Flu Scan for Mar 25, 2014

News brief

China reports H7N9 case, more findings in poultry

China today reported one new H7N9 influenza case, which was confirmed in a 58-year-old man who lives in Guangdong province, according to a health department statement translated and posted by FluTrackers, an infectious disease news message board. The man is hospitalized in critical condition in a Guangzhou hospital.

His illness brings the outbreak's overall total to 401 cases, according to a case list kept by FluTrackers. The unofficial number of deaths remains at 121. The latest case bumps the number reported during the second wave of illnesses to 265, compared with 136 in the first.

In other developments, Chinese agriculture officials yesterday reported the latest results of H7N9 testing in birds, which revealed positive findings from two live bird markets and a commercial farm in Guangdong province, according to a report to the World Organization for Animal Health (OIE). Sampling was done as part of the national surveillance plan, and no clinical signs were seen in birds at the three locations.

The two markets that yielded positive tests are in two different districts of Guangzhou. In one market, two samples were obtained and one tested positive. Two susceptible birds were culled to control the spread of the virus. At the other location, one of 25 samples was positive for the H7N9 virus, and 370 birds were destroyed.

The commercial farm where six positive samples were found is in Doumen district of the southern coastal city of Zhuhai. About 80,000 birds were culled to stem the spread of the virus. The finding is notable because nearly all of the other H7N9 findings in Chinese poultry have been in birds from live markets. The farm appears to be the same one that sourced a batch of H7-infected chickens found at a Macau poultry quarantine facility on Mar 12.
Mar 25 FluTrackers thread
FluTrackers human H7N9 case list
Mar 24 OIE report

Flu season slows globally, with only type B showing increases

Influenza is on the decline globally with a few exceptions, particularly with regard to influenza B, according to an update from the World Health Organization (WHO) yesterday covering the weeks of Feb 23 through Mar 8.

North America's flu season appears to be nearing its end, although there has been a small increase in influenza B detections, the agency said. Flu activity in Europe decreased in the southwestern and northern regions but increased in the east.

Eastern Asia is seeing declines in flu activity except for a slight increase in type B cases, the WHO said. Activity is stable in China but is elevated in Mongolia. Cases in tropical Asia are on the decline with the exception of Thailand, where the proportion of type B cases is increased and type A/H1N1 incidence remains elevated.

Western Asia and northern Africa are also experiencing increasing proportions of flu B cases, although activity in general is declining.

The WHO's report is based on data from 96 countries. About 75% of samples positive for influenza were type A, with the remainder type B. Of subtyped flu A samples, about 65% were the H1N1 strain and 35% were H3N2. The large majority (about 87%) of subtyped flu B samples were of the Yamagata lineage (87%) with the remainder the Victoria lineage.
Mar 24 WHO update

News Scan for Mar 25, 2014

News brief

WHO reports 2 MERS cases in UAE, raising global count to 200

In separate announcements today, the World Health Organization (WHO) reported two more Middle East respiratory syndrome coronavirus (MERS-CoV) cases in the United Arab Emirates (UAE), one of them fatal, raising the global MERS count to 200 cases.

One case involves a 49-year-old man from Abu Dhabi who has underlying medical conditions and had contact with another MERS patient, the WHO said in a statement. He was hospitalized Feb 27 and then discharged on Mar 9 after improving. But he was hospitalized again on Mar 16 and is now in critical condition. UAE authorities informed the WHO of the case on Mar 20.

The patient had not traveled recently and has had no recent contact with animals, but he did have contact with a MERS patient whose case was reported to the WHO on Mar 11, the agency reported. That patient was a 68-year-old Abu Dhabi man who owns camels, the agency reported on Mar 12. Both patients were treated in the same hospital on Mar 1.

The WHO announced the second new case via Twitter this afternoon. UAE officials reported the case to the WHO on Mar 23, saying it involves an Omani, the WHO post said. Without listing the patient's age or gender, the agency said he or she had no recent history of travel and no contact with animals or other MERS patients.

A separate WHO tweet said the second case raises the agency's MERS count to 200 cases, including 85 deaths.
Mar 25 WHO statement on case in 49-year-old
WHO Twitter feed

WHO confirms polio detection in Iraq, more cases in Syria

The WHO has confirmed a wild poliovirus type 1 (WPV-1) case in Iraq, the country's first case in 14 years, according to a Mar 21 statement. The infection occurred in a 6-month old boy from Baghdad who had not been immunized and who experienced paralysis on Feb 10.

Gene sequencing suggests that the virus is closely related to viruses detected in Syriaproviding further evidence of regional spread, the agency said. The virus was also isolated from the boy's 3-year-old sister, who did not have symptoms.

The WHO said prospects for controlling the disease in Iraq are promising, because the country has participated in a Middle East outbreak response that was triggered by Syria's polio outbreak in October. The agency estimated that two nationwide immunization campaigns and three subnational efforts reached about 95% of children in Iraq, though coverage varied by area. Global health groups put the 2012 routine immunization level for Iraq at 70%, with the level in Baghdad higher, at 81%.

In its statement, the WHO also said 20 more WPV-1 cases have been detected in Syria since its last update on Nov 26, raising the total so far to 37. It said 25 of the cases have been reported by Syria's health ministry and 12 have been reported from contested areas in Aleppo, Edleb, and Deir Al Zour. The most recent case-patient had paralysis onset on Dec 17.
Mar 21 WHO statement

Measles outbreak tied to cruise ship reaches 34 cases

A total of 34 cases of measles on or associated with the Mediterranean cruise ship Costa Pacifica had been reported as of Mar 21, according to an epidemiologic update today from the European Centre for Disease Prevention and Control (ECDC).

The outbreak began in February, and the majority of case-patients (22) have been crew members or other workers. No new cases among crew members have been reported since Mar 14. However, five contacts of an Italian passenger who developed measles and disembarked on Mar 14 also contracted measles; one had pneumonia and was admitted to an intensive care unit.

The index case-patient, an Italian crew member who had fever and rash, received care off the ship Feb 22; his diagnosis was confirmed Feb 27. The majority of cases in crew members occurred from Feb 20 to 27.

Vaccinations were given to more than 800 of the 1,000 crew members between Feb 28 and Mar 1. Passengers embarking and disembarking since the outbreak began have been given information and offered vaccinations since Feb 28.
Mar 25 ECDC update
Mar 6 CIDRAP News story on the outbreak
Mar 14 CIDRAP News scan on the outbreak