Saturday, December 8, 2012

H3N2 strain of the flu expected to make people sicker this year

December 6, 2012

The flu hasn’t quite hit central Pennsylvania yet, but medical professionals are gearing up for what could be a bad year.
The federal Centers for Disease Control and Prevention has seen significant increases in flu cases in the past couple of weeks, especially in Texas, Alabama, Mississippi, Louisiana and Tennessee.

The strain of flu that seems to predominate this year — the H3N2 strain of influenza A — was last seen nearly a decade ago. It is a strain that has tended to make people sicker, with higher fever, more respiratory distress and other symptoms more likely to send them to a doctor or land them in a hospital.
It will likely be hitting Pennsylvania soon, according to John Goldman, an infectious disease specialist with PinnacleHealth.
As of Dec. 1, the state Department of Health reported some increase in flu cases, especially in the western part of the state. Cases have been reported in 53 of 67 counties.
John Messmer, a family practitioner with the Penn State Milton S. Hershey Medical Center, said it is hard to predict the severity of a flu season because the virus tends to mutate. Sometimes a slight change in the strain can make a big difference in the body’s reaction to it.
“The message is, you just don’t know,” he said.
It’s always best to get a flu shot to be safe, he said. There are plenty available.
Goldman said he has seen a couple of cases of flu so far, and the flu season seems to be starting earlier than normal. Once it starts in one part of the country, it usually spreads quickly, he said.
Nationwide, two children have died of the illness this year. The last time the H3N2 strain struck, more than 48,000 people died in one of the most lethal seasons in the past 35 years, according to the CDC.
But Goldman said there is an advantage this year compared to the 2003-04 flu season. This year, the type of vaccine matches well with the strains of virus. That was not the case nine years ago.
The CDC recommends flu shots for everyone over six months old, and says they are particularly important for pregnant women, anyone with a chronic illness, anyone over 65, children under 5 and people living with the elderly or others at high risk of developing complications.
More than 200,000 people are hospitalized every year due to complications of the flu, according to the CDC.
Flu vaccines are readily available. Many employers provide them, and they are available at doctors’ offices, walk-in clinics and many pharmacies.
Patient First runs 42 clinics in three states, including clinics in Mechanicsburg and the Colonial Park area. It offers flu shots on a walk-in basis from 8 a.m. to 10 p.m. daily.
So far, the clinics are delivering about the same number of vaccines as last year, according to spokeswoman Dara Rees. But the numbers have increased by 73 percent this week compared to last week, after the CDC promoted National Influenza Vaccination Week Dec. 2 to Dec. 8.

Public Health Chiefs, Drs. Frieden And Fauci, Discuss Flu Season And Vaccines On C-SPAN

[bolding is mine]

Saturday, December 8, 2012
With flu season upon us already, and most state health departments issuing advisories warning about influenza, Americans are in for a long season.
In an interview on C-SPAN’s Washington Journal Dec. 8, Dr. Anthony Fauci, National Institute of Allergy & Infectious Diseases Director and Dr. Thomas Frieden, Centers for Disease Control & Prevention Director discuss the role and state of public health in America with a strong emphasis on the current flu season.
How well is America prepared for the flu season?
Dr. Fauci says we are in the beginning of the 2012-13 flu season and we are seeing a “tick-up” earlier this year. Flu season generally kicks off during the late December to January months.
Fauci does say although we are off to an early start, the flu strain circulating (H3N2) is very well matched to the flu vaccine, in which 112 million doses have already been administered. In addition, this strain is not showing resistance to antiviral flu drugs like Tamiflu.
CDC Director Frieden also sounds optimistic on preparations for this flu season; however, he did express some concerns.
The vaccination rate of allied health care workers and nursing home workers are below 50 percent, becoming a risk both to themselves and to the patients they treat.
Pregnant woman and the flu is also an area of concern, Frieden states. Pregnant women who contract the flu can get very ill and even die from the viral illness.
Frieden stresses, “the single most important factor in determining if a pregnant woman gets vaccinated is  whether her obstetrician offers the vaccine in his or her office.” If the OB doctor does offer it, Frieden says that there is a 75 percent that she will get the vaccine.
Making getting the flu vaccine easier is a key to getting the population vaccinated.
Fauci says that the likelihood of flu mutation or development of resistance to antivirals this year is small.
Frieden says that influenza, which can be mild most people, sends hundreds of thousands of people to the hospital annually and kills thousands. In fact, Frieden reports several deaths in children already.
“Anyone six months or older should get vaccinated”, says Frieden. In addition, children with special needs should receive treatment quickly.
Should parents be concerned giving the flu vaccine to their children?
Fauci unequivocally says no. “On the contrary, they should be encouraged to give their children the vaccine”.
He says the vaccine had decades of safety experience plus if you keep infections low among children, the elderly grandparents are less likely to contract the flu. The elderly are also particularly susceptible to the flu.
The flu vaccine typically takes roughly  two weeks to induce a good immune response and in about a month excellent protection.
Fauci also states that it is a myth that people get sick from the flu shot. Typically what happens is people get the flu before the vaccine take effect or possibly its just the common cold.
Frieden says that the billion dollar question concerning the flu is, could there be a repeat of 1918 pandemic?
“Of all the infectious disease threats, I still think its still influenza that makes a most concerned because a severe pandemic is still possible”, he said.
A global warning system is in place just for this reason. Frieden says we have to be ready for something like this because if not, it’ll be very costly in terms of economics and lives.
Frieden and Fauci also discuss other areas of public health to include HIV/AIDS in the interview. To view the entire 1 hr. 20 min interview, click here.
For more infectious disease news and information, follow the Infectious Disease News Facebook page

