what’s new in the world of influenza? · what’s new in the world of influenza? centers for...
TRANSCRIPT
What’s new in the world of influenza?
Centers for Disease Control and Prevention
New Zealand Influenza Symposium
University Of Otago
11th November, 2015
Marc-Alain Widdowson
A Swedish Smorgasbord
Talk outline
• Tuberculosis as a risk factor for influenza
• Update on oseltamivir
• Measuring vaccine impact in Brazil
• Novel influenza viruses – what are they up to?
Association of influenza with HIV
South Africa
C Cohen et al Clin Infect Dis. (2012) 55 (7): 996-1003.
Influenza-Related Mortality Among Adults Aged 25–54
Years With AIDS in South Africa and the United States
of America
Association of influenza with Tuberculosis
Walaza et al; PloS One 2015
Revised Metaanalysis on effect of oseltamivir(Dobson et al Lancet 2015)
• Individual-record based metaanalysis of 9 trials (N=4328)
• Intention to treat (ITT) and Intention to treat infected (ITTI) analysis
• Reduction in symptoms of 21% (25h)
• 44% reduction in lower respiratory tract infection
• 63% reduction in hospitalization
Dobson et al Lancet et al 2015
Metanalysis of effect of Oseltamivir on duration of symptoms and complications due to flu
Effect of early treatment with oseltamivir among hospitalized adults (Chaves et al CID, 2015)
• 3 seasons of persons >65 years with influenza (N=6953)
• Compared risk of new admission to extended care after hospitalization by treatment with Oseltamivir [early (<4days) vs late (>4 days)]
• Adjusted OR for early treatment = 0.38 (0.17-0.85)
Impact of Oseltamivir on extended care in elderly
Chaves et al Clinical Infectious Diseases, 2015
Detection of HPAI in United States August 31, 2015
https://www.aphis.usda.gov/animal_health/downloads/animal_diseases/ai/hpai-incident-map.pdf
H5N1 as of Nov 4, 2015
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Onset of Illness
Epidemic Curve for Avian Influenza A(H5N1) Cases by Onset of Illness Date for 2003-2015 (N=844)
Canada (n=1) Bangladesh (n=7) Laos (n=2)Myanmar (n=1) Pakistan (n=3) Azerbaijan (n=8)Nigeria (n=1) Cambodia (n=56) China (n=52)Djibouti (n=1) Egypt (n=346) Indonesia (n=199)Iraq (n=3) Thailand (n=25) Turkey (n=12)Vietnam (n=127)
Avian Influenza A (H7N9) Update – GlobalNovember 4, 2015
* Onset date unknown for 54 cases.
For official, internal use only, please do not distribute
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Epidemic Curve for Confirmed Cases of Avian Influenza A(H7N9), Global: 18 Feb 2013 – 3 Nov 2015 (N=685)*
Canada (n=2)
Malaysia (n=1)
China (n=682)
Avian Influenza A (H7N9) Update – ChinaMap – October 2, 2014
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Regional trade of poultry
Poultry value chain
Alex Millman et al Emerg Infect Dis 2015
November 7 – Sierra Leone Ebola free!
