NEWS SCAN: New pan flu framework, 4-strain flu vaccine trial, rinderpest lab stock destruction, cholera in Cuba

Dec 10, 2012

CDC framework assesses emerging flu pandemics for both spread and severity
A key lesson learned from the 2009 H1N1 influenza pandemic was that plans and severity scales did not address the severity of the novel strain. In response, a team of CDC experts has developed an evidence-based framework for assessing the public health impact of flu pandemics as they emerge, with a two-tier approach recognizing that transmissibility and severity are hard to assess early in a pandemic, according to a report in Emerging Infectious Diseases. The team reviewed data from past flu seasons and pandemics to characterize severity and transmissibility based on the US experience. They outlined an approach to assessing the potential effects of a novel influenza virus using a broad dichotomous scale in the initial assessment but then refining the tool with more precise values as more data become available. This more refined assessment would have scaled values of severity and transmissibility plotted along an x-axis and y-axis, respectively, and could be stratified by age to reflect different effects on different age-groups. "By organizing and prioritizing data collection," the authors write, "this approach may inform an evidence-based assessment of pandemic effects and guide decision making."
Dec 8 Emerg Infect Dis report

Sanofi trial supports immunogenicity, safety of quadrivalent flu vaccine
Sanofi Pasteur's quadrivalent influenza vaccine (QIV) containing two influenza B strains performed comparably to two trivalent vaccines (TIVs) in a phase 2 clinical trial assessing immunogenicity and safety, according to a report in Vaccine. The company in October filed for US approval of the vaccine. (A quadrivalent intransal vaccine from MedImmune was approved in February.) TIVs contain just one B strain, but it's difficult to predict which of the two influenza B lineages—Victoria or Yamagata—will be more common each flu season. The trial compared the QIV with the 2008-09 and 2009-10 seasonal flu vaccines, which contained single B strains (one Victoria, one Yamagata). Adults, 190 in each group, were randomly assigned to receive one of the three vaccines. Antibody titers (measured by hemaggluination inhibition) in the QIV group were noninferior to those in the TIV groups. In addition, rates of seroprotection (antibody titer over 40) and seroconversion (a fourfold or greater rise in titer after vaccination) were similar in all three groups. The QIV left recipients with substantially higher B antibody levels than each group of TIV recipients had for the B strain not contained in their vaccine. As for safety, the incidence and severity of solicited injection-site and systemic reactions and adverse events were similar in all the groups.
Dec 8 Vaccine report
Oct 18 CIDRAP News item about Sanofi filing for its QIV

OIE chief repeats call for destruction of rinderpest lab stocks
The chief of the World Organization for Animal Health (OIE) today repeated calls for most laboratories to destroy remaining stocks of rinderpest virus, which causes a devastating disease in cattle and was eradicated in 2011, the first time humans have ever snuffed out an animal disease in the wild. Bernard Vallat, DVM, OIE director-general, made the comments at the Biological Weapons Convention Meeting of States Parties in Geneva, Agence France-Presse (AFP) reported. In July the OIE and the United Nations Food and Agriculture Organization (FAO) issued a joint call for labs across the world to destroy any remaining virus samples or ship them to high-security OIE/FAO labs for storage. Vallat told AFP that dozens of labs house the virus, including some that don't adhere to strict biosafety standards, which poses a risk of an accidental or intentional release.
Dec 10 AFP story
Jul 23 CIDRAP News scan "OIE, FAO call for destruction of rinderpest virus stores"
In related news, Vallat today urged weapons convention members to strengthen veterinary services as a way to protect the world from biologic threats related to animal pathogens, according to an OIE press release. "The best way to protect the entire world from rising bio-threats linked with animal pathogens is to ensure that all national veterinary services comply with OIE international standards on quality. This must be a basis for bio risk management policies," Vallat said in the statement.
Dec 10 OIE press release

Hurricane flooding sparks more cholera in Cuba
Parts of Cuba are experiencing a rise in cholera and dengue infections in the wake of flooding caused by Hurricane Sandy, according to a Dec 8 report from the Miami Herald that quoted several dissidents in the country. The spike in activity follows a summer outbreak centered in the eastern city of Manzanillo that was Cuba's first in a century. The current wave of infections has targeted the eastern third of Cuba, and though the government hasn't issued any public statements about the outbreak, it has established hand and shoe disinfection stands at the entrances of government buildings, with some public health workers going to houses to assess for disease symptoms and distribute water purification tablets. Sources told the Herald that at least 12 deaths had been reported and that cholera cases have recently led to quarantines at hospitals and prisons and closures at schools and restaurants. Also, the report said police stationed at hospitals are asking visitors to keep quiet about cholera and other diseases, apparently to avoid hurting Cuba's tourism industry.

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