NEWS SCAN: European flu activity, anti-inflammatories in H1N1, cholera in NYC, malaria control

Feb 7, 2011

Flu activity high in several European nations
Georgia and Luxembourg are reporting very high levels of influenza, while eight other European nations are reporting high levels, according to the World Health Organization's (WHO's) most recent EuroFlu update. The report says that Georgia reported a severe impact on its healthcare system. The report, for the week ending Jan 30, says that flu is increasing in most countries in the WHO's European Region, which includes parts of Asia, with 23 nations reporting widespread activity. The report says 46% of patients with flu-like illness or acute respiratory infections tested positive for influenza. The circulating flu strains continue to match well with the three strains in the vaccine: pandemic 2009 H1N1, H3N2, and B. Pandemic H1N1 viruses account for 65% of flu specimens typed, with influenza B making up 35%. Novel H1N1 is dominant in 19 countries, influenza B in 4 nations, and the two strains were "co-dominant" in 13 countries. The countries reporting high flu activity are Albania, Bulgaria, Greece, Italy, Lithuania, Norway, Russia, and Turkey.
EuroFlu update

Study: Anti-inflammatory drugs failed to ameliorate H1N1 flu
The use of immunomodulatory drugs, including corticosteroids, macrolides, and statins, failed to reduce the severity of pandemic H1N1 influenza in a series of patients in Spain, according to an "in press" report published online by the Journal of Infection. The observational prospective cohort study was conducted at 13 tertiary hospitals. Included in the research were 197 patients, 68 of whom received some form of anti-inflammatory treatment after admission—corticosteroids for 37, macrolides for 31, and statins for 12. Twenty-nine of the 68 patients (14.7%) suffered severe disease, defined as intensive care unit admission or death. After researchers adjusted for confounding factors, they found that the drugs as a group did not lower the risk of having severe disease (odds ratio, 0.64; 95% confidence interval, 0.22 to 1.86). Further multivariate analysis did not show a reduction in risk for any of the drugs individually.
J Infect study

Cholera confirmed in New York City travelers
New York City health officials have confirmed three cholera cases in adults who got sick after returning from a wedding in the Dominican Republic, the New York Times reported on Feb 5. The patients experienced diarrhea and dehydration but did not require hospitalization, and all recovered, the Times reported. The cases follow other reports of people who got sick with cholera, including patients in Venezuela, Montreal, and Massachusetts, upon their return from a Dominican Republic wedding. City health officials told the Times they were working with the US Centers for Disease Control and Prevention (CDC) to identify what the New York patients ate and what strain of cholera they had. In other developments, the Pan American Health Organization (PAHO) on Feb 4 warned international travelers to get up-to-date with their vaccinations before traveling to Haiti to avoid unintentionally importing the disease into the country, which is battling a cholera epidemic and recovering from a January 2010 earthquake. The warning comes in the wake of investigations of suspected polio and measles outbreaks in Haiti. Lab tests have ruled out polio in four cases of acute flaccid paralysis in cholera patients. The second probe involves measles in an 8-month-old baby of a US volunteer who traveled from Pennsylvania to Haiti in December. The baby and two siblings got sick with measles after they returned to the United States on Jan 4. Four of the family’s six children were unvaccinated. An investigation into a cluster of pediatric rash and fever cases in the area where the relief worker and baby had visited turned up chickenpox, but not measles. No cases of measles have been identified in Haiti, and investigators say the child may have been exposed to the disease in a US airport. PAHO said the disease scares serve as a warning about vaccinations for travelers and that the polio vaccine is being offered alongside diphtheria and measles vaccines as a precaution.
Feb 5 New York Times story
Feb 4 PAHO report

Thai-Cambodia border dispute may hinder malaria control
An ongoing border dispute and military buildup between Thailand and Cambodia could stall global efforts to contain drug-resistant malaria, according to the United Nations' IRIN News. Health officials are concerned that the forested, rugged border harbors mosquitoes that carry malaria-causing Plasmodium falciparum parasites that are increasingly resistant to artemisinin, the most effective malaria drug. The military maneuvers along the border are hampering surveillance, diagnosis, and treatment efforts, according to the story. "I hope the critical importance of a global health emergency takes precedence over a political conflict," said Robert Newman, director of the WHO's Global Malaria Program. His comments follow a similar warning on Feb 1 from Doung Socheat, director of Cambodia's National Center for Parasitology, Entomology, and Malaria.
Feb 4 IRIN News story

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