Influenza Virus Mashup

Influenza Virus Mashup

Archive for March, 2010

(Sat, 27 Mar 2010 12:20:00 +0000)

 

 

# 4465

 

You haven’t seen them all.

 

At least, not according to a letter that appears in the latest edition of the CDC’s Journal of Emerging Infectious Diseases.

 

Novel H1N1, as everyone knows by now, is a descendent of a triple reassorted H1N1 swine flu virus that first appeared in American swine herds in 1998.  It apparently bounced around in swine herds for a decade before finding the right genetic mutations to adapt to humans.

 

But H1N1 isn’t the only swine flu virus out there.  Known Swine influenza A viruses include H1N1, H1N2, H3N1, H3N2, and H2N3.

Surveillance and reporting of infected herds is suboptimal in this country and around the world, and many farmers find financial disincentives to testing their herds (see Swine Flu: Don’t Test, Don’t Tell).

 

Today, we’ve news of another triple-reassortant swine flu virus – this time H3N2 – that has been spreading in pigs for more than a decade, that has now shown up in waterfowl in South Dakota.

 

 

 

Volume 16, Number 4–April 2010
Letter

Triple Reassortant Swine Influenza A (H3N2) Virus in Waterfowl

Muthannan A. Ramakrishnan, Ping Wang, Martha Abin, My Yang, Sagar M. Goyal, Marie R. Gramer, Patrick Redig, Monte W. Fuhrman, and Srinand Sreevatsan 

 

To the Editor: In 1998, a new lineage of triple reassortant influenza A (H3N2) virus (TR-H3N2) with genes from humans (hemmaglutinin [HA], neuraminidase [NA], and polymerase basic 1 [PB1]), swine (matrix [M], nonstructural [NS], and nucleoprotein [NP]), and birds (polymerase acidic [PA] and PB2) emerged in the U.S. swine population.

 

Subsequently, similar viruses were isolated from turkeys (1,2), minks, and humans in the United States and Canada (3,4). In 2007, our national influenza surveillance resulted in isolation of 4 swine-like TR-H3N2 viruses from migratory waterfowl (3 from mallards [Anas platyrrhynchos] and 1 from a northern pintail [Anas acuta] of 266 birds sampled) in north-central South Dakota. We report on the characterization of these TR-H3N2 viruses and hypothesize about their potential for interspecies transmission.

(Continue . . . )

 

 

For now, this is mostly a scientific curiosity, not a tangible public health threat.   But of course, one could have said the same thing about the triple reassortant H1N1 in pigs 12 months ago.

 

Which is why many scientists are calling for far more rigorous testing and surveillance of our farm animals. 

 

While one could argue that these viruses have circulated in pigs and other animals for thousands of years without our knowledge, and only rarely have emerged as human health threats, that ignores the recently introduced dynamic of factory farming. 

 

We now put thousands of pigs, and sometimes hundreds of thousands of chickens, in unnaturally close quarters to raise them.  This is believed conducive to promoting the spread, and mutation, of certain bacterial and viral pathogens.

 

Diseases that might never have caught fire fifty years ago, when Old McDonald had a half dozen sows on his farm, have a better opportunity to spread and mutate when introduced into a CAFO (Concentrated Animal Feeding Operation) with thousands of pigs or hundreds of thousands of chickens.

 

For more perspective on this, you might wish to read Dr. Michael Greger’s  Bird Flu: A Virus Of Our Own Hatching (available free, online) and watch his Human Society video on Flu Factories (online here).

 

The significance of this finding, of a swine H3N2 virus in waterfowl in South Dakota, is less than clear.  It may have no public health implications at all, or it could be a harbinger of some future health threat.

 

 

Without good, ongoing animal surveillance, it is impossible to establish a baseline and impossible to determine if something new or unusual is happening.  

 

And if the next virus to jump to man is more virulent than novel H1N1, the price of that ignorance could be very high.

(Sat, 27 Mar 2010 10:52:00 +0000)

 

 

# 4464

 

 

Victories over continually evolving pathogens are often fleeting at best.   No sooner do researchers release a new generation of antibiotics or antivirals, than these organisms begin to find ways to work around them.

 

Maryn McKenna’s terrific book Superbug: The Fatal Menace of MRSA goes into great detail about the road to antibiotic resistance, but we are seeing a similar path being followed by antivirals as well.

 

Amantadine managed to remain an effective treatment and/or prophylaxis against influenza A for four decades, although it was used only sparingly for the first 30 years or so.   

