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Tracking the next pandemic: Avian Flu Talk

CDC Flu Report, 8 States Now Regional or Local Flu

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jdljr1 View Drop Down
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    Posted: December 08 2006 at 1:34pm
    Weekly Report: Influenza Summary Update
Week ending December 2, 2006-Week 48

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Synopsis:
During week 48 (November 26  December 2, 2006)*, a low level of influenza activity was reported in the United States. One hundred and six (4.3%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories were positive for influenza. The proportion of patient visits to sentinel providers for influenza-like illness (ILI) and the proportion of deaths attributed to pneumonia and influenza were below baseline levels. Four states reported regional influenza activity; four states reported local influenza activity; 27 states, the District of Columbia, and New York City reported sporadic influenza activity; and 15 states reported no influenza activity.


Laboratory Surveillance*:
During week 48, WHO and NREVSS laboratories reported 2,441 specimens tested for influenza viruses, 106 (4.3%) of which were positive: fifteen influenza A (H1) viruses, one influenza A (H3), 61 influenza A viruses that were not subtyped, and 29 influenza B viruses.

Since October 1, 2006, WHO and NREVSS laboratories have tested a total of 22,677 specimens for influenza viruses and 724 (3.2%) were positive. Among the 724 influenza viruses, 568 (78.5%) were influenza A viruses and 156 (21.5%) were influenza B viruses. One hundred forty-four (25.4%) of the 568 influenza A viruses have been subtyped: 135 (93.8%) were influenza A (H1) viruses and 9 (6.2%) were influenza A (H3) viruses. Thirty-six states have reported positive laboratory influenza tests, but of the 724 influenza positive tests reported this season, 398 (55.0%) have been reported from Florida.



View WHO-NREVSS Regional Bar Charts | View Chart Data | View Full Screen

Antigenic Characterization:
CDC has antigenically characterized 27 influenza viruses [10 influenza A (H1) and 17 influenza B viruses] collected by U.S. laboratories since October 1, 2006.

Influenza A (H1)[10]
" Eight of the 10 viruses were characterized as A/New Caledonia/20/99-like, which is the influenza A (H1) component of the 2006-07 influenza vaccine.
" Two of the 10 viruses showed somewhat reduced titers with antisera produced against A/New Caledonia/20/99.
Influenza B (B/Victoria/02/87 and B/Yamagata/16/88 lineages)[17]
Victoria lineage [6]
" Six (35.3%) of the 17 influenza B viruses characterized belong to the B/Victoria lineage of viruses.
o Three of these 6 viruses were similar to B/Ohio/01/2005, the B component of the 2006-07 influenza vaccine.
o Three of these 6 viruses showed somewhat reduced titers with antisera produced against B/Ohio/01/2005.
Yamagata lineage [11]
" Eleven (64.7%) of the 17 influenza B viruses characterized belong to the B/Yamagata lineage of viruses.
It is too early in the influenza season to determine which influenza viruses will predominate or how well the vaccine and circulating strains will match.

Pneumonia and Influenza (P&I) Mortality Surveillance*:
During week 48, 6.34% of all deaths were reported as due to pneumonia or influenza. This percentage is below the epidemic threshold of 7.08% for week 48.



View Full Screen

Influenza-Associated Pediatric Mortality*:
No influenza-associated pediatric deaths were reported for week 48 and no deaths have been reported for the 2006-07 influenza season.

Influenza-Associated Pediatric Hospitalizations*:
Laboratory-confirmed influenza-associated pediatric hospitalizations are monitored in two population-based surveillance networks : the Emerging Infections Program (EIP) and the New Vaccine Surveillance Network (NVSN). No influenza-associated pediatric hospitalizations have been reported from either network this season.


Influenza-like Illness Surveillance*:
During week 48, 1.7%*** of patient visits to U.S. sentinel providers were due to ILI. This percentage is less than the national baseline**** of 2.1%. On a regional level**, the percentage of visits for ILI ranged from 0.8% to 3.3%. Two regions reported ILI above their region-specific baseline****: the East South Central region reported 2.6% compared to its baseline of 2.4% and the West South Central region reported 3.3% compared to its baseline of 3.0%.


