Flu Scan for Jan 23, 2015

News brief

US flu activity ebbing a bit but still elevated

US flu activity last week showed some signs of decline but continued at an elevated pace, well above epidemic levels, the US Centers for Disease Control and Prevention (CDC) said today in its weekly update.

Of 26,205 specimens tested in the week that ended Jan 17, 5,104 (19.5%) were positive for influenza. That number is down from 20.2% the week before. Geographic spread of flu was reported as widespread in 44 states, compared with 46 the week before.

But the proportion of outpatient visits for influenza-like illness (ILI) was 4.5%, up slightly from 4.4% the week before, and well above the epidemic threshold of 2.0%. ILI levels were reported as high in 23 states, down from 24 states the week before.

Eleven pediatric deaths were confirmed, compared with 19 the week before. Three of the new deaths were attributed to H3N2, by far the most dominant strain, with eight attributed to an influenza A virus that was not subtyped.

The hospitalization rate jumped from 29.9 per 100,000 population in the previous week to 36.3 per 100,000 population last week, which is typical for this point in the season. About 97% of the hospitalizations were caused by influenza A, and 99.7% of those were associated with H3N2.

Of 68,679 samples that have tested positive for flu this season, 65,086 (94.8%) have been influenza A and 3,593 (5.2%) influenza B. Of the 27,870 "A" strains that have been subtyped, 27,752 (99.6%) have been H3N2 and only 118 (0.4%) 2009 H1N1. About 64% of the H3N2 strains do not match the H3N2 component of the vaccine, just slightly lower than reported the week before.

None of the H3N2 strains tested have been resistant to neuraminidase inhibitors, the most common flu antiviral drug, but 1 of 14 2009 H1N1 viruses tested has shown resistance. This is the first report of the season of antiviral resistance.
Jan 23 CDC weekly FluView update

Europe, meanwhile, is seeing increased flu activity, with 15 of 39 countries reporting medium influenza activity, according to an update today from the European Centre for Disease Prevention and Control (ECDC).

The proportion of sentinel specimens testing positive for flu increased from 35% to 40% week to week, with H3N2 predominating. The proportion of influenza-positive specimens was above 10% for the fifth consecutive week, the agency said.
Jan 23 ECDC update

H7N9 sickens 3 people in mainland China, 1 in Hong Kong

Chinese authorities have reported four new H7N9 avian flu cases today, three of which occurred on the Chinese mainland and one that was likely imported from southern China to Hong Kong.

Hong Kong's Centre for Health Protection (CHP) today confirmed H7N9 infection in a 79-year-old man who presented to a clinic with respiratory symptoms on Jan 19 and was hospitalized and isolated in stable condition yesterday. The man traveled to the mainland provinces of Zhangmutou, Dongguan, and Guangdong on Jan 5, where he visited a live-poultry market but had no contact with birds.

The CHP will quarantine and provide antiviral treatment to the case-patient's close contacts and monitor other contacts for symptoms, the agency said in a new release. The case reported today is Hong Kong's second imported case this winter; 12 cases of H7N9 avian flu have been imported to Hong Kong since March 2013.

The CHP also reported three cases of H7N9 on the Chinese mainland today. Two patients are from Guangdong province and involve a 68-year-old man from the city of Shantou who is hospitalized in serious condition and a 4-year-old boy from the city of Zhaoqing who is reported to be in stable condition.

The third case-patient is a 75-year-old woman from Shanghai who is in critical condition and receiving emergency treatment. She is Shanghai's second case of H7N9 avian flu this year, according to Xinhua, China's official news agency.

The four new cases bring the global H7N9 total to 524, according to FluTrackers, an infectious disease news message board.
Jan 23 CHP press release on imported case
Jan 23 CHP press release on mainland cases
Jan 23 Xinhua story
FluTrackers H7N9 case list

Egypt confirms an H5N1 death and new case

Egypt's health ministry reported that a 5-year-old boy from Asyut governorate has died of H5N1 avian flu, according to the Cairo Post today.

The Egyptian Ministry of Health and Population also confirmed a new case of H5N1 in a 60-year-old woman from Gharbia governorate, which is located near the Nile Delta.

Egyptian authorities continue to urge people to take precautions when handling or being near poultry. Of the 25 cases of H5N1 avian flu reported in Egypt this year, 8 people have recovered, 9 are receiving treatment, and 8 people have died, the Cairo Post said.
Jan 23 Cairo Post story

News Scan for Jan 23, 2015

News brief

FDA approves second group B meningococcal vaccine

The US Food and Drug Administration (FDA) today approved Bexsero, a Novartis vaccine to prevent meningococcal disease caused by Neisseria meningitidis serogroup B in people 10 through 25 years, the second group B vaccine approved by the FDA.

In October the agency approved Wyeth's Trumenba, also for people 10 to 25 years old. Both group B vaccines had been fast-tracked after several serogroup B outbreaks of meningitis on college campuses. Two other vaccines previously approved for US use cover the A, C, Y, and W-135 serogroups.

Three studies evaluating Bexsero's effectiveness were conducted in Canada, Australia, Chile, and the United Kingdom in about 2,600 adolescents and young adults. Two doses of Bexsero produced antibodies to three different strains of serogroup B N meningitidis in 62% to 88% of study participants, the FDA said in a press release.

Safety trials involved about 5,000 US and international volunteers, with the most common side effects being pain and swelling at the injection site, headache, diarrhea, muscle pain, joint pain, fatigue, and chills. In addition, safety was monitored in more than 15,000 people who received Bexsero in response to two university outbreaks of serogroup B meningococcal disease in the United States, the FDA said.
Jan 23 FDA news release

Oman reports 3rd MERS case, Saudi Arabia reports death

The World Health Organization (WHO) today confirmed Oman's third MERS-CoV case this year, in a man who had contact with one of the earlier patients, and Saudi Arabia reported the death of a previously reported MERS patient.

The Omani patient with MERS-CoV (Middle East respiratory syndrome coronavirus) is a 43-year-old from Dakhiliyah governorate in the north central part of the country. His case was identified through contact tracing and reported to the WHO on Jan 17 by Omani officials.

The man visited the country's fatal case-patient at home and participated in his funeral, the WHO said. The agency previously identified the previous patient as a 32-year-old man who died in an intensive care unit on Jan 7.

The recently reported patient was admitted to a hospital on Jan 16 and was discharged on Jan 19 but has not had symptoms. He has no preexisting disease and reported no exposure to other risk factors in the 2 weeks before a respiratory sample was taken.

The third Omani case reported this year is in a 31-year-old woman who lived with the man who died of MERS, the WHO reported last week. She was reported to be hospitalized in stable condition.
Jan 23 WHO statement
Jan 16 WHO report on MERS in Oman

In Saudi Arabia, the country's Ministry of Health (MOH) reported no new MERS-CoV cases after reporting seven in Riyadh in the preceding 5 days. The MOH did, however, report the death of an 80-year-old man in Riyadh whose case was first reported yesterday.

The agency also said that a 61-year-old man in Riyadh has recovered from MERS. Both men had preexisting conditions.
Jan 23 MOH update