Flu Scan for May 01, 2018

News brief

New review finds flu infects 1 in 5 unvaccinated kids, 1 in 10 adults

An updated analysis of the seasonal flu attack rate in unvaccinated people found that the virus infects 1 in 5 children each year and 1 in 10 adults, with symptomatic illness seen in about half of the infections. A team from Australia and New Zealand reported its findings yesterday in Vaccine.

The investigators noted that there's a lot of uncertainly and lack of data to guide estimates on the annual flu attack rate, which makes it difficult to plan vaccination programs and gauge the impact of future interventions. For their new analysis, they looked at 32 randomized, controlled vaccine trials containing 13,329 participants that reported on lab-confirmed flu in the placebo groups. Six were conducted before 2000, 3 covered the 2009 H1N1 pandemic period but only reported on rates for seasonal flu, and 8 reported on multiple flu seasons.

Overall, rates of symptomatic infection were highest in children (12.7%), followed by the elderly (7.2%) and all adults (4.4%). For both symptomatic and asymptomatic flu combined, the attack rates were 22.5% for children and 10.7% for adults. Older people had similar rates of symptomatic and asymptomatic infection.

The team found large variability among the studies, such as symptomatic attack rates in kids that varied from 5.3% to 29.8%. They also found differences in studies conducted before and after 2000, with attack rates for symptomatic flu lower in the more recent studies, which they said might reflect a real decline in attack rates, perhaps to changes in population immunity, improved prevention, or changes in testing.

The authors concluded that the estimates will allow more accurate modeling of flu prevention tactics, and they added that future studies might someday include high-quality observational studies that allow researchers to assess attack rates for different vaccination levels.
Apr 30 Vaccine abstract

Study finds no evidence of asthma long-term after nasal spray flu vaccine

Kaiser Permanente researchers found no evidence of increased risk of subsequent asthma diagnosis years later among children younger than 3 years of age who received live attenuated influenza vaccines, according to a study today in the Pediatric Infectious Disease Journal.

The researchers write, "Live-attenuated influenza vaccines (LAIVs) are not licensed in children younger than 2 years of age because of a wheezing safety signal that has not been fully elucidated." LAIV is administered as a nasal spray.

In 2000, Kaiser Permanente scientists conducted a placebo-controlled randomized clinical trial of LAIV in children. Because many of these children were still enrolled in Kaiser Permanente in 2014, the researchers involved in today's study could assess the long-term association between LAIV and asthma.

The team identified 1,151 children who were 12 to 35 months old at the time of the first study and had received two LAIV doses or a placebo. Of these, 767 were still Kaiser Permanents patients and were enrolled in the new study, and the investigators found no evidence of an increase in asthma diagnosis among those who had received LAIV at an early age.
May Pediatr Infect Dis J study

News Scan for May 01, 2018

News brief

Analysis shows US states strongly benefit from global health funding

A state-by-state analysis of global health spending published today estimates that US government investments bring jobs, health security, and an economic boost to state economies while saving millions of lives worldwide, according to a report by the Global Health Technologies Coalition (GHTC).

The Trump Administration has proposed slashing funding to fight global health threats such as malaria, Ebola, and HIV/AIDS, which could cost states thousands of jobs and millions of dollars and put the health of residents at risk, according to the GHTC report. The analysis quantifies how federal funding to create vaccines and treatments to combat deadly global diseases also benefits American states, to the tune of $2.5 billion in one state, and almost $1 billion in several others.

"While the Administration claims cuts to global health research are putting America first, the data suggest otherwise," said GHTC Director Jamie Bay Nishi, MD, in a GHTC news release. "US funding for global health research is not only saving lives worldwide, it's also paying significant economic and health dividends across American states."

The new analysis builds on a report released last year by GHTC and the public health think tank Policy Cures Research. Last year's report found that, from 2007 to 2015 alone, $14 billion in US government investments in global health innovations created 200,000 new US jobs and generated $33 billion in US economic growth. It also showed that, while this spending may be directed at solving global health challenges, 89 cents of every dollar stays in the United States.

GHTC notes that, outside the emergency allocation for the Ebola response in 2014-16, US public health investment has declined since 2012, with a modest uptick in 2016, and the Trump administration has called for a 36% cut to global health programs.

The top five states benefitting from global health investments, according to the new research, are Maryland ($2.5 billion, 30,700+ jobs), New York ($916 million, 9,600+ jobs), California ($876.4 million, 11,800+ jobs), Virginia ($874.5 million, 9,700+ jobs), and Washington ($783.9 million, 9,700+ jobs).
May 1 GHTC news release
GHTC state-by-state data

Multistate outbreak of Serratia marcescens identified in 3 children

The Nebraska Department of Health and Human Services (NDHHS) said yesterday an investigation is under way into a multistate outbreak of Serratia marcescens bloodstream infections in three pediatric patients. The patients are from Colorado, Tennessee, and Ohio.

Officials said isolates collected from the patients are closely related or indistinguishable, suggesting a shared exposure to S marcescens. The pediatric patients had central venous access, and likely exposures include heparin and saline flushes, specifically, PosiFlush Pre-Filled Heparin Lock Flush Syringes (10 USP units/mL and 100 USP units/mL) and PosiFlush Sterile Field Saline Flush Syringes, all manufactured by the medical supply company, BD (Becton, Dickinson and Company), of Franklin Lakes, N.J.

"Out of an abundance of caution, BD is voluntarily recalling certain lots of BD PosiFlush™ Heparin Lock Flush and BD™ Pre-Filled Normal Saline Flush syringes due to this potential contamination with S. marcescens," the NDHHS said in an advisory.

Clinicians should consider using alternatives to BD products at this time, the NDHHS said.
Apr 30 NDHHS alert

Study details benefits of studying Zika in marmosets

Marmosets may be a useful animal model for studying Zika and other viruses that might harm developing fetuses, researchers from the Texas Biomedical Research Institute (TBRI) reported today in Scientific Reports.

Animals such as macaques and baboons have been used as animal models to investigate Zika virus infection and for the development of drugs and vaccines, but they have drawbacks such as large body size and longer gestational periods. In contrast, marmosets appear to be especially sensitive to Zika virus and are about as big as rats. Scientists who have captured marmosets in the wild have found that they had antibodies to Zika virus.

In today's study, the team reported that pregnant marmosets experimentally infected with Zika at specific points during the first half of their pregnancy spontaneously aborted the fetuses at almost exactly the same time, about 2 weeks postinfection. Also, examination of fetal tissue found neurologic abnormalities.

Suzanna Tardif, PhD, scientist at TBRI and associate director of research at the Southwest National Primate Research center, said in a press release from the institute, "It's early days, but the results are encouraging."

A 2017 study from TBRI and University of California at San Francisco researchers found that male marmosets mimic human Zika infection, with the virus lingering in saliva and semen. The research group hopes to extend their work to explore the impact of West Nile and cytomegalovirus infections in pregnant marmosets.
May 1 Sci Rep abstract
May 1 TBRI press release