CDC: Early Data Suggests Potentially Severe Flu Season

 

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As follow up to this morning’s blog (see CDC HAN Advisory On `Drifted’ H3N2 Seasonal Flu Virus), and a blog I wrote a month ago called A `Drift’ In A Sea Of Influenza Viruses, we’ve got a press release from the CDC warning that there are early signs that might indicate a rough flu season ahead.

Earlier today CDC Director Dr. Thomas Frieden and Dr. Joseph Bresee held a teleconference, where they went over last night’s HAN announcement, and discussed the recent influx of a newly `drifted’ H3N2 virus not well covered by the current vaccine. 

 

Since vaccine strain selections must be made 6 months before the start of each flu season, there’s always a chance that one or more of the viruses in circulation will drift away from the vaccine.  This constant evolution of influenza viruses is illustrated quite nicely in the NIAID video Influenza: Get the (Antigenic) Drift.

 

A transcript of today’s briefing and audio file should be posted on the CDC’s media website  later today or tomorrow. In the meantime, we’ve the following press release:

 

Early Data Suggests Potentially Severe Flu Season

CDC Urges Vaccination, Treatment

 

For Immediate Release: Thursday, December 4
Contact: Media Relations
(404) 639-3286

Early data suggests that the current 2014-2015 flu season could be severe. The Centers for Disease Control and Prevention (CDC) urges immediate vaccination for anyone still unvaccinated this season and recommends prompt treatment with antiviral drugs for people at high risk of complications who develop flu.

So far this year, seasonal influenza A H3N2 viruses have been most common. There often are more severe flu illnesses, hospitalizations, and deaths during seasons when these viruses predominate. For example, H3N2 viruses were predominant during the 2012-2013, 2007-2008, and 2003-2004 seasons, the three seasons with the highest mortality levels in the past decade. All were characterized as “moderately severe.”

Increasing the risk of a severe flu season is the finding that roughly half of the H3N2 viruses analyzed are drift variants: viruses with antigenic or genetic changes that make them different from that season’s vaccine virus. This means the vaccine’s ability to protect against those viruses may be reduced, although vaccinated people may have a milder illness if they do become infected. During the 2007-2008 flu season, the predominant H3N2 virus was a drift variant yet the vaccine had an overall efficacy of 37 percent and 42 percent against H3N2 viruses.

“It’s too early to say for sure that this will be a severe flu season, but Americans should be prepared,” said CDC director Tom Frieden, M.D., M.P.H. “We can save lives with a three-pronged effort to fight the flu: vaccination, prompt treatment for people at high risk of complications, and preventive health measures, such as staying home when you’re sick, to reduce flu spread.”

Depending on the formulation, flu vaccines protect against three or four different flu viruses. Even during a season when the vaccine is only partially protective against one flu virus, it can protect against the others.

“While the vaccine’s ability to protect against drifted H3N2 viruses this season may be reduced, we are still strongly recommending vaccination,” said Joseph Bresee, M.D., Chief of the Influenza Epidemiology and Prevention Branch at CDC. “Vaccination has been found to provide some protection against drifted viruses in past seasons. Also, vaccination will offer protection against other flu viruses that may become more common later in the season.”

Influenza viruses are constantly changing. The drifted H3N2 viruses were first detected in late March 2014, after World Health Organization (WHO) recommendations for the 2014-2015 Northern Hemisphere vaccine had been made in mid-February. At that time, a very small number of these viruses had been found among the thousands of specimens that had been collected and tested.

A committee of experts must pick which viruses to include in the vaccine many months in advance in order for vaccine to be produced and delivered in time for the upcoming flu season. There is always the possibility that viruses will drift during that time.

Influenza activity is currently low in the United States as a whole, but is increasing in parts of the country. “We are just at the beginning of the season. It’s not too late to get your vaccine,” Dr. Frieden says.

Influenza antiviral drugs – Tamiflu (oseltamivir) and Relenza (zanamivir) can reduce severe complications such as hospitalization and potentially death for people who are at high risk of serious flu complications or are very sick. Treatment of high risk patients should begin as soon after symptoms develop as possible, without waiting for lab tests to confirm flu infection.

Those at high risk from influenza include children younger than 5 years (especially those younger than 2 years); adults 65 years and older; pregnant women; and people with certain chronic health conditions such as asthma, diabetes, heart or lung disease, and kidney disease.

CDC recommends that people at high risk check with their doctor or other health care professional promptly if they get flu symptoms. Studies show that flu antiviral drugs work best for treatment when they are started in the first 48 hours after symptoms appear. Flu symptoms can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue.

 

WHO: Statement From The Cairo MERS-CoV Conference

Photo Credit WHO

 

# 7419

 

The three-day meeting in Cairo this week on coordinating an international response to the MERS coronavirus (see WHO: Health Officials Meet In Cairo Over MERS-CoV) has now concluded, and the World Health Organization has released, via email, a press statement (which I assume will be posted on the EMRO site shortly).

 

This document stresses the need for international cooperation, and calls upon member states to `share data with WHO and report any confirmed and probable cases of MERS-CoV within 24 hours of classification.’

 

This meeting identified 7 key areas where actions were needed to enhance the international community’s ability to deal with emerging diseases, like MERS-CoV. 

