Login   

EINet Alert ~ Feb 12, 2010


*****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:

1. Influenza News
- 2010 Cumulative number of human cases of avian influenza A/H5N1
- Global: WHO situation update on pandemic influenza H1N1
- Global: WHO to decide on flu vaccine strains
- Global: Tamiflu-resistant H1N1 cases reach 225
- Egypt: Three new case of human H5N1 avian influenza infection
- Israel & Qatar: H1N1 vaccine orders canceled
- Australia (Queensland): Free pandemic H1N1 vaccination given at high schools
- Australia (NSW): Officials urge H1N1 vaccination for children
- Cambodia (Takeo): H5N1 influenza outbreak in poultry
- Indonesia (Lampung): Suspected human H5N1 avian influenza infection
- Indonesia (Jakarta & Bekasi): Two human H5N1 avian influenza cases
- Myanmar (Yangon): H5N1 influenza outbreak in chickens
- Nepal: Outbreak of H5N1 in poultry
- Thailand: H1N1 patient experienced quadriplegia
- Viet Nam: H5N1 bird flu hits many provinces

2. Updates
- INFLUENZA A/H1N1
- AVIAN INFLUENZA

3. Articles
- Mathematical Modeling of the Effectiveness of Facemasks in Reducing the Spread of Novel Influenza A (H1N1)
- Influenza A/H1N1 (2009) infection in pregnancy-an Asian perspective
- Delayed Clearance of Viral Load and Marked Cytokine Activation in Severe Cases of Pandemic H1N1 2009 Influenza Virus Infection
- High frequency of cross-reacting antibodies against 2009 pandemic influenza A (H1N1) virus among the elderly in Finland
- Higher all-cause mortality in children during autumn 2009 compared with the three previous years: pooled results from eight European countries
- Susceptibility of turkeys to pandemic-H1N1 virus by reproductive tract insemination
- The pandemic influenza planning process in Ontario acute care hospitals

4. Notifications
- Emerging Infectious Diseases in Response to Climate Change
- 14th International Congress on Infectious Diseases (ICID)
- International Swine Flu Conference (ISFC)
- ISHEID Symposium on HIV and Emerging Infectious Diseases
- CDC 7th International Conference on Emerging Infectious Diseases
- Options for the Control of Influenza VII
- Updated influenza guidance and information from the US CDC


1. Influenza News

Global
2010 Cumulative number of human cases of avian influenza A/H5N1
Economy / Cases (Deaths)
Egypt / 7 (0)
Indonesia / 1 (1)
Total / 8 (1)

***For data on human cases of avian influenza prior to 2010, go to: http://depts.washington.edu/einet/humanh5n1.html

Total no. of confirmed human cases of avian influenza A/(H5N1), Dec 2003 to present: 471 (282)
(WHO 2/10/10 http://www.who.int/csr/disease/avian_influenza/country/cases_table_2010_02_12/en/)

Avian influenza age distribution data from WHO/WPRO (last updated 12/30/09): http://www.wpro.who.int/sites/csr/data/data_Graphs.htm

WHO's map showing world's areas affected by H5N1 avian influenza (status as of 9/24/09): http://gamapserver.who.int/mapLibrary/Files/Maps/Global_H5N1Human_2009_FIMS_20090924.png.

WHO's timeline of important H5N1-related events (last updated 1/4/10): http://www.who.int/csr/disease/avian_influenza/ai_timeline/en/index.html

^top

Global: WHO situation update on pandemic influenza H1N1
As of 7 February 2010, worldwide more than 212 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 15,292 deaths.

In the temperate zone of the northern hemisphere, overall pandemic influenza activity continued to decline in most countries. The most active areas of transmission continue to be in later peaking areas, particularly northern Africa, South Asia, and East Asia. Of note, Senegal became the third country within the past month (and fifth overall) to confirm first cases of pandemic H1N1 2009 in West Africa. There is insufficient evidence at this point to determine if this heralds the beginning of a period of more widespread transmission in West Africa, which heretofore may have been largely spared a significant period of communitywide pandemic influenza virus transmission.

In North Africa, pandemic influenza transmission persists but substantial declines in activity have been observed over the past month across the region. In Morocco, levels of ILI have returned to near baseline, and in Egypt, the number of confirmed cases has declined considerably.

