Zoonotic Swine Flu News since 28 Jan till 12 Oct 2021

Wyoming Department of Health: Don't Overlook Need for Flu Shot [K2 Radio, 12 Oct 2021]

By Nick Perkins

Though the COVID-19 pandemic has certainly taken center stage in terms of vaccine warnings, influenza (otherwise known as the flu) is still something to be taken seriously. As is the need for the flu shot.

The Wyoming Department of Health said that the need for flu shots remains extremely important to help protect Wyoming residents from influenza, despite a relatively quiet flu season last year.

“As the next flu season begins, we know flu shots remain the first and most important step in influenza protection,” said Dr. Alexia Harrist, state health officer and state epidemiologist with WDH. “Flu vaccines are safe and reduce illness, hospitalizations and deaths. Everyone six months of age and older should receive a flu shot.”

In a press release sent out Tuesday, the department of health stated that they have received "sporadic reports of flu from across Wyoming in recent weeks."

Influenza is a respiratory illness, with symptoms ranging from a simple cough, to a fever, a sore throat, a runny or stuffy nose, headache, extreme fatigue, muscle or body aches, and more. The flu can come on suddenly, and it is contagious.

The department noted that while most healthy people can recover from the flu, they can also spread it to people who are not as healthy and who are more at-risk for complications from the flu.

The flu, in many ways, is similar to COVID-19 and the two virus circulating at the same time could see a spike in flu or COVID-related deaths, which emphasizes the importance of getting both the flu and the COVID-19 vaccine.

Especially vulnerable people (IE: those who sometimes can't just 'get over' the flu) include young children, pregnant women, individuals with chronic health conditions such as asthma, diabetes, or heart and lung disease, and more. This sector also includes people 65 years and older, as well as healthcare workers and people who live with, care for, or are in contact with high-risk individuals.

“As we begin a new flu season, we expect influenza will circulate while COVID-19 remains a threat,” Harrist said. “Unfortunately, the pandemic continues to put a strain on our healthcare system. While we are unable to predict how much flu we’ll see in Wyoming this season, we are concerned about the combined impact of both influenza and COVID-19 on our hospitals and on our state’s residents. Both flu and COVID-19 can result in serious illness and that’s one reason testing is helpful. Testing can help guide treatment and care."

Harrist said that it's safe to kill two birds with one stone (or two viruses with one trip to the pharmacy) by getting the COVID vaccine, including then recently authorized booster doses, and the Flu vaccine at the same time. In fact, the department noted, many testing options (like the ones run through the Wyoming Public Health Lab) can detect influenza and COVID-19 in the same sample.

It takes approximately two weeks after receiving the vaccine for it to begin offering protection.
Last year, there were significantly fewer cases of influenza in Wyoming and beyond. The reasons for this can be argued, but the general consensus seems to be that, because of COVID-19, individuals were being much more cautious in their behaviors and activities.

“Reported flu activity was unusually low over the past flu season. Looking back, it appears the precautions intended to slow the spread of COVID-19 also likely reduced the impact of influenza significantly,” Harrist said. “People were not traveling as much, they weren’t socializing as frequently, they were often wearing masks and they were taking extra care with measures such as handwashing and cleaning.”

As precautions seem to settle down (less mask-wearing, for instance), it's entirely possible for the number of flu cases to skyrocket, which is why getting your flu shot is a quick, easy, and relatively painless way to keep yourself and others healthy.

The Wyoming Department of health noted that vaccines are available in many locations, including public nursing offices, workplaces, doctors' offices, pharmacies, retail stores, and more. Flu shots are generally covered by most insurance plans.

Additionally, the department said, Wyoming's public vaccine programs, which are available at participating providers, can help to protect some adults and children from "vaccine-preventable diseases, such as influenza, at little to no cost for eligible patients."

While much is still unknown about the coronavirus and the future, what is known is that the currently available vaccines have gone through all three trial phases and are safe and effective.

It will be necessary for as many Americans as possible to be vaccinated in order to finally return to some level of pre-pandemic normalcy, and hopefully these 30 answers provided here will help readers get vaccinated as soon they are able.

'Gainesville Plague': Flu symptoms widespread on campus [The Independent Florida Alligator, 11 Oct 2021]

By J.P. Oprison
The increase in cases follows a near flu-free year during the COVID-19 pandemic

Coughs, runny noses and sore throats are now common symptoms for many UF students.
After a decrease of flu cases in 2020, students are once again catching the “Gainesville Plague” three months into the semester.

Cold and flu season reaches UF every year and is often referred to as the “Gainesville Plague,” said Ronald Berry, director of the Student Health Care Center. Students seem to use the label because the illness spreads quickly, leaving many sick in a short span of time, he said.

However, last year there were fewer flu cases worldwide because of precautions taken to protect against COVID-19. The number of flu cases last flu season was so small Berry said the SHCC didn’t keep track of how many there were.

Flu cases are rising now, Berry said, partly because of a lack of mandated precautions at UF, such as mask wearing and social distancing.

Jack Nelson, a 20-year-old UF graphic design junior, said he’s noticed students in his graphic design program falling ill. In the last three weeks, the attendance in Nelson’s class dropped to almost half, he said.