 

Overuse of Amantadine, particularly its inclusion into chicken feed during the 1990s to combat bird flu in Asia – has been credited with a dramatic rise in influenza’s resistance to the drug by 2005. 

 

Tamiflu (oseltamivir), released in 1999 proved extremely effective against influenza until 2008, when a resistant version of seasonal H1N1 appeared and quickly spread around the world.   Seasonal H3N2 remained susceptible to the drug. 

 

These two seasonal viruses have been (at least temporarily) replaced by novel H1N1, which fortunately remains sensitive to the drug.   Scientists do worry that over time, novel H1N1 could pick up resistance to Tamiflu as well.

 

Which brings us to a report issued yesterday by the NIH about two patients that developed resistance to Tamiflu, and in one case, to the newly approved peramivir.   

 

FOR IMMEDIATE RELEASE
Friday, March 26, 2010

Media Contact: Anne A. Oplinger
(301) 402-1663
niaidnews@niaid.nih.gov

Rapid Development of Drug-Resistant 2009 H1N1 Influenza Reported in Two Cases

Reevaluation of Treatment Strategies for Prolonged Infection Urged

Two people with compromised immune systems who became ill with 2009 H1N1 influenza developed drug-resistant strains of virus after less than two weeks on therapy, report doctors from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Doctors who treat prolonged influenza infection should be aware that even a short course of antiviral treatment may lead to drug-resistant virus, say the authors, and clinicians should consider this possibility as they develop initial treatment strategies for their patients who have impaired immune function.

 

Both patients in the new report developed resistance to the key influenza drug oseltamivir (Tamiflu), and one also demonstrated clinical resistance to another antiviral agent, now in experimental testing, intravenous peramivir, note senior authors Matthew J. Memoli, M.D., and Jeffery K. Taubenberger, M.D., Ph.D. This is the first reported case of clinically significant peramivir-resistant 2009 H1N1 illness, say the scientists. The report is scheduled to appear in print on May 1 in Clinical Infectious Diseases and is now online.

 

The people in the current case report had immune limitations due to blood stem cell transplants that occurred several years previously. Both recovered from their influenza infections.

 

“While the emergence of drug-resistant influenza virus is not in itself surprising, these cases demonstrate that resistant strains can emerge after only a brief period of drug therapy,” says NIAID Director Anthony S. Fauci, M.D. “We have a limited number of drugs available for treating influenza and these findings provide additional urgency to efforts to develop antivirals that attack influenza virus in novel ways.”

 

The 2009 H1N1 influenza virus is susceptible to just one of the two available classes of anti-influenza drugs, the neuraminidase inhibitors. Besides oseltamivir, other neuraminidase inhibitors are zanamivir (Relenza), which is inhaled, and the intravenously administered investigational drug peramivir. As the H1N1 influenza pandemic unfolded, laboratory tests of virus strains isolated from patients showed that some strains contained a genetic mutation (the H275Y mutation) that makes the virus less susceptible to some neuraminidase inhibitors.

(Continue . . . )

 

 

Lisa Schnirring at CIDRAP News has more details on this story.

 

 

Researchers report peramivir-resistant H1N1 case

Lisa Schnirring * Staff Writer

Mar 26, 2010 (CIDRAP News) – Researchers today sounded two warnings for clinicians who manage pandemic H1N1 patients: that even a short course of oseltamivir (Tamiflu) can lead to antiviral resistance and that patients can develop resistance to peramivir, an alternative to oseltamivir in emergency situations.

 

The warnings come from a case report of two patients published today in an early online edition of Clinical Infectious Diseases (CID). The authors are from the National Institute of Allergy and Infectious Diseases (NIAID) and the US Food and Drug Administration (FDA). The study is scheduled to appear in the May 1 issue of CID.

 

The research team, headed by senior authors Matthew J. Memoli, MD, and Jeffery K. Taubenberger, MD, PhD, said the report details the first clinically significant peramivir-resistant pandemic H1N1 case.

(Continue . . .)

 

These are, admittedly, isolated incidents.  

 

And it should be noted that these two cases involved spontaneous resistance forming in immune compromised patients receiving Tamiflu, and are not due to some new Tamiflu/peramivir  resistant strain circulating in the wild.

 

The takeaway message from this report isn’t that these drugs are losing effectiveness, but that resistance can develop quickly in rare instances in some people receiving these medications.  

 

Which is another good reason why getting a flu shot every year is an exceedingly good idea.

 

While not 100% protective, getting the flu shot can significantly reduce your chances of catching the flu.

 

After all, it is better to try to prevent an illness, than to have to treat one.   

