Dec 7, 2012 (CIDRAP News) – Influenza is widespread in eight US states, and some other indicators of an early flu season continue to rise, the Centers for Disease Control and Prevention (CDC) said today.
The percentage of patients' respiratory samples testing positive for flu grew to 20.7% in the week ending Dec 1, up from 15.2% the week before. And, as before, the H3N2 strain continues to dominate, which can be a sign of a more severe flu season.
The percentage of flu-positive specimens varied widely by region, from 6.2% in the Southwest to 33.5% in Midwestern states. Southern states also reported percentages above the national average.
The CDC reported three new flu-related deaths in children, bringing the season's total to five. One of those deaths was attributed to influenza B and the other two to influenza A viruses that were not subtyped.
The agency reports geographic spread of flu as assessed by state epidemiologists. This week Alabama, Alaska, Mississippi, New York, North Carolina, Ohio, Rhode Island, and South Carolina reported widespread activity, 15 states reported regional activity, 15 experienced local activity, and 12 had sporadic activity
In its state-by-state summary of influenza-like illness (ILI) activity, the CDC classified four states as having high levels: Alabama, Louisiana, Mississippi, and Texas. Three states are experiencing moderate activity, 6 states low activity, and 37 states minimal activity.
Two other flu indicators, however, are below epidemic thresholds: the proportion of outpatient medical visits for ILI (at 1.9%, below the 2.2% threshold) and pneumonia and influenza mortality (6.5% of all deaths, below the 6.8% threshold).
Of the 1,139 respiratory specimens that tested positive for flu during the week, three fourths were influenza A and one fourth influenza B. Of the 410 flu A viruses that were subtyped, 406 (99%) were H3 and only 4 (1%) were pandemic 2009 H1N1 (pH1N1).
The CDC reported no antiviral-resistant flu isolates, nor were any infections with novel H3N2 viruses found.
In contrast to the US situation, flu activity in the rest of the Northern Hemisphere has picked up only slowly, the World Health Organization (WHO) said in an update.
H3N2 activity in Canada has increased slightly, the agency said, while in Europe flu activity remains low, with only sporadic detections.
Tropical countries seeing slightly increased activity include Honduras, Cambodia, and Sri Lanka, the WHO said. The Southern Hemisphere is reporting only sporadic activity.
Globally, the H3N2 strain also dominates, according to WHO data. Flu A is outpacing flu B 70% to 30%, while H3N2 has accounted for 82% of type A viruses so far this season, compared with 18% for pH1N1.
Flu season could be the worst in nearly a decade
Five children have died from the flu so far this year and health officials are urging people to get vaccinated. “We expect it to accelerate...to get worse before it gets better in the next few weeks,” said a doctor at Le Bonheur Children’s Hospital in Memphis, Tenn. NBC’s Robert Bazell reports.
HHS offers some forecasts on medical countermeasures
Robert Roos News Editor
Dec 11, 2012 (CIDRAP News) – A new report from the US Department of Health and Human Services (HHS) offers a few predictions on when certain new countermeasures against biological threats will become available, including a forecast for two novel influenza drugs and possibly a next-generation anthrax vaccine within the next 5 years.
The 2012 Public Health Emergency Medical Countermeasures (PHEMCE) Implementation Plan outlines expected developments for the next few years for anthrax, smallpox, pandemic flu, botulism, and other bacterial and viral threats.
It says HHS's Biomedical Advanced Research and Development Agency (BARDA) "will support advanced development of at least two drugs with novel mechanisms of action through Phase III clinical studies; two drugs are expected to be approved in the U.S." in fiscal years 2015 to 2017.
The report also says that two more flu antivirals are expected to be approved in the long term, meaning in fiscal 2018 or later.
The report doesn't name the drugs, but BARDA Director Robin Robinson, PhD, noted that one of the antivirals BARDA is supporting is NexBio's Fludase, also known as DAS181. "This product candidate inhibits a cell surface molecule rather than a viral target like currently licensed flu antiviral drugs," he told CIDRAP News.
On Oct 3 BARDA announced a $26.5 million contract for further development of Fludase, saying it could be effective against all known flu strains, including ones resistant to existing antivirals. The major existing US-approved drugs, oseltamivir (Tamiflu) and zanamivir (Relenza), are neuramindase inhibitors, which work by blocking newly hatched viral particles from exiting infected cells.
Robinson said other flu drugs in the pipeline include laninamivir and intravenous zanamivir, both of which are neuraminidase inhibitors. Laninamivir, marketed in Japan under the name Inavir, is a single-dose, long-acting drug given by inhaler. It is also known as CS-8958.
In 2011 BARDA awarded Biota Scientific Management of Melbourne, Australia, a $231 million, 5-year contract to establish manufacturing of laninamivir in the United States and to support clinical trials.
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