News Scan for Sep 21, 2017

H3N2v flu in fairgoers
Flu vaccine in low-income nations
EU malaria transmission

Seven fairgoers contract H3N2v flu in Maryland

Seven people who had close contact with swine at the Charles County Fair in Maryland have been diagnosed as having H3N2v, a variant swine-origin flu. The Maryland Department of Health (MDH) published details of the cases on its Web site yesterday.

All seven patients reported close contact with pigs while at the county fair, but none have developed serious illness or been hospitalized, the MDH said. The patients are being treated as though they have seasonal flu.

State officials recommend that any Maryland residents with flu-like symptoms and contact with pigs in the previous 7 days contact their healthcare provider.

There have now been 27 cases of variant influenza in the United States this year, most related to animal exposures at fairs. Twenty-five of those cases also involved the H3N2v strain, with the other 2 attributed to H1N2v. According to the MDH, in 2012, 13 people developed influenza after direct contact with sick pigs at the Queen Anne's County fair in Maryland.
Sep 20 MDH statement


WHO: Existing flu vaccine not well suited for low-, middle-income countries

The results of a World Health Organization (WHO) working group convened to develop preferred product characteristics for next-generation influenza vaccines determined that current vaccines are not optimal for low- and middle-income countries (LMICs). The findings were published yesterday in Vaccine.

The authors said the current seasonal influenza vaccine does not fit well into LMICs' nationalized healthcare programs for a number of reasons. Chiefly, the expiration dates of the vaccine are based on temperate climates, and the seasonal nature of the influenza vaccine requires more than annual trips to a healthcare setting.

LMICs are more likely to have immunization programs in place for children under the age of 2, but fewer adults regularly receive vaccines or boosters. Adults need to be targeted, the working group concluded.

Ultimately, the working group recommended developing a vaccine that would protect against influenza A for at least 5 years.
Sep 20  Vaccine report


ECDC reports malaria spread, some involving hospitals

The European Centre for Disease Prevention and Control (ECDC) yesterday said five local malaria events have recently been reported in four countries: Greece, Cyprus, France, and Italy.

Three of the clusters are linked to an imported case or an infected imported mosquito. The other two are probably related to nosocomial mosquito-borne or iatrogenic transmission of P falciparum, the ECDC said. Illness onsets range from May 2 to Aug 29.

In the affected countries:

  • France reported two malaria cases involving P falciparum in people who attended the same wedding in Auvergne-Rhone-Alpes region. Neither patient had recently visited a country in which the disease is endemic. The investigation concluded that the cases may be related to a patient from Burkina Faso who had spent time in the area 2 weeks before the wedding.
  • Greece reported a cluster of five P vivax illnesses, following recent introduction into the area, and one case involving P falciparum in a patient who had been hospitalized in a ward where another person had been treated for the same type of infection.
  • Italy reported a fatal case involving P falciparum in a 4-year-old girl who had been hospitalized in the same facility in Trento where two other patients had been treated for the same infection type. Molecular sequencing is under way to explore possible links to other cases, and an entomologic investigation is under way to see if infected mosquitoes were present in Bibione, in Venice, where the girl had vacationed.
  • The United Kingdom reported three P vivax cases in travelers returning from northern Cyprus.

Though the risk of further malaria spread in the European Union is thought be very low, the ECDC urged healthcare providers to be aware of the risk of nosocomial infection and to follow standard precautions.
Sep 20 ECDC risk assessment

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