News Scan for Jan 24, 2019

Flu vaccine protection in Canada
Fluzone age expansion
Listeria tied to caramel apples
Avian flu in 3 nations

Study: Flu vaccine offers 68% protection in Canada, 72% against H1N1

Today in Eurosurveillance, researchers published the first estimates of vaccine effectiveness (VE) for the 2018-19 seasonal flu vaccine administered in Canada, showing that overall VE was 68% in a season driven by influenza A(H1N1) viruses and 72% against the predominant strain.

The study was based on 1,518 eligible specimens collected by the Canadian Sentinel Practitioner Surveillance system from Nov 4, 2018, through Jan 12, 2019. Among those specimens, 661 (44%) tested positive for influenza, including 656 (99.2%) specimens typed as influenza A, 4 (0.6%) as influenza B, and 1 (0.2%) as an influenza A/B co-infection.

For all flu types, VE was 68%. For the H1N1 strain alone, it was 72% (95% confidence interval [CI], 60% to 81%). According to the study, adjusted VE estimates against H1N1 were 91% (95% CI, 67% to 98%) in children ages 1 to 8 years, 71% (95% CI, −60% to 95%) in 9- to 19-year-olds, 68% (95% CI, 51% to 80%) in adults ages 20 to 64, and 65% (95% CI, −1% to 88%) in adults 65 and older. The estimates for 9- to 19-year-olds and those 65 and older, however, were not statistically significant.

All influenza vaccines manufactured for Canada for the current flu season were egg-based, and more than 95% were the inactivated vaccine.

"Our 2018/19 VE estimate of 72% (95% CI: 60 to 81) against influenza A(H1N1)pdm09 viruses is comparable to a preliminary report from Australia using the same vaccine component for their 2018 season (78%)," the authors concluded.
Jan 24 Eurosurveillance study


FDA approval expands Fluzone quadrivalent indication for youngest kids

Sanofi Pasteur announced yesterday that the US Food and Drug Administration (FDA) has approved an expanded age indication for the use of the 0.5-milliliter (mL) dose of Fluzone quadrivalent flu vaccine for children ages 6 through 35 months.

In a statement, David Greenberg, MD, the company's regional medical head for North America, said the expanded indication will streamline immunization efforts for pediatricians by allowing the same 0.5-mL dose for the youngest children as for other children. The company said doctors will have both the 0.25-mL dose and the 0.5-mL dose available for the expanded age indication for the upcoming 2019-20 season.

Sanofi said the FDA's approval was based on a phase 4 safety and immunogenicity study in nearly 2,000 children that suggested one or two 0.5 mL doses of children ages 6 through 35 months had a safety profile that was similar to the smaller dose, with no new safety concerns and with a robust immune response.
Jan 23 Sanofi press release


CDC: Three in 2017 sickened with listeriosis after eating caramel apples

Today's Morbidity and Mortality Weekly Reports (MMWR) includes information on a cluster of listeriosis patients sickened after eating caramel apples in the fall of 2017.

The apples were sold in clamshell packs at grocery store chains throughout the country, and the cases occurred in Illinois, Iowa, and Michigan. All case-patients were men from 55 to 71. All three were hospitalized for listeriosis, but none died.

Investigators did not find the outbreak strain of Listeria monocytogenes on any caramel apples collected during the outbreak investigation nor during testing of apple production environments. Nevertheless, the authors said the epidemiologic evidence indicated that caramel apples were the cause of the outbreak.

Grocery store recipes collected from the patients showed all three had eaten the same caramel apples in the weeks prior to symptom onset.

"All outbreak-associated ill persons consumed a specific brand of a relatively uncommon food product in the month before their illness onset, and all were infected with indistinguishable L. monocytogenes strains," said the authors, who are from the Centers for Disease Control and Prevention and state health departments. "Caramel apples were previously implicated in a large multistate outbreak of listeriosis during 2014-2015, caused by contamination of whole apples."
Jan 24 MMWR study


Avian flu outbreaks reported in India, Taiwan, Dominican Republic

In the latest avian flu developments, India reported more highly pathogenic H5N1 detections in poultry and in wild birds, Taiwan reported more highly pathogenic H5N2 outbreaks at poultry farms, and the Dominican Republic reported an outbreak involving low-pathogenic H5N2, according to separate notifications from the World Organization for Animal Health (OIE).

In India, the agriculture ministry reported two more H5N1 outbreaks in backyard poultry, both in Bihar state. One began on Dec 15, and the other started on Jan 3. Combined, the outbreaks killed 57 of 4,046 susceptible birds, which were culled to curb the spread of the virus. So far, the source of the virus hasn't been determined. In late December, the country reported a similar outbreak at a different location in Bihar state, the first appearance of H5N1 in India since June 2018.

Also, India reported four more H5N1 events in wild birds, three involving house crows found dead in Bihar state and one in an Indian pond heron found dead in Orissa state. In total, 39 bird deaths were reported. Earlier this month, the country reported finding the virus in house crows in both Bihar and Orissa states.

Taiwan's new H5N2 outbreaks are part of poultry detections that have been occurring since 2015. The latest events struck commercial poultry farms in Changhua and Yunlin counties, with start dates on Dec 6 and Jan 9, respectively. The report didn't note any poultry deaths but said 11,719 birds were destroyed at the two locations.
Jan 24 OIE report on H5N1 in Indian poultry
Jan 24 OIE report on H5N1 in India wild birds
Jan 23 OIE report on H5N2 in Taiwan

Meanwhile, animal health officials in the Dominican Republic said low-pathogenic H5N2 was found in an outbreak involving backyard birds that began on Nov 2 in the city of Puerto Plata. Affected birds included hens, ducks, turkeys, and guinea fowl.

The virus killed 745 of 1,126 susceptible birds, and authorities destroyed the survivors as part of the outbreak response. The country's last outbreak involving the outbreak strain occurred in May 2018.
Jan 24 OIE report on low-path H5N2 in the Dominican Republic

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