He said he has been sick for about a month, since the day of the first UF football game, with a sore throat and congestion.

“Since then I’ve had those same symptoms, they’ve gotten a little worse here and there,” Nelson said. “It feels like I’m basically just on cruise control.”

In September, 1,440 students with symptoms were seen at UF’s infection units, which were created when COVID-19 first hit, Berry said. The unit performed 545 COVID-19 tests: 5% came back positive. Of all strep tests, 16% were positive, and of all flu tests, just 1% were positive.
Most of the students probably have colds, Berry said.

UF set up several infection units across campus to reduce spread as flu season began, and the Student Health Care Center added appointment slots for flu shots. More students have been visiting the units this past month, Berry said.

To stay safe as illnesses spread, Berry said students should continue to wear masks and social distance. With a rapid flu test, students can receive flu medicine within the first couple of days of infection for a faster recovery. Berry also recommends students get their flu shot and COVID-19 vaccine.

“We recommend getting the flu shot early in the flu season, which is the fall,” Berry said. “That covers you into the spring.”

It’s possible the flu could get worse, he said. Flu cases in Gainesville usually peak in January when students return to campus from Winter break because it spreads more easily in cold weather.

In Fall 2019, there were 191 flu cases through December. January 2020 also saw 191 cases, followed by another 100 total cases in February and March. During that flu season, 60% of all cases were in the Spring semester, he said.

But right now, students like Jeremy Rutenberg, a 21-year-old UF mechanical engineering junior, said he has friends who’ve been sick for the past two weeks with cold symptoms, such as a runny nose, coughing and headaches. However, he isn’t worried about getting sick.

“I stay away from people who are sick, definitely wash my hands regularly,” Rutenberg said.

Kyle Giovanniello, a 19-year-old UF aerospace engineering sophomore, said he’s worried about the Gainesville Plague continuing to spread, even though he first heard of it this semester.
Because his three roommates got sick with it quickly, he thinks it’s highly contagious.
“But it doesn’t seem like it’s that bad, so I’m not too worried about the severity of it,” Giovanniello said.

Jacob Hutchinson, a 21-year old UF instrumental performance senior, said he isn’t worried about the sickness either. He said some might think the spread is worse than it is because people are more aware of symptoms with the COVID-19 pandemic. For example, more people could be self-quarantining when they have symptoms.

“I don’t think that I would avoid going out or anything for the Gainesville Plague alone,” Hutchinson said.

Flu practically vanished last year. Now doctors are bracing for potential ‘twindemic’ of flu and covid-19 spikes. [The Washington Post, 8 Oct 2021]

by Fenit Nirappil

Health officials are urging Americans to get their flu shots, warning the flu season that didn’t materialize when most of society was shut down last year could come roaring back and strain hospitals in the months ahead.

Survey data released Thursday found slightly more than half of American adults plan to be vaccinated against influenza. That’s not much of a change from pre-pandemic surveys conducted by the National Foundation for Infectious Diseases, but health authorities are alarmed because some evidence points to a potentially more severe flu season. Experts say Americans have built up less natural immunity against influenza because so few were infected in 2020.

“This low flu activity was likely due to the widespread implementation of covid-19 preventive measures like masks, physical distancing and staying home,” Centers for Disease Control and Prevention Director Rochelle Walensky said in a Thursday briefing announcing flu vaccination efforts.

“Because of so little disease last year, population immunity is likely lower, putting us all at risk of increased disease this year,” she added.


The United States already saw a similar pattern with the spring and summer resurgence of common viruses including respiratory syncytial virus, known as RSV. Hospitals reported surprisingly high numbers of toddlers coming in with severe cases, likely because they were not exposed as infants in the early months of lockdown.

Flu viruses may also roar back with more opportunities to spread this fall and winter in reopened schools, workplaces and businesses, especially where masks are not mandated.
Hospitals already battling simultaneous pediatric spikes in covid-19 and RSV fear oxygen and staffing will be stretched thin if flu and coronavirus admissions surge together in the months ahead — a dreaded scenario they avoided during the last winter surge.

Covid cases among children are soaring. In Tennessee, kids are largely unmasked
The fears are especially acute after hospital systems, especially in the South, struggled to manage the summer wave of covid-19 admissions, said Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association.

She noted some hospitals, including in Florida and California, were running out of oxygen because of the heavy demand from covid-19 patients struggling to breathe. Hospital leaders also fear burnout among doctors, nurses and respiratory therapists who have been on the front lines of the pandemic and have been growing frustrated as they confront coronavirus surges that robust vaccinations would have prevented.

“The same specialists who would care for covid patients are among those who would be caring for flu patients as well,” Foster said last week. “We don’t want those individuals to be so overworked they cannot appropriately care for you, regardless of what brought you into the hospital.”

The Cedars-Sinai health-care system in Southern California, which battled a devastating coronavirus surge in the winter but had zero flu cases, is among the hospitals urging people to get coronavirus vaccinations and flu shots to prevent spikes of both.

“It would be worst-case scenario,” said Soniya Gandhi, an infectious-disease physician and vice president for medical affairs. “There are several hospitals (nationally) operating at full capacity. And that’s now. So going into the winter, the best way to protect and preserve that hospital capacity is for individuals to be vaccinated as much as possible.”

