Scoping Review on Search Queries and Social Media for Disease Surveillance: A Chronology of Innovation

J Med Internet Res. 2013 Jul 18;15(7):e147.

Bernardo TM, Rajic A, Young I, Robiadek K, Pham MT, Funk JA.

Source

College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States. TheresaBernardo@gmail.com.

Abstract

BACKGROUND:

The threat of a global pandemic posed by outbreaks of influenza H5N1 (1997) and Severe Acute Respiratory Syndrome (SARS, 2002), both diseases of zoonotic origin, provoked interest in improving early warning systems and reinforced the need for combining data from different sources. It led to the use of search query data from search engines such as Google and Yahoo! as an indicator of when and where influenza was occurring. This methodology has subsequently been extended to other diseases and has led to experimentation with new types of social media for disease surveillance.

OBJECTIVE:

The objective of this scoping review was to formally assess the current state of knowledge regarding the use of search queries and social media for disease surveillance in order to inform future work on early detection and more effective mitigation of the effects of foodborne illness.

METHODS:

Structured scoping review methods were used to identify, characterize, and evaluate all published primary research, expert review, and commentary articles regarding the use of social media in surveillance of infectious diseases from 2002-2011.

RESULTS:

Thirty-two primary research articles and 19 reviews and case studies were identified as relevant. Most relevant citations were peer-reviewed journal articles (29/32, 91%) published in 2010-11 (28/32, 88%) and reported use of a Google program for surveillance of influenza. Only four primary research articles investigated social media in the context of foodborne disease or gastroenteritis. Most authors (21/32 articles, 66%) reported that social media-based surveillance had comparable performance when compared to an existing surveillance program. The most commonly reported strengths of social media surveillance programs included their effectiveness (21/32, 66%) and rapid detection of disease (21/32, 66%). The most commonly reported weaknesses were the potential for false positive (16/32, 50%) and false negative (11/32, 34%) results. Most authors (24/32, 75%) recommended that social media programs should primarily be used to support existing surveillance programs.

CONCLUSIONS:

The use of search queries and social media for disease surveillance are relatively recent phenomena (first reported in 2006). Both the tools themselves and the methodologies for exploiting them are evolving over time. While their accuracy, speed, and cost compare favorably with existing surveillance systems, the primary challenge is to refine the data signal by reducing surrounding noise. Further developments in digital disease surveillance have the potential to improve sensitivity and specificity, passively through advances in machine learning and actively through engagement of users. Adoption, even as supporting systems for existing surveillance, will entail a high level of familiarity with the tools and collaboration across jurisdictions.

http://www.ncbi.nlm.nih.gov/pubmed/23896182 

Hong Kong: CHP investigating influenza-like illness outbreak

July 31, 2013
The Centre for Health Protection (CHP) of the Department of Health is today (July 31) investigating an influenza-like illness outbreak at an elderly home in Aberdeen affecting 20 residents and reminds members of the public and staff of institutions to maintain good personal and environmental hygiene against influenza.

     The affected residents, four men and 16 women, aged between 65 and 102, had developed symptoms of upper respiratory tract infection, including fever, coughing, runny nose and sore throat, since July 23.

     Five of them required hospitalisation and all of them are currently in stable condition.
     The respiratory tract specimens of three affected residents tested positive for influenza A.
     Officers of the CHP have visited the elderly home and advised the management to adopt measures against respiratory tract infection.

Continued:  http://www.chp.gov.hk/en/view_content/30331.html

Saudi Arabia Travel Warning Dept. of State Bureau of Consular Affairs

Saudi Arabia

July 25, 2013

Department of State urges U.S. citizens to carefully consider the risks of traveling to Saudi Arabia. As the August 26, 2012, arrest of two terrorist cells by Saudi security authorities indicates, there remains an ongoing security threat due to the continued presence of terrorist groups, some affiliated with al-Qaida, who may target Western interests, housing compounds, hotels, shopping areas, and other facilities where Westerners congregate. These terrorist groups may employ a wide variety of tactics, including small-scale attacks, and may target Saudi government facilities and economic/commercial targets within the Kingdom. This replaces the Travel Warning issued May 18, 2012, to update information on the current security situation in Saudi Arabia and the continuing threat posed by terrorism, and to reiterate recommendations on security awareness.

