What Will the 2013 Flu Season Bring?

Before we get into this season’s flu trends, it’s worth learning a little bit about influenza.

What Is Influenza?

Influenza refers to illnesses and symptoms, ranging from mild to severe, caused by a number of different influenza viruses. Typical symptoms are fever, coughing, sore throat, runny or stuffy nose, headaches, body aches, chills and fatigue. Annual outbreaks of seasonal influenza usually occur during the late fall through early spring.

Have a look at our post: Seasonal Influenza, A Helpful Reminder to learn how to protect yourself influenza and what to do if you become sick.

2013 Flu Trends

2013 Flu Season

2013 flu season (dark blue) compared to the past six years.

By looking at data gathered by Google so far this year, we can see that 2013 is beginning to look like one of the worst flu seasons in recent years. Compared to the previous 6 years, this season is only overshadowed by the 2009 H1N1 outbreak. Unfortunately, it is still to early to determine if flu cases will continue to rise.

By using millions of data points, Google Flu Trends is able to determine (with a high-level of accuracy) how big of an impact the flu is having on a seasonal basis.

This data is important because it can show flu queries in real-time, often weeks ahead of reporting agencies.

Flu season

Comparing flu search results throughout Canada.

How does Google Flu Trends Work? (excerpt from Google)

Each week, millions of users around the world search for health information online. As you might expect, there are more flu-related searches during flu season, more allergy-related searches during allergy season, and more sunburn-related searches during the summer.

Flu trends

Google Flu Trends compared to Public Health Agency of Canada records.

We have found a close relationship between how many people search for flu-related topics and how many people actually have flu symptoms. Of course, not every person who searches for “flu” is actually sick, but a pattern emerges when all the flu-related search queries are added together. We compared our query counts with traditional flu surveillance systems and found that many search queries tend to be popular exactly when flu season is happening. By counting how often we see these search queries, we can estimate how much flu is circulating in different countries and regions around the world. 

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As you can see, Google Flu Trends is a very powerful tool that can predict the severity of the upcoming flu season with frightening accuracy. Given the intensity of the flu in 2013, it is as important as ever to get vaccinated. Learn more about vaccination here: http://www.phac-aspc.gc.ca/im/vs-sv/vs-faq17-eng.php

Go explore Google Flu Trends yourself!

 
 
 

Polio – The Final One Percent

Eradicating an infectious disease of humans on a worldwide scale is no simple task. In fact, it is so difficult mankind has only achieved it once before – with smallpox.

Currently (with massive effort) we are on track to eradicate a few more diseases, such as polio, the measles and malaria. But even with all the effort we have made towards its eradication, the World Health Assembly voted to renew polio as a global emergency in May. This comes at a time when cases of the deadly virus are at an all-time low.

Eradication of Polio

How can polio be a global emergency when it’s been almost entirely eradicated?

First, there are only three countries (Pakistan, Afghanistan, and Nigeria) where polio is endemic (occurring without spreading from somewhere else). But in these countries the reported number of cases has actually gone up.

Second, the polio eradication effort has fallen short near $1-billion in funding due to tough economic times.

This can come as a shock as the efforts to eradicate this terrible disease have made huge leaps forward in recent years with help from the Bill & Melinda Gates Foundation, which has donated $1 billion to polio eradication since 2009.

With the Gates Foundation’s help, there were just 650 cases of polio in 2011, down from 1,352 in 2010, and just this year India was removed from the WHO list of polio-endemic countries.

Growth of Polio

But in Pakistan, Afghanistan, and Nigeria, the number of cases has risen in 2011. In Pakistan, the number of cases increased from 144 to 197; in Afghanistan from 25 to 80; in Nigeria from 21 to 62.

Click to see infographicpolio infographic

Although these infection rates are very low (especially for a disease that used to infect millions), the $9 billion eradication effort will only be successful once new polio cases cease to exist, ending the spread once and for all. This could lead to $50 billion in saved health costs.

