. No new cases were reported in the update.

Since June of 2012, 723 cases of MERS-CoV have been reported from Saudi Arabia, 300 of them fatal. Active cases continue in 27 patients.
Aug 17 MOH update

Study: MERS-CoV present in African camels for more than 30 years

The MERS-CoV appears to have been circulating for more than 30 years in dromedary camels in Sudan and Somalia, among the main exporting countries of the animals to the Middle East, found the authors of a study published Aug 15 in Emerging Infectious Diseases. The findings extend by a decade the duration of the virus noted in previous studies.

Archived serum samples from 189 dromedary camels from Sudan, Somalia, and Egypt, which imports camels from the other two countries, were analyzed by the authors. The samples from Somalia were collected in 1983-84, from Sudan in the summer of 1984, and from Egypt in the summer of 1997.

Positive results for MERS-CoV on recombinant MERS-CoV spike protein subunit 1–based enzyme linked immunosorbent assay (rELISA) were present in 159 (84.1%, range among countries 80.0% to 86.7%) samples. Neutralizing activity with reciprocal titers of more than 80 was found in 153 samples (81.0%, range 68.0% to 86.9%).

The authors say that it is possible the virus has caused human MERS-CoV infections in African or Arabian countries in the past that have gone unrecognized.
Aug 15 Emerg Infect Dis study