Study finds influenza C in kids hospitalized with pneumonia

Dec 7, 2012 (CIDRAP News) – Influenza C generally isn't thought to be a cause clinically significant disease, but a study in Italian children who were seen in the emergency department for pneumonia found the virus in five children, with a disease severity that resembled influenza A. 

The study evaluated data from four flu seasons from 2008-09 to 2011-12 at a pediatric clinic in Milan and appeared today in an early online edition of Influenza and Other Respiratory Viruses.
Influenza C can infect humans and pigs, and infections are rare compared with influenza A and B. 

The researchers included healthy children from ages 1 month to 14 years who were seen because of fever and lower respiratory tract symptoms and whose chest radiographs suggested community-acquired pneumonia. Respiratory swabs and sera were collected, and researchers noted patients' clinical information and whether each child was hospitalized. 

Respiratory samples were tested for influenza A, B, and C, and the samples that tested positive were tested for several other viral coinfections. Researchers sequenced the positive influenza C samples to determine the lineage. 

Of 391 children included in the study, influenza C was identified in 5 (1.3%). Influenza A was detected in 26 children, and influenza B was found in 3. Influenza C was found only during two of the four seasons: 2008-09 and 2009-10. 

Four of the children with influenza C were younger than 3 years old, and one was 14 years old. No viral coinfections were found in the children who had influenza C. 

All of the children with influenza C infections were hospitalized, but their clinical symptoms improved a few days later. Researchers observed that the severity of influenza C symptoms was similar to those for influenza A, but worse than in kids with pneumonia related to influenza B. All children with influenza C pneumonia recovered with no disease recurrence, according to the study. 

Phylogenetic analysis showed that the five influenza C viruses clustered in two of the six lineages: Kanagawa/1/76 and Sao Paulo/378/82. 

The group wrote that the study is the first that they know of that gauges the importance of influenza C in pediatric community-acquired pneumonia. However, they noted that further study is needed to determine what role influenza C plays during other parts of the year, given that previous studies have shown that the virus doesn't have the same seasonal pattern as the other two flu types. 

Though the similar clinical pictures between influenza A and influenza C have been found in other studies, the role of influenza C is notable, especially since it can be an important cause of community-acquired pneumonia in kids, the authors write. 

The findings of the study have parallels to a 2006 study on hospitalized Spanish infants conducted from September 1999 through July 2003, which found influenza C infections in six of 706 children. 

Three of the six, however, had viral coinfections, and the earlier study did not focus exclusively on community-acquired pneumonia. As with the Italian study, though, the influenza C infections in the Spanish study were clinically similar to influenza A infections. 

Principi N, Scala A, Daleno C, et al. Influenza C virus-associated community-acquired pneumonia in children. Influenza Other Respi Viruses 2012 Dec 7 [Abstract]
See also:
October 2006 Emerg Infect Dis letter

European labs use novel coronavirus tests, devise new ones

Dec 7, 2012 (CIDRAP News) – Diagnostic tests for the novel coronavirus (CoV) that recently emerged in the Middle East are being deployed rapidly in Europe, and about 250 patients have already been tested for the virus, according to the European Centre for Disease Prevention and Control (ECDC). 

An ECDC survey revealed that a screening test for the virus is available in 23 of 46 responding countries in the World Health Organization's (WHO's) European Region, according to a report yesterday in Eurosurveillance. Those include 19 of 30 countries in the European Union (EU) and the European Economic Area (EEA). 

Confirmatory testing of positive screened samples is available in 22 of 46 responding countries, including 18 of 30 EU and EEA countries, according to the survey. Six EU and EEA countries reported that they had tested about 250 patients who met the WHO surveillance criteria, the ECDC said. 

The available screening test was the upE RT-PCR (reverse-transcriptase polymerase chain reaction) assay, while confirmatory testing involved ORF1b RT-PCR or other target RT-PCR assays with sequence analysis, the report said. 

Nine novel CoV infections, with five deaths, have been identified in the world so far.
In a companion report, a German team describes a new confirmatory test for the novel CoV and a serologic test to detect antibodies to the virus. The authors say the recent investigation of a cluster of novel CoV cases in Saudi Arabia suggested that RT-PCR testing may miss cases in patients with symptoms and epidemiologic links to known cases. 

The team used samples from a patient who was treated in Germany to develop their tests. (The WHO reported on Nov 23 that a Qatari man had been flown to Germany for treatment and recovered there.) The new confirmatory test is described as a "rigorously validated and highly sensitive" real-time RT-PCR assay targeting the ORF1a gene, called the 1A assay, which can be used in combination with the previously reported upE assay. 