Unfortunately, if we cannot continue to fight the disease at the same rapid pace, it’s likely the number of cases will continue to rise, until the disease affects hundreds of thousands of children again. Even one small outbreak can change the course of the eradication effort.

Future of Polio

Why can’t we continue on our current path of mass immunization? The answer is simple; the immunizations efforts so far are just not feasible on a regular basis. And even vaccines are available; it’s not always easy to vaccinate everyone, especially when some even prefer not to be vaccinated for various personal reasons.

polio vaccination

Child Receiving Polio Vaccination

The polio eradication shows us just how difficult it is to rid ourselves of any disease. We are so close, yet we still need to apply pressure. Amazing strides have been made so far in the fight against polio, but there is still much to do.

As experts in pandemic preparedness those of us at Iridia can relate the polio eradication effort to that of the recent H1N1 outbreak and the cropping up of the H5N1 avian flu.

These diseases are similarly difficult to eradicate and will remain with us until every single case has been stamped out. We believe we will get there one day, but until that time all we can do is be prepared.

H1N1 More Deadly Than Previously Thought

H1N1 Emerges

In 2009 the world was taken by surprise. A new global flu pandemic swooped into our lives, creating media frenzy.

As pandemic and emergency preparedness specialists, we at Iridia Medical were prepared to fight the outbreak and did just that.

But by August 2012, little over a year after the H1N1 virus became breaking news, the Director-General of the World Health Organization declared an end to the pandemic and left everyone wondering, “did the WHO exaggerated the danger,” spreading fear and confusion.

Influenza Virus - H1N1

Influenza Virus

When the H1N1 virus spread around the world three years ago, there was little over 18,500 deaths reported; a number much lower than the global media attention would have one believe.

Shedding New Light

Criticism and finger pointing are inevitably part of an outbreak cycle. During the H1N1 outbreak some even went as far to call it a “false pandemic.” Contrary to this belief, a new study suggests the outbreak was more severe than originally thought.

Now that the dust has settled, the actual number of deaths from the 2009 H1N1 pandemic has been pegged at more than 15 times higher than earlier estimates.

Based on a study published online in The Lancet Infectious Diseases, researchers estimate 284,400 people actually died in the first year alone.

According to the study authors, the actual number of deaths linked to the H1N1 flu virus could range anywhere from 151,700 to 575,400.

H1N1 Map

H1N1 reported cases from 2009

H1N1 – A Numbers Game

The sudden change in statistics is due to a number of reasons:

• Health officials did not take into account laboratory-confirmed flu deaths can considerably underestimate of the actual number of deaths from the flu.
• During the 2009 pandemic, many countries, particularly in Africa and Southeast Asia, lacked the ability to perform routine laboratory tests and therefore had difficulty identifying H1N1-related deaths.
• The WHO data suggests less than 12% of the confirmed deaths were in Africa and Southeast Asia, this new study estimates 51% of the deaths may have been from those two regions alone.

Lessons Learned

Dawood, a medical epidemiologist (also known as a disease detective) at the Centers for Disease Control and Prevention, says she hopes this research will help “limit the loss of human life in future pandemics.”

Studies like this are important as they can provide us with solid evidence of disease spread, infection rates and the impact of pandemics in various geographical regions; leading to future prevention efforts.

H5N1 – The Great Debate

In 2009 we experienced a global pandemic. The H1N1 influenza spread so quickly many were unprepared. The virus has caused 18,000 deaths to date.

18,000 deaths is a staggering number, but not when you realise that the virus caused 600 thousand infections, a fatality rate of .03%. Although it spread easily from human to human, it was not very deadly overall.

As a leader in emergency preparedness, Iridia has worked with many organizations to develop their pandemic plans. In most cases these plans had to be created from scratch as a pandemic is a state of emergency, of which many were unprepared. These plans consisted of:

• Communication tools and protocols
• Human resources policies
• Vaccine and antiviral usage
• Personal protective equipment strategies
• Infection control measures

Throughout the H1N1 pandemic, it became clear that our society was not ready. But what would happen if it had been worse?

