10 Feb 2017: Neonatal deaths show spread of Zika

Ann Morrison
By Ann Morrison February 14, 2017 17:04

Update as of 10 Feb 2017

20170210 John-Ann Zika-Texas incinerate or inter abortion remains-Zika

20170210 Dr Bill Deagle-Ann Zika and fetal remains

20170210 Dr Bill Deagle-Ann Texas wants fetal remains incinerated or interred

Contents

Biosecurity: Zika

Biosecurity: Bird Flu

Radiation

Preparation

Constitution – Crony Capitalism

Climate Change

Solar

Seismic

 

______________________________________________________________

.

Climate Change

Arctic Ozone Watch 07 February 2017

Arctic Ozone Watch 07 February 2017

NASA

National Aeronautics and Space Administration Goddard Space Flight Center
https://ozonewatch.gsfc.nasa.gov/ozone_maps/images/Y2017/M02/OZONE_D2017-02-07_G%5E716X716.IOMI_PAURA_V8F_MGEOS5FP_LNH.PNG

.

Antarctic Ozone Hole Watch 7 February 2017

Antarctic Ozone Hole Watch 07 February 2017

NASA

https://ozonewatch.gsfc.nasa.gov/ozone_maps/images/Y2017/M02/OZONE_D2017-02-07_G%5E716X716.IOMI_PAURA_V8F_MGEOS5FP_LSH.PNG

.

Northern Jet Stream crosses the Equator!

2017-2-9 1500 UTC Wind at 250hPa

Nullschool

https://earth.nullschool.net/#current/wind/isobaric/250hPa/orthographic/loc=-125.834,42.681

.

Current Large Fire Incidents 9 February 2017

Oklahoma 14, Arkansas 4, Kansas 2, North Carolina 2, Missouri 1

 Oklahoma 14, Arkansas 4, Kansas 2, North Carolina 2, Missouri 1 Fires on 2017-02-09

National Interagency Fire Council

https://fsapps.nwcg.gov/afm/

.

Broken dam in northeast Nevada flooding homes, farms and railroads

Broken dam in northeast Nevada flooding homes, farms, and railroads

Chopper 5 KSL TV

10PM: Broken dam in northeast Nevada flooding homes, farms and railroads

 

Chopper 5, KSL TV
By McKenzie Romero   | Posted Feb 8th, 2017 @ 10:38pm Nicole Vowell, KSL TV MONTELLO, Nevada —

 

A broken dam in Elko County, Nevada, flooded farmland and homes in the community of Montello, stopped Union Pacific trains nearby and prompted a warning to people in extreme northwest Utah to avoid the rural highway into the Silver State.

And while Utah has recently experienced a quick warmup after heavy snows, state water officials think a similar breach is unlikely in the Beehive State.

The National Weather Service reported Wednesday the failure of the 21 Mile Dam was sending water spilling out in a “dangerous and life-threatening situation.”

“Water in the reservoir continues to rapidly empty and is heading downstream. Ongoing flash flooding will continue and could potentially get worse,” the National Weather Service advised. A flash flood warning for Elko County has been issued through midnight Thursday.

As the water flows into the Dake Reservoir, there is a risk the dam there could overflow leading to more flooding, according to the warning.

Union Pacific rail traffic in the area has also come to a halt, Justin Jacobs, a Union Pacific spokesman for the area, confirmed.

Trains headed toward the flood-affected area have been stopped and face indeterminate delays, Jacobs said, while Union Pacific is assessing options to re-route trains that are further out.

It was unclear whether freight or commuter trains, or both, were being impacted, Jacobs said. And until the water stops flowing, Union Pacific will be unable to inspect the tracks and see just how much damage has been done.

Fast-flowing water through the streets of Montello, an unincorporated community in Elko County in northeast Nevada, had emergency crews responding to set up sand bags around homes and businesses. Footage captured by KSL-TV’s Chopper 5 shows wide breaks in the earthen dam, water rushing along rail routes and trains stopped on the tracks.

Kevin Hall, a captain with the East Elko Fire Protection District, said the flooding and the breach are due to heavy runoff and snowmelt. Earlier in the day responders were dealing with just a few inches of water, but since the dam failed it has risen to a few feet in depth, he said.

“We’ve got about 3-foot trenches down in the front of the businesses now that it’s washing out along the pavement,” Hall said. “We’ve got a fuel station, a gas station here, and we’re trying to protect the pumps from fuel contamination into the water, which causes big problems.”

Hall said areas of Nevada’s state Route 233 are also at risk of washing out and warned drivers out of Box Elder County to stay away.

“Do not travel it, it’s getting dangerous,” Hall warned.

Dam failure caused flash flooding in east central Elko County Nevada

Chopper 5 KSL TV

Dam failure caused flash flooding in east central Elko County, Nevada. (Chopper 5, KSL TV)

As January storms dumped twice the normal snowpack in Utah’s mountains, dam safety engineer Everett Taylor with the Division of Water Rights says the state’s reservoirs are about half full at last measurement and are prepared to take on plenty of runoff.

Representatives from the division meet monthly with the Natural Resources Conservation Service regarding the state’s snowpack as well as the National Weather Service to assess projected weather patterns, Taylor said. The collaborative effort is designed to pinpoint concerns with reservoirs before they arise.

“If we’re anticipating a large runoff, then we can begin to draw water down from the reservoirs so we have additional storage capacity for the water,” Taylor said. “At this point in time, that’s not the case. We have suffered some pretty good drought the past few years with minimal snowpack, so we have good storage available to capture this runoff.”

Taylor also noted that the warm up Utahns have felt in the valleys hasn’t yet impacted higher altitudes.

Regular dam inspections are also ongoing, Taylor said.

“We generally identify maintenance issues, and in those cases we let the owners know what maintenance needs to be done and we’ll follow up with them on our next inspection,” Taylor said. “If we see a significant issue, something that raises significant concern that we see poses a risk, we will address it immediately.”

There are no concerns about any Utah dams failing, Taylor said.

In Wasatch County, the Heber City Police Department warned residents in a Facebook post Wednesday to prepare for runoff as the weather warms.

“If your home is by a canal, creek, in a flood plain, or if you have experienced flooding before – you may want to consider the purchase of sand and sandbags,” police said.

The department also advised residents to consider looking into flood insurance.

Contributing: Nicole Vowell
© 2017 KSL.com | KSL Broadcasting Salt Lake City UT | Site hosted & managed by Deseret Digital Media – a Deseret Media Company v11
Accessed at https://www.ksl.com/?sid=43126767&nid=148 on February 9, 2017.

.

Rift in Antarctica Growing Rapidly, Could Lead to Massive Iceberg

Larson C Rift 2010 - Jan 2017

(c) MIDAS Project, A. Luckman, Swansea University

Wed, 02/08/2017 – 10:18am by Kenny Walter – Digital Reporter – @RandDMagazine

 

A rift in Antarctica that has grown substantially in 2017 may lead to one of the largest icebergs ever recorded.

The latest satellite data shows that the rift in the Larsen C ice shelf in Antarctica has grown 10 kilometers (km) since the New Year, bringing the total to 175 km.

Professor Adrian Luckman of Swansea University College of Science in the U.K., explained the threat the rift is causing.

“We can report a further extension of the rift which threatens to calve an iceberg measuring more than 5,000 sq. km in area from the Larsen C Ice Shelf,” Larsen said in a statement.

The rift has grown parallel to the shelf edge, meaning that the 5,000 square km iceberg remains attached by only about 20 km of ice.

“If it doesn’t go in the next few months, I’ll be amazed,” Luckman said. “There hasn’t been enough cloud-free Landsat images but we’ve managed to combine a pair of Esa Sentinel-1 radar images to notice this extension, and it’s so close to calving that I think it’s inevitable.”

When it calves, the ice shelf will lose more than 10 percent of its area, leaving the ice front at its most retreated position ever recorded.

This is expected to fundamentally change the landscape of the Antarctic Peninsula.

Luckman estimated that when the area breaks apart it will be about 5,000 sq. km, which would be among the 10 biggest icebergs ever recorded.

Larsen C is approximately 350 meters thick and floats on the seas at the edge of West Antarctica, holding back the flow of glaciers that feed into it.

Researchers have been tracking the rift for several years following the collapse of the Larsen A ice shelf in 1995 and the disintegration of Larsen B seven years later, following a similar rift-inducing calving event.

Larson C Ice rift

(c) MIDAS Project, A. Luckman, Swansea University

“We are convinced, although others are not, that the remaining ice shelf will be less stable than the present one,” Luckman said. “We would expect in the ensuing months to years further calving events and maybe an eventual collapse but it’s a very hard thing to predict and our models say it will be less stable; not that it will immediately collapse or anything like that.”

Last year Project MIDAS—a U.K.-based Antarctic research project charged with investigating the effects of a warming climate on the Larsen C ice shelf—reported that the rift was growing fast.

However, in December the rift began to grow even further by 18 km in just a few weeks.

According to Luckman, the rift is a geographical event and not a climate event, although climate warming may have brought forward the likely separation of the iceberg.

According to estimates, if all the ice that the Larsen C shelf currently holds back entered the sea, global waters would rise by 10cm.

The MIDAS Project will continue to monitor the development of the rift and assess its ongoing impact on the ice shelf.

Accessed at http://www.rdmag.com/article/2017/02/rift-antarctica-growing-rapidly-could-lead-massive-iceberg?et_cid=5820670&et_rid=598083810&type=headline&et_cid=5820670&et_rid=598083810&linkid=content on February 8, 2017.

.

Solar

Meteor lights up sky above Chicago area, Midwest

Meteor streaks across sky in Chicago area

Meteor lights up sky above Chicago area-Midwest 20170206

Posted by Marcella Canfora

EMBED </>More News Videos

<iframe width=”476″ height=”267″ src=”http://abc7chicago.com/video/embed/?pid=1739864″ frameborder=”0″ allowfullscreen></iframe>

While most people were sleeping, people across the Chicago area and the Midwest got spotted a meteor early Monday morning. (WLS)

By Diane Pathieu Updated 35 mins ago LISLE, Ill. (WLS) —

While most people were sleeping, some sky watchers across the Chicago area and the Midwest got a glimpse of a meteor early Monday morning.

According to the American Meteor Society, more than a hundred reported seeing the fireball at about 1:26 a.m. Many of the sightings were in the Chicago area, but the meteor was also seen in Iowa, Wisconsin, Indiana, Ohio, Minnesota, Missouri and Ontario, Canada.

The fireball was spotted on several dashcams from area police departments as well by a security camera that footage was posted on Facebook.

One video is from Plover Wisconsin, in the northwest part of the state. The man that posted the video said it was from his security camera.

Fireball 6 Feb 2017 01 25 15 NWS

National Weather Service

In dashcam video from Lisle police, you can clearly see the meteors glow as it falls from the sky.

Fireball over northern Illinois

Lisle IL Police Department

Kelly Tournis in Highland, Indiana. shared a video she took on the ABC7 Chicago Facebook page.

Fireball 6 Feb 2017 01 25 15 NWS

National Weather Service

A camera on the roof of the University of Wisconsin’s Atmospheric, Oceanic & Space Sciences Building also captured the meteor.

Fireball 6 Feb 2017 01 25 15 NWS

National Weather Service

Copyright © 2017 ABC Inc., WLS-TV Chicago. All Rights Reserved.
Accessed at http://abc7chicago.com/news/meteor-lights-up-sky-above-chicago-area-midwest/1739809/ on February 6, 2017.

.