The authors describe their serologic test as a biologically safe immunoflorescence assay, but they note that it is unknown to what extent novel CoV antibodies cross-react with those against common human coronaviruses such as OC43 and HKU1. 

They suggest that the serologic test might be used for confirmatory testing of persons epidemiologically linked to novel CoV cases. In addition, the scientists describe two other new RT-PCR assays for sequencing, targeting the novel CoV RdRp gene and N gene. 

Palm D, Pereyaslov D, Vaz J, et al. Laboratory capability for molecular detection and confirmation of novel coronavirus in Europe, November 2012. Euro Surveill 2012 Dec 6;17(49):pii=20335 [Full text]
Corman VM, Muller MA, Costabel U, et al. Assays for laboratory confirmation of novel human coronavirus (hCoV-EMC) infections. Euro Surveill 2012 Dec 6;17(49):pii=20334 [Full text

U.S. Dept. of Ag.: Cuba Considered High Risk Source for High Pathogenic Avian Influenza

Saturday, December 8,2012
Miami Man Guilty of Smuggling Birds from Cuba After 16 "Negritos de Cuba" Found in His Pants.

Alberto Diaz Gonzalez pled guilty to attempting to import undeclared wildlife from Cuba after a total of 16 Cuban bullfinches (Melopyrrha nigra) or “Negritos de Cuba” were found concealed in his pants.

MIAMI -- Alberto Diaz Gonzalez, 76, of Miami, pled guilty today in Miami, for his involvement in an attempt to import undeclared wildlife from Cuba, in violation of the federal anti-smuggling statute, Title 18, United States Code, Section 545, according to Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, Resident Agent in Charge David Pharo, United States Fish & Wildlife Service, Alysa Erichs, Special Agent in Charge, Homeland Security Investigations, and Vernon Foret, Director of Field Operations, Miami Field Office, Customs and Border Protection.

U.S. District Judge Joan A. Lenard accepted the plea of guilty and scheduled sentencing for February 25, 2013 at 2:00 pm. At sentencing, Diaz Gonzalez faces a possible maximum sentence of up to 20 years in prison, to be followed by up to 3 years of supervised release, and a fine of up to $250,000.
Under federal law, all wildlife, including birds, being imported into the United States must, before being released for lawful entry, first be made available for inspection and properly declared to the United States Fish and Wildlife Service and the United States Customs and Border Protection, pursuant to Title 50, Code of Federal Regulations, Sections 14.52 and 14.61. Some wildlife is also subject to quarantine before they can be released into the country. The purpose of the quarantine regulations are, in part, to protect both commercial and wild species of avians in the United States from possible exposure to diseases such as Newcastle’s and other maladies against which they would have no natural immunity. According to the U.S. Department of Agriculture, Cuba is considered a high-risk source country for high pathogenic avian influenza and exotic Newcastle’s disease.

Full article: 

Taiwan: H5N2 Confirmed in Poultry Penghu Island

2012/12/08 19:16:08 Taipei, Dec. 8 (CNA) Outlying Penghu Island has reported the first highly pathogenic avian influenza outbreak and all chickens on the affected farm have been destroyed, an official from the Council of Agriculture (COA) said Friday.

Huang Kuo-ching, deputy director of the COA’s Bureau of Animal and Plant Health Inspection and Quarantine, said the owner of the chicken farm first detected a massive die-off of 150 chickens Nov. 19 and alerted the health authorities.

Another 50 chickens died the next day and test results obtained Nov. 22 showed that H5N2 was to blame, prompting the Penghu county government to order the surviving 431 chickens killed.

According to scholars, the H5N2 virus is normally low pathogenic, but the latest outbreak was caused by a highly pathogenic strain that they said could be a mutation of the virus.

Huang said the farmer had bought chickens at an auction in Chiayi Nov. 14 and speculated that the outbreak was caused by these birds.

There are three other chickens farms around the affected one, but the bureau said it had detected no abnormalities so far, although it added that safety can only be assured after a three-month observation period.

Thursday, December 6, 2012

European Revised Plans For Pandemic Preparedness, Workshop Held 5-7 December 2012

Revising pandemic influenza preparedness strategies

Evaluations of the response to the 2009 pandemic have shown that the world is ill-prepared to respond to a severe influenza pandemic or to any similar global, sustained and threatening public health emergency.
From the lessons learned it can be concluded that existing country pandemic plans have a number of gaps. Member States are in the process of revising their pandemic plans and 4 countries of the WHO European Region have published their revised plans. 
A key activity of WHO/Europe in collaboration with the European Centre for Disease Prevention and Control (ECDC) is to provide a strong and clear guide, so that all countries of the Region can revise their pandemic influenza preparedness strategies. To this end, the existing European guidance is being revised in line with revisions from the WHO global pandemic guidance. This new version of the European guide will be discussed during a workshop on pandemic preparedness that will be held 5-7 December 2012 in Copenhagen, Denmark for countries of the South-eastern Europe Health Network (SEEHN), newly independent states, Switzerland and Turkey.
The meeting is organized in collaboration with the SEE Regional Health Development Centre for Communicable Diseases Surveillance in Tirana, Albania and will be facilitated by experts from WHO collaborating centres at the University of Nottingham, United Kingdom and the University of Geneva, Switzerland as well as WHO headquarters.
Experts from ECDC and Centers for Disease Control and Prevention (CDC) Central Asian Region, Almaty, Kazakhstan will also participate. 
For more information please contact:


