30 Jul 2015

#USA, #Flesh-eating #bacteria kills #Virginia #fisherman [#Vibrio Vulnificus] (Channel News Asia, July 30 2015)

[Source: Channel News Asia, full page: (LINK).]

Flesh-eating bacteria kills Virginia fisherman [      ]

POSTED: 30 Jul 2015 02:55

REUTERS: A Virginia fisherman stabbed by a catfish barb has died of a flesh-eating bacteria, a state health official said on Wednesday.




New #CDC #Laboratory #Study Suggests #US #H5 #BirdFlu #Viruses Currently Pose Low #Risk to #People (@CDCgov, July 30 2015)

[Source: US Centers for Disease Control and Prevention (CDC), full page: (LINK).]

New CDC Laboratory Study Suggests U.S. H5 Bird Flu Viruses Currently Pose Low Risk to People [      ][      ]

Language: [ English | Español ]


A new CDC study describes findings from a series of CDC laboratory experiments designed to improve understanding of the human health risk posed by two H5 bird flu viruses detected in birds in the United States: H5N2 and H5N8.

Findings of this study indicate that the H5N2 and H5N8 bird flu viruses detected in the United States were less lethal in mammals and replicated (made copies of themselves during infection) at a lower level than the H5 bird flu viruses from Asia that have caused infections, serious illness and deaths in people.

Overall findings suggest that these new U.S. bird flu viruses are unlikely to easily infect or spread between people in their current form and are likely to be associated with mild to moderate illness compared to the more severe illness associated with Asian H5 viruses.

These U.S. bird flu viruses would need to undergo additional changes in order to pose a pandemic health risk to people.

This study, published today in the Journal of Virology, involved a combination of laboratory tests, some of which included animals and others that involved human lung cells grown in the laboratory via cell culture.

CDC often uses such tests to infer how newly detected flu viruses can impact human health. These studies are part of a routine public health risk assessment process that CDC undertakes whenever a new virus with pandemic potential is identified.

Experiments conducted in this study include the following:

  • tests in mice to determine the severity of disease associated with these viruses,
  • tests in ferrets to determine characteristics of how these viruses spread between mammals and within the body, and
  • tests using cell culture to measure the ability of these viruses to grow in human airway/lung cells (specifically human airway epithelial Calu-3 cells) in a laboratory setting.

Results in mice showed that mice infected with these viruses did not experience severe disease unless given very high doses of the virus.

Virus was detectable in the lungs of mice, though, which is a characteristic that can be associated with more serious illness.

However, compared to Asian H5 viruses, these U.S. H5 bird flu viruses demonstrated less severe, more moderate disease characteristics.

Health researchers consider mice to be a reliable model for how disease associated with H5 bird flu viruses develops and progresses in mammals.

Transmission experiments involving ferrets showed that these U.S. H5 bird flu viruses did not spread between flu naïve ferrets (i.e., ferrets that had never been exposed to flu viruses previously) placed in the same cage as infected ferrets.

This indicates that the virus is unlikely to spread efficiently among people, if they were to become infected by close contact with H5N2- or H5N8-infected poultry.

Also, illness in the infected ferrets was generally mild, and the viruses did not spread systemically to multiple organs, which is a characteristic associated with more severe disease.

These results are consistent with previous studies of H5N8 bird flu viruses in South Korea, which also showed low to moderate virulence in mammals.

Ferrets are considered an excellent model for studying flu transmission and they also exhibit signs of disease that are similar to people infected with the flu.

Researchers also evaluated the ability of these bird flu viruses to replicate in human lung cells in laboratory experiments involving cell culture. The ability of a virus to infect human lung and airway cells is a trait that can be associated with more severe illness. These tests showed that H5N2 and H5N8 viruses replicated in human lung and airway cells at significantly lower levels compared to the Asian H5N1 viruses that have caused human deaths in Asia and elsewhere. While replication did occur, it was at a level comparable to human seasonal H1N1 flu virus.