In South and Southeast Asia, pandemic influenza virus continues to circulate widely across the region, however, overall activity continues to decrease or remain low in most places. In India, influenza transmission persists, particularly in western, and to a lesser extent, in northern India, however, overall the numbers of cases have declined substantially. In Thailand, overall activity remains low and unchanged since the previous reporting period, however, focal areas of increased ILI activity were reported in central and northern Thailand.

In East Asia, pandemic influenza transmission persists across the region; however, overall activity has declined substantially in most places. In China, pandemic and seasonal influenza viruses continue to co-circulate, however, over the last several weeks, seasonal influenza type B viruses have been predominant. In Japan, influenza activity continues to decrease towards seasonal baselines, including in Okinawa which is experiencing greater levels of influenza activity than in other parts of the country. In South Korea, levels of ILI have decreased substantially to near baseline levels.

In Europe, although pandemic influenza virus continues to circulate widely, particularly across central, southern, and eastern Europe, the overall intensity of pandemic influenza activity has declined substantially from peaks of activity seen earlier during the winter transmission period. Among 15 countries testing more than 20 sentinel respiratory samples, the proportion of samples testing positive for influenza ranged from 0-14%. Recent slight increases in rates of ARI in Slovakia, Slovenia, and Russia, do not appear to be associated with detections of influenza viruses and may be due to other circulating respiratory viruses.

In Sub-Saharan Africa, limited data suggest that pandemic influenza virus transmission may be geographically localized in most countries reporting surveillance data to WHO, and the overall intensity of activity may be low.

In the Americas, both in the tropical and northern temperate zones, overall pandemic influenza activity continued to decline or remain low in most places. In Central America and Caribbean, pandemic influenza virus transmission persists but overall activity remains low or unchanged in most places. A high intensity of respiratory diseases with increasing trend was reported in Guatemala, however, the increased activity does not appear to be associated with increased detections of influenza viruses and may be due to other circulating respiratory viruses.

In temperate regions of the southern hemisphere, sporadic cases of pandemic influenza continued to be reported without evidence of sustained community transmission. Pandemic influenza (H1N1) 2009 virus continues to be the predominant influenza virus circulating worldwide. In addition to the increasing proportion of seasonal influenza type B viruses recently detected in China, low levels of seasonal H3N2 and type B viruses are circulating in parts of Africa, East and Southeast Asia and are being detected only sporadically on other continents.
(WHO 2/12/2010)

^top

Global: WHO to decide on flu vaccine strains
Influenza experts will meet 14-19 February 2010 at the WHO headquarters to decide which flu strains to recommend for use in vaccines for the Northern Hemisphere's 2010-11 flu season. In a recent question-and-answer statement, the US CDC said the vaccine, as in past years, is likely to be trivalent, "although committee members may consider other options." In line with a WHO recommendation made last September, the seasonal vaccine that Australia will use for its upcoming winter flu season includes the pandemic H1N1 virus along with an H3N2 strain and an influenza B strain.
(CIDRAP 2/8/2010)

^top

Global: Tamiflu-resistant H1N1 cases reach 225
The WHO has reported that 225 cases of H1N1 flu with resistance to oseltamivir (Tamiflu) have been found worldwide, and resistant viruses have spread from person to person in several clusters but have not spilled into the community. The cases come from 20 countries and include 65 cases in the Americas, 77 in Europe, 1 in Africa, and 82 in the Western Pacific region, the agency said. All the isolates had the H275Y mutation that confers resistance to oseltamivir but not to the other neuraminidase inhibitor in general use, zanamivir (Relenza).
Many of the resistant cases involved people with severely weakened immunity, reinforcing the importance of monitoring for the problem in such patients, the WHO said in the 5 February 2010 issue of its Weekly Epidemiological Record.
(CIDRAP 2/5/2010)

^top


Europe/Near East
Egypt: Three new case of human H5N1 avian influenza infection
The Ministry of Health of Egypt has announced three new cases of human H5N1 avian influenza infection.

The first case is a 40-year-old female from Banha District in Qalyubiya Governorate. She developed symptoms on 31 January 2010 and was hospitalized on 2 February 2010, where she received oseltamivir treatment. She is in stable condition.

The second case is a 29-year-old female from Elsadat District, Menofya Governorate. She developed symptoms on 27 January 2010 and was hospitalized on 3 February 2010, where she received oseltamivir treatment. She is in a critical condition.