[Flu Wiki Forum] News Reports for March 28, 2010

Posted by Automator On March - 28 - 2010

(Sat, 27 Mar 2010 03:29:18 GMT)

Reminder: Please do not post whole articles, just snippets and links. Thanks!!



?  H (Link)

United States

?  AR: H1N1: Another Wave Coming? (Link)

?  H1N1 expenses close to $200,000 for Western NY (Link)

?  KY: Flu cases rise again in Greene County  (Link)

?  AL: Etowah County death linked to swine flu (Link)

?  TX: First H1N1 death for Comal County  (Link)

?  FL: Swine flu claims 67-year-old man (Link)

News for March 27, 2010 is here.

US Influenza-Like Illness Reports
Week ending Mar. 20, 2010


Thanks to all of the newshounds!
Special thanks to the newshound volunteers who translate international stories - thanks for keeping us all informed!

Other useful links:

CDC A(H1N1) Site

WHO A(H1N1) Site

WHO H5N1 human case totals, last updated March 16, 2010
Charts and Graphs on H5N1 from WHO
Google Flu Trends (U.S.)
CDC Weekly Influenza Summary
Map of seasonal influenza in the U.S.
CIDPC (Canada) Weekly FluWatch
European CDC Influenza News
UK RCGP Weekly Data on Communicable and Respiratory Diseases
Flu Wiki Main Page

[Flu Wiki Forum] News Reports for March 27, 2010

Posted by Automator On March - 27 - 2010

(Sat, 27 Mar 2010 03:28:08 GMT)

Reminder: Please do not post whole articles, just snippets and links. Thanks!!



?  H (Link)

News for March 26, 2010 is here.

US Influenza-Like Illness Reports
Week ending Mar. 20, 2010


Thanks to all of the newshounds!
Special thanks to the newshound volunteers who translate international stories - thanks for keeping us all informed!

Other useful links:

CDC A(H1N1) Site

WHO A(H1N1) Site

WHO H5N1 human case totals, last updated March 16, 2010
Charts and Graphs on H5N1 from WHO
Google Flu Trends (U.S.)
CDC Weekly Influenza Summary
Map of seasonal influenza in the U.S.
CIDPC (Canada) Weekly FluWatch
European CDC Influenza News
UK RCGP Weekly Data on Communicable and Respiratory Diseases
Flu Wiki Main Page

[Crof's H5N1] El Salvador: First H1N1 death of 2010

Posted by Automator On March - 27 - 2010

Via Prensa Latina: Reportan primera muerte por gripe A H1N1 en El Salvador. [First H1N1 death reported in El Salvador] Excerpt, with my translation:

Una mujer embarazada murió a causa de la gripe A H1NI en El Salvador y se convirtió en la primera víctima fatal este año de la pandemia en el país, informó hoy el ministerio de Salud.   

A pregnant woman has died from H1N1 influenza in El Salvador, becoming the country’s first pandemic fatality this year, the Health Ministry has said. 

El director de Vigilancia de la Salud de esa cartera, Julio Romero, anunció que al bebé de la fallecida se le logró salvar la vida ayer mediante una cesárea y se recupera satisfactoriamente en el hospital de Maternidad. 

The director of Health Surveillance in the ministry, Julio Romero, said the baby had been delivered by caesarean section and is in satisfactory condition in the Maternity Hospital.

Romero precisó que la mujer, de 41 años de edad y cuyo nombre no fue hecho público, sufría también neumonía e insuficiencia respiratoria. De acuerdo con el funcionario, se estudian otros cuatro casos sospechosos de padecer la gripe.

Romero said that the woman, 41 years old, and whose name was not made public, had also suffered from pneumonia and respiratory insufficiency. According to the official, four other persons are suspected of suffering from H1N1.

[Crof's H5N1] Chile reports first H1N1 case in quake zone

Posted by Automator On March - 27 - 2010

Via LaNacion.cl: Minsal reporta primer caso de A-H1N1 en zona afectada por terremoto. [Health Ministry reports first H1N1 case in zone affected by earthquake] Excerpt, with my translation: 

El ministerio de Salud informó este viernes que el laboratorio regional de PCR del Hospital Guillermo Grant Benavente de Concepción confirmó un nuevo caso de influenza A-H1N1 en un niño de 5 años residente en Isla Mocha, quien fue trasladado a ese establecimiento. 

The Ministry of Health reported this Friday that the regional laboratory of Guillermo Grant Benavente de Concepción confirmed a new case of H1N1 influenza in a 5-year-old boy living in Isla Mocha, who was taken to this hospital.

El niño se encuentra hospitalizado y evolucionando favorablemente. 