While the Saudi government has greatly improved the security environment throughout the Kingdom since the major terrorist attack against foreign nationals in 2007, it is important to note that an ongoing security threat remains. U.S. citizens who visit Saudi Arabia are strongly encouraged to carefully select hotels or housing compounds with security measures in place that meet their particular needs. This is a personal and individual decision for the traveler and/or sponsor. In addition, given that terrorists may seek predictable targets, U.S. citizens should always be aware of their surroundings when traveling or visiting commercial establishments frequented by Westerners. U.S. citizens are also advised to keep a low profile, vary times and routes of travel, exercise caution while driving, entering or exiting vehicles, and ensure that travel documents and visas are current and valid.

If the security threat changes or specific threats affecting U.S. citizens are discovered, this information will be made available through the Smart Traveler Enrollment Program (STEP) and U.S. Mission websites. Emergency Messages, Security Messages, and Messages for U.S. Citizens can be found on the U.S. Embassy Riyadh website.

The Department of State encourages U.S. citizens living overseas or planning to travel abroad to enroll in the Smart Traveler Enrollment Program (STEP). By enrolling, U.S. citizens make it easier for the Embassy to contact them in case of emergency. U.S. citizens without internet access may enroll directly with the U.S. Embassy in Riyadh or the Consulates in Dhahran or Jeddah.

http://travel.state.gov/travel/cis_pa_tw/tw/tw_5813.html 

Local & State Officials Attend 2nd Health Summit - One Health Illinois

Tue, 07/30/2013 - 7:00am | Debra Pressey

CHAMPAIGN — It's been four years since the H1N1 virus had folks lining up for an extra flu shot. Should we take the threat of another pandemic seriously?
A local expert says yes, but risk isn't that easy to communicate to the public.
"People stop listening after a while," said Dr. John Herrmann, director of the University of Illinois College of Veterinary Medicine's Center for One Health Illinois.
The center held its first One Health summit in 2010 and will hold its second Thursday in Champaign to update the health of Illinois' human, animal and ecosystem communities and develop an action plan.
Local and state human- and animal-health experts will be attending the summit. It isn't open to the public.
Like H1N1 — which originated in swine — the next pandemic will more than likely originate in an animal and spread to people.
International travel makes pandemics a threat to take seriously in the U.S. So does residential and agricultural sprawl that keeps encroaching on more wildlife areas, Herrmann said.
"We're getting pets and people exposed to things we haven't developed resistance for," he said.
One current concern (but not a current international emergency) is the viral illness known as Middle East respiratory syndrome, caused by a coronavirus, Herrmann said.
First reported in Saudi Arabia in 2012, MERS has been linked to 91 illnesses and 46 deaths. No cases have been identified in the U.S. to date, according to the Centers for Disease Control and Prevention.
Herrmann said the Center for One Health Illinois aims, through this summit, to assess human health, animal health and the ecosystem and develop a plan to improve all three because they're all related.
"They're so intertwined, you can't have one without the other," he said.
One focus at this year's summit will be an integrated health-surveillance system under development for Illinois, in which data — such as hospital admissions, school illness trends, pet illnesses, temperature and humidity information, even personal-care purchases at retail outlets that might indicate people are suddenly buying a lot of cold drugs — could be kept, Herrmann said.
Getting proprietary information from labs and retailers for the surveillance system is a challenge, he said, but he sees potential for that data.
"The intent is not to just sit and do the assessment," he said. "Illinois needs to have an integrated system that will integrate human, animal and ecosystem data."

http://www.news-gazette.com/news/local/2013-07-30/second-health-summit-set-thursday.html

