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Source: http://www.cidrap.umn.edu/news-persp...an-mar-27-2014
Flu Scan for Mar 27, 2014
H7N9 case, death in China; Flu vaccine and PICU illness; Markers for flu immunity
Filed Under:
H7N9 Avian Influenza; Avian Influenza (Bird Flu); Influenza Vaccines; Influenza, General
H7N9 sickens one, kills another in China
China reported one new H7N9 infection today, as well as a death from the virus in a previously confirmed patient. Both are from Guangdong province, according to a health department statement translated and posted by FluTrackers, an infectious disease news message board.
The province's latest case-patient is a 55-year-old woman who is hospitalized in critical condition in Huizhou. The patient who died had an H7N9 infection that was confirmed on Mar 7, likely a 70-year-old man who had been hospitalized in critical condition in Meizhou.
The newly reported infection raises the outbreak total to 402 cases, according to a list of human infections maintained by FluTrackers. The death would bump the unofficial number of fatalities to 122. So far 266 infections have been reported in the second wave of infections that began in October, compared to 136 in the first wave last spring.
Mar 27 FluTrackers thread
FluTrackers human H7N9 case list
In related developments, the World Health Organization (WHO) filled in more details on reports of six H7N9 cases that it received from China from Mar 20 to Mar 25. All the patients are men, ranging from 32 to 82 years old. The group includes four from Guangdong province, along with one each from Anhui and Hunan provinces.
Illness onsets range from Mar 10 to Mar 18. Four of the patients are in critical condition, and two are listed in severe condition. Three of them had been exposed to poultry before they got sick.
Mar 27 WHO statement
Study finds vaccine 74% effective against ICU flu in kids
In a first effort to measure flu vaccine effectiveness (VE) against flu-related pediatric intensive care unit (PICU) hospitalization, US researchers found the seasonal vaccine to be 74% effective in a study yesterday in the Journal of Infectious Diseases (JID) that involved 44 case-patients, 8 of whom had been fully vaccinated.
Researchers from the Centers for Disease Control and Prevention (CDC) and various states analyzed medical records from kids ages 6 months through 17 years in 21 US PICUs who had acute severe respiratory illness during the 2010-11 and 2011-12 flu seasons. Of the 216 patients studied, 44 had lab-confirmed influenza, and the remaining 172 served as PICU controls.
Fifty-five percent of case-patients had at least one underlying chronic condition that placed them at higher risk of serious flu-related complications. The investigators were able to verify that 18% of case-patients (8 children) and 31% of controls (54 children) were fully vaccinated against flu.
Compared with unvaccinated kids, those who were fully vaccinated were 74% less likely to have flu compared with the PICU controls (95% confidence interval [CI], 19%-91%). When compared with 93 community controls, VE rose to 82% (95% CI, 23% to 96%).
Among the limitations of the study that the authors list is the small number of cases. However, Alicia Fry, MD, MPH, a medical officer in CDC's Influenza Division, said in a CDC press release, "These study results underscore the importance of an annual flu vaccination, which can keep your child from ending up in the intensive care unit."
Mar 26 JID study
Mar 27 CDC press release
HAI titer of 1:40 may not reflect 50% protection against flu
A hemagglutination-inhibition antibody (HAI) titer of 1:40 is generally correlated with 50% protection against influenza, but a JID study yesterday found that measure to be associated with only 31% protection against the pre-pandemic H1N1 and H3N2 strains among household contacts.
Hong Kong researchers analyzed data on 182 index patients with seasonal H1N1 from January 2008 through August 2009 and 115 index patients with H3N2 during the same period. In the households of the H1N1 index patients, 146 of 558 (26%) provided serum specimens, compared with 52 of 337 (15%) in household contacts of the H3N2 index patients.
They found that HAI titers of 1:40 were both associated with 31% protection against lab-confirmed H1N1 and H3N2 infection (95% CI, 13%-46% for H1N1 and 1%-53% for H3N2). By comparison, a microneutralization titer of 1:40 against H3N2 was associated with 49% protection (95% CI, 7% to 81%).
The authors surmise that the lower protection seen with the HAI assay may result from exposures of greater duration or intensity in confined household settings.
