H5N1 Bird Flu Research Is Safe to Publish, Panel Says

Excerpt from an article in

The New York Times

Saturday, March 31, 2012

H5N1 Bird Flu Research Is Safe to Publish, Panel Says

By DENISE GRADY

After a public furor over experiments that made a dangerous flu virus more contagious, a panel of scientific advisers reversed itself on Friday and recommended that full details of the research be published in scientific journals.

Dr. Paul Keim, acting chairman of the panel, said the new manuscripts made it clear that the experiments were not as dangerous as they originally appeared to be and that the benefits of the research were greater. The benefits come from information that can be used to help predict which flu viruses circulating in the environment may be developing pandemic potential.

The panel, the National Science Advisory Board for Biosecurity, recommended in December that scientific reports about the research be published only if certain details were withheld, to prevent others from replicating the experiments. The fear was that bioterrorists would use the information to create germ weapons, or that the virus would leak out of a laboratory by accident.

Lugar Highlights Nunn-Lugar Bio-threat Reduction Measures in Georgia

Press Release of Senator Lugar Lugar Highlights Nunn-Lugar Bio-threat Reduction Measures in Georgia Thursday, March 22, 2012 U.S. Senator Dick Lugar (R-IN) underscored for Richard B. Norland, the U.S. Ambassador-Designate to Georgia, the importance of Nunn-Lugar bio-threat reduction programs in Georgia.  Lugar discussed bio-threat efforts during Ambassador-Designate Norland’s nomination hearing before the Senate Foreign Relations Committee on Wednesday.   “If you are confirmed,” he told Norland, “we would look forward to your attention to that important mission.” The Nunn-Lugar Central Public Health Research Laboratory was opened one year ago in Tbilisi, Georgia.  “Nunn-Lugar labs are critical for advancing cooperative efforts to identify and report on deadly pathogens before they can spread,” Lugar said. The lab’s mission is to promote infectious disease detection, epidemiological surveillance, and research for the benefit of the United States, Georgia, the Caucasus region, and the global community.  The CPHRL facilitates an important U.S. presence in the country and attracts world-renowned experts for on-site collaboration. “We cannot wait for threats to come to our shores,” Lugar said at the time of the Laboratory’s opening.  “Nunn-Lugar projects make Americans safer, day by day, by working cooperatively with nations around the globe.” Senator Lugar is working to address emerging WMD threats in new locations.  Building on Nunn-Lugar’s nearly 20 years of experience in helping secure WMD in the former Soviet States, Senator Lugar recently undertook a mission to East Africa that was focused on biological threats. ###

From the CDC

Peep, chirp, quack!

What you should know about Salmonella if you keep backyard poultry

It’s not unusual to see soft and cute baby poultry put on display in agricultural feed stores, especially during the spring. But most people do not realize that live poultry (chicks, chickens, ducks, ducklings, geese, turkeys) can be a source of human Salmonella infections, especially for children. >>Learn more

From the CDC

Illinois hospitals collaborated  [PDF-552KB] to reduce Clostridium difficile infections 15% to 26%; one strategy included engaging environmental service workers.

Massachusetts’ CDI Prevention Collaborative  [PDF-547KB] reduced Clostridium difficile infections 25% by empowering frontline hospital staff on multidisciplinary teams.

New York’s Clostridium difficile Collaborative saves millions in hospital costs  [PDF-676KB] using an evidence-based infection prevention bundle and standardized environmental cleaning protocols.

