– Advertisement – Reigning world champions South Africa intend to remain a part of the Rugby Championship – Advertisement – “The southern hemisphere rugby powers have recognised the need for change in these difficult times and have committed to an international rugby future through to 2030,” SANZAAR said in a statement.SANZAAR chief executive Andy Marinos added: “The re-commitment by the four unions to the long-term future of the international game is an important start as we embark in a new direction. South Africa withdrew from this year’s Rugby Championship over player welfare concerns; the country’s Super Rugby franchises could joined an expanded PRO16 Last Updated: 04/11/20 7:44am
Scotland head coach Shelley Kerr says the weight of the country is on counterpart Steve Clarke’s shoulders but he will not be distracted McLeish managed Lazio midfielder Sergej Milinkovic-Savic while the pair were at Genk in Belgium and the former Rangers boss says Serbia have quality in the squad.“It is a tough one, it is not one that you can say ‘we will definitely beat them’,” he said.“We’ve all got to be optimistic and say this is now or never, although it is not now or never because there have been great signs over the past few weeks and a great result against the Czech Republic.“But that is a tough team and it is a tough place to go to, albeit no fans. That is still a very difficult game. They have guys like Aleksandar Mitrovic and Sergej Milinkovic-Savic – a young guy I had at Genk – and he is in the form of his life as well, so very dangerous players.” Hearts forward Naismith, who won the most recent of his 51 caps for his country in the victory over Kazakhstan last November, knows the importance of the clash to the nation and thinks Scotland have a few advantages going into the game. – Advertisement – Thursday 12th November 7:00pm Steven Naismith believes “all the small things” are going in Scotland’s favour ahead of their Euro 2020 play-off final against Serbia on Thursday.Steve Clarke’s side travel to Belgrade knowing that a win will see Scotland qualify for their first major tournament since the World Cup in France in 1998.- Advertisement – – Advertisement – 0:34 Former Scotland manager Alex McLeish is expecting a tough match in Thursday’s winner-takes-all play-off against Serbia Kick off 7:45pm 1:19 Naismith sees talented players throughout the squad and believes their ability to win in different circumstances is key for Scotland.“The confidence that I get is that the backbone and spine of the squad are talented, talented players,” he said.“They have consistently improved but also come up with the goods. Whether, way back against Cyprus, we are going a goal down, we are getting back into the game and winning the game, whether we need to defend well to see out a game the boys have come up with the goods every time. That’s what gives me confidence.”Former Scotland manager Alex McLeish says the team have to be optimistic heading into the game but is well aware of the test in front of them. “We are on a run of good performances and good results and the players have bought into what the manager expects and I am very optimistic but I would guard that they are a very good team that we are coming up against.”Scotland are unbeaten in eight games heading into the final after recent impressive wins over the Czech Republic and Slovakia. “It’s massive, I’ve been involved in the national team for close to 15 years and I don’t think there is a bigger game, it’s as simple as that,” he said.“It is a one-off game, it is going to be a really tough game but all the small things I would say are going in our favour – there are no fans away from home, it is a one-off game and the Nations League has been good for us.- Advertisement –
Jumeirah at Saadiyat Island Resort has announced the appointment of Savino Leone to the role of general manager at the prestigious hotel.Joining the property with more than 25 years of hospitality experience, Leone has had an extensive international career, having held roles spanning the globe in countries including Japan, Egypt, the UK, Dubai and France.- Advertisement – He has been at the helm of several successful hotel openings and, with a passion for food and beverage, is committed to driving luxury service, quality standards and developing teams.Under Jumeirah Group’s committed management for years to come, Jumeirah at Saadiyat Island Resort is the brand’s flagship property in Abu Dhabi and sits majestically on the island’s prime beach, providing a backdrop of refined island life and quiet understated luxury. Under his leadership, Leone aims to maintain and exceed its leading reputation as a luxury hotel in the region.