Flu Scan for Dec 10, 2019

News brief

Mainland China reports 2 new cases of H9N2 avian flu

According to Avian Flu Diary, an infectious disease tracking blog, Taiwan's Centers for Disease Control and Ministry of Health today reported two human cases of H9N2 avian flu originating in mainland China were reported to the World Health Organization in November.

The cases come from Fujian and Anhui provinces and represent the first H9N2 cases of this flu season. Though the cases have no epidemiologic relation, they were both in young children (ages 4 and 5) with a history of poultry contact, including poultry slaughterhouse exposure, prior to symptom onset.

Both patients have recovered. The cases raise the total number of H9N2 cases in mainland China since 2013 to 39. Since 2013, there has been one fatality attributed to H9N2.

So far, H9N2 has not produced continuous transmission among humans but is widespread in poultry across Asia and the Middle East.
Dec 10 Avian Flu Diary post

Data show adjuvanted flu vaccine offers protection against hospital stay

New unpublished data show that Seqirus's adjuvanted flu vaccine, Fluad reduced hospitalizations in older adults living in nursing homes compared with a standard trivalent (three-strain) flu vaccine. An adjuvant is an additive that boosts a person's immune response to the vaccine.

The findings were presented recently at the National Foundation for Infectious Diseases 2019 Clinical Vaccinology Course, which took place in Washington, DC, the company said in a news release yesterday. In the large study, 823 nursing homes were randomized to offer either Fluad or a standard trivalent influenza vaccine (TIV) during the 2016-17 flu season. Of the 50,012 residents in all the nursing homes, who were 65 and older, about 15% did not choose to receive either vaccine, which left 21,278 to receive Fluad and 21,269 to receive TIV.

During the 2016-17 season, the H3N2 strain predominated and was not well-matched to the H3N2 component of flu vaccines, and vaccine effectiveness was low: 20% overall and 21% against H3N2.

In spite of this, the researchers reported that Fluad was 20% more effective than TIV in reducing hospitalization rates for influenza and pneumonia. In addition, nursing home residents receiving Fluad had a 6% lower rate of hospitalization for any cause. The study, however, has not been published in a peer-reviewed medical journal.

"This study highlights that, even in adults 65 years and older sufficiently impaired to require nursing home care, adjuvanted seasonal influenza vaccine can help reduce the risk of hospitalization," said Stefan Gravenstein, MD, MPH, of Brown University and lead author of the study. "These data are particularly significant given the low vaccine effectiveness observed in the study season overall."
Dec 9 Seqirus news release

News Scan for Dec 10, 2019

News brief

Health insurance claims show increasing Lyme prevalence in US

A survey of health insurance claims made in the United States from 2007 through 2018 shows that claim lines with a diagnosis of Lyme disease increased 117%. The information is included in a white paper published today by FAIR Health, an independent nonprofit organization dedicated to healthcare costs and health insurance information.

Lyme disease was the predominate tick-borne disease on health insurance claims, representing 94% of tick-borne claims, and, in 2018, 0.058% of all medical claims.

The most active month for claims was July 2018, and throughout the study period, women were more likely than men to receive a Lyme diagnosis, except if the patient was under the age of 10 years or older than 70.

Adults ages 51 to 60 had the highest rate of claims, and urban areas saw a bigger claim jump than rural areas, 121% compared to 105%.

"Historically, tick-borne diseases have been associated more with rural than urban areas," the report said. "More people from urban areas could be going to the country on vacation and picking up an infection that is only diagnosed when they return home to the city. In addition, Lyme disease may be spreading increasingly to suburban and urban areas."

The geographic spread of claims also changed from 2007 to 2018. In 2007, the top states with Lyme claims were three New England states plus New Jersey and New York; by 2018, North Carolina had joined New Jersey, Connecticut, Rhode Island, and Vermont as the states with the highest rate of Lyme disease claims.
Dec 10 FAIR Health report

Large cholera vaccine campaign launches in Bangladesh

A 3-week-long cholera vaccine campaign began yesterday in Cox's Bazar, Bangladesh, which aims to reach more than 635,000 Rohingya refugees and others, the World Health Organization (WHO) said in a news release yesterday.

More than 1,450 teams comprising 4,300 volunteers will attempt to reach about 140,000 Rohingya preschoolers in refugee camps with oral cholera vaccine (OCV), as well as 495,000 people older than 1 year in the broader community. The effort is led by the country's health ministry with support from the WHO, UNICEF, and other partners. The campaign is funded by Gavi, the Vaccine Alliance.

Earlier rounds of cholera vaccination, which have taken place since the beginning of emergency response efforts in 2017, have helped prevent outbreaks, the WHO said. To date, more than 1 million people have been vaccinated against the deadly disease.

"We want to equip these populations with more protection against diarrheal diseases," said Bardan Jung Rana, MD, WHO representative in Bangladesh. "Despite the progresses made to ensure access to quality water and sanitation, such diseases remain an issue of concern: approximately 80% of host community living near the camps have not been targeted in previous OCV campaigns and are still vulnerable."
Dec 9 WHO press release