Emerging Infectious Diseases - April 2012

Wednesday, March 21, 2012

Table of Contents
Volume 18, Number 4–April 2012


 
 
RESEARCH
MEDSCAPE CME ACTIVITY
Determinants for Autopsy after Unexplained Deaths Possibly Resulting from Infectious Causes, United States
     L. Liu et al. 
MEDSCAPE CME ACTIVITY
Influenza-associated Hospitalizations by Industry, 2009–10 Influenza Season, United States
     S.E. Luckhaupt et al. 
Risk Factors for Chronic Q Fever, the Netherlands
     L.M. Kampschreur et al. 
Geographic Distribution of Hantaviruses Associated with Neotomine and Sigmodontine Rodents, Mexico
     M.L. Milazzo et al. 
Shiga Toxin–producing Escherichia coli serotype O78:H– in Family, Finland, 2009
     T. Lienemann et al. 
Identification of Intermediate in Evolutionary Model of Enterohemorrhagic Escherichia coli O157
     C. Jenke et al. 
Emergence of Unusual G6P[6] Rotaviruses in Children, Burkina Faso, 2009–2010
     J. Nordgren et al. 
Comparison of Escherichia coli ST131 Pulsotypes by Epidemiologic Traits, 1967–2009
     J.R. Johnson et al. 

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POLICY REVIEW
Lessons Learned during Dengue Outbreaks in the United States, 2001–2011
     A.A. Adalja et al. 

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HISTORICAL REVIEWS
Malaria in Highlands of Ecuador since 1900
     L.L. Pinault and F. F. Hunter 
Dengue and US Military Operations from Spanish–American War through Today
     R.V. Gibbons et al. 

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DISPATCHES
Bartonella spp. in Rats and Zoonoses, Los Angeles, California, USA
     V.A.K.B. Gundi et al. 
Detection of Plasmodium spp. in Human Feces
     M. Jirku et al. 
Extraintestinal Infections Caused by Salmonella enterica Subspecies II–IV
     S.L. Abbott et al. 
Subclinical Infections with Crimean-Congo Hemorrhagic Fever Virus, Turkey
     H. Bodur et al. 
Crimean-Congo Hemorrhagic Fever, Kazakhstan, 2009–2010
     B. Knust et al. 
Vector Blood Meals and Chagas Disease Transmission Potential, United States
     L. Stevens et al. 
emm59 Group A Streptococcus Strains, United States
     N. Fittipaldi et al. 
Characterization of Mycobacterium orygis as M. tuberculosis Complex Subspecies
     J. van Ingen et al. 
Cosavirus Infection in Persons with and without Gastroenteritis, Brazil
     A. Stocker et al. 
Drug Susceptibility of Mycobacterium tuberculosis Beijing Genotype and Association with MDR TB
     J.E.M. de Steenwinkel et al. 
Highly Divergent Novel Lyssavirus in African Civet
     D.A. Marston et al. 
Coccidioides posadasii Infection in Bats, Brazil
     R. de Aguiar Cordeiro et al. 
Surveillance for West Nile Virus, Dengue, and Chikungunya Infections, Italy, 2010
     F. Gobbi et al. 
De Novo Daptomycin-Nonsusceptible Enterococcal Infections
     T. Kelesidis et al. 
Dengue in Patients with Central Nervous System Manifestations, Brazil
     F. Araujo et al. 
Human Parvovirus 4 Infection, Cameroon
     M. Lavoie et al. 
Neuroinvasive Disease and West Nile Virus Infection, North Dakota, USA, 1999–2008
     P.J. Carson et al. 

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ANOTHER DIMENSION
Leaving the Hospital
     A. Silver 

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LETTERS
West Nile Virus Lineage 2 from Blood Donor, Greece
     A. Papa et al. 
Tuberculosis Screening before Anti–Hepatitis C Virus Therapy in Prisons
     S. Babudieri et al. 
Deficient Reporting in Avian Influenza Surveillance, Mali
     S. Molia et al. 
Myxozoan Parasite in Brain of Critically Endangered Frog
     A. Hartigan et al. 
Mayaro Virus Infection in Swiss Traveler Returning from Amazon Basin, Northern Peru
     A. Neumayr et al. 
Meningoencephalitis Complicating Relapsing Fever in Traveler Returning from Senegal
     E. Bottieau et al. 
Orthopoxvirus Infection in Buffaloes, Brazil
     F. Lopes de Assis et al. 

Methicillin-Susceptible Staphylococcus aureus ST398, New York and New Jersey, USA
     J.R. Mediavilla et al. 