H5N1 

In contrast to the H1N1, the H5N1 avian influenza has a very hard time spreading from human to human. But once an individual has become infected, it has a 60% fatality rate. To put that in perspective, if the H1N1 virus was that deadly, it would have caused 360 thousand deaths (20x more).

h5n1 virus

H5N1 Virus

It took some time, but after months of debate and controversy, research (you can search for it online) describing how to transform the deadly H5N1 in a human-contagious form was published in May 2012.

The study has made headlines around the world since 2011. A debate quickly heated up. Many were concerned about broadcasting potentially lethal information to would-be bioterrorists who might use the information to set off a pandemic.

In December, it was recommended by the U.S. National Science Advisory Board for Biosecurity (NSABB) that the study not be published in full. An expert panel convened by the World Health Organization (WHO) later disagreed with the decision, which paved way for publication.

“Given the possibility of accidental escape from the lab — not too uncommon events — the risks seem to me enormous, while the benefits are very small,” said Richard Roberts, a Nobel Prize-winning geneticist who now works at New England Biolabs.

Conversely, over the last several months, many objections to the research have frequently been called uninformed. “Fear needs to be put to rest with solid science and not speculation,” wrote microbiologist Peter Palese of the Mount Sinai School of Medicine.

There are two sides to every debate. Through research we undoubtedly gain a better understanding of viruses and in turn we discover clues that can lead to vaccines. But do these deadly “recipes” need to make the rounds for everyone to see?

Want more details? Read the story here: Sciencemag

What do you think?

[polldaddy poll=6213924]

Stay Home and Have an Influenza Day

Who doesn’t enjoy a break from school on a snow day? For many they are blessing; a free day to have some fun, where otherwise, you would be counting sheep waiting while minutes to tick by. The good news, you may get the break you’re looking for. The bad news, there will have to be a flu pandemic first.

 Influenza Day

Have an Influenza Day!

A recent study in Alberta has shown that by closing schools, we could potentially slow the spread of a flu pandemic. The study in the Annals of Internal Medicine analyzed data on H1N1 infections in the province during the 2009 pandemic.

View the study summary:
http://www.annals.org/content/156/3/I-28.full.pdf

How does shutting down the school reduce the spread of a flu pandemic? Well, it turns out children play an important role. “School-age children were fundamentally important drivers of [pandemic H1N1] transmission in 2009,” the study’s lead author, Prof. David Earn of McMaster University in Hamilton.

“We suggest that school closures [either local or regional] should be seriously considered if a pandemic occurs during the school year.”

Researchers used the data they collected to plot lab-confirmed H1N1 cases on a graph. A correlation between school closed for the summer and a drop in incidence began to emerge.

“Using state-of-the-art modelling, we then demonstrated that transmission was reduced by at least 50 percent,” Earn said.

50 percent by school closures alone! That’s quite the change, but not the only factor. The model also showed that a large drop in temperature seemed to influence a spike in H1N1 cases throughout the province, but the weather changes were less important than closing school for the summer.

By chance, schools in Alberta happened to be closed for during the first wave of H1N1 infections in summer 2009, but the observations suggest that closing all schools could affect the course of future epidemics, the researchers said.

On an interesting note, during the pandemic, public health authorities recommended against school closures. While other provinces tightened criteria to test for respiratory viruses when the first wave of the pandemic grew in intensity, Alberta did not; this gave the researchers higher-quality data to model.

The study highlights the important issue of how to prevent the spread of influenza. However, the verdict is still out on the long-term benefits of this course of action. Perhaps future studies will shed some light.

 

 

Seasonal Influenza, A Helpful Reminder

Seasonal Influenza

It’s that time of the year again, leaves are changing colour, days are getting shorter and our noses are getting runnier. There is not much we can do about the leaves or the days but we can protect ourselves and others from catching Seasonal Influenza.

What Is Influenza?