WHO notes new MERS case and another death in Saudi Arabia

CIDRAP:  News Scan for Jul 29, 2013

The World Health Organization (WHO) has recognized the latest MERS-CoV (Middle East respiratory syndrome coronavirus) case and another death from the infection, both in Saudi Arabia, raising the agency's MERS count to 91 cases and 46 deaths.
The illness is in an 83-year-old man from the southwestern region of Assir who fell ill on Jul 17 and is hospitalized, the WHO said in a statement e-mailed to journalists. Also, a patient whose case was announced previously, also from Assir, has died. No other details about the deceased patient were given.
continued:

http://www.cidrap.umn.edu/news-perspective/2013/07/news-scan-jul-29-2013

Hong Kong: Rare Drug-resistant Superbug in Sheung Shui Pig slaughterhouse detected, Mortality Rate Humans: 40-70%

July 28, 2013
Excerpt, editing is mine:

A rare superbug detected in a slaughterhouse in Sheung Shui has never before been found among livestock in Hong Kong or Asia, a University of Hong Kong study has confirmed.
-snip-
"It indicates that there may have been widespread use by some farmers of antibiotics to keep their pigs healthy," Ho Pak-leung said. "This is one explanation as to why [the Sheung Shui] pork contains the drug-resistant bug."
Humans can catch the superbug through eating uncooked pork or coming into contact with infected livestock, Ho said
-snip-
The superbug, vancomycin-resistant Enterococcus faecium(VRE), was detected in one of 137 batches of pork samples collected in January at a slaughterhouse in Sheung Shui.

Genetic analysis confirmed the bug to be of the sequence type ST6, never before detected in any animal bred for consumption in Asia. Another strain of VRE, ST414, is more common in Hong Kong and causes several deaths a year during hospital outbreaks, Ho said.

VRE infections tend to occur in already debilitated patients, and usually break out within a contaminated institution, such as a hospital. Mortality rates for VRE infections have been calculated at between 40 and 70 per cent. It can be contracted and carried by a healthy person for years without any symptoms, only to attack when the carrier becomes sick or is injured.

Continued, complete article:  http://www.scmp.com/news/hong-kong/article/1292722/rare-superbug-found-hong-kong-has-never-been-detected-asia

Webcast Today: CSIS: A Greater Mekong Health Security Partnership

Webcast time:  Monday, Jul 29, 2013 | 12:00 pm - 2:00 pm EST
  
Please join us for a lunchtime launch of an important new CSIS publication, A Greater Mekong Health Security Partnership, which argues there is a unique, time-sensitive opportunity for a targeted, major U.S. initiative to improve health security in the Greater Mekong Subregion. A U.S. push to strengthen partnerships with Myanmar, Cambodia, Vietnam, and Laos -- to manage pandemic threats, control resistant malaria, and improve maternal and child health -- will advance both U.S. strategic interests and bring real health benefits to millions. It can be done if there is high-level U.S. leadership, better leveraging of the substantial civilian and military U.S. health engagement efforts already underway, and focused integration of the skills and expertise of Thailand and China.

Welcoming remarks will be given by Dr. John Hamre, CSIS President and CEO. Keynote addresses will be given by Admiral William Fallon, U.S. Navy (retired) and Lieutenant General James Peake, U.S. Army (retired), who co-chaired this effort. These remarks will be followed by a roundtable discussion on how the United States can creatively and cooperatively utilize its  health capacities and good will to strengthen partnerships and improve health security in South East Asia, which will be moderated by Dr. J. Stephen Morrison, Director of the Global Health Policy Center. Panelists will include Deputy Assistant Secretary of State Michael Fuchs; Rear Admiral Scott Dowell, U.S. Public Health Service, Director of the Division of Global Disease Detection & Emergency Response at the Centers for Disease Control and Prevention; Dr. Bernard Nahlen, President's Malaria Initiative; and Rear Admiral Dave Smith, U.S. Navy (retired), Deputy Assistant Secretary of Defense for Force Health Protection and Readiness.

