Rapid Flu Tests May Reduce Threat Of Antibiotic Resistance

New tests to rapidly detect the flu are allowing doctors to cut down on the number of hospital patients who receive antibiotics, helping soften the rapidly worsening threat of antibiotic resistance, according to a study to appear in the Feb. 26 issue of the Archives of Internal Medicine. The study was posted online by the journal Jan. 22 because of the importance of the findings to public health.

The research was done by infection control experts at Rochester General Hospital in Rochester, N.Y., who are on the faculty at the University of Rochester Medical Center.

"I was pleasantly surprised by the results," said Ann Falsey, M.D., who led the study. "Rapid testing does give physicians evidence to discontinue antibiotics, and some physicians are responding to the evidence.

Falsey's team analyzed the records of 166 patients who definitely had the flu when hospitalized. Eighty-six of the patients tested positive with the rapid test, which gives an answer within minutes, while the 80 others either did not have the rapid test done, or they tested negative at the time but were later found to have the flu. The team checked the subsequent treatment to see if there was a difference in the use of antibiotics, which aren't effective or useful against viruses like the flu.

They found that 86 percent of the patients whose flu was confirmed early on were treated with antibiotics, compared to 99 percent of the patients whose flu wasn't identified immediately. It's not a huge difference in numbers, but the study showed that the difference is significant, demonstrating that the rapid test does reduce the use of antibiotics in the hospital.

"At least some proportion of doctors is willing to stop antibiotics when patients have a documented viral infection," said Falsey. "This is certainly encouraging, but there is a lot more work to do."

The issue is important, says Falsey, because the over-use of antibiotics makes patients and the community more vulnerable to dangerous microbes resistant to most treatments. It's particularly important in hospitals, where people most prone to infection are treated.

Yet, Falsey noted in the study that 61 percent of patients who were generally at low risk for bacterial infection continued to receive antibiotics. She says that the prescription of antibiotics to patients with a viral infection is often done by doctors who believe that their patient may also have a bacterial infection or that antibiotics will prevent subsequent bacterial infections that could occur while the person is weak with the flu or another virus. In the current study, for instance, those patients with the flu who were still receiving antibiotics tended to be older, smokers, and have breathing difficulties. In other words, they were the ones most vulnerable to such an infection.

Nevertheless, Falsey notes that there have been no studies proving that such a practice is effective at preventing infections.

"Doctors are trying to do the right thing by their patients. Sometimes they perceive antibiotics as the safest choice, even though a virus may be the cause of their patient's illness," said Falsey, noting that 90 percent of people with the flu who see a doctor are given antibiotics, even though the drugs won't help.

The simplest solution to antibiotic resistance would be for doctors to not prescribe antibiotics when they're unlikely to help, such as when a patient definitely has the flu, the common cold, or most cases of sore throat. But when patients don't feel well, many march into their doctor's office expecting an answer and feel neglected if they don't receive a prescription in return for their visit. That leaves doctors caught between prescribing medication that probably won't help, vs. appearing unhelpful to their patients.

"Oftentimes people get sick, they just want to feel better, and they assume there is a pill that will make them better quickly," said Falsey. "Unfortunately, that's not the case for many respiratory illnesses that are caused by viruses. Instead they should rest, drink plenty of fluids, and take over-the-counter medications to help ease their symptoms. But many patients don't want to hear that, and it can be difficult for a doctor to deliver the news."

###

The study, conducted with funding from the National Institutes of Health was conducted by Falsey, Edward Walsh, M.D., and Yoshihiko Murata, M.D., Ph.D. All three are involved in infection control at Rochester General Hospital and are on the faculty of the Infectious Diseases Division of the Department of Medicine at the University of Rochester Medical Center.

Contact: Tom Rickey
University of Rochester Medical Center

Hundreds With Suspected Stomach Flu On QEII Cruise Ship

According to US health officials, more than 300 people on board the Queen Elizabeth II cruise ship have been struck down with a suspected stomach flu.

