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Vol. IX, No. 23 ~ EINet News Briefs ~ Nov 24, 2006
*****A free service of the APEC Emerging Infections Network*****
APEC EINet News Briefs offers the latest news, journal articles, and notifications for emerging infections affecting the APEC member economies. It was created to foster transparency, communication, and collaboration in emerging infectious diseases among health professionals, international business and commerce leaders, and policy makers in the Asia-Pacific region.
In this edition:
- Global: Cumulative number of human cases of avian influenza A/(H5N1)
- Romania: Enhanced surveillance and lack of avian influenza H5N1 infection in birds
- Greece: Avian influenza infection suspected in wild ducks
- Indonesia: Avian influenza infection suspected in human
- South Korea: Avian influenza suspected in poultry deaths
- Australia (Canberra): Influenza A (H1) kills 6 in nursing home
- China: Increase in rabies cases in humans and dogs
- Japan: Kyoto man and Yokohama man contract rabies from Philippines
- USA: HHS says most H5N1 vaccine on hand is still potent
- USA: HHS awards 3 contracts for more H5N1 vaccine
- USA: Norovirus outbreak suspected on trans-Atlantic cruise ship
- Egypt: Need for enhanced surveillance of avian influenza in poultry
- Avian/Pandemic influenza updates
- Cholera, diarrhea & dysentery
- West Nile Virus
- CDC EID Journal, Volume 12, Number 12--Dec 2006
- Preparing for an influenza pandemic
- Influenza-related articles from the Lancet
- Influenza-related articles from the Canadian Medical Association Journal
- HHS issues planning guide for mass casualty events
- Pandemic influenza: science to policy
- H5N1 influenza--continuing evolution and spread
- Positive emotional style predicts resistance to illness after experimental exposure to rhinovirus or influenza A virus
- Clinicians raise questions about respirator use in pandemic
- FluMist called safe, effective for kids with asthma
- Reports show difficulty of diagnosing H5N1 cases
- Salmonella enteritidis on the rise in chickens
- National Influenza Vaccination Week--Nov 27--Dec 3, 2006
- Satellite Broadcast: Adult Immunization 2006
- IMED 2007 Plenary Speakers Announced
- 62nd INCDNCM Conference
Global: Cumulative number of human cases of avian influenza A/(H5N1)
Economy / Cases (Deaths)
Total no. of confirmed human cases of avian influenza A/(H5N1), Dec 2003 to present: 258 (153).
Avian influenza age & sex distribution data from WHO/WPRO: http://www.wpro.who.int/sites/csr/data/data_Graphs.htm.
WHO's maps showing world's areas reporting confirmed cases of H5N1 avian influenza in humans, poultry and wild birds (last updated 23 Nov 2006): http://gamapserver.who.int/mapLibrary/
Romania: Enhanced surveillance and lack of avian influenza H5N1 infection in birds
Through an increased focus on clinical and laboratory testing, the Romanian poultry sector is confident it will be able to begin improving its reputation -- which has been dented by a number of outbreaks of HN51. Having now eradicated all outbreaks of Avian Influenza detected between 2005 and 2006, it has been reported that Romanian authorities believe that after 2 years of combating the disease the country is currently in a period of "epidemiological peace." The announcement will be welcomed by meat processors in the country, who have experienced a tough 2 years after being found to be the first European nation affected by the virus. Following the initial news that the disease had reached the country Sep 2005, the EU quickly banned all exports of living and processed poultry goods from Romania into the bloc. Though the disease has had no affects on humans, its constant reoccurrence in wild birds throughout the country continued to keep Romanian poultry from the EU market. However, experts from the UN Food and Agriculture Organization (FAO) have found no new traces of the disease. Following 2 weeks of tests on while ducks and geese arriving in the Danube Delta region, tests on 162 wild birds and 26 corpses were all found to be free of the disease. (Promed 11/17/06)
Greece: Avian influenza infection suspected in wild ducks
Indonesia: Avian influenza infection suspected in human
A 6-year-old child suspected of being infected with avian flu virus died at Adam Malik Hospital in North Sumatra, a hospital director said 16 Nov 2006. M. Nur Rasyid Lubis, deputy director of the hospital, said the child died after experiencing breathing difficulties, coughing and loss of appetite. The victim was previously admitted to a private hospital near his home. Reportedly the child experienced a high fever for 2 weeks, following the death of a number of chickens around his house. Rasyid said more tests were needed to officially determine whether the boy's death was caused by avian flu. A blood sample from the victim has been sent to a lab in Jakarta to help determine the cause of death.
