News Scan for Nov 05, 2018

More acute flaccid myelitis cases
Updated pandemic flu vaccine allocation guidance
Avian flu outbreaks

CDC: Suspected AFM cases rise to 219

The US Centers for Disease Control and Prevention (CDC) today said it and state health partners are investigating 28 more suspected acute flaccid myelitis (AFM) cases, lifting the national number of suspected cases for 2018 to 219.

Also, the CDC said 8 more suspected cases have been confirmed as AFM, raising that total to 80. Diagnosing AFM is based on a thorough review of a patient's clinical syndrome and radiographic findings. One more state reported a confirmed case, raising the total of states reporting illnesses this year to 25.

In October, the CDC said it and its partners were investigating a jump in AFM cases, though still very rare, that's similar to spikes reported in 2014 and 2016. Children make up most of the cases, and symptoms include sudden onset of polio-like symptoms that include limb weakness and decreased muscle tone. Despite intensive investigations, no consistent common cause has been found, but researchers are exploring possible roles for infectious diseases such as enterovirus D68 (EV-D68) and environmental toxins.

The CDC will host a Clinical Outreach and Communication Activity (COCA) call on AFM for clinicians on Nov 13 at 2 pm Eastern Time.
Nov 5 CDC AFM investigation update
Oct 31 CDC COCA call information


CDC updates guidance on allocating pandemic vaccine

The CDC recently updated its interim planning guidance for allocating pandemic influenza vaccine during a flu pandemic, which weaves in its updated pandemic severity categories and lessons learned during the 2009 H1N1 pandemic.

The 25-page document, posted on Oct 26, also covers the possibility that two doses of vaccine or an adjuvant may be needed to provide immunity.

CDC's interim plan has a tiered allocation system, which can be refined based on vaccine quantity available. A change in the update is the addition of pharmacists and pharmacy technicians to the top tier, given that they would play a key role in antiviral dispensing and because many pharmacists would be giving pandemic vaccine immunizations.

The update also based its population group numbers on 2015 US Census estimates.
Oct 26 CDC interim planning guidance on allocating pandemic vaccine

High-path avian flu strikes birds in Vietnam and South Africa

Two countries recently reported new highly pathogenic avian influenza outbreaks, including Vietnam with H5N6 in village birds and South Africa with H5N8 at a commercial ostrich farm.

Vietnam's outbreak began on Oct 29 in a village in Nghe An province in the north, according to notification from the World Organization for Animal Health (OIE). The virus killed 280 of 1,500 poultry and authorities culled the survivors as part of the response to the event.

The latest outbreak from Vietnam comes just 3 days after the country reported another H5N6 outbreak in village birds in Phu Yen province in the south.

Elsewhere, South Africa's agriculture ministry reported an H5N8 outbreak at a commercial ostrich farm in Western Cape province in the south of the country, according to a separate report from the OIE. The event began on Sep 15, killing 2 of 1,014 birds. The remaining ones are slated for destruction.

South Africa has had several H5N8 outbreaks since the middle of 2017, and it reported its last outbreak involving the strain on Sep 17.
Nov 5 OIE report on H5N6 in Vietnam
Nov 2 OIE report on H5N8 in South Africa

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