WHO/Europe: Coronavirus infections: new strain identified

In September 2012, WHO was alerted to the identification of a novel coronavirus in two patients from Saudi Arabia and Qatar who presented with symptoms of severe respiratory disease. Upon further investigation, a total of 9 cases, 5 of which were fatal, have been identified since April 2012 and reported to WHO under the International Health Regulations (IHR) in three countries, Saudi Arabia, Qatar and Jordan. This particular strain of coronavirus has not been previously identified in humans and the characterization of the full genome sequence of the virus indicates that it belongs to a novel species of coronavirus in the genus Betacoronavirus that is distinct from other known coronaviruses and severe acute respiratory syndrome (SARS).


Coronaviruses are a large family of RNA viruses capable of infecting humans and a number of animal species. In humans, coronaviruses may cause a range of illnesses, from the common cold to SARS. Currently, 4 coronaviruses are known to circulate in the human population, HCoV-229E, -OC43, NL63, and –HKU1, where they usually cause mild to moderate upper-respiratory tract illness. Viruses of this family cause a number of animal diseases.
WHO/Europe will continue to provide input to all aspects of this response. In this way, more information on transmission, severity and clinical impact will be obtained and disseminated to Member States.

Wednesday, December 5, 2012

Vietnam: More Information on Suspected H5N1 Avian Influenza Death, Tested Negative

[Here is another article on the death in Vietnam.  If he was transferred there over the weekend, and was there for 5 days, he could have died last Saturday, as the previous article stated that he died "over the weekend".]

(SGGP). - Dinner at 3-12, Dr.-BS Nguyen Van Vinh Chau, director of the Hospital for Tropical Diseases Ho Chi Minh City, said suspected cases of avian influenza A/H5N1 died after being treated here. That NVS patients (42 years old, live in Kien Giang) is transferred from the hospital in Binh Duong to the Hospital for Tropical Diseases Ho Chi Minh City over the weekend in a state of high fever, cough, sore throat, shortness of breath ...
X-ray results reported patients with large cardiac shadow, pleural effusion associated with clinical symptoms doctors suspected of being infected with influenza virus A / H5N1. HCMC Hospital for Tropical Diseases and the Pasteur Institute in Ho Chi Minh City have taken swabs from molecular biological tests but showed negative results for influenza A/H5N1 virus.
After 5 days of active treatment, patients with S. died of severe pneumonia, acute respiratory distress ... Mr. S. are working women in the town of Thuan An, Binh Duong. Before admission, he visited the home in Kien Giang and eat ducks die from farming families.

How animals spread diseases to us

IOWA CITY — "Everybody knows that pestilences have a way of recurring in the world; yet somehow we find it hard to believe in ones that crash down on our heads from a blue sky." — Albert Camus, "The Plague"
In May, 1997, a 3-year-old boy was admitted to an ICU in Hong Kong after suffering from influenza for a week. Two days later, the boy died of pneumonia. His case would have been merely a curiosity if it weren't for 17 more patients who came down with the illness months later. In all, six people died from a strain of influenza that had never been seen in humans before, dubbed H5N1.
However, H5N1 wasn't really "new." It had caused outbreaks in Scottish chickens in 1959 and British turkeys in 1991. It had killed geese in Guangdong, China, in 1996. But these bird outbreaks weren't considered important by physicians or researchers on human disease — this was an avian strain of influenza, and it was thought that humans had little to be concerned about.
That changed abruptly in 1997, when the human cases led to the destruction of 1.3 million chickens in Hong Kong to stop the outbreak. That strategy seemed to work in the short term, but H5N1 has since surfaced in more than two dozen countries and caused more than 600 human infections since 1997 — almost half of them fatal.


DHS seeks help in quickly detecting agricultural pathogens

Coping with
avian influenza
DHS is gathering information from potential small business 8(a) contractors about how they might assist the department by developing field-deployable detection systems that can detect agricultural pathogens -- such as foreign animal diseases and certain pests -- within minutes.

DHS wants to be able to use such detection systems during a disease outbreak or during routine surveillance, explains a notice published by the department’s chief procurement officer on Dec. 5.
“The cost to deploy tests must be inexpensive due to a large number of samples that are anticipated for processing,” says the notice.

The agricultural pathogens that DHS would like to be able to detect and identify include such foreign animal diseases as avian influenza, classic swine fever, foot-and-mouth disease, rift valley fever and others. The partial list of pests that concern the department includes Mediterranean fruit flies, bark and ambrosia beetles, Khapra beetles, potato brown rust and others.

