Heiman Wertheim, Clinical Microbiologist, Oxford University Clinical Research Unit-Hanoi, Vietnam.
John Spiker, Acting Director General, Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Canada.
Elena Govorkova, Division of Virology, Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA.
David Reedy, F.Hoffmann-La Roche Ltd., Pharmaceuticals Division, Basel, Switzerland
David Fedson, Sergy Haut, France
Manon Cox, COO, Protein Sciences Corp., Meriden, CT, USA
Otfried Kistner, Baxter AG, Donau, Austria
Klaus Stohr, Novartis, USA
Representative from Sanofi-Pasteur, Lyon, France
The third in an annual series of Influenza Symposia, was held at the new John Curtin School of Medical Research Auditorium, Australian National University, Canberra on 4-5th October 2007. The meeting was co-organised by the WHO Collaborating Centre for Influenza (Melbourne) and the TGA. The major sponsor for the meeting was the Office of Health Protection, Department of Health and Ageing, Australian Government.
Over 100 delegates attended the meeting from all over Australia and New Zealand as well as a number of international visitors such as Dr Jackie Katz (CDC, Atlanta, USA), Dr David Fedson (France), Dr Manon Cox (Protein Sciences, USA) and Dr Roland Saenger (GSK, Belgium). Various presentations were given covering seasonal influenza, vaccine development, antivirals and pandemic preparedness. The full program and abstracts for selected talks is available here
Influenza season in 2008 for Australia and New Zealand and the region New (29.8.08)
Influenza activity in Australia has begun to increase in the last few weeks especially in Queensland and South Australia. New Zealand have also reported increased influenza like activity in the past weeks. Much of this activity has been associated with outbreaks of influenza B which have occurred in a number of schools in Australia (Tasmania and in the Northern Territory - Alice Springs) as well as in New Zealand (see below for an extract from AAP). Overall, Australia continues to see a mainly influenza B season with some A(H3) and fewer still A(H1) viruses. In New Zealand A(H3) and B viruses have mainly circulated but there has been a recent surge in influenza B viruses. Of the B viruses that have been tested from Australia and NZ most have been of the B/Yamagata-lineage (the same lineage that is contained in the Australian and New Zealand vaccine for 2008) but there have been an increasing number of recent viruses of the alternative B lineage (B/Victoria-lineage) found recently in Australia and New Zealand. Some of these cases were found at the World Youth Day in Sydney where there were also outbreaks of A(H1) and A(H3) viruses during this week in mid July. Recently cases of A(H1) viruses that are resistant to oseltamivir have been detected in Australia (but not in NZ) with 8 detected in WYD samples and 2 from other parts of Australia. Oseltamivir resistant viruses have also predominated in South Africa during the 2008 winter season. (see the WHO website here for more data). More information of the Australian influenza season can be accessed from the CDNA site (click here) and from the New Zealand season from the ESR website (click here).
Classes continue as virus rampages through school
28 August 2008
AAP General News (Hobart)
Classes are continuing at a Tasmanian school despite a flu outbreak putting several students and a teacher in hospital and causing almost half the school's population to go off sick. The Lauderdale Primary School near Hobart is dealing with a suspected Influenza A epidemic that has affected almost 300 children and staff.
School principal Mike Woods said 271 students and 20 staff, including 11 classroom teachers, were absent today due to the illness. "Most alarmingly it seems to be affecting young children's breathing and several children have been hospitalised, usually overnight, over the last week, as a precaution," Mr Woods said. "We did have a staff member admitted to hospital for a couple of nights as well but she's home now."
Health and education authorities have not suspended classes at the school. Mr Woods said there was no intention of closing the school at this stage. "Head office has given us staff to fill the gaps, and at the moment we are managing," he said. "We are making every attempt to provide a meaningful education program for the kids who are here. "Some parents want the school temporarily closed, fearing a major public health incident is unfolding. Kelly Hoges has a 10-year-old daughter at the school. "How many people do actually have to be sick - or worse - before they actually close it," she told ABC Radio. "What would it hurt to close, contain it, and then reassess the situation because they've got a problem there - it's obvious."