Rickettsia monacensis and Mediterranean Spotted Fever–like Illness, Italy
     G. Madeddu et al. 
Leishmania Resistance to Miltefosine Associated with Genetic Marker
     S. Cojean et al. 
Prolonged KI Polyomavirus Infection in Immunodeficient Child
     V. Falcone et al. 
African Swine Fever Virus Caucasus Isolate in European Wild Boars of All Ages
     S. Blome et al. 

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ABOUT THE COVER
Military Magic or Nature's Fool
     P. Potter 

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ONLINE ONLY

Multidisciplinary and Evidence-based Method for Prioritizing Diseases of Food-producing Animals and Zoonoses
     M.-F. Humblet et al.  

World TB Day - March 24, 2012

NIAID Statement on World TB Day - March 24, 2012

Christine F. Sizemore, Ph.D., Richard E. Hafner, M.D., and Anthony S. Fauci, M.D., National Institute of Allergy and Infectious Diseases, National Institutes of Health

The theme of World TB Day 2012, Eliminate TB in My Lifetime, boldly challenges us to improve and expand tuberculosis (TB) control and related research efforts that recently have led to slowly declining rates of illness and death from this ancient disease. Even with the technological advances available in the early part of the 21st century, the elimination of TB will be an enormous task. TB claimed 1.45 million lives worldwide in 2010, according to the World Health Organization. An estimated one-third of the world’s population is latently infected with the bacterium that causes TB, meaning they experience no symptoms but are at risk for developing active disease. Among people with HIV/AIDS, TB is a major co-infection and the leading cause of death, responsible for killing approximately 350,000 HIV-infected individuals in 2010. The interface of the TB and HIV epidemics and the continuing emergence of drug-resistant TB are serious threats to achieving TB control worldwide. Although recent progress against the disease is heartening, the control and eventual elimination of TB will require a long-term, multifaceted commitment from the global health and research communities.

TB control and the care of TB-infected people are being improved by making existing TB interventions more accessible and affordable, as well as simpler to administer. Comprehensive TB control can be markedly enhanced, however, with better medical tools. To transform the field, we must address long-standing challenges in TB research, such as identifying the factors involved in the immune control of latent TB infection that allow 90 percent of otherwise healthy TB-infected individuals to never develop active disease. We need to use novel scientific tools and apply modern approaches to answer this and other fundamental questions. High-throughput sequencing, for example, can efficiently analyze the genomes of drug-sensitive and drug-resistant TB strains and help us to identify genetic markers useful for developing tests to quickly detect resistance to anti-TB drugs. A systems biology approach helps us make sense of the complex networks of biological responses in the TB bacterium on the part of the human host so we can better understand the disease and give direction to vaccine and drug discovery projects. In this regard, a renewed focus on fundamental TB research will enable us to refine our strategies for developing and applying innovative interventions against TB. To this end, the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health leads the U.S. government’s biomedical research effort in TB and supports scientists worldwide engaged in these efforts.

An important milestone in modernizing TB control was the WHO Global Tuberculosis Control Report 2011, which for the first time included biomedical research as a critical component of the global fight against TB. Integrating biomedical research into the framework of global TB control is an essential component of the WHO report as well as other recent strategic documents developed by the TB research community, including An International Roadmap for Tuberculosis Research and the updated Strategic Blueprint for TB vaccines. These collaborative efforts to identify gaps and opportunities in biomedical research are critical for developing new interventions and control strategies.

Integral to these efforts, NIAID also is increasing TB clinical research capacity for adults and children with and without HIV co-infection through its existing international HIV/AIDS clinical trials networks. Recent results from two clinical trials sponsored by the Institute have advanced the management of HIV and TB co-infection by defining the optimal time to initiate antiretroviral treatment in relationship to TB therapy. Several NIAID-funded clinical research sites in Africa recently joined other collaborators in an ongoing clinical trial testing an investigational TB vaccine in infants at risk for TB infection. These networks and other NIAID resources are helping to dramatically improve the efficiency of drug and vaccine development and systematically advance the current pipeline of potential TB diagnostics and interventions into clinical application. As part of our emphasis on clinical research, NIAID is supporting multiple efforts and partnerships focused on the discovery of novel biomarkers to rapidly assess the status of infection, response to treatment and protective immunity.

