H5N1

ECDC: Influenza activity in Europe, week 10

Via ECDC: Substantial influenza activity in Europe but many countries report declining transmission: ECDC weekly monitoring. Click through to download the report and use other links. The summary:

During week 10, 18 of the 27 countries reporting indicated wide geographic spread on influenza, 16 of which also reported high/medium-intensity transmission, states the Weekly influenza surveillance overview. Only one country reported an increasing trend, and 19 countries reported a decreasing trend in influenza activity. 

Virological surveillance shows that the overall proportion of influenza-positive cases among sentinel specimens continues to remain high (54%), but it has decreased from the peak observed in early February. 

Since week 40/2012, 48% of sentinel specimens positive for influenza virus have been of type A and 52% of type B. The proportion of A(H1)pdm09 has remained at about 60% of subtyped type A viruses. 

ECDC published its annual risk assessment for seasonal influenza 2012-13 in early February based on data up to week 3/2013.

France: Flu epidemic this year "more intense" than usual

Thanks to Lucie Lecomte for sending the link to this FranceInfo.fr report: The flu epidemic this year is "more intense" than usual. Excerpt, Google-translated from French:

More than half a million people in consultation for the flu last week, according to figures from the Institute of Health Surveillance. Epidemic this winter is particularly long. This is the eighth week, and a crisis was open to the Public Assistance Hospitals of Paris, to manage the increase in hospitalizations.

But click through to see the map, which makes the point very dramatically.

ECDC: Seasonal influenza transmission in Europe

ECDC has published Seasonal influenza transmission in Europe. Click through to download the full report as a PDF. Excerpt from the summary:

Today ECDC publishes its risk assessment on the 2012/13 seasonal influenza epidemics in Europe. Epidemics started earlier than in the previous season and western Europe and Scandinavia were the first affected areas.  

To date, south-western European countries (Spain and Portugal) have been less affected. ECDC advises central and eastern Europe to continue preparing for a similar pattern of transmission and intensity to that seen in western Europe and Scandinavian countries. Overall, this year there is no clear dominance of any particular influenza viruses. 

ECDC has produced an annual risk assessment of the seasonal influenza epidemics in Europe since the 2010/11 season following the model developed by ECDC during the 2009 pandemic. It gives an early description of the influenza season in the countries affected earliest, providing guidance and information to countries that are affected later, as influenza progresses across Europe over several months. It describes any specifics of the season, particularly in areas where public health or clinical actions are envisaged, as well as highlights areas of uncertainty where further work is required.   

Marc Sprenger, director of ECDC said: “Influenza has to be taken seriously – each year, around 10% of the population is infected and influenza-related complications cause hundreds of thousands of hospitalisations across Europe. ECDC takes this very seriously which is why we work closely with our partners and countries across Europe to gather and share information as quickly as possible. 

"ECDC is thankful to its partners such as WHO Regional Office for Europe and European countries that gather and share information as quickly as possible throughout influenza season. This allows us all to recognise influenza patterns early which gives countries involved the best opportunity to plan resources and hopefully reduce the burden of the disease.” 

The proportions of type A and type B viruses have been fairly even. The A(H3N2), A(H1N1)   and both lineages of B viruses are all circulating though with different countries reporting different dominant viruses. 

This pattern differs from what is observed in North America where influenza A(H3N2) viruses have been predominating among the A viruses. In other northern hemisphere countries outside Europe the intensity of influenza activity is high, but heterogeneous.

Canada: Nine deaths in Newfoundland attributed to influenza

Via The Telegram: Nine deaths in province attributed to influenza. Excerpt:

Widespread influenza activity is still being reported across Newfoundland, with more than 400 lab-confirmed cases and nine deaths so far this flu season. 

The latest weekly influenza report from the Department of Health and Community Services shows a total of 149 confirmed flu cases for the latest week for which figures are available —Jan. 13-19. For that one-week alone, there were 50 hospitalizations, five intensive care unit (ICU) admissions and four deaths. 

To date this flu season, which began in August 2012, there have been 408 lab-confirmed cases in the province, involving 138 hospitalizations, 16 ICU admissions and nine deaths. 

While influenza activity is considered sporadic in Labrador, it's still categorized as widespread across the island. 

The Department of Health report says the number of laboratory-confirmed cases recently increased significantly in Central Health and Western Health, with a stabilization of cases in Eastern Health.

Sudanese refugees: winter diseases emerging, no medicines

Via Radio Dabanga: Sudanese refugees: winter diseases emerging, no medicines. Excerpt:

Sudanese refugees living on camp Touloum in eastern Chad are complaining about the emergence of “winter diseases” and the sharp scarcity of medicines. 

Haider Suleiman Gardia, head of the camp, urged the health organization CWF to return to Touloum and “assume its duties during the winter period”, when speaking to Radio Dabanga on Sunday. 

He said the flu is spreading especially among children and the elderly amid the acute shortage in medicine.    

As a result, the camp’s population is not able to perform their work as well as they used to, Gardia pointed out.  

Another Radio Dabanga report says a mysterious disease has killed 15 donkeys in a Sudanese refugee camp in Chad. This is a crisis because the donkeys are the only way the refugees can use to travel to their farms and to collect firewood.

ECDC: Monitoring current threats, week 2

Via ECDC: Monitoring current threats, week 2. Click through to download the full report as a PDF. The summary:

During week 2 of 2013, from 6-12 January, ECDC monitored several communicable disease outbreaks that may pose a threat in EU countries. 

The weekly Communicable Disease Threats Report (CDTR) reported increasing seasonal influenza in a number of European countries, especially in north-western Europe. 