The boy is still hospitalized and his case is developing favourably.

Con este, suman 16 los casos confirmados de virus influenza humana por laboratorio en el país desde el 1 de enero de 2010, declaró la secretaría de Estado mediante un comunicado de prensa. Se trata del primer caso detectado en una de las zonas más afectadas por el terremoto del pasado 27 de febrero.

His case makes 16 confirmed H1N1 cases in the country since January 1, said the Secretary of State in a media release. It is the first case detected in one of the zones most affected by the February 27 earthquake.

Saturday, February 27, 2010 | 20:09 pm
Bahasa Indonesia JAMBI | SOLAR Online -

Five areas in Jambi province is Jambi city and four districts, contracted avian influenza (H5N1), resulting in hundreds of chickens owned by residents, died suddenly.

Chief Provincial Livestock Office of Jambi in Jambi Hanif Lubis, Saturday (27/2/2010), said the four districts that contracted the bird flu is Muarojambi District, Batanghari, Tebo and Kerinci regency.

“The worst attack in the Kerinci regency, at least 400 residents of chickens died suddenly. Everything chicken or chicken pieces are kept in cages, “he said.

While the city of Jambi and three other districts, the dead chicken fewer, and most of the chicken is left free to roam.

Hanif said, to anticipate the spread of the disease, and that is not contagious in humans, the medical officer deployed to the field to take action, either to destroy, isolate the infected areas, to vaccination and other measures.

Therefore, the poultry farmers in bird flu infected area were asked incentive to do sanitation, spraying and vaccination to prevent transmission of the disease.

Residents are also asked to report immediately to the nearest farm workers if they find a chicken or poultry that died suddenly in abundance, so that action can be taken.

The people who found the chicken died suddenly also asked to not make direct contact with the animal.

“If anything has touched the animal, should immediately shower and wash your hands clean so as not infected,” said Hanif.

Animal Husbandry Department, he added, also tighten the traffic flow of animals, because a number of neighboring provinces also contracted the disease.

translated

http://www.surya.co.id/2010/02/27/empat-kabupaten-di-jambi-terjangkit-flu-burung.html

China
• More vaccine problems reported in S. China city (Link)

Ghana
• Ghana: Swine flu hits Achimota school (Link)

Mexico
• 72,133 H1N1 cases and 1,128 deaths (Link)

Netherlands
• Outbreak of rare disease in the Netherlands (Link)
• 2700 ducks to be killed today (Link)

Tasmania
• Swine flu season begins with ‘concerning’ first case recorded in Tasmania (Link)

Uganda
• Reported Ugandan smallpox is likely chickenpox (Link)

United States
• FL: Health Department confirms 6th swine flu death (Link)
• GA: New flu cases revive concern (Link)
• IL: One death, 18 hospitalizations this week (Link)
• KS: Sedgwick County Confirms Six Additional H1N1 Cases (Link)

General
• CIDRAP: CDC advises keeping unexpired H1N1 vaccine until fall (Link)

Research
• Study: Rapid Emergence of Oseltamivir Resistance (Link)
• Structure Of ‘Swine Flu’ Virus Revealed By Scripps Research Team (Link)
• One of H1N1’s mysteries explained (Link)

Commentary
• Recombinomics: Alarming Spike In H1N1 Hospitalizations and Deaths In Georgia (Link)
• Effect Measure: Immunity and the 1918 and 2009 pandemics (Link)

[Crof's H5N1] Cuba will vaccinate over one million against H1N1

Posted by Automator On March - 27 - 2010

Via Prensa Latina: Más de un millón de cubanos serán vacunados contra influenza A(H1N1).[More than a million Cubans will be vaccinated against H1N1 flu] Excerpt, with my translation:

Más de un millón 120 mil personas serán inmunizadas en Cuba contra la influenza A(H1N1), en una campaña que iniciará el próximo 1 de abril, informaron expertos del ministerio de Salud Pública (MINSAP).   

Over 1,120,000 persons will be immunized in Cuba against H1N1 flu, in a campaign starting April 1, according to experts in the Ministry of Public Health.

En conferencia de prensa, el doctor Luis Estruch, viceministro de Higiene y Epidemiología del MINSAP, explicó que la vacuna fue donada por la Organización Mundial de la Salud (OMS) y la Oficina Sanitaria Panamericana (OPS). 

In a press conference, Dr. Luis Estruch, vice-minister for Hygiene and Epidemiology, said the vaccine has been donated by the World Health Organization and the Panamerican Health Office.

Las dosis serán aplicadas en dos etapas, la primera que se extenderá hasta el 20 de abril y una segunda del 3 al 15 de mayo.

