Human transmission likely in 2004 Thai avian flu cases

first_imgJan 24, 2005 (CIDRAP News) – Researchers who analyzed a family cluster of three cases of H5N1 avian influenza in Thailand say in an article published today that two family members probably acquired the disease from the third.The mother and an aunt of an 11-year-old girl who died of probable avian influenza last September most likely caught the disease from the girl when they cared for her in a hospital, according to the report published online by the New England Journal of Medicine.The findings appear to be the strongest evidence so far of person-to-person transmission of H5N1 avian flu since the disease became widespread in Southeast Asia last year. But the authors say they found no sign of any further transmission and no evidence of mutations that could enable the H5N1 virus to spread easily among people. Disease experts fear that such mutations could lead to a flu pandemic.The 11-year-old girl, who lived with her 32-year-old aunt, died of pneumonia on Sep 8, 2004, according to the report by Kumnuan Ungchusak, MD, MPH, of the Thai Ministry of Public Health, and colleagues from Thailand and the US Centers for Disease Control and Prevention. The girl had fallen ill 3 or 4 days after having contact with dying chickens.While the girl was in a hospital, her 26-year-old mother, who worked in a distant city, came to be at her bedside, providing “16 to 18 hours of unprotected nursing care,” the report says. The mother, who had no known exposure to poultry, became ill with a fever Sep 11 and died Sep 20.The girl’s aunt also helped care for her in the hospital, spending about 12 hours at her bedside on Sep 7. The aunt in turn fell ill with fever Sep 16 and eventually experienced pneumonia, but she gradually recovered and was discharged Oct 7.Because no adequate tissue samples were preserved, investigators could not confirm that the girl had avian flu, but her case had all the cardinal features of previous cases, the report says. Laboratory tests (reverse-transcriptase polymerase chain reaction) confirmed the disease in her mother and aunt.The mother made a 10-minute visit to her daughter’s household Sep 7 but had no known exposure to poultry before she became ill on Sep 11, the article says. The aunt’s last known exposure to poultry was 17 days before she fell ill, a period longer than the typical incubation period of 2 to 10 days.”We believe that the most likely explanation for the family clustering of these three cases of avian influenza is that the virus was transmitted directly from the infected index patient to her mother and to her aunt,” the report states.Epidemiologic investigation revealed no other human cases associated with the family cluster. In addition, RT-PCR analysis and phylogenetic analysis of the virus showed no changes that could equip it for efficient person-to-person transmission.The report says avian flu has spread from person to person before. For example, in Hong Kong’s 1997 outbreak of H5N1, some healthcare workers were found to have antibodies to the virus, and one reported mild symptoms. However, “The current family cluster is unique in that the secondary infections resulted in severe disease and death and in that the epidemiologic circumstances and laboratory findings made it possible to rule out transmission from poultry.”The lack of further transmission in the family cluster should not be an excuse for complacency, the authors write. If H5N1 avian flu remains endemic for years in the affected countries, “it is likely that such clusters will occur again, and it will be necessary to investigate each one rapidly and thoroughly to determine whether a critical change in the virus has occurred,” they conclude.Ungchusak K, Auewarakul P, Dowell SF, et al. Probable person-to-person transmission of avian influenza A (H5N1). N Engl J Med 3005;352(4):333-40 [Full text]last_img read more