Sixteen European countries have reported increasing trend of influenza transmission. Medium intensity of influenza transmission is reported by eleven countries, and one country reports high intensity. The virological pattern seen in Europe is different from that in North America.

Canada: Flu hits Calgary

Via the Calgary Herald: Nasty flu bug bites Calgarians hard: 'Even my eyeballs hurt,' says patient. Excerpt:

While most of us rang in the New Year with good cheer, other not-so-lucky Calgarians started off 2013 with visits to their doctor’s office, walk-in clinics and hospital emergency departments, seeking respite from what’s been described by its victims as one of the nastier influenza strains to hit in years. 

A widespread outbreak in this city, combined with a surge in Norovirus cases, has packed Calgary hospitals to the point where nearly a dozen surgeries so far have had to be cancelled to cope with the deluge. 

While Calgary has more than 300 confirmed cases of influenza, hospitals in some areas of the province are reporting a quadrupling of those with flu symptoms coming to their emergency departments. 

Such chaos is also occurring south of the border, with hospitals across the United States reporting an earlier and bigger-than-usual surge in patients complaining of flu-like symptoms. One hospital in Pennsylvania was so overcapacity that it set up a tent outside its emergency department to tend to patients. 

On Wednesday, the city of Boston declared a public health emergency due to an influx of patients. On Tuesday, the situation here came to a boiling point when precautions by 23 long-term care facilities in the city meant seniors who had been treated for the highly contagious Norovirus couldn’t immediately return to their homes. Hospital hallways have been pressed into service to provide places for them to sleep. 

The crisis has led Alberta Health Services officials to remind Calgarians the flu is a virus that in all but the more severe cases is best treated at home. They’re urging those worried about their symptoms to seek out their family doctor, walk-in clinic or urgent care centre so as not to overburden hospitals.

Hong Kong: Flu activity at baseline level

Via the Hong Kong government website: Flu activity at baseline level. Translation: Flu activity is about to rise. The whole report: 

Influenza activity is at the baseline level, according to the latest surveillance data of the Centre for Health Protection.   

The weekly number of influenza detections at the Public Health Laboratory Centre was 48 in the week ending January 5, as compared to 40, 41 and 45 in the preceding three weeks.

The weekly influenza-like illness consultation rates for sentinel general out-patient clinics and private doctors were 1.9 and 34.2 in the week ending January 5, which were also at the baseline level.   

The current circulating influenza viruses consisted mainly of influenza A(H3N2) at 56.2%, influenza A(H1N1)2009 at 41.7%, and influenza B at 2.1%.   

The viruses were similar to those currently circulating in the US and match well with the vaccine viruses in Hong Kong.   

As the influenza season is expected to begin in the coming weeks, target groups are advised to receive influenza vaccinations as soon as possible to protect their health.

US: Tracking flu on Google

Via Slate: Flu shot time? Google Flu Trends predicts worst season on record. Excerpt:

By the CDC’s latest “outpatient surveillance” estimates, roughly 5.6 percent of Americans visiting the doctor are reporting respiratory illnesses, or flu-like symptoms. That’s a large number, significantly higher than the national baseline of 2.2 percent or the 2.3 percent peak of last year’s mild flu season. 

But it’s not entirely out of the ordinary. The figure approached 6 percent in the moderately severe 2007-2008 season and topped out at 7.7 percent in October 2009 in the midst of the H1N1 pandemic. 

But here’s the thing: The CDC’s current estimates aren’t all that current. Because they are based on after-the-fact reports from more than 3,000 health care providers around the country, the numbers can tell us only how many people were suffering from the flu a couple weeks ago. Today’s CDC FluView figures, for instance, come from the week of Dec. 23. We won’t know until Friday how many people visited the doctor with respiratory symptoms during the week that began on Dec. 30. 

That’s where Google comes in. In fall 2008, the company’s charitable arm, Google.org, unveiled Flu Trends, a site that scans millions of Google searches from around the world to track flu activity in near real time. 

According to a study published in Nature in February 2009, the system can detect outbreaks nearly two weeks before they show up in the official CDC reports. And the site can tell you on any given day what countries, states, and even cities are likely seeing the largest number of cases. 

Today, Flu Trends is painting a foreboding picture. On a global scale of green (minimal flu activity) to bright red (intense flu activity), the United States is the reddest country in the world. Zoom in, and the red stretches are almost unbroken across the country’s eastern two-thirds. (Hang in there, Connecticut!) Boston, New York, Philadelphia, Houston, and Denver are among a slew of cities tagged with the “intense” rating.

UK: Flu activity update for January 10

Via HPA: Flu activity update: 10 January 2013. Excerpt:

Latest figures from the Health Protection Agency (HPA) up to 6 January 2013 show that flu activity remain at similar levels to those reported in the previous week based on a number of indicators, including GP consultation rates in England and the proportion of calls to NHS direct. 

The latest figures show that GP consultation rates have decreased slightly from 32.7 per 100,000 in week 52 ending on 30 December to 29.2 on week 1 ending 6 January 2013. Meanwhile, 2.0% of the calls received by NHS Direct concerned influenza compared to 2.1% in week 52. 

In week 1 (ending 6 January 2013), the weekly primary care ILI consultation rate decreased in England (29.2 per 100,000) and increased in Wales (33.0 per 100,000), Scotland (46.3 per 100,000) and Northern Ireland (87.0 per 100,000). 

Dr Richard Pebody, head of seasonal flu surveillance at the HPA said: 

“The flu activity has remained similar to last week across several of our indicators in line with the trend we expect to see at this time of year. 

“However, the latest data should be interpreted with caution due to GP practices being closed on the bank holidays which may have impacted on GP consultation rates."