Meteor lights up February sky

Lisle, IL Police Department

Posted: Feb 06, 2017 4:48 AM CST, Updated: Feb 06, 2017 4:48 AM CST, By Peter Kastella Milwaukee –

An apparent meteor streaked across the Midwestern sky early Monday morning. The American Meteor Society has received more than 170 reports of a fireball crossing the Wisconsin sky around1:25 AM.   The green fireball was seen in Wisconsin and Illinois, but the AMS has received other reports of seeing the fireball from Michigan, Indiana, Ohio, Iowa, New York, Kentucky, Minnesota and Ontario, Canada.

The AMS estimates the trajectory of the meteor as traveling from the southwest to the northeast, ending its flight over Lake Michigan somewhere between Manitowoc and Sheboygan.

All content © Copyright 2000 – 2017 WDJT. All Rights Reserved.
Accessed at http://www.cbs58.com/story/34432682/meteor-lights-up-february-sky on February 6, 2017.

.

LUNAR ECLIPSE THIS FRIDAY NIGHT

penumbral eclipse of Snow Moon 20170210

NASA

The full Moon will lose some of its usual luster on Friday night, February 10th, 2017, as an eerie shadow creeps across the lunar disk. It’s a penumbral lunar eclipse, visible from parts of every continent except Australia. Graphic artist Larry Koehn created this animation of the event:

penumbral eclipse of Snow Moon visibility map 20170210

NASA

A penumbral eclipse happens when the Moon passes through the pale outskirts of Earth’s shadow. It is much less dramatic than a total lunar eclipse. In fact, when observers are not alerted beforehand, they sometimes do not realize an eclipse is underway. Nevertheless, the shadow of Earth can be plainly visible to the naked eye.

The best time to look is Friday night around 07:44 p.m. Eastern Time (00:44 UT Saturday). That’s the time of maximum coverage when Earth’s shadow creates a clear gradient of light and shadow across the lunar disk. Check out this global visibility map to see if you are in the eclipse zone:

 

According to folklore, a full Moon in February is called the “Snow Moon.” For northerners, it often feels like the brightest Moon of the year as moonlight glistens off the white landscape. For a while on Friday night, the Snow Moon won’t seem quite so bright.

Accessed at ©2016 Spaceweather.com. All rights reserved. This site is penned daily by Dr. Tony Phillips. on February 9, 2017.

.

Seismic

Volcanic Activity for the week of 1 February-7 February 2017

Volcanic Activity for the week of 1 February-7 February 2017

USGS/Smithsonian

Smithsonian’s Global Volcanism Program and the US Geological Survey’s Volcano Hazards Program

The Weekly Volcanic Activity Report is a cooperative project between the Smithsonian’s Global Volcanism Program and the US Geological Survey’s Volcano Hazards Program. Updated by 2300 UTC every Wednesday, notices of volcanic activity posted on these pages are preliminary and subject to change as events are studied in more detail. This is not a comprehensive list of all of Earth’s volcanoes erupting during the week, but rather a summary of activity at volcanoes that meet criteria discussed in detail in the “Criteria and Disclaimers” section. Carefully reviewed, detailed reports on various volcanoes are published monthly in the Bulletin of the Global Volcanism Network.

http://volcano.si.edu/reports_weekly.cfm#vn_282080

.

Piton de la Fournaise | Reunion Island (France) | Elevation 2632 m

indian ocean volcanoes

USGS

http://www.shipdetective.com/images/maps/hazards/indian_ocean_volcanoes.gif
© 2016 Shipdetective, LLC. All Rights Reserved.

OVPF reported that seismicity and inflation at Piton de la Fournaise significantly increased on 2 January. Based on seismic data, an eruption began at 1940 on 31 January. Visual observations on 1 February confirmed that the active vent was located about 1 km SE of Château Fort and about 2.5 km ENE of Piton de Bert. Lava fountains rose 20-50 m above the 10-m-high vent, and ‘a’a lava flows branched and traveled 750 m. Two other cracks had opened at the beginning of the eruption but were no longer active. Tremor levels decreased in the early hours of the eruption; RSAM values then fluctuated at mid-range, and lava-fountain heights were variable (between 20-50 m). On 2 February two lava fountains at the vent were visible, and lava flows had traveled an additional 500 m E. The vent was 128 m long and about 35 m high at the highest part. The next day RSAM levels were more stable, at a value which was half of what it was at the beginning of the eruption. On 4 February OVPF noted that significant fluctuations of volcanic tremor were detected for more than 24 hours, with intensity levels reaching those observed at the onset of the eruption. Higher levels of seismicity continued through 7 February. Poor weather conditions prevented visual observations during 4-7 February.

Source: Observatoire Volcanologique du Piton de la Fournaise (OVPF)

.

Kilauea | Hawaiian Islands (USA) | Elevation 1222 m

Hawaii Kilauea

USGS

http://www.virtualuppermantle.info/Volcano-Hawaii-Kilauea.htm

During 1-7 February HVO reported that the lava lake continued to rise and fall, circulate, and spatter in Kilauea’s Overlook vent. Webcams recorded incandescence from long-active sources within Pu’u ‘O’o Crater and from a vent high on the NE flank of the cone. The 61G lava flow, originating from a vent on Pu’u ‘O’o Crater’s E flank, continued to enter the ocean at Kamokuna. All surface flows were active within 2.4 km of Pu’u ‘O’o.

HVO geologists noted an extensive crack running parallel to the sea cliff about 5-10 m behind the stream of lava entering the ocean at Kamokuna. The crack was 30 cm wide on 28 January and 70 cm wide four days later, on 1 February. In addition, the seaward block bounded by this crack was visibly moving up to 1 cm, and ground shaking could be felt up to several hundred meters away. On 2 February the crack was wider and steaming, and the stream of lava that had been pouring into the ocean from an opening in a lava tube about 20 m above the water was no longer visible (though lava continued to enter the ocean). At about 1255 almost the entire section of the sea cliff that was seaward of the hot crack collapsed. The collapsed block generated a wave that propagated outward from the coast. After the collapse, no lava was visible entering the ocean though a steam plume and spatter from explosions indicated that the entry remained active.

Source: US Geological Survey Hawaiian Volcano Observatory (HVO)

.

VA SIGMETs valid 9 Feb 2017 Volcanic Ash Hazards

No volcanic ash sigmets 20170209

NOAA

https://www.aviationweather.gov/sigmet

.

World earthquakes for the week ending 9 Feb 2017

World earthquakes for the week ending 9 Feb 2017

USGS

http://earthquake.usgs.gov/earthquakes/map

.

UTC 2017-02-07 22:03:56 M 6.3 – 12.9 WSW of Pasni, Pakistan 16 mi depth

UTC 2017-02-07 22 03 56 M 6_3 - 12_9 WSW of Pasni Pakistan 16 mi depth

USGS

.

Radiation

Pilgrim Massachusetts Event 52352 Excess Vibration in Main Coolant Pump

Event 52352 Pilgrim Massachusetts Excess Vibation in Main Coolant Pump

NRC

http://www.nbcnews.com/id/42555888/ns/us_news-life/

 

Power Reactor Event Number: 52352
Facility: PILGRIM Region: 1 State: MA
Unit: [1] [ ] [ ] RX Type: [1] GE-3
NRC Notified By: MIKE HETTWER HQ OPS Officer: JEFF HERRERA
Notification Date: 11/07/2016 Notification Time: 20:44 [ET]
Event Date: 11/07/2016 Event Time: 16:09 [EST]
Last Update Date: 11/07/2016 Emergency Class: NON EMERGENCY
10 CFR Section: 50.72(b)(3)(v)(D) – ACCIDENT MITIGATION
Person (Organization): RAY MCKINLEY (R1DO)

 

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N Y 100 Power Operation 100 Power Operation

Event Text

HPCI DECLARED INOPERABLE DUE TO FAILURE OF IST SURVEILLANCE TEST

“On November 7, 2016, at 1609 [EST], with the reactor at 100 percent core thermal power and steady state conditions, the High Pressure Coolant Injection (HPCI) system was declared inoperable. Pilgrim Nuclear Power Station (PNPS) was performing planned quarterly testing per Technical Specifications 4.13.A.1. During a review of the HPCI pump data taken during the test, it was determined that the recorded vibration reading on the Main Pump Outboard horizontal point (P4H) was 0.8335 in./sec which exceeds the IST required action range high limit of less than or equal to 0.830 in./sec. Accordingly, the HPCI pump was declared inoperable.

“The Limiting Condition for Operation Action Statement 3.5.C.2 has been entered and planned troubleshooting into the cause of the high vibration is in progress. In accordance with 10 CFR 50.72(b)(3)(v)(D), PNPS is providing an 8-hour non-emergency notification that the HPCI System is inoperable.

“This event had no impact on the health and/or safety of the public.

“The NRC Resident Inspector has been notified.”

The licensee will be notifying the State of Massachusetts regarding the event.

Page Last Reviewed/Updated Tuesday, November 08, 2016
Accessed at http://www.nrc.gov/reading-rm/doc-collections/event-status/event/2016/20161108en.html on November 10, 2016.

.

Vogtle Georgia Event 52534 SCRAM Failure to transfer to alternate incoming power

Vogtle map

NRC

http://www.nbcnews.com/id/42555888/ns/us_news-life/

 

Power Reactor Event Number: 52534
Facility: VOGTLE Region: 2 State: GA
Unit: [1] [ ] [ ] RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: MATTHEW NORRIS HQ OPS Officer: STEVE SANDIN
Notification Date: 02/03/2017 Notification Time: 18:56 [ET]
Event Date: 02/03/2017 Event Time: 15:45 [EST]
Last Update Date: 02/03/2017 Emergency Class: NON EMERGENCY
10 CFR Section: 50.72(b)(2)(iv)(B) – RPS ACTUATION – CRITICAL, 50.72(b)(3)(iv)(A) – VALID SPECIF SYS ACTUATION
Person (Organization): SHAKUR WALKER (R2DO)

 

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 M/R Y 100 Power Operation 0 Hot Standby

 

Event Text

UNIT 1 MANUAL REACTOR TRIP DUE TO LOOP 1 MSIV STARTING TO FAIL CLOSED

“At 1545 EST on 2/3/17, Vogtle Unit 1 was manually tripped from 100% power when loop 1 Main Steam Isolation Valve (MSIV) started to fail closed. Non-Safety Related 4160V bus 1NA01 failed to transfer to alternate incoming power supply automatically and was successfully manually energized.

“All control rods fully inserted and AFW [Auxiliary Feedwater] and FWI [Feedwater Isolation] actuated as expected.

“Unit 1 is in Mode 3 and stable with decay heat being removed by AFW.”

The licensee informed the NRC Resident Inspector.

Accessed at https://www.nrc.gov/reading-rm/doc-collections/event-status/event/2017/20170206en.html on February 9, 2017.

.

RADCON on 9 February 2017 Six of Concern-Watch

Radcon Six of Interest 20170209

© Copyright 2012-2014 Nuclear Emergency Tracking Center, LLC (netc.com).All information that is produced by netc.com websites belongs to Nuclear Emergency Tracking Center, LLC (netc.com).