​Chart of the week: Responsible investment surges in importance

first_imgTim Manuel, head of responsible investment for Aon in the UK, said: “In the UK, where regulations in favour of responsible investing continue to strengthen, we see investors taking more concrete steps to implement responsible investments within their funds.”The fact that Aon had a high response to the survey in the UK, with 43% of overall respondents being based there, was indicative of this frame of mind, Manuel said.Meredith Jones, author of the report and global head of responsible investing at Aon, said the consultancy was also observing significant investor-led RI efforts where regulation was not driving activity, however. Year-on-year change in responsible investing attitudes by geographic region Responsible investment (RI) surged in importance for all types and sizes of institutional investor around the world in the last year, a new survey has found, with the biggest gains in positive sentiment towards the approach recorded among respondents in the UK.Of the UK respondents to Aon’s 2019 Global Perspectives on Responsible Investing survey, 42% indicated RI was very important or critical to their organisation, up from 19% in 2018, and 87% answered that they believed the approach was at least somewhat important, up from the 66% who gave that response in 2018.In continental Europe, those percentages were 85% in 2019, up from 80% in 2018.In the US, meanwhile, the percentages were 78% compared to 57%, and in Canada the proportions were 78% — up from 66%. Source: Aon, Global Perspectives on Responsible Investing 2019The survey polled nearly 230 investment professionals internationally.Corporate pension funds were revealed to have undergone a sea change in their attitudes to responsible investing, with the share of investors expressing a positive sentiment toward the approach growing from 56% in 2018 to 86% in 2019. Public pensions saw similar growth, according to the poll, but from a different departure point, with positive sentiment spreading from 70% of respondents last year to 92% in 2019.Year-on-year change in responsible investing attitudes by investor type center_img Source: Aon, Global Perspectives on Responsible Investing 2019The most popular primary motivation for pursuing RI — across all investors — was the belief that incorporating environmental, social and governance (ESG) data leads to better investment returns, Aon said.However, the firm said many UK and European respondents indicated in the survey that they were motivated to engage in RI in order to have an effect on global issues such as climate change, diversity or social justice.“By contrast, only 10% of US investors and 8% of Canadian investors indicated global impact as a motivator,” Aon said.According to the survey, lack of agreement on key issues, such as terminology and materiality, was a hindrance for fewer investors this year than last: 14% of those polled in the 2019 survey, down from 26% in 2018. However, Aon said the industry continued to struggle with what constitutes ESG, socially responsible investing (SRI), and impact investing. In its view, imprecise terms have been applied on a wide variety of investment products, with a number launched over the last 12 months under an ESG label when they included features that fell more under the headng of SRI and/or had impact goals as well. Aon said it continued to advocate “for the apt imposition of names when it comes to all things RI”. It also said it planned to launch an impact fund and a low carbon factor fund for its discretionary asset management clients.last_img read more

624 New COVID-19 Cases Wednesday

first_imgStatewide — The Indiana State Department of Health (ISDH) has reported that 624 additional Hoosiers have been diagnosed with COVID-19 on Wednesday. A total of 107,809 Indiana residents have tested positive for the coronavirus. To date, 1,261,892 individual tests have been reported to ISDH at an 8.5% positive rate and 12 new deaths were reported for a total of 3,247 Hoosier deaths.Dearborn County has a total of 612 cases and 28 deaths reported (up 4 new cases), Decatur County has a total of 446 positive cases and 39 deaths (up 1 new death), Franklin County has 290 positive cases and 25 deaths (up 1 new case), and Ripley County has 270 positive cases and 8 deaths (up 1 new case). Locally, this is an increase of 6 new positive cases and 1 new death.last_img