South Korea: Avian influenza suspected in poultry deaths
Australia (Canberra): Influenza A (H1) kills 6 in nursing home
The outbreak is probably due to an influenza A virus, but is unusual, as influenza typically occurs in the middle of the year in this region. For this reason, rigorous diagnostic testing will continue to be required of cases. PCR testing of nose/throat swabs has resulted in 6 positives out of 10 samples. An H1 subtype has been detected. Sequencing results are expected 20 Nov 2006. The facility reports good influenza vaccination coverage among residents (greater than 90 per cent) and vaccination rates among staff of about 55 percent. Immunization against influenza will continue to be recommended for unvaccinated residents and staff at the facility, along with infection control and all other measures specified in the Guidelines for the Prevention and Control of Influenza Outbreaks in Residential Care Facilities. The importance of preventing spread to other institutions, the prescription of antiviral therapy (oseltamivir/Tamiflu) for all residents and staff is under way as an additional preventive measure. General practitioners in the ACT region and other doctors are being kept informed of developments.
The Australian Medical Association (AMA) warned 19 Nov 2006 that Australia's pandemic management plan lacked consistency. AMA president Mukesh Haikerwal said state governments had neglected to share their pandemic plans with doctors, and there was a lack of coordination across states and territories on the role of fever clinics and how to direct patients to the most appropriate care. Australia has spent AUD 600 million [USD 462 million] since 2003 preparing for a possible influenza outbreak.
China: Increase in rabies cases in humans and dogs
Police are killing strays before they can bite people, and ordering owners to register their pets. Beginning 1 Nov 2006, owners without a license bearing their pet's photo will face fines of up to 5000 yuan (USD 635) and the confiscation of the animal. Beijing authorities also introduced a 1-dog per owner policy and is enforcing a decade-old ban on "violent and large dogs," such as German shepherds. "There has been a significant rise in the number of human cases of rabies particularly over the last 3 years in China," said Julie Hall, WHO’s team leader for communicable diseases in Beijing. "This is something that requires action." Police are stepping up enforcement as the rate of infection rises and China is spending USD 34 billion in preparation for the 2008 Olympics in Beijing. More than 8900 unregistered dogs were nabbed in the city this year. Dog-bite injuries in Beijing are increasing by about 10 000 a year, and reached 70 000 in the first half of 2006. The trend is similar in other cities.
Asia accounts for more than 80 percent of rabies cases worldwide, according to a study published in Dec in Emerging Infectious Diseases journal. In China, 103 200 people died of rabies in 4 epidemic waves between 1950 and 2004, the study's authors said. Human cases are now approaching levels not seen since the 1980s. A "fifth epidemic wave of rabies that began in the 1990s is gaining momentum," the authors said. Abandoned dogs bear much of the blame, they said. "In China it is extortionately expensive to register an animal," WHO's Hall said. Pets are often kept illegally and unvaccinated, she added, recommending that vaccination be compulsory and cheap. Initial registration costs 1000 yuan (USD 127) and includes the first rabies vaccination. The fee, including a booster shot, declines to 500 yuan in subsequent years.
Japan: Kyoto man and Yokohama man contract rabies from Philippines
A Yokohama man is in serious condition, having contracted rabies after being bitten by a dog in the Philippines, the Ministry of Health, Labor and Welfare stated 22 Nov 2006. This is the second rabies case discovered in Japan in less than a week. Ministry officials responded to the resurgence of the disease by displaying posters warning about the dangers of rabies. The Ministry plans to put up the posters at airports and quarantine centers. The latest case involved a man in his 60s who normally lives in the Philippines but had temporarily returned to Yokohama. A dog in the Philippines bit him on his hand around Aug 2006. He returned to Japan Oct 2006 and fell ill Nov 2006. Tests confirmed he had contracted rabies virus infection.
