Human infection with influenza A(H7N9) virus in China - update
7 April 2013 - As of 7 April 2013 (16:30 CET), the Chinese health authorities notified WHO of an additional three laboratory-confirmed cases of human infection with influenza A(H7N9) virus.
The first patient is a 59-year-old man resident of Shanghai, who became ill on 25 March 2013, and is now in critical condition. The second patient is a 55-year-old man from Anhui who became ill on 28 March 2013, and is now in stable condition. The third patient is a 67-year-old man from Shanghai who became ill on 29 March 2013, and is considered a mild case.
To date, a total of 21 cases have been laboratory confirmed with influenza A(H7N9) virus in China, including six deaths, 12 severe cases and three mild cases.
More than 530 close contacts of the confirmed cases are being closely monitored. In Jiangsu, investigation is ongoing into a contact of an earlier confirmed case who developed symptoms of illness.
The Chinese government is actively investigating this event and has heightened disease surveillance. Retrospective testing of recently reported cases with severe respiratory infection may uncover additional cases that were previously unrecognized. An inter-government task force has been formally established, with the National Health and Family Planning Commission leading the coordination along with the Ministry of Agriculture and other key ministries. The animal health sector has intensified investigations into the possible sources and reservoirs of the virus.
WHO is in contact with national authorities and is following the event closely. The WHO-coordinated international response is also focusing on work with WHO Collaborating Centres for Reference and Research on Influenza and other partners to ensure that information is available and that materials are developed for diagnosis and treatment and vaccine development. No vaccine is currently available for this subtype of the influenza virus. Preliminary test results provided by the WHO Collaborating Centre in China suggest that the virus is susceptible to the neuraminidase inhibitors (oseltamivir and zanamivir).
At this time there is no evidence of ongoing human-to-human transmission.
WHO does not advise special screening at points of entry with regard to this event, nor does it recommend that any travel or trade restrictions be applied.
Flu Epidemic? Worst Outbreak of Influenza in 10 Years, Says CDC
January 10, 2013 By Janelle Vaesa
This is the worst flu season in ten years, says the Centers for Disease Control and Prevention, and it seems to be getting worse by the day. The flu season is from November until March and we haven't hit the peak yet..
Hospitals are struggling to keep up with the patients that are coming in with the flu and some hospitals are having to turn people away. Some hospitals, like Lehigh Valley Hospital are setting up a triage area outside because the emergency rooms are overflowing with patients. In one hospital in Chicago, they have seen a twenty percent increase in flu patients every day, according to ABC News.
Swine Flu Pandemic 2009 vs. 2012-2013 Flu Season
Many of us recall the H1N1 flu (or swine flu) outbreak of 2009. It was a new virus and many people were frightened about its implications. In April 2009 the United States saw its first case of the H1N1 flu. By June 11, 2009 the WHO declared a pandemic. From April 15, 2009 to July 24, 2009 states reported a total of 43,771 cases of probable and confirmed influenza cases. Of these cases 5,011 people were hospitalized and 302 people died, according to the CDC. So how does this compare to what we are seeing during this flu season?
First, the H1N1 was a novel strain, meaning that it was new; this is not the case during the 2012-2013 flu season. That makes a huge difference in numbers. With a new illness, experts don't know how it's spread, what treatment options will work, and other information that help protect and prevent a large number of cases. Having a 'regular' flu season helps keep numbers low, since experts know how the viruses are spread and what treatment options work.
For the 2012-2013 flu season, 29 states are reporting high amounts of flu activity and the CDC reports that flu is widespread in 41 states. Since October 1, 2012 there have been 2,257 people hospitalized with the flu, and 18 children have died. The numbers are still much lower than what we saw in the H1N1 flu pandemic; however, the flu season is not over yet.
The 2012-2013 flu season continues to worsen as the days go on, and as of Wednesday, January 9, 2013 Boston has declared a health emergency. According to CBS News, Boston has 700 confirmed cases of the flu, where last year at this time they only had 70. With states seeing such a large increase in flu activity, are we on our way to seeing an influenza epidemic? An epidemic occurs when the number of people infected climbs well above what is normally expected for that place and time..
The CDC reports that the baseline for office visits for influenza-like-illness in the United States is 2.2 percent. The week ending in December 29, the rate was 5.6 percent, over twice the baseline amount of visits. During the H1N1 flu season, office visit rates peaked at 7.7 percent. The percentage of flu-related deaths during that time frame was 7% - just under the epidemic threshold of 7.1%.
Flu Outbreak Spreads Across U.S. As Media Drops the Ball - The Daily Beast
A major influenza epidemic is taking hold across much of the United States, but there's a curious lack of coverage in the media. Dr. Kent Sepkowitz looks at the strain of flu hitting us and whether a vaccine will work.