The third case is a 37-year-old male from Helwan District, Helwan Governorate. He developed symptoms on 31 January 2010 and was hospitalized on 6 February 2010, where he received oseltamivir treatment. He is in critical condition.

The cases were confirmed by the Egyptian Central Public Health Laboratories, a National Influenza Center of the WHO Global Influenza Surveillance Network (GISN). Of the 97 laboratory confirmed cases of avian influenza A(H5N1) reported in Egypt, 27 have been fatal.
(WHO 2/8/2010, 2/10/2010)

^top

Israel & Qatar: H1N1 vaccine orders canceled
Israel has canceled orders for its remaining H1N1 vaccine after receiving 4.6 million doses. The original order was for 7.3 million doses, but only 700,000 doses have been used. The government of also Qatar intends to cancel part of its remaining order for H1N1 vaccine. Though 1.5 million doses were ordered and 500,000 delivered, only 40,000 people have been vaccinated, including 21,000 children.
(CIDRAP 2/9/2010, 2/10/2010)

^top


Asia
Australia (Queensland): Free pandemic H1N1 vaccination given at high schools
The Queensland Government says free clinics for H1N1 influenza vaccinations will be set up at high schools throughout Queensland. Health Minister Paul Lucas says the clinics will start at the end of the February 2010 and be open to the public. Mr. Lucas has told Parliament the idea is to limit the impact of a predicted second wave of swine flu. According to the Queensland branch of the Australian Medical Association, only 13 percent of the state's population has been vaccinated thus far.
(Australian Broadcasting Corporation 2/10/2010)

^top

Australia (NSW): Officials urge H1N1 vaccination for children
The government of New South Wales says now is the ideal time for young children to be vaccinated against H1N1 influenza, as the date for their return to day care or school approaches. Kerry Chant, chief health officer for New South Wales, said H1N1 is likely to be the dominant flu strain in Australia in 2010.
(CIDRAP 2/8/2010)

^top

Cambodia (Takeo): H5N1 influenza outbreak in poultry
Hundreds of ducks and chickens in Takeo province's Pralay Meas village were destroyed on 3 February 2010 in the first day of a cull that officials said was ordered to contain a newly confirmed outbreak of the H5N1 avian influenza virus. Authorities killed about 710 ducks and 350 chickens in and around Pralay Meas village, located in Romenh commune, Koh Andeth district. The ministry's bird flu containment protocol requires all farm fowl within a 5-km radius of the outbreak zone to be destroyed. Thai Ly, chief of domesticated animals at the Takeo province agriculture department, said that nearly 20,000 ducks had died and that 35,270 had fallen ill before the first specimens were sent for testing on 31 January 2010, and that an unspecified number had succumbed to the virus since then.
(ProMED 2/7/2010)

^top

Indonesia (Lampung): Suspected human H5N1 avian influenza infection
Abdul Moeloek General Hospital in Bandarlampung, Lampung has again quarantined a patient suspected of being infected with H5N1 avian influenza after showing symptoms of high fever, coughing and difficulties of breathing. The patient was reported to have had direct contact with her chickens that had suddenly died. Her husband said thousands of chickens near his home had abruptly died in the past two weeks. Laboratory tests on the dead chickens in Way Laga subdistrict showed that the birds were infected with the avian flu virus.

A doctor treating the patient said the medical team had to wait for lab tests to determine whether she had an avian influenza infection.
(ProMED 2/10/2010)

^top

Indonesia (Jakarta & Bekasi): Two human H5N1 avian influenza cases
Two suspected avian influenza victims have tested positive for avian influenza (H5N1) virus infection. According to a Ministry of Health official, a 25-year-old resident of Bekasi, West Java province, tested positive for H5N1 infection. The victim died on 25 January 2010. Another victim, a 3-year-old resident of Jakarta, with mild influenza-like illness also tested positive for avian influenza (H5N1) virus infection.

***Note: As of 12 February 2010, the WHO has only confirmed the 25-year-old as a case of human H5N1 infection.
(ProMED 2/10/2010)

^top

Myanmar (Yangon): H5N1 influenza outbreak in chickens
An H5N1 avian influenza outbreak erupted in Yangon's Mayangong township in early February 2010. The outbreak affected 2,455 chickens, of which 100 died and 2,335 were destroyed. Laboratory confirmation was through PCR and rapid test.