A recent report released by Cunard Line says that laboratory tests on board the ship has confirmed the highly infectious gastrointestinal norovirus as the agent of the infection.

The ship docked in San Francisco on Wednesday, having started its 108 day journey in New York on the 8th of January.

The Vessel Sanitation Program of the US Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), reported on Monday that 276 of 1652 passengers (17 per cent), and 28 of 1002 crew (3 per cent), on the Cunard Line vessel have contracted an illness whose predominant symptoms are diarrhea and vomiting.

Cunard had informed the CDC on January 11th that there were some passengers on board who had fallen ill with symptoms of vomiting and diarrhea.

Cunard Line and its staff have taken a number of actions to address the problem. This includes increasing the cleaning and disinfection routines, telling passengers what is happening and what to do to avoid infection. There are also a number of environmental health specialists on board giving advice and support.

Officials from the CDC's Vessel Sanitation Program boarded the ship in Acapulco on the 19th of January. They will be investigating the outbreak, conducting an environmental inspection, asking questions of passengers and crew members, including the ones who fell ill, and then making recommendations.

Cunard Line have reported that all but 4 of the passengers have made a full recovery.

The CDC will continue to receive daily updates on the situation until the number of people who are ill recedes to normal levels.

Norovirus, sometimes called winter vomiting disease or stomach flu, is usually transmitted via the fecal-oral route by means of contaminated water or food.

Norovirus outbreaks are common at this time of year and cause the usual gastroenteritis symptoms of nausea, vomiting, diarrhea and abdominal pain. Sometimes this is accompanied by mild fever and headaches. The symptoms last for several days and are not normally life-threatening, unless patients who are vulnerable, such as the elderly, very young children and those who are immune-compromised, become dehydrated.

In November last year, 700 passengers and crew on board the cruise ship Liberty, owned by Carnival Cruise Line, fell ill with suspected norovirus.

CDC Vessel Sanitation Program

More information on Norovirus (wikipedia).

Written by: Catharine Paddock
Writer: Medical News Today

Groups Urge FDA To Review Policy That Bans MSM From Donating Blood

The American Red Cross and other organizations that collect donated blood are urging FDA to review a policy in effect since the early 1980s that prohibits men who have sex with men -- regardless of sexual activity, safer-sex practices or HIV status -- from donating blood, the San Jose Mercury News reports. According to the San Jose Mercury News, potential blood donors are asked to fill out a questionnaire before donating, and MSM, injection drug users, people who got a tattoo within the previous 12 months and pregnant women are prohibited from donating. A California high school student recently was not permitted to donate blood after he identified himself as an MSM, prompting some groups to challenge the FDA policy, which they claim is discriminatory. ARC, the American Association of Blood Banks and America's Blood Centers in March 2006 asked FDA to review the policy, saying that banning MSM from donating blood within 12 months of sexual activity with another man would be more fair than a lifelong ban, the Mercury News reports. The groups say that the likelihood of receiving a unit of HIV-infected blood is one in two million and that blood banks use nucleic acid testing, which detects HIV and hepatitis earlier than older testing methods. Michael Busch, vice president for Research and Scientific Affairs of the Blood Centers of the Pacific, said, "The testing systems are extremely robust because we test for antibodies and the virus itself." In addition, HIV is increasingly transmitted through heterosexual sex, and women account for more than one-quarter of all new HIV/AIDS cases in the U.S., according to CDC. Karen Riley, an FDA spokesperson, said that the agency reviews the policy periodically but that discussions usually support the current policy. "We understand that our recommendation for permanent deferral has the effect of deferring all gay men, but it really comes down to epidemiology," Riley said, adding, "Men who have sex with men are 60 times more likely to be HIV-infected than the general population. ... The policy is in place for the protection of the nation's blood supply." California Assembly member John Laird (D) said, "The FDA policy is out of date and is based on facts that existed a quarter of a century ago," adding, "I'm worried that we're cutting off a potential source of blood that is sorely needed" (Hull, San Jose Mercury News, 1/22).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

New Culture Method For Hepatitis C Virus Uses Primary Hepatocytes And Patient Serum

Researchers open the way for improved study of hepatitis C virus by devising a novel virus culture system that allows replication of patient-isolated virus in nontransformed hepatocytes, instead of culture-adapted virus strains in transformed cell lines. The related report by LГЎzaro et al, "Hepatitis C virus replication in transfected and serum-infected cultured human fetal hepatocytes," appears in the February issue of The American Journal of Pathology.

