Tag Archives: pandemic

More DRC Ebola cases as risk raised to ‘very high’

Ebola recovery efforts
Stephanie Soucheray | News Reporter | CIDRAP News
Sep 28, 2018

There are now 155 cases (124 confirmed, 31 probable), including 102 deaths, in the outbreak.

Uptake and effectiveness of influenza vaccine in those aged 65 years and older in the United Kingdom, influenza seasons 2010/11 to 2016/17

Background

In 2016/17, seasonal influenza vaccine was less effective in those aged 65 years and older in the United Kingdom. We describe the uptake, influenza-associated mortality and adjusted vaccine effectiveness (aVE) in this age group over influenza seasons 2010/11–2016/17. Methods: Vaccine uptake in 2016/17 and five previous seasons were measured using a sentinel general practitioners cohort in England; the test-negative case-control design was used to estimate pooled aVE by subtype and age group against laboratory-confirmed influenza in primary care from 2010–2017. Results: Vaccine uptake was 64% in 65–69-year-olds, 74% in 70–74-year-olds and 80% in those aged 75 and older. Overall aVE was 32.5% (95% CI: 11.6 to 48.5); aVE by sub-type was 60.8% (95% CI: 33.9 to 76.7) and 50.0% (95% CI: 21.6 to 68.1) against influenza A(H1N1)pdm09 and influenza B, respectively, but only 5.6% (95% CI: – 39.2 to 35.9) against A(H3N2). Against all laboratory-confirmed influenza aVE was 45.2% (95% CI: 25.1 to 60.0) in 65–74 year olds; – 26.2% (95% CI: – 149.3 to 36.0) in 75–84 year olds and – 3.2% (95% CI: – 237.8 to 68.5) in those aged 85 years and older. Influenza-attributable mortality was highest in seasons dominated by A(H3N2). Conclusions: Vaccine uptake with non-adjuvanted, normal-dose vaccines remained high, with evidence of effectiveness against influenza A(H1N1)pdm09 and B, though poor against A(H3N2), particularly in those aged 75 years and older. Forthcoming availability of newly licensed vaccines with wider use of antivirals can potentially further improve prevention and control of influenza in this group.

CDC: More Than 900,000 Hospitalizations & 80,000 Deaths In Last Winter’s Flu Season

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Last night CDC Director Dr. Robert Redfield, in an interview with the Associated Press, revealed that at least 80,000 Americans died during last winter’s severe flu season, while more than 900,000 were hospitalized.  

Both are record breaking numbers, probably not matched since the 1968 H3N2 pandemic. Moreover, those estimates – once refined – could even go higher.

As we discussed last June (see A Snapshot From Last Winter’s Severe Flu Season – Texas), getting `good’ estimates  on flu-related deaths can be  extraordinarily challenging.

Heart attacks and strokes have been linked to recent flu infection (see Eur. Resp.J.: Influenza & Pneumonia Infections Increase Risk Of Heart Attack and Stroke) and many of those deaths are attributed to cardiovascular – not viral – causes. To be picked up by the P&I surveillance system, influenza or pneumonia has to be cited on the death certificate as being a contributing factor to a patient’s death.

If the patient had cancer, or heart problems, was of advanced age, or had any other significant co-morbidity – that – not influenza or pneumonia, is usually listed as the primary cause of death.

The CDC has an `expected range’ of seasonal influenza hospitalizations and deaths (see chart below), but even without a novel virus, it is possible to see an unusually severe `outlier’ season.  

https://www.cdc.gov/flu/about/disease/burden.htm

And last year clearly falls into that category, with at least 40% more deaths than the `maximum expected’ seasonal flu-related fatalities. While all of this is based on – as yet – unpublished data, we have a statement this morning from the CDC on last year’s influenza impact.

National Press Conference Kicks Off 2018-2019 Flu Vaccination Campaign
On September 27, 2018, the Centers for Disease Control and Prevention (CDC) and the National Foundation for Infectious Diseases (NFID) along with other public health and medical groups kicked off the 2018-2019 flu vaccine campaign at a press conference held at the National Press Club in Washington, D.C. CDC early estimates indicate that more than 900,000 people were hospitalized and more than 80,000 people died from flu last season[1]. These new estimates are record-breaking, and emphasize the seriousness and severity of flu illness and serve as a strong reminder of the importance of flu vaccination.

Flu vaccination has been shown to reduce the risk of flu illness, and a growing body of evidence supports the fact that vaccination also reduces the risk of serious flu outcomes that can result in hospitalization and even death. CDC estimates that flu vaccines prevent tens of thousands of hospitalizations each year and a CDC study in 2017 was the first of its kind to show flu vaccination reduced the risk of flu-associated death by half (51 percent) among children with underlying high-risk medical conditions and by nearly two-thirds (65 percent) among healthy children.

Most recently, an August 2018 study showed that flu vaccination lessened the risk of severe flu among adults, including reducing the risk of hospitalization and admission to the intensive care unit, and also lessened severity of illness. These benefits are especially important for people at high risk of serious flu complications, like people 65 and older, children younger than 5 years, pregnant women and people with certain underlying long-term medical conditions like heart and lung disease, or diabetes.

CDC recommends that people be vaccinated anytime between now and the end of October. CDC recommends an annual flu vaccine for everyone age six months and older.