Flu seasons are notoriously difficult to predict. While experts agree another nonexistent season is unlikely, other evidence suggests the upcoming one could be typical or milder than normal.
Some experts say the remnants of coronavirus-containing measures, from school mask mandates to office reopenings delayed until next year, could block the virus from circulating as it would in a normal year.

How the delta surge upended back-to-office plans
The public may have also learned some good infectious-disease practices after more than 18 months of pandemic life. The National Foundation for Infectious Diseases survey found that nearly half of respondents were more likely to stay home when sick because of the pandemic and slightly more would wear masks in some crowded situations.

The survey was also conducted in early August before the late summer surge in coronavirus cases brought more attention to the pandemic’s continued dangers and before public health authorities could launch an extensive flu vaccine drive.

“None of us can predict whether it will be mild, moderate or severe flu season, but we are certain that there will be flu activity,” said William Schaffner, medical director of the National Foundation for Infectious Diseases. “We certainly don’t want a twindemic, both covid and influenza.”

Public health authorities are worried that parents may let their guard down about the flu. While one child died in the 2020-21 flu season, nearly 200 did the year before.

Walensky cited new estimates showing that about 59 percent of children ages 6 months to 17 years received a flu shot the past season, a slight decline from the previous season. She attributed the decrease to disruptions in routine medical care during the pandemic.

Regulators could authorize the Pfizer-BioNTech coronavirus vaccine for children between the ages of 5 and 12 as soon as November, paving the way for some children to receive flu and coronavirus shots at the same time. Doctors are urging parents to bring their children in for flu shots earlier with flu season already starting in much of the country.

Brandi Freeman, a pediatrician at the University of Colorado School of Medicine, said parents have already been pushing for flu shots since August, although the first shipment didn’t arrive until this month.

The demand is welcome news to a pediatrician emerging from an unusually busy summer and not expecting much of a break with schools back in session and kids becoming exposed to viruses for the first time.

“We are trying to restructure our clinic, restructure our staffing to be able to accommodate what we expect to be a pretty intense season,” Freeman said.

The summer coronavirus surge has started to ebb, but delta’s danger remains
She’s also told parents to expect doctors to be overwhelmed trying to figure out which respiratory virus is making which child sick, especially if multiple infections spike at once. The more viruses a child has been vaccinated against, the easier that detective work becomes.

Children’s Healthcare of Atlanta, one of many hospitals throughout the Southeast reporting a spike in pediatric RSV cases over the summer, is preparing for the possibility of a similar surge in pediatric flu cases after the Thanksgiving and Christmas holidays.

“One of the challenges we face is because we thankfully did not have a very active flu season last year, some parents feel flu is not a concern,” said Andi Shane, the hospital system’s medical director of infectious disease. “I think it’s important we understand what happened last year was great in the sense we didn’t have a lot of transmission … but we may have less immunity.”

Why easing COVID restrictions could prompt a fierce flu rebound [Nature, 7 Oct 2021]

By Nicola Jones

As pandemic restrictions ease, other respiratory viruses are returning in unexpected ways.

The COVID-19 pandemic is continuing to have unusual and unexpected effects on a number of respiratory diseases — some have been quashed, others have ploughed through and still more are rebounding off-season. These fluxes are complicating medical responses to the pandemic, but also providing scientists with an opportunity to study how these viruses spread.

As cold-and-flu season ostensibly starts in the Northern Hemisphere, researchers warn to expect the unexpected. “If anyone tells you they know, they don’t know,” says epidemiologist John Paget at the Netherlands Institute for Health Services Research in Utrecht. Most agree that influenza will eventually rebound, possibly fiercely, as travel restrictions and societal interventions designed to curb the coronavirus, such as mask wearing, wane. “Once we let our good health practices lapse, then flu is likely to hit hard,” says Robert Ware, a clinical epidemiologist at Griffith University in Queensland, Australia.

Seasonal flu typically kills 290,000–650,000 people a year worldwide. But for most of 2020 and 2021, it practically vanished from much of the globe. FluNet, a tool for tracking global virological data on influenza maintained by the World Health Organization, shows that the proportion of positive flu tests has remained roughly flat since April 2020, despite increased surveillance (see ‘Viral shift’).

Flu break
The United States recorded just 646 flu deaths in the 2020–21 season — the annual average is in the tens of thousands — and there was only one paediatric flu death. Australia has had no seasonal influenza deaths so far in 2021, compared with between 100 and 1,200 in previous years.

The decline in flu has persisted despite the variable lifting of social interventions to curb coronavirus. This hammers home the importance of international travel in bringing flu to any given country, says Richard Webby at St. Jude Children’s Research Hospital in Memphis, Tennessee. “It says a lot about seeding events and how important they are,” he says. Flu has continued to circulate at low levels in the tropics, researchers note, so will probably spread from there once borders reopen.

Pandemic response measures also seem to have suppressed some bacterial infections, including those that cause pneumonia and meningitis and are associated sepsis1. But some viruses have behaved differently. Rhinoviruses, for example, a major cause of the common cold, continued to spread throughout the pandemic, and infections even shot up in some countries2, possibly because these viruses aren’t as susceptible as many others to measures such as surface cleaning and hand washing, and because they faced little competition from other respiratory viruses. There is emerging evidence that these mild viruses might protect people from more serious diseases during infection3,4.