 

They are:

1. surveillance
2. mass gatherings preparation
3. clinical management of cases
4. laboratory diagnostics
5. infection control,
6. communications
7. International Health Regulation (2005) reporting

 

Dr. Keiji Fukuda, WHO Assistant Director-General for Health Security and the Environment, is quoted as saying:

 

“At the moment we have an important window where cases have still been relatively few and human transmission is relatively limited.

 

We need to exploit this chance to agree and implement the best public health measures possible across the board for, in so doing, we stand the best chance of controlling this virus before it spreads further.”

 

My thanks to  Sharon Sanders on FluTrackers for posting this, and I’ll update this blog with a direct link to this press release on the WHO website when it is published.

 

 

WHO News Release (EMRO)
22 June 2013

Public Health Officials Agree Priority Actions to Detect and Control MERS-CoV

Cairo, 20-22 June 2013

22 JUNE 2013 / CAIRO - Strengthening countries’ abilities to control, detect, and treat cases of MERS-CoV infection are among the most urgent actions needed at national level to stem the growing outbreak of disease caused by the virus, over 100 public health experts meeting at WHO’s Eastern Mediterranean Regional Office agreed.

 

The experts, who came from all countries in the Middle East and North Africa and Europe which have already registered MERS-CoV cases, and from throughout WHO’s Eastern Mediterranean Region (EMR), agreed that there is a list of priority actions which need to be agreed internationally and implemented nationally.

 

At an international level, fast and complete reporting of cases, with contact histories, clinical care and treatment outcomes in as much detail as possible, and collected in a uniform manner across countries, is necessary for the international public health community to be able to build up a picture of what works and what doesn’t in combatting this virus.

 

“Having the same tools and protocols in all countries allows us to draw on and implement best practice from around the world, and to pool our information and resources most effectively on an international level,” said Dr Ala Alwan, WHO Regional Director for the EMR, who chaired the meeting. “This meeting has taken us an important step in that direction.”

 

“At the moment we have an important window where cases have still been relatively few and human transmission is relatively limited,” added Dr Keiji Fukuda, WHO Assistant Director-General for Health Security and the Environment. “We need to exploit this chance to agree and implement the best public health measures possible across the board for, in so doing, we stand the best chance of controlling this virus before it spreads further.”

 

The meeting agreed that a series of actions in seven key areas were key to increasing Member States’ and the international community’s ability to prepare for, control, detect, alert the world to, and treat cases of diseases caused by MERS-CoV. These areas are surveillance, mass gatherings preparation, clinical management of cases, laboratory diagnostics, infection control, communications, and International Health Regulation (2005) reporting.

 

Participants agreed, for example, that every country should enhance surveillance for severe acute respiratory illness in accordance with prevailing local situation and urgently investigate any cluster of pneumonia with unusual clinical presentations, or any immune-compromised patient or healthcare worker with any unusual sign of acute respiratory infection. Furthermore, Member States should share data with WHO and report any confirmed and probable cases of MERS-CoV within 24 hours of classification.

 

In the area of mass gatherings, the participants agreed that Member States should to develop specific plans when MERS-CoV might be an additional risk for an event, and they also highlighted the need for standardised protocols for serological testing, and systematic and sequential sample collection.

 

In the area of communications, the value of fast and transparent reporting of cases both to the public and to WHO via the system of International Health Regulations National Focal Points was highlighted, while the needs to better understand the probability and means of hospital-based transmission of the disease, and to ensure hospitals had adequate knowledge and facilities to treat cases, including the most severe ones, were also highlighted.

 

“Collecting and sharing epidemiological, clinical, immunologic, and genetic information related to MERS-CoV infections in the right way is essential if the disease is to be better characterized in terms of source, exposure and presentation. Coordinated and intersectoral global action to increase regional and inter-regional collaboration between countries, WHO and other international partners is vital,” the meeting concluded.

FDA Warning On Extortion Scam

 

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A hat tip to Missouriwatcher on FluTrackers for posting this FDA press release from last week that I somehow missed. 

 

This announcement concerns an extortion scam being run by individuals claiming to be agents of the FDA and other federal agencies.

 

FDA NEWS RELEASE

For Immediate Release: Dec. 29, 2009

Media Inquiries: Tom Gasparoli, 301-796-4737, thomas.gasparoli@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

FDA Warns Public of Continued Extortion Scam by FDA Impersonators

The U.S. Food and Drug Administration is warning the public about criminals posing as FDA special agents and other law enforcement personnel as part of an international extortion scam.

 

The criminals call the victims -- who in most cases previously purchased drugs over the Internet or via "telepharmacies" -- and identify themselves as FDA special agents or other law enforcement officials. The criminals inform the victims that purchasing drugs over the Internet or the telephone is illegal, and that law enforcement action will be pursued unless a fine or fee ranging from $100 to $250,000 is paid. Victims often also have fraudulent transactions placed against their credit cards.

 

The criminals always request the money be sent by wire transfer to a designated location, usually in the Dominican Republic. If victims refuse to send money, they are often threatened with a search of their property, arrest, deportation, physical harm, and or incarceration.

 

"Impersonating an FDA official is a violation of federal law," said Michael Chappell, the FDA's acting associate commissioner for regulatory affairs. "The public should note that no FDA official will ever contact a consumer by phone demanding money or any other form of payment.”

 

(Continue . . . )

For more on FDA’s concerns about unlawful drug sales on the Internet, see

 

http://www.fda.gov/ForConsumers/ProtectYourself/default.htm.