- Advertisement – An Italian national, with dual French citizenship, Leone speaks fluent English, French and Italian.Speaking of his appointment, he commented: “It is a privilege to be joining the incredible team at Jumeirah at Saadiyat Island Resort, a hotel that has become synonymous with leading luxury hospitality throughout the region. “I am delighted to be continuing my journey with Jumeirah Group at this breath-taking hotel, and I look forward to welcoming guests to this unique destination.” Jumeirah Group, a member of Dubai Holding and a global luxury hotel company, operates a world-class 6,500-key portfolio of 26 properties across the Middle East (including the flagship Burj Al Arab Jumeirah) Europe and Asia, with more properties currently under construction around the globe.Fergus Stewart, acting chief operating officer at Jumeirah Group, also commented: “On behalf of Jumeirah Group, we are thrilled to welcome Savino Leone as the general manager for Jumeirah at Saadiyat Island Resort. “An experienced hotelier with a proven track record of success within the organisation, we look forward to seeing his strong leadership skills in action to help continue to position the hotel as one of the best luxury hospitality experiences in Abu Dhabi and the region.”More InformationJumeirah at Saadiyat Island Resort is considered Abu Dhabi’s Leading Luxury Resort by voters at the World Travel Awards. OlderEurowings launches two new Middle East connections He has more than three years’ experience in leading luxury Jumeirah Group hotels, having originally been appointed in 2017 as the general manager of Jumeirah Messilah Beach Hotel & Spa in Kuwait. During his tenure at the property, the hotel retained the number one position in RGI and TripAdvisor, as well as maintaining an outstanding reputation in the market. Under his leadership, the team at Jumeirah Messilah Beach Hotel & Spa achieved eleven awards in 2018, including recognition as Kuwait’s Leading Business Hotel at the World Travel Awards.- Advertisement – – Advertisement –
The plot to attack American passengers came weeks before the Paris attacks in which 130 people died.- Advertisement –
Jun 1, 2006 (CIDRAP News) – Indonesian officials reported still another human case of H5N1 avian influenza today on the basis of local tests, while the cause of the recent family cluster of cases in Sumatra continued to elude investigators.A hospitalized 8-year-old girl from Pamulang, on the outskirts of Jakarta, tested positive for the virus in a local laboratory, according to an Associated Press (AP) report quoting Nyoman Kandun of the Indonesian Health Ministry. The story gave no other details on her case.Indonesia’s confirmed avian flu toll stands at 48 cases with 36 deaths, according to the World Health Organization. The 8-year-old girl’s case and a fatal case in a 15-year-old boy, reported yesterday, have not yet been confirmed by a WHO-accredited laboratory.Indonesia had 15 cases, 11 of them fatal, in May, according to WHO reports. The country’s toll is second only to that of Vietnam, which has had 93 cases and 42 deaths, but none in recent months.The recent case cluster in North Sumatra province accounted for seven of the 15 cases in May. A WHO official said at a press conference in Jakarta today that investigators still haven’t determined what touched off the case cluster, which, officials have said, probably involved limited human-to-human transmission.”There are three possible sources of infection, but there is no conclusion,” said WHO epidemiologist Stephen Bjorge, as quoted by Agence France-Presse (AFP). As suggested by the WHO previously, he said the 37-year-old woman who was the first family member to get sick might have been infected by her sick chickens, by chicken feces she used as fertilizer, or at a “wet” market where chickens are sold.Meanwhile, Indonesian Health Minister Siti Fadilah Supari today denied that the family cluster involved human-to-human transmission, according to the AP. “I say firmly that it has not yet been transmitted from humans to humans,” she said.However, Indonesian authorities plan to continue monitoring the village where the cluster occurred for 3 more weeks, a week longer than recommended by the WHO, according to the AFP report.Bjorge said Indonesia is doing too little to control the disease in birds, AFP reported. “The situation is that there is a leak in the roof, and the ministry of health is just mopping up the floor every day,” he said. “And the leak in the roof is this continuing transmission of the virus from bird to bird.”He said Indonesia needs to launch mass culling of infected birds and increase testing of birds suspected of infection.The AP reported that authorities killed about 1,300 chickens today within a half mile of the home of the 15-year-old boy whose fatal case of avian flu was reported yesterday. The boy lived in the Tasikmalaya district of West Java province.