Eliminating TB in a generation, while an ambitious goal, can become a reality through the continued commitment and collaboration of the key stakeholders in biomedical research and global health. To date, these efforts have provided the knowledge and novel methodologies to develop a robust pipeline of new TB countermeasures. Fostering even closer integration of biomedical research with the TB control community will help assure that new medical tools are applied in the most effective manner to make TB a disease of the past.
For more information about TB, visit NIAID’s Tuberculosis Web portal and the HHS Healthfinder link on Tuberculosis.

Anthony S. Fauci, M.D., is director of NIAID. Richard E. Hafner, M.D., is acting chief of the TB Clinical Research Branch in the NIAID Division of AIDS; Christine F. Sizemore, Ph.D., is chief of the Tuberculosis and Other Mycobacterial Diseases Section in the NIAID Division of Microbiology and Infectious Diseases.

NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov/.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH...Turning Discovery Into Health

CDC Safe Healthcare Blog

In today's CDC Safe Healthcare Blog, Neil Fishman of the University of Pennsylvania Health System talks about the growing focus on antimicrobial stewardship in the face of rising antibiotic resistance. He also discusses his recent position as guest editor for the April issue of Infection Control and Hospital Epidemiology (ICHE), which focuses on the science supporting antimicrobial stewardship, the importance of stewardship in improving patient safety and health, and policy statements to help organizations move from talking to acting.

Learn more about the need for effective antimicrobial stewardship and join the discussion by visiting http://blogs.cdc.gov/safehealthcare/.

Merck and Safe Water Network Launch Initiative to Improve Water Access and Help Reduce the Impact of Water-Borne Disease in India

Merck and Safe Water Network Launch Initiative to Improve Water Access and Help Reduce the Impact of Water-Borne Disease in India

Collaboration advances Merck's commitment to fighting disease to help the world be well