WHO estimates that rabies caused 55 000 deaths in 2004, including 248 fatalities in the Philippines. Rabies, after its symptoms develop, has no known cure and a fatality rate of almost 100 percent. However, its effects can be fought through if detected early enough. Although rabies vaccination is not a requirement for entry into any country, travelers to and from rabies-endemic countries should be made aware of the risk of contracting rabies. In addition to the ever-present risk of bites from unvaccinated dogs, travelers with extensive unprotected outdoor exposure in rural areas might be at high risk even if their trip is brief.
USA: HHS says most H5N1 vaccine on hand is still potent
The Department of Health and Human Services said that loss of potency is affecting less than 20% of H5N1 avian influenza vaccine doses in the national stockpile. Bill Hall, an HHS spokesman, said the agency has acquired a total of about 7.5 million doses of H5N1 vaccine to date, and about 200,000 of those have been used for research. About 1.4 million doses have begun to lose potency, Hall said. "That leaves about 5.9 million doses that are mostly in bulk, with some in vials, that still have potency," he said. HHS has been stockpiling H5N1 vaccine in preparation for the threat of an influenza pandemic sparked by the avian flu virus. In a Nov 13, 2006 pandemic planning update, HHS Secretary Mike Leavitt said the agency had enough vaccine on hand for about 3 million people. A previous update in Jul 2006 said the stockpile contained enough vaccine for about 4 million people. Hall cited the loss of potency in some of the vaccine as the main reason for the decrease in the number of people who could be immunized. "The expected shelf life of seasonal flu vaccine is probably about a year," so the fact that most of the stockpile is still good after about 2 years "is probably a good thing," he said.
Also, the pandemic planning report released this week, called Pandemic Planning Update III, discusses stockpiling of antiviral drugs. So far HHS has stored 16 million treatment courses of antivirals, en route to a goal of 26 million courses by the end of this year and 36 million by Mar 2007. The longer goal is to have 50 million courses by the end of 2008. HHS is buying both oseltamivir (Tamiflu) and zanamivir (Relenza) for the stockpile, according to Hall. The goal is for the stockpile to be about 80% oseltamivir and 20% zanamivir. Leavitt's planning update says HHS also has been stockpiling personal protective equipment. The government now has 73.1 million N95 respirators, used to protect healthcare workers from airborne pathogens, with another 31.8 million on order. The stockpile also contains 37.4 million surgical masks, along with face shields, gloves, and gowns. In addition to buying antivirals directly, HHS is offering a 25% cost-share to help states buy their own supplies, up to a total of 31 million courses. The report says 33 states have ordered antivirals under that program, and only 4 states don't plan to take full advantage of the subsidy.
USA: HHS awards 3 contracts for more H5N1 vaccine
Sanofi Pasteur said its new contract is for a vaccine based on a clade 2 (subgroup 2) H5N1 virus. The existing stockpile is based on clade 1 viruses, which circulated and caused human cases in Thailand, Vietnam, and Cambodia in 2004 and 2005. Clade 2 viruses circulated in birds in China and Indonesia in 2003-04 and spread to the Middle East, Europe, and Africa in 2005 and 2006. In a pandemic planning update, HHS noted its intention to begin stockpiling vaccine based on clade 2 viruses, out of concern that a vaccine based on one clade won't work well against a pandemic strain stemming from a different clade. Recently, WHO cautioned governments against rushing to stockpile pre-pandemic flu vaccines, saying too many scientific uncertainties remain. They said vaccines that work against one clade may not work against others and that the level of measured immune response representing adequate protection is unknown.
Sanofi previously won a $13 million contract Sep 2004 to make 2 million doses of H5N1 vaccine. In Sep 2005 the company won what was then listed as a $100 million contract to make more of the vaccine. The latest company statement said that contract is worth $150 million. Novartis will make the H5N1 vaccine in 2007 after production of next year's seasonal flu vaccine is finished. "The US government will determine the dosage and formulation of the final product, including potentially adding an adjuvant such as MF59, at a later date," Novartis said. Earlier this year Novartis acquired Chiron Corp., which had won a $62.5 million H5N1 vaccine contract award from HHS Oct 2005. A GSK statement said HHS may require that the vaccine include an adjuvant, which could reduce the amount of antigen needed per dose. The company said earlier that preliminary results of a clinical trial of an H5N1 vaccine with a novel adjuvant looked promising.
