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  #21  
Old 01-02-2015, 07:25 AM
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Mary Pat Campbell
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SEASONAL FLU

http://abcnews.go.com/Health/15-chil...9&from=related

Quote:
Fifteen children have died from complications of the flu so far this season, the Centers for Disease Control and Prevention noted, as it officially declared the illness an epidemic.

The number of states reporting a high amount of “influenza-like” illness activity has increased from 13 to 22 since last week’s report from the agency, with outbreaks in every region of the country.

....
At least six Tennessee children have died from the flu this year, the state's Department of Health reported. Tennessee is under the widespread outbreak category, as of Monday, according to the CDC. So far, East Tennessee Children’s Hospital has seen 442 children with the flu just this month.

While this year’s strain of the virus is especially severe, ABC News chief health and medical editor Dr. Richard Besser said, flu can always be deadly for children, the elderly and anyone with a compromised immune system.

“Every year about a hundred children die from the flu,” he said today on “Good Morning America.”

About 90 percent of flu cases so far this year have been the H3N2 subtype, the CDC reported.

....
H3 subtypes tend to lead to the largest number of hospitalizations and deaths, Tosh said.

The hardest hit states are in the south, Midwest and western parts of the country, though Patsy Stinchfield, the director of infection prevention and control with Children's Hospitals and Clinics of Minnesota, said it’s unclear why.

......
Besser said for the past four years flu season has been hitting earlier and earlier and that is a worrying trend.

“It seems to be peaking at the end of December and it used to be it did not peak until February or March,” he said.

Although the current vaccine does not seem to be a good match for this year’s strain of the virus, Besser said, it still makes sense to get a flu shot, especially if you are in a high-risk group.

“There may be some level of cross-protection,” he added,” but we won’t know until March or so until we look back.”

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  #22  
Old 01-02-2015, 09:23 AM
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"This year, the vaccine protection rate may be even lower because, even in the red-hot super-cool molecular science world of the 21st century, we still generate flu vaccine like it’s 1963. Here’s the staid approach: In winter each year, certified flu experts meet in a room and decide which of the dozens of strains circulating worldwide are likeliest to cause the most harm when the next winter’s flu season hits, eight to 10 months hence. "
They are still doing it that way? Is this program run by people who are uniquely qualified to predict the future? I thought a program was being set up a few years ago to improve the vaccine development time line.
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  #23  
Old 01-02-2015, 09:30 AM
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Originally Posted by JMO View Post
"This year, the vaccine protection rate may be even lower because, even in the red-hot super-cool molecular science world of the 21st century, we still generate flu vaccine like it’s 1963. Here’s the staid approach: In winter each year, certified flu experts meet in a room and decide which of the dozens of strains circulating worldwide are likeliest to cause the most harm when the next winter’s flu season hits, eight to 10 months hence. "
They are still doing it that way? Is this program run by people who are uniquely qualified to predict the future? I thought a program was being set up a few years ago to improve the vaccine development time line.
They still incubate it in chicken eggs, iirc. That takes a lot of time.

Let me google!

http://www.cdc.gov/flu/protect/vacci...ccine-made.htm

Quote:
There are three different influenza vaccine production technologies approved by the U.S. Food and Drug Administration (FDA):

egg-based flu vaccine,
cell-based flu vaccine, and
recombinant flu vaccine.
All commercially available flu vaccines in the United States are made by private sector manufacturers. Different manufacturers use different production technologies, but all flu vaccines meet FDA safety and efficacy requirements. The different vaccines are approved with different indications. See Influenza Vaccines — United States, 2013–14 Influenza Season for specific indications.

Egg-Based Flu Vaccines

The most common way that flu vaccines are made is using an egg-based manufacturing process that has been in existence for more than 70 years. Egg-based vaccine manufacturing is used to make both inactivated (killed) vaccine (usually called the “flu shot”) and live attenuated (weakened) vaccine (usually called the “nasal spray”).

......
There are many different manufacturers that use this production technology to make flu vaccines for use in the United States. This production method requires large numbers of chicken eggs to produce vaccine and usually takes the longest period of time to produce vaccine.

Cell-Based Flu Vaccines

There also is a cell-based production process for flu vaccines, which was approved by FDA in 2012. This production process also begins with egg-grown vaccine viruses per FDA regulations. Manufacturers mix the vaccine viruses with cultured mammalian cells (instead of incubating them in eggs) and leave them to replicate for a few days. Then the virus-containing fluid is collected from the cells and the virus antigen is purified. The manufacturing process continues with purification and testing. Next the manufacturers put doses into vials or syringes, while waiting for FDA testing and approval to release lots.