Symptoms of the school's virus, which started spreading at the school 10 days ago, include vomiting, diarrhoea, aches and pains, and headaches. The state's senior medical adviser, Dr Avner Misrachi, today said it was not yet clear what was causing the illness at the school. "We won't know what is causing the flu-like illness affecting Lauderdale Primary School until we get test results back in the next 24 hours," he said. Dr Misrachi said flu was very contagious, and a person could infect others before they even realised they were sick. Only 52 adults and children in Tasmania have been confirmed to have influenza this year, he said. "But there has been an increase in notifications in the last few weeks," he said.
| Above: L to R; Dr Peter Siba, Mr Kevin Rudd, Naomi Komadina | Above: George Koki from IMR loads an agarose gel |
WHO Northern Hemisphere Influenza Vaccine Recommendation for 2008-9 (New 14.3.08)
Listed below is the WHO recommended composition of influenza vaccines for use in 2008-2009 northern hemisphere influenza season, for the full recommendation see here.
It is recommended that vaccines for use in the 2008-2009 influenza season (northern hemisphere winter) contain the following:
— an A/Brisbane/59/2007 (H1N1)-like virus;
— an A/Brisbane/10/2007 (H3N2)-like virus;*
— a B/Florida/4/2006-like virus.#
* A/Brisbane/10/2007 is a current southern hemisphere vaccine virus.
# B/Florida/4/2006 and B/Brisbane/3/2007 (a B/Florida/4/2006-like virus) are
current southern hemisphere vaccine viruses.
(Taken from the WHO website here )
WHO Influenza Vaccine Recommendations for the Southern Hemisphere for 2008 (11.10.07)
Recommended composition of influenza virus vaccines for use in the 2008 southern hemisphere influenza season
It is recommended that vaccines to be used in the 2008 season (southern hemisphere winter) contain the following:
—
an A/Solomon Islands/3/2006 (H1N1)-like virus*;
— an A/Brisbane/10/2007 (H3N2)-like virus;
— a B/Florida/4/2006-like virus.
*A/Solomon Islands/3/2006 is a current vaccine virus
For more information click here
AIVC decision on Influenza vaccine composition for Australia 2008 (11.10.07)
The meeting of the Australian Influenza Vaccine Committee (AIVC) on Influenza Vaccines was held on the 3 October 2007.
The committee considered information on international surveillance by WHO, recent data from Australia, New Zealand, South Africa and Argentina on epidemiology and strain characterisation, and the recommendations of the WHO annual consultation on the composition of influenza vaccine for the Southern Hemisphere, held in Geneva on 17-19 September.
The Committee agreed to adopt the September WHO recommendations. The influenza vaccine components for year 2008 season should contain the following:
A
(H1N1): an A/Solomon Islands/3/2006 (H1N1) - like strain, 15 µg HA per
dose
A (H3N2): an A/Brisbane/10/2007 (H3N2) - like strain, 15 µg HA per dose
B: a B/Florida/4/2006 - like strain, 15 µg HA per dose
The following viruses are suitable vaccine strains:
-
A/Solomon Islands/3/2006 (H1N1) (IVR-145)
- A/Brisbane/10/2007 (H3N2) (IVR-147)
- B/Florida/4/2006 or B/Brisbane/3/2007
- The SRID reference standard reagents for A/Solomon Islands/3/2006 (H1N1) (IVR-145) strain are available from NIBSC (UK).
-
The SRID reference standard reagents for A/Brisbane/10/2007 (H3N2) (IVR-147)
and B/Brisbane/3/2007 will be available from TGA following calibration in December
2007.
TGA website see here
Influenza season in 2007 for Australia and New Zealand (11.10.07)
Influenza activity in Australia has now subsided after a particularly severe season in several states this winter especially in the state of Queensland. Other states such have also had increased activity compared to the last 3 years when influenza activity has been low. There were 6 deaths in children in which influenza A was present and these were all under 5 years of age (3 in WA, 1 each in Victoria, Queenland and NSW). The predominant strain circulating in Australia in 2007 was A(H3) although in Queensland there was an equal mix of A(H3) and A(H1) viruses while H1 viruses have also circulated to a lesser extent other states. In contrast, there were low levels of influenza B activity reported. In New Zealand the the 2007 season has been a relatively mild one and has mainly been due to A(H1) viruses with some A(H3) viruses and few influenza B viruses circulating. No deaths in children were reported. More information of the Australian influenza season can be accessed from the CDNA site (click here) and from the New Zealand season from the ESR website (click here).