The chief procurement officer emphasized that his office is only issuing a Request for Information (RFI), and has not committed itself to any future procurement. The department plans to conduct a workshop, “where capable contractors could demonstrate their capabilities in providing analytical approaches to meeting the possible future government needs,” explains the notice.
Further information is available from Vaughn Oswald, a contract specialist, at 202-254-2406 or

Tuesday, December 4, 2012

Nature News: FDA under pressure to relax drug rules

Industry says antibiotic pipeline is being blocked by overly stringent clinical-trial requirements for new treatments. Heidi Ledford 04 December 2012 The latest skirmish in the battle between human and microbe played out on 29 November in a hotel conference room in Silver Spring, Maryland. There, an assembly of scientists and clinicians debated the merits of an experimental antibiotic. For some, the coveted prize was not just an endorsement of the drug itself, but a sign that the US Food and Drug Administration (FDA) is finally ready to rethink its clinical-trial requirements for antibiotics — requirements that the drug industry says are unrealistic. The number of FDA approvals of new antibiotics has dropped even as multi-drug-resistant strains of bacteria have proliferated. FDA advisers at last week’s meeting did recommend approval of telavancin (Vibativ) — a derivative of vanco­mycin — for the treatment of hospital-acquired pneumonia when alternative drugs are not suitable. But that vote came nearly two years after the FDA had rejected the drug for a second time because clinical data did not measure up to the agency’s guidelines. Continued:

India: Two Separate Suspected Outbreaks in Birds

On December 3rd, I reported several dead cranes in Amreli, Assam here. Today, I reported a story of at least 50 Great Cormorant, that died in Kaziranga National Park, here. It is hundreds of miles between the two.
Left Postmark: Amreli; Right: Borbeel

India: Migratory birds die in Kaziranga National Park,probe ordered

Kaziranga National Park
December 04, 2012
At least 50 Great Cormorant migrant birds have been found dead inside the Kaziranga National Park, a world heritage site, following which a probe has been ordered.
The birds were found dead at Borbeel in Bagori range on November 28 last.
"We are concerned at the death of the winged creatures who are annual visitors to the park from other places in Assam and north India. A probe has been ordered", Assam chief conservator of forest and director KNP N K Vasu told PTI.

"The Centre for Wildlife Rehabilitation and Conservation (CWRC) and the state veterinary department were called. Samples were collected and they would soon submit a report", he said.
Initial reports suggested it could be a result of poisoning but later findings ruled it out. "So we called experts from the North Eastern Regional Disease Diagnostic Laboratory for a probe and the report is expected soon", Vasu said.
Samples were collected and a team headed by deputy director of the state veterinary department and his team had reached the spot the next day for verification, he said.
"We observed the behaviour of fishes and pelicans inside the park and found no change. There was also a possibility of avian influenza but that was also ruled out", the director said.
All the 152 forest camps inside the 840 sq km park were asked to report about about any death of avians but after that date nothing was reported, he said.
The National Park has been in the news this year for poaching of the highly endangered one-horned rhinos.
Apart from housing nearly 2200 one horned rhinos, the highest in the world, the KNP also has a pelican park of migratory birds who annually visit the park from various parts of the world, including Russia.

Monday, December 3, 2012

Indonesia: Update on Bekasi #H5N1 Outbreak

I previously posted on the outbreak, here.
Once there tested positive of bird flu (H5N1) from the rapid tests on dozens of chickens that died suddenly in Kampung Pulopajang, Sukamakmur Village, District Sukakarya, made ​​of Animal Health Animal Husbandry Department of Fisheries and Marine Resources (EPF) Bekasi Regency (29/11) and then, until now there is no preventive action from Bekasi regency.
Therefore, there is no prevention for the spread of H5N1 that.

Residents accused Bekasi regency is not serious and indifferent to overcome the virus that causes the deadly disease. One resident, believers say, having known positive test result declared, Bekasi regency should react quickly to address the spread of this virus. This case should not be taken lightly, Bekasi regency should fast motion, then if there are even blaming the victim," he complained.

Admittedly, the EPF has done spraying disinfectant around the cages were dozens of chickens died suddenly. However, he regretted that after that no follow-up, as the case of bird flu was over.

Vietnam: 42 yo suffers with Influenza Symptoms Similar to Bird Flu

Like bird flu deaths

42-year-old male patient with acute respiratory suspected H5N1 flu death last weekend in HCMC Hospital for Tropical Diseases.

Doctors Hospital for Tropical Diseases Ho Chi Minh City, said the patient was transferred up from Binh Duong Hospital in critical condition.
"Patients with severe pneumonia, acute respiratory distress. Emergency We have positive but he has not recovered," a doctor said.
According to medical reports, patients with symptoms consistent with the H5N1 avian influenza infection, such as sore throat, prolonged fever, shortness of breath and fluid. Before getting sick, I have been in contact with influenza duck and duck meat.
"The epidemiological factors and disease manifestations are made doctors think of the H5N1 bird flu. Yet tests at the hospital and the Pasteur Institute in Ho Chi Minh City were negative," said Dr. Le Manh Hung, deputy director of the disease Hospital for Tropical Diseases Ho Chi Minh City said.
According to the patient, before you get sick, you can go home in Kien Giang play. Here you contact with infected ducks and duck meat. When back to the Pacific, he began to feel tired, sore throat and fever that lasts.