WHITEHOUSE STATION, March 20, 2012 - Merck (NYSE: MRK), known as MSD outside the United States and Canada, and Safe Water Network, announced today the launch of a three-year, $1.5M partnership to increase access to safe water and reduce the impact of water-borne disease among impoverished communities in Andhra Pradesh, India. Safe Water Network is a not-for-profit organization committed to developing locally owned and operated water-purification systems that achieve lasting health impact. This initiative addresses a critical need in India where an estimated 70 – 80 percent of the total burden of disease is related to water contamination and poor sanitation, and where more than 120,000 children under the age of five die each year from rotavirus diarrhea alone¹. "Clean water is fundamental to the world's health and to Merck's mission of fighting disease and helping the world be well. No where is this more true than in India, which faces a significant challenge related to clean water," said K. G. Ananthakrishnan, managing director, MSD India. "Our partnership with Safe Water Network is a testament of our commitment to help reduce the impact of water-related illness in India and of Merck's overall efforts to improve health globally." Building on Safe Water Network's field activities in the area, this collaboration will provide clean water to additional villages in Andhra Pradesh and develop demand generation programs that seek to increase household usage. Together, Merck and Safe Water Network will also work to increase awareness of the importance of clean water and hygiene to drive behavior change. The campaigns will be assessed to measure the impact on safe water usage and improved health. "This partnership aims to expand the impact of our safe-water projects," said Kurt Soderlund, chief executive officer, Safe Water Network. "It will accelerate our work to develop solutions that can be broadly replicated. The initiative demonstrates how companies like Merck can play an important role in developing solutions to global water challenges." This collaboration is aligned with Merck's commitment to addressing access to clean water, a key component of the company's corporate responsibility approach. A signatory to the UN's CEO Water Mandate, Merck will apply its core business expertise, advocacy efforts and employee social responsibility programs to address access to clean water in India. About India's Water Challenge India faces significant water and sanitation challenges. Seventy-five percent of the country's surface water is contaminated by human, agricultural and industrial waste², while half of the country's population lacks access to basic sanitation³. Those living in urban slums and rural environments are most affected. In many areas of the country, a growing dependence on groundwater for drinking is associated with a rise in health problems due to fluoride, salinity, water-borne pathogens, nitrate and other contaminants found in the water. In Andhra Pradesh, only 31 percent4 of households treat their water before use, and 43 percent5 of children under the age of five are stunted, a common result of frequent episodes of diarrhea. About the Initiative This joint effort draws on Safe Water Network's field experience in India, Ghana and Kenya to address the operating, economic, cultural and environmental challenges to safe water access. The team will apply a rigorous method to data collection and analysis to produce effective demand generation and education methods that can be replicated at scale throughout India. The initiative will add a dozen sites to Safe Water Network's existing field projects in Andhra Pradesh, which already provide nearly 40,000 people access to clean water. The additional sites will provide safe water access to another 20,000 - 30,000 people. Each phase of the initiative will be documented, including the data on health outcomes. Key findings will be shared with the water and sanitation sector as well as other organizations to help raise awareness to address the global water crisis. Merck and Safe Water Network are also exploring employee volunteer opportunities as part of the partnership in the areas of health, behavior change and quality assurance. Merck's commitment complements the work of other global organizations that already bring expertise to various Safe Water Network field projects. About Merck Today's Merck is a global healthcare leader working to help the world be well. Merck is known as MSD outside the United States and Canada. Through our prescription medicines, vaccines, biologic therapies, and consumer care and animal health products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to healthcare through far-reaching policies, programs and partnerships. For more information, visit www.merck.com and connect on Twitter, Facebook and YouTube. The Merck Company Foundation is a U.S.-based, private charitable foundation. Established in 1957 by Merck & Co., Inc., Whitehouse Station, N.J., USA, the Foundation is funded entirely by the company and is its chief source of funding support to qualified non-profit, charitable organizations. Since its inception, The Merck Company Foundation has contributed more than $600 million to support important initiatives that address societal needs and are consistent with the company's overall mission to help the world be well. About Safe Water Network Co-founded in 2007 by actor and philanthropist Paul Newman along with prominent civic and business leaders, Safe Water Network's mission is to develop new solutions that provide safe, affordable water to those in need. Through our field initiatives in India, Ghana and Kenya, we work with the private and public sectors, not for profits, and universities, to develop locally owned and managed water systems that can be broadly replicated. We bring sustained commitment to solving the operating, economic, cultural and environmental challenges to local ownership and management. We also document and share this work through reports, forums and publications. For more information, visit www.safewaternetwork.org and connect on Twitter, Facebook and YouTube. Forward-Looking Statement This news release includes "forward-looking statements" within the meaning of the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995. Such statements may include, but are not limited to, statements about company's plans, objectives, expectations and intentions and other statements that are not historical facts. Such statements are based upon the current beliefs and expectations of Merck's management and are subject to significant risks and uncertainties. Actual results may differ from those set forth in the forward-looking statements. Merck undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward-looking statements can be found in Merck's 2011 Annual Report on Form 10-K and the company's other filings with the Securities and Exchange Commission (SEC) available at the SEC's Internet site (www.sec.gov).

¹ Tate et al. (2009). “Disease and economic burden of rotavirus diarrhoea in India.” Vaccine. Vol. 27, supplement 5. ² “India Failing to Control Open Defecation Blunts Nation’s Growth,” Bloomberg, March 3, 2009. ³ UNICEF and World Health Organization Joint Monitoring Programme. 4 National Family Health Survey 2005‐2006 state report for Andhra Pradesh. 5 National Family Health Survey 2005‐2006 state report for Andhra Pradesh.

# # #

Viruses Are Recruited and Flipped as Cancer Killers

Excerpt from an article in

The New York Times

Tuesday, March 20, 2012

Viruses Are Recruited and Flipped as Cancer Killers

By RACHEL NUWER

THE HYPOTHESIS

Viruses can be designed to attack tumors.