Below is an earlier report from the Australian newspaper
The Australian, 14 August 2007
Boy, 2 dies of influenza.
A two-year-old NSW boy has become the sixth child in Australia to die from influenza this year. NSW Health director of communicable diseases Jeremy McAnulty last night said the toddler had died at his parents' home in the state's central west. Preliminary tests show the death was probably caused by the influenza A virus. Five other children -- three in Western Australia, one in Queensland and one in Victoria -- have also died from illness associated with influenza A.
A 37-year-old Queensland man with impaired immunity has also died of flu. "This tragic death is a reminder to all people that NSW and the rest of Australia is experiencing one of the worst flu seasons for some years," Dr McAnulty said. "Influenza is not like a common cold. It affects all ages and deaths in children are very rare," he said. Dr McAnulty said parents should monitor children with influenza symptoms carefully, especially if they have a fever or breathing problems. Queensland's influenza vaccine stockpile has been made available to nursing homes to ensure the worst outbreak in six years does not cause avoidable deaths among the elderly.
Amid confusion over the availability of anti-viral drugs, and community fears of a major influenza outbreak, Queensland Health yesterday made available 40,000 doses of Tamiflu from a stockpile kept in the event of a pandemic. Chief health officer Jeannette Young said the department was working with the Pharmacy Guild to ensure commercial stocks of the anti-viral drugs were available after reports that some chemists were telling customers they had run out of the vaccine. The stockpile has been made available to nursing homes and chemists who have run short.
There were earlier reports in July of 3 influenza-related deaths in toddlers in Western Australia. An extract from Promed is shown below.
INFLUENZA
A DEATHS, CHILDREN - AUSTRALIA (WA)
*********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases <http://www.isid.org>
[1]
Date: Fri 6 Jul 2007
Source: News.com.au, 6 Jul 2007 [edited] <http://www.news.com.au/story/0,23599,22030064-2,00.html>
Deaths
of children in Perth blamed on flu
-----------------------------------------------------
A total of 3 children under 5 years of age have died in Perth, Australia, in
the past few days from what is believed to be a severe form of influenza, the
Western Australian Health Department says. The department is urging parents
to quickly see a doctor if their children show signs of respiratory illness.
Director of Communicable Disease Control, Dr. Paul Van Buynder, said the speed at which the 3 children fell ill was a concern. "While we do not want to create unnecessary panic, it is important for parents to be aware that the disease can cause serious illness within 24 hours," Dr. Van Buynder said. "Parents whose children have cold or flu-like symptoms, including a cough and a fever, should see their general practitioner (GP)." The Health Department is advising all parents of young children to see a doctor for flu vaccination if they have not already done so.
Dr
Van Buynder said one of the children had been identified with having the influenza
A virus, which is covered by this year's flu vaccine, and it was likely all
3 children had that strain of the virus. They had been well and became very
sick within a day, he said.
"It's not about large numbers, it's about that we had 3 children who got
sick very quickly," he said.
Of the children who fell ill in Perth's Princess Margaret Hospital for Children, tests revealed that 2 of them had developed a form of pneumonia. "Samples taken from the 2 children who died in hospital suggested they had secondary bacterial pneumonia. We'll be able to confirm that over the next few days."
Dr.
Van Buynder said the Department was advising parents to see a doctor quickly
if their children developed flu symptoms because secondary chest infections
could usually be stopped with antibiotics. The 3rd child did not receive hospital
treatment.
WHO National Influenza Centres meet in Melbourne (18.5.07)
From the 1-4 May 2007 the National Influenza Centres from the WHO Western Pacific Region and the South East Asian Region met in Melbourne to discuss issues surrounding influenza surveillance and testing as well as participating in a Biosafety Workshop. The meeting was held at the Melbourne University complex at Bio21. Below is a picture of the participants in the meeting. It is planned to have a similar meeting each year in the future.
