News Scan for Jul 25, 2018

Mixed Southern Hemisphere flu picture
Avian flu in Saudi Arabia, Russia
Thrombocytopenia syndrome

Southern Hemisphere flu levels show mixed picture

The Southern Hemisphere's flu season, which typically lasts through October, shows mixed patterns, with activity that may have peaked in southern Africa, is increasing in South America, and is still below seasonal thresholds in Australia and New Zealand, the World Health Organization (WHO) said in its latest global flu update.

Most of the flu activity in southern Africa is from the 2009 H1N1 virus. In South America's temperate regions, flu activity has been reported in most countries, with H3N2 predominant in Chile and 2009 H1N1 predominant in Brazil, which is circulating alongside H3N2. In tropical countries in the Americas, flu activity varied, with hot spots including Guatemala and Honduras, where 2009 H1N1 is predominant, and elevated levels still reported in Colombia and Peru.

Though flu activity in Australia and New Zealand is still low, 2009 H1N1 is the most frequently detected flu virus.

In western Africa, influenza B from both lineages is predominant. In tropical parts of Asia, flu activity remained low except for Cambodia, where levels increased slightly.

Globally, influenza A made up 81.5% of detections for the week ending Jul 8. Of subtyped influenza A viruses, 80.7% were 2009 H1N1.
Jul 23 WHO global flu update


High-path avian flu outbreaks reported in Saudi Arabia, Russia

In the latest highly pathogenic avian influenza outbreak developments, Saudi Arabia detected H5N8 in poultry at a market in Riyadh and Russia reported 13 more H5 outbreaks, according to notifications from the World Organization for Animal Health (OIE).

Saudi Arabia's agriculture ministry said active surveillance on Jul 17 at the Alazizia bird market identified the virus in 1 of 20 ducks tested. All of the susceptible 14,675 birds at the location were destroyed to curb the spread of the virus, and authorities temporarily closed the market and applied other control measures. The country reported its last H5N8 outbreak in June, which involved a poultry farm in the city of Al Kharj in Riyadh province.

Of Russia's 13 H5 outbreaks, 12 are in the Republic of Tatarstan and 1 in Saratov Oblast, both in the west. The OIE report didn't list the subtype, but a recent report from the United Kingdom said the Russian outbreaks involve H5N8. The latest outbreaks are part of ongoing activity since the middle of June.

The outbreaks began from Jul 12 to Jul 20, and all occurred in backyard poultry. The virus killed 244 of 990 susceptible birds, and authorities culled the surviving ones as part of the steps to curb the spread of the virus.
Jul 24 OIE report on H5N8 in Saudi Arabia
Jul 25 OIE report on H5 in Russia


Chinese researchers describe rare thrombocytopenia syndrome

A study yesterday in The Lancet Infectious Diseases details the clinical and epidemiologic features of severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease. The study describes a 16.2% case-fatality rate for the tick-borne infection.

Researchers conducted the prospective observational study at a hospital in Henan province, China, among lab-confirmed SFTS cases. From Apr 1, 2011, to Oct 31, 2017, a total of 2,096 cases were diagnosed. The mean age of patients was 61.4 years, and 59% of patients were female. The median time from symptom onset to hospital admission was 5 days, and the median duration of hospitalization was 8 days.

The case-fatality rate was 16.2%, and death was associated with males, older age, delay in diagnosis, and diarrhea. The development of hemorrhagic signs (adjusted odds ratio [OR], 2.79; 95% confidence interval [CI], 2.18-3.57; P < 0.0001) or neurologic symptoms (adjusted OR, 30.26; 95% CI, 21.39-42.81; P < 0.0001), were most strongly associated with fatal cases of SFTS.

SFTS, which is caused by a phlebovirus, was first recognized in China in 2009, and in South Korea and Japan in 2012.

In a commentary published alongside the study, Xue-Jie Yu, PhD, who was not involved in the study, writes that the clinical descriptions of SFTS support "that SFTS is a viral haemorrhagic fever, since the authors found a higher frequency of haemorrhagic signs than have been reported for Ebola virus disease or dengue."
Jul 24 Lancet Infect Dis study
Jul 24 Lancet Infect Dis commentary

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