THE INVESTIGATORS

Dr. Robert Martuza, Harvard Medical School; Dr. Bernard Roizman, University of Chicago; Dr. Ian Mohr, New York University.

In 1951, a 4-year-old boy with leukemia contracted chickenpox. His liver and spleen, swollen by the cancer, soon returned to normal, and his elevated blood cell count fell to that of a healthy child.

His doctors at the Laboratory of Experimental Oncology in San Francisco were thrilled by his sudden remission, but the blessing was short-lived. After one month, his leukemia returned and progressed rapidly until the child’s death.

In the early 1900s, not much could be done for cancer patients. Unless surgeons could excise a tumor, the disease typically spelled a swift and inevitable end. But in dozens of published cases over the years, doctors noticed a peculiar trend: Struggling cancer patients sometimes enjoyed a brief reprieve from their malignancies when they caught a viral infection.

It was not a coincidence. Common viruses sometimes attack tumor cells, researchers discovered. For decades, they tried to harness this phenomenon, to transform it into a cancer treatment. Now, after a long string of failures, they are nearing success with viruses engineered to kill cancer.

“It’s a very exciting time,” said Dr. Robert Martuza, chief neurosurgeon at the Massachusetts General Hospital and professor of neuroscience at Harvard Medical School. “I think it will work out in some tumor, with some virus.” Candidates are already in advanced trials, he noted.

Cancer cells are able to replicate wildly, but there’s a trade-off: They cannot ward off infection as effectively as healthy cells. So scientists have been looking for ways to create viruses that are too weak to damage healthy cells yet strong enough to invade and destroy tumor cells. It has been a long, difficult challenge.

Gut Infections Are Growing More Lethal

Excerpt from an article in

The New York Times

Tuesday, March 20, 2012

Gut Infections Are Growing Much More Lethal

By DENISE GRADY

Gastrointestinal infections are killing more and more people in the United States and have become a particular threat to the elderly, according to new data released last week.

Deaths from the infections more than doubled from 1999 to 2007, to more than 17,000 a year from 7,000 a year, the Centers for Disease Control and Prevention reported. Of those who died, 83 percent were over age 65. 

Two thirds of the deaths were caused by a bacterium, Clostridium difficile, which people often contract in hospitals and nursing homes, particularly when they have been taking antibiotics. The bacteria have grown increasingly virulent and resistant to treatment in recent years.

But researchers were surprised to discover that the second leading cause of death from this type of illness was the norovirus. It causes a highly contagious infection, sometimes called winter vomiting illness, that can spread rapidly on cruise ships and in prisons, dormitories and hospitals.

“I think there is perhaps a misperception that norovirus causes a mild illness,” said Aron Hall, an epidemiologist at the disease centers. “But this suggests a major problem that requires some attention.”

Both diseases are spread by the fecal-oral route, meaning that people swallow germs found in feces, often spread by people who did not wash their hands after using the toilet.

Problems with C. difficile are not new: Health officials first began warning in 2004 that a more virulent and drug-resistant strain had emerged. It produces high amounts of two potent toxins that can wreak havoc in cells lining the intestine.

But few people anticipated what gains the bacteria would make. Among hospitalized patients, cases rose to 336,000 in 2009 from 139,000 in 2000. Deaths from the infection seem to have leveled off in the past few years, but researchers say they are still far too high and should be dropping, as other hospital-related infections are.

Estimates of cases occurring outside hospitals run as high as three million annually. Overall, C. difficile infections cost $1 billion a year, according to the disease centers.