USA: Norovirus outbreak suspected on trans-Atlantic cruise ship
Noroviruses affect 23 million Americans annually, according to CDC. A dozen incidents of the illness have been reported on cruise ships so far in 2006. Spokeswoman Jennifer de la Cruz said Carnival hasn't nailed down the outbreak's origin, though she noted 2 passengers acknowledged getting sick in Rome prior to boarding. Noroviruses are enteric viruses present in the stool or vomit of infected people, and cause severe diarrhea, nausea and vomiting. The virus can be spread through the air. Most people recover with no lasting side effects. Severe dehydration can be a problem, especially for the very young, the very old and the immuno-compromised. Prevention is best achieved by thorough hand-washing. Epidemics occur frequently during winter months in situations where people congregate in close proximity such as on cruise ships.
Egypt: Need for enhanced surveillance of avian influenza in poultry
With the discovery of another avian flu case in poultry 10 Nov 2006 in Luxor, Ministry of Health (MOH) announced a slight shift in their strategy to combat the disease's spread. MOH spokesman Abdel Rahman Shaheen said it's unlikely the government will impose a ban on domestic poultry breeding as it did last year. "A ban would lead many to conceal their birds, heightening the danger rather than quelling it," said Shahine.
The government rounded up as many as 30 million birds last winter from "backyard" farms around the country and placed a ban on domestic breeding that only expired with the beginning of summer. But while the ban found partial success in urban centers, few complied in rural governorates since raising poultry often constitutes citizens' lone source of income. Egypt is home to an estimated 1.5 million poultry farmers. WHO estimates Egyptians rely on poultry for 60 percent of their animal protein intake.
Talib Ali, regional animal health and production officer for the Food and Agriculture Organization [FAO], says the actual number of bird flu cases in poultry may be higher. The new avian flu cases, he says, are reported by the government's Central Poultry Laboratory, which collected 2800 random samples from 9 governorates. An effective survey, he says, must be conducted on a wider scale and be accompanied by fair compensation for poultry owners whose chickens are destroyed. Ali says the government allocated just LE 50 million [USD 8.73 million] for compensation for 30 million culled chickens. A fair system needs to set aside at least LE 500 million for compensation, he says. Last year's outbreak of the disease raised poultry and egg prices by as much as 200 percent. Prices have since dropped gradually but have not reached pre-flu levels. Egypt's bird-flu statistics, in humans and animals, are available at the State's bird-flu web-site <http://birdflu.sis.gov.eg/html/flu01001.htm>.
Avian/Pandemic influenza updates
- WHO: http://www.who.int/csr/disease/avian_influenza/en/index.html.
- UN FAO: http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/special_avian.html. Read the article: “Support for governance relating to the prevention and control of animal diseases: the OIE takes another step forward” and the editorial from the D.G.: “The OIE recognition of country sanitary status for freedom from diseases”.
- OIE: http://www.oie.int/eng/en_index.htm. Basic information about the upcoming conference (20-22 Mar 2007), “Vaccination, a tool for the control of avian influenza” is available.
- The US government’s web site for pandemic/avian flu: http://www.pandemicflu.gov/.
- Health Canada: information on pandemic influenza: http://www.influenza.gc.ca/index_e.html. Information on avian influenza: http://www.hc-sc.gc.ca/dc-ma/avia/index_e.html.
- CIDRAP: http://www.cidrap.umn.edu/. Frequently updated news and journal articles.
- PAHO: http://www.paho.org/English/AD/DPC/CD/influenza.htm.
- American Veterinary Medical Association: http://www.avma.org/public_health/influenza/default.asp.
- US Geological Survey, National Wildlife Health Center Avian Influenza Information: http://www.nwhc.usgs.gov/disease_information/avian_influenza/index.jsp.
(WHO; FAO, OIE; CDC; Health Canada; CIDRAP; PAHO; AVMA; USGS)
Cholera, diarrhea & dysentery
USA (South Dakota)
The DOH has come under some pressure this year because the outbreak has exceeded the maximum targets set at the beginning of Oct 2006 of "under 500 dengue fever cases and zero deaths from the disease." The DOH has already pooled the resources of local and central governments to assist in disinfecting and spraying pesticides in affected areas. Incentives to report dengue fever cases will be in place from now to the end of the year. An outpatient doctor who reports a dengue fever case will be rewarded TWD 1000 [USD 31], while an inpatient doctor be awarded TWD 3000 [USD 92] for every case reported.