Aug 29, 2006 (CIDRAP News) – Final tests confirmed that two mute swans in Michigan had a mild strain of H5N1 avian influenza virus, not the lethal Asian variety, the US Department of Agriculture (USDA) announced yesterday.Authorities discovered the virus in the wild swans, which appeared healthy, when they were sacrificed on Aug 8 and tested in conjunction with a population-reduction plan at a game area on Lake Erie in southeastern Michigan. Initial tests detected an H5 virus along with an N1 subtype, but experts weren’t sure if the birds were infected with two separate avian flu strains or if the findings represented low-pathogenic H5N1.The testing, done at the USDA National Veterinary Services Laboratories in Ames, Iowa, detected the “North American strain” of low-pathogenic H5N1 in one of 20 samples collected from the two swans, according to a USDA press release. Preliminary test results on Aug 14 indicated that an H5N1 strain could be present in two of the samples, but only one sample contained enough of the virus to permit testing.Low-pathogenic avian flu viruses are common in wild birds and typically cause minor illness or no signs of disease. The mild form of H5N1 has been found several times in wild birds in North America and poses no threat to humans, the USDA said.In other avian flu news, the US Environmental Protection Agency (EPA) recently released a disposal guide for handling chickens and other domestic birds infected with avian flu. The guide discusses topics such as roles during disposal activities, carcass management, equipment cleaning and disinfection, transportation, and protective equipment. Though the USDA is the lead federal agency in responding to large-scale animal carcass disposal, the EPA provides technical assistance and support for decontamination and disposal issues.In Vietnam, health officials said yesterday that the H5N1 virus was found on a small duck farm in the southern Ben Tre province, according to a Reuters report. The source of the infection is not known. An animal health official in the district told Reuters that all 84 ducks were culled and that ducks on 14 nearby farms tested negative for the disease. An H5 virus resurfaced in ducks and storks in the past month, but no human H5N1 infections have been reported in Vietnam since December, the Reuters report notes.Meanwhile in the Netherlands, testing of two northern hawk owls that were found dead at a Rotterdam zoo did not confirm that they died of H5N1 avian flu, according to a Dutch government report posted 2 days ago on ProMED-mail, the Internet-based reporting system of the International Society for Infectious Diseases. Two rounds of testing raised suspicions about the presence of the H5N1 in the birds, but investigators have not been able to isolate the virus.See also:Aug 28 USDA press release on negative H5N1 test results in Michigan mute swans
Jan 14, 2008 (CIDRAP News) – A research report published last week says that the factors governing whether H5N1 avian influenza viruses can invade human cells are more complex than previously thought and have to do with the particular shape of the cell-surface sugar molecules to which viruses attach.The conventional wisdom has been that avian flu viruses, including H5N1, prefer to attach to receptor molecules known as alpha 2-3 glycans, whereas human flu viruses, such as H1N1 and H3N2, prefer to bind to receptors called alpha 2-6. The terms refer to the nature of the link between sialic acid, which forms the tip of the receptor molecule, and galactose, an adjoining sugar unit.Alpha 2-6 glycans are said to be abundant in the human upper respiratory tract. The accepted view has been that a change in the H5N1 virus’s binding preference from alpha 2-3 to alpha 2-6 would be a key step toward its transformation into a human pandemic strain.But the new study, published in Nature Biotechnology, suggests that the difference in binding preference between human and avian flu viruses is more complicated than just alpha 2-6 versus alpha 2-3. Rather, it is an affinity for a particular topology, or shape, of alpha 2-6 glycan receptor that characterizes human flu viruses, says the report, written by a team from the Massachusetts Institute of Technology (MIT) and the Centers for Disease Control and Prevention.Why shape mattersSpecifically, the researchers report that human flu viruses prefer long alpha 2-6 receptors that occupy an umbrella-shaped space, as opposed to those, including alpha 2-3 and some alpha 2-6 receptors, that occupy a cone-shaped space.”The efficient human adaptation of these viruses is . . . correlated with HA binding to sialylated glycans of a characteristic umbrella-like