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Source: http://www.cidrap.umn.edu/news-persp...an-dec-11-2019
News Scan for Dec 11, 2019
Combination flu treatment; Northern Hemisphere flu rise; UK avian flu outbreak
Filed Under:
Influenza, General; Avian Influenza: Agricultural and Wildlife Considerations
Study finds combination of antivirals may aid in recovery from severe flu
Patients with severe flu treated with a combination of the antiviral drugs favipiravir and oseltamivir compared with oseltamivir (Tamiflu) alone had faster recoveries, according to findings published today in The Journal of Infectious Diseases.
The retrospective study offers the first data on combination therapy for severe flu, and was conducted by Chinese and British researchers, who compared 40 patients given combination therapy and 128 patients treated with oseltamivir alone. All patients had severe lab-confirmed influenza, were hospitalized, and were symptomatic for less than 10 days.
The combination therapy group exhibited higher rates of clinical improvement by day 14 than the monotherapy group (62.5% vs 42.2%, P = 0.0247). The proportion of undetectable viral RNA at day 10 was higher in the combination group than in the oseltamivir group (67.5% vs 21.9%, P < 0.01), the authors said, and there were no significant differences in mortality rates in the two groups.
Oseltamivir is the most widely used neuraminidase inhibitor in flu patients, while favipiravir is a novel inhibitor of influenza RNA.
"To date, no antiviral randomized controlled trials (RCTs) have established a treatment regimen superior to oseltamivir monotherapy in hospitalized patients with influenza due to susceptible strains," the authors concluded. "Of concern is the relatively high frequency of emergence of oseltamivir-resistant variants in critically ill patients and their association with poor outcomes."
The authors said their findings should prompt an RCT of favipiravir-oseltamivir treatment for severe flu.
Dec 11 J of Infect Dis study
Flu markers on the rise in Northern Hemisphere, WHO reports
Flu activity is risking in most Northern Hemisphere countries, with all subtypes circulating in North America and influenza A strains predominant in Europe, except for its eastern region where influenza B is more common, the World Health Organization (WHO) said on Dec 9 in its global flu update, which covers the middle part of November.
In the Middle East, flu increased in Bahrain, Kuwait, and Saudi Arabia, mainly involving 2009 H1N1. Also, Iran reported an increase in flu, mainly involving the 2009 H1N1 virus.
In Asia, Laos and Vietnam continue to report flu activity. In eastern Asia flu increased in most countries, with levels rising above the seasonal threshold in South Korea, where 2009 H1N1 is the dominant strain.
Globally, of the most recent flu viruses tested, 71.1% were influenza A and 28.9% were influenza B. Of the subtyped influenza A viruses, 71.5% were H3N2 and 28.5% were 2009 H1N1. Of the characterized influenza B viruses, nearly all (96.8%) belonged to the Victoria lineage.
Dec 9 WHO global flu update
Low-path H5 avian flu strikes UK poultry farm
Animal health officials in the United Kingdom yesterday announced that a low-pathogenic H5 avian flu outbreak has been detected at a large commercial poultry arm in Suffolk County in eastern England.
In a statement from the UK's Department for Environment, Food, and Rural Affairs (DEFRA), Christine Middlemiss, BVMS, MBA, chief veterinary officer, said 27,000 birds on the chicken farm will be culled and that immediate steps have been taken to limit the spread. A 1-kilometer restriction zone has been placed around the farm, and health officials are looking for the source of the virus and any other spread.
Farmers have been urged to be alert for any disease signs, including mild breathing problems, though affected birds may not show any symptoms.
The UK's last low-pathogenic avian flu outbreak occurred in January 2016 in Dunfermline, Scotland. Public Health England said the public health risk from the virus is very low, though as a precaution, health officials are offering health advice and antivirals to those who had contact with the birds, according to standard practice.
Dec 10 DEFRA statement
In other avian flu developments, two countries—South Africa and Taiwan—reported more highly pathogenic outbreaks, according to notifications from the World Organization for Animal Health (OIE).
South Africa reported two H5N8 outbreaks, both affecting commercial ostrich farms in Western Cape province. The events began in the middle of September and the middle of October, sickening 8 of 787 birds combined at the two locations. The birds were slated for culling. The country has reported sporadic H5N8 outbreaks since 2017.
Taiwan, meanwhile, reported six more outbreaks involving H5N2, part of ongoing activity involving the strain since 2015. The affected commercial farms housed meat ducks or native chickens, and the start dates for the events ranged from Nov 7 to Nov 27. Taken together, the virus killed 1,256 of 45,341 susceptible birds, and all of the surviving birds were culled to control the spread of the virus.