[1] Note: Estimates based on unpublished CDC data[435 KB, 4 pages]

While we could get lucky, and see a much milder flu season this year – as I wrote last January in Remembering 1951: The Year Seasonal Flu Went Rogue – even a mild flu season can turn ugly without warning.

The flu vaccine is admittedly not as protective as we’d like it to be – and a better vaccine is sorely needed – but it still provides moderate protection most years.

Even when it fails to prevent infection, it has been shown it can reduce the severity of illness (see CMAJ Research: Repeated Flu Vaccinations Reduce Severity of Illness In Elderly).

When combined with practicing good flu hygiene (covering coughs, staying home when sick, and washing/sanitizing your hands) – they are the best steps you can take each year to reduce your chances of getting the flu.

You’ll find more information in the following statement, released today, from NFID (National Foundation for Infectious Diseases).


INFLUENZA AND PNEUMOCOCCAL DISEASE CAN BE SERIOUS, HEALTH OFFICIALS URGE VACCINATION

Data Shows Importance of Protection Against Influenza for Everyone 6 Months and Older

WASHINGTON, D.C., September 27, 2018 – Following a particularly severe 2017-2018 influenza (flu) season with a record-breaking estimated 900,000 hospitalizations and more than 80,000 deaths in the U.S., the National Foundation for Infectious Diseases (NFID), along with public health and medical organizations, presented the benefits of flu vaccination and urged the public and healthcare professionals to follow the Centers for Disease Control and Prevention (CDC) recommendation that everyone age 6 months and older get vaccinated against flu each year.

“Last season illustrated what every public health official knows — influenza can be serious in people of all ages, even in the healthiest children and adults,” says U.S. Surgeon General Jerome M. Adams, M.D., M.P.H. “It is critical that we focus national attention on the importance of influenza vaccination to protect as many people as possible every season. Today, I am leading by example and getting vaccinated against flu.”

(Continue . . . )

NOAA Declares Unusual Mortality Event – Harbor & Grey Seals In The Northeast

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Credit NOAA

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Three weeks ago, in NOAA Investigating Unusual Seal Strandings & Deaths In New England we looked at reports of an unusual spike in seal mortality along the Maine, New Hampshire, and Massachusetts coastlines, which was reminiscent of a 2011 event caused by a novel H3N8 avian flu (see New England Seal Deaths Tied to H3N8 Flu Virus).

That 2011 outbreak caused considerable stir, both in the press and the scientific community, because the virus was shown to have acquired significant mammalian adaptations (see  Nature Communications: Respiratory Transmission of Avian H3N8 In Ferrets).

Roughly two weeks ago, avian influenza (subtype not specified), along with Phocine Distemper virus, was confirmed as being present in at least some of the seals recovered in this latest die off (see NOAA: Seals in New England Test Positive for Avian Flu & Phocine Distemper Virus).

Last Friday NOAA Fisheries declared a UME (Unusual Mortality Event) among penipeds in the Northeast, along with a second UME among bottlenosed dolphins in Southwest Florida linked to a Red Tide outbreak.  

We’ve a 51 minute audio file of a press conference held by NOAA Fisheries, followed by a brief written statement (below).

The $64 question still outstanding is what subtype of avian influenza was detected in these seals?   And for that, we still have no answers.  During the 2011 outbreak it took roughly 6 weeks after influenza A was announced before we learned it was due to H3N8.

Although the risk is likely low, the  public is being urged not to approach within 100 yards of dead, sick, or stranded seals, and to keep all pets on a leash to prevent contact.
 

2018 Pinniped Unusual Mortality Event along the Northeast Coast

https://www.fisheries.noaa.gov/new-england-mid-atlantic/marine-life-distress/2018-pinniped-unusual-mortality-event-along-northeast

Since July 2018, elevated numbers of harbor seal and gray seal mortalities have occurred across Maine, New Hampshire and Massachusetts. This event has been declared an Unusual Mortality Event (UME).

New England/Mid-Atlantic

Since July 2018, elevated numbers of harbor seal (Phoca vitulina) and gray seal (Halichoerus grypus) mortalities have occurred across Maine, New Hampshire and Massachusetts. This event has been declared an Unusual Mortality Event (UME).

Why are seals stranding?

Full or partial necropsy examinations have been conducted on several of the seals and samples have been collected for testing.  Preliminary testing has found some seals positive for either avian influenza or phocine distemper virus.  We have many more samples to process and analyze, so it is still too soon to determine if either or both of these viruses are the primary cause of the mortality event.

As part of the UME investigation process, an independent team of scientists (Investigative Team) is being assembled to coordinate with the Working Group on Marine Mammal Unusual Mortality Events to review the data collected and provide guidance for the investigation.

How can I help?

Report a stranded or floating seal

The most important step members of the public can take to assist investigators is to immediately report any sightings of live seals in distress or dead seals.  Make the report by calling the NOAA hotline at 866-755-NOAA (6622) or by contacting your local marine mammal stranding network member by visiting our Stranding Network web page for local contact information. 

Please, do not approach or touch the seal.

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For some past blogs on influenza in seals, you may wish to revisit:

PLoS One: Pathology Of A/H10N7 In Harbor Seals

SwAM: European Seal Deaths Continue From H10N7 Flu

mBio: A Mammalian Adapted H3N8 In Seals

The 2009 H1N1 Virus Expands Its Host Range (Again)