In April 2008, the World Animal Health Organization (OIE) declared Myanmar as a bird-flu-free country. This is the first report of an H5N1 outbreak from Myanmar in 2010.
(ProMED 2/7/2010)

^top

Nepal: Outbreak of H5N1 in poultry
Nepal has reported an outbreak of 153 cases of H5N1 highly pathogenic avian influenza virus in poultry. Confirmation was made through RT-PCR and real time PCR.
(OIE 2/10/2010)

^top

Thailand: H1N1 patient experienced quadriplegia
A letter in Emerging Infectious Diseases outlines the case of a Thai patient with pandemic flu who developed acute respiratory distress followed by severe neurologic problems, including quadriplegia. Physicians ruled out Guillain-Barré syndrome, and the patient later regained muscle strength.
(CIDRAP 2/5/2010)

^top

Viet Nam: H5N1 bird flu hits many provinces
Avian influenza is now spreading rapidly in many provinces after a long period of containment, the Department of Animal Health (DAH) said 8 February 2010. The provinces of Ca Mau, Ha Tinh, Dien Bien, Soc Trang, Kon Tum, and Quang Tri have all reported cases of bird flu infection between 18 January 2010 and 8 February 2010. The DAH asked these provinces to step up their preventive measures and vaccination campaigns during the Lunar New Year holiday when demand for poultry products increases.
(ProMED 2/11/2010)

^top


2. Updates
INFLUENZA A/H1N1
- WHO
Influenza A/H1N1: http://www.who.int/csr/disease/swineflu/en/index.html
Influenza A/H1N1 frequently asked questions: http://www.who.int/csr/disease/swineflu/frequently_asked_questions/en/index.html
Pandemic Influenza Preparedness and Response - A WHO Guidance Document
http://www.who.int/csr/disease/influenza/pipguidance2009/en/index.html
International Health Regulations (IHR) at http://www.who.int/ihr/en/index.html.

- WHO regional offices
Africa: http://www.afro.who.int/
Americas: http://new.paho.org/hq/index.php?option=com_content&task=blogcategory&id=805&Itemid=569
Eastern Mediterranean: http://www.emro.who.int/csr/h1n1/
Europe: http://www.euro.who.int/influenza/ah1n1
South-East: http://www.searo.who.int/EN/Section10/Section2562.htm
Western Pacific: http://www.wpro.who.int/health_topics/h1n1/

- North America
US CDC: http://www.cdc.gov/flu/swine/investigation.htm
US pandemic emergency plan: http://www.flu.gov
MOH México: http://portal.salud.gob.mx/index_eng.html
PHA of Canada: http://fightflu.ca

- Other useful sources
CIDRAP: Influenza A/H1N1 page: http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/biofacts/swinefluoverview.html
ProMED: http://www.promedmail.org/

^top

AVIAN INFLUENZA
- UN: http://www.undp.org/mdtf/influenza/overview.shtml UNDP's web site for information on fund management and administrative services. This site also includes a list of useful links.
- WHO: http://www.who.int/csr/disease/avian_influenza/en/
- UN FAO: http://www.fao.org/avianflu/en/index.html. View the latest avian influenza outbreak maps, upcoming events, and key documents on avian influenza H5N1.
- OIE: http://www.oie.int/eng/info_ev/en_AI_avianinfluenza.htm. Link to the Communication Portal gives latest facts, updates, timeline, and more.
- US CDC: Visit "Pandemic Influenza Preparedness Tools for Professionals" at: http://www.cdc.gov/flu/pandemic/preparednesstools.htm. This site contains resources to help health officials prepare for an influenza pandemic.
- The US government's website for pandemic/avian flu: http://www.flu.gov/. "Flu Essentials" are available in multiple languages.
- CIDRAP: Avian Influenza page: http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/.
- PAHO: http://www.paho.org/English/AD/DPC/CD/influenza.htm. Link to the Avian Influenza Portal at: http://influenza.bvsalud.org/php/index.php?lang=en. The Virtual Health Library's Portal is a developing project for the operation of product networks and information services related to avian influenza.
- US National Wildlife Health Center: http://www.nwhc.usgs.gov/disease_information/avian_influenza/index.jsp Read about the latest news on avian influenza H5N1 in wild birds and poultry.