© Copyright 2012-2014 Nuclear Emergency Tracking Center, LLC (netc.com).All information that is produced by netc.com websites belongs to Nuclear Emergency Tracking Center, LLC   (netc.com).
https://netc.com/
NETC.COM   © 2014

 

  1. Station ID 6:40000-4004   Kurume, Fukuoka, JP

nSv/h: current 55 Low 33 High 71

Average 37

Last updated: 2017-02-09 15:00:00 GMT-0600

 

  1. Station ID 5:101   Hartford, CT, US

CPM: current 412 Low 268 High 419

Average 316(CPM of Gamma in energy range 600-800keV)

Last updated: 2017-02-09 06:46:00 GMT-0600

 

  1. Station ID 5:304   Virginia Beach, VA, US

CPM: current 313 Low 133 High 322

Average 198(CPM of Gamma in energy range 600-800keV)

Last updated: 2017-02-09 06:10:00 GMT-0600

 

  1. Station ID 5:211   Edison, NJ, US

CPM: current 270 Low 132 High 304

Average 169(CPM of Gamma in energy range 600-800keV)

Last updated: 2017-02-09 05:57:00 GMT-0600

 

  1. Station ID 5:321   Dover, DE, US

CPM: current 252 Low 117 High 259

Average 160(CPM of Gamma in energy range 600-800keV)

Last updated: 2017-02-09 04:36:00 GMT-0600

 

  1. Station ID 5:301   Baltimore, MD, US

CPM: current 246 Low 138 High 259

Average 164(CPM of Gamma in energy range 600-800keV)

Last updated: 2017-02-09 05:52:00 GMT-0600

.

Constitution – Crony Capitalism

Judge extends injunction blocking Texas’ fetal remains burial rule

fetal remain burial

© 2017 Catholic Stand

© 2017 Catholic Stand

 

By Andrea Zelinski, Houston Chronicle Updated 7:02 pm, Friday, January 27, 2017 AUSTIN —
Texas letter re abortion remains

Texas Department of State Health Services

Texas has a long and complex history with the issue of abortion and reproductive rights. Photo: Brian Rosenthal | Houston Chronicle

A federal judge on Friday issued a preliminary injunction blocking the state of Texas from implementing a controversial new rule targeting abortion by requiring the burial or cremation of fetal remains.

The 24-page ruling from U.S. District Judge Sam Sparks ordered the parties move forward with a case challenging the new state rule mandating the cremation or burial of the remains from an abortion, miscarriage or ectopic pregnancy.

Texas Attorney General Ken Paxton immediately promised to appeal Sparks’ ruling.

“Texas has chosen to dignify the life of the unborn by requiring the humane disposition of fetal remains,” Paxton said. “Indeed, no longer content with merely ending the life of the unborn, the radical left now objects to even the humane treatment of fetal remains. Texas stands committed to honoring the dignity of the unborn and my office is proud to continue fighting for these new rules.”

Opponents to the rule celebrated the ruling, calling it a victory for women’s rights.

“Anti-abortion attacks cannot and will not slow us down,” said Amy Hagstrom Miller, founder and CEO of Whole Woman’s Health, a plaintiff in the case. “It is so important that our resiliency continues to blaze a path that people in all communities are empowered to stand up and continue to fight back against political interference that attempt to regulate our lives.”

Officials in the state Health and Human Services Commission introduced the regulation at the behest of Gov. Greg Abbott, a Republican who later referenced the rule in a fundraising letter. The state quietly published the rule four days after the U.S. Supreme Court’s landmark ruling last summer found Texas had gone too far in regulating abortion, striking down a pair of Texas regulations as unconstitutional.

Sparks in a hearing earlier this month said it was “obvious” the new rule had no health benefits, striking a chord with the U.S. Supreme Court’s ruling that any regulation that burdens access to abortion must offer a sufficient medical benefit.

Embryonic and fetal tissue currently is disposed of the same way as medical waste which undergoes chemical disinfection, grinding, incineration or cremation which is then discarded in a sanitary sewer, sanitary landfill or by burial.

The state’s attorneys argued in court earlier this month the rule provides for the dignity of the unborn. Cremation and burial would be affordable if done in bulk, the state contends, and abortion supporters have failed to identify irreparable harm the rule would cause.

The Center for Reproductive Rights, which brought the suit on behalf of several Texas abortion and health care clinics, argues the regulation imposes government officials’ religious beliefs on women and would create an undue burden to accessing abortion.

“Today’s ruling acknowledges that these regulations do nothing to protect public health while imposing new burdens and uncertainty on health care providers and the diverse communities they serve,” said Nancy Northup, president and CEO of the center.

The plaintiffs in the suit include Brookside Women’s Medical Center PA, its founder, Lendol L. Davis, Nova Health Systems, Inc., Alamo City Surgery Center and Whole Woman’s Health.

Nearly 55,000 abortions were performed in Texas in 2014, the latest year figures were available.

A top Texas Department of State Health Services official said the agency envisioned the remains would be buried in one mass grave. The Texas Conference of Catholic Bishops has offered to make cemetery space available across the state for the remains.

Witnesses for both the state and abortion providers said the cost of burial and cremation services, if done in bulk, could amount to less than $2 per abortion, but would require facilities that handle aborted remains to store them in a freezer for weeks or months. Opponents of the rule say it would create additional emotional hardship for women undergoing an abortion or miscarriage.

The rule would apply to abortion clinics, as well as hospitals, forensic labs and pathology labs.

Abortion advocates and obstetricians testified in court that few if any women opt to have the fetal or embryonic remains buried.

Republican lawmakers vowed after their loss at the U.S. Supreme Court to search for additional ways to curb abortion in Texas. Several lawmakers since have drafted bills to change state law to require fetal burials or cremations. Other proposals include abolishing certain abortion procedures.

Rep. Byron Cook, R-Corsicana, has one such proposal to require the burial or cremation of fetal remains.

“Today’s ruling is disappointing, however, the two-day court hearing provided us with essential input to ensure we pass good, constitutionally sound public policy,” he said in a statement. “Committed to changing antiquated, abhorrent practices that do not offer dignity for unborn children — as we do for all deceased humans, I am committed to pursuing this important endeavor during the current 85th Session of the Texas Legislature.”

© Copyright 2017 Hearst Newspapers, LLC
Accessed at http://www.chron.com/news/politics/texas/article/headline-to-come-10889258.php on January 28, 2017.

.

Preparation

New perovskite material can convert heat, movement and sunlight into electricity

Perovskite is a class of materials used to make photovoltaic cells.

The polymer could lead to high-energy-density supercapacitors, an alternative to traditional batteries that store and distribute high volumes of energy, wrote Engadget.

“This will push the development of the Internet of Things and smart cities, where power-consuming sensors and devices can be energy sustainable,” researcher Yang Bai said.

By Brooks Hays   |   Feb. 7, 2017 at 1:42 PM Feb. 7 (UPI) —
New perovskite material can convert heat movement and sunlight into electricity

Photo by Craig Russell/Shutterstock

Perovskite is a class of materials used to make photovoltaic cells. Photo by Craig Russell/Shutterstock

In a newly published study, researchers in Finland detailed the ability of KBNNO, a type of perovskite, to convert heat, kinetic energy and sunlight into electricity.

Perovskite (pronunciation: /pəˈrɒvskaɪt/) is a calcium titanium oxide mineral composed of calcium titanate (CaTiO3). The mineral was discovered in the Ural Mountains of Russia by Gustav Rose in 1839 and is named after Russian mineralogist Lev Perovski (1792–1856).
Perovskite. (Image: Rob Lavinsky, Wikimedia, CC-BY-SA-3.0)
http://www.nanowerk.com/spotlight/id45249_1.jpg

Most perovskite materials are adept at energy conversion, though different perovskite materials typically specialize in a single type of energy conversion. Materials used in photovoltaic cells are efficient at deriving power from the sun’s rays, but usually fail to convert temperature and pressure changes into electricity.

Experiments conducted by materials scientists at the University of Oulu suggest KBNNO is multitalented.

Previous studies have highlighted the photovoltaic abilities of KBNNO, but less attention had been paid to the material’s pyroelectric and piezoelectric qualities — a material’s ability to convert changes in temperature and pressure, triggered by motion, into electricity.

KBNNO is ferroelectric, like all perovskites, which means it is littered with tiny electric dipoles. These dipoles are like tiny compass needles. They become misaligned during shifts in temperature, creating an electric current.

Researchers had previously tested KBNNO’s ferroelectric abilities at extremely low temperatures. The team from Oulu was the first to measure both KBNNO’s ferroelectric and photovoltaic abilities at room temperature.

While KBNNO isn’t the best at any one type of energy conversion, testing suggests it is relatively efficient at all three. What’s more, the study’s findings — detailed in the journal Applied Physics Letters — suggest the material can be improved.

“It is possible that all these properties can be tuned to a maximum point,” researcher Yang Bai said in a news release.

Bai and his colleagues hope to create a multi-energy-harvesting device in the near future.

“This will push the development of the Internet of Things and smart cities, where power-consuming sensors and devices can be energy sustainable,” Bai said.

Copyright © 2017 United Press International, Inc. All Rights Reserved.
Accessed at http://www.upi.com/Science_News/2017/02/07/New-perovskite-material-can-convert-heat-movement-and-sunlight-into-electricity/1661486489139/?spt=slh&or=4 on February 8, 2017.

.

For This Metal, Electricity Flows, But Not the Heat

For This Metal Electricity Flows But Not the Heat, VO2 20170126

Credit: Marilyn Chung/Berkeley Lab

Vanadium dioxide (VO2) nanobeams synthesized by Berkeley researchers show exotic electrical and thermal properties. In this false-color scanning electron microscopy image, thermal conductivity was measured by transporting heat from the suspended heat source pad (red) to the sensing pad (blue). The pads are bridged by a VO2 nanobeam. (Credit: Junqiao Wu/Berkeley Lab)

Berkeley-led study finds law-breaking property in vanadium dioxide that could lead to applications in thermoelectrics, window coatings

News Release Sarah Yang (510) 486-4575 • January 26, 2017

There’s a known rule-breaker among materials, and a new discovery by an international team of scientists adds more evidence to back up the metal’s nonconformist reputation. According to a new study led by scientists at the Department of Energy’s Lawrence Berkeley National Laboratory (Berkeley Lab) and at the University of California, Berkeley, electrons in vanadium dioxide can conduct electricity without conducting heat.

Berkeley Lab scientists Junqiao Wu, Fan Yang, and Changhyun Ko (l-r) are working at the nano-Auger electron spectroscopy instrument at the Molecular Foundry, a DOE Office of Science User Facility. They used the instrument to determine the amount of tungsten in the tungsten-vanadium dioxide (WVO2) nanobeams.

Credit: Marilyn Chung/Berkeley Lab

Berkeley Lab scientists Junqiao Wu, Fan Yang, and Changhyun Ko (l-r) are working at the nano-Auger electron spectroscopy instrument at the Molecular Foundry, a DOE Office of Science User Facility. They used the instrument to determine the amount of tungsten in the tungsten-vanadium dioxide (WVO2) nanobeams. (Credit: Marilyn Chung/Berkeley Lab)

The findings, to be published in the Jan. 27 issue of the journal Science, could lead to a wide range of applications, such as thermoelectric systems that convert waste heat from engines and appliances into electricity.

For most metals, the relationship between electrical and thermal conductivity is governed by the Wiedemann-Franz Law. Simply put, the law states that good conductors of electricity are also good conductors of heat. That is not the case for metallic vanadium dioxide, a material already noted for its unusual ability to switch from an insulator to a metal when it reaches a balmy 67 degrees Celsius, or 152 degrees Fahrenheit.

“This was a totally unexpected finding,” said study principal investigator Junqiao Wu, a physicist at Berkeley Lab’s Materials Sciences Division and a UC Berkeley professor of materials science and engineering. “It shows a drastic breakdown of a textbook law that has been known to be robust for conventional conductors. This discovery is of fundamental importance for understanding the basic electronic behavior of novel conductors.”