topology, going beyond the specific alpha 2-3 or alpha 2-6 linkage,” write the researchers, led by Aarthi Chandrasekaran of MIT. They say their findings will improve scientists’ ability to monitor the evolution of human adaptation of avian flu viruses.The authors used a combination of several techniques to gather and interpret their data. First, they used a staining technique and mass spectrometry on sections of human tracheal epithelial tissue to examine the distribution of alpha 2-6 glycans in the tissues. The results showed that these receptors were predominant in the upper respiratory tract lining and that they showed “substantial diversity” in length and composition.Data gathered from the first analysis were then used to determine the “conformational features” of the alpha 2-3 and alpha 2-6 glycans. The analysis led to the conclusion that alpha 2-3 and short alpha 2-6 receptors occupy a cone-shaped space, whereas the umbrella shape is unique to alpha 2-6 glycans and is typically assumed by longer versions of these molecules.Further, in part by using existing data on the structure of hemagglutinin (HA) in different flu viruses—the viral surface protein that links up with host cell receptors—the authors determined that the HAs in human flu viruses “have mutated from their presumed avian counterparts to gain additional contacts with alpha 2-6 in the umbrella-like topology.”The researchers sought further evidence in the extensive existing data from studies of glycan arrays, in which many different glycans are laid out on slides and then exposed to HAs from different flu viruses to see which ones bind to which glycans. Seeking correlations between the features of different glycans and the various HAs, the authors found more evidence that H5N1 HAs prefer to bind to alpha 2-3 and short alpha 2-6 glycans but not to long alpha 2-6 glycans.Finally, the scientists treated preserved sections of human tracheobronchial tissue with different concentrations of HAs from H1 and H3 human flu viruses and observed the resulting binding patterns. This work further demonstrated the “high-affinity binding” between these HAs and the long alpha 2-6 glycans. The researchers also found that two H5N1 viruses, used in high concentrations, showed some affinity for alpha 2-6 gylcans, but this was minimal compared with their affinity for alpha 2-3 glycans.”Taken together, the above findings show that the human-adapted HAs bind specifically to the long alpha 2-6 [glycans] (in the umbrella-like topology), which are predominantly expressed in the human upper respiratory tract,” the researchers state.They write that other flu virus genes may play a role in H5N1 transmission, but that mutations permitting the virus to bind to long alpha 2-6 receptors will be a necessary condition for it to fully adapt to humans.The authors recommend the use of glycan arrays containing long alpha 2-6 units to monitor the evolution and human adaptation of influenza A viruses. They call for the development of arrays to permit rapid dose-dependent analyses of HA binding patterns.Caveats citedDr. John Nicholls, an associate professor in the pathology department of Hong Kong University who has done research on how human and avian flu viruses bind to host cells, said the study sheds important light on how avian viruses may adapt to humans, but he also added some caveats.”This study was what was needed to put together what type of sialic acids the influenza viruses bind to and what was really available for binding within the respiratory tract,” Nicholls told CIDRAP News via e-mail. “As a note of caution, the analysis of what glycans are present in the respiratory tract has been done on cells grown in culture . . . and the question arises to what extent these represent normal human adult and paediatric trachea and bronchi, so clearly we need to move from this in vitro model to the in vivo setting.”He added that efficient human-to-human transmission of viruses may depend on viral replication not only in the bronchi, but also in the nasopharynx. Studies of H5N1-infected patients in Vietnam have shown that replication does occur in the nasopharynx, he said.In addition, Nicholls said, “It is not just binding that is a requirement for human adaptation (and more importantly what determines human to human transmission), but also, as the authors mention, factors such as neuraminidase and other viral gene products.” For example, studies by Kawaoka and colleagues have shown that changes in the PB2 gene allow the virus to replicate at different temperatures in the respiratory tract.”However,” Nicholls concluded, “the importance of this article is that it does shed more light on the finer details of this first step in viral adaptation to humans—binding. Importantly, the simple alpha 2-3 versus alpha 2-6 paradigm as a determinant of host specificity of influenza viruses appears to be a great over-simplification.”Chandrasekaran A, Srinivasan A, Raman R, et al. Glycan topology determines human adaptation of avian H5N1 virus hemagglutinin. Nature Biotech 2008 (advance online publication) [Abstract]