And some typical winter viruses have bounced back out of season. Infections caused by common human coronaviruses (another major common-cold culprit) and parainfluenza viruses were at very low levels in the United States in 2020 but started to rise to pre-pandemic levels in spring 2021 — an unusual time for colds to hit. Likewise, infections with respiratory syncytial virus (RSV), which usually causes mild cold symptoms but is also responsible for about 5% of deaths in children under 5 worldwide, were at a historic low for a year and then started rising months later than usual, in April 2021. RSV infections were still climbing at the end of August (see ‘Strong rebound’).

Off-season peaks
The strangely timed bumps might be related to school reopenings, according to a report from the US Centers for Disease Control and Prevention (CDC)5, along with a build-up of susceptible, unexposed infants in the absence of a vaccine (RSV vaccines are under development).

Off-season RSV peaks have been seen elsewhere, too, in countries including South Africa, Japan, Australia and the Netherlands. In Western Australia, an RSV peak in December 2020 was 2.5 times larger than the July peak for 20196. A steep onset of disease doesn’t necessarily translate to more cases overall, however: the total number of RSV cases in Queensland was lower than usual, Ware notes, “but because all the cases came close together it was much more intense”, putting strain on health resources.

It would be worrying to see rebound effects caused by a build-up of immunologically naive people in seasonal flu, researchers caution. Around the world, there are signs of circulating H3N2, H1N1 and B influenza viruses, says Amber Winn, an epidemiologist in the CDC’s Division of Viral Diseases in Atlanta, Georgia. A wave of influenza B infections in winter 2019–20, she notes, contributed to a record number of paediatric flu deaths that season. “That’s why getting your flu vaccine this season may be especially important,” she says.
doi: https://doi.org/10.1038/d41586-021-02558-8

References
1. Brueggemann, A. B. et al. Lancet Digital Health 3, E360–E370 (2021).
2. Takashita, E. et al. Influenza Other Respir. Viruses 15, 488–494 (2021).
3. Van Leuven, J. T. et al. Preprint at bioRxiv https://doi.org/10.1101/2020.11.06.371005 (2021).
4. Dee, K. et al. J. Infect. Dis. 224, 31–38 (2021).
5. Olsen, S. J. et al. Morbid. Mortal. Weekly Rep. 70, 1013–1019 (2021).
6. Foley, D. A. et al. Arch. Dis. Child. https://doi.org/10.1136/archdischild-2021-322507 (2021).

CDC director warns the U.S. is at risk of a severe flu season this year [CNBC, 6 Oct 2021]

By Berkeley Lovelace Jr.

Centers for Disease Control and Prevention influenza experts are concerned that the United States could be at risk for a severe flu season this year, Director Dr. Rochelle Walensky warned Wednesday.

That’s because the U.S. population may now have reduced immunity against influenza after seasonal flu cases reached an all-time low last year when large parts of the nation were shut down, Walensky told reporters during a White House press briefing.

During the 2020-2021 flu season, there were very few flu cases, “largely because of masking and physical distancing and other prevention measures put in place for the Covid-19 pandemic,” she said.

The next flu season will be a ‘whopper,’ former FDA chief Scott Gottlieb says
There were around 2,000 flu cases last influenza season, according to data reported to the CDC. By comparison, the 2019-2020 flu season saw an estimated 35 million cases, according to the agency.

Walensky urged Americans to get shots for both Covid and the flu, saying vaccinations are not just important for ending the pandemic but also preventing other infectious diseases. An increase in flu infections this winter could put an additional burden on the nation’s health-care system, increasing stress on health care workers who are already fighting a high number of hospitalizations due to Covid, she said.

About 69,000 Americans are currently in inpatient beds with Covid, according to the Department of Health and Human Services.

“We continue to see many hospitals and intensive care units across the country at full capacity,” Walensky said. “Each year in the United States, influenza can claim between 12,000 and 52,000 lives and result in 140,000 to 710,000 hospitalizations.”

She said it is safe and effective to get vaccines for Covid and the flu at the same time.

“We need as many people as possible to be vaccinated for influenza, so that we can provide protection for those who are at most risk, such as adults who are over 65, those of any age who have chronic health conditions such as asthma, heart disease or diabetes, and children, especially under five who are at risk of severe complications from the flu,” she said.

The Flus Return Puts Health Officials In Uncharted Territory [Patch.com, 22 Apr 2021]

By Andy Nguyen

Public health measures in response to the coronavirus all but stopped the flu but, it's poised for a comeback.

ACROSS AMERICA — The flu all but disappeared in the United States after large numbers of Americans stayed home in response to the coronavirus. However, as the country begins to reopen, it's not a question of if the flu will return but when, health officials say.

As the United States entered into fall last year, there were fears the country would see a "twindemic" with the nation battling both the flu and COVID-19 at the same time. But, the "twindemic" never happened, and the flu season all but disappeared, according to a report from The New York Times.