In the course of studying vanadium dioxide’s properties, Wu and his research team partnered with Olivier Delaire at DOE’s Oak Ridge National Laboratory and an associate professor at Duke University. Using results from simulations and X-ray scattering experiments, the researchers were able to tease out the proportion of thermal conductivity attributable to the vibration of the material’s crystal lattice, called phonons, and to the movement of electrons.

 

To their surprise, they found that the thermal conductivity attributed to the electrons is ten times smaller than what would be expected from the Wiedemann-Franz Law.

“The electrons were moving in unison with each other, much like a fluid, instead of as individual particles like in normal metals,” said Wu. “For electrons, heat is a random motion. Normal metals transport heat efficiently because there are so many different possible microscopic configurations that the individual electrons can jump between. In contrast, the coordinated, marching-band-like motion of electrons in vanadium dioxide is detrimental to heat transfer as there are fewer configurations available for the electrons to hop randomly between.”

Notably, the amount of electricity and heat that vanadium dioxide can conduct is tunable by mixing it with other materials. When the researchers doped single crystal vanadium dioxide samples with the metal tungsten, they lowered the phase transition temperature at which vanadium dioxide becomes metallic. At the same time, the electrons in the metallic phase became better heat conductors. This enabled the researchers to control the amount of heat that vanadium dioxide can dissipate by switching its phase from insulator to metal and vice versa, at tunable temperatures.

Such materials can be used to help scavenge or dissipate the heat in engines, or be developed into a window coating that improves the efficient use of energy in buildings, the researchers said.

“This material could be used to help stabilize temperature,” said study co-lead author Fan Yang, a postdoctoral researcher at Berkeley Lab’s Molecular Foundry, a DOE Office of Science User Facility where some of the research was done. “By tuning its thermal conductivity, the material can efficiently and automatically dissipate heat in the hot summer because it will have high thermal conductivity, but prevent heat loss in the cold winter because of its low thermal conductivity at lower temperatures.”

Vanadium dioxide has the added benefit of being transparent below about 30 degrees Celsius (86 degrees Fahrenheit), and absorptive of infrared light above 60 degrees Celsius (140 degrees Fahrenheit).

Yang noted that there are more questions that need to be answered before vanadium dioxide can be commercialized, but said that this study highlights the potential of a material with “exotic electrical and thermal properties.”

While there are a handful of other materials besides vanadium dioxide that can conduct electricity better than heat, those occur at temperatures hundreds of degrees below zero, making it challenging to develop into real-world applications, the scientists said.
Other co-lead authors of the study include Sangwook Lee at Kyungpook National University in South Korea, Kedar Hippalgaonkar at the Institute of Materials Research and Engineering in Singapore, and Jiawang Hong at the Beijing Institute of Technology in China. Lee and Hippalgaonkar started work on this paper as postdoctoral researchers at UC Berkeley. Hong began his work as a postdoctoral researcher at Oak Ridge National Laboratory. The full list of authors is available online.
Additional support for this work came through the use of facilities supported by the Electronic Materials Program at DOE’s Office of Science.
###
Lawrence Berkeley National Laboratory addresses the world’s most urgent scientific challenges by advancing sustainable energy, protecting human health, creating new materials, and revealing the origin and fate of the universe. Founded in 1931, Berkeley Lab’s scientific expertise has been recognized with 13 Nobel Prizes. The University of California manages Berkeley Lab for the U.S. Department of Energy’s Office of Science. For more, visit http://www.lbl.gov.
DOE’s Office of Science is the single largest supporter of basic research in the physical sciences in the United States, and is working to address some of the most pressing challenges of our time. For more information, please visit science.energy.gov.
Updated: January 26, 2017
TAGS: materials sciences, Molecular Foundry, nanoscience
A U.S. Department of Energy National Laboratory Managed by the University of California
Accessed at http://newscenter.lbl.gov/2017/01/26/electricity-not-heat-flows-in-vanadium-dioxide/ on February 8, 2017.

.

Scientific Breakthrough Yields Revolutionary Energy Storage Alternative

Wed, 12/07/2016 – 1:38pm by Ryan Bushey – Digital Editor – @R_Bushey

Scientists have developed a new type of plastic based on contact-lens technology that could solve some of the biggest problems associated with battery technology.

 

The polymer could lead to high-energy-density supercapacitors, an alternative to traditional batteries that store and distribute high volumes of energy, wrote Engadget.

Supercapacitors use electrolytes to quickly charge and discharge power, but their low density means they can’t store this energy for a long period of time unlike traditional batteries.

However, this plastic was designed to replace the electrolytes component boosting the energy density of these supercapacitors making them up to 10,000 times more powerful.

“There is a global search for new energy storage technology and this new ultra-capacity supercapacitor has the potential to open the door to unimaginably exciting developments,” said Brendan Howlin, Ph.D., a co-lead researcher on this project and a chemistry professor at the University of Surrey, in a statement.

Electric vehicles could benefit the most from this breakthrough, according to Bloomberg.

Infusing the technology into these cars could lead to a recharging process that would take a few minutes allowing for travel over long distances. It would be an improvement over the current charging process, which could take anywhere from six to eight hours.

Other potential applications include a durable power source for bioelectronics and similar wearable devices, such as smart watches.

The team’s next steps are seeking commercialization opportunities as they hope to build a full-fledged prototype by next year.

© Copyright 2016 Advantage Business Media
Accessed at http://www.rdmag.com/article/2016/12/scientific-breakthrough-yields-revolutionary-energy-storage-alternative?et_cid=5717649&et_rid=598083810&type=headline&et_cid=5717649&et_rid=598083810&linkid=content on December 7, 2016.

.

Biosecurity:   Bird Flu

Assessing Change in Avian Influenza A(H7N9) Virus Infections During the Fourth Epidemic — China, September 2015–August 2016

Week of illness onset A-H7N9 virus mainland China February 2013–August 2016

Hong Kong Center for Health Excellence

Week of illness onset A-H7N9 virus mainland China February 2013–August 2016

Asian Migratory Flyways

Hong Kong Center for Health Excellence

Weekly / December 16, 2016 / 65(49);1390–1394
Nijuan Xiang, MD1*; Xiyan Li, MD2*; Ruiqi Ren, MD1*; Dayan Wang, PhD2; Suizan Zhou, MPH3; Carolyn M. Greene, MD3; Ying Song, MD3; Lei Zhou, MD1; Lei Yang, MD2; C. Todd Davis, PhD3; Ye Zhang, MD2; Yali Wang, MPH1; Jian Zhao, PhD1; Xiaodan Li, MD2; A. Danielle Iuliano, PhD3; Fiona Havers, MD3; Sonja J. Olsen, PhD3; Timothy M. Uyeki, MD3; Eduardo Azziz-Baumgartner, MD3; Susan Trock, DVM3; Bo Liu, MD1; Haitian Sui, MD1; Xu Huang1; Yanping Zhang, MD1; Daxin Ni, MD1; Zijian Feng, MD4; Yuelong Shu, PhD2; Qun Li, MD1 (View author affiliations)

Summary

What is already known about this topic?

Influenza A(H7N9) virus is a low pathogenic avian influenza virus that can cause severe illness in humans, with a case-fatality rate of 40%. Since March 2013, China has experienced four annual avian influenza A(H7N9) virus epidemics with human infections. Most human infections have been associated with exposure to live poultry, particularly in live-poultry markets. In the first three annual epidemics, there was no evidence of sustained human-to-human transmission.

What is added by this report?

Epidemiology and virology data from the most recent (fourth) epidemic, September 2015–August 2016, suggest no evidence of increased transmissibility of A(H7N9) virus from poultry or environmental exposures to humans or of sustained human-to-human transmission. Characteristics of the fourth epidemic included greater percentages of patients admitted to intensive care units and with diagnoses of pneumonia, identification of the virus in new areas, a greater percentage of infected persons living in rural areas, and a longer epidemic period. Genetic changes in the virus have not been sufficient to alter antigenic properties or cause mismatch with candidate vaccines.

What are the implications for public health practice?

There is a need for a national containment-control-eradication program in poultry, in addition to effective A(H7N9) virus surveillance and continued risk assessment among humans and poultry in China and neighboring countries.

Since human infections with avian influenza A(H7N9) virus were first reported by the Chinese Center for Disease Control and Prevention (China CDC) in March 2013 (1), mainland China has experienced four influenza A(H7N9) virus epidemics. Prior investigations demonstrated that age and sex distribution, clinical features, and exposure history of A(H7N9) virus human infections reported during the first three epidemics were similar (2). In this report, epidemiology and virology data from the most recent, fourth epidemic (September 2015–August 2016) were compared with those from the three earlier epidemics. Whereas age and sex distribution and exposure history in the fourth epidemic were similar to those in the first three epidemics, the fourth epidemic demonstrated a greater proportion of infected persons living in rural areas, a continued spread of the virus to new areas, and a longer epidemic period. The genetic markers of mammalian adaptation and antiviral resistance remained similar across each epidemic, and viruses from the fourth epidemic remained antigenically well matched to current candidate vaccine viruses. Although there is no evidence of increased human-to-human transmissibility of A(H7N9) viruses, the continued geographic spread, identification of novel reassortant viruses, and pandemic potential of the virus underscore the importance of rigorous A(H7N9) virus surveillance and continued risk assessment in China and neighboring countries.

Epidemiology

As of August 31, 2016, mainland China had reported a total of 775 laboratory-confirmed human infections with A(H7N9) virus from 16 provinces and three municipalities during the four epidemics. In addition, travelers to mainland China accounted for 23 human cases of A(H7N9) virus infection, including four deaths; these infections were detected in Hong Kong (16 cases), Taiwan (four), Canada (two), and Malaysia (one).

Among 314 counties in China that reported at least one human A(H7N9) virus infection, 224 (71%) reported =2 infections. Most (83%) infections were reported in five eastern or southeastern coastal provinces. Whereas most infections in the first epidemic were identified during March–April 2013, the majority of infections identified in the subsequent three epidemics occurred during November–April of 2013–2014, 2014–2015, and 2015–2016 (Figure).

Among the 775 total reported infections, 659 (85%) patients reported exposure to live poultry in the 2 weeks preceding illness onset, including live-poultry markets (376 patients, 57%), backyard poultry (115, 17%), or both (120, 18%); and in other settings (48, 7%) (Table). Median age did not significantly differ between persons infected in the fourth epidemic (58 years) compared with the previous three epidemics (57 years). Twenty-five (3%) persons reported living with, working with, or having another epidemiologic link to a person infected with influenza A(H7N9) virus.

Among all 775 infections in the four epidemics, 55 (7%) were associated with 26 clusters (i.e., at least two epidemiologically linked infections), including 23 clusters of two infections each, and three clusters of three infections each. Most (23, 88%) clusters included family members only, and three involved nosocomial transmission (3,4). Among the index patients in the 26 clusters, 25 (96%) had a history of live poultry exposure in the 2 weeks before illness onset; secondary infections (29) in clusters resulted from possible human-to-human transmission (18), exposure to a common infectious source (three), or undetermined exposures (eight). The proportion of persons identified within clusters in the fourth epidemic was similar to the proportion in the three previous epidemics combined (10% compared with 7%, p = 0.16). There was no evidence of tertiary transmission in any cluster.

