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Zoonotic Bird Flu News - from 1 July 2017



 New changes to NPIP - Avian increased biosecurity [Southernminn.com, 17 July 2017]

by Mary Phipps

The 2015 Highly Pathogenic Avian Influenza event involved hundreds of poultry producers and dozens of companies and animal health officials in Minnesota, and other Midwestern states.

Analysis of the event and epidemiologic studies indicate that after the initial point source introductions of the H5N2 HPAI virus in 2015, most HPAI cases were due to farm-to-farm spread. Prevention and reduction of future outbreaks pointed to increased biosecurity.

The National Poultry Improvement Plan worked on principles to serve as the minimum management practices and principles a poultry operation must follow to be eligible for indemnity in the event HPAI is detected in their facility. Site specific plans for each poultry farm can be extrapolated from the minimum biosecurity principles.

On May 5, 2017 the Minnesota Board of Animal Health along with other NPIP State Agencies and Authorized Labs were notified that the proposed changes to the NPIP Program Standards were official. This included the 14 Biosecurity Principles which became effective on July 5, 2017. The 14 Point Biosecurity Principles are:

1. Biosecurity Responsibility.
2. Training.
3. Line of Separation
4. Perimeter Buffer Area
5. Personnel
6. Wild Birds, Rodents and Insects
7. Equipment and Vehicles
8. Mortality Disposal
9. Manure and Litter Management
10. Replacement Poultry
11. Water Supplies
12. Feed and Replacement Litter
13. Reporting of Elevated Morbidity and Mortality
14. Auditing

These Biosecurity Principles will be required for all commercial poultry premises with the following exemptions: Commercial table-egg laying premises with fewer than 75,000 birds; Raised for Release Upland Game Bird / Waterfowl premises that raise fewer than 25,000 birds annually; Commercial broiler premises that raise fewer than 100,000 broilers annually; Commercial meat-type turkey premises that raise fewer than 30,000 turkeys annually.

Next steps – The Minnesota Board of Animal Health will be responsible for conducting the audits and sending an audit summary to USDA-APHIS. All audits will be paper; there will be no site visits. Audit materials may be provided in either paper or electronic formats. Producers should be aware that all audits need to be completed by the Board within two years. Some audits may begin Fall 2017.



 AVIAN INFLUENZA : THE STRENGTHENED BIOSECURITY IN THE FARMS [The Siver Times, 15 July 2017]

The minister of Agriculture wants to break the black series. On 13 July, Stéphane Travert announced the strengthening of biosecurity measures in the poultry and waterfowls. The decree, which shall enter into force on the 1st of September, has the objective of limiting the risk of spread of avian influenza in the country.

This time, the department has decided to anticipate and to act before the migration of wild birds, which occur each fall. It must be said that in October 2016, this season has caused an epidemic of highly pathogenic avian influenza (H5N8) in poultry farms of the South-west. For the second year in a row, farmers have had to empty their aviaries and meet a crawlspace.

Now, breeders will be subject to an obligation of results. This new ordinance requires the development of specifications and guides for biosecurity. These will have to be scrupulously respected.

Shelter farms

The ministry is also calling for the protection of food intended for the captive animals. These tanks can be a mode of contamination ideal if the wild birds to feed on. Limit the contacts is therefore a priority.

The radius of the novelties is also the mandatory testing within the farms breeding stock. In effect, the resident animals are more likely to change their structure.

Always in the purpose of protection, the vehicles that circulate within a farm must be strictly followed. The idea is clear : if a pathogenic virus is introduced in a structure, its spread must be resisted by all means.

This arsenal may yet prove to be very constraining for farmers. But the stakes are real. The two epidemics successive has cost the farmers who had to cull their birds. By itself, the outbreak of 2016 has resulted in the death of 3.7 million ducks. This represents 250 million euros of losses.



 Africa: Agriculture, Forestry and Fisheries Updates On Avian Influenza H5N8 Outbreak in South Africa [AllAfrica.com, 12 July 2017]

The HPAI H5N8 virus was confirmed in two further locations in South Africa, bringing the total of affected properties to four. The new locations involved commercial layer chickens on farms in Gauteng and Mpumalanga.

The two farms were immediately placed under quarantine by the state Veterinarian. The quarantine includes, as a minimum, a prohibition of the movement of chickens and chicken products onto and off the farm. The necessary measures have been taken to contain and eliminate the disease as efficiently as possible on both farms.

Forward tracing was done and cull chicken depots were identified, which had received live cull chickens from one of the affected farms in the last 21 days. The records of these cull depots are being followed up to trace as many of these chickens as possible. The new Poultry Disease management Agency (PDMA) system of registration of persons buying and selling live chickens made it possible to trace these culls.