Typical Human Influenza A H3N2 Virus in Maryland Cluster

Flu Spotlights

CDC Confirms Typical Human Influenza A H3N2 Virus in Maryland Cluster

March 16, 2012 -- CDC has confirmed that the influenza viruses isolated from the cluster of severe respiratory illness in one family in Maryland are seasonal influenza A H3N2 viruses. Genetic sequencing has confirmed that this is a typical human seasonal H3N2 virus that is more than 99% similar to other H3N2 influenza viruses submitted by the state of Maryland this season. While full antigenic testing is pending, based on genetic sequencing of some of the samples, these viruses are close to the H3N2 component of the 2011-2012 seasonal vaccine such that vaccination should offer protection against these viruses. Testing on the Methicillin-resistant staphylococcus aureus, (MRSA) isolates is ongoing, but preliminary results indicate that some of the MRSA isolates from Maryland are pulsed-field types USA300. Strains from the USA300 MRSA pulsed-field type can cause community MRSA infections including outbreaks of skin infections.
In early March 2012, Maryland reported a cluster of severe respiratory illness in four adults in the same immediate family. Three of the four family members died. The state of Maryland reported that all four people were confirmed to be positive for seasonal influenza A (H3N2) infection by the state Laboratories Administration. MRSA bacterial co-infections are reported to have occurred in at least two of the four patients. More information about the cases in Maryland is available at
http://www.dhmh.maryland.gov/publicrelations/pr.

Bacterial infections can occur as co-infections with influenza or occur after influenza infection. Staphylococcus aureus (staph) is one such bacterial co-infection. Concurrent infection (co-infection) with staph – which is what seems to have occurred in the cluster in Maryland – is a potentially catastrophic complication of influenza that can progress rapidly to serious illness and death.

No formal surveillance is conducted for influenza with bacterial co-infections, however, these are well documented in the literature going back to the 1918 influenza pandemic. While not common, these co-infections have been reported in both children and adults.

The best way to prevent influenza and its complications is an annual influenza vaccine. The United States is experiencing a late influenza season. Activity has only recently begun to increase and may continue for some time. This week’s FluView is reporting 15 states with widespread influenza activity and 5 states with high influenza-like-illness activity. Nationally, the percent of respiratory specimens testing positive for flu is 23 percent. People who have not gotten vaccinated yet this season should get vaccinated now.

More information about influenza is available at the CDC Seasonal Flu website.

More information about Staphylococcus aureus, or MRSA and flu is available at Seasonal Flu and Staph Infections.

More information about MRSA is available at Methicillin-resistant Staphylococcus Aureus (MRSA) Infections.

Gastrointestinal Infection Deaths More Than Doubled

The New York Times
Thursday, March 15, 2012

Gastrointestinal Infection Deaths More Than Doubled 

By DENISE GRADY

Deaths from gastrointestinal infections more than doubled in the United States from 1997 to 2007, to more than 17,000 a year from 7,000 a year, the Centers for Disease Control and Prevention announced Wednesday. The infections cause vomiting and diarrhea. Of those who died, 83 percent were over 65. Two-thirds of the deaths were caused by a bacterium, Clostridium difficile, which people often contract in hospitals and nursing homes, and which has become virulent and resistant to treatment. The second leading cause was the highly contagious norovirus, which has been a scourge on cruise ships and in prisons, dormitories and hospitals.
==========

News Release from KDHE

For Immediate Release March 9, 2012

Miranda Steele, (785) 296-5795

Flu Activity in Kansas Highest Level So Far This Season

TOPEKA, Kan. -Though influenza activity has remained lower than usual in Kansas this season, activity has been steadily increasing over the last several weeks with the latest weekly influenza surveillance report showing Kansas with “widespread” flu-like illness.

For the Centers for Disease Control and Prevention to identify a state as “widespread,” the outbreaks of influenza or increases in influenza-like illness cases and recent laboratory-confirmed influenza are in at least half the regions of the state with recent laboratory evidence of influenza in that state.

The Kansas Department of Health and Environment identified the first laboratory-confirmed influenza cases of the 2011-2012 flu season on Dec. 21. Symptoms of influenza include fever, headache, extreme tiredness, dry cough, and muscle aches. Complications can include pneumonia, ear and sinus infections, and dehydration; influenza may also worsen other chronic conditions.