Kien Giang Province

U.S.: Earliest start to flu season in nearly a decade

By Rachael Rettner
Published December 03, 2012

Flu activity around the country is high enough that health officials announced Monday the season is under way. It's the earliest start to the season since the 2003-2004 flu season, excluding the 2009 pandemic, said Dr. Thomas Frieden, director of the CDC.
While the course of a flu season is always unpredictable, this year's early start and the specific strains circulating suggest "this could be a bad flu year," Frieden said.
Last year, flu season did not begin until late February, which was the latest start in 24 years.
The level of flu activity that health officials are seeing now is usually not seen until January.
Fortunately, the strains in this year's flu vaccine closely match the strains in circulation, Frieden said.
If you haven't been vaccinated yet, it's time to get your shot, Frieden said.
"Vaccination is by far the best tool we have to protect ourselves against flu," he said. About 37 percent of the U.S. population ages 6 months and older have been vaccinated so far, the CDC said.

Sick chickens come home to roost: Deadly infection avian influenza or bird flu is present in our country

3 Dec, 2012, 07.12AM IST, Nidhi Nath Srinivas

What are the chances that a chicken infected with bird flu will land on your plate? Zero. What are the chances that a bird flu infection will increase the price you pay for chicken and eggs? 100%.
A virulent and deadly infection called avian influenza or bird flu is present in our country. The virus usually affects wild fowl which then infect chickens. The virus can survive for considerable lengths of time outside of the bird and can also be spread through vehicles, equipment and people travelling between farms, markets and abattoirs. Bird flu attacks can wipe out entire flocks. In 1997, scientists found for the first time that H5N1 flu could infect humans.
Till now, our border states -- the northeast, Odisha and West Bengal -- suffered from frequent attacks due to infection carried in from Bangladesh and Nepal. Southern India that produces 40% of our chicken and eggs escaped unscathed. Now the virus has breached this wall too.
In October, Karnataka reported bird flu at a government-run turkey farm that was so deadly that the birds died before they could display the classic symptoms. Immediately, the authorities scrambled into action to stop the infection from spreading. Even so the economic cost of such episodes is huge.
The Central Poultry Development Organisation and Training Institute, which ran the farm, has no work for now since its entire stock has been wiped out. Poultry farms within the 10-km radius have to kill their chickens to stamp out the infection. For an average-sized farm of 10,000 birds, this means losing minimum Rs 1 lakh and 20,000 kg meat. Neighbouring states bar eggs and chickens from the infection zone.
Exports are hit because major markets in the Middle East, most recently Oman, immediately banned Indian poultry and egg products. These bans are reviewed after 90 days in keeping with international norms. Two days ago, Japan, New Zealand, South Africa, South Korea and the US suspended all poultry imports from Australia because of bird flu on just one farm.
The curtailed domestic supply raises prices for consumers, restaurants and food companies in a market that is expanding 10% annually. In short, the damage is serious. A recent outbreak in Mexico cost the country $860 million.
Clearly, it is in everyone's interest to eradicate bird flu. The big question is can it be done? Government does not allow vaccination against bird flu. There are good reasons. One, vaccination is a herculean task. India has 649 million chickens. When even the Pulse Polio programme can't claim 100% success, there is a slim chance that small farmers will spend money to vaccinate chickens in their backyard. Since there is a new flock of broilers every two months, stamping out bird flu through vaccination is impossible, as Vietnam's experience shows.
There are trade issues as well. Both infected and vaccinated chickens carry bird flu antibodies. Unless farmers use specially formulated imported vaccines designed to overcome this confusion, Indian chickens could face unwonted hurdles overseas.
Faced with such issues, the current government policy of forcing farmers to cull birds and root out infection seems suitable. The catch is that farmers often suppress information about an outbreak to avoid losing their entire flock. Surreptitiously burying the few sick birds is common. In fact, the Karnataka episode was immediately highlighted only because it was on a government farm, say industry insiders.

Possibility of a pandemic grows as WHO discovers another SARS-related virus

Excerpts: The WHO reported that as of Friday two deaths in Jordan were among five confirmed deaths from the new virus in the Middle East this year. “These cases were discovered through testing of stored samples from a cluster of pneumonia cases that occurred in April 2012,” the U.N. agency said. In the Saudi Arabian family cluster, two of the three confirmed cases were fatal. One more family member also had a similar illness and recovered but tested negative by polymerase chain reaction, the WHO stated. Saudi Arabia’s deputy minister for public health, Ziad A. Memish, MD, today suggested that the virus in the Saudi Arabian family cluster may be different from the strain in the earlier cases. “We think the virus in the last family cluster is different as it had significant spread among households while none of the previous cases behaved in a similar way,” Memish said in e-mailed comments to CIDRAP News. Memish was among the authors of a description of Saudi Arabia’s second novel CoV case, published this week in the Saudi Medical Journal. But if the new virus is able to spread from person to person, even if inefficiently, that raises the possibility it can become more mobile, moving through human populations. “Even if the cases in Jordan were human-to-human spread — and we don’t know that — it wasn’t sustained,” WHO spokesman Gregory Hartl told the Canadian Press.

