News Scan for Dec 02, 2014

New MERS case
Novartis flu vaccine found safe
Global flu activity

Saudi Arabia reports new MERS case as WHO confirms 18

Saudi Arabia's Ministry of Health (MOH) reported a new MERS-CoV case today as the World Health Organization (WHO) confirmed 18 cases previously reported by the MOH.

The new case is in a 28-year-old male expatriate in Najran in the south. He is not a healthcare worker (HCW) and had no exposure to other patients with MERS-CoV (Middle East respiratory syndrome coronavirus). He did, however, have recent exposure to animals. He has no preexisting disease and is listed in critical condition.

The MOH also reported that three MERS case-patients in Riyadh have recovered, including a 40-year-old female HCW. The other two are 44- and 45-year-old men. All three patients are Saudis and had preexisting disease.

The country now has had 815 MERS-CoV cases, including 350 fatalities. The MOH said that 8 of the patients are still receiving care.
Dec 2 MOH update

The WHO report today includes 18 cases that the Saudi MOH reported from Nov 3 through Nov 19, including 4 deaths. The WHO report, however, offers new details.

Half (9) of the patients are from Riyadh, 3 each are from Al-Kharj and Taif, 2 are from Sakakah, and 1 is from Jeddah. Patients range in age from 22 to 99 years, with a median age of 51.

Four patients reported animal exposure; 7 had confirmed or possible MERS-CoV contact in a healthcare setting, including being in the same hospital as a confirmed patient; and 7 reported no MERS-CoV exposure. In contrast to today's MOH report, the WHO reported 12 active patients among the group, with 8 listed as currently in stable condition and 4 as critical or in intensive care.

In related news, a study in the American Journal of Infection Control covering 536 lab-confirmed MERS cases reported globally as of May 9 found 11 events that involved possible or confirmed healthcare-related transmission. The outbreaks involved high morbidity and mortality, mainly among patients with preexisting disease.
Dec 2 WHO report
December Am J Infect Control abstract


Italian drug agency calls Novartis flu vaccine safe

Italy's drug regulatory agency said yesterday that tests revealed no problems with a Novartis flu vaccine that had fallen under suspicion because of some deaths in vaccinees, according to a Reuters report.

The agency, AIFA, suspended use of about 500,000 doses of the vaccine, Fluad, last week because of reports that three people died within 48 hours after being vaccinated. The vaccine, which contains the adjuvant MF59, is used in the elderly.

Reuters said 16 additional deaths in vaccinees were reported after the suspension was announced, but experts were skeptical that the deaths were linked to the vaccine, and authorities urged continued vaccination against flu.

In a joint statement with the Italian health ministry, AIFA said, "The results of the tests confirm the safety of the anti-flu vaccine," according to Reuters. It said the tests on the suspended batches were "completely negative."

In view of the test results, the agency said reports of deaths following vaccination should be attributed to media attention to the issue, not to the vaccine, Reuters reported. Novartis said last week that the deaths may have been only coincidental, since the vaccine recipients are elderly.

AIFA did not announce whether it planned to release the two lots of Fluad that were suspended, the story said.
Dec 1 Reuters story
Related Dec 1 CIDRAP News story


WHO: Flu activity increasing in Pacific islands, parts of the Americas

Several Pacific islands, Cuba, Costa Rica, and Canada are showing increases in influenza activity, according to yesterday's WHO update. Other than these sites and slight increases in Europe, North America, and northern China, worldwide flu activity remains low.

The United States saw a slight increase of flu activity within usual levels, with 955 specimens (9.3%) testing positive, 87.5% of which were flu type A. Canada experienced a sharp increase in flu cases (4.6% of specimens testing positive compared with 2% on Nov 17), approximately half of which were diagnosed in people 65 years and older. Flu levels in Mexico remained low.

Africa and Asia are seeing low levels of flu activity, with the exception of a slight increase in H3N2 cases in northern China. Influenza type B continues to predominate in Vietnam.

Cuba and Costa Rica detected increases of both influenza A and respiratory syncytial virus, the WHO said. Flu activity remained high in the Pacific islands of American Samoa, Micronesia, French Polynesia, Guam, the Marshall Islands, the Northern Mariana Islands, the Solomon Islands, and Vanuatu.

Flu activity increased slightly in Europe, where 2% of sentinel specimens tested positive for influenza. Of the positive specimens, 65% were type A and 35% were type B.

Data are based on FluNet reporting from 45 countries as of Nov 27. A total of 34,452 specimens were tested, of which 2,572 (7.5%) were positive for flu. Among positive specimens, 82.5% were type A and 17.5% were type B. A large majority of type A specimens (97%) were H3N2; 2.9% were 2009 H1N1.
Dec 1 WHO update

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