This event will be webcast live at www.SmartGlobalHealth.org/Live

India: Team Arrives To Study Fever Situation for Dengue

July 28, 2013
The central team that arrived on Saturday to study the fever situation and the related medical complexities in the state would hold a meeting with state health minister VS Sivakumar at the secretariat on Sunday.

The team, comprising medical experts, has been sent to Kerala after the state government requested the Union health ministry to conduct a comprehensive study and suggest long term measures that would curb dengue fever outbreak in future. The team would also look into the suspected genetic mutation of dengue viruses and the presence of dangerous virus subgroups that make certain dengue attacks fatal.

The team is led by Dr Kalpana Baruva, joint director of the national vector borne disease control programme. The other members are Dr BV Tandale of National Institute of Virology, Pune, and Ratnakar Sahu of RML hospital, Delhi.

On the first day of its three-day visit, the team toured the medical college, other related institutions and the dengue-affected areas here on Saturday. It would visit Kollam on Sunday.

A statement issued by the office of the health minister said the team would return on Tuesday.http://timesofindia.indiatimes.com/city/thiruvananthapuram/Team-arrives-to-study-fever-situation/articleshow/21431584.cms     

India: Hingoli Man Dies H1N1, 100 Contacts, 20 on Tamiflu

July 29, 2013
Excerpt:
AURANGABAD: A 35-year-old man from Swarkheda village in Hingoli district died of swine flu at Government Medical College and Hospital (GMCH), Nanded, on Saturday evening. This is the first swine flu death in Aurangabad division this monsoon.
-snip-

"Since the patient approached the government hospital late, his condition deteriorated. With his oxygen saturation lowering, he was put on ventilator. However, his condition showed no signs of improvement and he died on Saturday evening," Runwal said.

The hospital has registered Pole's cause of death as acute respiratory distress syndrome, bilateral bronchopneumonia, H1N1 infection and cardio respiratory arrest.

The victim's relatives - Kavita (wife), Ganga Sagar (sister) and Vitthal (brother) - too complained of cough, fever and breathlessness and have been admitted to GMCH with swine flu symptoms. "Their swab samples have been sent to virology laboratory at Pune. Their condition is improving and is reported to be stable," Runwal said.

However, he ruled out fears of an epidemic in the village with a population of 2,000. "After the incident, the administration is geared up to take preventive measures to stop the spread of the virus. A team of doctors and paramedical staff was constituted, which conducted a survey of the village. Around 100 people, who were in contact with the victim, were screened of which 22 with mild symptoms were administered with Tamiflu tablets as a precautionary measure," he said.

Map of Hingoli

 http://timesofindia.indiatimes.com/city/aurangabad/Hingoli-man-dies-of-H1N1-first-victim-this-monsoon/articleshow/21439940.cms

India: Health dept. steps up fever to watch for H1N1 and SARS to avian influenza & dengue

[This article states they are keeping track of cases of fever on a daily basis, but are not screening them...yet.  I'm also not sure if they mean "Chennai" or India as a whole when they say "we" are collecting information.]
hat-tip @ makoto_au_japon
July 29, 2013

Chennai - In the light of Saudi Arabia and a few other countries reporting cases of Middle East respiratory syndrome coronavirus (MERS-CoV), the Health Department here is keeping track of cases of fever on a daily basis. However, officials said they had not received any formal communication regarding the institution of screening procedures. 

“So far, there has been no formal alert or advisory on checks at ports and airports. WHO has stated that there is no condition of public health emergency,” official sources said. Alerts, an official said, came from three sources – Centre for Disease Control, Atlanta, WHO and National Centre for Disease Control, New Delhi.

“We are however collecting information on cases of fever every day. From H1N1 and SARS to avian influenza and dengue, we are covering all kinds of cases in our surveillance mechanism. We are collecting daily reports from all major government and private hospitals,” he said.