West Nile Virus
* Cases with neurologic manifestations (such as WN encephalitis, meningitis, and myelitis).
CDC EID Journal, Volume 12, Number 12--Dec 2006
CDC Emerging Infectious Diseases Journal, Volume 12, Number 12—Dec 2006 issue is now available at: http://www.cdc.gov/ncidod/EID/index.htm.
Preparing for an influenza pandemic
Influenza-related articles from the Lancet
Influenza-related articles from the Canadian Medical Association Journal
HHS issues planning guide for mass casualty events
"To be effective in their planning efforts, local, state, and regional leaders need to be aware of the latest research, tools, and models available," said AHRQ Director Carolyn Clancy in a Nov 16 AHRQ press release. "With the publication of this new community planning guide, our nation's preparation and response efforts are strengthened by bringing needed focus on advance planning for mass casualty events." The guide expands on an earlier AHRQ publication, released Apr 2005, which outlined altered standards of medical care in a mass casualty setting. The new document, a collaboration between AHRQ and the Office of Public Health Emergency Preparedness, consists of papers written by experts on 6 topics: ethical considerations, legal issues, prehospital care, hospital and acute care, alternative care sites, and palliative care.
Several potential problem areas are highlighted, such as a complex emergency medical services (EMS) system and lack of standardized EMS disaster training. The guide emphasizes that hospitals will face surge capacity problems. To handle the overflow, the AHRQ recommends that officials start making plans to provide care in alternate locations such as mobile medical facilities and nonhospital buildings. The report provides planning checklists and tips for making wise use of limited medical resources. For example, the section on alternative care sites describes how difficult it would be to provide oxygen and suggests a possible solution. A centerpiece of the report is a case study on pandemic influenza. The authors list preparations for and responses to each stage of a pandemic, from the current prepandemic period to increased and sustained transmission in the US. For example, during the worst stage of a pandemic, the authors suggest a "bed czar" be appointed to monitor the supply of hospital beds and equipment and make assignments based on availability.
Pandemic influenza: science to policy
H5N1 influenza--continuing evolution and spread
Positive emotional style predicts resistance to illness after experimental exposure to rhinovirus or influenza A virus
Clinicians raise questions about respirator use in pandemic
Michael Bell, associate director for infection control in the CDC's Division of Healthcare Quality Promotion, emphasized that the new HHS guidance is not intended to change how clinicians respond to patients who have seasonal influenza. He said the difference in recommendations between seasonal and pandemic influenza stems from uncertainty about inherent immunity to a pandemic flu strain and potential shortages of antiviral medication and vaccines in a pandemic. He predicted that recommendations about respirator use will continue to evolve as researchers learn more about flu virus particle size and virulence. Another useful thing the recent HHS respirator recommendations do is to make a distinction between respirator use and use of negative-pressure isolation rooms, Bell said. The HHS guidance states that negative-pressure isolation is not required for routine care of patients with pandemic influenza, though such rooms should be used whenever possible for performing aerosol-generating procedures such as inhalational intubation. If negative-pressure rooms aren't available, it is prudent to perform such procedures in private rooms with the door closed or other enclosed areas, the document says.
Bell said HHS officials and other healthcare groups are brainstorming about how to stimulate more production of N95 respirators. "The companies are concerned about liability. They want to be free of that before they produce mass quantities," he said. Bell said HHS probably won't recommend N95 respirators to the general public unless people are caring for family members or neighbors who have pandemic influenza.
FluMist called safe, effective for kids with asthma
Currently, TIV is the only vaccine approved for use in high-risk children and adolescents, including those who have asthma. Young people with asthma are at increased risk for complications from respiratory infections and are more likely to be hospitalized when they have seasonal influenza. They are also more likely to experience asthma exacerbations after being sick with seasonal flu. In the new study, for the strains of influenza that the vaccines were designed for, FluMist was 35% more effective than the injected vaccine (flu attack rates: CAIV-T, 4.1%; TIV, 6.2%). Against all influenza subtypes, CAIV-T was 31.9% more effective than TIV. There were no significant differences between the two groups in the incidence of asthma exacerbations, mean peak expiratory flow rates, asthma symptom scores, or nighttime awakening scores. Slightly more patients who received CAIV-T reported runny nose or congestion (66.2% vs 52.5%), and about 70% of those who received TIV reported injection site reactions.
