FLU NEWS SCAN: H5N1 case in Indonesia, ferrets in flu research, fatal H3N2 strain

Mar 7, 2012

Indonesia reports another fatal human H5N1 case
A 24-year-old woman from Sumatra has died of an H5N1 avian influenza infection, marking Indonesia's fifth H5N1 death this year, Agence France-Presse reported today. A health ministry official, Rita Kusriastuti, said the woman had some poultry in her house and lived in an area with many ducks and chickens, according to the story. Meanwhile, the World Health Organization (WHO) today recognized two H5N1 cases in Bangladesh that were reported by news outlets earlier. The cases involved two men who work in live bird markets in Dhaka, an 18-year-old and a 26-year-old, both of whom have recovered, the WHO said. Their cases were the fifth and six reported in Bangladesh since 2008. In other news, Vietnam's latest H5N1 patient, a 22-year-old man, was discharged yesterday from a Ho Chi Minh City hospital in "stable health" after 9 days of treatment there, according to a Thanh Nien News report that cited the Tuoi Tre newspaper as its source. His case was Vietnam's third this year, the story said. The WHO puts the global H5N1 count at 594 cases with 392 deaths, including 186 cases and 154 deaths in Indonesia. (The WHO count shows only three Indonesian H5N1 cases so far this year; it does not include the Sumatra woman's case, and the case of a 23-year-old man who got sick in late December 2011 and died in January 2012 was counted as a 2011 case.)
Mar 7 WHO statement on Bangladeshi cases
Mar 6 Thanh Nien News story
WHO H5N1 case count

ECDC: For flu, ferret studies complement but don't replace human studies
The European Centre for Disease Prevention and Control (ECDC) offered a statement today on the value of ferrets as an experimental model for human influenza, a prominent issue in the current debate on publication of research on lab-derived H5N1 viruses with increased transmissibility in ferrets. The ECDC essentially said that ferret studies are useful but cannot fully predict how flu will behave in humans. The agency said many consider ferrets to be the best small-animal model for human flu and noted that for decades, ferret antibodies against flu strains in seasonal vaccines have been used to assess the antigenic match between the vaccine strains and drifted strains. Also, the ferret model was valuable during the 2009 H1N1 pandemic in assessing the transmissibility and pathogenicity of the novel virus. However, differences seen in ferrets between the effects of the pandemic H1N1 virus and the previous seasonal H1N1 virus "were not entirely borne out" during the pandemic in Europe. "In summary, work using the ferret model is complementary to, but does not substitute for studies of the virology, immunity [sic], epidemiology, transmission and pathogenicity of influenzas in humans," the statement says. It goes on to cite studies suggesting that not all highly pathogenic H5N1 viruses are virulent in ferrets, with results varying in different labs and with different routes of exposure. A footnote says that the authors of the statement received comments and suggestions from Ron Fouchier, PhD, lead author of one of the unpublished ferret studies at the center of the current controversy.
Mar 7 ECDC statement
Related Dec 23, 2011, CIDRAP News story

UK study says fatal H3N2 strain from 2003-04 flu season disappeared afterward
A particular strain of H3N2 flu that circulated in Britain in 2003-04 but not afterward caused an unusually high number of deaths in children, according to a study yesterday in PLoS One. UK researchers sequenced and conducted a phylogenetic analysis of the whole genomes of 63 viruses isolated from fatal cases and nonfatal "control" cases and found that 17 fatal UK cases were caused by a Fujian/411/2002-like H3N2 strain. That season this strain completely displaced the previously circulating H3N1 variant, A/Panama/2007/99, in the Northern Hemisphere. They found that two main genetic groups of this strain, groups I and II, both circulated and caused deaths, but they could find no associated amino acid substitution tied to a higher occurrence of fatal cases. They also found that the Fujian/411-like strain disappeared after 2004.
Mar 6 PLoS One study

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