NEWS SCAN: US flu update, H5N1 in Egypt, Nigerian farmer protest, intradermal flu vaccine, Tamiflu side effects, Salmonella developments

Apr 3, 2009

Influenza B viruses increase as overall flu activity ebbs
Although US influenza activity continued to slow during the week that ended Mar 28, the proportion of influenza B viruses relative to other types increased nationally and regionally, the Centers for Disease Control and Prevention (CDC) reported today. Thirteen states reported widespread activity, down from 24 the previous week. Eight pediatric flu-related deaths were reported, one each from California, Kentucky, Maryland, North Carolina, Nevada, and Washington, and two from Ohio, which pushes the season's total to 43. Nearly all (99.2%) of the influenza A/H1N1 viruses tested so far this season showed resistance to oseltamivir (Tamiflu). Of 211 influenza B viruses that have been characterized, 167 (79%) belonged to the Victoria lineage, which isn't covered by this year's vaccine.
[CDC flu update]

Another Egyptian child sick with H5N1 infection
Egypt's state news agency said today that another Egyptian toddler, a 21-month old boy, has been hospitalized with an H5N1 avian influenza infection, the second case in a child this week, Agence France-Presse (AFP) reported. He is from Beheira governorate, the same area as the 2-year-old boy announced earlier this week. Authorities said the latest patient was exposed to dead poultry. If the World Health Organization (WHO) confirms the boy's case, it will raise Egypt's H5N1 count to 62 cases, of which 23 have been fatal. In other developments, Egypt-based Strengthening Avian Influenza Detection and Response (SAIDR) today reported five more H5N1 avian influenza outbreaks. Two outbreaks occurred in Alexandria governorate in northern Egypt and two in 6th of October governorate on the outskirts of Cairo. The fifth outbreak was detected in Minya, the capital of Minya governorate in Upper Egypt. No details were available about the outbreak settings, the type of birds involved, or poultry vaccination status.
[Apr 3 AFP story]
[SAIDR site]

Nigerian farmers protest radio messages about avian flu
Poultry farmers in Nigeria's Oyo state recently lodged a protest against a local radio station that has been airing messages about how to prevent the spread of avian influenza, the Daily Sun, a Nigerian newspaper, reported today. The farmers claimed that chicken and eggs sales have dropped significantly over the 4 to 6 months that the prevention message has aired. The farmers threatened to topple the radio station's transmission tower unless the spots, sponsored by an international development agency, were stopped. However, the radio station manager has vowed to keep the public service announcements on the air.

Sanofi reports trial results for intradermal flu vaccine
An intradermal (ID) flu vaccine made by Sanofi Pasteur compared favorably with a conventional intramuscular (IM) vaccine in the last 2 years of a 3-year study, according to a Sanofi-sponsored study in BMC Medicine. In the first year, 1,150 adult volunteers were randomly assigned to receive an ID vaccine with 3 or 6 micrograms (mcg) of antigen for each of three flu strains, or an IM vaccine with the standard 15 mcg per strain. For years 2 and 3, with the same volunteers, the ID vaccine dose was increased to 9 mcg per strain. The lower doses of ID vaccine used in year 1 were less immunogenic than the IM vaccine, but in the last 2 years, both vaccines induced comparable immune responses and met European licensing requirements. However, the authors could not run a formal statistical comparison of the vaccines in years 2 and 3, because the volunteers were not naive to the ID vaccine after the first year. The ID vaccine was recently approved by the European Commission and will be marketed in Europe as Intanza and IDflu.
[Apr 3 BMC Medicine report]

No sign of increased psychiatric problems seen in Tamiflu recipients
In a study sponsored by Roche, the maker of the antiviral drug oseltamivir (Tamiflu), investigators examined a large US healthcare database and found no evidence of increased neuropsychiatric problems in people who were treated with the drug. Using a database containing records from commercial health insurance plans, the investigators looked at patients who were diagnosed with flu between 1999 and 2005. The analysis included 60,267 patients who received oseltamivir and 175,933 who did not. The researchers found no increase in the number of medical claims for neuropsychiatric events in the patients treated with the drug compared with those who were not. This held true in the overall analysis and in separate analyses of children and adults. The study was published in the April International Journal of Clinical Practice.
[Int J Clin Pract abstract]

FDA probes pistachio company's New York plant
In its probe of Salmonella contamination in pistachios processed by Setton Farms, the US Food and Drug Administration (FDA) yesterday investigated the company's affiliate in Commack, N.Y., that makes chocolate- and yogurt-covered nuts and dried fruit, the Associated Press (AP) reported yesterday. Last month the New York affiliate, Setton International Foods, Inc., failed its state health inspection because authorities found cockroaches and rodent droppings in the plant, though company officials say they have remedied the problems. New York's agriculture department told the AP that the company is holding all of its pistachio products and that state investigators were in the plant on Apr 1 to obtain product samples for microbiological testing. In other developments, Setton Farms' California operation told the FDA that its internal tests had previously detected the same four Salmonella subtypes that Kraft Foods found in independent testing, a finding that prompted the recent recall of the company's pistachios, USA Today reported yesterday. Setton Farms said the contaminated lots were destroyed.
[Apr 2 AP story]
[Apr 2 USA Today story]

FDA targets Salmonella spice warning to Asian food sellers
The FDA is taking its recent Salmonella warning about spices directly to Asian restaurants and food service companies that were the primary recipients of a California company's tainted white pepper, the Oregonian reported today. The FDA is worried that some customers who bought the spices do not speak English and may not be aware of the recall messages, David Acheson, MD, the FDA's associate commissioner of foods, told the paper. The agency has published its warnings in both English and Mandarin. Oregon's Public Health Division, which isolated the pathogen from ground white pepper from an Asian restaurant in Portland, added a Vietnamese version. Meanwhile, the FDA yesterday issued a public health alert about the Lian How and Uncle Chen brand spices, both produced by Union International Food Co. So far 42 illnesses matching the Salmonella Rissen outbreak strain have been reported in California, Nevada, Oregon, and Washington.
[Apr 3 Oregonian story]
[Apr 2 FDA public health alert]

NFID launches adult vaccination push
The National Foundation for Infectious Diseases (NFID) yesterday during an online symposium called for more action to boost adult immunization rates and launched a Web site to promote the importance of vaccinating adults against preventable diseases such as influenza, pertussis, and pneumococcal disease. The site includes key information about 13 adult diseases and the vaccines to protect against them, along with tools such as reminder postcards and patient education materials for healthcare providers. NFID's call to action is backed by several other medical groups, such as the American Medical Association and the Infectious Diseases Society of America.
[NFID adult vaccination Web site]

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