^top


3. Articles
Mathematical Modeling of the Effectiveness of Facemasks in Reducing the Spread of Novel Influenza A (H1N1)
Tracht SM, Del Valle SY, Hyman JM. PLoS ONE. 10 February 2010;5(2): e9018. doi:10.1371/journal.pone.0009018.
Available at http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0009018.

Abstract. On June 11, 2009, the World Health Organization declared the outbreak of novel influenza A (H1N1) a pandemic. With limited supplies of antivirals and vaccines, countries and individuals are looking at other ways to reduce the spread of pandemic (H1N1) 2009, particularly options that are cost effective and relatively easy to implement. Recent experiences with the 2003 SARS and 2009 H1N1 epidemics have shown that people are willing to wear facemasks to protect themselves against infection; however, little research has been done to quantify the impact of using facemasks in reducing the spread of disease. We construct and analyze a mathematical model for a population in which some people wear facemasks during the pandemic and quantify impact of these masks on the spread of influenza. To estimate the parameter values used for the effectiveness of facemasks, we used available data from studies on N95 respirators and surgical facemasks. The results show that if N95 respirators are only 20% effective in reducing susceptibility and infectivity, only 10% of the population would have to wear them to reduce the number of influenza A (H1N1) cases by 20%. We can conclude from our model that, if worn properly, facemasks are an effective intervention strategy in reducing the spread of pandemic (H1N1) 2009.

^top

Influenza A/H1N1 (2009) infection in pregnancy-an Asian perspective
Lim M, Chong C, Tee W, et al. BJOG. 10 February 2010; doi:10.1111/j.1471-0528.2010.02522.x.
Available at http://www.bjog.org/details/journalArticle/560575/Influenza_AH1N1_2009_infection_in_pregnancyx2014an_Asian_perspective.html.

Objective. To describe the characteristics of an obstetric population with influenza A/H1N1 (2009) infection, with a focus on the need for hospitalisation and complications.

Design. Cohort study.

Setting. Tertiary referral centre.

Population. Two hundred and eleven pregnant women with influenza A/H1N1 (2009) infection diagnosed by nasopharyngeal swab polymerase chain reaction (PCR).

Methods. Obstetric patients presenting to our centre were recruited and followed up. Data collected included demographic and clinical information.

Main outcome measures. H1N1 and pregnancy complications, and hospitalisation needs.

Results. The median age of the cohort was 29.0 years (range 16-42 years), the median gestation at referral was 23.0 weeks (range 4-38 weeks), the median time interval between illness onset and presentation was 2.0 days (range 1-7 days), and the median time interval between illness onset and commencement of oseltamivir was 2.0 days (range 1-11 days). Hospital admission was significantly associated with the presence of co-morbidity (OR 4.14, 95% CI 1.82-9.37, P = 0.0001), breathlessness (OR 5.2, 95% CI 2.19-12.41, P = 0.0003) and sore throat (OR 0.35, 95% CI 0.16-0.73, P = 0.005). There were two cases of pneumonia complicating H1N1 infection, but no mortality. Nine cases developed pregnancy complications. All women recovered.

Conclusions. The need for hospitalisation was significantly associated with breathlessness and co-morbidity. There was minimal morbidity and no mortality observed. We attribute this to early presentation, diagnosis and treatment.

^top

Delayed Clearance of Viral Load and Marked Cytokine Activation in Severe Cases of Pandemic H1N1 2009 Influenza Virus Infection
To KK, Hung IF, Li IW, et al. Clin Infect Dis. 5 February 2010; doi: 10.1086/650581.
Available at http://www.journals.uchicago.edu/doi/abs/10.1086/650581.

Background. Infections caused by the pandemic H1N1 2009 influenza virus range from mild upper respiratory tract syndromes to fatal diseases. However, studies comparing virological and immunological profile of different clinical severity are lacking.

Methods. We conducted a retrospective cohort study of 74 patients with pandemic H1N1 infection, including 23 patients who either developed acute respiratory distress syndrome (ARDS) or died (ARDS-death group), 14 patients with desaturation requiring oxygen supplementation and who survived without ARDS (survived-without-ARDS group), and 37 patients with mild disease without desaturation (mild-disease group). We compared their pattern of clinical disease, viral load, and immunological profile.