Apr 16, 2008 (CIDRAP News) – Acting on the premise that “disasters discriminate,” the Association of State and Territorial Health Officials (ASTHO) and several partner groups yesterday released a lengthy set of proposed guidelines for protecting the most vulnerable people during an influenza pandemic.The 105-page document posted on the ASTHO Web site contains recommendations on how state, local, territorial, and tribal health agencies can prepare to help “at-risk” groups—such as people who can’t afford to stockpile food, don’t speak English, or need assistance with daily activities—get through a pandemic.”In the face of a pandemic we have to recognize that some of those services that serve them [vulnerable groups] today may be able to expand to meet the need, but some of them will break down,” ASTHO Executive Director Paul E. Jarris, MD, MBA, told CIDRAP News. “How will we provide basic services to people who are homebound, for example, making sure they have food and water and care? This won’t happen by accident.”The guidance document, called “At-Risk Populations and Pandemic Influenza: Planning Guidance for State, Territorial, Tribal, and Local Health Departments,” was developed with input from representatives of the groups the recommendations are intended to help. ASTHO and its partner organizations held public engagement meetings recently in Boston and Kansas City to gather those groups’ suggestions.”The At-Risk Populations Project is a ground-breaking endeavor for the nation,” Jarris said in a news release. “The process is being brought directly to the at-risk populations who will be affected, as well as to the public health planners and other experts who will have responsibility for implementing the policies. Their vital feedback will help to ensure that those facing the most danger during a pandemic are protected.”ASTHO’s partners in the project are the University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP), publisher of CIDRAP News; the National Association of County and City Health Officials (NACCHO); and The Keystone Center. The Centers for Disease Control and Prevention (CDC) proposed the project and funded it with a grant to ASTHO.ASTHO seeks public commentsASTHO is inviting the public to comment on the guidance document for 30 days. After that, plans call for editing the document and releasing the final version by May 31, according to Anna DeBlois, ASTHO’s senior director for immunization and infectious disease. The project has been on a tight schedule because of CDC budgetary considerations, said Jarris.The guidance consists of five chapters that discuss how to identify and collaborate with at-risk populations, communicate with and educate them about pandemic flu, provide clinical and non-clinical services to them, and how to test, exercise, measure, and improve their preparedness.At-risk groups are defined as those that have the highest risk of suffering severe consequences from a pandemic or from measures used to fight the pandemic, such as community mitigation strategies. Examples include those who can’t afford to stockpile food or stay home from work for even a short time; those who have no support network, such as homeless people and those who are socially or geographically isolated; and those who need help with daily activities because of physical disabilities, blindness, hearing impairment, medical conditions, or other factors.Each chapter offers detailed background information and a list of recommendations for public health agencies. For example, a section on communicating with at-risk groups discusses potential barriers to communication, the need to develop audience-appropriate messages, possible message content, and the need to find “trusted messengers.” The chapter suggests a wide variety of potential message vehicles, ranging from church bulletins and radio announcements to cars with loudspeakers and “telenovelas,” described as Spanish television mini-series that can be powerful health education vehicles.A few other examples of the many recommendations in the guidance:To identify at-risk groups, use data from transportation and mass-transit planners to find local groups who need help to use public transit.To build collaborations, reach out to community leaders without formal roles, such