Flu Scan for Jun 12, 2013

News brief

Mexico reports 8 more H7N3 outbreaks, culls 800,000 birds

Eight more outbreaks of H7N3 avian flu have struck Mexican chicken farms in recent weeks, prompting the destruction of more than 800,000 birds and the vaccination of 5 million more, Mexican authorities reported to the World Organization for Animal Health (OIE) today.

The outbreaks involved two commercial layer farms, two heavy breeder flocks, three broiler flocks, and a backyard farm in four different states: Jalisco, Puebla, Guanajuato, and Aguascalientes.

The number of susceptible birds totaled 1,049,220, of which 815,034 were destroyed to stop the outbreaks. The report says only three actual cases were reported but notes that information was missing.

In Guanajuato, the outbreaks have prompted the vaccination of 5,512,080 chickens on breeder and layer farms. The earliest outbreaks started on Apr 4 and the latest on May 23.

Mexico's last report to the OIE, on May 8, listed five outbreaks, which prompted the culling of 850,000 birds.
Jun 12 OIE report
May 8 CIDRAP News item on previous outbreaks

H5N1 found in smuggled exotic bird

The H5N1 avian flu virus was detected in a group of exotic birds from Asia that were found in suitcases at the Vienna, Austria, airport, the Czech News Agency (CTK) reported yesterday.

The smugglers from the Czech Republic were headed back to their country when officers found the birds during a routine check with two sniffer dogs. The officers apprehended the smugglers and immediately handed the birds, many of which were dead, to health officials for testing, which revealed one of the dead birds was infected with H5N1.

The London Daily Mail said today that the species included wild parrots and birds of paradise that had been sent from Bali to Qatar before they were stopped in Vienna.

The remaining birds were culled, and people who were in contact with them have been notified and are receiving treatment, the story said.
Jun 11 CTK story
Jun 12 Daily Mail story

South America sees respiratory infection rise

Several South American countries are reporting high levels of acute respiratory infection levels, with increasing trends in most countries, but within expected levels for this time of year, the Pan American Health Organization (PAHO) reported today in its weekly update.

So far respiratory syncytial virus (RSV) predominates in most countries, though the 2009 H1N1 flu virus is dominant in Brazil. RSV and seasonal flu viruses, mainly H1N1, are cocirculating in some countries, including Argentina, Chile, Colombia, and Venezuela.

Locations seeing RSV cocirculation with H3N2 include Bolivia (La Paz), Ecuador, and Peru.

The World Health Organization (WHO) said in its most recent flu update that flu activity is starting to increase in South America and South Africa, but levels are still low in Oceania.
Jun 12 PAHO influenza update
Jun 7 WHO flu update

News Scan for Jun 12, 2013

News brief

Multistate berry-linked hepatitis A outbreak grows to 99 cases

Twelve new cases have been reported in the past 2 days in an outbreak of acute hepatitis A linked to an organic frozen berry mix, bringing the total to 99, the US Centers for Disease Control and Prevention (CDC) said today.

Based on information from 73 of the patients, 38 (52%) have been hospitalized, 47 (64%) are female, and 63 (86%) reported eating Townsend Farms Organic Anti-Oxidant Blend frozen berry and pomegranate mix.

All case-patients reported buying the mix from Costco, but the product was also sold at Harris Teeter stores, with no cases linked to those outlets so far. Patients range from 2 to 87 years old and are from eight southwestern states.

Analysis of samples from two states suggests the hepatitis A outbreak strain is genotype 1B, which is rarely seen in the Americas but circulates in North Africa and the Middle East.

The CDC first reported the outbreak on May 31, and Townsend Farms, of Fairview, Ore., recalled lots of the berry blend on Jun 3.
Jun 12 CDC update

Antibiotic program dropped levels in peds practices

An antibiotic stewardship intervention in pediatric outpatient clinics almost halved prescribing of broad-spectrum antibiotics for acute illnesses and decreased by 75% the use of off-guideline antibiotics for kids with pneumonia, researchers reported today.

The study, in the Journal of the American Medical Association (JAMA), included 162 clinicians at 25 pediatric primary care practices in Pennsylvania and New Jersey and monitored prescribing patterns from electronic health records 20 months before the intervention and 12 months afterward.

The intervention was a 1-hour clinician education session followed by 1 year of personalized, quarterly audit and feedback on prescribing for bacterial and viral acute respiratory tract infections. The control group knew they were part of the study, but did not receive the interventions.

Broad-spectrum prescribing fell from 26.8% to 14.3% in the intervention group, compared with a drop from 28.2% to 22.6% in controls. Off-guideline antibiotic prescribing for pneumonia decreased from 15.7% to 4.2% in the intervention group and from 17.1% to 16.3% in the controls.

In an editorial in the same issue, Jonathan Finkelstein, MD, MPH, a pediatrician at Boston Children's Hospital and Harvard Medical School, wrote that the authors may have underestimated the effect of the intervention, because they did not include data on antibiotics in kids with otitis media, which also may have decreased.
Jun 12 JAMA abstract
Jun 12 JAMA editorial extract