Flu Scan for Aug 29, 2013

News brief

Michigan reports fair-linked H3N2v case

Michigan health officials today reported a variant H3N2 (H3N2v) flu infection in a child who exhibited swine at the Berrien County Youth Fair, which took place Aug 12 through Aug 17 in Berrien Springs, Mich., in the southwest corner of the state.

The case raises the nation's number of H3N2v cases this year to 17. Though Michigan had a few H3N2v cases last summer, the child's illness is its first this year.

The child was not hospitalized, according to a news release from the Michigan Department of Community Health (MDCH). Samples from a sick pig from the fair tested positive for the virus at the National Veterinary Services Laboratories in Ames, Iowa.

Michigan health officials said the virus poses no food safety concern, but as a precaution they have reached out to meat processing plants that received pigs from the fair so that they can protect their employees from getting sick. The MDCH said it contacted managers of eight other fairs to alert them about the H3N2v detection and to remind them to use proper safety measures to prevent the spread of the virus.

Rick Johansen, MD, medical director for the Berrien County Health Department, said in the statement that because of the short incubation period, it's unlikely that there will be new cases from direct exposure at the fair. Officials will be on the lookout for secondary cases, though so far human-to-human H3N2v cases have been rare.
Aug 29 MDCH news release

The World Health Organization (WHO) said today in its monthly update on influenza at the human-animal interface that so far this year all US H3N2v case-patients had close contact with swine the week before they got sick, and no ongoing human-to-human transmission has been reported.

It said three candidate vaccine viruses for H3N2v have been developed and could be used to produce a vaccine, if needed. More human cases and small clusters are expected, the agency said, because the virus is circulating in US swine and the fair season is still under way. The WHO added that it's important to continue to monitor illnesses and the virus for any changes.
Aug 29 WHO update

Complications common in kids hospitalized for flu, study says

More than a quarter of children hospitalized with influenza develop pneumonia, and 2% have positive bacterial cultures, a large, multistate study in the Journal of Infectious Diseases yesterday concluded.

Researchers from the Centers for Disease Control and Prevention (CDC) and several states found that, of 6,769 kids hospitalized with flu in 10 states from 2003 through 2010, 28% had pneumonia, 22% asthma exacerbations, and 21% dehydration.

Other, more serious complications such as lung abscess/empyema, encephalopathy, sepsis, and acute renal failure were rare—occurring in under 2% of kids—but were associated with a median hospital stay of more than 6 days. Also, 48% to 70% of children with those severe complications required intensive care.

Positive bacterial cultures were confirmed in 107 (2%) of the children, with Staphylococcus aureus and Streptococcus pneumoniae the most common.

The authors conclude, "Complications add substantially to the burden of hospitalized children with influenza through intensive care requirements and prolonged hospitalization, highlighting the importance of primary prevention with influenza vaccination."
Aug 28 J Infect Dis abstract

H7N7 strikes fourth Italian poultry farm

Italian livestock officials yesterday reported a fourth highly pathogenic H7N7 outbreak at a commercial poultry farm in the Emilia-Romagna region. The outbreak was detected at a layer farm in Mordano in Bologna province, the same city hit by an H7N7 outbreak about a week ago, according a report from the World Organization for Animal Health (OIE).

The report said the site of the most recent event was already under restrictions due to its proximity to earlier outbreaks. Lab tests on the birds on Aug 23 were negative, but the flock was tested again after birds started dying on Aug 26. Real-time polymerase chain reaction tests at the National Reference Laboratory in Padova confirmed the H7 finding.

The outbreak sickened 27,000 of 121,705 susceptible birds and killed 364 of them. The remaining birds will be culled to curb the spread of the virus.

Highly pathogenic H7N7 sporadically crops up in European wild birds and poultry. In 2003 the virus caused an outbreak in humans in the Netherlands that resulted in mild infections in at least 89 people and one death in a veterinarian.
Aug 28 OIE report

News Scan for Aug 29, 2013

News brief

CDC: Most adolescent vaccine coverage progressing, but HPV lags

Progress is being made overall in achieving the targets set out by the Healthy People 2020 program for fully immunizing adolescents, but human papillomavirus (HPV) vaccine coverage is lagging and healthcare providers should use every opportunity to administer it, says a Centers for Disease Control and Prevention (CDC) report today in Morbidity and Mortality Weekly Report (MMWR).

Vaccines recommended for administration to preteens (ages 11 and 12) by the Advisory Committee on Immunization Practices (ACIP) are one dose of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine, one dose of meningococcal conjugate (MenACWY) vaccine, and three doses of HPV vaccine, plus the annual flu vaccine and any overdue childhood vaccines.

To determine the success of preteen immunization programs, the CDC analyzed data from the National Immunization Survey–Teen to determine coverage in 13- to 17-year-olds. The researchers found that, from 2011 to 2012, coverage with one or more doses for Tdap increased from 78.2% to 84.6% and for MenACWY from 70.5% to 74.0%.

As for HPV vaccine, in boys the coverage with one or more doses increased from 8.3% to 20.8% and in girls it stayed similar or declined between the 2 years, standing at 28.1% for those 13 to 15 years of age.

Given that the national targets for Healthy People 2020 are to reach 80% of 13- to 15-year-olds with Tdap, MenACWY, and HPV, the first two vaccines are on track, but HPV lags far behind.

Thirty-six states met or exceeded Tdap coverage targets, and 12 met or exceeded MenACWY targets. No states met HPV coverage target for girls. Overall, the Northeast had the highest coverage rates for all vaccines, but coverage among states and vaccines varied widely.

"Whether for health problems or well-checks, providers, parents, and adolescents should use every health-care visit as an opportunity to review adolescents' immunization histories and ensure that every adolescent is fully vaccinated," the report says.
Aug 30 MMWR report

India initiates efforts to reduce Salmonella in spices

Officials in India are pushing major changes in food safety practices surrounding the country's spice trade ahead of a soon-to-be-released report from the US Food and Drug Administration (FDA) implicating imported spices as a potential source of Salmonella contamination, the Sydney Morning Herald reported today.

Farmers are taking steps such as boiling their spice harvest after an FDA study of more than 20,000 spice shipments found frequent Salmonella contamination, the story said, citing a recent study in Food Microbiology.

In that study, 14% of samples from Mexico and 9% of samples from India contained Salmonella. Those countries had the highest levels. About a fourth of spices, oils, and food coloring used in the United States comes from India, the story said.

The study found that 15% of coriander, 12% of oregano and basil, and 4% of black pepper shipments were contaminated. Sesame seeds, curry, and cumin were also found to contain some level of Salmonella.
Aug 29 Sydney Morning Herald article
June Food Microbiol abstract