Hepatitis C virus (HCV) infection affects approximately 170,000,000 people worldwide. HCV liver disease, which may induce liver inflammation, cirrhosis, and/or hepatocellular carcinoma, represents the foremost reason for liver transplantation in much of the U.S.

Study of HCV replication within liver cells, or hepatocytes, has been hampered by a lack of adequate virus culture systems. Some systems allow the virus to infect cells but do not permit prolonged replication and production of virus, while other systems rely on derivatives of permissive virus isolates for efficient replication in transformed (mutated) cell lines. Still lacking has been a system to sustain replication of novel virus isolates from patients using nontransformed hepatocytes.

Nelson Fausto of the University of Washington School of Medicine has crossed this hurdle using a human fetal hepatocyte culture system that was previously developed in his lab. Using this system, his group has demonstrated sustained replication and production of virus particles for at least 2 months, with these virus particles able to infect new cells.

In their first experiments, Fausto and colleagues transfected hepatocyte cultures with HCV genomic RNA and found replication of HCV RNA genomes and production of core protein (for virus particle formation). Release of infectious virus particles was confirmed, as media from these cells were able to infect naive hepatocytes. Finally, virus particles were examined by electron microscopy and shown to possess the expected size and shape of HCV virus particles.

Once the system was established, the group examined whether sera from patients carrying HCV could infect the human fetal hepatocytes. When sera from patients infected with different HCV strains were added to the hepatocyte culture system, viral replication occurred and new virus particles were produced.

In both transfection and infection models, virus particles were released in a cyclical manner, with bursts of virus produced every 10-14 days. This is similar to what has been reported during clinical HCV infection, possibly due to the host's natural defenses. Interestingly, cultured hepatocytes responded to viral replication by displaying signs of distress and cell death and by expressing interferon-beta, a cellular antiviral, in an effort to control the infection.

This culture system provides a breakthrough in studying HCV replication in nontransformed hepatocytes, the natural target of the virus. By allowing infection by patient serum containing a wide array of virus strains, this system may allow better understanding of the differences between different strains, further improving treatment strategies.

###

This work was supported by grants from the National Institutes of Health and the Center for AIDS Research.

LГЎzaro CA*, Chang M*, Tang W, Campbell J, Sullivan DG, Gretch DR, Corey L, Coombs RW, Fausto N. Hepatitis C virus replication in transfected and serum-infected cultured human fetal hepatocytes. Am J Pathol 2007 170: 478-489. *These authors contributed equally to this work.

The American Journal of Pathology, the official journal of the American Society for Investigative Pathology (ASIP), seeks to publish high-quality original papers on the cellular and molecular mechanisms of disease. The editors accept manuscripts which report important findings on disease pathogenesis or basic biological mechanisms that relate to disease, without preference for a specific method of analysis. High priority is given to studies on human disease and relevant experimental models using cellular, molecular, biological, animal, chemical and immunological approaches in conjunction with morphology.