Fewer A(H7N9) infections were reported during the fourth epidemic (n = 118) than in the first (134), second (304), or third (219) epidemics. The epidemic period during which persons developed illness in the fourth epidemic (interquartile range = 73 days) was more than four times as long as that noted during the first epidemic (15 days), twice as long as the second (35 days), and more than one and a half times as long as the third epidemic (43 days). More than half of infections in the fourth epidemic were reported from two adjacent provinces located on the southeast coast of China; however, one province (Liaoning) and one municipality (Tianjin City) each reported their first A(H7N9) virus infection in the fourth epidemic, indicating spread of the virus to new areas. The percentage of A(H7N9) virus–infected persons living in rural areas in the fourth epidemic was higher than in the three previous epidemics combined (54% compared with 42%; p = 0.01).

Since April 2013, the Ministry of Agriculture in China has published surveillance data on poultry samples tested for the presence of A(H7N9) virus. As of September 1, 2016, a total of 233 positive samples in 16 provinces were detected. All samples were from live-poultry markets, except one from a farmer’s free-range backyard flock.

Clinical Features

Among the 775 persons with A(H7N9) infections during the four epidemics, 316 (41%) died. Among 547 (71%) patients with data on symptoms available, 95% (517 of 547) reported fever and 81% (445 of 547) cough. Fifty-three percent (289 of 545) of patients with medical history data had at least one underlying medical condition (Table). Ninety-one percent (480 of 526) of patients experienced at least one medical complication, including pneumonia, respiratory failure, or acute respiratory distress syndrome (Table); 68% (358 of 529) were admitted to an intensive care unit (ICU) and 85% (506 of 592) had severe illness* (Table). The median intervals (interquartile ranges) from illness onset to various medical outcomes ranged from 1 day (onset to first medical encounter) to 17 days (onset to death) (Table).

Although the proportion of patients with severe illness (91%) in the fourth epidemic was not statistically different from that in the three previous epidemics combined, persons infected in the fourth epidemic were more likely to develop pneumonia (99% compared with 87%, p = 0.003) and be admitted to the ICU (78% compared with 66%, p = 0.04) than were patients in the three previous epidemics (Table). The median interval between illness onset and initial medical consultation, hospitalization, diagnosis, time to antiviral treatment initiation, and death were similar between the fourth and the first three epidemics.

Laboratory Findings

Since the emergence of A(H7N9) virus, the majority of viruses from both humans and poultry have contained two hemagglutinin (HA) amino acid residues, 186V and 226L/I in H3 numbering (177 and 217 in H7 numbering), which are likely to increase human receptor binding (5). During the first three epidemics, the number of A(H7N9) viruses identified in humans retaining the avian receptor binding residues decreased (5). In the fourth epidemic, all 41 A(H7N9) viruses from humans and 10 from environmental samples contained these two mutations associated with increased human receptor binding (supplemental figure https://stacks.cdc.gov/view/cdc/42868). The majority of A(H7N9) viruses isolated from patients in each epidemic carried the PB2-627K mutation, which has been associated with mammalian adaptation. This mutation was found in 68% (62 of 91) of viruses in the first epidemic, 79% (122 of 154) in the second, 62% (52 of 84) in the third, and 71% (29 of 41) in the fourth epidemic. Almost all A(H7N9) viruses isolated from birds and humans had PB1-368V, which might also enhance A(H7N9) virus transmission to humans (5).

Among the 391 A(H7N9) viruses isolated from humans that were tested for the presence of substitutions associated with reduced sensitivity to neuraminidase (NA) inhibitors, only 16 (4%) possessed these substitutions in the NA protein: E119V (four), A246T (one), or R292K (11). These mutations were not identified in 498 A(H7N9) viruses sampled from birds or the environment, suggesting the mutations occurred during human infection or as a result of antiviral drug treatment. Antigenic analysis of viruses from all four epidemics showed that viruses were well inhibited by postinfection ferret antisera raised against the candidate vaccine virus, A/Anhui/1/2013, indicating that recent A(H7N9) viruses remain antigenically well matched to current candidate vaccine viruses (5). Reassortment with A(H9N2) virus internal genes continues to be detected, which might mediate future host adaptation and interspecies transmission of A(H7N9) virus (6).

Discussion

Many characteristics and clinical features of human infections with influenza A(H7N9) virus in China reported during the fourth epidemic (September 2015–August 2016) were similar to those in the previous three epidemics since 2013, including age and sex distribution, and exposure history. However, during the fourth epidemic, infections continued to be reported from areas that had not reported infections in the past, a higher proportion of infected persons lived in rural areas, and a higher percentage of patients required ICU admission. In addition, the duration of the epidemic has been increasing each year.

Viruses collected from both humans and environmental samples from the fourth epidemic showed few genetic changes in the HA and NA genes compared with viruses from earlier epidemics. Although genetic markers of mammalian adaptation continue to be identified in viral polymerase genes, their frequency remains consistent across each epidemic. Few antigenic differences were identified between the viruses from the fourth epidemic and vaccine strains available for manufacturing, suggesting that recently circulating viruses remain antigenically well matched to currently developed candidate vaccine viruses. As the A(H7N9) epidemic season occurs during China’s winter seasonal influenza peak, ongoing viral genome risk assessment is needed to monitor mutations and reassortment.

Since 2013, local governments have implemented numerous prevention and control measures, including temporary closure of live-poultry markets and disinfection protocols, which have decreased the prevalence of A(H7N9) virus in live-poultry market environments (7,8). However, because the A(H7N9) virus is a low pathogenic avian influenza virus and infections in poultry are subclinical, identifying when the virus is spreading among poultry or when humans might be at risk for infection is challenging. The continued identification of the virus in new areas highlights the need for a national containment-control-eradication program in poultry.

The findings in this report are subject to at least three limitations. First, although fewer infections were reported during the fourth epidemic than the first three, the percentages of patients who developed pneumonia and were admitted to the ICU were higher. It is possible that this observed increase in clinical severity in the fourth epidemic represents a surveillance artifact. Several provinces with the highest prevalence of human A(H7N9) virus infections recently established provincial pneumonia surveillance systems, which might have increased identification and reporting of pneumonia in persons with A(H7N9) virus infection. In addition, mild illnesses might be less likely to be detected (9) as concern about A(H7N9) virus as a public health threat declined over time, possibly leading to a decrease in identification and reporting of less severe infections. Further, as more infections occur in rural areas with fewer health care resources, there might be less ability to both identify and promptly treat persons before they develop severe illness. Second, data on medical history, illness presentation, and clinical course were missing for nearly one third of all persons with infections. Finally, for all four epidemics, self-reported exposure history was subject to recall bias.

There is no evidence of increased transmissibility of A(H7N9) virus from poultry or environmental exposures to humans in China or sustained human-to-human transmission; however, using the Influenza Risk Assessment Tool (10), CDC found that A(H7N9) virus has the highest potential pandemic risk of any novel influenza A viruses that have been assessed. The recent geographic spread, the identification of divergent virus lineages, and the pandemic potential of the virus underscore the importance of effective A(H7N9) virus surveillance and continued risk assessment among humans and poultry in China and neighboring countries.

Acknowledgments
Provincial, municipal and local CDCs and designated hospitals in Zhejiang, Guangdong, Jiangsu, Shanghai, Hunan, Fujian, Anhui, Jiangxi, Beijing, Shandong, Henan, Xinjiang, Guangxi, Jilin, Guizhou, Hebei, Hubei, Liaoning, and Tianjin.
Corresponding author: Qun Li, liqun@chinacdc.cn, 86-10-58900545.
1Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing; 2Chinese National Influenza Center, National Institute for Viral Disease Control and Prevention, Collaboration Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing; 3Influenza Division, National Center for Immunization and Respiratory Diseases, CDC; 4Chinese Center for Disease Control and Prevention, Beijing.
*These authors contributed equally to this report.
† Based on the National Health and Family Planning Commission. Diagnosis and Treatment Protocol of Human Infection with A(H7N9) Avian Influenza Virus (2014 version), 2014.01.26, (http://www.moh.gov.cn/yzygj/s3593g/201401/3f69fe196ecb4cfc8a2d6d96182f8b22.shtml), severe illness was defined as an illness with any one of the following: chest radiograph indicative of multilobar lesions or >50% increase in size of lesions within a 48-hour period; dyspnea or respiratory rate >24 times per minute for adults; severe hypoxia, defined as =92% oxygen saturation while receiving 3–5 liters of supplemental oxygen per minute; or shock, acute respiratory distress syndrome, or multiple organ dysfunction syndrome.
References
   Gao R, Cao B, Hu Y, et al. Human infection with a novel avian-origin influenza A (H7N9) virus. N Engl J Med 2013;368:1888–97. CrossRef PubMed
   Xiang N, Iuliano AD, Zhang Y, et al. Comparison of the first three waves of avian influenza A(H7N9) virus circulation in the mainland of the People’s Republic of China. BMC Infect Dis 2016;16:734. CrossRef PubMed
   Chen H, Liu S, Liu J, et al. Nosocomial co-transmission of avian influenza A(H7N9) and A(H1N1)pdm09 viruses between 2 patients with hematologic disorders. Emerg Infect Dis 2016;22:598–607. CrossRef PubMed
   Fang CF, Ma MJ, Zhan BD, et al. Nosocomial transmission of avian influenza A (H7N9) virus in China: epidemiological investigation. BMJ 2015;351:h5765. CrossRef PubMed
   Wang D, Yang L, Zhu W, et al. Two outbreak sources of influenza A(H7N9) viruses have been established in China. J Virol 2016;90:5561–73. CrossRef PubMed
   Wang D, Yang L, Gao R, et al. Genetic tuning of the novel avian influenza A(H7N9) virus during interspecies transmission, China, 2013. Euro Surveill 2014;19:20836. CrossRef PubMed
   Kang M, He J, Song T, et al. Environmental sampling for avian influenza A(H7N9) in live-poultry markets in Guangdong, China. PLoS One 2015;10:e0126335. CrossRef PubMed
   Wang X, Liu S, Mao H, Yu Z, Chen E, Chai C. Surveillance of avian H7N9 virus in various environments of Zhejiang Province, China before and after live poultry markets were closed in 2013–2014. PLoS One 2015;10:e0135718. CrossRef PubMed
   Qin Y, Horby PW, Tsang TK, et al. Differences in the epidemiology of human cases of avian influenza A(H7N9) and A(H5N1) viruses infection. Clin Infect Dis 2015;61:563–71. CrossRef PubMed
   CDC. Influenza Risk Assessment Tool (IRAT). Atlanta, GA: US Department of Health and Human Services, CDC; 2016. http://www.cdc.gov/flu/pandemic-resources/tools/risk-assessment.htm
Top
Return to your place in the textFIGURE. Week of illness onset among persons infected with avian influenza A(H7N9) virus (N = 775) — mainland China, February 2013–August 2016
The figure above is a histogram showing the week of illness onset among persons infected with avian influenza A(H7N9) virus (N = 775) in China during 2013–2016.
Top
Return to your place in the textTABLE. Number and percentage of patients with reported avian influenza A(H7N9) virus infection (N = 775), by demographic and clinical characteristics and period of illness — mainland China, February 19, 2013–August 31, 2016
Abbreviations: IQR = interquartile range; LPM = live-poultry market.
* Significant difference between Epidemic 4 and Epidemics 1–3 (p<0.05).
† Other occupations include laborers, persons working in government or government-affiliated institutions, business service providers, children, and students.
§ Illness with any one of following: chest radiograph indicative of multilobar lesions or >50% increase in size of lesions within a 48-hour period; dyspnea or respiratory rate >24 times per minute for adults; severe hypoxia defined as <92% oxygen saturation while receiving 3–5 liters of supplemental oxygen per minute; or shock, acute respiratory distress syndrome, or multiple organ dysfunction syndrome.
Suggested citation for this article: Xiang N, Li X, Ren R, et al. Assessing Change in Avian Influenza A(H7N9) Virus Infections During the Fourth Epidemic — China, September 2015–August 2016. MMWR Morb Mortal Wkly Rep 2016;65:1390–1394. DOI: http://dx.doi.org/10.15585/mmwr.mm6549a2.
Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.
References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.
All HTML versions of MMWR articles are generated from final proofs through an automated process. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version (https://www.cdc.gov/mmwr) and/or the original MMWR paper copy for printable versions of official text, figures, and tables.
Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
   Page last reviewed: December 15, 2016
   Page last updated: December 15, 2016
   Content source:
       Centers for Disease Control and Prevention
   U.S. Department of Health & Human Services
   HHS/Open
   USA.gov
Accessed at https://www.cdc.gov/mmwr/volumes/65/wr/mm6549a2.htm on February 8, 2017.