Since September, the Centers for Disease Control and Prevention has logged around 2,000 cases of the flu in the country. Under normal circumstances, the number of cases in that same time frame would be around 206,000, according to The Times.

Scientists credit the measures implemented by health agencies responding to the coronavirus as a key reason the country saw the dramatic reduction in flu cases. But they don't know if any one action, like more frequent handwashing or vigilant masking wearing in public, was a contributing factor.

With more people getting vaccinated against COVID-19 and returning to normal activities like going out to eat and spending time with friends, the flu's return is inevitable, according to The Times. Scientists aren't sure what the flu will look like when it does come back.

"We're in uncharted territory," Richard Webby, a virologist at St. Jude Children's Research Hospital in Memphis, Tennessee, told The Times. "We haven't had an influenza season this low, I think as long as we've been measuring it. So what the potential implications are is a bit unclear."

It's estimated that 9 million to 45 million people nationwide get the flu each year, according to the CDC. Of that amount, around 12,000 to 61,000 people die from it.

The flu's dormancy has made it difficult to determine how to tailor the annual flu vaccine. With fewer people getting sick, scientists have had trouble predicting which flu strains the vaccine should protect against, The Times reported.

Because of this uncertainty and the low rates of infection, scientists theorize the return of the flu may lead to larger outbreaks across America. They'll likely also occur outside the normal flu season.

However, there is an upside, according to The Times.

Because the flu hasn't been circulating as much during the pandemic, flu strains haven't been able to mutate, and it could mean the current vaccine will still be effective.

Taiwan records first flu death this season [Focus Taiwan News Channel, 30 Mar 2021]

By Elizabeth Hsu

Taipei, March 30 (CNA) Taiwan's Centers for Disease Control (CDC) on Tuesday reported the first influenza death of the current season, which started last October.

The patient, in his 80s, had multiple chronic illnesses, including diabetes and high blood pressure, and had previously suffered a stroke, CDC physician Lin Yung-ching (林詠青) said at a press conference held by the Central Epidemic Command Center.

The man, who had not received the seasonal flu vaccine, was hospitalized in southern Taiwan on March 21 with breathing problems and vomiting, Lin said. The patient was later diagnosed with aspiration pneumonia and was transferred to an intensive care unit, Lin added.

On March 25, the man tested positive for the A-type flu virus, and he died two days later of severe flu complications that included kidney failure and septic shock, Lin said.

CDC data shows that since the beginning of the flu season in October last year, two severe flu cases have been reported, one of which was an H3N2 virus infection.

The number of severe flu cases and deaths so far this season has been much lower than in the past four seasons, when severe cases ranged between 360 and 966 and deaths were 56-159, according to the data.

As of March 28, 52.5 percent of Taiwan's over-65 population had been vaccinated against seasonal flu, under a government-funded inoculation program that started last October, while 51.1 percent of pre-school children had received the shots, the CDC said in a press release Tuesday.

The flu season in Taiwan usually lasts from October to March.

'Swine flu' case reported in North Carolina - Outbreak News Today [Outbreak News Today, 27 Mar 2021]

The Centers for Disease Control and Prevention (CDC) reported a case of human infection with a novel influenza A virus, or “swine flu” in North Carolina, in their latest FluView report.

According to the report ending March 20, the individual was infected with an influenza A(H1N1) variant (A(H1N1)v) virus in 2020. The patient is an adult > 18 years of age, was not hospitalized, and has recovered from their illness.

An investigation into the source of the infection revealed that the patient worked with and had daily contact with swine. No human-to-human transmission has been identified in association with this patient.

While this variant virus infection was not identified until 2021, it represents the first influenza A(H1N1)v virus identified from a specimen collected in the United States in 2020 (during the 2020-21 season). No influenza A(H1N1)v virus infections have been identified in specimens collected in 2021 thus far.

When an influenza virus that normally circulates in swine is detected in a person, it is called a variant influenza virus and is labeled with a ‘v’.

Influenza viruses such as H1N1(v) and other related variants are not unusual in swine and can be directly transmitted from swine to people and from people to swine.

When humans are in close proximity to live swine, such as in barns and livestock exhibits at fairs, movement of these viruses can occur back and forth between humans and animals.

The illnesses resulting from H1N1(v) infection are similar to seasonal influenza. Symptoms include fever, muscle aches, decreased energy, coughing, runny nose, and sore throat.

Pirbright study creates swine flu antibodies that can improve human flu vaccine [The Pig Site, 5 Mar 2021]

The Pirbright Institute has generated the first pig antibodies against swine flu that could improve human health treatments and guide flu vaccine selection.

HUMAN

The Pirbright Institute has generated the first pig antibodies against swine influenza (flu) that protect against infection and recognise the same parts of the flu virus as human antibodies. This indicates they could be used to develop and assess human antibody therapies and their delivery methods. The pig antibodies also have the potential to improve how flu virus evolution is monitored and inform decisions about annual flu vaccine selection.

Antibodies form a vital part of the immune system’s response and help to fight off infections by latching on to important parts of invading microorganisms to neutralise them. In the case of flu viruses, many antibodies target a protein on the surface of the virus called haemagglutinin, which then prevents the virus from entering cells and replicating.