The authors said their results are consistent with a similar study involving children aged 6 to 71 months who had a history of recurrent respiratory tract infections. "Although the reasons for higher observed relative efficacy for CAIV-T were not evaluated in these trials, induction of innate and specific mucosal immunity, as well as other factors, may play a role," they wrote. Despite strong recommendations that high-risk children, including those with asthma, receive an annual flu shot, many children with asthma don't receive them. Earlier studies have shown that major barriers to vaccinating high-risk children are physicians' failure to recommend the vaccine and parents' lack of knowledge about their child's risk of serious complications from the flu. Interventions, such as reminder systems, are needed to improve physician and parent awareness about the importance of annual vaccinations for children with asthma.
Fleming DM, et al. Comparison of the efficacy and safety of live attenuated cold-adapted influenza vaccine, trivalent, with trivalent inactivated influenza virus vaccine in children and adolescents with asthma. Pediatr Infect Dis J 2006;25(10):860-9.
Dombkowski KJ, et al. Effect of missed opportunities on influenza vaccination rates among children with asthma. Arch Pediatr Adolesc Med 2006;166(9):966-71.
Reports show difficulty of diagnosing H5N1 cases
The Turkish report describes 8 of the 12 confirmed cases the country has had so far. All 8 patients—4 of whom survived—were treated at a hospital. The patients included sets of 3 and 2 siblings, and 7 lived in the same community. The hospital tested a total of 290 patients for avian flu during the outbreak, using a rapid influenza test, enzyme-linked immunosorbent assay (ELISA), and real-time PCR. All the rapid and ELISA test results were negative. 4 of the 8 case-patients initially had negative results on all 3 tests, using nasopharyngeal specimens. Because the patients were severely ill, the tests were repeated using tracheal aspirate specimens, and the real-time PCR tests then were positive. Tests of nasopharyngeal specimens established the diagnosis in the other 4 patients. "Before H5N1 infection was diagnosed in the 8 patients, a total of 8 real-time PCR tests, 12 rapid influenza tests, and 12 ELISA tests were negative," the article states.
The Indonesian report covers 3 family clusters of H5N1 cases that occurred between Jun and Oct 2005 and included the country's first cases. The clusters consisted of 3 cases in Tangerang, Java; 2 cases in Bintaro, Java; and 3 in Lampung, Sumatra. 4 of the 8 patients died. All rapid tests on the patients were negative, and many reverse-transcriptase PCR tests were negative, particularly with nasal specimens. Throat swabs were more likely to test positive on RT-PCR than nasal swabs were.
The Turkish authors write, "Because of the difficulties in detecting H5N1 infection, repeated testing from nasopharyngeal swabs or deep tracheal-aspiration samples in patients who are strongly suspected of having H5N1 infection should be performed even if tests of initial nasophyaryngeal swabs are negative." Also, the Indonesian report says that the source of infection for the first patient in 2 of the clusters was never identified. The 3 patients in the first cluster reported no contact with birds, other animals, or sick people other than family members before they fell ill. In the second cluster, patients reported no contact with birds, other animals, or sick people, but the index patient used fertilizer containing chicken droppings that tested positive for H5N1. The report says limited person-to-person transmission could not be ruled out in the first 2 Indonesian clusters, since the patients had no other known exposures to the virus.
3 of the 4 Indonesian patients who recovered were children (aged 4, 5, and 9) who had mild disease. This resembles the pattern in Hong Kong's 1997 H5N1 outbreak, in which most children who were infected had relatively mild disease. The Indonesian authors write that the clusters in Indonesia and Turkey, as well as others in Hong Kong, Vietnam, Thailand, China, and Azerbaijan, "raise questions as to whether genetic or other factors may predispose some persons to H5N1 virus infection or to severe disease." They add that more investigation is needed to understand "the role of mild cases in the epidemiology of this disease and whether genetic, behavioral, immunologic, and environmental factors may contribute to case clustering."
Oner AF, et al. Avian influenza A(H5N1) infection in eastern Turkey in 2006. N Engl J Med 2006 Nov 23;355(21):2179-85.
