News Scan for Oct 14, 2013

News brief

CDC: 2011 measles outbreaks cost public health up to $5 million

The United States experienced a marked increase in imported measles cases in 2011. A new analysis of 16 outbreaks that year involving imported measles found that they cost public health agencies from $2.7 million to $5.3 million.

Writing today in Vaccine, scientists from the Centers for Disease Control and Prevention (CDC), said they analyzed data from the outbreaks (defined as three or more epidemiologically linked cases), which totaled 107 confirmed cases.

The cumulative estimated contacts of these cases ranged from 8,936 to 17,450, which required from 42,635 to 83,133 hours of work by local and state public health officials. From those numbers, the authors estimated the monetary public health cost of the outbreaks.

"Investigating and responding to measles outbreaks imposes a significant economic burden on local and state health institutions," they conclude.
Oct 14 Vaccine abstract

Cholera case count in Mexico reaches 159

The count of cholera cases in a Mexican outbreak that began about a month ago has reached 159, including one death, the Pan American Health Organization (PAHO) reported on Oct 12.

Hidalgo state has had 145 cases, with the rest scattered among the Federal District and the states of Mexico, San Luis Potosi, and Veracruz, PAHO said. Forty-three patients (27%) have been hospitalized. Contaminated river water is the probable source of the outbreak in Hidalgo, the agency said.

The current outbreak marks the first local transmission of cholera in Mexico since 2001, when a 10-year-old epidemic ended, the statement said. The Vibrio cholera strain circulating in Mexico is more than a 95% match for the strain circulating in Haiti, the Dominican Republic, and Cuba.

The case count in Haiti's cholera epidemic, which began 3 years ago this month, has reached 679,637, with 8,297 deaths, according to PAHO. That represents an increase of 797 cases and 8 deaths since an Oct 1 PAHO update.
Oct 12 PAHO update

Flu Scan for Oct 14, 2013

News brief

Southern Hemisphere flu drops as Northern Hemisphere's season starts

As the end of the Southern Hemisphere's flu season draws near, activity in Australia and New Zealand seems to have peaked, though over the last few weeks South Africa has seen a second, smaller peak, the World Health Organization (WHO) said today in a global flu update.

Meanwhile, as the Northern Hemisphere entered the start of its flu season, activity in Europe is starting to increase, based on increasing doctor's visits for flulike illness. Overall, in most temperate-zone countries in that part of the globe flu activity is still at interseasonal levels. One exception is Hong Kong, which is experiencing increased transmission due to H3N2, the WHO said.

Elsewhere in Asia, flu activity in southern China remained at interseasonal levels, though the number of flu detections has been higher during the period this year compared with last year, according to the WHO.

In the virologic part of its update the WHO said lab tests on flu viruses in the last half of September found that influenza A viruses accounted for 78% of the positives, of which almost 69% were H3N2 and about 31% were 2009 H1N1. Of the influenza B viruses that were detected, nearly 70% belonged to the Yamagata lineage.

Meanwhile, the European Centre for Disease Prevention and Control (ECDC) on Oct 11 published its first report of the new flu surveillance season. It said all 26 reporting countries had low-intensity flu activity, with only 2% of 132 sentinel specimens testing positive for flu. Malta reported local flu activity, and France, Lithuania, Norway, and Scotland reported sporadic activity. Countries reporting increasing trends included Bulgaria, Poland, Romania, and Slovakia.

The United States has not published any flu surveillance reports for the last 2 weeks due to a government shutdown. The Centers for Disease Control and Prevention (CDC) said, however, that limited support for outbreak investigations continues, along with emergency processing of flu samples for possible pandemic strains to comply with International Health Regulations.
Oct 14 WHO global flu epidemiologic update
Oct 14 WHO global flu virologic update
Oct 11 ECDC weekly flu surveillance report
Oct 11 CIDRAP News story "Suspension of CDC flu tracking raises concern"

Taiwan hopes to have H7N9 vaccine in 2014

Taiwan plans to produce a vaccine against H7N9 avian flu by the end of next year, Agence France-Presse (AFP) reported today. A 53-year-old Taiwanese man contracted H7N9 flu in April after working in Suzhou, China, marking the only H7N9 case outside of mainland China.

"We plan to start [a] phase 2 clinical trial in March," which will involve 300 recipients, said Su Ih-jen, director of the National Institute of Diseases and Vaccinology at Taiwan's National Health Research Institutes (NHRI). Phase 3 trials are slated for next June and will involve 1,000 patients, he said.

If phase 3 trial results are encouraging, the NHRI can produce 200,000 doses of the cell-based vaccine, Su said.

Last month, the US National Institutes of Health (NIH) announced it was launching two phase 2 trials of an H7N9 vaccine, which are scheduled to be completed in December 2014. Mainland China has confirmed 134 H7N9 cases, 44 of them fatal.
Oct 14 AFP article
Sep 18 CIDRAP News story "NIH to test H7N9 vaccines with adjuvants"