Child in Iowa Diagnosed with H3N2v Influenza A Strain

December 3, 2012 Cedar Rapids child diagnosed with rare strain of swine flu. The Centers for Disease Control and Prevention confirmed the H3N2v influenza A strain in the child, KCRG-TV in Cedar Rapids reported. State epidemiologist Dr. Patricia Quinlisk said the child, who has since recovered, had not been in contact with swine, one of the modes of transmission. Continued:

40 demoiselle cranes found dead in Amreli

Amreli is in India.

AHMEDABAD: At least 40 demoiselle cranes were found dead near Victor Dam at Rajula in Amreli district. While preliminary investigation suggested the migratory birds died due to breathing problem, experts are not ruling out the possibility of bird flu.

 "We carried out the post-mortem locally and doctors opine the birds died of breathing disorder. We have sent the samples to the veterinary hospital in Jungadh to know whether the birds were infected with avian influenza," said district forest officer G C Makwana.

Dr Asad Rahmani, director of Bombay Natural History Society (BNHS), said, "The possibility of bird flu cannot be ruled out since the cranes died in large numbers. The forest department should collect the blood samples and send them to the High Security Animal Disease Laboratory in Bhopal."

On Saturday, volunteers brought five dead cranes to the forest department office in Rajula and one was in its last throes. The crane was treated and was sent to the forest hospital where its condition is said to be stable. Interestingly, two kites were also found dead in the same area. Officials believe that scavengers might have fed on the carcass of the cranes. Dinesh Goswami, a wildlife activist, said, "I was in the area and about 10 cranes died within 30 minutes. It looked like the birds were having some breathing trouble and were frothing as well."

Oman: And Wreikat: laboratory results proved the death of two cases last April «new Coruna

Oman -  Constitution Kausar Sawalha Health Minister Dr. Abdul Latif Wreikat officially recognized laboratory results injuring two died in April last illness «new Coruna» with an emphasis on the non-registration of new cases of the disease SARS-like new since April this year. announcement came in a press conference held yesterday, commenting on the announcement of the World Health Organization within the registration cases disease «Corona new», where the statement that «It is said that the number of cases detected disease Coruna new 9 cases recorded in the Eastern Mediterranean Region, five cases in Saudi Arabia, and two in Qatar, and two in Jordan ».  

minister added that after been definitely confirmed that two deaths in Jordan Natjtan disease Coruna new that were not until recently known internationally is not available with reagents, it was announced that to remove ambiguity imposed nature of the disease the new knowledge derived for the world around him, and availability Reagents for him. between the announcement at this time gives the opportunity for the WHO team is currently in Jordan to investigate and investigate the epidemiological situation, a procedure followed by Saudi Arabia and Qatar after recording injuries sick new, as well as allowing scope for raising the capacity of the epidemiological monitoring laboratory for diseases flu kinds in laboratories Jordanian all.  

confirmed Wreikat that the ministry did not register since last April until today any case virus Koruna new characterized deploy limited. Minister reviewed at the conference sequence recording the cases mentioned in hospital blue state, explaining that the cases were fired upon and the media in April last «mysterious disease», because in that time recorded in the Department of intensive care in hospital blue state 11 cases of pneumonia severe during the period from 7 to April 21, including two cases of doctors and 9 cases among cadres nursing, and underwent all the treatment and turned severe cases of infection to a hospital for . , adding that the ministry has taken preventive measures and treatment by protocols health tired globally in such cases were withdrawn samples Laboratory for examination in laboratories Ministry and King Hussein Cancer Center and the University of Science and Technology did not show laboratory results then any positive result for the disease intractable and the results were negative for any type of flu viruses such as bird flu and swine and SARS and even Koruna except some positive results for the bacteria pseudomonas aeroginosa. said 

«In the meantime, and on April 19, died nurse Ash from with pneumonia severe hospital blue, it is under treatment at a private hospital, and died later on April 26 also demanded university at the age of 25 years, a resident of the blue, and ministry announced at the time of these deaths ». , he noted instructed then in April to transfer university student from hospital blue government to Prince Hamzah Hospital as he was complaining of a sore membranes heart and suspicion disease tuberculosis and encountered his hospitalization in conjunction with the pandemic it. 

said «did not stop the ministry from continuing operations monitoring and survey epidemiological laboratory for cases with symptoms similar in blue did not report any injury outside the hospital and close the file at the time for lack of evidence of any cases of disease flu kinds laboratory either in laboratories Jordanian or reference to the World Health Organization as well as the lack of injuries similar through monitoring and survey epidemiological ».  

And that, in the development of a global later, World Health Organization announced abruptly for two deaths Natjtin for new disease types of flu called Koruna new in Saudi Saudi Arabia in July of this year and announced it officially in September. minister said that the ministry has stepped up its measures preventive, as vaccinated pilgrims Bmtaum flu seasonal before traveling to Saudi Arabia, as well as giving Scion of health personnel in hospitals, and when pilgrims return to Jordan was conducted process monitoring them and give them precautionary preventive treatment for flu at border crossings. and pay announcement WHO ministry to demand from laboratories Navy SEAL (NAMRU 3) in Cairo, re-examination of samples of the disease named Corona new which was not known previously, that particular lab reagents for the disease became available after the announcement of the deaths in Saudi Arabia Bcesp new disease.showed results of laboratory tests to NAMRU 3 in November 14 of last Arbainet deceased (nurse) and the young university it was positive for Corona new. informed the ministry WHO on Thursday registered cases of injury بالكورونا new after ascertaining diagnostic laboratory, despite the non-registration of any similar injury since April this year so far, according to Dr. Wreikat who said that this confirms that the cases were limited to the intensive care unit in a hospital blue. 