Outbreaks in birds of H5N2, H5N8 and a new H5N1 bird flu virus were detected in the United States first in late 2014. Both of the bird flu viruses involved in this study were detected in Washington State: the H5N8 bird flu virus was obtained from an infected gyrfalcon and the H5N2 virus was obtained from a northern pintail duck. Most of the U.S. poultry outbreaks reported this year have been associated with the H5N2 virus, resulting in the loss of nearly 50 million chickens and turkeys on over 200 farms since the virus was first identified in December 2014. No human infections with these viruses have been detected at this time.

These findings reaffirm CDC’s current assessment that these viruses pose a low risk to the general public. CDC will continue to closely monitor and assess the risk of these viruses to human health as part of its routine pandemic preparedness responsibilities and activities.

This study is available for online viewing via the Journal of Virology. The latest information and guidance related to H5 bird flu viruses detected in the United States is available from the CDC H5 Viruses in the United States( website.



#Human #dendritic #cell response signatures distinguish 1918, #pandemic and #seasonal #H1N1 #influenza #viruses (J Virol., abstract, edited)

[Source: Journal of Virology, full page: (LINK). Abstract, edited.]

Human dendritic cell response signatures distinguish 1918, pandemic and seasonal H1N1 influenza viruses [      ]

Boris M. Hartmann a,b, Juilee Thakar c, Randy A. Albrecht d,g, Stefan Avey e, Elena Zaslavsky a,b, Nada Marjanovic a, Maria Chikina a, Miguel Fribourg a, Fernand Hayot a,b, Mirco Schmolke f, Hailong Meng c, James Wetmur d, Adolfo García-Sastre d,g,h, Steven H. Kleinstein c,e# and Stuart C. Sealfon a,b#

Author Affiliations: Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USAa Center for Translational Systems Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USAb Department of Pathology, Yale School of Medicine, New Haven, CT 06510, USAc Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USAd Interdepartmental Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT 06510, USAe Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, CH-1211, Switzerlandf Global Health & Emerging Pathogens Institute at Icahn School of Medicine New York, NY 10029, USAg Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USAh



Influenza viruses continue to present global threats to human health. Antigenic drift and shift, genetic reassortment, and cross-species transmission generate new strains with differences in epidemiology and clinical severity. We compared the temporal transcriptional responses of human dendritic cells (DC) to infection with two pandemic (A/Brevig Mission/1/1918, A/California/4/09) and two seasonal (A/New Caledonia/20/99, A/Texas/36/1991) H1N1 influenza viruses. Strain-specific response differences included stronger activation of NFκB following infection with A/New Caledonia/20/99 and a unique cluster of genes expressed following infection with A/Brevig Mission/1/1918. A common anti-viral program showing strain-specific timing was identified in the early DC response and found to correspond with reported transcript changes in blood during symptomatic human influenza infection. Comparison of the global response to the seasonal and pandemic strains showed that a dramatic divergence occurred after 4 h, with only the seasonal strains inducing widespread mRNA loss.



Continuously evolving influenza viruses present a global threat to human health however, these host responses display strain-dependent differences that are incompletely understood. Thus we conducted a detailed comparative study comparing the immune response of human DC to infection with two pandemic and two seasonal H1N1 influenza strains. We identified in the immune response to viral infection both common, but also strain specific, features. Among the stain specific elements were a time shift of the ISG response, selective induction of NFκB signaling by one of the seasonal strains and massive RNA degradation as early as 4 hours post-infection by the seasonal, but not the pandemic, viruses. These findings illuminate new aspects that characterize the distinct differences in the immune response to pandemic or seasonal influenza viruses.



#Adress correspondence to Stuart C. Sealfon, or Steven H. Kleinstein,

Copyright © 2015, American Society for Microbiology. All Rights Reserved.



#Pathogenesis and #transmission of novel HP #Avian #Influenza #H5N2 and #H5N8 #viruses in #ferrets and mice (J Virol., abstract, edited)

[Source: Journal of Virology, full page: (LINK). Abstract, edited.]

