Flu Scan for Jul 01, 2013

News brief

CDC says more H3N2v may be on the way, cautions at-risk groups

Last week's report of four variant H3N2 (H3N2v) influenza cases linked to a county fair in Indiana "may foreshadow a number of outbreaks this summer," like those last summer, the Centers for Disease Control and Prevention (CDC) said in a Jun 28 update statement.

In view of the risk, the CDC renewed the advice it emphasized last year: that people at risk for serious flu complications should avoid pigs and swine barns at fairs.

Genetic sequencing on one of the Indiana H3N2v isolates confirmed that it is 99% similar to the H3N2v strain that circulated last summer, the CDC said. Last year there were 309 cases, with 16 hospitalizations and 1 death, the agency said. There were no hospitalizations or deaths in the Indiana outbreak.

Flu is believed to jump from pigs to people mainly via droplets from infected pigs that are sneezing and coughing, the CDC said. But it cautioned that pigs that look healthy can be infected and can spread flu viruses.

The agency also noted that children under the age of 10 have little or no immunity to the virus.

No H3N2v vaccine is available, but development of one is under way, the CDC noted. Antiviral drugs used to treat seasonal flu can also be used to treat H3N2v.
Jun 28 CDC statement

In other developments, Clinical Infectious Diseases today published a CDC-sponsored supplement on what was learned from the first wave of H3N2v cases, from July 2011 through April 2012.

One article profiles the 13 cases reported during that period, and additional articles use data from those cases to estimate the number of unreported cases and assess the pig-to-human transmissibility of the virus.
Jul 1 CID supplement on H3N2v

Nepal reports three more H5N1 outbreaks

Livestock officials in Nepal recently reported three H5N1 avian flu outbreaks, two in the country's Lumbini zone and one in the city of Bharatpur in Narayani zone, all in south central Nepal.

The outbreaks started at various times between May 28 and Jun 7, according to a report yesterday to the World Organization for Animal Health (OIE).

The outbreaks in Lumbini zone affected backyard ducks and birds in a village and a small broiler farm. The event in Bharatpur, Nepal's fifth-largest city, involved household birds.

The three outbreaks killed 410 of 1,675 susceptible birds, and the remaining ones were destroyed to control the spread of the virus. Authorities are cleaning and disinfecting the outbreak sites, and intensive surveillance activities are under way, according to the report.

The new outbreaks follow a recent spate of outbreaks across different parts of the country that were reported at the end of May.
Jun 30 OIE report

Shanghai rolls out new rules for poultry sellers

In an effort to prevent the spread of H7N9 influenza in Shanghai poultry markets, the city's government on Jun 28 issued new rules, according to a Jun 29 report from Xinhua, China's state news agency.

Shanghai reopened poultry markets Jun 20 after they were temporarily shuttered to reduce H7N9 exposure to humans. The new laws require wholesale markets to close 1 day each week and retail markets to close 1 day every other week to allow operators to thoroughly clean and disinfect the areas.

The rules also urge poultry markets to be located away from residential complexes or crowded downtown areas. Wholesale and retail markets are now required to establish and maintain a bird tracking system, as well as to keep daily sales and disinfection records, according to the report.
Jun 20 Xinhua story

News Scan for Jul 01, 2013

News brief

Steroid-linked fungal outbreak grows to 749 cases, 61 deaths

A multistate outbreak of fungal infections linked to contaminated steroids grew in June by 4 cases and 3 deaths, to 749 cases and 61 deaths, the CDC said today. Its previous update was Jun 3.

The CDC said 233 cases were meningitis only, 151 involved meningitis with spinal or paraspinal infections, 7 involved stroke without lumbar puncture, 323 were paraspinal or spinal infections only, 33 were peripheral joint infections only, and 2 were paraspinal or spinal infections with peripheral joint infections.

The outbreak emerged last fall and was linked to three recalled lots of methylprednisolone acetate made by New England Compounding Center in Framingham, Mass.

The four new cases were in Indiana (3) and Tennessee (1). The state having the most cases by far is Michigan, with 264, followed by Tennessee, with 153, and Indiana, with 91.

The CDC said it will update the outbreak numbers again on Jul 29.
Jul 1 CDC update

Israel to vaccinate 150,000 children in wake of poliovirus detection

As a result of the detection of wild poliovirus (WPV) in sewage, Israel plans to conduct a supplementary immunization campaign targeting 150,000 children, according to press reports and the World Health Organization (WHO).

Health officials decided on the vaccination effort following a visit from WHO experts over the past few days, according to a Jun 30 story from Israel National News.

WPV was found in sewage in Beersheva in southern Israel in February, and since then it has been detected in sewage in other places, the WHO Regional Office for Europe said today.

"The decision to launch the campaign reflects both the estimated extent of circulation of the virus and the Israeli authorities' commitment to interrupt transmission as rapidly as possible," the WHO said.

It said the aim of the campaign is to protect any children who may have missed routine vaccinations. In southern Israel, adults are also being assessed, and those thought to be susceptible are being immunized.

Israel has been free of indigenous polio transmission since 1988, the WHO said. "Given the high level of population immunity and the continuing response to the detection of WPV in the environment, WHO assesses the risk of the further international spread of this virus strain from Israel as moderate," it added.

An international team of polio experts visited Israel for 5 days to assess the polio risk and recommend action, the WHO said. The visit, which was requested by Israeli officials, ended on Jun 26.
Jun 30 Israel National News story
Jul 1 WHO Europe statement