 WHO representative in Oman Dr. Akram Toum confirmed Send organized a technical team to support the efforts of the Ministry of Health in the survey and surveillance of the disease and respiratory epidemiological situation in general at the provincial level, and it depends protocols to investigate the disease, especially new viruses Lyman Organization importance of research and survey in the detection of infected cases and provide early treatment and conduct field and laboratory research. He added that Jordan is a beacon for technical cooperation in the various fields of health, especially monitoring, he developed and developing countries at the level of the region, compared with other regions in the world, because the Kingdom has strong health systems. 

 And the director of Primary Health Care Department, Dr. Bassam Hijjawi that disease Koruna new is a viral disease that affects the respiratory system and is accompanied by a rise in temperature, dry cough and difficulty in breathing which often infects humans and animals and is similar to SARS is not available to him vaccine does not treat the two types. said Hijjawi The ministry adopted since 2008 monitoring system in 3 hospitals in Amman and the north and south, to investigate the respiratory disease severe as it has been withdrawn 234 sample from April until the end of last June were sent to laboratories (NAMRU 3) and appeared results negative is, they is infected with coronavirus new. He said the teams epidemiological survey in accordance with the approved monitoring systems in the ministry, and in collaboration with the technical team of the World Health Organization (WHO), yesterday went to Karak to make sure monitoring systems capabilities there and investigate the epidemiological situation. 

Sequence and phylogenetic analysis of highly pathogenic avian influenza H5N1 viruses isolated during 2006--2008 outbreaks in Pakistan reveals genetic diversity

Virology Journal Published: 3 December 2012
Abstract (provisional) Background
Since the first outbreak recorded in northern areas of Pakistan in early 2006, highly pathogenic avian influenza H5N1 viruses were isolated from commercial poultry and wild and domestic birds from different areas of Pakistan up to July 2008. Different isolates of H5N1 were sequenced to explore the genetic diversity of these viruses.
Phylogenetic analysis revealed close clustering and highest sequence identity in all 8 genes to HPAI H5N1 isolates belonging to unified H5 clade 2.2, sub-lineage EMA-3 recovered from Afghanistan during the same time period. Two subgroups with in Pakistani H5N1 viruses, from domestic and wild birds, were observed on the basis of their sequence homology and mutations. HPAI motif, preferred receptor specificity for alpha-(2, 3) linkages, potential N-linked glycosylation sites and an additional glycosylation site at the globular head of HA protein of four Pakistani H5N1 isolates. While, the amino acids associated with sensitivities to various antiviral drugs (Oseltamivir, Zanamivir, Amantadine) were found conserved for the Pakistani H5N1 isolates. Conspicuously, some important mutations observed at critical positions of antigenic sites (S141P, D155S, R162I & P181S) and at receptor binding pocket (A185T, R189K & S217P) of HA-1. A high sequence similarity between Pakistani HP H5N1 and LP H9N2 viruses was also observed. Avian like host specific markers with the exception of E627K in PB2, K356R in PA, V33I in NP, I28V in M2 and L107F in NS2 proteins were also observed.
Various point mutations in different genes of H5 viruses from Pakistan were observed during its circulation in the field. The outbreaks started in Khyber Pakhtoon Khawa (North West) province in 2006 and spread to the Southern regions over a period of time. Though migratory birds may have a role for this continued endemicity of clade 2.2 H5N1 viruses during 2006--2008 in Pakistan, the possibility of their transmission through legal or illegal poultry trade across the borders cannot be ignored.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production. 

Sunday, December 2, 2012

Egypt: Strict measures in Gharbiya in anticipation of emergence of foci infected with foot and mouth disease or avian influenza

Translation 2-12-2012 Counsel issued Muhammad Abdul Qadir, governor of the West on Sunday instructed the Undersecretary of the Ministry of Veterinary Medicine Gharbiya take all preventive measures in case of suspected epidemic diseases of animals, such as foot and mouth disease, or bird flu, and the implementation of programs that have been developed for this purpose. noted conservative to the importance of awareness necessary for educators to protect themselves and their children and animals from epidemic diseases which they may be exposed, and the implementation of all credit conditions in animal husbandry farms, or home education. For his part, Dr. Wafik star, Undersecretary of the Ministry of Veterinary Medicine, that in case of the emergence of foci satisfactory any epidemic disease is routed to a committee of veterinarians to replace the focus to assess the epidemiological situation and take preventive measures instant such as isolating infected animals from healthy animals and give medicines required under veterinary supervision. and pointed out that it is implementing the program sprayed with disinfectant for viruses to reduce the spread of the disease, and the closure of markets selling animals in the region replaced the focus, with emphasis on the non-transfer of animals to or from the affected area, in coordination with the police, and in the case of the presence of dead animals is coordination with the EEAA to get rid of dead animals and buried in the cemetery healthy and make a place disinfected necessary.