Influenza Virus Mashup

(Sat, 25 Sep 2010 10:55:00 +0000)

# 4934

While it is a bit lacking in scientific specificity, an article appearing this morning in Outlook India does give a pretty good overview of the panoply of medical problems cascading through India right now.

It is called Deep In The Miasma, and appeared on NewsNow overnight, albeit with a bad link.   With a little digging, I was able to find the right url.

This article dangles tantalizing statements, such as:

. . .  almost all diseases are showing changes in aetiology, symptoms and even geography . . .

 

. . .  a new variant of bird flu is among the many causes for concern . . .

But offers precious little follow through, I suspect primarily because this article appears in the `popular press’ and is filed under Society-Health-Epidemics.

In other words, it is geared for a more general audience.

Disappointingly, the statement about a `new variant’ of bird flu is tossed out, but never clarified, leaving us in the dark as far as to what exactly the authors are referring to.  

 

But those quibbles aside, this relatively short article does paint a disturbing, yet fascinating picture of the increasing disease burden being reported across the Indian sub-continent.

Including:

• Dengue
• Malaria
• Chikungunya
• Japanese Encephalitis
• Typhoid
• Cholera
• Gastroenteritis
• Swine Flu
• `Mystery’ Fevers
• Antibiotic Resistance

The article also includes a pretty good graphical look at the problem, as well.

Read:

Deep In The Miasma

A monsoon that refuses to go away breeds a panoply of diseases

Amba Batra Bakshi, Snigdha Hasan, Madhavi Tata

Via Xinhua: A/H1N1 flu claims four in Nepal. Excerpt:

Nepal recorded its fourth death from A/H1N1 flu, according to Saturday’s The Kathmandu Post daily. 

Project Coordinator of Avian Influenza Control Project (AICP), under the Ministry of Health and Population, Dr. Anand K Shrestha, was quoted by the daily as saying a 43-year-old male patient died of the flu at Om Hospital in the capital Kathmandu. 

Shrestha said the dead, who had been suffering from diabetes and hypertension, had earlier been admitted to the Thapathali- based Norvic Hospital. Om Hospital hospital recorded his death early on Thursday morning. It will officially declare the death on Sunday after an AICP team completes its investigation.

Via Vaccine News Daily: Dynavax begins universal flu vaccine test earlier than expected.

Dynavax Technologies Corporation has begun immunizing volunteers with its universal influenza vaccine candidate in Phase Ib clinical trials half a year earlier than originally planned. 

The Berkeley, California, based company was able to begin Phase Ib testing six months earlier than expected because of its dramatic positive safety results from test Phase Ia, which are still being conducted. Phase I testing, according to BizJournals.com, is usually geared towards measures of safety and tolerability. They are typically conducted on small numbers of test subjects. 

The Phase Ib clinical trials will evaluate a combination vaccine made of Dynavax’s N8295, the novel component of the universal flu vaccine, and an investigational H5N1 avian flu vaccine produced by Novartis. 

By looking at the combination of N8295 and the H5N1 vaccine, Dynavax is seeking to broaden its understanding of the immunological properties of the candidate in human subjects without a pre-existing immunity to the H5N1 avian flu strain, BizJournals.com reports.

(This isn’t flu news but I thought it important enough to share. -cottontop)

24 September 2010 Last updated at 08:10 ET

Food watchdogs have issued an alert after finding that a chemical marketed online as a health supplement was similar to industrial-strength bleach.

‘Miracle Mineral Supplement’ is 28% sodium chlorite – which becomes bleach when mixed with citric acid.

Even taken as instructed, experts say it can cause severe vomiting and diarrhoea – and mixing it wrongly could lead to respiratory failure.

The Food Standards Agency is seeking to track down any UK-based sellers.

The supplement, which claims to have beneficial effects against a wide range of illnesses, ranging from HIV and hepatitis to H1N1 flu, has already been the subject of warnings from the Food and Drug Agency (FDA) in the US.

snip

Legal action

In the US, the Food and Drug Administration (FDA) has reported cases of severe nausea and vomiting among people taking the supplement, even though they had mixed it according to the instructions provided.

When sodium chlorite is mixed with acid, it becomes chlorine dioxide, the active ingredient in bleach.

Household bleach is generally less than 5% chlorine dioxide, and if users failed to follow dilution instructions properly it could mean an even more potent concentration ends up in the body, said experts.

This could cause damage to the gut and red blood cells, potentially leading to respiratory failure.

Because sodium chlorite is not licensed as a food supplement in the UK, local authorities have the power to take legal action against any company supplying it from an address in their area.

full article

http://www.bbc.co.uk/news/health-11404218

In August the US CDC issued an H3N2 health alert linked to two small outbreaks in eastern Iowa. The level of H3N2 in the US last season was very low, due largely to the spread of pandemic H1N1. However, H3N2 began to rebound in several Asian countries, and labs worldwide have been releasing H3N2 sequences.