Mar 26 JID study
Flu Scan for Mar 27, 2014
H7N9 case, death in China; Flu vaccine and PICU illness; Markers for flu immunity
Filed Under:
H7N9 Avian Influenza; Avian Influenza (Bird Flu); Influenza Vaccines; Influenza, General
H7N9 sickens one, kills another in China
China reported one new H7N9 infection today, as well as a death from the virus in a previously confirmed patient. Both are from Guangdong province, according to a health department statement translated and posted by FluTrackers, an infectious disease news message board.
The province's latest case-patient is a 55-year-old woman who is hospitalized in critical condition in Huizhou. The patient who died had an H7N9 infection that was confirmed on Mar 7, likely a 70-year-old man who had been hospitalized in critical condition in Meizhou.
The newly reported infection raises the outbreak total to 402 cases, according to a list of human infections maintained by FluTrackers. The death would bump the unofficial number of fatalities to 122. So far 266 infections have been reported in the second wave of infections that began in October, compared to 136 in the first wave last spring.
Mar 27 FluTrackers thread
FluTrackers human H7N9 case list
In related developments, the World Health Organization (WHO) filled in more details on reports of six H7N9 cases that it received from China from Mar 20 to Mar 25. All the patients are men, ranging from 32 to 82 years old. The group includes four from Guangdong province, along with one each from Anhui and Hunan provinces.
Illness onsets range from Mar 10 to Mar 18. Four of the patients are in critical condition, and two are listed in severe condition. Three of them had been exposed to poultry before they got sick.
Mar 27 WHO statement
Study finds vaccine 74% effective against ICU flu in kids
In a first effort to measure flu vaccine effectiveness (VE) against flu-related pediatric intensive care unit (PICU) hospitalization, US researchers found the seasonal vaccine to be 74% effective in a study yesterday in the Journal of Infectious Diseases (JID) that involved 44 case-patients, 8 of whom had been fully vaccinated.
Researchers from the Centers for Disease Control and Prevention (CDC) and various states analyzed medical records from kids ages 6 months through 17 years in 21 US PICUs who had acute severe respiratory illness during the 2010-11 and 2011-12 flu seasons. Of the 216 patients studied, 44 had lab-confirmed influenza, and the remaining 172 served as PICU controls.
Fifty-five percent of case-patients had at least one underlying chronic condition that placed them at higher risk of serious flu-related complications. The investigators were able to verify that 18% of case-patients (8 children) and 31% of controls (54 children) were fully vaccinated against flu.
Compared with unvaccinated kids, those who were fully vaccinated were 74% less likely to have flu compared with the PICU controls (95% confidence interval [CI], 19%-91%). When compared with 93 community controls, VE rose to 82% (95% CI, 23% to 96%).
Among the limitations of the study that the authors list is the small number of cases. However, Alicia Fry, MD, MPH, a medical officer in CDC's Influenza Division, said in a CDC press release, "These study results underscore the importance of an annual flu vaccination, which can keep your child from ending up in the intensive care unit."
Mar 26 JID study
Mar 27 CDC press release
HAI titer of 1:40 may not reflect 50% protection against flu
A hemagglutination-inhibition antibody (HAI) titer of 1:40 is generally correlated with 50% protection against influenza, but a JID study yesterday found that measure to be associated with only 31% protection against the pre-pandemic H1N1 and H3N2 strains among household contacts.
Hong Kong researchers analyzed data on 182 index patients with seasonal H1N1 from January 2008 through August 2009 and 115 index patients with H3N2 during the same period. In the households of the H1N1 index patients, 146 of 558 (26%) provided serum specimens, compared with 52 of 337 (15%) in household contacts of the H3N2 index patients.
They found that HAI titers of 1:40 were both associated with 31% protection against lab-confirmed H1N1 and H3N2 infection (95% CI, 13%-46% for H1N1 and 1%-53% for H3N2). By comparison, a microneutralization titer of 1:40 against H3N2 was associated with 49% protection (95% CI, 7% to 81%).
The authors surmise that the lower protection seen with the HAI assay may result from exposures of greater duration or intensity in confined household settings.
Mar 26 JID study