-snip-

Over 4,000 pilgrims will leave for Mecca in September from the State. Officials of Airports Authority of India (AAI) said that there has been no screening of passengers in the airport as yet. “A few years ago, during the SARS virus scare, all passengers were subject to an automatic screening system. If a passenger whose body temperature was high passed through the device, the system would beep. He would then be taken to the doctor for examination. But in this case, we have not begun screening the passengers,” said an AAI official.

Continued:  http://www.thehindu.com/news/cities/chennai/health-dept-steps-up-fever-watch/article4964148.ece

New Hampshire gets high marks for health emergency drills

July 28, 2013

CONCORD, N.H. (AP) — A review of New Hampshire's public health emergency preparedness drills shows that the state continues to improve.
The Centers for Disease Control and Prevention conducts annual assessments of state and regional emergency preparedness under what's called the Strategic National Stockpile Program.

The assessment, which has been in place for nine years, looked at state efforts, regional work by Public Health Networks and regional sites from February 2012 to February 2013.

State officials say New Hampshire continues to improve its readiness.
"Each year we are evaluated on our planning efforts including exercises and drills," said New Hampshire Public Health Director Dr. Jose Montero. "We've been working closely with our regional public health partners and have shown steady improvement in our assessment evaluation over the years and continue to do well in our overall plan, communications, security and inventory control."

Continued:  http://www.timesunion.com/news/article/NH-gets-high-marks-for-health-emergency-drills-4691760.php

 

#H7N9 China Hebei people infected with H7N9 last three close contacts discharged medical observation

July 27, 2013
Translation
Langfang City, Hebei Province, July 27 latest official informed that, Langfang people infected with H7N9 bird flu Zhang last three close contacts, as of the 27th, under medical observation expires, no abnormal symptoms, according to the provisions relieve medical observation.

As at 9:00 on July 27, Langfang No new discoveries of human infection with H7N9 avian influenza suspected and confirmed cases.

According to reports, July 20, Langfang one case was diagnosed Zhang went to Beijing for treatment of patients infected with human H7N9 avian influenza confirmed cases, this is the first case of human infection of Hebei Province found confirmed cases of H7N9 avian influenza in the province immediately take appropriate measures , in close contact tracing for patients and medical observation, surveillance and other emergency measures.

http://scitech.people.com.cn/n/2013/0727/c1057-22349983.html

#MERS #Coronavirus Saudi Arabia 39 Deaths Total

 July 27, 2013 - Translation
The Ministry of Health Saudi Arabia on Saturday, the death of Saudi and wounding another virus "Coruna" killer, bringing the number of victims of the disease to 39 deaths.

 And revealed the Ministry of Health, in a press release in Riyadh on Saturday, for the death of a Saudi citizen who previously announced the injury in the same area. The ministry said that it had been revealed cases of HIV Coruna to a Saudi citizen in the Asir region (south of the country) at the age of 83 years, she said, "Health" The announcement comes a continuation of the fact-epidemic of a disease virus (Corona) new strain of AIDS Middle East respiratory tract. The World Health Organization (WHO), said that the spread of the virus, "Corona" in the Middle East has not yet reached emergency levels, but urged health authorities worldwide to tighten control of the disease.

أعلنت وزارة الصحة السعودية اليوم السبت، وفاة سعودى وإصابة آخر بفيروس "كورنا" القاتل، ليرتفع عدد ضحايا المرض إلى 39 حالة وفاة. 

وكشفت وزارة الصحة، فى بيان صحفى فى الرياض اليوم السبت، عن وفاة مواطن سعودى ممن أعلن عن إصابتهم سابقا فى المنطقة ذاتها.

وقالت الوزارة إنه تم كشف حالة إصابة بفيروس كورونا لمواطن سعودى فى منطقة عسير (جنوب البلاد) يبلغ من العمر 83 عاما، وقالت "الصحة" إن إعلانها يأتى استمرارا للتقصى الوبائى لمرض فيروس (كورونا) الجديد المسبب لمتلازمة الشرق الأوسط التنفسية.