Pathogenesis and transmission of novel HPAI H5N2 and H5N8 avian influenza viruses in ferrets and mice [      ]

Joanna A. Pulit-Penaloza, Xiangjie Sun,  Hannah M. Creager, Hui Zeng, Jessica A. Belser, Taronna R. Maines and Terrence M. Tumpey #

Author Affiliations: Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333



A novel highly pathogenic avian influenza (HPAI) H5N8 virus, first detected in January 2014 in poultry and wild birds in South Korea, has spread throughout Asia and Europe, and caused outbreaks in Canada and the United States by the end of the year. The spread of H5N8 and the novel reassortant viruses, H5N2 and H5N1 (H5Nx), in domestic poultry across multiple states in the U.S. pose a potential public health risk. To evaluate the potential of cross-species infection, we determined the pathogenesis and transmissibility of two Asian-origin H5Nx viruses in mammalian animal models. The newly isolated H5N2 and H5N8 viruses were able to cause severe disease in mice only at high doses. Both viruses replicated efficiently in the upper and lower respiratory tracts of ferrets; however clinical symptoms were generally mild and there was no evidence of systemic dissemination of virus to multiple organs. Moreover, these influenza H5Nx viruses lacked the ability to transmit between ferrets in a direct contact setting. We further assessed viral replication kinetics of the novel H5Nx viruses in a human bronchial epithelium cell line, Calu-3. Both H5Nx viruses replicated to a level comparable to a human seasonal H1N1 virus, but significantly lower than a virulent Asian-lineage H5N1 HPAI virus. Although the recently isolated H5N2 and H5N8 viruses displayed moderate pathogenicity in mammalian models, their ability to rapidly spread among avian species, reassort, and generate novel strains underscores the need for continued risk assessment in mammals.



In 2015, highly pathogenic avian influenza (HPAI) H5 viruses have caused outbreaks in domestic poultry in multiple U.S. states. The economic losses incurred with H5N8 and H5N2 subtype virus infection have raised serious concerns for the poultry industry and the general public due to the potential risk of human infection. This recent outbreak underscores the need to better understand the pathogenesis and transmission of these viruses in mammals, which is an essential component of pandemic risk assessment. This study demonstrates that the newly isolated H5N2 and H5N8 viruses lacked the ability to transmit between ferrets and exhibited low to moderate virulence in mammals. In human bronchial epithelial (Calu-3) cells, both H5N8 and H5N2 viruses replicated to a level comparable to a human seasonal virus, but significantly lower than a virulent Asian-lineage H5N1 (A/Thailand/16/2004) virus. The results of this study are important for the evaluation of public health risk.



#Corresponding Author: Terrence M. Tumpey, Influenza Division, MS G-16, 1600 Clifton Rd. NE, Atlanta, GA 30333, Tel: 404-639-5444404-639-5444, Fax: 404-639-2350, Email:

Copyright © 2015, American Society for Microbiology. All Rights Reserved.



#Efficacy and Long-Term #Safety of a #Dengue #Vaccine in Regions of Endemic Disease (N Engl J Med., abstract, edited)

[Source: The New England Journal of Medicine, full page: (LINK). Abstract, edited.]

Original Article

Efficacy and Long-Term Safety of a Dengue Vaccine in Regions of Endemic Disease [      ]

Sri Rezeki Hadinegoro, M.D., Ph.D., Jose Luis Arredondo-García, M.D., Maria Rosario Capeding, M.D., Carmen Deseda, M.D., Tawee Chotpitayasunondh, M.D., Reynaldo Dietze, M.D., H.I. Hj Muhammad Ismail, M.B., B.S., Humberto Reynales, M.D., Ph.D., Kriengsak Limkittikul, M.D., Doris Maribel Rivera-Medina, M.D., Huu Ngoc Tran, M.D., Ph.D., Alain Bouckenooghe, M.D., Danaya Chansinghakul, M.D., Margarita Cortés, M.D., Karen Fanouillere, M.Sc., M.P.H., Remi Forrat, M.D., Carina Frago, M.D., Sophia Gailhardou, Pharm.D., Nicholas Jackson, Ph.D., Fernando Noriega, M.D., Eric Plennevaux, Ph.D., T. Anh Wartel, M.D., Betzana Zambrano, M.D., and Melanie Saville, M.B., B.S. for the CYD-TDV Dengue Vaccine Working Group

