News Scan for Jun 26, 2014

News brief

Suriname reports suggest local chikungunya transmission

Suriname health officials yesterday said more chikungunya infections have been detected, suggesting the possibility of local transmission, Caribbean Media Corporation (CMC) reported today.

The Suriname Bureau of Public Health (BOG) has now confirmed 17 cases, which included two announced earlier in travelers—one in a man who returned from St Martin and the other in a woman who was in neighboring Guyana. The BOG said the 15 other cases were confirmed yesterday and that it expects widespread illnesses to follow. A local media report translated and posted by FluTrackers, and infectious disease news message board, said of the 15 new cases, two are family members of the first case-patient and are considered imported cases. It said the other 13 patients contracted the disease locally.

Locally transmitted cases have been detected in two countries that border Suriname, Guyana to the west and French Guiana to the east.

At a press conference yesterday with the ministry and other regional health groups, officials warned that the virus could affect thousands unless precautions are taken, such as avoiding mosquitoes and emptying outdoor water containers.

In other developments, Alabama has reported its first chikungunya case this year in a traveler, the Associated Press (AP) reported yesterday. The Alabama Department of Public Health said the patient is a woman from Huntsville who was exposed to the virus while traveling in Haiti.

So far this year 74 imported cases from 23 states have been reported to the US Centers for Disease Control and Prevention (CDC), according to a Jun 24 update from the agency. The number is much more than the average total of 28 cases in a whole year. All but one of the cases this year had a link to Caribbean travel.
Jun 26 CMC story
Jun 25 AP story
FluTrackers thread

Nature editors: CDC anthrax scare hints at risks of GOF studies

Last week's incident involving possible exposure of numerous CDC staffers to live Bacillus anthracis adds fuel to the heated debate over laboratory work on dangerous pathogens, including "gain-of-function" (GOF) research, says an editorial published in Nature yesterday.

"If an accident can happen at the CDC, then it can happen anywhere," states the piece.

Last week's episode involved anthrax bacteria that were supposedly inactivated in a biosafety-3 (BSL-3) lab for use in research at several BSL-2 labs. It was found that a lapse in safety procedures may have allowed live bacteria to survive in the samples, potentially exposing more than 80 CDC workers at the BSL-2 labs, which do not provide adequate protection for the handling of dangerous live pathogens, to the live bacteria.

The workers were warned and offered prophylactic antibiotics. The CDC has since said that preliminary environmental testing at the labs showed negative results.

Questions as to the advisability of GOF research, in which pathogens are engineered to be more lethal and/or to transmit more easily, have been raised since late 2011, when two groups modified H5N1 avian flu viruses to increase their transmissibility. The resulting controversy promoted a temporary moratorium on influenza GOF research, which has since expired.

Says the Nature editorial, "It is impossible to read about the CDC [anthrax] incident and not breathe a large sigh of relief that it did not involve a novel engineered pandemic influenza strain."

It adds, "The CDC accident shows that, should such [GOF] research proliferate, the idea of an accidental release of a potentally pandemic flu virus cannot be completely written off. This demands that such research proposals receive the utmost scrutiny."
Jun 26 Nature Editorial
Jun 19 CIDRAP News story on CDC anthrax incident
Jun 19 CIDRAP News commentary on GOF controversy
May 22 CIDRAP News story on GOF controversy

Avian Flu Scan for Jun 26, 2014

News brief

H5N1 hospitalizes Egyptian man

Egypt's health ministry yesterday announced the nation's fourth H5N1 case of the year, which involves a 34-year-old from Minya who is hospitalized and on a ventilator, according to a report today from the Middle East News Agency (MENA).

The man was originally isolated at Minya Fever Hospital and has been transferred to a Cairo hospital. Health officials are monitoring the health of the man's family, and so far no avian flu symptoms have been detected, according to the report.

Egypt has reported three other H5N1 infections this year, according to earlier reports. The other patients include included a 56-year-old woman, a 4-year-old child, and an 86-year-old woman.

Egypt's count of H5N1 infections confirmed by the World Health Organization (WHO) has dropped sharply over the past 3 years. The country has had 173 cases since 2006, not including this year's infections, according to the WHO. So far 63 deaths have been reported. The country has the world's second highest numbers of infections and deaths.
Jun 26 MENA story
WHO cumulative H5N1 case count

Human transmission unlikely in family H5N1 cluster in Cambodia

An analysis of H5N1 avian flu cases in a mother and her child in Cambodia in 2011 suggests that there was no human-to-human transmission but that the two victims may have had a genetic susceptibility to the virus, according to a report today in Eurosurveillance.

The report focuses on a 19-year-old mother who got sick on Feb 4, 2011, and her 9-month-old baby boy, who became ill early the next morning. Both of them died, and H5N1 infection was confirmed posthumously.

Investigators collected specimens from 11 household and 3 neighbor contacts of the two patients, all of which tested negative for H5N1 by polymerase chain reaction (PCR). Also, no H5N1 antibodies were found in follow-up serum samples from the 11 household contacts.

In addition, 26 healthcare workers who were exposed to the two patients without adequate protective equipment stayed healthy in the ensuing 2 weeks.

The two patients had visited for 33 days in a village where poultry were dying, but they had no direct contact with sick or dead poultry. The researchers concluded that both the mother and child probably were infected through exposure to a contaminated environment.

The investigators determined that the patients had less exposure to sick poultry or their environments than other household members did, yet none of the household members were infected. "This suggests the possibility of genetic susceptibility as a risk factor for infection," they wrote.
Jun 26 Eurosurveillance report

Study finds diversity in H10N8 samples from human, poultry

Chinese researchers who analyzed samples from the country's first H10N8 avian influenza case, in an older woman from Jianxi province who died in December, and compared them with a sample from a poultry market found that the two were similar, but with different origins.

The team published its findings today in Eurosurveillance. So far three human H10N8 illnesses have been reported in China, two of them fatal. All were from Jiangxi province.

The researchers analyzed two H10N8 samples from the patient and one obtained from chickens at a poultry market where the woman had shopped. For all three viruses, the hemagglutinin (HA) and neuraminidase (NA) genes were similar, having spread from wild birds to ducks and then to chickens. The team also found that several other genes—the PA subunit of the virus polymerase complex, the nucleoprotein (NP), M, and nonstructural (NS) genes—were similar to those in H9N2 viruses from chickens

However, they found that the PB1 and PB2 genes of the poultry sample probably came from H7 viruses in ducks and that the same genes in the human samples probably came from H9N2 viruses circulating in chickens. Taken together, the findings suggest greater diversity in H10N8 viruses than previously thought, the team wrote.

Also, the human H10N8 viruses had the E627K substitution in the PB2 gene, which in other viruses such as H5N1 and H7N9 has been linked to increased virulence in mammals.

The researchers concluded that H10N8 viruses might have become established in poultry, requiring more intensive surveillance, and that role of H9N2 as gene donors for H10N8 and H7N9 viruses should be explored further, as should the role of H9N2 in enabling wild-bird influenza viruses to jump to humans.
Jun 26 Eurosurveill study