View Sentinel Providers Regional Charts | View Chart Data | View Full Screen

Influenza Activity as Assessed by State and Territorial Epidemiologists*:
During week 48, the following influenza activity was reported:
" Regional activity was reported by four states (Alabama, Florida, Georgia, and Mississippi).
" Local activity was reported by four states (Connecticut, Louisiana, South Carolina, and Tennessee).
" Sporadic activity was reported by the District of Columbia, New York City, and 27 states (Alaska, Arizona, Arkansas, California, Delaware, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming).
" No influenza activity was reported by 15 states (Colorado, Kansas, Maine, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, Rhode Island, South Dakota, Vermont, and Washington).



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--------------------------------------------------------------------------------



Foot notes

Report prepared December 8, 2006
John L
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This is interesting
 
 
Archive Number 20061208.3470
Published Date 08-DEC-2006
Subject PRO/AH/EDR> Undiagnosed illness - USA (IA): RFI
UNDIAGNOSED ILLNESS - USA (IOWA): REQUEST FOR INFORMATION
****************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 8 Dec 2006
From: ProMED-mail <promed@promedmail.org>
Source: Radio Iowa, Fri 8 Dec 2006 [edited]
<http://www.radioiowa.com/gestalt/go.cfm?objectid=13BCE066-ADD3-44D8-9A300DCCFCCCADC9&dbtranslator=local.cfm>


Several outbreaks of illnesses have hit clusters of Iowans in recent 
weeks and yet another mystery case has appeared now in Waterloo/Cedar 
Falls. The Black Hawk County Health Department is investigating more 
than a dozen cases of what's known as serious diarrheal illness.

Health officials right now aren't exactly sure what's causing it, but 
they've not ruled out food poisoning. Since Wed [6 Dec 2006], at 
least 10 people have gone to area hospitals to be treated for 
symptoms that include respiratory illness and serious diarrhea. 
Officials are saying that norovirus is likely not the cause, however, 
they're still looking into the matter.

[Byline: Scott Fenzloff]

--
ProMED-mail
<promed@promedmail.org>

[The combination of respiratory and gastrointestinal symptoms 
suggests a viral infection. The exclusion of norovirus infection, 
usually associated with sudden onset illness of short duration, 
suggests that the symptoms are not resolving rapidly. Further 
information from an informed local source would be appreciated. - Mod.CP]
..................mpp/cp/pg/mpp
http://www.promedmail.org/pls/promed/f?p=2400:1000
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jdljr1 Quote  Post ReplyReply Direct Link To This Post Posted: December 09 2006 at 3:37pm
Saturday, December 9, 2006 6:14 AM CST
At least 33 sick after eating at Taco John's
By JENS MANUEL KROGSTAD, Courier Staff Writer

CEDAR FALLS --- At least 33 people have become ill with symptoms that include severe diarrhea and stomach cramps after dining at Taco John's in Cedar Falls.

Black Hawk County Health Department reports the disease has hospitalized 14 and sickened 19 people. Preliminary test results suggest E. coli bacteria is to blame, though a definitive report isn't expected until Monday, said Tom O'Rourke, Black Hawk County Health Department director.

Taco John's, located at 6210 University Ave., remains open. Local health officials said the restaurant has fully cooperated with efforts to identify sick customers and ensure food safety. The restaurant replaced all its food products with ones from different lot numbers, and it purchased fresh, local vegetables, O'Rourke said.

"We have no reason to believe a threat still exists," he said

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Brian Dixon, vice president of marketing for Taco John's, said the restaurant has sent a corporate representative to review cooking and food storage procedures, and to examine cleaning reports and employee health records.

"In terms of this particular case, the franchise owners have been deeply involved and we have been cooperating with the health department," he said. "At this point, both the owners and us as a corporate support organization have done everything we can do to cooperate and explore the situation."