July 27, 2015 / DOI: 10.1056/NEJMoa1506223




A candidate tetravalent dengue vaccine is being assessed in three clinical trials involving more than 35,000 children between the ages of 2 and 16 years in Asian–Pacific and Latin American countries. We report the results of long-term follow-up interim analyses and integrated efficacy analyses.


We are assessing the incidence of hospitalization for virologically confirmed dengue as a surrogate safety end point during follow-up in years 3 to 6 of two phase 3 trials, CYD14 and CYD15, and a phase 2b trial, CYD23/57. We estimated vaccine efficacy using pooled data from the first 25 months of CYD14 and CYD15.


Follow-up data were available for 10,165 of 10,275 participants (99%) in CYD14 and 19,898 of 20,869 participants (95%) in CYD15. Data were available for 3203 of the 4002 participants (80%) in the CYD23 trial included in CYD57. During year 3 in the CYD14, CYD15, and CYD57 trials combined, hospitalization for virologically confirmed dengue occurred in 65 of 22,177 participants in the vaccine group and 39 of 11,089 participants in the control group. Pooled relative risks of hospitalization for dengue were 0.84 (95% confidence interval [CI], 0.56 to 1.24) among all participants, 1.58 (95% CI, 0.83 to 3.02) among those under the age of 9 years, and 0.50 (95% CI, 0.29 to 0.86) among those 9 years of age or older. During year 3, hospitalization for severe dengue, as defined by the independent data monitoring committee criteria, occurred in 18 of 22,177 participants in the vaccine group and 6 of 11,089 participants in the control group. Pooled rates of efficacy for symptomatic dengue during the first 25 months were 60.3% (95% CI, 55.7 to 64.5) for all participants, 65.6% (95% CI, 60.7 to 69.9) for those 9 years of age or older, and 44.6% (95% CI, 31.6 to 55.0) for those younger than 9 years of age.


Although the unexplained higher incidence of hospitalization for dengue in year 3 among children younger than 9 years of age needs to be carefully monitored during long-term follow-up, the risk among children 2 to 16 years of age was lower in the vaccine group than in the control group. (Funded by Sanofi Pasteur; numbers, NCT00842530, NCT01983553, NCT01373281, and NCT01374516.)



#Ebola in the #US — #Public #Reactions and #Implications (N Engl J Med., extract)

[Source: The New England Journal of Medicine, full page: (LINK). Extract.]


Ebola in the United States — Public Reactions and Implications [      ]

Gillian K. SteelFisher, Ph.D., Robert J. Blendon, Sc.D., and Narayani Lasala-Blanco, Ph.D.

July 29, 2015 / DOI: 10.1056/NEJMp1506290


Although there had been only two cases of Ebola transmission inside the United States and both patients had survived, a November 2014 opinion poll revealed that the U.S. public ranked Ebola as the third-most-urgent health problem facing the country — just below cost and access and higher than any other disease, including cancer or heart disease, which together account for nearly half of all U.S. deaths each year (see Table S1 in the Supplementary Appendix, available with the full text of this article at




#Community #Trust and the #Ebola #Endgame (N Engl J Med., extract)

[Source: The New England Journal of Medicine, full page: (LINK). Extract.]


Community Trust and the Ebola Endgame [      ]

Ranu S. Dhillon, M.D., and J. Daniel Kelly, M.D.