“Flu activity in Kansas is now widespread and is at the highest level so far this season. Influenza will continue to circulate through spring, so there is still time for people to get a flu vaccination to protect themselves, their families and the community,” said Robert Moser, MD., KDHE Secretary and State Health Officer. “The seasonal influenza types we’ve seen in Kansas are covered by the current vaccine.”

Influenza vaccination is effective for reducing the chances of getting sick and spreading influenza to others. Additional ways to avoid spreading influenza include covering coughs and sneezes, washing your hands and staying home when sick.

All persons six months and older are recommended to receive an annual influenza vaccine. This is especially important for anyone at high risk of complications or who is caring for, or in regular contact with, an infant less than six months of age. Babies this age are too young to be vaccinated and are more vulnerable to the complications from influenza disease. 

On average, five to 20 percent of the U.S. population contracts influenza yearly and more than 200,000 people are hospitalized with complications. Older people, pregnant women, young children, and people with certain health conditions are at high risk for serious complications. Serious complications of the influenza can lead to pneumonia and even death.

For information on receiving the influenza vaccine, please contact your health care provider or the local health department. Find your local health department at http://www.kdheks.gov/olrh/LHD_CntyMap.htm.
Influenza Surveillance can be viewed at www.kdheks.gov/flu/surveillance.htm, and the information reflects data collected for the week ending the previous Saturday.

# # # 

News Release from Pfizer

March 12, 2012 08:59 AM Eastern Daylight Time 

Pfizer’s Prevnar 13^® Shown to be Immunogenic in Older Children and Adolescents

Results from Phase 3 Study Presented at the 8th International Symposium on Pneumococci and Pneumococcal Diseases

NEW YORK--(BUSINESS WIRE)--Pfizer Inc. (NYSE:PFE) announced today that data from a Phase 3 study of Prevnar 13^®*(Pneumococcal 13-valent Conjugate Vaccine [Diphtheria CRM₁₉₇ Protein]) met all study endpoints, showing immunogenicity and establishing a safety profile in children and adolescents aged 5 through 17 years. These data, which are being presented today during the 8th International Symposium on Pneumococci and Pneumococcal Diseases (ISPPD) in Iguacu Falls, Brazil, will support planned regulatory submissions seeking to expand the Prevnar 13 label in the United States, the European Union, and other countries around the world.

Vaccine immunogenicity and safety were evaluated in the Phase 3, open-label trial of 598 healthy children, including children aged 5 to 10 years who had previously been vaccinated for the prevention of invasive pneumococcal disease with Prevnar^® (Pneumococcal 7-valent Conjugate Vaccine [Diphtheria CRM₁₉₇ Protein]), the original version of the vaccine, and vaccine-naïve children and adolescents aged 10 through 17 years.

“As a global leader in pneumococcal disease prevention, we are excited about the potential to further define the clinical utility of Prevnar 13 with the aim of seeking to broaden prevention efforts to additional age groups,” says Emilio Emini, PhD, chief scientific officer, Vaccine Research, Pfizer Inc. “While pneumococcal disease most often strikes younger children, older children and adolescents who have certain medical conditions are also at heightened risk for contracting the disease.”

The primary objective of this study was to assess the pneumococcal immune responses induced by Prevnar 13 when measured one month after vaccination in each of the age groups. The safety objective of the study was to evaluate the safety profile of Prevnar 13 as measured by the incidence rates of local reactions, systemic events, and adverse events. The most common adverse events after vaccination were cough, headache, vomiting, fever, sore throat, influenza and sinusitis.

The data (late-breaker poster #881) will be presented at ISPPD during the daily poster viewing sessions.

About Prevnar 13

Prevnar 13, which is based on the scientific foundation and proven experience of Prevnar, offers the broadest coverage of any pneumococcal conjugate vaccine. Prevnar 13 was first introduced for use in infants and young children in December 2009 in Europe and is now approved for such use in more than 110 countries worldwide. The most widely used pneumococcal conjugate vaccine in the world, Prevnar 13 is part of the routine immunization program in more than 50 countries.