as elderly people or hairdressers.Offer mini-grants to community-based and faith-based organizations for pandemic preparedness planning, if budgets permit.Provide preparedness workshops for people who support at-risk individuals, including family, friends, and paid caregivers.Encourage community-based and faith-based organizations to develop contracts or memoranda of understanding to provide essential services and supplies during a pandemic.Consider the pros and cons of developing a community registry in which at-risk groups would describe the services and equipment they would need during a pandemic, and work with first responders to make sure the registry provides them useful information.Each chapter also includes a chart of existing tools and resources—most of them accessible online—that may be helpful in carrying out the recommendations.Developing federal guidance outside the governmentASTHO officials credit Toby Merlin, MD, deputy director of the CDC’s Influenza Coordinating Unit, for coming up with the idea for the At-Risk Populations Project, which they describe as unique because it is federal guidance developed by non-federal groups.”Toby Merlin came to us to ask ASTHO to organize, with CIDRAP and Keystone, a process for developing guidance outside the federal government, and also including the very important component of community engagement,” said Jarris. “We’ve had community engagements around pandemic community mitigation measures and vaccine prioritization before, but what was really new was moving the engagement outside the federal government.”ASTHO set up an advisory panel of experts to guide the project and organized five working groups consisting of about 70 people, including academicians and public health practitioners, from around the country to develop the chapters. To get at-risk groups involved, public engagement meetings were held Mar 8 in Boston and Mar 15 in Kansas City, drawing a total of more than 100 people. In addition, a stakeholders meeting was held Mar 20 in Washington, DC, to gather input from groups ranging from the CDC to volunteer organizations that serve vulnerable people.Comments gathered at the meetings led to various additions and adjustments to the guidance, according to Caroline Barnhill, MPH, ASTHO’s senior analyst for infectious diseases. One important point influenced by the feedback was the definition of at-risk groups.”We asked if the groups we had identified were sufficient, and they had some thoughts on the words we used,” Barnhill said. “We took that information into consideration and changed some of the wording to reflect their feedback. It was very helpful.”Overall, the comments didn’t prompt any big changes in direction, but they “enhanced what we were already doing,” Barnhill said. “We got a lot of good anecdotes and points that we hadn’t thought of.”Public engagementOne of those who attended the Boston public meeting is David Mortimer, a Sudbury, Mass., resident who has been in a wheelchair since he was injured in a car accident in 1993. He chairs the city’s disability commission and represents that group on the city emergency planning committee.”My intent [in attending the meeting] was hoping I would find people similar to myself and find out what success they were having in convincing commissions to be more inclusive in their emergency planning,” Mortimer told CIDRAP News.He said the Boston meeting, held at Boston University, drew at least 50 people, consisting mostly of people with limited mobility, those with hearing impairments, and people working with the homeless and those with mental health problems.After being briefed on the project, those attending broke into subgroups and, with the help of facilitators, came up with the suggestions for things to include in the guidance. “There was something in the neighborhood of 15 recommendations that were brought to the full group for comment and feedback,” Mortimer said.He said he was impressed by “the willingness to work from the ground up, not coming in and dictating what people need but going out and asking the affected groups what are their major needs regarding treatment in a pandemic. The process is remarkable and hopefully will be a model.”Mortimer also attended the Washington stakeholders meeting after he was asked to report there on the Boston meeting. In the wake of the meetings, he said, “I think I’ll be bringing a lot more focus to our local emergency planning people about pandemic flu.”He said it was hard to tell how well local planners would heed concerns about pandemic preparedness, since Sudbury is small and has no public health department. “It’ll get added to the many things that I’m a voice