The health department received the first report of a food borne illness Wednesday morning, and suspects the first person became ill Nov. 28. The department continued to receive new cases Friday, and will work through the weekend to identify the source of the outbreak, O'Rourke said.

The symptoms present in the sick, particularly bloody diarrhea, is one of the telling symptoms of an E. coli infection. The Centers for Disease Control urges anyone who suddenly develops diarrhea with blood to be tested for E. coli 0157:H7, the strain that makes people sick.

Health officials haven't determined the exact source of the bacteria, which could have originated from an employee or previously contaminated food, O'Rourke said. The outbreak isn't associated with green onions, a suspected source in other E. coli outbreaks around the country, he said.

At least eight of the sick are University of Northern Iowa students, said Jim O'Connor, UNI associate director of public relations.

Since Wednesday, seven people at Sartori Hospital, five at Allen Hospital and two at Covenant Medical Center have been hospitalized with symptoms that include bloody diarrhea and stomach cramps, according to hospital officials.

Mark Linda, the health department's environmental health manager, said norovirus, the gastrointestinal illness active this winter, is probably not the culprit.

"The cases we're dealing with here are more serious diarrheal cases, and that kind of rules out norovirus," he said.

Even though health officials had zeroed in on Taco John's as the source of the outbreak, they never released the restaurant's name, citing Iowa Code 139A.3.2c. The code states information identifying a person or business identified in such a case is confidential unless the state epidemiologist or director of public health determines release of the information is necessary to protect the public's health.

Health officials said the best way to prevent the spread of the disease is regular hand washing of at least 15 seconds in warm, soapy water. Food workers with diarrhea or flu symptoms shouldn't go to work until cleared by a doctor to return. Anyone with these symptoms should seek medical care immediately.

The health department is asking the public to report any symptoms of bloody diarrhea and cramping that occurred after Nov. 28. The number is (319) 415-8913. If the phone isn't answered, leave a message and your call will be returned.

Staff writer Emily Christensen contributed to this article.

Contact Jens Manuel Krogstad at (319) 291-1580 or jens.krogstad@wcfcourier.com.

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John L
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Thanks for the great posts.
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 Canada
 
Archive Number 20061209.3477
Published Date 09-DEC-2006
Subject PRO/EDR> Streptoccus pneumoniae, serotype 5 - Canada (BC)
STREPTOCCUS PNEUMONIAE, SEROTYPE 5 - CANADA (BRITISH COLUMBIA)
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: 9 Dec 2006
From: Samara David <Samara.David@bccdc.ca>
Source: British Columbia Centers for Disease Control


Outbreak of Serotype 5 Pneumococcal Disease in Vancouver, British 
Columbia, Canada
-----------------------------------------------
Vancouver, British Columbia (BC) is experiencing an outbreak of 
invasive pneumococcal disease (IPD) in an inner city neighborhood. To 
date in 2006, 376 cases of IPD have been reported in BC (incidence 
8.7 cases/100 000 population); 137 of these are from Vancouver 
(incidence 22.9 cases/100 000 population). The majority of these 
cases are serotype 5.

The Vancouver outbreak was identified by St. Paul's Hospital, which 
serves Vancouver's inner city. Normally, 0-5 cases of IPD are 
admitted per month to St. Paul's Hospital. An increase began in 
August 2006; 46 cases of IPD were admitted in November 2006 and 
admissions are continuing in December 2006. Serotype data available 
to date indicate that 85 percent of cases from St. Paul's Hospital 
are serotype 5. A small number of serotype 5 cases have also been 
admitted to other hospitals in Greater Vancouver, most with direct 
links to Vancouver's poor inner city neighborhood. To date, 6 BC 
serotype 5 IPD cases have been reported from areas outside of 
Vancouver. Of these, 4 had some connection with the affected 
Vancouver demographic; exposures for the other 2 are being assessed.