Pirbright scientists worked in collaboration with the University of Oxford, The Francis Crick Institute and The Pirbright Livestock Antibody Hub to generate pig antibodies in the laboratory (known as monoclonal antibodies, or mAbs). These are the first pig mAbs to be generated which target the influenza virus.

These mAbs recognise the same two main sites of the flu virus haemagglutinin protein that are targeted by human antibodies, and were found to be just as effective at neutralising the swine flu strain that caused the 2009 pandemic. Pigs that were treated with one of the mAbs prior to infection were protected from severe disease and the flu virus was eliminated from their lungs. This indicates that the mAbs have great therapeutic potential and could be used to evaluate mAb delivery methods.

This work reinforces the use of pigs as powerful model to predict human responses in infection and vaccination.

PROFESSOR JOHN HAMMOND, LEADER OF THE PIRBRIGHT LIVESTOCK ANTIBODY HUB
Ferrets are commonly used as models to monitor flu virus evolution and to design or select vaccines that will provide the best protection against human seasonal flu strains. However, ferret antibodies only recognise one of the two main haemagglutinin sites that human antibodies target. The findings in the study, published in PLOS Pathogens, demonstrate that pig mAbs are more closely matched to human antibodies and could therefore improve the reliability of human vaccine selection.

Dr Elma Tchilian, Mucosal Immunology Group Leader at Pirbright, said: “These data demonstrate that pigs and humans, which are both natural hosts for influenza viruses, generate very similar immune responses. This makes the pig an excellent translational model for testing novel vaccines and monoclonal antibody delivery methods.”

Professor John Hammond, leader of The Pirbright Livestock Antibody Hub, added: “These results are a fantastic demonstration of how The Pirbright Livestock Antibody Hub can promote the use of new tools and methods, providing the opportunity to examine detailed antibody responses to inform the next generation of vaccines and therapies. This work reinforces the use of pigs as powerful model to predict human responses in infection and vaccination.”

Belgium has no flu epidemic, health authorities say [The Brussels Times, 14 Feb 2021]

The number of visits to the doctor for influenza symptoms since the Summer of 2020 is higher than in previous years, due to the novel Coronavirus, but there is no flu epidemic for the moment in Belgium, Sciensano notes in a press release.

These trends can also be seen in Europe and the rest of the world, the public health institute added.

For an outbreak of flu to be considered an epidemic, the number of weekly visits to a general practitioner must he higher than a certain epidemic threshold, while at least 20% of patients’ breath samples need to test positive for the flu virus.

This year, “despite the number of samples analysed, the number testing positive for flu is much lower than in previous winters,” Sciensano reported.

It is impossible to tell flu symptoms from those linked to the novel Coronavirus, so the public health institute can only base its assessment on the spread of flu on the number of positive lab tests and positivity rates among patients with flu symptoms.

Thus far, “very few positive laboratory results for flu have been registered in Belgium,” Sciensano said in its press release. Other monitoring networks, such as nursing homes and hospitals, “have also not reported any positive sample for the flu virus,” it added, concluding that “the flu epidemic is therefore not here, for now.”

The small number of flu infections is likely due to the hygiene and preventive measures taken against the novel Coronavirus. Moreover, more people took the flu vaccine in Autumn.

Laboratory test results for other respiratory infections are also down this winter.

Why the Flu Season Basically Disappeared This Year [Healthline, 11 Feb 2021]

by Julia Ries & Michael Crescione

• Flu season has been mild this year, thanks to the mitigation measures used to contain COVID-19, such as physical distancing and mask wearing.
• School and office closures also contributed to the unusually inactive flu season.
• The mitigation measures curbed influenza activity even though COVID-19 surged.

Last summer, infectious disease specialists warned that the COVID-19 pandemic could spiral into a “twindemic” when seasonal influenza hit.

But that nightmare scenario never unfolded. The flu didn’t get a strong footing in the United States this season and a twindemic never struck.

COVID-19 is likely far more contagious than the flu.

Because the virus that causes seasonal influenza spreads via respiratory droplets, the safety precautions used to prevent COVID-19, such as mask wearing and physical distancing, also helped cut down flu activity.

What drove down flu activity?

Due to influenza’s short incubation period and widespread population immunity, the measures used to stop the spread of COVID-19 also caused flu activity to drastically drop.

Between Oct. 1 and Jan. 30, only 155 people in the United StatesTrusted Source have been hospitalized with the flu.

That’s a 98 percent decrease from the same window of timeTrusted Source in the 2019-2020 flu season in which 8,633 people were hospitalized with the flu.

The precautions used to prevent COVID-19 ended up drastically reducing influenza transmission.

Both are respiratory infections that spread via aerosol droplets.

“Any precaution you take to avoid COVID will also reduce your risk of contracting an influenza virus. Hand washing, social distancing, and wearing masks are certainly driving down cases of the flu,” said Dr. Casey Kelley, a family medicine physician and the founder and medical director of Case Integrative Health in Chicago.

School and office closures led to a drop in transmission

The closure of schools also contributed to this year’s low flu activity.

According to Kelley, children have less immunity to the flu since their immune systems haven’t been exposed to many pathogens.

SchoolsTrusted Source are also high-contact environments, making kids particularly susceptible to catching and transmitting the flu.