The CDC released the sequence from Iowa. It was the Perth/16 strain, but like most of the H3N2 circulating in late 2009, early 2010 it had evolved away from the Perth target, which had been isolated in April, 2009.

(Snip) in addition to these isolates, two of the CDC sequences, A/Pennsylvania/02/2010 and A/Kansas/06/2010, had evolved beyond these Perth-like sequences, raising concerns that a more evolved strain was emerging. This concern was confirmed by another series of sequences released by the CDC, which showed that these more evolved sequences had spread worldwide.

(Snip) the CDC released 21 more H3N2 sequences from recent isolates, collected between June and August, 2010. 10 of those sequences, had evolved further, and all 10 had S199A (Snip)). Earlier (mostly 2004-2005), a small subset of H3N2 sequences had S199A (Snip)

The rapid spread of S199A on an emerging variant which also has receptor binding domain change I230V raises concerns that the virus will have limited reactivity with antibodies directed against prior H3N2, including the Perth/16 vaccine. One of the recent sequences with S199A, A/Columbia/6722/2010, has been designated a “low reactor” by the CDC. This emerging strain may cause widespread H3N2. In contrast to pandemic H1N1, the elderly population is most vulnerable to an emerging H3N2.

http://www.recombinomics.com/News/09231001/H3N2_S199A.html

Australia
• CIDRAP: Study – Pneumonia test, nasopharyngeal swab not good indicators of severe H1N1 (Link) PLoS ONE Study (Link)

Canada
• Flu outbreak at London, Ont., long-term care facility, health unit says (Link)

India
• Swine flu toll 66 in Madhya Pradesh (Link)
• Efforts on to tackle swine flu outbreak (Tamil Nadu) (Link)

• H1N1 claims two more, toll now 417 (Link)
• Contacts of flu cases will also be treated (Link)
• Critical swine flu patient treated using ECMO (Link)

New Zealand
• Pandemic Influenza H1N1 2009 (swine flu) – Update (Link)

General
• 2009 H1N1 News Scan: Multidrug resistance, fast-emerging resistance, antiviral treatment failures, severe cases (Link)

Research
• Dynavax Begins Phase 1b Study for Universal Flu Vaccine (Link)

 

Via CIDRAP: NEWS SCAN: H1N1 prevention, neurologic complications; detecting flu severity; food bill deadlock; dengue in the Bahamas. Excerpt:

Blood test tracking shows pandemic flu prevention measure benefits 

In one of the first large-scale serologic studies to assess the effectiveness of public health measures during the 2009 H1N1 pandemic, a study of military units in Singapore found lower rates of infection in soldiers who were subject to more stringent disease-prevention measures. 

The observational study, in the Journal of Infectious Diseases, involved 1,015 soldiers from 14 units. Researchers studied serum samples and symptom questionnaires between Jun 22 and Oct 9, 2009. 

Soldiers were subject to three levels of protection—normal, essential, or healthcare worker—based on their job duties. The normal group was provided flu information and urged to seek medical care when sick. Additional prevention measures for the essential group included enhanced surveillance and segregation into smaller work groups. Healthcare workers wore N-95 respirators, gloves, and gowns during working hours. 

Serum evidence of H1N1 infection was lower in the essential and healthcare groups, at 17% and 11% respectively, compared with the normal group, which had a 44% seroconversion rate. 

The authors concluded that their findings show the benefit of flu-prevention measures, which they say could especially be important for countries with scarce flu vaccine.

Click through the link to find the abstract and the other reports.

(Fri, 24 Sep 2010 17:55:00 +0000)

# 4933

The World Health Organization’s FluNet site has released their latest snapshot of the types of influenza strains being reported by selected countries around the world, and once again – in a number of regions, at least – the H3N2 virus leads the pack.

Compare this to six months ago (see below), when nearly all the influenza being reported around the world was either the 2009 H1N1 Influenza A  virus or the Influenza B virus.  

Flu Trends in March, 2010

The H3N2 virus being reported appears to be the new Perth/16 strain, which emerged in the spring of 2009 at roughly the same time as the novel pandemic virus (see Who Knew? New Flu).

The swine flu strain, being a novel virus, spread far faster and almost immediately outperformed this new H3 strain.  For a time, it wasn’t entirely certain that this new strain would survive.

But in recent months, the Perth H3 strain has managed a bit of a comeback.

It is still too early to know how big a player the H3 virus will be this winter in the northern hemisphere. 

Influenza is notoriously unpredictable.  And I’m not fool enough to try to second guess it.

The good news is this year’s flu shot has antigens against both this new strain of H3, as well as against the H1N1 pandemic strain and a B strain.

And it certainly isn’t too early to get your shot.  I got mine last Saturday.