July 29, 2015 / DOI: 10.1056/NEJMp1508413


Six-year-old Fatou was exposed to Ebola at her uncle's funeral in Forécariah, a district along Guinea's border with Sierra Leone where about 50% of all Guinea's Ebola cases since February 2015 have occurred.1 Fatou's entire family was registered as contacts to be monitored for the next 21 days, during which the disease could develop.




S. #Korea reported no new #MERS-CoV cases in the last 24 hours (MoH, July 30 2015, extract, edited)

[Source: South Korea Ministry of Health, full page: (LINK). Automatic translation, extract, edited.]

S. #Korea reported no new #MERS-CoV cases in the last 24 hours [      ]

(July 30 2015)


Middle East respiratory Syndrome Daily Tracking Report

  • 12 patients are currently under treatment (6.4%), 138 patients recovered and discharged from hospital (74.2%), 36 patients died (19.4%), cumulative number of confirmed cases: 186.
  • In the last 24 hours: no new recoveries, no new deaths and no new confirmed cases have been reported.
  • The last confirmed case was recorded on July 4; no close contacts are currently under surveillance.
  • Of the 12 patients under treatment: 9 are in stable condition, 3 are critical.




29 Jul 2015

#Influenza at the #human–#animal interface–#Summary and #assessment as of 17 July 2015 [#avian #influenza #H5N1 & #H7N9] (@WHO, July 29 2015, edited)

[Source: World Health Organization, full PDF file: (LINK). Edited.]

Influenza at the human-animal interface - Summary and assessment as of 17 July 2015 [      ]


Human infection with avian influenza A(H5) viruses

From 2003 through 17 July 2015, 844 laboratory-confirmed human cases of avian influenza A(H5N1) virus infection have been officially reported to WHO from 16 countries. Of these cases, 449 have died.

Since the last WHO Influenza update on 23 June 2015, two new fatal laboratory-confirmed human cases of avian influenza A(H5N1) virus infection were reported to WHO from Egypt.

A 40-year-old male from Sohag governorate had an onset of illness on 14 June, was hospitalized on 16 June, but passed away on 22 June 2015. The likely source of exposure to the virus for this case was either direct exposure to poultry or indirect exposure via a contaminated environment.

A five and a half-year-old male from Aswan governorate, with illness onset on 16 June was hospitalized on 24 June, but passed away on 27 June 2015. This case had a history of exposure to poultry. Both cases were given oseltamivir one day after hospitalization.

In addition, one laboratory-confirmed human case of avian influenza A(H5N6) virus infection was reported to WHO from China.

A 37-year-old female from Yunnan province had an onset of illness on 6 July, was hospitalized on 9 July, but passed away on 10 July. There was no evidence of human-to-human transmission of this virus among the close contacts of this case.

Various influenza A(H5) subtypes, such as influenza A(H5N1), A(H5N2), A(H5N3), A(H5N6) and A(H5N8), continue to be detected in birds in West Africa, Asia, Europe, and North America, according to reports received by OIE.

Although these influenza A(H5) viruses might have the potential to cause disease in humans, so far no human cases of infection have been reported, with exception of the human infections with influenza A(H5N1) viruses and the four human infections with influenza A(H5N6) virus detected in China since 2014.


Overall public health risk assessment for avian influenza A(H5) viruses:

Whenever avian influenza viruses are circulating in poultry, sporadic infections and small clusters of human cases are possible in people exposed to infected poultry or contaminated environments, therefore sporadic human cases would not be unexpected.

With the rapid spread and magnitude of avian influenza outbreaks due to existing and new influenza A(H5) viruses in poultry in areas that have not experienced this disease in animals recently, there is a need for increased vigilance in the animal and public health sectors.

Community awareness of the potential dangers for human health are essential to prevent infection in humans. Surveillance should be enhanced to detect human infections if they occur and to detect early changes in transmissibility and infectivity of the viruses.