New York City and much of the U.S. are a week or two into a major influenza epidemic. Boston declared a public-health emergency Wednesday after reporting four deaths, and North Carolina is seeing its biggest number of cases in a decade. To place the problem into graphic corporate terms, the charts sent around to compare this year's activity with other years' have required rescaling to accommodate the scary red line going up and up.
Perhaps it's not a surprise. After all, flu dilly-dallied last season, barely making a peep. So maybe we're owed a compensatory wallop. But no one really knows just why this season is so bad. We try to do all the right things--we unceasingly rub our hands with waterless alcohol products, we have learned how to sneeze and cough into the crooks of our elbows, and of course, we are receiving more vaccine than ever: some states require it of their health-care workers, and the drugstore chains, with their wide reach and slippery advertising, have set about vaccinating everyone else.
So what went wrong? One alarming possibility is that this year's vaccine against influenza is not well matched to the current disease-causing strains. This exposes a significant problem in the modus operandi of influenza-vaccine production--it's mired in techniques and approaches developed before World War II; in fact, soldiers from that war were among the first to get this brand of vaccine. Here's how it works: each year, around February, world experts select from a menu of dozens of just three influenza strains--two of flu A and one of flu B--to place into the coming season's vaccine. More than three would require a shot with too large a volume and might blunt the body's immune response. Once selected, the three viruses are grown painstakingly, on hens' eggs (what year is this?). Then, after a big-enough crop has been raised, the virus is killed, stabilized, and sent around for injections--all on the hope that the experts guessed right.
To date, the Centers for Disease Control and Prevention has found strong agreement between the vaccine strains and the current clinical strains, suggesting the vaccine ought to work just fine. But some clinicians have their doubts. This much activity, is the thinking, can only be due to extremely limited protection from vaccine. For some it feels like 2009 all over again, when the novel flu strain, so called because it had never previously been seen in people or animals, appeared. It was first recognized after spring-break revelers from Queens returned from south of the border. Because of its novelty, no vaccine was active against it (at least at the start), so we saw the unchecked spread of influenza zipping across the country in no time flat.
More testing will be done, and the circulating disease-causing strains again will be compared with the components in the vaccine. Until we know more, we should be thankful for one thing: though nasty enough, the number of fatalities is not horrific (yet). And unlike the flu of 2009, this one is not unusually severe in the pregnant or the obese. It's just contagious--mighty, mighty contagious. So contagious that watching it play out makes you begin to understand the concept of a magic spell, so quickly does it seem to spread.
Despite all of this activity, flu, until the last day or two, hasn't been much covered by the media, which usually love scary flu tales. I mean, this is not just an outbreak this year, but a real outbreak. Where is everybody? All right, there are a few hyperventilatory articles, including one about a "tent city" popping up outside a community hospital in Pennsylvania. Only a close read, though, reveals that the hospital had created an annex to swiftly and safely evaluate those with possible flu while keeping them apart from other patients who had not yet begun to sniffle. Those hoping to read about a "tent city" like that used in the great 1918 pandemic will surely be disappointed at the sight of the bulbous drapes raised in a lone parking lot.
It suggests that epidemics, like explosions and tsunamis, are of interest only if there is a body count to headline the story.
It suggests that epidemics, like explosions and tsunamis, are of interest only if there is a body count to headline the story. Our all-news-all-the-time-except-real-news approach to information operates is if there were an extreme shortage of space, despite that we have hundreds of cable networks, endless radio stations, and, of course, the Internet, infinite in capacity, though with such a broad lunatic fringe encircling it that many have opted to remain within a very narrow boundary of a few dozen sites. Perhaps the lack of the crucial theatrical trinity of tragedy, death, and closure has made the current epidemic boring, giving the media the OK to duck their public-service responsibility of educating a vulnerable public.
Or perhaps they are showing deference to a CDC worried about explaining the mess. What if, after all their work to sell vaccination, it turns out that we have a mega-epidemic regardless? Looks bad, no? Actually, not. After all, we can't expect them to hit it right every year, hobbled as they are by using a 19th-century approach improved in the 20th century against this most 21st century of infections, the very wily and evasive influenza virus. This season's hyperactivity demonstrates emphatically how critical vaccination is to control of influenza. If indeed the vaccine isn't a good match this year, what we are seeing is, as in 2009 with novel H1N1, unchecked influenza spreading ruthlessly. In addition to the rare death, it ties hospitals into knots, forces drugstores to run out of medication, and makes work absenteeism a common event. Indeed, there can be no greater advertisement for vaccination or a louder call for better vaccines than the great influenza outbreak of 2012-13.