News Scan for Feb 21, 2017

H7N9 cases in China
Poultry worker avian flu exposure
Yemen polio campaign
Multi-disease mosquito vaccine

China reports 2 more H7N9 cases, updates treatment recommendations

China today reported two more H7N9 avian influenza infections in humans, and the country's top health officials have announced an update to treatment recommendations for patients.

The latest cases are both from Sichuan province in southwestern China, according to a state news agency report translated and posted by FluTrackers, an infectious disease news message board.

Investigations found no connections between the two patients and said they had a history of exposure to live poultry.

China is in the midst of its fifth and biggest wave of H7N9 activity since the virus was first detected in humans in early 2013. Since October, at least 424 cases have been reported.

In a related development, China's National Health and Family Planning Commission yesterday unveiled updated H7N9 treatment recommendations, according to a government announcement released yesterday and translated and posted by FluTrackers. Officials urge doctors to start antiviral treatment early, preferably within 48 hours of symptom onset, without waiting for influenza test results.
Feb 21 FluTrackers thread on new H7N9 cases
Feb 20 FluTrackers thread on H7N9 treatment


Study of Chinese poultry workers finds high rate of H5, H9 exposure

In an effort to better clarify clinical and transmission patterns of H7N9 and other avian influenza strains, given that severe infections might be the tip of the iceberg, researchers from the Netherlands and China's Guangdong province yesterday published new findings from a 3-year serology study that compared serology findings in poultry workers with those of healthy blood donors. The study, which noted a fairly high prevalence of H5N1 exposure, appeared in Zoonoses and Public Health.

Using a test to detect antigens to 13 different hemagglutinin (HA) antigens of H5N1, H7N7, H7N9, and H9N2, the investigators tested serum samples collected from poultry workers in 2012, 2013, and 2014 by the Guangdong province Centers for Disease Control. The workers held different jobs, ranging from wholesale markets to poultry transport. As a control group, the researchers tested the serum of 96 people who donated blood in November 2013 in the city of Guangzhou.

Higher antibody levels were found in the blood of poultry workers for recent H5 and H9 strains, with the differences most pronounced in younger age-groups for antigens from the older strains. The team found that 7% of poultry workers had titers above 80 for H5N1 antigen along with an H5 antibody profile specific to that group, suggesting a substantial rate of mild or asymptomatic H5N1 infections in at-risk people in Guangdong province.

For H7, the team found a much lower prevalence, with findings limited to poultry workers from two live-poultry markets. Overall, the findings suggest that H5 and H9 infections are more common than is currently known. The authors said follow-up studies are needed to gauge the range of health effects linked to seroconversion to animal flu viruses.
Feb 20 Zoonoses Public Health abstract


Polio vaccine campaign launched in Yemen

Yesterday Yemen began a new polio eradication campaign, according to the World Organization of Health (WHO). The 3-day campaign aims to immunize 5,019,648 children under the age of 5.

Yemen last held a polio vaccination campaign in April 2016. But ongoing conflict and movement of internally displaced people have made vaccinating vulnerable populations challenging. Yemen has been polio-free since 2006, and the country said the campaign will help maintain this status.

"WHO is working closely with UNICEF and health authorities to keep Yemen polio-free. The threat of virus importation is serious and this campaign aims to curb any possible return of the virus to Yemen," said Nevio Zagaria, MD, the WHO acting representative in Yemen.
Feb 20 WHO news release


Multi-disease vaccine that responds to mosquito saliva enters phase 1 trials

AGS-v, an investigational vaccine that triggers an immune response to mosquito saliva rather than to a specific virus or parasite carried by mosquitoes, has entered phase 1 clinical trials, according to a press release today by the National Institute of Allergy and Infectious Diseases (NIAID).

Rather than targeting one mosquito-borne disease, the vaccine aims to protect people from the bug's bites and in the process halt the transmission of Zika, dengue, or yellow fever.

"Mosquitoes cause more human disease and death than any other animal," said NIAID Director Anthony S. Fauci, MD, in the release. "A single vaccine capable of protecting against the scourge of mosquito-borne diseases is a novel concept that, if proven successful, would be a monumental public health advance."

The vaccine is made from four synthetic proteins derived from mosquito salivary glands. The proteins should induce antibodies in a vaccinated individual and cause an allergic response that can prevent infection when a person is bitten by a disease-carrying mosquito.

Sixty healthy adults aged 18 to 50 will participate in the study, which is expected to be completed by the summer of 2018.
Feb 21 NIAID press release

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