 

All data are preliminary and may change as more reports are received.

.

During week 4 (January 22-28, 2017), influenza activity increased in the United States.

Laboratory-Confirmed Influenza Hospitalizations Cummutative Rates as of 28 Jan 2017

CDC/MMWR

September 2015–August 2016
Morbidity and Mortality Weekly Report (MMWR)
CDC MMWR

Synopsis:

  • Viral Surveillance: The most frequently identified influenza virus subtype reported by public health laboratories during week 4 was influenza A (H3). The percentage of respiratory specimens testing positive for influenza in clinical laboratories increased.
  • Pneumonia and Influenza Mortality: Due to data processing problems, the National Center for Health Statistics (NCHS) mortality surveillance data for the week ending January 14, 2015 (week 2) will not be published this week.
  • Influenza-associated Pediatric Deaths: Seven influenza-associated pediatric deaths were reported.
  • Influenza-associated Hospitalizations: A cumulative rate for the season of 20.3 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
  • Outpatient Illness Surveillance:The proportion of outpatient visits for influenza-like illness (ILI) was 3.9%, which is above the national baseline of 2.2%. All 10 regions reported ILI at or above their region-specific baseline levels. New York City and 15 states experienced high ILI activity; Puerto Rico and 11 states experienced moderate ILI activity; 14 states experienced low ILI activity; 10 states experienced minimal ILI activity, and the District of Columbia had insufficient data.
  • Geographic Spread of Influenza: The geographic spread of influenza in Puerto Rico and 40 states was reported as widespread; Guam and nine states reported regional activity; the District of Columbia and one state reported local activity; and the U.S. Virgin Islands reported no activity.

National and Regional Summary of Select Surveillance Components

*HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).

† Elevated means the % of visits for ILI is at or above the national or region-specific baseline

  • Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands

‡ National data are for current week; regional data are for the most recent three weeks

 

U.S. Virologic Surveillance:

INFLUENZA Virus Isolated

WHO/NPHL

WHO and NREVSS collaborating laboratories, which include both public health and clinical laboratories located in all 50 states, Puerto Rico, and the District of Columbia, report to CDC the total number of respiratory specimens tested for influenza and the number positive for influenza by virus type. In addition, public health laboratories also report the influenza A subtype (H1 or H3) and influenza B lineage information for the viruses they test and the age or age group of the persons from whom the specimens were collected.

Additional data are available at http://gis.cdc.gov/grasp/fluview/fluportaldashboard.html and http://gis.cdc.gov/grasp/fluview/flu_by_age_virus.html.

Influenza Positive Tests Reported to the CDC Natioal Summary 2016-2017 Season

WHO/PHL

The results of tests performed by clinical laboratories during the current week are summarized below.

The results of tests performed by public health laboratories, as well as the age group distribution of influenza positive tests, during the current week are summarized below.

*The percent of specimens testing positive for influenza is not reported because public health laboratories often receive samples that have already tested positive for influenza at a clinical laboratory and therefore percent positive would not be a valid indicator of influenza activity. Additional information is available at http://www.cdc.gov/flu/weekly/overview.htm.

INFLUENZA Virus Isolated

Influenza Positive Tests Reported to the CDC Natioal Summary 2016-2017 Season

WHO/PHL

Influenza Virus Characterization:

CDC characterizes influenza viruses through one or more tests including genomic sequencing, hemagglutination inhibition (HI) and/or neutralization assays. These data are used to compare how similar currently circulating influenza viruses are to the reference viruses used for developing influenza vaccines, and to monitor for changes in circulating influenza viruses. Historically, HI data have been used most commonly to assess the similarity between reference viruses and circulating viruses to suggest how well the vaccine may work until such a time as vaccine effectiveness estimates are available.

For nearly all virus positive surveillance samples received at CDC, next-generation sequencing is performed to ascertain genomic data of circulating influenza viruses. Viruses can be classified into genetic groups/clades based on analysis of their HA gene segments using phylogenetics and key amino acid changes (Klimov Vaccine 2012).

A proportion of influenza A (H3N2) viruses don’t yield sufficient hemagglutination titers for antigenic characterization using the hemagglutination inhibition test. Therefore, CDC selects a subset of influenza A (H3N2) viruses to test using a focus reduction assay for supplementary antigenic characterization.

Genetic Characterization

During the 2016-2017 season, 12,967 influenza positive specimens have been collected and reported by public health laboratories in the United States (figure, left). CDC genetically characterized 729 influenza viruses [79 influenza A (H1N1)pdm09, 494 influenza A (H3N2), and 156 influenza B viruses] collected by U.S. laboratories. The HA gene segment of all influenza A (H1N1)pdm09 viruses analyzed belonged to genetic group 6B.1. Influenza A (H3N2) virus HA gene segments analyzed belonged to genetic groups 3C.2a or 3C.3a. Genetic group 3C.2a includes a newly emerging subgroup known as 3C.2a1. The HA of influenza B/Victoria-lineage viruses all belonged to genetic group V1A. The HA of influenza B/Yamagata-lineage viruses analyzed all belonged to genetic group Y3.

The majority of U.S. viruses submitted for characterization come from state and local public health laboratories. Due to Right Size Roadmap considerations, specimen submission guidance issued to the laboratories request that, if available, 2 influenza A (H1N1), 2 A influenza (H3N2), and 2 influenza B viruses be submitted every other week. Because of this, the number of each virus type/subtype characterized should be approximately equal. In the figure below, the results of tests performed by public health labs are presented on the left and sequence results by genetic group of specimens submitted to CDC are presented on the right.

Genetic Characterization

Percentage of Visits for ILI Reports by US Outpatient Weekly Natioanl Summary 2016-2017

CDC/Outpatient Surveillance Network

Antigenic Characterization

CDC has antigenically characterized 419 influenza viruses [74 influenza A (H1N1)pdm09, 257 influenza A (H3N2), and 88 influenza B viruses] collected by U.S. laboratories since October 1, 2016.

Influenza A Virus [331]

  • A (H1N1)pdm09 [74]: All 74 (100%) influenza A (H1N1)pdm09 viruses were antigenically characterized using ferret post-infection antisera as A/California/7/2009-like, the influenza A (H1N1) component of the 2016-2017 Northern Hemisphere vaccine.
  • A (H3N2) [257]: 248 of 257 (96.5%) influenza A (H3N2) viruses were antigenically characterized as A/Hong Kong/4801/2014-like, a virus that belongs in genetic group 3C.2a and is the influenza A (H3N2) component of the 2016-2017 Northern Hemisphere vaccine, by HI testing or neutralization testing. Among the viruses which reacted poorly with ferret antisera raised against A/Hong Kong/4801/2014-like viruses, 6 out of 9 (66.7%) are more closely related to A/Switzerland/9715293/2013, a virus belonging to genetic group 3C.3a.

Influenza B Virus [88]

  • Victoria Lineage [32]: 29 of 32 (90.6%) B/Victoria-lineage viruses were antigenically characterized using ferret post-infection antisera as B/Brisbane/60/2008-like, which is included as an influenza B component of the 2016-2017 Northern Hemisphere trivalent and quadrivalent influenza vaccines.
  • Yamagata Lineage [56]: All 56 (100%) B/Yamagata-lineage viruses were antigenically characterized using ferret post-infection antisera as B/Phuket/3073/2013-like, which is included as an influenza B component of the 2016-2017 Northern Hemisphere quadrivalent influenza vaccines.

 

Antiviral Resistance:

Testing of influenza A (H1N1)pdm09, influenza A (H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir, zanamivir, and peramivir) is performed at CDC using a functional assay. Additional influenza A (H1N1)pdm09 and influenza A (H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.

High levels of resistance to the adamantanes (amantadine and rimantadine) persist among influenza A (H1N1)pdm09 and influenza A (H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.

Neuraminidase Inhibitor Resistance Testing Results on Samples Collected Since October 1, 2016

The majority of recently circulating influenza viruses are susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir, zanamivir, and peramivir; however, rare sporadic instances of oseltamivir-resistant and peramivir-resistant influenza A (H1N1)pdm09 viruses and oseltamivir-resistant influenza A (H3N2) viruses have been detected worldwide. Antiviral treatment as early as possible is recommended for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.

 

Pneumonia and Influenza (P&I) Mortality Surveillance:

Due to data processing problems, the National Center for Health Statistics (NCHS) mortality surveillance data for the week ending January 14, 2017 (week 2) will not be published this week. Instead, updated data thru the week ending January 7, 2017 (week 1) is presented below.

Background: Weekly mortality surveillance data includes a combination of machine coded and manually coded causes of death collected from death certificates. There is a backlog of data requiring manual coding within NCHS mortality surveillance data. The percentages of deaths due to P&I are higher among manually coded records than more rapidly available machine coded records and may result in initially reported P&I percentages that are lower than percentages calculated from final data. Efforts continue to reduce and monitor the number of records awaiting manual coding.

Beginning in the week ending October 8, 2016 (week 40), CDC retired the 122 Cities Mortality Reporting System and uses only the NCHS Mortality Surveillance System.

Region and state-specific data are available at http://gis.cdc.gov/grasp/fluview/mortality.html.

INFLUENZA Virus Isolated

View Regional and State Level Data | View Chart Data | View Full Screen | View PowerPoint Presentation

 

Influenza-Associated Pediatric Mortality:

Seven influenza-associated pediatric deaths were reported to CDC during week 4. Three deaths were associated with an influenza A (H3) virus and occurred during weeks 1, 2, and 4 (the weeks ending January 7, 14, and 28, 2017, respectively). Three deaths were associated with an influenza A virus for which no subtyping was performed and occurred during weeks 1, 3, and 4 (the weeks ending January 7, 21, and 28, 2017, respectively). One death was associated with an influenza B virus and occurred during week 3 (the week ending January 21, 2017).

A total of 15 influenza-associated pediatric deaths have been reported for the 2016-2017 season.

Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
Click on image to launch interactive tool
View Interactive Application | View Full Screen | View PowerPoint Presentation

 

 

Influenza-Associated Hospitalizations:

The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003-2004 influenza season) and adults (since the 2005-2006 influenza season).