Right now, there is just one FDA-approved cell-based flu vaccine in the United States. Cell-based flu vaccine production does not require large numbers of chicken eggs because the vaccine viruses used to make vaccine are grown in animal cells. This method takes slightly less time to manufacture vaccine than egg-based technology.


Recombinant Flu Vaccines

There is a third production technology for flu vaccines that was approved for use in the U.S. market in 2013 and that involves using recombinant technology. This production method does not require an egg-grown vaccine virus and does not use chicken eggs at all in the production process. Instead, manufacturers isolate a certain protein from a naturally occurring ("wild type") recommended vaccine virus (the HA protein, which induces an immune response in people). These proteins are then combined with portions of another virus that grows well in insect cells. This “recombinant” vaccine virus is then mixed with insect cells and allowed to replicate. The flu HA protein is then harvested from these cells and purified. The purified protein is packaged while waiting for FDA testing and approval to release lots. Recombinant flu vaccine is the only 100% egg-free vaccine on the U.S. market.

There are other vaccines on the U.S. market that use similar recombinant manufacturing processes. This process can produce vaccine in the shortest amount of time because it is not dependent on an egg supply or limited by the selection of vaccine viruses that are adapted for growth in eggs. There is one influenza vaccine produced using recombinant technology approved by the FDA for use in the United States at this time.

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  #24  
Old 01-02-2015, 04:56 PM
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CHIKUNGUNYA VIRUS

http://www.cdc.gov/chikungunya/geo/united-states.html

Quote:
Chikungunya is not a nationally notifiable disease in the United States. However, chikungunya cases can be reported to ArboNET, the national surveillance system for arthropod-borne diseases.

From 2006‒2013, studies identified an average of 28 people per year in the United States with positive tests for recent chikungunya virus infection (Range 5‒65 per year). All were travelers visiting or returning to the United States from affected areas, mostly in Asia. Only a quarter of the cases were reported to ArboNET.

Beginning in 2014, cases were identified in travelers returning from the Caribbean. As of December 16, a total of 2,021 chikungunya virus disease cases have been reported to ArboNET from U.S. states (Table 1). Eleven locally-transmitted cases have been reported from Florida (Figure 1). All other cases occurred in travelers returning from affected areas in the Americas (N=1,989), Asia (N=11), or the Pacific Islands (N=10).

A total of 4,023 chikungunya virus disease cases have been reported to ArboNET from U.S. territories (Table 2). Of these, 3,984 were locally-transmitted cases reported from Puerto Rico and the US Virgin Islands. The remaining 39 cases occurred in travelers returning from other affected areas in the Americas.

With the recent outbreaks in the Americas and the Pacific, the number of chikungunya cases among travelers visiting or returning to the United States from affected areas will continue to increase. These imported cases could result in local spread of the virus in the continental United States.
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  #25  
Old 01-03-2015, 03:42 PM
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EBOLA

http://www.scientificamerican.com/ar...SA_WR_20141231

Quote:
Genetic sequencing can allow scientists to start answering questions about where the virus is coming from – say if Ebola was clearly just being passed from one person to the next or if the virus was being repeatedly introduced to communities from an outside source, likely an animal. One such study published in Science this summer concluded that so far Ebola circulating in Sierra Leone does not appear to have originated from multiple reintroductions of the virus. Rather, by sequencing 99 Ebola virus genome sequences of the majority of Ebola patients in Sierra Leone this past spring the group found that all the cases were traceable to a “patient zero” of Ebola in the community. Yet if there was continuous reintroduction of the same strain of the virus from animals to humans there may not be significant enough mutations to detect what was happening and it could appear to be a continuous chain of transmission, cautions Gary Kobinger, head of the special pathogens program at the Public Health Agency of Canada. And if the virus, hypothetically, somehow adapted to the human population and became less aggressive over time then perhaps that would provide an early sign of endemicity, he says. But tracing that evolution would prove quite challenging. Still, top Ebola experts are not ready to start calling Ebola endemic, at least not yet.
also, maybe I should change the name of the thread to endemic/epidemic watch
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  #26  
Old 01-11-2015, 09:26 PM
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SEASONAL FLU

http://news.yahoo.com/flu-becomes-mo...180457535.html

Quote:
NEW YORK (AP) — In the midst of a worrisome flu season, health officials are pushing doctors to prescribe antiviral medicines more often.

The Centers for Disease Control and Prevention on Friday sent a new alert to doctors, advising prompt use of Tamiflu and other antivirals for hospitalized flu patients and those at higher risk for complications like pneumonia.