Results. Patients with severe disease were older, more likely to be obese or having underlying diseases, and had lower respiratory tract symptoms, especially dyspnea at presentation. The ARDS-death group had a slower decline in nasopharyngeal viral loads, had higher plasma levels of proinflammatory cytokines and chemokines, and were more likely to have bacterial coinfections (30.4%), myocarditis (21.7%), or viremia (13.0%) than patients in the survived-without-ARDS or the mild-disease groups. Reactive hemophagocytosis, thrombotic phenomena, lymphoid atrophy, diffuse alveolar damage, and multiorgan dysfunction similar to fatal avian influenza A H5N1 infection were found at postmortem examinations.

Conclusions. The slower control of viral load and immunodysregulation in severe cases mandate the search for more effective antiviral and immunomodulatory regimens to stop the excessive cytokine activation resulting in ARDS and death.

^top

High frequency of cross-reacting antibodies against 2009 pandemic influenza A (H1N1) virus among the elderly in Finland
Ikonen N, Strengell M, Kinnunen L, et al. Euro Surveill. 4 February 2010;15(5):pii=19478.
Available at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19478.

Summary. Since May 2009, the pandemic influenza A(H1N1) virus has been spreading throughout the world. Epidemiological data indicate that the elderly are underrepresented among the ill individuals. Approximately 1,000 serum specimens collected in Finland in 2004 and 2005 from individuals born between 1909 and 2005, were analysed by haemagglutination-inhibition test for the presence of antibodies against the 2009 pandemic influenza A(H1N1) and recently circulating seasonal influenza A viruses. Ninety-six per cent of individuals born between 1909 and 1919 had antibodies against the 2009 pandemic influenza virus, while in age groups born between 1920 and 1944, the prevalence varied from 77% to 14%. Most individuals born after 1944 lacked antibodies to the pandemic virus. In sequence comparisons the haemagglutinin (HA) gene of the 2009 pandemic influenza A(H1N1) virus was closely related to that of the Spanish influenza and 1976 swine influenza viruses. Based on the three-dimensional structure of the HA molecule, the antigenic epitopes of the pandemic virus HA are more closely related to those of the Spanish influenza HA than to those of recent seasonal influenza A(H1N1) viruses. Among the elderly, cross-reactive antibodies against the 2009 pandemic influenza virus, which likely originate from infections caused by the Spanish influenza virus and its immediate descendants, may provide protective immunity against the present pandemic virus.

^top

Higher all-cause mortality in children during autumn 2009 compared with the three previous years: pooled results from eight European countries
Mazick A, Gergonne B, Wuillaume F, et al. Euro Surveill. 4 February 2010;15(5):pii=19480.
Available at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19480.

Abstract. The paper describes weekly fluctuations of all-cause mortality observed in eight European countries during the period between week 27 and 51, 2009, in comparison with three previous years. Our preliminary data show that the mortality reported during the 2009 influenza pandemic did not reach levels normally seen during seasonal influenza epidemics. However, there was a cumulative excess mortality of 77 cases (1 per 100,000 population) in 5-14-year-olds, and possibly also among 0-4-year-olds.

^top

Susceptibility of turkeys to pandemic-H1N1 virus by reproductive tract insemination
Pantin-Jackwood M, Wasilenko JL, Spackman E, et al. Virol J. 3 February 2010;7(1):27.
Available at http://www.virologyj.com/content/7/1/27.

Abstract. The current pandemic influenza A H1N1 2009 (pH1N1) was first recognized in humans with acute respiratory diseases in April 2009 in Mexico, in swine in Canada in June, 2009 with respiratory disease, and in turkeys in Chile in June 2009 with a severe drop in egg production. Several experimental studies attempted to reproduce the disease in turkeys, but failed to produce respiratory infection in turkeys using standard inoculation routes. We demonstrated that pH1N1 virus can infect the reproductive tract of turkey hens after experimental intrauterine inoculation, causing decreased egg production. This route of exposure is realistic in modern turkey production because turkey hens are handled once a week for intrauterine insemination in order to produce fertile eggs. This understanding of disease exposure provides an improved understanding of the pathogenesis of the virus and can advance poultry husbandry to prevent disease outbreaks.