The FluSurv-NET covers more than 70 counties in the 10 Emerging Infections Program (EIP) states (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN) and additional Influenza Hospitalization Surveillance Project (IHSP) states. The IHSP began during the 2009-2010 season to enhance surveillance during the 2009 H1N1 pandemic. IHSP sites included IA, ID, MI, OK and SD during the 2009-2010 season; ID, MI, OH, OK, RI, and UT during the 2010-2011 season; MI, OH, RI, and UT during the 2011-2012 season; IA, MI, OH, RI, and UT during the 2012-2013 season; and MI, OH, and UT during the 2013-2014, 2014-2015, 2015-2016, and 2016-2017 seasons.

Data gathered are used to estimate age-specific hospitalization rates on a weekly basis, and describe characteristics of persons hospitalized with severe influenza illness. The rates provided are likely to be an underestimate as influenza-related hospitalizations can be missed, either because testing is not performed, or because cases may be attributed to other causes of pneumonia or other common influenza-related complications.

Between October 1, 2016 and January 28, 2017, 5,683 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 20.2 per 100,000 population. The highest rate of hospitalization was among adults aged =65 years (94.7 per 100,000 population), followed by adults aged 50-64 (19.9 per 100,000 population) and children aged 0-4 years (10.9 per 100,000 population). Among 5,683 hospitalizations, 5,305 (93.3%) were associated with influenza A virus, 334 (5.9%) with influenza B virus, 17 (0.3%) with influenza A virus and influenza B virus co-infection, and 27 (0.5%) with influenza virus for which the type was not determined. Among those with influenza A subtype information, 1,377 (98.6 %) were A(H3N2) and 19 (1.4%) were A(H1N1)pdm09 virus.

Clinical findings are preliminary and based on 693 (12.2%) cases with complete medical chart abstraction. Among 643 hospitalized adults with complete medical chart abstraction, 610 (94.9%) had at least one reported underlying medical condition; the most commonly reported were cardiovascular disease, metabolic disorders, and obesity. Among 50 hospitalized children with complete medical chart abstraction, 26 (52.0%) had at least one underlying medical condition; the most commonly reported were asthma, chronic lung disease, neurologic disorder, and obesity. Among the 50 hospitalized women of childbearing age (15-44 years), 15 (33.3%) were pregnant.

Additional FluSurv-NET data can be found at: http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.

 

Click on graph to launch interactive tool

Data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), a population-based surveillance for influenza related hospitalizations in children and adults in 13 U.S. states. Cumulative incidence rates are calculated using the National Center for Health Statistics’ (NCHS) population estimates for the counties included in the surveillance catchment area.

View Interactive Application | View Full Screen | View PowerPoint Presentation

 

Click on graph to launch interactive tool2

FluSurv-NET data are preliminary and displayed as they become available. Therefore, figures are based on varying denominators as some variables represent information that may require more time to be collected. Data are refreshed and updated weekly. Asthma includes a medical diagnosis of asthma or reactive airway disease; Cardiovascular diseases include conditions such as coronary heart disease, cardiac valve disorders, congestive heart failure, and pulmonary hypertension; does not include isolated hypertension; Chronic lung diseases include conditions such as chronic obstructive pulmonary disease, bronchiolitis obliterans, chronic aspiration pneumonia, and interstitial lung disease; Immune suppression includes conditions such as immunoglobulin deficiency, leukemia, lymphoma, HIV/AIDS, and individuals taking immunosuppressive medications; Metabolic disorders include conditions such as diabetes mellitus; Neurologic diseases include conditions such as seizure disorders, cerebral palsy, and cognitive dysfunction; Neuromuscular diseases include conditions such as multiple sclerosis and muscular dystrophy; Obesity was assigned if indicated in patient’s medical chart or if body mass index (BMI) >30 kg/m2; Pregnancy percentage calculated using number of female cases aged between 15 and 44 years of age as the denominator; Renal diseases include conditions such as acute or chronic renal failure, nephrotic syndrome, glomerulonephritis, and impaired creatinine clearance; No known condition indicates that the case did not have any known high risk medical condition indicated in medical chart at the time of hospitalization.

View Interactive Application | View Full Screen | View PowerPoint Presentation

 

 

Outpatient Illness Surveillance:

Nationwide during week 4, 3.9% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is above the national baseline of 2.2%. (ILI is defined as fever (temperature of 100°F [37.8°C] or greater) and cough and/or sore throat.)

Additional data are available at http://gis.cdc.gov/grasp/fluview/fluportaldashboard.html.

national levels of ILI and ARI

View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation

 

On a regional level, the percentage of outpatient visits for ILI ranged from 2.2% to 6.9% during week 4. All ten regions reported a proportion of outpatient visits for ILI at or above their region-specific baseline levels.

 

ILINet State Activity Indicator Map:

Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.

During week 4, the following ILI activity levels were experienced:

New York City and 15 states (Alabama, Arkansas, Georgia, Indiana, Kansas, Kentucky, Louisiana, Missouri, New Jersey, New York, Oklahoma, Pennsylvania, South Carolina, Tennessee, and Wyoming) experienced high ILI activity.

Puerto Rico and 11 states (California, Hawaii, Illinois, Iowa, Maryland, Minnesota, North Carolina, North Dakota, South Dakota, Texas, and Virginia) experienced moderate ILI activity.

14 states (Alaska, Arizona, Colorado, Connecticut, Massachusetts, Michigan, Mississippi, Nebraska, Nevada, New Mexico, Oregon, Rhode Island, Utah, and Wisconsin) experienced low ILI activity.

10 states (Delaware, Florida, Idaho, Maine, Montana, New Hampshire, Ohio, Vermont, Washington, and West Virginia) experienced minimal ILI activity.

Data were insufficient to calculate an ILI activity level from the District of Columbia.

Click on map to launch interactive tool

Click on map to launch interactive tool

*This map uses the proportion of outpatient visits to health care providers for ILI to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.

Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.

Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data are received.

Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.

 

Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.

During week 4, the following influenza activity was reported:

Widespread influenza activity was reported by Puerto Rico and 40 states (Alabama, Alaska, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Virginia, Washington, Wisconsin, and Wyoming).

Regional influenza activity was reported by Guam and nine states (Arizona, Colorado, Hawaii, Michigan, North Carolina, Tennessee, Utah, Vermont, and West Virginia).

Local influenza activity was reported by the District of Columbia and one state (Indiana).

No influenza activity was reported by the U.S. Virgin Islands.

Flu Activity data in XML Format | View Full Screen

 

Additional National and International Influenza Surveillance Information

FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.

U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.

 

World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.

WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).

Europe: For the most recent influenza surveillance information from Europe, please see WHO/Europe and the European Centre for Disease Prevention and Control at http://www.flunewseurope.org/.

Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/

Public Health England: The most up-to-date influenza information from the United Kingdom is available at https://www.gov.uk/government/statistics/weekly-national-flu-reports

 

Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.

An overview of the CDC influenza surveillance system, including methodology and detailed descriptions of each data component, is available at: http://www.cdc.gov/flu/weekly/overview.htm.

——————————————————————————–

Full report also available as PDF

   Page last reviewed: February 3, 2017
   Page last updated: February 3, 2017
   Content source:
       Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD)
       Page maintained by: Office of the Associate Director for Communication, Digital Media Branch, Division of Public Affairs
Accessed at https://www.cdc.gov/flu/weekly/index.htm on February 8, 2017.

.

Biosecurity: Zika

Outcomes for Completed Pregnancies in the United States and District of Columbia, 2016-2017

Completed pregnancies with or without birth defects 999
Liveborn infants with birth defects* 38 3.8%
Pregnancy losses with birth defects** 5 0.5%

Includes aggregated data reported to the US Zika Pregnancy Registry*

*As of January 24, 2017

What these numbers show

  • The number of completed pregnancies with or without birth defects include those that ended in a live birth, miscarriage, stillbirth, or termination.
  • The number of liveborn infants and pregnancy losses with birth defects include those among completed pregnancies with laboratory evidence of possible Zika virus infection that have been reported to the US Zika Pregnancy Registry.
  • These numbers rely on reporting to the US Zika Pregnancy Registry and may increase or decrease as new cases are added or information on existing cases is clarified. For example, CDC cannot report the number of completed pregnancies with or without poor pregnancy outcomes that have not yet been reported to the US Zika Pregnancy Registry.
  • The number of liveborn infants and pregnancy losses with birth defects are combined for the 50 US states, and the District of Columbia. CDC is not reporting individual state, tribal, territorial or jurisdictional level data to protect the privacy of the women and children affected by Zika. CDC is using a consistent case inclusion criteria to monitor brain abnormalities and other adverse pregnancy outcomes potentially related to Zika virus infection during pregnancy in the US states and territories. Puerto Rico is not using the same inclusion criteria; CDC is not reporting numbers for adverse pregnancy outcomes in the territories at this time.
  • Birth defects reported include those that have been detected in infants infected with Zika before, during, or shortly after birth, including microcephaly, calcium deposits in the brain indicating possible brain damage, excess fluid in the brain cavities and surrounding the brain, absent or poorly formed brain structures, abnormal eye development, or other problems resulting from damage to brain that affects nerves, muscles and bones, such as clubfoot or inflexible joints, and confirmed hearing loss.

What these new numbers do not show

  • These numbers are not real time estimates. They reflect the outcomes of pregnancies with any laboratory evidence of possible Zika virus infection reported to the US Zika Pregnancy Registry as of 12 noon Tuesday the week prior. Additionally, there may be delays in reporting of pregnancy outcomes from the jurisdictions.
  • Although these outcomes occurred in pregnancies with laboratory evidence of possible Zika virus infection, we do not know whether they were caused by Zika virus infection or other factors.

Where do these numbers come from?

  • These data reflect pregnancies reported to the US Zika Pregnancy Registry. CDC, in collaboration with state, local, tribal and territorial health departments, established this system for comprehensive monitoring of pregnancy and infant outcomes following Zika virus infection.
  • The data collected through this system will be used to update recommendations for clinical care, to plan for services and support for pregnant women and families affected by Zika virus, and to improve prevention of Zika virus infection during pregnancy.
   Page last reviewed: February 2, 2017
   Page last updated: February 2, 2017
   Content source:
       Centers for Disease Control and Prevention
       National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
       Division of Vector-Borne Diseases (DVBD)
Accessed at https://www.cdc.gov/zika/geo/pregnancy-outcomes.html on February 8, 2017.

.

Zika in Texas Podcast Transcript

January 2017 Texas Health Steps Online Provider Education

Logo

Texas Department of State Health Services

Host:

Welcome to this podcast, hosted by Texas Health Steps Online Provider Education. We will hear from Dr. John Hellerstedt, commissioner of the Texas Department of State Health Services, about the impact of Zika in Texas and get recommendations about how health-care providers should respond. Dr. Hellerstedt, to start with give us an overview of the impact Zika has had in Texas to date.

Dr. Hellerstedt:

Yes. To date we have more than 300 cases that we’ve identified as confirmed cases of Zika. We know of two infants who were infected with the virus before birth. We also know now of five cases of confirmed local mosquito vector transmission of the disease in Texas; specifically, in Brownsville in Cameron County, Texas. As a result of that, we’ve expanded our human and mosquito surveillance, especially in the lower Rio Grande Valley.

Host:

What is the outlook for 2017?

Dr. Hellerstedt:

I think the outlook for 2017 is guarded. We really need to prepare for the possibility that Zika will emerge at the very beginning of the mosquito season in 2017. We know through very credible sources that all of the Mexican communities along the Texas border have local mosquito vector transmission of Zika. As a result of that, that means that all of those communities are really in very close proximity to one another. Every day, thousands of people go back and forth across the border legally—that is the way they go to work, they go to school, they visit their family, they go shopping. That’s a way of life there.

