NY Times

“Stung by the lack of vaccines to fight the West African Ebola epidemic, a group of prominent donors announced Wednesday that they had raised almost $500 million for a new partnership to stop epidemics before they spiral out of control.

The partnership, the Coalition for Epidemic Preparedness Innovations, will initially develop and stockpile vaccines against three known viral threats, and also push the development of technology to brew large amounts of vaccine quickly when new threats…arise……Bill Gates, founder of the Bill and Melinda Gates Foundation, one of the largest initial donors…has often predicted that the catastrophe most likely to kill 10 million people in the near future is a pandemic rather than nuclear war, terrorism, famine or natural disaster.

The other donors….include the governments of Japan and Norway, and Britain’s Wellcome Trust. Each is putting up $100 million to $125 million over five years; Germany, India and the European Commission are expected to announce donations soon.

Six major vaccine makers — GlaxoSmithKline, Johnson & Johnson, Merck, Pfizer, Sanofi and Takeda — joined in the coalition as “partners” rather than donors, as did the World Health Organization and Doctors Without Borders……”

History Channel

•  “…The quake struck in the middle of a densely populated area with poorly constructed buildings and homes, resulting in a horrific death toll…”

BBC

VOA

Hindustan Times

WEAK53 PAAQ 220440
TIBAK1

Tsunami Information Statement Number 1
NWS National Tsunami Warning Center Palmer AK
840 PM PST Sat Jan 21 2017

…THIS IS A TSUNAMI INFORMATION STATEMENT FOR ALASKA, BRITISH
COLUMBIA, WASHINGTON, OREGON AND CALIFORNIA…

EVALUATION
———-
* There is no tsunami danger for the areas listed above.

* Based on the depth of the earthquake a tsunami
is not expected.

* An earthquake has occurred with parameters listed below.

PRELIMINARY EARTHQUAKE PARAMETERS
———————————
* The following parameters are based on a rapid preliminary
assessment and changes may occur.

* Magnitude      8.0
* Origin Time    1930 AKST Jan 21 2017
2030  PST Jan 21 2017
0430  UTC Jan 22 2017
* Coordinates    6.1 South 155.2 East
* Depth          104 miles
* Location       near the Solomon Islands

ADDITIONAL INFORMATION AND NEXT UPDATE
————————————–
* Refer to the internet site ntwc.arh.noaa.gov for
additional information.

* Pacific coastal regions outside California, Oregon,
Washington, British Columbia and Alaska should refer to the
Pacific Tsunami Warning Center messages at ptwc.weather.gov.

* This will be the only U.S. National Tsunami Warning center
message for this event unless additional information becomes
available.

$$

Eurosurveillance

Trebbien R, Pedersen SS, Vorborg K, Franck KT, Fischer TK. Development of oseltamivir and zanamivir resistance in influenza A(H1N1)pdm09 virus, Denmark, 2014. Euro Surveill. 2017;22(3):pii=30445. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2017.22.3.30445

“Influenza virus is the cause of annual seasonal epidemics worldwide, and leads to high morbidity in the population. Severe disease and deadly outcome due to influenza virus are recognised in the defined risk groups, in particular elderly persons > 65 years of age and immunocompromised patients. Influenza is normally an acute self-limiting disease with a duration of 5 to 7 days, however, in immunocompromised patients prolonged infections lasting several months have been reported [1–4]. Prevention of severe influenza disease is mainly based on immunisations with split vaccines which are produced annually to accommodate the changing antigenicity of seasonal epidemic viruses [5,6]. The effect of vaccination in immunocompromised patients is questionable and this is why other modes of prevention and/or treatment often are considered for this risk group [7–12]. For treatment of influenza viruses only a few antiviral drugs are available; the neuraminidase (NA) inhibitors and the matrix-2 (M2)-ion channel inhibitors. The current circulating epidemic influenza viruses harbour natural resistance towards the M2-ion channel inhibitors therefore these are not an option for treatment [13–15]. The NA inhibitors bind to the NA surface protein and prevent it from facilitating the release of new virus particles from an infected cell [16]. In Denmark, two different NA inhibitors are approved and available for treatment of influenza: oseltamivir (Tamiflu) and zanamivir (Relenza). Oseltamivir is the drug of choice for treatment due to its easy oral administration whereas zanamivir (intravenous or inhalation) is often used when the effect of oseltamivir is limited, e.g. in case of development of resistance. In the NA gene of the H1N1 viruses a range of amino acid mutations are recognised to confer reduced inhibition by NA inhibitors [16–18]. Among these, two well characterised mutations are the H275Y mutation which results in viruses with highly reduced inhibition by oseltamivir and the I223R mutation which results in reduced inhibition by both oseltamivir and zanamivir [16,17].