CDC officials say a nasty strain of flu is going around that is more dangerous to elderly people and very young children. What's more, officials think the flu vaccine doesn't work well against this particular virus. So "it's more important than usual" that doctors treat certain patients with Tamiflu or other antiviral medications, CDC Director Dr. Tom Frieden said at a press conference Friday.

CDC officials said flu was reported to be widespread in 46 states last week, up from 43 the week before. But there was a small drop in states reporting high numbers of flu-related doctor's office visits. That's one sign that for some areas, the worst stretch of the current flu season may be ending.

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Old 01-12-2015, 10:03 AM
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INSURERS

http://www.lifehealthpro.com/2015/01...916&page_all=1

Quote:
When Ebola showed signs of spreading, a few insurers moved quickly to exclude coverage. Gigi Norris, managing director of Aon Risk Solutions’ western regional health care practice in San Francisco, calls the reaction reprehensible. ‘With respect to Ebola, this is the first time I’ve ever seen anything like this with everyone rushing to issue an exclusion,” she said.

Norris says the move is a reactive one, and based on what she calls a culture of fear. In her estimation, those fears are unfounded. With approximately 13,000 people around the world sick with Ebola, she believes the exclusions aren’t warranted.

That’s to be expected, says Huhnsik Chung, partner in the insurance and reinsurance department with Edwards Wildman Palmer in New York. “Every few years, we have an epidemic that’s localized and there’s a growing fear it may grow into a pandemic,” she said. “Insurers tend to narrow and exclude the scope of coverage, which leads to certain market opportunists providing that coverage.”

Still, Norris says some of the exclusions are based on sound reasons. “To be fair, most of the exclusions I’ve seen have been targeted at certain industries – energy, defense, and mining,” Chung explained. “They have exposures in those industries with people going to Africa to these potentially infected countries, and coming back.”

Still, some insurers, including Lexington Insurance, Gallagher and Hiscox, have launched various policies to act as either stand-alone products or wrap around existing coverage in an attempt to provide some risk transfer with Ebola.

In general, however, little coverage exists for pandemic situations. Richard Kosinski, president of Specialty Insurance Advisors in Boston, an exclusive U.S. distributor for Lloyds of London, says it’s because pandemics are typically short-lived and can’t be underwritten with any amount of certainty. He understands the reaction by insurers. “Some new pandemic throws everything into chaos,” said Kosinski. “They don’t understand how to underwrite it or price it, and how to implement it. That’s what you’re seeing [with Ebola]. The first reaction is to exclude it.”

Sound reasoning
That, said Chung, is just good business strategy. He uses the example of influenza: “With influenza, there have been hundreds of millions of deaths within the last 100 years. Every 50 or 60 years, something bad comes along and a ton of people die. If you see the impact of that kind of real global pandemic on the global economies and the impact on insurance, the losses to insurers now if something like that were to happen, that’s going to create a hole into which will drain all of the reserves of the insurance companies. It would cost hundreds of billions of dollars,” Chung predicts.

Norris points out that even with coverage, some of the triggers are so specific that coverage may never apply. One policy states that coverage is triggered when ‘an order of an authorized governmental agency prohibits access to an insured location as a result of the enforcement of any law or ordinance regulating the actual — not suspected — presence of communicable disease.’ Norris says “A civil authority is not going to come and shut down a hospital because of a communicable disease. That’s why hospitals exist. On an environmental policy, do you have to wait to clean up the offending material until somebody shuts you down so your insurance policy will trigger?”

.....
.Norris says a pandemic product is harder to underwrite because it affects everybody at the same time. “That’s conflagration risk, and it’s difficult to get your arms around,” she adds. “With pandemic, there’s pretty much nothing you can buy, that we’ve found, that is responsive.”

Of Ebola, Norris says “This is a perfect event, if you ask me. This shows that hey, maybe there’s just a lot of fear here and there’s not a lot of real exposure. This is something that’s underwritable.”

But she doesn’t see the insurance community ready to take the reins just yet. “In many ways, this is one of the last frontiers of insurance. It’s really something that folks haven’t cracked the code around. There are some different ways that it can be addressed. There are opportunities there for insurers if they’re willing to be creative.”

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  #28  
Old 01-12-2015, 10:20 AM
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Is this reinsurance not covering it or direct writers? I didn't think the ACA would let a direct writer exclude it without some very careful language.
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Old 01-12-2015, 11:08 AM
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This might not be simply health coverage they're talking about

could be business interruption, liability, etc
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Old 01-12-2015, 11:10 AM
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I mean yes, I'm putting this "watch" thread in Health/Disability, but it may touch other insurance areas
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