Flu Scan for Aug 17, 2018

More H1N2v flu cases
Flu vaccine and narcolepsy
Avian flu outbreaks in Europe

CDC confirms 4 new H1N2v flu cases in 3 states

For the second week in a row the Centers for Disease Control and Prevention (CDC) has confirmed four cases of variant H1N2 (H1N2v) flu, this time in California, Michigan, and Ohio.

In its weekly FluView report today, the CDC said 2 of the new H1N2v cases are in California and 1 each in Michigan and Ohio. Last week the agency confirmed 2 cases in California and 2 in Michigan. The only other variant flu case reported so far this year was caused by the much more common H3N2v strain, in a patient in Indiana.

Of the four new cases, three involved exposure to swine at agriculture fairs in the week before illness onset, while the other person attended a fair but had no contact with swine, the CDC said. Three patients were children and one an adult younger than 25. None required hospitalization.

"Early identification and investigation of human infections with novel influenza A viruses are critical so that the risk of infection can be more fully understood and appropriate public health measures can be taken," the CDC said.
Aug 17 CDC FluView report


Study finds no tie between pH1N1 vaccine, narcolepsy except in Sweden

A study involving data from nine countries has found that, other than elevated narcolepsy levels after 2009-10 pandemic flu vaccination campaigns in Sweden, there was no association between narcolepsy and AS03- or MF59-adjuvanted 2009 H1N1 (pH1N1) flu vaccines in children or adults.

Reporting yesterday in the journal Vaccine, a large international group of scientists said they used electronic health databases to conduct a dynamic retrospective cohort study to assess narcolepsy incidence before and during pH1N1 virus circulation—and after pH1N1 vaccination campaigns—in Canada, Denmark, Spain, Sweden, Taiwan, the Netherlands, and the United Kingdom. In addition, they used a case-control study design to evaluate the risk of narcolepsy following AS03- and MF59-adjuvanted pH1N1 vaccines in Argentina, Canada, Spain, Switzerland, Taiwan, and the Netherlands.

In 2010, narcolepsy was associated with vaccination with Pandemrix, an AS03-adjuvanted monovalent pH1N1 vaccine. Adjuvants boost the body's immune response to a virus.

The researchers found no change in narcolepsy rates in any period in single-study sites except in Sweden and Taiwan. In Taiwan, narcolepsy incidence increased after wild-type pH1N1 virus circulation, and in Sweden it increased after the start of pH1N1 vaccination.
Aug 16 Vaccine abstract


Russia reports H5N2 avian flu on farm; other strains in Denmark, Bulgaria

In highly pathogenic avian flu developments, Russia reported an H5N2 outbreak in commercial poultry and two European countries—Denmark and Bulgaria—reported new detections of different subtypes: H5N6 in a wild bird and H5N8 in backyard poultry.

Russia's H5N2 outbreak is the second involving the subtype this year in poultry in Kostrom oblast, in the west of the country. The latest event began Aug 9 at a location housing 498,485 birds, with the virus killing 506, according to a notification yesterday from the World Organization for Animal Health (OIE). So far 1,223 birds have been destroyed as part of the outbreak response.

The report said an analysis of the virus's H and N gene fragments suggest that it belongs to the Asian lineage of the highly pathogenic avian influenza clade that spread in Russia, Europe, the Middle East, and African countries from 2016 through 2018.

Elsewhere, Denmark said tests on a mute swan found dead on a beach near the city of Korsar on Aug 9 were positive H5N6. The country had reported its last detection of the virus in April. And Bulgaria reported an H5N8 outbreak in backyard poultry that began Jul 6 in a town in Dobric, killing 10 of 62 birds. Its most recent outbreak involving the subtype was in June at a commercial farm in Dobric, which is in the northeastern part of the country.
Aug 16 OIE report on H5N2 in Russia
Aug 17 OIE report on H5N6 in Denmark
Aug 17 OIE report on H5N8 in Bulgaria

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