Past evidenceTrusted Source suggests kids are the number one source responsible for bringing the flu into householdsTrusted Source.

Like schools, offices are flu hotspots.

Flu germsTrusted Source can live on common surfaces — like doorknobs or the copy machine — for up to 24 hours. They also shoot through the air when a person coughs, sneezes, or exhales.

“Public transit, office buildings and business travel are all high-contact events that are down significantly [this year],” Kelley said.

Stories from a Past Pandemic [Scientific American, 28 Jan 2021]

Readers write in about their ancestors’ experiences during the 1918 flu
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A recent Scientific American feature explores how the catastrophic 1918 influenza pandemic seemed to quickly slip from public discourse. The event killed more than 50 million people worldwide, yet it takes up comparatively little space in society’s “collective memory.” The article considers, by analogy, how the current COVID-19 pandemic might be remembered by future generations. Scientific American accompanied the feature with a call for letters telling the stories of families affected by the 1918 crisis. Below are some examples of what we received.

READERS RESPOND

For what it’s worth, and because you asked for notes about this: my grandfather died in what I believe was the second wave of the pandemic on September 24, 1918. He was 26 and otherwise very healthy. He had two daughters, aged two and under one. The older daughter was my mother, and of course, she and her sister never knew their father in any real sense. My grandmother was deeply affected by his death, as you can imagine, and she always seemed to believe that he had caught a cold and that she could have done more to save him. This made her deeply anxious, more or less permanently, about the health of everyone in the family and especially me—I was named after my grandfather and was very close to her—and I always hid any cold that I had from her. In lots of ways, my grandfather’s death reverberated through the generations: it had a real effect on my mother and, eventually, me. His name was Samuel Rubinson, born August 15, 1892.

Samuel Guttenplan
Professor emeritus of philosophy, Birkbeck, University of London

Regarding the lack of collective memory of the 1918 pandemic, I had the same question when I heard of the pandemic and that my grandmother had died during it. It was the only family story ever told about her. Gone at 38, leaving five small children. My father was nine years old. In my book, Influenza and Inequality: One Town’s Tragic Response to the Great Epidemic of 1918, I wrote of this lack of memory. My book covers the epidemic, and epidemic behavior, in one small town—Norwood, Mass. I have dozens of personal stories in there, stories I heard from survivors, families and descendants. I believe that this lack of collective memory is linked in large part to the population of victims: the majority were young, foreign-born and poor.
Influenza did not discriminate but, like today, those who could afford to stay home and avoid infection were the privileged. Then, as now, it was marginal communities—those who lived and worked in hazardous environments and lacked medical access—who were struck down. In 1918 Hispanics and Asians in California; Mexicans in New Mexico and Texas; Polish, Italian and Irish immigrants in northern cities; and, as always, Native Americans and Black individuals were the most severely affected. Children left orphaned were often adopted by others and never told of their history. And, of course, unlike today, the majority of victims were between 20 and 40 years old. Who was going to remember young, poor immigrants? Who was going to build a memorial or write a history for such outcasts? They were nameless, voiceless and, as one scholar noted, “rapidly replaced.” Another early historian of the 1918 epidemic wrote, “If the pandemic had killed one or more of the really famous figures of the nation or the world it would have been remembered.... Spanish influenza characteristically killed young adults and therefore rarely men in position of great authority.” That’s no defense. Hopefully, today’s victims will not be so invisible and easily forgotten.

Patricia J. Fanning
Professor emeritus of sociology, Bridgewater State University

I just read your article on the 1918 flu (the University of Washington sent it out on our daily newsletter because you interviewed a U.W. faculty member), and I noted the call for stories about ancestors at the end.

It’s funny, that very “forgetting” rang true for me and my family, too. I just spoke with my 91-year-old grandmother about 10 days ago, and she told me that her father (my great-grandfather, Georg Monsen) survived the 1918 pandemic but that his older brother, the older brother's wife and their two kids all died of it. I’ve been alive for four decades and am close to my grandmother, but I never heard any of this history until now. Plus, she said that her father had hearing loss for the rest of his life because of the effects of that flu, as did other members of the family that had it but survived. This all took place in western Norway, where my grandmother is originally from.

Tabitha Grace Mallory
Henry M. Jackson School of International Studies, University of Washington

I’m 71 years old. During my college years, I’d stay at my grandmother’s house almost every weekend. Grandmother and her sister, Anita, shared the house. On Sunday, we’d all go to the local Methodist church that my dad had helped build when he was younger.

One day, back home from church, my Great-Aunt Anita told me that after World War I, her whole family died from the 1918 flu: her husband and children. She believed, very strongly, that God had punished her, and she did not know why.

She still went to church and prayed.

She never talked about it again. If she’d told me how many children she’d had, I don’t remember.

My Grandmother and Aunt Anita have since passed away.

Steven Oliver
via e-mail

My great-grandfather, Navy Captain John King, made it through the Great War and died of influenza on a hospital ship off City Island in New York City. My grandmother (his daughter) used to take me to lunch on City Island. We always had to drive to the end of the avenue, where we could look across the Long Island Sound and East River to where the ship had been.