Influenza refers to illnesses and symptoms, ranging from mild to severe, caused by a number of different influenza viruses.  Typical symptoms are fever, coughing, sore throat, runny or stuffy nose, headaches, body aches, chills and fatigue.  Annual outbreaks of seasonal influenza usually occur during the late fall through early spring.

How to Protect Yourself and Others?

The best prevention for influenza is getting vaccinated.  An influenza vaccine not only provides protection for an individual, it also helps protect vulnerable populations that are at a higher risk of complications from influenza.

These “high risk” groups include:

  • Pregnant women
  • Children 5 years of age and younger
  • Adults 65 years of age and older
  • People with chronic illnesses, such as asthma, heart disease and diabetes and immunocompromised persons

Receiving an influenza vaccine is particularly important if you work in a high-rick environment such as a hospital. As you can be infectious with the influenza virus for up to 24 hours before displaying symptoms, you could inadvertently spread influenza before you become sick with symptoms.   The seasonal influenza vaccine is extremely safe for everyone, including pregnant women and children.  Other ways to help protect yourself and others from getting influenza include:

  • Staying home from work if you have influenza-like symptoms
  • Regularly washing your hands with soap and water or hand sanitizer
  • Coughing and sneezing into your sleeve or a tissue

What if I Get Sick With Influenza?  

If you have influenza-like symptoms you should:

  • Stay home, drink clear fluids
  • Get plenty of rest
  • Avoid close contact with others

If you have significant influenza symptoms or are in one of the high risk groups (see above), you should see your health care provider, preferably within the first 48 hours, to see if you are eligible for antiviral medications.  If you are taking care of someone at home who has influenza remember to protect yourself and others in the household.

What Is Pandemic Influenza Again?

Pandemic influenza refers to a novel influenza A virus for which there is little or no immunity in the human population.  Because it is a novel virus, it takes approximately 6 months to develop an effective vaccine.  A pandemic influenza virus can cause serious illness and spreads easily from person-to-person worldwide.  The most recent example of a pandemic influenza was in 2009, caused by the novel H1N1 (swine) virus.

Further Information  More information on this year’s seasonal influenza may also be found at:
http://www.phac-aspc.gc.ca/influenza/index-eng.php 

H1N1 Paves the Way for Possible Universal Flu Vaccine

A study published by researchers in the Journal of Experimental Medicine suggests that scientist are nearing an understanding of influenza viruses that could lead to a universal flu vaccine.

Universal Flu Vaccine

Before a vaccine was available in 2009, the team analyzed antibodies found in nine patients whom had been infected during the first pandemic wave of H1N1. They found five antibodies that proved cross-protective against a number of influenza variants including the 1918 pandemic strain and the avian flu, H5N1.

Universal Flu Vaccine

Sample structure of a flu virus. The hemagglutinin proteins are labelled “HA”

Flu viruses possess a lollipop-shaped protein structure called hemagglutinin. The protein at the “head” of the lollipop allows the virus to latch onto and infect other cells. Since all viruses require this structure to reproduce, flu drugs and vaccines focus on identifying this protein to the immune system so that it can fight infection. The genius of the flu virus is that this protein readily mutates so that the virus appears to the immune system to be completely different from one flu season to the next.

Two years ago, researchers found that the stalk of the protein –the lollipop’s “stick”– does not mutate and is generally the same for all flu viruses. Because the H1N1 strain was so different from other flu viruses, it’s likely that the immune systems of those infected made antibodies for the only part of the virus that it recognized: the hemagglutinin stalk. “Previously, this type of broadly protective, stalk-reactive antibody was thought to be very rare,” said Jens Wrammert, a member of the research team. But in the H1N1 patients, they were “surprisingly abundant.”

According to Patrick Wilson, who also worked on the project from the University of Chicago, these antibodies could demonstrate “how to make a single vaccine that could potentially provide permanent immunity to all influenza.”

The US National Institutes of Health is now running human tests on a two-step vaccine process that uses stalk-reactive antibodies to prime the immune system before a regular flu shot. Reuters