وقالت منظمة الصحة العالمية، إن انتشار فيروس "كورونا" فى الشرق الأوسط لم يصل بعد إلى مستويات الطوارئ، ولكنها حثت السلطات الصحية فى جميع أنحاء العالم تشديد مراقبة المرض.

http://www.aldarwaza.net/page.asp?id=14492 

Pandemic: what are the criteria for a disease to be considered a PHEIC?

PHEIC = Public Health Emergency of International Concern.  Nowhere in this article does it mention the word "Pandemic".  This article speaks of a PHEIC.  Who will make the call of a Pandemic?

WHO Assistant Director-General for Health Security and the Environment Dr. Keiji Fukuda explained that there is no specific menu or checklist. Instead, health experts find an answer to the question if the situation or event really poses a danger for the global community.

Important questions also need to be answered like: How serious or severe is the infection? How fatal is it? Is the event or situation spreading and growing? Will the declaration of a PHEIC help address the situation?

In answering these questions, the Emergency Committee also ensures that any of their recommendations would be balanced, appropriate and proportional to the situation or event. As mentioned, a declaration of PHEIC would signal the global community to give MERS-CoV its highest level of priority.

Speaking of the WHO, from the article:

Apart from guidelines for health workers, the WHO is expected to release travel recommendations in relation to MERS-CoV in the coming days given the large number of people that are on pilgrimage due to the Hajj and Umrah.

The future of MERS-CoV remains uncertain.

Yesterday, the WHO posted travel advice for pilgrimages to Saudi Arabia on MERS-CoV.  

From the document (excerpts):

2.1. Actions to take before Umra or Hajj

• Countries should advise pilgrims that pre-existing major medical conditions...

• 
  Countries should make information known to departing pilgrims and travel organizations on general travel health precautions,¹ which will lower the risk of infection in general...

• Health advisories should be made available to all departing travellers to Umra or Hajj ... 

Additional information on Actions to take during after Umra or Hajj are also posted.  This WHO document will be located on the right side-bar of the blog under "Coronavirus MCoV" for future reference.
The lead in article of this post also states:

Health experts recommend close monitoring of the virus. Countries are likewise being encouraged to strengthen surveillance and laboratory capacity to detect infection. The people, on the other hand, are urged to stay informed and take necessary precautions to prevent the spread of MERS-CoV and other infections.

Indonesia has posted their Guidelines/Awareness for the approaching pilgrimage.  Some excerpts:

JULY 25, 2013 

Approaching the peak pilgrimage and pilgrimage, make the world health authorities (WHO) and Saudi Arabia feel the need to raise awareness, including Indonesia. DG P2PL convey some awareness of the Middle East activities Respiratory Syndrome Corona Virus (Mers-CoV) that have been carried out by the Directorate General of P2PL, among others, as follows:

First, the readiness of facilities and health workers, DG P2PL already made a circular letter to the Provincial Health Office... 

Second, DG P2PL has held a coordination meeting on July 11, 2013 by DG P2PL ranks followed by The Center for Health Haji, representatives of the Directorate General of Health Services and Development Agency and the WHO. Surveillance and activities at the port of entry will be strengthened,...

In addition, the CTF also prepared Thermal Scanner tool, but at this time according to the agreement and the WHO South-East Asia Region Countries not need to activate the device and will be evaluated from time to time.

Up to the month of June 2013, 28 Ports, Airports, and Transboundary Inland Post (PLBD) in 22 CTF has made pandemic preparedness and anticipation, to do drafting contingency plans and response simulation as required in the International Health Regulations (IHR) 2005. The activity is the anticipation of pandemic preparedness and influenza, which in principle can also be used as a preparedness and anticipation of Mers-CoV.