The doses will be given in two stages, the first lasting until April 20 and the second from the 3rd to the 15th of May.

February 22, 2010

Let’s Work Together

The Public Health Preparedness Summit, held at the Marriott Marquis in Atlanta last week, brought together experts in public health and shed light on lessons learned during the H1N1 pandemic. The summit opened with strong statements from Health and Human Services (HHS) Secretary Kathleen Sebelius who spoke about the H1N1 pandemic.

“The flu is still circulating and is still a deadly disease,” she told the audience.

Sebelius also acknowledged that there are improvements to be made in preparedness strategies for public health emergencies, emphasizing the importance of collaboration and technology as factors of success. She called for investments in technologies to improve vaccine production. An investigation is currently being conducted into current vaccine technologies, led by Dr. Nicole Currie, Assistant Secretary for Preparedness and Response with the HHS.

In addition to the nuts and bolts of pandemic response, Sebelius recognized the importance of collaboration in addressing emergencies. She outlined the new partnerships that were forged between public health officials and education, business, and medical industries.

Public health officials coordinated their messaging with the American College of Obstetricians and Gynecologists. This may have led to the higher rates of H1N1 vaccination than usual rates of seasonal influenza vaccination among pregnant women.

continued

http://www.naccho.org/communications/blog/H1N1/Posts/feb22.cfm

Angola
• H1N1 Flu Epidemiological Situation Still Stable (Link)

Bhutan
• New outbreak of H5N1 in birds (Link)

Cambodia
• Swine flu vaccinations set to begin (Link)

• Influenza-Like Illness ,Fatal – Cambodia Mondulkiri (Link)

China
• Probe into lame boy after swine flu jab (Link)

Denmark
• Another case of H7 on Danish duck farm (Link)

Ghana
• 6 Students Get Swine Flu (Link)

India
• Vendor caught selling “dead chicken” in Dimapur (Link)

Indonesia
• Indonesia Has 163 Bird Flu Deaths (tanslated) (Link)

Nepal
Bird flu detected in Banke (Link)
• Nepal – Bird flu (Link)

Uganda
• Undiagnosed Illness, POX VIRUS Suspected (Link)
• WHO investigating smallpox outbreak (Link)

United States
• FL: H1N1 Flu Cases Increase In Duval County (Link)
• LA: DHH Launches H1N1 Open Clinic Campaign This Week (Link)

• US: CIDRAP – As H1N1 vaccinations taper, CDC lists changes in distribution (Link)
• NBSB webinar tomorrow (Link)
• GA: Swine Flu Hospitalizations Up in Georgia (Link)
• MN: 2 new swine flu deaths confirmed (Link)

Vietnam
H5N1 outbreaks in birds (Link)

General
Bird flu remains a threat: WHO (Link)

 

[Crof's H5N1] Egypt: H1N1 cases drop; another H5N1 death

Posted by Automator On March - 27 - 2010

Via Daily News Egypt, a routine report with a sting in its tail: Swine flu cases continue to drop. Excerpt:

Swine flu in Egypt has substantially declined, announced the Central Operation Room of Crisis and Disaster Management at Information and Decision Support Center at the Cabinet of Ministers. 

The Ministry of Health has announced that the number of swine flu cases in Egypt is substantially declining by nearly half. 

The number of cases is now 16,164, according to the latest swine flu report; of these cases 15,891 have received treatment and recovered, which is 98.3 percent. These include 5,615 cases reported in schools and 865 reported in universities. 

Due to the decline of the virus, during the second semester of the academic year, there will be no shutting down of any classrooms where the H1N1 virus appears. Precautionary measures will be limited to giving the student who exhibits swine flu symptoms one week off.  

On the other hand, the death toll from the H1N1 virus has reached 273 with one swine flu related death during the past two weeks. 

But despite the substantial decrease in the number of new swine flu cases since the beginning of February, the Ministry of Health still advises all citizens to take all the precautionary measures against he virus. 

Meanwhile, the Ministry of Health has announced one death from bird flu, a four-year-old boy from the Bani Suef, raising the death toll from the virus to 33 since it first appeared in Egypt in 2006.

The latest H5N1 situation update from WHO, published on March 4, says 30 Egyptians have died of bird flu. WHO’s latest cumulative tally, published on March 16, lists 32 deaths, 5 of them this year. Sixteen persons have contracted H5N1 so far this year. 

Considering that 2006 was Egypt’s first and worst year for H5N1 (18 cases, 10 deaths), the current tally in under three months does not bode well for 2010.