The CDC would like you to know that flu shots are extremely safe, and most years are very effective:

(Fri, 24 Sep 2010 13:53:00 +0000)

# 4932

Admittedly, this isn’t the sort of post I normally make, but with this title rattling around in my head all morning, who could blame me for making an exception.

Yes . . .  it’s time for the unveiling of the long awaited emergency N95 bra . . .  the EBbra!

CNET and TIME magazine have both taken notice, so I’m in good company.

 

Emergency Bra: Unsnap, separate cups, inhale…

by Elizabeth Armstrong Moore 

 

 

Introducing the ‘Emergency’ Bra-Turned-Face Mask

By: Megan Friedman   

Reportedly there is a male version of this in the works (presumably not the infamous Seinfeld `BRO’), but frankly I’m a little worried over that prospect.

If this turns out to be an N95 jock strap, I just don’t think I’m interested.

Via Ida at Bird Flu Information Corner, a translated report from Tribun Timur: Pinrang, South Sulawesi ::: Thousands of backyard chickens die of bird flu. Excerpt:

Thousands of backyard chickens in three sub-districts of Kabupaten (municipal) Pinrang, have suddenly died of bird flu since Monday (21/9).  

Three affected sub-districts are Kecamatan Lanrisang, Watang Sawitto and Paleteang.  

The outbreak is probably caused by high rain rate in this later week, said Head of Animal Health Division, Livestock Service of Pinrang, Elvi Martina. Last bird flu outbreak in Pinrang occurred in 2005, she added.  

Following to this, Livestock Service will conduct surveillance in 12 sub-districts of Pinrang.  

The chief of Kecamatan Lanriseng – one of the affected sub-districts – M Husein predicted about 800 to 1000 chickens had died until now. This number will possibly increase. 

Ida also has a report from Metro TV on a B2B H5N1 outbreak in East Java.

(Fri, 24 Sep 2010 12:51:00 +0000)

# 4931

Although Dengue fever cases have been increasing throughout the Caribbean (see Dengue: Puerto Rico & Beyond - Week 33), and even making inroads into the southernmost reaches of Florida, Dengue fever in the Bahamas has till now been an uncommon occurrence.

According to PAHO numbers released in August, through the 24th week of the year, the Bahamas had only reported 1 laboratory confirmed case of Dengue in 2010.

But two reports this morning suggest that Dengue may be suddenly on the rise in that island nation. 

First, the Bahamas Press is reporting that there have been 16 recent cases of Dengue fever reported in the Capital, including a suspected fatal case this week  – that of a 23 year-old woman, and mother of 3.

Officials have not, apparently confirmed this fatality.

One reported death as a result of Dengue Fever in the Bahamas

Posted by media on Sep 23, 2010

Meanwhile, the Department of Public Health has issued this advisory – carried by The Bahamas Weekly – on the recent spike in Dengue cases.

 

Public Advisory on Dengue Fever By Bahamas Department of Public Health and the Ministry of Health

Sep 23, 2010 - 5:31:46 PM

The Bahamas - There has been significant increase in dengue activity throughout the Caribbean region and the Region of the Americas with outbreaks reported from Barbados, Grenada, Puerto Rico, Trinidad and Tobago, and the French Territories.

 

The Department of Public Health has confirmed that there have been five laboratory confirmed cases to date and more than twenty persons have been investigated for dengue fever in The Bahamas.  The Department is working closely with the Department of Environmental Health Services to prevent and control the spread of dengue fever, a viral infection which is transmitted through the bite of an infected Aedes aegypti mosquito.

 

Symptoms of dengue fever include fever, muscle and joint pains, excessive tiredness, headache and pain behind the eyes.  Nausea and vomiting may also occur.  A more severe form of dengue fever, Dengue Haemorrhagic Fever, presents with episodes of bleeding.

 

There is no vaccine to prevent dengue fever and treatment is given to lessen the symptoms of the infection.  The majority of persons recover within five to fourteen days.

 

The public is advised to seek medical attention at your nearest clinic if you experience any of these symptoms.

 

The Department of Public Health and the Ministry of Health wish to advise the public to:

(1) avoid mosquito bites by wearing protective clothing and applying insect repellent to  exposed areas;

(2)  use safe household insecticides indoors;

(3)  where possible, have intact window and door screens; and

(4)  remove all breeding sites that collect water, such as old tires, flower vases, planters and garbage.

While the number of cases don’t quite match up between these stories, the underlying message is that Dengue does appear to be increasing in Nassau, and around the Bahamas.

Of course, you don’t have to travel to the Bahamas, or Puerto Rico, or South Florida to be exposed to mosquito borne illnesses.  

West Nile virus (WNV), La Crosse virus (LACV), and St. Louis encephalitis virus (SLEV) (among others) also circulate at very low levels in the United States, as well as many other countries around the world. 

 

The odds of contracting any of these viruses are actually pretty low.   But they are not zero.

So it makes sense to take reasonable precautions whenever you are around mosquitoes.