Dec 10 OIE report on H5N8 in South Africa
Dec 10 OIE report on H5N2 in Taiwan
News Scan for Dec 11, 2019
Combination flu treatment; Northern Hemisphere flu rise; UK avian flu outbreak
Filed Under:
Influenza, General; Avian Influenza: Agricultural and Wildlife Considerations
Study finds combination of antivirals may aid in recovery from severe flu
Patients with severe flu treated with a combination of the antiviral drugs favipiravir and oseltamivir compared with oseltamivir (Tamiflu) alone had faster recoveries, according to findings published today in The Journal of Infectious Diseases.
The retrospective study offers the first data on combination therapy for severe flu, and was conducted by Chinese and British researchers, who compared 40 patients given combination therapy and 128 patients treated with oseltamivir alone. All patients had severe lab-confirmed influenza, were hospitalized, and were symptomatic for less than 10 days.
The combination therapy group exhibited higher rates of clinical improvement by day 14 than the monotherapy group (62.5% vs 42.2%, P = 0.0247). The proportion of undetectable viral RNA at day 10 was higher in the combination group than in the oseltamivir group (67.5% vs 21.9%, P < 0.01), the authors said, and there were no significant differences in mortality rates in the two groups.
Oseltamivir is the most widely used neuraminidase inhibitor in flu patients, while favipiravir is a novel inhibitor of influenza RNA.
"To date, no antiviral randomized controlled trials (RCTs) have established a treatment regimen superior to oseltamivir monotherapy in hospitalized patients with influenza due to susceptible strains," the authors concluded. "Of concern is the relatively high frequency of emergence of oseltamivir-resistant variants in critically ill patients and their association with poor outcomes."
The authors said their findings should prompt an RCT of favipiravir-oseltamivir treatment for severe flu.
Dec 11 J of Infect Dis study
Flu markers on the rise in Northern Hemisphere, WHO reports
Flu activity is risking in most Northern Hemisphere countries, with all subtypes circulating in North America and influenza A strains predominant in Europe, except for its eastern region where influenza B is more common, the World Health Organization (WHO) said on Dec 9 in its global flu update, which covers the middle part of November.
In the Middle East, flu increased in Bahrain, Kuwait, and Saudi Arabia, mainly involving 2009 H1N1. Also, Iran reported an increase in flu, mainly involving the 2009 H1N1 virus.
In Asia, Laos and Vietnam continue to report flu activity. In eastern Asia flu increased in most countries, with levels rising above the seasonal threshold in South Korea, where 2009 H1N1 is the dominant strain.
Globally, of the most recent flu viruses tested, 71.1% were influenza A and 28.9% were influenza B. Of the subtyped influenza A viruses, 71.5% were H3N2 and 28.5% were 2009 H1N1. Of the characterized influenza B viruses, nearly all (96.8%) belonged to the Victoria lineage.
Dec 9 WHO global flu update
Low-path H5 avian flu strikes UK poultry farm
Animal health officials in the United Kingdom yesterday announced that a low-pathogenic H5 avian flu outbreak has been detected at a large commercial poultry arm in Suffolk County in eastern England.
In a statement from the UK's Department for Environment, Food, and Rural Affairs (DEFRA), Christine Middlemiss, BVMS, MBA, chief veterinary officer, said 27,000 birds on the chicken farm will be culled and that immediate steps have been taken to limit the spread. A 1-kilometer restriction zone has been placed around the farm, and health officials are looking for the source of the virus and any other spread.
Farmers have been urged to be alert for any disease signs, including mild breathing problems, though affected birds may not show any symptoms.
The UK's last low-pathogenic avian flu outbreak occurred in January 2016 in Dunfermline, Scotland. Public Health England said the public health risk from the virus is very low, though as a precaution, health officials are offering health advice and antivirals to those who had contact with the birds, according to standard practice.
Dec 10 DEFRA statement
In other avian flu developments, two countries—South Africa and Taiwan—reported more highly pathogenic outbreaks, according to notifications from the World Organization for Animal Health (OIE).
South Africa reported two H5N8 outbreaks, both affecting commercial ostrich farms in Western Cape province. The events began in the middle of September and the middle of October, sickening 8 of 787 birds combined at the two locations. The birds were slated for culling. The country has reported sporadic H5N8 outbreaks since 2017.
Taiwan, meanwhile, reported six more outbreaks involving H5N2, part of ongoing activity involving the strain since 2015. The affected commercial farms housed meat ducks or native chickens, and the start dates for the events ranged from Nov 7 to Nov 27. Taken together, the virus killed 1,256 of 45,341 susceptible birds, and all of the surviving birds were culled to control the spread of the virus.
Dec 10 OIE report on H5N8 in South Africa
Dec 10 OIE report on H5N2 in Taiwan