In the event that the virus spreads rapidly out of control, who then will call a Pandemic?  From the WHO "Pandemic Influenza Risk Management Interim Guidance, 2013"

The global phases – interpandemic, alert, pandemic and transition – describe the spread of the new influenza subtype, taking account of the disease it causes, around the world. As pandemic viruses emerge, countries and regions face different risks at different times. For that reason, countries are strongly advised to develop their own national risk assessments based on local circumstances, taking into consideration the information provided by the global assessments
produced by WHO. Risk management decisions by countries are therefore expected to be informed by global risk assessments, but based on local risk assessments.
The risk-based approach to pandemic influenza phases is represented in Figure 1 as a continuum, which also shows the phases in the context of preparedness, response and recovery, as part of an all-hazards approach to emergency risk management. Both WHO guidance and international standards exist that describe formats and conduct of such risk assessment (see Section 4.2). One of the underlying principles of this guidance is to acknowledge that emergency risk management at country level needs to be sufficiently flexible to accommodate different consequences within individual countries, for example, different severities and different numbers of waves of illness.
The global phases will be used by WHO to communicate the global situation. They will be incorporated into IHR (2005) related communications to National IHR Focal Points, in Disease Outbreak News releases and various other public and media interactions, including through social media channels.

Deadly Middle East coronavirus:  Not yet a PHEIC - http://www.abs-cbnnews.com/focus/07/26/13/deadly-middle-east-coronavirus-not-yet-pheic

WHO Travel Advice:  http://www.who.int/ith/updates/20130725/en/index.html

WHO Influenza Risk Management Interim Guide:   http://www.who.int/influenza/preparedness/pandemic/GIP_PandemicInfluenzaRiskManagementInterimGuidance_Jun2013.pdf

Sanofi Pasteur ships first lots of 2013-2014 seasonal influenza vaccine in US

July 26, 2013

Sanofi Pasteur, the vaccines division of Sanofi (Euronext:SAN) (NYSE: SNY), announced on Thursday that the first lots of Fluzone (Influenza Virus Vaccine) for the 2013-2014 season have been released by the US Food and Drug Administration (FDA) for US distribution and were shipped on 24 July 2013.

Reportedly, this shipment represents the first of over 60 million doses of seasonal influenza vaccine the company plans to deliver to US health care providers this autumn. This influenza vaccine is anticipated to be available to the public from local health care providers and pharmacies in August 2013.

Also, the company said that for the 2013-2014 season, two new influenza virus strains have been included in the trivalent seasonal influenza vaccine, a new A (H3N2) antigen and a new influenza B antigen. The A (H1N1) component of the vaccine is unchanged since the 2009 pandemic.

According to the company, the 2013-2014 influenza season will be the first in which quadrivalent influenza vaccines will be available in the US. Fluzone Quadrivalent vaccine includes two A strains and two B strains to help protect against influenza disease.

Sanofi also added that that no presentations of Fluzone vaccine contain natural rubber latex.

http://www.individual.com/storyrss.php?story=179570413&hash=ba3ef8b999353c2ebbee884a1b6fd8b3 

#MERS #Coronavirus Saudi Arabia MOH Statement July 25, 2013

Press Release
July 25, 2013

Within the framework of the epidemiological surveillance of the novel Coronavirus (MERS-CoV), the Ministry of Health (MOH) has announced that one confirmed case of this virus, aged 83, has been recorded in Asir.

Within the same vein, MOH has announced the death of one case, who had been previously announced to be infected with this virus in Asir, May Allah have mercy upon him.

http://www.moh.gov.sa/en/CoronaNew/PressReleases/Pages/Mediastatement-2013-07-25-001.aspx

#H7N9 Univ. of HK Study human bronchial cells 24 hrs after propagation 25 times faster than #H5N1

Translation out of China
July 26, 2013

 Sun spread of avian influenza H7N9 and H5N1 stronger than Injurious! New research shows University of Hong Kong, H7N9 avian influenza virus propagation speed geometrically increasing, virus attack human bronchial cells twenty-four hours after propagation speed 25 times faster than H5N1, seventy hours after a thousand times faster; virus on lung cells also have a similar situation, and specifically attack lung tissue cells responsible for regeneration, affecting the patient recovered after infection progress.  Experts warning H7N9 contagious, be careful winter outbreak.

