Analysis: Many H3N2v cases linked to Maryland fairs in risk groups

An investigation into 40 variant H3N2 (H3N2v) influenza cases in people exposed to pigs at three agriculture fairs in Maryland in September 2017 found that 30 (75%) occurred in people at high risk for flu complications. Researchers from the US Centers for Disease Control and Prevention and Maryland described their findings today in Morbidity and Mortality Weekly Report (MMWR).

Patient ages ranged from 9 months to 79 years, though all but 3 were younger than 15 years old. The people at high risk for flu complications included 24 who were younger than 5 years, one who was age 65 or older, and 6 who had chronic medical conditions.

Twenty-six (65%) of the patients had direct contact with pigs, and 14 (35%) had only indirect contact, such as walking through a swine barn.

The most common symptoms were fever, cough, and sore throat. Two children were hospitalized, one of whom had an underlying medical condition and had direct contact with swine. The other child was previously health and was admitted to the intensive care unit and had been wheeled in a stroller through a swine barn. All patient recovered.

Genetic analysis is samples from humans and pigs suggested that the viruses were similar to variant cases linked to swine exhibits in other states in 2017.

The authors said the findings highlight the ongoing health risk from variant flu and that people at high risk for complications should avoid pigs and swine barns. They also noted that the outbreak underscores the need to expand monitoring for swine and human illnesses before and during agricultural fairs within the same region.

"Finally, this outbreak highlights the need for a One Health approach to investigating and responding to variant influenza virus outbreaks, including the application of both swine and human infection control measures, as well as collaboration between agricultural, environmental, and public health agencies on surveillance and communications strategies," they wrote.
Oct 26 MMWR report

New point-of-care tests for flu, strep approved

Today the US Food and Drug Administraion (FDA) approved the use of two new rapid point-of-care test manufactured by Abbott that can be used for diagnosing influenza and streptococcal infections.

"These Influenza A & B 2 and Strep A 2 assays combine speed with efficacy for rapid delivery of molecular results, further driving value for healthcare systems where time equals money," said Sharon Bracken, Abbot's senior vice president of rapid diagnostics, in an Abbott press release. "By delivering fast and accurate molecular results at the point of care, these tests provide physicians with the confidence to give the right diagnosis and the ability to prescribe the right treatment earlier."

According to Abbot, the Influenza A & B assay will offer the fastest point-of-care molecular detection and differentiation of influenza A and B virus available, producing results in 5 to 13 minutes.

The Strep A 2 test provides molecular detection of Group A Streptococcus bacterial nucleic acid, in 2 to 5 minutes. No culture confirmation is required for negative results, says Abbott, which is based in Abbott Park, Ill.

"The ability to obtain early call outs for positive test results with molecular accuracy in as little as five minutes for influenza and two minutes for Strep A is a game-changing development that allows prompt treatment decisions at the point of care," said Gregory J. Berry, PhD, director of molecular diagnostics for Northwell Health Laboratories in Lake Success, N.Y. "Rapid testing may also help reduce improper antibiotic usage, which can occur when treatment is based exclusively on a patient's symptoms, and contributes to antibiotic resistance."
Oct 25 Abbott press release

H5N6 avian flu strikes again in Chinese poultry

China's agriculture ministry has reported another highly pathogenic H5N6 avian flu outbreak in poultry, according to a report today to the World Organization for Animal Health (OIE).

The outbreak struck village poultry in Hubei province, located in the central part of the country. The event began on Sep 24, killing 340 of 5,337 susceptible birds. The surviving ones were culled to control the spread of the virus.

According to the report, the investigation found that the source of the outbreak was introduction of new live animals.

H5N6 has been responsible for poultry outbreaks in a few Asian countries, and the virus has been linked to human infections in China that have often been fatal. The latest outbreak comes on the heels of a report earlier this month of an H5N6 event in backyard birds in Hunan province.
Oct 25 OIE report