^top

The pandemic influenza planning process in Ontario acute care hospitals
Zoutman DE, Ford BD, Melinyshyn M, Schwartz B. Am J Infect Control. February 2010;38(1):3-8.
Available at http://www.ajicjournal.org/article/S0196-6553%2809%2900890-6/abstract.

Background. There will be little time to prepare when an influenza pandemic strikes; hospitals need to develop and test pandemic influenza plans beforehand.

Methods. Acute care hospitals in Ontario were surveyed regarding their pandemic influenza preparedness plans.

Results. The response rate was 78.5%, and 95 of 121 hospitals participated. Three quarters (76.8%, 73 of 95) of hospitals had pandemic influenza plans. Only 16.4% (12 of 73) of hospitals with plans had tested them. Larger (chi(2) = 6.7, P = .01) and urban hospitals (chi(2) = 5.0, P = .03) were more likely to have tested their plans. 70.4% (50 of 71) of respondents thought the pandemic influenza planning process was not adequately funded. No respondents were "very satisfied" with the completeness of their hospital's pandemic plan, and only 18.3% were "satisfied."

Conclusion. Important challenges were identified in pandemic planning: one quarter of hospitals did not have a plan, few plans were tested, key players were not involved, plans were frequently incomplete, funding was inadequate, and small and rural hospitals were especially disadvantaged. If these problems are not addressed, the result may be increased morbidity and mortality when a virulent influenza pandemic hits.

^top


4. Notifications
Emerging Infectious Diseases in Response to Climate Change
New York City, USA, 2 March 2010
This symposium examines the complex relationship between the climate, environment, and infectious diseases.
Additional information and registration available at http://www.nyas.org/Events/Detail.aspx?cid=aa4086a1-6917-4cd3-b14f-7317214ed96c.

^top

14th International Congress on Infectious Diseases (ICID)
Miami, Florida, USA, 9-12 Mar 2010
Additional information and registration available at http://www.isid.org/14th_icid/.

^top

International Swine Flu Conference (ISFC)
London, United Kingdom, 10-12 Mar 2010
Reflecting their strong agreement about the importance of the International Swine Flu Conference (ISFC), renowned medical experts have agreed to share end-to-end H1N1 prevention, preparedness, and response and recovery strategies at the event.
Additional information and registration available at http://www.new-fields.com/isfc_uk/.

^top

ISHEID Symposium on HIV and Emerging Infectious Diseases
Marseille, France, 24-26 Mar 2010
Tackling each topic from basic science to clinical applications, this meeting will deal with issues of HIV/AIDS, Viral Hepatitis, Emerging Infectious Diseases, and welcome many key opinion leaders.
Additional information and registration available at http://www.isheid.com/.

The ISHEID 2010 congress organizing office...
E-mail: isheid@clq-group.com; Ph. : +33 1 44 64 15 15 - Fax : +33 1 44 64 15 16

^top

CDC 7th International Conference on Emerging Infectious Diseases
Atlanta, Georgia, USA 11-14 Jul 2010
The 2010 International Conference on Emerging Infectious Diseases (ICEID) is the principal meeting for emerging infectious diseases organized by CDC. This conference includes plenary and panel sessions, as well as oral and poster presentations, and covers a broad spectrum of infectious diseases of public health relevance. ICEID 2010 will also focus on the impact of various intervention and preventive strategies that have been implemented to address emerging infectious disease threats.
Additional information is available at http://www.iceid.org/.

^top

Options for the Control of Influenza VII
Hong Kong, 3-7 Sep 2010
Options for the Control of Influenza VII is the largest forum devoted to all aspects of the prevention, control, and treatment of influenza. As it has for over 20 years, Options VII will highlight the most recent advances in the science of influenza. The scientific program committee invites authors to submit original research in all areas related to influenza for abstract presentation. Accepted abstracts will be assigned for oral or poster presentation.
Additional information is available at http://www.controlinfluenza.com.

^top

Updated influenza guidance and information from the US CDC
Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices: Guidance from Stakeholders
Released 2 February 2009.
Available at http://www.cdc.gov/h1n1flu/guidance/pdf/abb_pandemic_influenza_plan.pdf.

2009 H1N1 and Seasonal Influenza and Hispanic Communities: Questions and Answers
Released 11 February 2009
Available at http://www.cdc.gov/h1n1flu/qa_hispanic.htm.

^top

 apecein@u.washington.edu