Kandun IN, et al. Three Indonesian clusters of H5N1 virus infection in 2005. N Engl J Med 2006 Nov 23;355(21):2186-94. http://content.nejm.org/cgi/content/full/355/21/2186?query=TOC
Salmonella enteritidis on the rise in chickens
The USDA researchers tested rinse water samples collected from 2000 through 2005 at plants that slaughter broiler chickens. Eligible poultry processors were randomly selected for sampling, which involved collecting rinse water used on 1 chilled broiler chicken carcass per day for 51 days. Over the 6-year study, researchers identified 280 S enteritidis isolates from 51,327 broiler rinses; the annual number of isolates rose from 23 in 10,057 samples in 2000 to 120 in 9,592 samples in 2005. As a proportion of all Salmonella strains found, S enteritidis increased from 2.5% in 2000 to 7.7% in 2005. The proportion of establishments that had positive tests increased from 17 of 197 (9%) in 2000 to 47 of 187 (25%) in 2005. In addition, the number of states where the strain was found increased from 14 in 2000-2002 to 24 in the ensuing 3 years.
"Enteritidis in broilers is noteworthy given the increase in human Salmonella enteritidis infection rates in the US and recent findings that eating chicken is a new and important risk factor for sporadic infection," the authors state. They point to a recent FoodNet report that showed a strong association between infection with S enteritidis phage types 8 and 13 and eating chicken. "The possible emergence of these 2 phage types in broiler chickens suggests that industry should implement appropriate Salmonella enteritidis controls for broiler chickens," they write. To read the article: http://www.cdc.gov/ncidod/EID/vol12no12/06-0653.htm
National Influenza Vaccination Week--Nov 27--Dec 3, 2006
Influenza vaccination is the best way to prevent influenza and its severe complications. Anyone who wants to reduce their risk for acquiring influenza should be vaccinated each influenza season. However, annual influenza vaccination is recommended for the following groups:
Persons at high risk for influenza-related complications and severe disease, including: children aged 6--59 months, pregnant women, persons aged >50 years, persons of any age with certain chronic medical conditions; and persons who live with or care for persons at high risk, including: household contacts who have frequent contact with persons at high risk and who can transmit influenza to those persons at high risk, and health-care workers.
Although influenza vaccination is recommended before or early in the influenza season, persons who are not vaccinated early (particularly those in the recommended groups) should seek vaccination as soon as possible throughout the fall and winter months; influenza viruses can circulate anytime during Nov--Apr. To help raise awareness regarding the importance of influenza vaccination throughout the influenza season, the Department of Health and Human Services, CDC, the National Influenza Vaccine Summit, and other partners have designated Nov 27--Dec 3 as National Influenza Vaccination Week. Free materials are available at http://www.cdc.gov/flu/gallery.
Satellite Broadcast: Adult Immunization 2006
IMED 2007 Plenary Speakers Announced
• Dr. James Hughes is Director, Program in Global Infectious Diseases; Associate Director, Southeastern Center for Emerging Biologic Threats, Emory University School of Medicine and Rollins School of Public Health; and former director of the National Center for Infectious Diseases at CDC.
IMED 2007 will bring together the public health community, scientists, health care workers, and other leaders in the field of emerging infectious diseases. The meeting will include poster and oral presentations of submitted abstracts. In addition to the plenary speakers, there are over 20 confirmed speakers on a wide range of emerging disease and surveillance issues. For more information visit: http://imed.isid.org. The abstract deadline is 1 Dec 2006, and the early registration deadline is 22 Dec 2006.
62nd INCDNCM Conference
INCDNCM conferences are multidisciplinary and include topics on viral, rickettsial, bacterial, parasitic, and prion-related diseases acquired from natural sources, including animals, contaminated water or food supplies, arthropod vectors and other sources. Presentations are typically 10-15 minutes in length and can describe epidemiological, clinical, ecological, diagnostic or laboratory-related aspects of the above diseases. Student presentations are encouraged. The focus of the meeting is to present information from clinical, epidemiological, research and diagnostic areas primarily related to zoonotic diseases, both current and emerging. This meeting is especially suited to public health practitioners and healthcare workers, such as laboratorians, epidemiologists, veterinarians, infectious disease specialists, medical health officers, researchers and students, who have an interest in zoonotic infections and wish to present their findings either orally or through posters sessions. For additional information: http://www.union.wisc.edu/INCDNCM/index.html and http://www.union.wisc.edu/conferences/.