Since the outbreak of H7N9 in February this year, there have been one hundred thirty-four cases of human H7N9 infection, 43 people died. University of Hong Kong yesterday in the international scientific journal "Lancet Respiratory Medicine" published studies, the use of in vitro cultivation, including bronchus, lung, nasopharynx, tonsils and other human airway tissue, analysis of human H7N9 and H5N1 viruses, and to compare lethal. The results showed that, H7N9 can infect humans efficiently and extensive bronchial epithelial cells, the situation is similar with ○ 九年 swine flu, H5N1 viruses multiply faster rate than more geometrically increments.

Continued:

 http://hk.news.yahoo.com/h7n9%E6%A5%B5%E9%80%9F%E7%B9%81%E6%AE%96-%E6%81%90%E7%A7%8B%E5%86%AC%E5%A4%A7%E7%88%86%E7%99%BC-224505570.html

ABC Australian scientists join international fight against the next human pandemic

[previously posted on here,  here and here]
Excerpt:

By science and technology correspondent Jake Sturmer, ABC  

Updated July 25, 2013, 2:07 pm

Australian scientists are working with researchers from around the world to pre-empt and prepare for the next human pandemic.
CSIRO researchers have joined a $20 million partnership alongside scientists from the Duke University in the US and the National University of Singapore (Duke-NUS).
The CSIRO's Biosecurity Flagship director Gary Fitt says 70 per cent of new diseases in humans originate in animals and it is time for a new approach to security.

"It's a collaborative centre that will allow us to expand the range of work we do," he said.

"We bring to this partnership fantastic skills in animal health through the Australian Animal Health Laboratory at Geelong.

-snip-

The Australian scientists and Duke-NUS are already working together, with research underway aiming to develop early and rapid detection tests for diseases like the Hendra virus.
If they are developed, CSIRO staff will trial and validate the new tests at the Geelong facility.

http://au.news.yahoo.com/latest/a/-/latest/18140258/australian-scientists-join-international-fight-against-the-next-human-pandemic/ 

Deadly Middle East virus unlikely to cause SARS-like epidemic

Thu Jul 25, 2013 6:30pm EDT

* Middle East virus has killed 45 among 90 confirmed cases
* SARS virus belongs to the same coronavirus family
* Health risk to haj pilgrims "very low" - WHO
By Kate Kelland


LONDON, July 26 (Reuters) - Despite its high current death rate, the Middle East Respiratory Syndrome (MERS) that emerged in Saudi Arabia last year is unlikely to cause a SARS-like epidemic because it is not spreading as easily, scientists said on Friday.
In the fullest clinical analysis yet of the new virus, British and Saudi researchers said that while there are many similarities between MERS and severe acute respiratory syndrome (SARS) - which emerged in China in 2002 and killed around 800 people worldwide - there are also important differences.
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Ali Zumla, a professor of infectious diseases and international health at University College London, said the evidence from his study suggested a large MERS epidemic with many hundreds of deaths was unlikely.

Continued:  http://www.reuters.com/article/2013/07/25/health-saudi-mers-idUSL6N0FV3YA20130725 

WHO issues MERS-related travel advice; new case reported

Robert Roos | News Editor | CIDRAP News

 

Jul 25, 2013

The World Health Organization (WHO) advised today that people who have chronic medical conditions and want to go on a pilgrimage to Saudi Arabia, epicenter of MERS-CoV (Middle East respiratory syndrome coronavirus), should talk with their healthcare provider about the risks.
Saying the risk to travelers is "very low," the WHO recommended no travel restrictions or border screening during the Muslim Umrah and Hajj pilgrimages, which are expected to draw millions of people to Saudi Arabia. The recommendations focus on awareness and routine precautions to prevent travel-related infections.
Meanwhile, Saudi Arabia today reported another MERS case and the death of a previously reported case-patient, according to a translated government statement posted on FluTrackers, an infectious disease message board.

Continued:  http://www.cidrap.umn.edu/news-perspective/2013/07/who-issues-mers-related-travel-advice-new-case-reported