crying in the wilderness about,” he said.Filling a needVarious groups have recognized a need for guidance to help protect vulnerable people during a pandemic and have worked on aspects of the problem, but there has been no comprehensive effort until now, according to Jarris and DeBlois.”There’s a recognition that there’s a huge need, but there’s been a real gap in planning guidance for state and local agencies,” said DeBlois. “This project really fills that gap and provides consistent guidance to all the states as to what the best practices and key recommendations are.”The large number and variety of groups that serve vulnerable people made development of the guidance a complex challenge, said DeBlois.”There’s such a huge network of organizations and individuals that serve at-risk populations that it all works together right now like a web of different agencies that are truly the most connected to these folks,” she said. “Understanding how that works and what would need to happen to ensure that at-risk populations continue to be served in such an intense public health emergency was really challenging.”Jarris said he couldn’t predict to what extent public health agencies will use the guidance, but he expressed hope that it would induce them to build relationships with vulnerable groups.”I think there are people who are very hungry for guidance around this [issue],” he said. “So much of this work is building relationships with people in the community and those who are serving them that guidance is only the beginning. . . . There’s no substitute for getting out there and building those relationships.”See also: Full text of “At-Risk Populations and Pandemic Influenza: Planning Guidance for State, Territorial, Tribal and Local Health Departments”http://www.astho.org/Programs/Infectious-Disease/At-Risk-Populations/At-Risk-Pop-and-Pandemic-Influenza-Planning-Guidance-Executive-Summary/ASTHO’s At-Risk Populations Project sitehttp://www.astho.org/Programs/Infectious-Disease/At-Risk-Populations/At-Risk-Populations-Project-Methods,-Timeline,-Advisory-Panel-Members,-and-Project-Staff/
Jul 29, 2008 (CIDRAP News) – After more than 1,300 cases of Salmonella infection in 43 states over 3 months, investigators have finally found a smoking gun: a contaminated jalapeno pepper from the home of a Colorado resident who was sickened in the outbreak.The jalapeno tainted with the outbreak strain, Salmonella enterica serotype Saintpaul, was provided by a patient from Montezuma County, the Colorado Department of Public Health and Environment (CDPHE) announced yesterday. The county is in the state’s southwestern corner.”The pepper was purchased at a local Wal-Mart, likely on June 24, and the individual became ill on July 4,” the agency said in a news release. “This is the first pepper linked directly to an ill person in this outbreak.”Previously investigators had found the outbreak pathogen in a jalapeno at a Texas produce distributor but had not found it in any produce from the homes of patients.The Colorado announcement came yesterday as the Centers for Disease Control and Prevention (CDC) reported that the outbreak had increased to 1,304 cases in 43 states, plus Washington, DC, and Canada. Thirty-seven people became ill this month, and the latest reported illness onset date was Jul 12, the CDC said. The epidemic peaked in May.Tomatoes were long suspected as the cause of the outbreak, which was first publicized in early June, and investigators still have not excluded them as the possible cause of some early cases. But on the basis of investigations of several restaurant-related case clusters, suspicion fell on jalapeno and Serrano peppers early in July.On Jul 9 the Food and Drug Administration (FDA) warned that vulnerable groups, including the elderly, infants, and people with weakened immunity, should not eat raw jalapeno or Serrano peppers. Eight days later, the agency dropped its weeks-old warning against eating certain types of tomatoes. On Jul 21 the FDA announced that a jalapeno contaminated with the outbreak strain had been found at a distributor in McAllen, Tex.On Jul 25 the agency cleared US-grown peppers of blame for the outbreak but said consumers should continue to avoid eating raw jalapeno peppers from Mexico. The FDA also said people in high-risk groups should continue to avoid raw Serrano peppers grown in Mexico.See also: Jul 28 Colorado Department of Health news releasehttp://www.cdphe.state.co.us/release/2008/072808.htmlCDC update on the outbreakhttp://www.cdc.gov/salmonella/saintpaul/FDA Salmonella outbreak pagehttp://www.fda.gov/oc/opacom/hottopics/tomatoes.html#news