Serotype 5 _Streptococcus pneumoniae_ was previously uncommon in BC 
(one case per year in 2004 and 2005), but was responsible for recent 
outbreaks among similar high-risk populations in neighboring Alberta.

Risk factors for cases include homelessness or living in rooming 
houses, use of crack cocaine and other illicit drugs, and underlying 
medical risk factors such HIV and hepatitis C infection. Many cases 
require ICU admission, and there have been at least 3 deaths. There 
has not been an increase in cases of simple pneumonia associated with 
this outbreak of invasive disease.

In response to the outbreak, Vancouver Coastal Health launched a 
pneumococcal immunization campaign in inner city Vancouver beginning 
in early November 2006. Polysaccharide pneumococcal vaccine 
(23-valent, including serotype 5) is being given in rooming houses, 
shelters, food banks and other community locations by teams of 
outreach nurses. This campaign is modeled after similar, successful 
immunization blitzes for influenza, hepatitis A and hepatitis B in 
the same neighborhood. Other health responses in BC include:

* accelerated pneumo 23 polysaccharide immunization of indigent and 
drug-using people in regions adjacent to Vancouver

* enhanced surveillance by serotype to track the distribution of 
disease within BC

* stringent facility infection control practices

Updates on changes in epidemiology of IPD in neighboring states and 
provinces would be appreciated.

[Posted by Marc Romney and Mark Hull, Providence Health; Reka 
Gustafson and Patricia Daly, Vancouver Coastal Health; David Patrick 
and Samara David, BC Centre for Disease Control, British Columbia, Canada]

--
Samara David, MHSc
Surveillance Epidemiologist
BC Centre for Disease Control
655 West 12th Avenue
Vancouver, BC
Canada V5Z 4R4

[Invasive pneumococcal disease is quite common, and the pneumococcus 
is the most frequent cause of bacteremia. However, the incidence 
figures cited for Vancouver in the report are higher than those seen 
normally in the era since routine pneumococcal conjugate vaccine use. 
The routine use of these conjugate vaccines in children has 
dramatically reduced the rates of invasive pneumococcal disease in 
children and appears to be reducing the disease burden in the rest of 
the population as well.

It is interesting to note that pneumococcal serotype 5 (serotype 
designations are based on the structure of the bacterial 
polysaccharide capsule) is not included in the conjugate vaccines, 
which currently cover only the 7 most prevalent serotypes (there are 
over 90 known serotypes). One of the fears regarding widespread 
vaccination has been that "serotype replacement" would occur with 
non-vaccine serotypes. This appears to be happening in the Vancouver 
and Alberta outbreaks, hence the recommendation here for vaccination 
with the older, unconjugated 23-valent vaccine that does confer 
protection to serotype 5. Unfortunately, the older vaccine is less 
immunogenic and works poorly in young children, the highest risk group.

No information on antibiotic resistance is given, suggesting that the 
isolates have been penicillin-susceptible.

The authors of the report have requested information regarding 
pneumococcal disease in neighboring areas, and ProMED would also be 
interested in any such data. - Mod.LM]
..................mpp/lm/msp/mpp
http://www.promedmail.org/pls/promed/f?p=2400:1000
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Its spreading around here in the northeast. Flulike symptoms, saw people buying cold flu emds in CVS. N95 masks on bottom shelves below cought syrup!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dlugose Quote  Post ReplyReply Direct Link To This Post Posted: December 11 2006 at 4:48pm
Originally posted by jdljr1 jdljr1 wrote:

    Weekly Report: Influenza Summary Update
Week ending December 2, 2006-Week 48 

The proportion of patient visits to sentinel providers for influenza-like illness (ILI) and the proportion of deaths attributed to pneumonia and influenza were below baseline levels.
 
There's not much interesting in this except that it is a slower flu season than normal (under the predicted curve).
 
Pneumonia And Influenza Mortality
Dlugose RN AAS BA BS Cert. Biotechnology. Respiratory nurse
June 2013: public health nurse volunteer, Asia
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