If we have Zika local mosquito transmission in Mexico, it acts, if you will, as a reservoir for the disease in the Texas communities. I think we need to be very, very prepared, especially for surveillance, to really be looking for the presence of Zika in our Texas communities. We also need to be prepared to respond if we see it; in other words, use the countermeasures that we have in place to try and fight the ongoing transmission of Zika.

Host:

Can you tell us a little bit about the basic biology of the Zika virus and how it’s transmitted?

Dr. Hellerstedt:

The way it happens in most cases—the way it has spread throughout, for instance, South America and Central America and the Caribbean Basin—is primarily through the bite of two specific mosquito species. The primary one, though, is the Aedes aegypti mosquito. The way it works is a human being has Zika, they’re actually in an active infection phase of the infection so that they have Zika in their bloodstream. They get bitten by one of these particular mosquito species. That mosquito then ingests the virus in their blood meal that they use as part of their reproductive cycle. Then the next time that mosquito bites somebody about 10 days later—it takes some time for the mosquito to have the virus reproduce in its system—it bites the next susceptible person and passes the virus along.

You have this chain of transmission from an infected human being to a mosquito, then it becomes an infected mosquito, and then the mosquito bites the next uninfected person, and that’s really the chain of transmission. That’s the primary modality. We do know, for instance, though, that it can be sexually transmitted from human to human. It can be transmitted from male to male, male to female, and female to male. It can also be transmitted from the mother to the baby, either in the womb through the placenta, or at the time of birth. There is the possibility of transmission by blood transfusion—that’s taken place in other countries. We have very robust screening processes in place in the United States to prevent that from happening. We do know of some isolated cases where perhaps other bodily fluids were the mechanism of transmission, but those really are not terribly well understood.

As far as the symptoms, I think are something people, I want providers to be aware of. The primary ones would be fever, a rash—and in particular an itchy rash, if you will, a pruritic rash—joint pain, conjunctivitis, sort of red eye—as people call it, pink eye. They can have muscle pain, headache, and other general, “I don’t feel so good,” type of symptoms. Some people though don’t have any symptoms at all. We don’t know exactly what percentage of people that is. I think it’s anywhere from, I’ve seen anywhere from 50 percent to even 80 percent of folks who are infected with Zika don’t have any symptoms at all. But of course the symptoms they have are often quite mild, so people don’t necessarily go seek medical attention, and they get over this disease. That’s good for the individual, but it makes it very difficult to track from a public health standpoint.

Host:

What is the latest information health-care providers need to know about virus transmission and identifying patients who should be screened or tested?

Dr. Hellerstedt:

For one, I would really want to refer folks to our website, www.texaszika.org. It’s all one word, texaszika.org. It’s really got a wealth of information on what our testing criteria are. It’s got information for the general public, for pregnant women, for health-care providers. In particular, it does lay out how to submit samples for testing to our labs. It’s really complicated. Even if you’re a health-care provider it will take you some time to study these and understand what the testing protocols are, so I’m not going to attempt to really give those in any detail here.

Host:

Considering many patients don’t exhibit symptoms of Zika, what advice would you give clinicians on who to test?

Dr. Hellerstedt:

In a nutshell, the most important part is history. You need to have a history of exposure. That could involve either travel to a foreign country where we know Zika is very prevalent. That includes now any part of Mexico. But if we get ongoing sustained mosquito vector transmission in Texas, it will also mean travel to or residing in an area where we have active Zika infection. That’s really what the clinician needs to key on, I think, is that history of potential exposure. The other is going back to that list of symptoms that we have. Really, if they have three out of the four major symptoms of Zika they might consider testing, especially if it’s a pregnant woman.

Host:

As you mentioned, Zika is especially dangerous to the developing fetus. Why does that seem to be the case? How can health-care providers help women avoid exposure?

Dr. Hellerstedt:

Absolutely. Protecting the infant developing in a womb is really what Zika is all about. That’s what makes it different than most of the other viral type of illnesses that we have. Other viruses that can be spread through the same mosquito can be very dangerous, they can be deadly, but in this particular case, it seems to have a predilection for, in some cases, crossing the placenta of a pregnant woman and infecting the fetus. Once it gets into the fetus, it seems to have a special ability or affinity to attack the developing nervous system.

What can happen is, early in the development of the unborn baby’s nervous system, the Zika virus infects those brain cells, and basically, they stop growing. Much of the brain and the central nervous system fails to develop. When you hear about microcephaly—in other words, a small head—that’s measuring the head circumference of the baby once it’s born. But what’s really driving the fact that they have a small head is the fact that their brain hasn’t developed and they don’t have that normal contents of the skull in order to provide them with a normal head size.

Host:

Can we talk about babies that are born with infections? What can providers expect to see?

Dr. Hellerstedt:

That’s really a question about the basic science, the basic biology, of Zika. Not all of the answers are known. There is some fear that a baby could appear completely normal at birth, in other words, have a normal head size, and even have studies of the size of the brain—for instance, like ultrasound—that are done that are non-invasive. Those could be normal, but over time as the baby develops, they might show some signs that in fact they had had a Zika infection and that had affected their ability for their brain to continue to develop after birth. There are some reports that that’s the case. That would be, if you will, one end of the spectrum.

Actually, I’ll put it differently. One end of the spectrum is that the baby doesn’t get infected at all, and they’re completely normal. If they do have infection they could have, as I just explained, no obvious signs of it at first, but there are some concern that over time as the baby develops and grows, the development of the brain and head size lag behind. That’s one end of the spectrum.

The other end of the spectrum is that the baby has a very severe interruption of the development of the central nervous system in utero. We think that the earlier in pregnancy that you get it—in other words, first trimester is more risky than second trimester, is more risky than third trimester. Some of those babies who were infected early on in the pregnancy may have very, very severe small heads, very underdeveloped, almost absent, central nervous system. The result of the fact that that affects their ability to move and develop their extremities and their muscles and that sort of thing in utero, they even visibly have deformed limbs at the time they’re born.

One of the most important things, though, is to try and identify whether or not the mother has had infection. If there’s signs of infection, we want those pregnant mothers to be registered. There’s a national registry of pregnant women for Zika. Then any of the babies that are born would also be in that registry and be followed. There are blood tests that can be performed to see whether or not the baby either has virus in their system or has evidence of viral infection due to their immune response in their system. Again, those babies are followed along over time.

To recap, some babies don’t get infected and they’re completely normal. We don’t know which ones those are or even what the percentage of those are. Other babies are infected and they could have a spectrum of disease, ranging from very, very severe interruption of the central nervous system to perhaps very subtle and even indistinguishable signs at birth.

Host:

Zika joins mosquito-spread viruses like Dengue and Chikungunya that have public health implications. What role can doctors and nurses play in their clinical practice, and also in their communities, to promote public health and to prevent infections from Zika?

Dr. Hellerstedt:

The number one thing is awareness and helping their patients to understand how to stop the transmission of Zika. There are a number of ways to do it. One thing is creating barriers between the individual and the mosquito bite. That can happen through things like screens and using air conditioning, which is much more common in the United States to have that ability than it has been in the other countries where this has caused so much problem. That’s a big factor in our favor. Also using long clothing_there’s a type of spray that you can put on a clothing that’s on our website—and then people are very familiar with mosquito repellent, especially DEET.

I want to really emphasize the fact that it’s not just about pregnant women taking these precautions. The virus establishes itself in a local mosquito population through biting anybody, really, of any age. We can all help the pregnant women, and we can all help the unborn babies in our community if, during the mosquito season, we are very consistent in creating those barriers between us and a bite: screens, physical barriers, and chemical barriers, if you will, like mosquito repellent. The other things that we can do are to take action to deny breeding habitats to the mosquito. These mosquitos, particularly the Aedes aegypti species, which is the primary species that spreads it, really has a predilection to want to live around human beings.

We think that it only travels maybe 150 yards in its entire lifetime. From the point where it hatches it really gets all of its meals and does its entire life cycle in a very small area. That’s good and bad. The Aedes aegypti is especially adapted to live with human beings. In some cases it actually lives inside the home. For instance, in poor communities where there might be leaks or water actually inside the dwelling place, they can reproduce there. They can reproduce in very, very small amounts of water. People can go out and deny those breeding habitats.

Host:

Is there a vaccine on the horizon? If so, when might we expect it?

Dr. Hellerstedt:

That’s the $64,000 question, as it were. Everybody would love to have a vaccine against Zika. It’s certainly in development; vaccine researchers are working very, very hard on it. My latest information is that they will be able to begin doing some human trials, I believe, within the next year or two. However, vaccine development is one of the most complex activities that we engage in. In particular in the case of Zika, knowing what the effects are of the vaccine on a pregnant woman and her baby is going to be really important, and that’s one of the highest risk groups of people to test vaccines on. It will take some time. I’m sure it will be here. I think it will nonetheless for a period of years still remain one of the tools that we have to fight Zika, but not necessarily the only one.

Host:

What is the most important message for the community to hear about Zika and how to protect themselves?

Dr. Hellerstedt:

Protecting the community from Zika is everyone’s responsibility. I would really like individuals to take that responsibility. I would very much like if they’re active in their community, if they have community organizations, I would like them to consider Zika prevention and Zika response to be something that they can undertake as a community organization. There again, the information that we have on texaszika.org could help any kind of volunteer organization to go out there and knock on their friends’ and neighbors’ doors and make them aware, provide them this information. One of my biggest concerns is the difference between people knowing about Zika and maybe even being a little bit afraid of Zika—and I think that’s appropriate because it’s a menace, there’s absolutely no doubt about it—but they have to translate that into action. A call to action: if we take all of these steps we will vastly decrease the chance that we have a big, serious problem with the Zika virus in Texas.

Host:

Thank you Dr. Hellerstedt. Thank you for joining this podcast. You can find links to helpful resources about Zika on the Texas Health Steps Online Education website. That’s txhealthsteps.com.

Zika in Texas Podcast

Texas is on the front lines combating Zika, especially since locally transmitted cases have been identified in the state. Learn how the virus is projected to affect Texas and how health-care professionals can assess, test, and protect vulnerable populations, especially pregnant women and their babies. This podcast offers valuable information and guidance for all Texas health-care professionals who provide direct patient care.

Texas Department of State Health Services

Dr. Hellerstedt has served as DSHS commissioner since January 2016. In that role, he coordinates the state’s response to the Zika virus. Dr. Hellerstedt is a long-time Texas pediatrician who has been chief medical officer at the Seton Family of Hospitals and vice president of medical affairs at Dell Children’s Medical Center, both in Austin. He previously served the state as medical director for Medicaid and the Children’s Health Insurance Program.

Accessed at http://casestudies.txhealthsteps.com/stepsQuickCourses/Zika/index.html on February 8, 2017.

.

Map Of At-Risk Area For Virus Transmission

Map Of At-Risk Area For Zika Virus Transmission 20170208

Ann Morrison
By Ann Morrison February 14, 2017 17:04
Write a comment

No Comments

No Comments Yet!

Let me tell You a sad story ! There are no comments yet, but You can be first one to comment this article.

Write a comment
View comments

Write a comment

Your e-mail address will not be published.
Required fields are marked*

Donations Greatly Appreciated – Give To Help Out the Cause

DR. BILL DEAGLE’S WEBSITE: HOME OF THE NUTRIMEDICAL REPORT AND DR. BILL’S HIGHEST QUALITY NUTRITIONAL SUPPLEMENTS!

Subscribe to Blog via Email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Categories