Public Health Seattle and King County, in its revised school closure guidance posted yesterday, said its policy change is an enhanced version of the approach it uses for seasonal influenza and is based on what is known about the new influenza virus and its spread. The guidance notes that the new strain, already spread widely, will continue for some time and that illness severity doesn’t appear to be greater than typical seasonal influenza. Schools that have a confirmed novel influenza case have three options: remain open with the individual isolated at home, close schools based on public health and community assessment, or close schools for a set number of days based on CDC guidance, which could change. Therefore, he said, the CDC is considering changing its advice from automatically closing schools to asking schools and parents to weed out sick children and individually send them home for at least a week. The CDC’s advice to close schools for 2 weeks has been “very aggressive—you may only get one chance to get out in front of a new infectious disease,” Besser said. But the rapid spread of the virus across the country, plus information from multiple locations that the spectrum of disease is about as severe as average seasonal flu, has caused the agency to reconsider. Besser said that, in those areas, parents are asked to check their children in the morning, and, if they are sick or are starting to feel a little sick, to keep them home for a full 7 days, even if they start to feel better before that period is up. In addition, schools and individual teachers are asked to take a close look at children as they arrive in the morning and to send them home if the school believes they are developing illness—for 7 days or until they are proven not to have flu. That procedure is already followed in Canada and in Seattle, which “asks people to really push hard on personal responsibility,” Besser said, and today Minnesota followed suit. Health and education officials in that state released updated school closure guidance that asks parents and teachers to identify and isolate children who have a fever and a recent onset of flu-like symptoms. Acting CDC director Dr. Richard Besser said in a press briefing that the virus is so widespread in the United States that “closing the schools as a means of not letting [the novel flu] spread through the community is not very effective.” “The fact that the novel influenza is currently behaving like regular flu does not mean we can relax,” said Sanne Magnan, MD, Minnesota commissioner of health, in a press release today. “Seasonal flu is a major health concern in its own right. It’s one of our leading causes of death, year in and year out.” As the outbreak progresses, laboratory diagnosis will identify a shrinking proportion of cases, as testing demand exceeds capacity and many people who have mild infections won’t see their doctors. “Closing schools where cases happen to be diagnosed while leaving most schools with undiagnosed cases open does not make sense as an ongoing influenza control strategy in our community,” the department said. May 4, 2009 (CIDRAP News) – The Centers for Disease Control and Prevention (CDC) signaled today that it will change its current recommendation—which is to close schools for at least 2 weeks when a confirmed case of novel H1N1 swine flu is found among students—as health officials in the Seattle area and Minnesota scaled back their guidance to reflect more of a seasonal influenza approach. “I would expect that as we get more information we will be looking to revise that guidance,” he said. Minnesota officials today unveiled similar guidance aimed at keeping students and staff with influenza symptoms out of schools, rather than routinely closing schools. They said in a statement that it’s not possible to identify every case of novel influenza, because the symptoms mimic those of other respiratory diseases. “We also know that we have other acute viral respiratory infections circulating in Minnesota,” they said in the statement. Public Health Seattle and King County has several tools for schools and parents on its Web site, including a guide for parents on when to keep a child home from school, a flu symptom checklist, and advice on how to care for someone who has influenza. “Individualized school closure based on reports of diagnosed cases is less effective, in addition to being impractical, as a control measure,” the Seattle-King County health department said. However, officials added that, consistent with seasonal influenza policy, some schools might be closed if large numbers of students or faculty become ill. Minnesota officials also said they are developing enhanced school-based surveillance for influenza-like illnesses.