Grandma would recall her mother asking to be driven there to remember—remember her husband coming home from war and then being on that ship and never coming home again. After this the family (mom and four kids) moved to Baltimore, and Great-Grandma became an expert seamstress to pay the bills.

Karen Romano Young
via e-mail

Among the 675,000 people in the U.S. who lost their lives 102 years ago were nearly all of my great-grandmother’s immediate family. Both of her parents and a brother died. Her first husband and their one-year-old daughter died the same day in October 1918 and were buried together in the same coffin. After losing them, she wrote a letter to the local newspaper thanking friends and neighbors for helping to see her through the devastation. At the age of only 22, she was pregnant with her second child, a son who would never know his father. She also had to raise her younger siblings who survived. Later, she remarried. I am descended from that second marriage.

This happened in Oklahoma, a state that is currently dealing with spikes of COVID-19 and very sporadic mask compliance—with no statewide mandate in place. It’s demoralizing that a century after the 1918 pandemic, I have to ask: What have we learned? That those who do not learn from history are doomed to repeat it.

Shannon Leigh O’Neil
via e-mail

My dad would have been about 16 years old when the 1918 influenza both took his own father's life and sickened him. I was a child when he told me that, as the disease faded, “all [his] hair fell out.” It would be interesting to know if hair loss (head, body or both) was common in survivors of that disease. I’ve read it can follow high fevers.

In 1920 my father—with, by then, an abundant resupply of hair—entered the U. S. Naval Academy. No doubt at least some of his classmates were also influenza survivors. I’m inclined to believe that in the process of bonding with one another, they would have shared their “collective memories” of experiencing “the flu.”

It was routine, in this bonding process, for the men to confer on one another rather graphic or comic nicknames, which sometimes stuck with their recipients. I sometimes wonder whether a fellow survivor in my dad’s unit, being less blessed than my dad with an exuberant regrowth of hair, gave him the nickname that would follow him for the rest of his Navy career: “Woof.”

At age 75, I’m at the tail end of those who were spared by vaccination from the terrible scourges of smallpox, tetanus and diphtheria. But we had to experience for ourselves—and risk the complications—of illnesses now rarely seen in the developed world: measles, rubella, chicken pox, mumps, polio. Such experiences have certainly generated moments of collective memory.
It may not be like surviving the sinking of the Titanic—but each of these epidemics brought a potentially catastrophic aura, and each marked the families who suffered through them.

Elizabeth R. Hatcher
Topeka, Kan.

My paternal grandmother was born in 1900 in Conshohocken, just outside of Philadelphia, to immigrants from Molise, Italy. She was the fourth of 13 children. She was a strong women with few stories. Yet when I was a youngster in the 1960s, several times she told me a short one: “When I was 18 [years old], four of my younger [siblings] died during the [Great Influenza].
They were buried in a mass grave along the cemetery wall. My father died a few years later from a weakened heart.” I am a fairly good amateur family genealogist, having uncovered many family facts, but I have been unable to track this one down well. From the local newspaper and records from the area’s Catholic cemetery, I have confirmed a substantial two-week spike in deaths in Conshohocken shortly after the peak in Philadelphia in the fall. For those two weeks, the front page of the local newspaper was split vertically down the middle: one side covered the Great War, and the other side, the “Spanish flu.” My great-grandfather did indeed die in 1925. For the past five decades, family stories from remote relatives only know of nine children, not 13. Unfortunately, I don’t know the four other children’s names or genders, as I cannot find them in the 1910 census. And by 1920 they are dead—no death certificates. I need to keep working at it.

Michael F. Iademarco
Rear admiral and assistant surgeon general, U.S. Public Health Service
Director, Center for Surveillance, Epidemiology, and Laboratory Services, U.S. Centers for Disease Control and Prevention

First flu-associated death reported in Washoe County [KRNV My News 4, 28 Jan 2021]

RENO, Nev. (News 4 & Fox 11) — A man in his 60s is the first influenza-associated death in Washoe County for the current flu season and the first flu-associated death since December of 2019.

According to the Washoe County Health District, the man had underlying health conditions.
The latest influenza surveillance report (Week 2), shows nine flu hospitalizations reported by area hospitals and medical care providers.

In contrast, during Week 2 of the 2019-2020 surveillance report (Page 66 of 100), there were three flu-associated deaths and 90 hospitalizations reported.

“We have seen far fewer flu hospitalizations and deaths reported than in previous years,” District Health Officer Kevin Dick said. “However, with COVID-19 still being transmitted in our community, the same mitigations measures apply and we strongly encourage you to get a flu shot. It’s not too late. Having a flu shot will help prevent getting the flu and also will lead to less-severe symptoms if you do get it.”

With the flu season extending into May, the district is urging people to get a flu shot, as it is not too late.

If you anticipate receiving the COVID-19 vaccine, be advised that there must be a minimum interval of 14 days before or after administration with any other vaccine, including the flu shot.

According to the health district, while the flu shot cannot be guaranteed to keep you from getting the flu, those who do get a flu shot typically experience less severe symptoms if they do get the flu and are more likely to recover faster than if they had not received immunization for flu.

According to the Centers for Disease Control and Prevention (CDC), seasonal influenza in the United States in lower than usual for this time of year.