Contact: Audra Cox
American Journal of Pathology

Widespread Discrimination, Lack Of HIV Education Fueling Spread Of Virus In Caribbean, Health Officials Say

A widespread lack of HIV/AIDS awareness and education in the Caribbean is hampering efforts to reduce the spread of the virus in the region, health officials said on Sunday at the Caribbean Summit on HIV/AIDS in St. Croix, U.S. Virgin Islands, the AP/International Herald Tribune reports. In addition, HIV-positive people often delay seeking treatment for fear of discrimination by employers and others, and many people in the region perceive HIV/AIDS as a disease that largely affects men who have sex with men, officials said at the conference. "It's going to be a political challenge because, unfortunately, we live in a society that is very homophobic," Douglas Slater, health minister for St. Vincent and the Grenadines, said. According to Rep. Donald Payne (D-N.J.), co-chair of the Congressional Caribbean Caucus, the 15-member Caribbean Community has not obtained sufficient international funding for prevention and treatment efforts in the region. "Caricom needs to step up to the plate and demand these federal funds," Payne said. An estimated 500,000 people in the Caribbean, or 2.4% of the population, are HIV-positive, and the region has the second-highest prevalence after sub-Saharan Africa, the AP/Herald Tribune reports. About 24,000 people in the Caribbean died from AIDS-related illnesses in 2005, making the disease the leading cause of death among people ages 15 to 44, Barry Featherman -- president of the Inter-American Economic Council, which organized the conference -- said. Caribbean-based studies have found businesses that invest in HIV prevention programs save money by reducing health care costs and hiring more productive workers, officials said. However, efforts to educate the population on HIV/AIDS prevention and treatment have not been strengthened, Payne said. Albert Ramdin, assistant secretary-general for the Washington, D.C.-based Organization of American States, said, "This (pandemic) has major implications for governance, national security, human security and the economic viability of many of these countries whose resources are already stretched" (AP/International Herald Tribune, 1/21).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Microwave Oven Can Sterilize Sponges, Scrub Pads, Researchers Say

Microwave ovens may be good for more than just zapping the leftovers; they may also help protect your family.

University of Florida engineering researchers have found that microwaving kitchen sponges and plastic scrubbers - known to be common carriers of the bacteria and viruses that cause food-borne illnesses - sterilizes them rapidly and effectively.

That means that the estimated 90-plus percent of Americans with microwaves in their kitchens have a powerful weapon against E. coli, salmonella and other bugs at the root of increasing incidents of potentially deadly food poisoning and other illnesses.

"Basically what we find is that we could knock out most bacteria in two minutes," said Gabriel Bitton, a UF professor of environmental engineering. "People often put their sponges and scrubbers in the dishwasher, but if they really want to decontaminate them and not just clean them, they should use the microwave."

Bitton, an expert on wastewater microbiology, co-authored a paper about the research that appears in the December issue of the Journal of Environmental Health, the most recent issue. The other authors are Richard Melker, a UF professor of anesthesiology, and Dong Kyoo Park, a UF biomedical engineering doctoral student.

Food-borne illnesses afflict at least 6 million Americans annually, causing at least 9,000 deaths and $4 billion to $6 billion in medical costs and other expenses. Home kitchens are a common source of contamination, as pathogens from uncooked eggs, meat and vegetables find their way onto countertops, utensils and cleaning tools. Previous studies have shown that sponges and dishcloths are common carriers of the pathogens, in part because they often remain damp, which helps the bugs survive, according to the UF paper.

Bitton said the UF researchers soaked sponges and scrubbing pads in raw wastewater containing a witch's brew of fecal bacteria, viruses, protozoan parasites and bacterial spores, including Bacillus cereus spores.

Like many other bacterial spores, Bacillus cereus spores are quite resistant to radiation, heat and toxic chemicals, and they are notoriously difficult to kill. The UF researchers used the spores as surrogates for cysts and oocysts of disease-causing parasitic protozoa such as Giardia, the infectious stage of the protozoa. The researchers used bacterial viruses as a substitute for disease-causing food-borne viruses, such as noroviruses and hepatitis A virus.

The researchers used an off-the-shelf microwave oven to zap the sponges and scrub pads for varying lengths of time, wringing them out and determining the microbial load of the water for each test. They compared their findings with water from control sponges and pads not placed in the microwave.

The results were unambiguous: Two minutes of microwaving on full power mode killed or inactivated more than 99 percent of all the living pathogens in the sponges and pads, although the Bacillus cereus spores required four minutes for total inactivation.

Bitton said the heat, rather than the microwave radiation, likely is what proves fatal to the pathogens. Because the microwave works by exciting water molecules, it is better to microwave wet rather than dry sponges or scrub pads, he said.

"The microwave is a very powerful and an inexpensive tool for sterilization," Bitton said, adding that people should microwave their sponges according to how often they cook, with every other day being a good rule of thumb.

Spurred by the trend toward home health care, the researchers also examined the effects of microwaving contaminated syringes. Bitton said the goal in this research was to come up with a way to sterilize syringes and other equipment that, at home, often gets tossed in the household trash, winding up in standard rather than hazardous waste landfills.

The researchers also found that microwaves were effective in decontaminating syringes, but that it generally took far longer, up to 12 minutes for Bacillus cereus spores. The researchers also discovered they could shorten the time required for sterilization by placing the syringes in heat-trapping ceramic bowls.

Bitton said preliminary research also shows that microwaves might be effective against bioterrorism pathogens such as anthrax, used in the deadly, still-unsolved 2001 postal attacks.

Using a dose of Bacillus cereus dried on an envelope as a substitute for mail contaminated by anthrax spores, Bitton said he found he could kill 98 percent of the spores in 10 minutes by microwaving the paper - suggesting, he said, one possible course of action for people who fear mail might be contaminated. However, more research is needed to confirm that this approach works against actual anthrax spores, he said.

Credits

Writer
Aaron Hoover

Source and Contact:
Gabriel Bitton
University of Florida

European Union Offers Improved Relations With Libya If Medical Workers Are Released

The European Union on Monday said that the body would improve its relations with Libya if the country releases the five Bulgarian nurses and Palestinian doctor sentenced to death for allegedly intentionally infecting hundreds of Libyan children with HIV, Reuters Health reports (Brunnstrom [1], Reuters Health, 1/22). The health workers in May 2004 were sentenced to death by firing squad for allegedly infecting 426 children through contaminated blood products at Al Fateh Children's Hospital in Benghazi, Libya. They also were ordered to pay a total of $1 million to the families of the HIV-positive children. The Libyan Supreme Court in December 2005 overturned the medical workers' convictions and ordered a retrial in a lower court. A court in Tripoli, Libya, last month convicted the health workers and sentenced them to death. The health workers say they are innocent of the charges, claiming that they were forced to confess and that they were tortured by Libyan officials during interrogations. The European Parliament on Thursday in a resolution called on E.U. member states to review their trade relations with Libya and to urge Libya to release the medical workers. The resolution called on E.U. members to review "the common policy of engagement with Libya in all relevant fields" (Kaiser Daily HIV/AIDS Report, 1/18). Foreign ministers from 27 E.U. countries in a statement released after talks in Brussels, Belgium, expressed "grave concern" over last month's verdict (Brunnstrom [1], Reuters Health, 1/22). The ministers called for a "positive, fair and prompt solution" to the case (Brunnstrom [2], Reuters Health, 1/22). "In this context, the relations between the European Union and Libya can further develop," the statement said (Brunnstrom [1], Reuters Health, 1/22). According to an E.U. diplomat, E.U. members "want to send a very firm signal of solidarity with the Bulgarians and to make clear our position that the trial and verdict were not acceptable." Spanish Foreign Minister Miguel Angel Moratinos before the talks said that Spain has offered to provide treatment for some of the HIV-positive children, although numbers have not been discussed, Reuters Health reports (Brunnstrom [2], Reuters Health, 1/22).

European Parliament Should Not Politicize Case, Libyan Official Says
Seif al-Islam Gaddafi -- the son of Libyan leader Muammar Gaddafi and head of Gaddafi International Foundation for Charity Associations -- in a statement issued Saturday said that members of the European Parliament should not politicize the case of six medical workers, the AP/Washington Post reports. "Pressures by Europeans on Libya will have a negative impact on the situation of the nurses and the Palestinian doctor and will take the case out of its legal and judicial context to the political arena," Gaddafi in the statement said. He also said that European pressure would "hinder efforts exerted in several directions to reach a just solution and complete settlement for this issue" (El-Deeb, AP/Washington Post, 1/20). Mohammed Abdel-Rahman Shalgam, Libyan Foreign Liaison and International Cooperation Minister, speaking to the Libyan General People's Congress on Saturday said the country will not agree to the "unfair" European demands. "The independence of the Libyan judicial system is a red line, being part of our independence and sovereignty, and we can never accept interference in its affairs," Shalgam said, adding, "On the one hand, they (European countries) request the transparency and fairness of the judiciary, but when they see the fairness and transparency of judiciary, they demand the state's interference in the work of judiciary." Shalgam said that the current sentences are not the final word in the case and that decisions from the Supreme Court and the High Judicial Council are expected. "The High Judicial Council alone is the one to ratify the court's ruling," Shalgam said (Sarrar, Reuters, 1/21).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Seasonal Influenza On Increase In Europe

It is official - this year's influenza season has begun, the European Influenza Surveillance Scheme (EISS) confirmed today. There is currently increased influenza activity reported in five countries: Greece, the Netherlands, Northern Ireland, Spain and Switzerland, and this has been accompanied by increases in laboratory confirmed influenza cases. This increase in activity signals the start of the influenza season and, based on historical data, influenza activity is expected to increase in many more countries over the coming weeks.

В  Laboratory confirmed cases from population based samples for Europe as a whole have risen from less than 100 per week up to week 50/2006 to over 350 in week 2/2007, and are expected to peak at between 1,000 and 2,000 as influenza affects more countries. The majority of influenza virus detections in Europe were reported from England, France, Greece, Norway, Scotland, Spain, Sweden and Switzerland, and in most other countries across Europe influenza viruses have been detected in low numbers.

В  Professor Koos van der Velden, Chairman of EISS, says, "Influenza strikes and spreads quickly, so rapid action is vital. The key to a quick response is accurate and timely surveillance. Data from the EISS network enable us to track influenza across Europe, including the pattern and speed of its spread and the predominant virus strain. We can then alert health care professionals and patients to facilitate rapid diagnosis and treatment and minimise the potential impact of the season."

В  This year's (2006-2007) season starts about two weeks earlier than last year's (2005-2006), which had high levels of influenza virus detections in Europe from mid-February to late April[1].В  And, unlike last year when influenza B was the dominant virus in Europe, this year's cases to date have primarily been of the H3 strain of the more virulent influenza A virus. Studies have shown that there is significantly higher mortality associated with the influenza A H3 virus compared to the influenza B virus[i].

В  Influenza is highly contagious and spreads rapidly by coughs and sneezes from people who are already carrying the virus[ii].В  Influenza affects approximately one in 10 people around the world every year[iii], creating substantial demands on healthcare resources and escalating costs due to increases in primary care consultations, hospitalisations, clinical complications, drug treatment and absence from work[iv],[v],[vi],[vii]. During an annual season, or epidemic, the number of deaths from influenza and its complications can be as high 500,000 people around the world every year[viii].

В  The EISS network receives data from 30 member countries in Europe tracking clinical activity, geographical spread and virus types. This information is reported in a weekly surveillance report available via the website and is uploaded to an influenza map on the home page. National data is available for all those countries who have reported weekly updates. The supply of timely surveillance information is critical to enable health authorities and health care professionals to respond appropriately.

В  "It's all very well having public health systems in place, whether for seasonal or pandemic influenza, but their effectiveness rests on having timely information and the ability to rapidly set the plan in motion when required.В  We urge health care providers to take advantage of our extensive resources and ensure they underpin their influenza systems with the most up-to-the-minute tracking data available", said Professor van der Velden.

В  The effects of influenza are debilitating, putting people out of action altogether, and recovery can take up to two weeks.В  Anyone can get the flu and it can be especially serious for the elderly, children and people with certain medical conditions (commonly defined as high-risk people).В  The most common symptoms of influenza include an abrupt onset of fever, headache, muscle ache and a dry cough1.В 

В  To reduce the risk of infection, particularly high-risk people should get an influenza vaccine as early as possible in the season.В  Now that the season has begun, the public should take general health precautions and, where possible, those infected with influenza should try to avoid close contact with others. To help prevent infection or reduce the severity and duration of infection, antiviral medications are available on prescription and are most effective the earlier they are taken in the course of the illness.В 

В  "Speed is the key to all influenza management", says Professor van der Velden, "Acting swiftly is crucial, both for health authorities and the general public.В  Flu is fast, so to beat it we need to be very quick too."

This article is supported by Roche for the advancement and support of medical, scientific and patient initiatives.

В  About influenza

Influenza, commonly called "the flu", is an acute respiratory illness that affects the upper and/or lower parts of the respiratory tract and is caused by an influenza virus. В There are three types of influenza viruses: A, B, and C[ix]. Influenza A subtypes and B viruses are classified by 'strains', variations of the virus caused by ongoing mutation.В  When a new strain of human influenza virus emerges, antibody protection that may have developed after infection or vaccination with an older strain may not provide protection against the new strain[x].В  Seasonal influenza usually occurs in the autumn and winter months, and usually peaks between December and March in the Northern hemisphere[xi].

В  About EISS

The European Influenza Surveillance Scheme (EISS), established in 1996, is a modern and efficient European surveillance system that collects high quality data, combining both epidemiological and virological information.В  The mission of EISS is to contribute to a reduction in morbidity and mortality from influenza in Europe.В 

В  The spread of influenza virus strains and their impact in Europe are monitored by EISS in collaboration with the WHO Collaborating Centre in London (United Kingdom) and the European Centre for Disease Prevention and Control in Stockholm (Sweden).В 

-- Graph showing how this year's influenza season compares with last year's

The key services managed by EISS include:

-- Weekly surveillance reports from all 30 member countries (26 EU member states, Norway, Switzerland, Serbia and the Ukraine), reported by over 13,500 sentinel physicians and 38 national reference laboratories, covering a total population of over 480 million inhabitants.

-- Influenza surveillance maps of Europe.В  (NB. Clicking on the map of a specific country will also link to the website of the national surveillance authority).

-- A weekly surveillance report, posted on the website and distributed at 12pm every Friday to subscribers, featuring the latest information on:
- Consultation rates
- Geographical spread intensity
- Historical time trends
- Virus types and dominant strains

-- A database of research mapping the trends of influenza over the past 10 years, available via the website. Data includes maps and graphical representations of all reporting countries.

В  Please visit the EISS website at http://www.eiss.org for further information.

References

i - Thompson et al JAMA January 8 Vol 289(2):179-186. Mortality associated with influenza and respiratory syncytial virus in the US.

ii - Department of Health, Centres for Disease Control and Prevention, Flu Facts, 2006.

iii - European Influenza Surveillance Scheme, Influenza Factsheet.В  Accessed 11 January 2007

iv - Meier CR, Napalkov PN et al. Population based study on incidence risk factors, clinical complications and drug utilisation associated with influenza in the United Kingdom. European J Clinical Microbiological Infectious Disease 2000; 19: 834-842

v - Fleming DM. The impact of three influenza epidemics on primary care in England and Wales, PharmacoEconomics 1996; 9 (suppl.3)

vi - Barker. WHO, impact of epidemic type A influenza in a defined adult population. American Journal of Epidemiology 1980; 112 (6)

vii - Keech M et al. The impact of influenza and influenza like illness on productivity and healthcare resource utilization in a working population. Occup Med (Lond). 1998;48(2):85-90

viii - WHO Factsheet 211. Revised March 2003. Accessed 11 January 2007

ix - Department of Health 'Immunisation Against Infectious Disease (The Green Book), Third edition'.В  В Chapter 19: Influenza. В London. The Stationery Office December 2006 link here (pdf)

x - Centers for Disease Control and Prevention, Influenza (flu)

xi - Health Protection Agency 'Frequently asked questions on influenza' Reviewed on 12 December 2005

Researchers Propose Reason For Severe Side-Effects Of Northwick Park Clinical Trial

A possible reason why the Northwick Park clinical trial of the drug TGN1412 in the UK caused multiple organ failure in human volunteers is revealed in research presented at a conference near Paris.

The research shows that stimulating the molecule CD28 on cells that mediate the immune response, known as T cells, can have an adverse effect if these immune cells have been activated and altered by infection or illness in the past.

The scientists found that when they artificially stimulated CD28 on these previously activated 'memory' T cells, this caused the cells to migrate from the blood stream into organs where there was no infection, causing significant tissue damage. CD28 is an important molecule for activating T cell responses and the TGN1412 drug tested on the human volunteers strongly activates CD28.

Around 50% of adult human T cells are memory cells, having been activated by infections and illnesses during the course of a person's life. However, animal models, such as those used to test TGN1412 before tests were carried out on humans, do not have many memory T cells because they are deliberately kept in a sterile environment where they are shielded from infections.

The research, by scientists from Imperial College London, King's College London, and the Babraham Institute, was presented at the Club de la Transplantation conference in Cernay la Ville, near Paris.

Dr Federica Marelli-Berg, lead author of the research from the Department of Immunology at Imperial College London, explained: "The drug TGN1412 appeared to be relatively safe when it was tested in animal models. However, when the drug was tested on human volunteers, some experienced very severe side-effects.

"Our research suggests that this is because the human subjects' memory T-cells lost their sense of direction and started migrating into several areas of the body where they were not supposed to go, and caused damage."

The researchers reached their conclusions after memory T cells in which CD28 had been previously stimulated were injected into healthy mice. These cells immediately migrated from the blood into many organs including the kidney, the heart and the gut, where they are not normally found unless there is an infection.

TGN1412 was developed to treat chronic inflammatory conditions, including rheumatoid arthritis, leukaemia and multiple sclerosis, which are caused by the body's immune system attacking itself. It was thought that by targeting CD28, the drug could over-stimulate the rogue T cells, making them burn out and die.

###

The study was funded by the British Heart Foundation.

Contact: Laura Gallagher
Imperial College London

Toward Medical Implants With An Antibiotic Coating

The search for ways to protect polymer-based medical implants -- used in devices ranging from contact lenses to artificial hearts, as well as surgical devices and operating room equipment -- from bacterial infections has led scientists in Mississippi to develop a penicillin-coated version of a key polymer biomaterial.

In a report scheduled for the Feb. 12 edition of ACS' Biomacromolecules, a monthly journal, Marek W. Urban and colleagues describe a new way to modify expanded poly(tetrafluorethylene), or ePTFE, so that penicillin adheres to its surface and remains highly effective. This polymer is used in medical procedures ranging from vascular grafting to plastic and reconstructive surgery. In laboratory experiments, the researchers also demonstrated that the penicillin-coated surfaces showed highly effective antibacterial activity against Staphylococcus aureus, which causes many serious human infections.

The researchers believe this is the first study to report such activity. "This approach may serve as a general surface modification process for the development of polymeric surfaces with anti-microbial properties," their report states.

ARTICLE #4
"Antibacterial Surfaces on Expanded Polytetrafluoroethylene; Penicillin Attachment"

CONTACT:

Marek W. Urban, Ph.D.
The University of Southern Mississippi
Hattiesburg, Mississippi

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ACS News Service Weekly PressPac -- Jan. 17, 2007

The American Chemical Society -- the world's largest scientific society -- is a nonprofit organization chartered by the U.S. Congress and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.

Contact: Michael Woods
American Chemical Society