Antiviral treatment of immunocompromised patients with prolonged influenza virus infection can lead to multidrug-resistant influenza quasispecies in the same patient [1]. We describe how the emergence of such virus variants poses challenges in the combat of a severe influenza infection in a Danish patient treated with antivirals. The patient had sustained shedding of influenza A(H1N1)pdm09 virus for 6 months and was treated with oseltamivir and subsequently zanamivir. Antiviral resistance mutation profiles were evaluated using conventional Sanger sequencing and next generation sequencing (NGS)…..”

Flu News Europe

Week 2/2017 (9 – 15 January 2017)

• Influenza activity remained widespread across the region with high or very high intensity in 8 out of 44 reporting countries or regions and medium intensity in 26 countries.
• The proportion of influenza virus detections among sentinel surveillance specimens was 46%, a slight decline from 52% in the previous week.
• The great majority of influenza viruses detected were type A (97%) and, of those subtyped, 99% were A(H3N2).
• Most of the hospitalized laboratory-confirmed cases reported have occurred in people aged 65 years or more.
• Excess all-cause mortality among the elderly has been observed in the past 1 to 2 months in most of the 18 countries that take part in  EuroMOMO.

Season overview

• Influenza activity started early this season compared to previous seasons.
• Week 46/2016 is the earliest week that the overall influenza-positivity rate in sentinel specimens reached 10% since the emergence of A(H1N1)pdm09 viruses in the 2009 season; during the last 6 seasons this occurred between weeks 48 and 51.
• Since week 40/2016, influenza A viruses have predominated, accounting for 96% of all sentinel detections; the great majority (99%) of subtyped influenza A viruses from sentinel sites has been A(H3N2).
• In an influenza season in which A(H3N2) viruses predominate, elderly populations can be expected to be most severely affected. Indeed, confirmed cases of influenza A infection reported from hospitals have predominantly been in adults aged over 65 years.
• So far, circulating A(H3N2) viruses are antigenically similar to the vaccine strain. While about two-thirds of the A(H3N2) viruses characterized belong to a new genetic subclade (3C.2a1), these viruses are antigenically similar to the vaccine strain (clade 3C.2a).
• Early monitoring of vaccine effectiveness in Finland and Sweden suggests levels of effectiveness similar to estimates from multi-country studies during the seasons 2011–2012 to 2014–2015 with 26% (95% CI 22% to 30%) and 24% (95% CI 11% to 34%) vaccine effectiveness, respectively, in persons aged 65 years and older with laboratory-confirmed influenza A. Given the partial effectiveness of influenza vaccines, rapid use of neuraminidase inhibitors for laboratory-confirmed or probable cases of influenza infection should be considered for vaccinated and non-vaccinated patients at risk of developing complications.
• No reduced antiviral susceptibility has been observed among the viruses tested.
• A risk assessment on seasonal influenza in EU/EEA countries was published by ECDC on 24 December 2016. The above summary is in line with the findings of the risk assessment.

Figure. Influenza virus detections in sentinel-source specimens by type and subtype, by week and cumulatively

CDC

Summary of Weekly FluView Report