Human infection with other non-seasonal influenza viruses

Human infections with avian influenza A(H7N9) viruses in China

A total of 677 laboratory-confirmed cases of human infection with avian influenza A(H7N9) viruses, including at least 275 deaths1, have been reported to WHO.

The majority of recently reported human cases are associated with exposure to infected live poultry or contaminated environments, including markets where live poultry are sold.

Influenza A(H7N9) viruses continue to be detected in poultry and their environments in the areas where human cases are occurring. There have been no major genetic changes in the viruses isolated from recent patients compared to previously-isolated viruses from humans. Information to date suggests that these viruses do not transmit easily from human to human.


Overall public health risk assessment for avian influenza A(H7N9) viruses:

Overall, the public health risk from avian influenza A(H7N9) viruses has not changed since the assessment of 23 February 2015.


Please find the most updated information at



1 The total number of fatal cases is published on a monthly basis by China National Health and Family Planning Commission.



Live #animal #markets in #Minnesota: a potential #source for emergence of novel #influenza A #viruses and #interspecies #transmission (Clin Infect Dis., abstract, edited)

[Source: Clinical Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Live animal markets in Minnesota: a potential source for emergence of novel influenza A viruses and interspecies transmission [      ][      ][      ]

Mary J. Choi 1,*, Montserrat Torremorell 2,*, Jeff B. Bender 2, Kirk Smith 3, David Boxrud 3, Jon R. Ertl 2, My Yang 2, Kamol Suwannakarn 2, Duachi Her 3, Jennifer Nguyen 3, Timothy M. Uyeki 1, Min Levine 1, Stephen Lindstrom 1, Jacqueline M. Katz 1, Michael Jhung 1, Sara Vetter 3, Karen K. Wong 1, Srinand Sreevatsan 2, and Ruth Lynfield 3

Author Affiliations: 1Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA  2University of Minnesota College of Veterinary Medicine, Minnesota Center of Excellence Influenza Research and Surveillance, 1988 Fitch Ave, Rm 385 Anim Sci/Vet Med, St. Paul, MN, USA 3Minnesota Department of Health, 625 Robert Street North, PO Box 64975, St. Paul, MN 55164, USA

Contact information for corresponding author: Dr. Montserrat Torremorell, 1988 Fitch Ave, St. Paul, MN 55108 at

* These authors contributed equally to this work.

Alternate corresponding author: Kirk Smith, 625 Robert Street North, St. Paul, MN 51555-2538 at




Live animal markets have been implicated in transmission of influenza A viruses (IAVs) from animals to people. We sought to characterize IAVs at two live animal markets in Minnesota to assess potential routes of occupational exposure and risk for interspecies transmission.


We implemented surveillance for IAVs among employees, swine, and environment (air and surfaces) during a 12-week period (October 2012–January 2013) at two markets epidemiologically associated with persons with swine-origin IAV (variant) infections. Real-time reverse transcription polymerase chain reaction (rRT-PCR), viral culture, and whole genome sequencing were performed on respiratory and environmental specimens, and serology on sera from employees at beginning and end of surveillance.


Nasal swabs from 11 (65%) of 17 employees tested positive for IAVs by rRT-PCR; seven employees tested positive on multiple occasions and one employee reported influenza-like illness. Eleven (73%) of 15 employees had baseline hemagglutination-inhibition antibody titers ≥40 to swine-origin IAVs, but only one demonstrated a 4-fold titer increase to both swine-origin, and pandemic A/Mexico/4108/2009 IAVs. IAVs were isolated from swine (72/84), air (30/45) and pen railings (5/21). Whole genome sequencing of 122 IAVs isolated from swine and environmental specimens revealed multiple strains and subtype codetections. Multiple gene segment exchanges among and within subtypes were observed, resulting in new genetic constellations and reassortant viruses. Genetic sequence similarities of 99%–100% among IAVs of one market customer and swine indicated interspecies transmission.


At markets where swine and persons are in close contact, swine-origin IAVs are prevalent and potentially provide conditions for novel IAV emergence.


© The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: