Influenza Virus Mashup

CIDRAP has published News Scan: E coli beef recall, AAP flu vaccine guidance, Tamiflu-resistant H1N1, DoD budget cuts, vaccine-autism ruling. Excerpt:

Trials to assess the pathogenicity and transmissibility of oseltamivir-resistant 2009 H1N1 viruses in mice and ferrets suggest that the resistant strain is as fit as counterparts that are sensitive to the drug, according to Japanese researchers. 

The group, which includes Dr Yoshihiro Kawaoka, a virologist from the University of Wisconsin at Madison, reported their findings in PLoS Pathogens. 

In testing the susceptibility of the resistant viruses to antiviral drugs, they also explored the effect of two new antivirals, CS-8958, a long-acting neuraminidase inhibitor, and the viral RNA polymerase inhibitor favipiravir. 

The group found that the new drugs reduced viral replication and could be promising candidates to help fight 2009 H1N1 viruses. They also concluded that their findings support concerns about overuse of antiviral drugs.

The Press Information Bureau has published Weekly data of influenza A H1N1 (For the week ending 22nd August 2010). The total number of confirmed cases since May 2009 is now 38,730, with 1,335 in the week of August 16-22. In that week, 79 persons died of H1N1, for a total of 2,024. Forty of those deaths were in Maharashtra state. 

Ida at Bird Flu Information Corner has two items today: Meulaboh’s chickens test positive bird flu; Forty percent Indonesia’s bird flu victims are children. The second story is from MetroTV News:

National Committee of Avian Influenza Control and Influenza Pandemic Preparedness (Komnas FPBI) recorded forty percent of 160 bird flu victims in Indonesia are children. 

This was stated by Communication Specialist Staff, Arie Rukmantara in Padang, West Sumatera, Sunday (29/8) at a meeting of animal and human bird flu information dissemination for West Sumatera authorities. “Data was taken from 2006 to 2009. Of forty percent cases mostly occurred in Jakarta, Banten and Surabaya,” said Arie.

(Mon, 30 Aug 2010 12:59:00 +0000)

# 4850

From the International Pharmaceutical Federation’s (FIP) conference in Lisbon, Portugal (Aug 28th-Sept 2nd), an illuminating press release on a paper to be presented today on the widespread parental misuse of over-the-counter (OTC) medicines for children.

A research team led by Dr. Rebekah Moles of the University of Sydney, New South Wales, reports that the inappropriate use, and incorrect dosing of OTC meds lead to a large number of accidental drug poisonings each year.

Running through a  variety of scenarios, nearly 100 adult caregivers were asked to decide what OTC medicines were appropriate for a child given their symptoms, and asked to measure out an appropriate dose.

A brief excerpt from the press release outlining the abysmal results follows.  By all means, click the link to read it in its entirety.

Widespread parental misuse of medicines puts children at risk

(Excerpt)

Common OTC medicines were made available, together with different types of dosing devices, including household spoons. Participants then chose whether or not to give a medicine, at what stage, and at what dose. They were asked to measure the dose for the researchers. Because doses for children are often small, the risk of getting the measurement wrong is greatly increased, the researchers say.

 

“Taking all the scenarios together, 44% of participants would have given an incorrect dose, and only 64% were able to measure accurately the dose they intended to give. We found that 15% of participants would give a medicine without taking their child’s temperature, and 55% would give medicine when the temperature was less than 38 degrees”, said Dr. Moles. Paracetamol was the preferred treatment, even for coughs and cold, and was used most often – 61% of the time – despite the child having no fever. Only 14% of carers managed the fever scenario correctly.

(Continue . . .)

(Mon, 30 Aug 2010 12:03:00 +0000)

# 4849

As Hurricane Earl ramps up in the eastern Caribbean, forecasters and emergency operations agencies all along the Atlantic seaboard have a difficult week ahead.

This morning, the official track from the NHC takes the storm close to, but just off shore from, the eastern coast of the United States as a major hurricane. 

Close enough that portions of the coastline are within the cone of forecast uncertainty.

With the Labor Day weekend ahead, considered to be the last hurrah of the summer for many visitors to the eastern shore, the stakes for getting this forecast right are understandably high.

The good news is, the worst of the weather in a tropical system generally remains to the right of the storm, and in this case, should remain off shore.

The bad news is, computer models continue to run the storm up the eastern seaboard; close enough to pose a danger, but far enough out that it could easily spare the area entirely.

Making this a difficult forecast indeed.

And an unenviable week for emergency planners as well, who must decide at least 48 hours in advance whether to pull the trigger and issue evacuations or other local warnings.

A thankless job, particularly if they err on the side of caution, and the storm stays out to sea.

 

Be glad this isn’t your call to make.

Although most of the computer models keep Earl offshore, they waver and change with every run (usually twice daily), and a few put the storm uncomfortably close to the coast in 96 to 120 hours.

I’m not going to get into `model wars’ (a favorite pastime on the hurricane forums), or in speculating whether this storm affects the U.S. coastline.

It is enough to acknowledge that sections of the coast lie within the cone of forecast uncertainty.  Which no doubt will have a lot of planners burning the midnight oil the next couple of nights.

And on the heels of Earl, we are likely to have Fiona threatening the Leeward Islands by week’s end, although it is too soon to know where she goes after that.

Which means that – no matter where you live along the Gulf or Atlantic Coastlines (and inland for hundreds of miles) – you need to be watching developments in the Caribbean and taking steps to prepare should one of these storms head your way.

This from FEMA.

Hurricane Season 2010

FEMA is urging residents to be prepared for their personal safety and survival in case a hurricane threatens their community. To assist in these efforts, FEMA, along with the National Oceanic and Atmospheric Administration, is helping to raise awareness of steps that can be taken to help protect citizens, their communities and property.

Be Prepared for 2010

• Take Action – Get a Kit
• Weather Radios
• Hurricane Preparedness from Ready.gov (PDF 27KB, TXT 6KB)
• The Disaster Declaration Process (PDF 278KB, TXT 6KB)
• Hurricane Season and Flooding (PDF 278KB, TXT 4KB)
• Inland Flooding (PDF 30KB, TXT 4KB)
• Preparing for Your Pets (PDF 30KB, TXT 7KB)
• Use of Social Media Tools (PDF 106KB, TXT 12KB)

(Mon, 30 Aug 2010 11:07:00 +0000)

# 4848

Late summer is generally a quiet time for bird flu reports, as the H5N1 virus tends to spread more easily during cooler weather.

Still, Egypt has reported two human infections in August, and a lack of timely reporting out of China and Indonesia doesn’t exactly guarantee that all is quiet in those countries.

So - even in these dog days of August - we keep our eyes open for reports that either suggest or confirm bird flu, even if many of these stories appear relatively minor.

With that in mind, a small selection of bird flu reports from the past couple of days, gathered by newshounds in Flublogia.

Ida at the Bird Flu Information Corner - a joint effort between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – has a pair of stories this morning.

Meulaboh, Aceh ::: Meulaboh’s chickens test positive bird flu.

Meulaboh – Chickens in Seuneubok village, kecamatan (sub-district) Johan Pahlawan, Meulaboh, West Aceh found to have suddenly died since Friday (27/8).

 

Further investigation by Participatory Disease Surveillance and Response (PDSR), Agriculture of Livestock Service West Aceh confirmed those chickens died of bird flu H5N1.

 

Control measures had been taken by burning and burying dead chickens, also by culling the survivors.

Source: Indonesia local newspaper, Serambi News.

A little geography for those unfamiliar with the area.

Meulaboh is the capital of the West Aceh Regency, Indonesia and was among the hardest hit areas by the 2004 Indian Ocean earthquake.

Indonesia ::: Forty percent bird flu victims in Indonesia are children

National Committee of Avian Influenza Control and Influenza Pandemic Preparedness (Komnas FPBI) recorded forty percent of 160 bird flu victims in Indonesia are children.

 

This was stated by Communication Specialist Staff, Arie Rukmantara in Padang, West Sumatera, Sunday (29/8) at a meeting of animal and human bird flu information dissemination for West Sumatera authorities.

 

“Data was taken from 2006 to 2009. Of forty percent cases mostly occurred in Jakarta, Banten and Surabaya,” said Arie.

 

Source: Indonesia TV news, Metro News.

Not exactly a surprising result, given that in the relatively brief history of H5N1, the virus has shown a decided predilection for the young. 

It isn’t known whether this pronounced shift towards younger victims is due to physiological, societal, or environmental reasons (or perhaps, a combination of factors).

Dutchy, posting on FluTrackers, has the following (somewhat confusing) item from China’s People’s Daily.  

 

While calling this outbreak in the Mongolian Capital `Bird Flu’, it also references `Newcastle’, which is a different type of avian disease entirely. 

Machine translations are often difficult to decipher, so we’ll probably need to wait for additional reports to get a better feel for what is going on in Ulan Bator.

Bird flu outbreak in Mongolian capital of Ulan Bator
on the August 30, 2010
 
People’s Network in Ulaanbaatar on August 30 (Xinhua Robert Footman), according to local media reports, the Mongolian capital of Ulan Bator-uul District 13, Area 27, a poultry farm confirmed bird flu. 28, Khan uul District, Area 13, the Government decided the area around the implementation of martial law there is an outbreak, local emergency office set up emergency headquarters, and to disinfect the affected areas, testing and other prevention work.

 

It was reported recently discovered that some of the farm raising chickens died due to unknown reasons, the epidemic prevention departments to conduct blood tests on 50 chickens to determine the chickens infected with avian flu as “Newcastle (Ньюкасл)” caused by the virus. Mongolia Emergency Committee today held a meeting to study the outbreak response.

Lastly, a small blurb appeared in my RSS feed this morning reporting that in the wake of recent bird flu reports out of Egypt, Bahrain has raised their bird flu alert level.

Bahrain on the alert for bird flu

Frankly, this is such a generic report, devoid of any real detail, that it could easily be a `phantom’ story from the past.  We get those occasionally, regurgitated from the news archives, and stamped with today’s date.

Pending  corroboration, my confidence in the age of this report is fairly low.

While bird flu reports have been on the back burner for the past year or so, it is worth remembering that H5N1 remains in Pre-Pandemic Phase III.  

Outbreaks occur primarily in birds, but sporadic widely scattered human cases are reported as well, particularly in Indonesia and Egypt.   Most (but not all) have been linked to close contact with infected poultry or birds.

The virus has yet to adapt well enough to human hosts to transmit effectively between people, although scientists still worry that the virus could mutate into a pandemic strain someday.

(Sun, 29 Aug 2010 20:51:00 +0000)

# 4847

After a brief downward blip in the number of reported cases of Dengue Fever in Puerto Rico last week (reporting week 30), this week’s surveillance numbers are back on the rise again.

As indicated by the chart above, the number of cases currently being reported are running at rates more than 4 times above the epidemic threshold, and the yearly total is on target to exceed that seen during the big 1998 epidemic.

1998 Epidemic – MMWR November 13, 1998 / 47(44);952-6 http://tinyurl.com/3ae6vdd

Roughly 9800 cases of suspected dengue were reported through the end of August, 1998.  This year, the number of suspected cases is roughly 9,700 through early August.

 

The sudden drop in cases detected in 1998 was due to Hurricane Georges interrupting surveillance efforts/ 

 

With heavy rains likely to spread across the island over the next couple of days courtesy of hurricane Earl, the island’s mosquito control efforts could well grow more challenging over the coming weeks.

The height of the Dengue season on the island is normally September through November  - which corresponds with the rainy season.

You can find the latest weekly Dengue Surveillance Report HERE and will find more information in the recent MMWR report:

Notes from the Field: Dengue Epidemic — Puerto Rico, January–July 2010

Weekly

July 23, 2010 / 59(28);878

For an extensive list of my blogs on Dengue and Mosquito Borne Diseases you can select the DENGUE Quick Search here,  on my sidebar.

Via RxPG News, an IANS report: 95 swine flu deaths in Karnataka till Aug 25. Excerpt:

A total of 95 people had died of swine flu in Karnataka till Aug 25 this year, state Health Minister B. Sriramulu said Friday. 

So far this year, 1,702 people had been affected by the H1N1 flu, he told reporters here after a meeting with health ministry officials to assess the preparedness of the state to tackle the flu as well chikungunya and dengue in view of the revival of the monsoon.

In 2009, there were 1,799 H1N1 cases in the state and 135 of the patients died, Sriramulu said.

District administrations and health authorities have been told to be pro-active to prevent the spread of contagious diseases as several parts of the state have been receiving heavy rains in the last three days, he said.

There were 927 chikungunya cases in the state but no death has occurred from the disease, Sriramulu said.

There has been one death due to dengue while 1,294 had been affected by it, the minister said.

Via RxPG News, an IANS report: 95 swine flu deaths in Karnataka till Aug 25. Excerpt:

A total of 95 people had died of swine flu in Karnataka till Aug 25 this year, state Health Minister B. Sriramulu said Friday. 

So far this year, 1,702 people had been affected by the H1N1 flu, he told reporters here after a meeting with health ministry officials to assess the preparedness of the state to tackle the flu as well chikungunya and dengue in view of the revival of the monsoon.

In 2009, there were 1,799 H1N1 cases in the state and 135 of the patients died, Sriramulu said.

District administrations and health authorities have been told to be pro-active to prevent the spread of contagious diseases as several parts of the state have been receiving heavy rains in the last three days, he said.

There were 927 chikungunya cases in the state but no death has occurred from the disease, Sriramulu said.

There has been one death due to dengue while 1,294 had been affected by it, the minister said.

(Sun, 29 Aug 2010 11:47:00 +0000)

UPDATED:  0840 EDT 08/29

Earl has been upgraded to a hurricane. 

# 4846

Although the Atlantic Hurricane season has been relatively quiet up until now, the tropics have awakened in the past week and we are watching a hurricane (Danielle), an intensifying tropical storm (Earl), and an impressive looking area of suspicion.

Danielle, which briefly reached CAT 4 strength earlier this week, has weakened and is headed for a cold watery death in the north Atlantic.

Earl is expected to reach hurricane strength later today, and is an immediate threat to Puerto Rico, the Virgin Islands, and parts of the northern Leeward chain of islands.

Later in the week, Earl may even pose a threat to the U.S. mainland as a major (CAT 3 or greater) hurricane, although it is far too early to tell.

Right now, the tropical storm-force wind field forecast shows only about a 20% probability for the mid-Atlantic coastline 5 days out.   These forecasts are subject to change and refinement, so interested parties need to check them every day.

Lastly, the area of disturbed weather in the far eastern Atlantic is following roughly the same path as Earl, although it is too early to know if it will pose a threat to the islands.

These tracking maps are likely to become very busy over the next 60 days as we traverse the peak of the hurricane season.   You can follow the latest tropical developments on the National Hurricane Center’s website or by following the @FEMA on Twitter.

May was National Hurricane Preparedness week, and during that month this blog devoted considerable time to the subject.  A few of my blogs on the subject included:

A Hurricane Reality Check

Hurricanes and Inland Flooding

Why I’ll Be Gone With The Wind

Storm Surge Monday

You Don’t Have To Live On The Coast

Everyone should have a preparedness plan, of course.

But if you live anywhere within a few hundred miles of the the Atlantic or Gulf Coasts - given the time of year – it makes sense to get those plans in order now.

Some essential hurricane resources to get you started include:

 

http://www.fema.gov/hazard/hurricane/index.shtm

 

http://www.ready.gov/america/beinformed/hurricanes.html