Dodgers take advantage of Madison Bumgarner’s short fuse to escape with victory

first_imgLOS ANGELES >> Madison Bumgarner lit a fire without a spark in the seventh inning Monday night.Since any little flame is a 4-alarm job when fanned by the San Francisco bullpen, the Dodgers pushed their National League West lead to six games with a 2-1 victory, and nudged the Giants one toe closer to the cliff.The highlight moment happened at the end of a classic performance by Bumgarner, who has scuffled during the Giants’ dismal second half. He and Clayton Kershaw allowed no earned runs, but the Giants scored on a wild throw to second by Yasmani Grandal and a wild pitch by Kershaw that Grandal could have smothered.Bumgarner gave the Dodgers only one hit. That was a double by Yasiel Puig in the second inning, a drive that did not improve his relationship with Bumgarner. However, Bumgarner indicated he left the game because it was time to do so. “You never want to come out of the game,” he said, “but you gotta be smart about it. The tank was getting low.”You also gotta be smart when you’re pitching classically, leading your rival by one run in a game that your team needs like plasma, and you basically risk ejection for nothing. Puig wasn’t even being Puig, at least not so anyone can tell.“I didn’t hear anything (from Puig),” Bumgarner said. “I think he was trying to stare me down, it looked like.”Anyway, the game was transferred into the quicksand pit that used to be the San Francisco bullpen, as Bochy repeatedly ambled out to the mound like a father trying to mollify a particularly agitated baby.Will Smith got two outs in the eighth. Derek Law came in after a single by Carlos Ruiz and retired Howie Kendrick. That still left the ninth inning, and Bochy wasn’t about to expose shell-shocked closer Santiago Casila, who has blown five of 15 saves since the All-Star break.The remarkable Andrew Toles led off the ninth with a hard single off Law. Here came Bochy. Lefty Javier Lopez, who used to be impossible for lefty hitters, came in. But Corey Seager was already 2-for-5 off Lopez in his career with a home run. Here, Seager hit a softer ground ball that got past second baseman Joe Panik and moved Toles to third.“I thought that was going to be a double-play ball,” Bochy said. “Joe couldn’t quite get to it. That would have been big.”Bochy walked out and asked for Hunter Strickland, whose entrance and exit velocity can both reach triple-figures. At least the agony wasn’t prolonged.Justin Turner singled to right field to tie it. Adrian Gonzalez whaled a double off Hunter Pence’s glove and the wall to win it. And the Giants officially have 38 saves and 29 blown saves, according to MLB.com.They also are tied with St. Louis for the No. 2 wild-card spot. At the All-Star break they led the NL West by six-and-a-half games and had the best record in the league, even better than the Cubs’.“Those last three outs, I don’t know if I’ve ever seen such a tough time getting them,” Bochy said. “It’s a shame. He (Bumgarner) threw a beautiful game. We’ve let a lot of these get away, but we’ll bounce back. We’ll absorb this, but I gotta say, we’ve absorbed quite a few.”An unidentified Giant slammed something against a wall, in an off-limits area of the clubhouse. Bumgarner dressed quickly. He became weary of the Puig conversation just as quickly. “I think we’re getting a little carried away with the questions here,” he said, at a strange time to be asking for restraint. “I don’t think they’re going to be going out to dinner anytime soon,” said Giants’ manager Bruce Bochy, when it was over.With two out in the seventh, Puig hit a dribbler down the first-base line and Bumgarner turned to throw him out. Bumgarner clapped his hands vigorously. Then he suddenly looked up at Puig, began snarling at him and ominously pointed to his own head — he had knocked down Corey Seager earlier in the game.Puig looked surprised, but he wasn’t letting it go either. Suddenly first baseman Brandon Belt, an innocent bystander, was watching Dodger first base coach George Lombard grab Bumgarner, and here came both benches and both bullpens. With the rosters as expanded as they are, it looked like the dash to catch the last plane out of Saigon.One might not expect fellows from Hudson, N.C. and Cienfuegos, Cuba to understand each other, but Bumgarner and Puig have been antagonists before. The immediate consequence was that the Giants lost Bumgarner for the final two innings. He had thrown only 97 pitches, with no walks and 10 strikeouts. He has thrown more pitches than that in six of his past eight starts. Yet he was removed from the game. Sure, it was his turn to bat, but Bumgarner is as much of a threat as most Giants pinch-hitters, and the Giants were leading besides.Bochy said he didn’t take out Bumgarner because he needed more runs. “We had a talk,” he said, “and I’ll leave it at that,” which indicated he might have taken him out for blood-pressure reasons.center_img Newsroom GuidelinesNews TipsContact UsReport an Errorlast_img read more