The PDMA registration process of sellers and traders of live chickens has progressed well and a number of initial challenges were ironed out. All role players in the poultry industry involved in the buying and selling of live chickens are strongly encouraged to comply with the registration and other requirements that are designed to allow the trade of live chickens to continue without compromising animal health.

The depopulation of the two poultry sites affected in June is complete. The carcasses, waste material, affected eggs and manure have been contained and will be dealt with to ensure prevention of spread of the disease, as well as to prevent contamination of the environment.

Export of chickens and chicken products from registered HPAI free compartments is continuing to countries that accept guarantees from such compartments. There is good cooperation from registered compartments to increase the testing frequency to monthly testing.

Exports of raw meat, eggs and live birds from South Africa to some trade partners have been disrupted, as one of requirements for the certification is country freedom from Highly Pathogenic Avian Influenza, which cannot be provided since 22 June 2017. The export of products, which had been processed to ensure destruction of the virus, is also continuing, unless the trade partner has raised an objection.

The H5N8 virus does not affect humans, Department of Health through the National Institute of Communicable Diseases tested workers from the affected farms and no human cases have been detected.

The HPAI H5N8 viruses that have been isolated from these outbreaks are similar to the viruses isolated from Zimbabwe in June 2017 and from Egypt in 2016, which makes the likelihood of the involvement of wild birds high. Chicken owners and farmers are encouraged to prevent contact of their chickens with wild birds as much as possible.

Increased surveillance in wild birds, commercial chickens and backyard chickens is continuing.

Chicken owners, farmers and the public should remain vigilant and all cases of high mortalities in chickens and other birds should be reported to the nearest State Veterinarian.

The public is advised to avoid any gathering of chickens for shows, auctions and similar activities. However, should such activities continue, the organisers are advised to liaise with the State Veterinary Authorities and the auction houses must also be registered with the PDMA.

Issued by: Department of Agriculture, Forestry and Fisheries



 Highly Pathogenic Avian Influenza update in SA [Independent Online, 12 July 2017]

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Johannesburg – The Department of Agriculture Forestry and Fisheries on Wednesday confirmed isolation of the virus on two other farms.

This follows the confirmation of an outbreak of Highly Pathogenic Avian Influenza of the H5N8 type on two farms in Mpumalanga.

“The farms involved are commercial layer chicken farms in Gauteng and Mpumalanga. Both farms have been quarantined and further control measures are being implemented to curb the spread of the disease. DAFF has also confirmed that the depopulation of the two sites affected in June has been completed”.

“This strain has been found not to be dangerous to humans and the birds affected are a very small percentage of the total South African chicken flock. At this stage there is still a limited impact on chicken and egg supply,” said the department.

The department said South African Poultry Association and the Poultry Disease Management Agency (PDMA) continue to support the efforts of South African Veterinary Service Authorities in implementing control measures for the disease.

“The registration process in respect of sellers and traders of live chickens is progressing well and role players are encouraged to comply with this control measure. Farmers are encouraged to observe strict biosecurity principles during this time to prevent introduction of the disease onto their farms. Should farmers require assistance they should contact their veterinarian or a state veterinarian,” said the department.

Members of the public were requested to report any sightings of higher than usual levels of chicken or wild bird mortalities to their local Department of Agriculture or alternatively to the PDMA.



 Outlook of Global Avian Influenza Market: Research Report during 2016-2021 [MedGadget, 11 July 2017]

Research-N-Reports-21.jpg


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Table of Contents
List of Tables
List of Figures
Report Guidance
Clinical Trials by Region
Clinical Trials and Average Enrollment by Country
Top Five Countries Contributing to Clinical Trials in Asia-Pacific
Top Five Countries Contributing to Clinical Trials in Europe
Top Countries Contributing to Clinical Trials in North America
Top Countries Contributing to Clinical Trials in Middle East and Africa
Top Countries Contributing to Clinical Trials in Central and South America
Clinical Trials by G7 Countries: Proportion of Avian Influenza to Infectious Disease Clinical Trials
Clinical Trials by Phase in G7 Countries
Clinical Trials in G7 Countries by Trial Status
Clinical Trials by E7 Countries: Proportion of Avian Influenza to Infectious Disease Clinical Trials
Clinical Trials by Phase in E7 Countries
Clinical Trials in E7 Countries by Trial Status
Clinical Trials by Phase
In Progress Trials by Phase
Clinical Trials by Trial Status
Clinical Trials by End Point Status
Subjects Recruited Over a Period of Time
Clinical Trials by Sponsor Type
Prominent Sponsors
Top Companies Participating in Avian Influenza Therapeutics Clinical Trials
Prominent Drugs
Clinical Trial Profile Snapshots
Appendix
Abbreviations
Definitions
Research Methodology
Secondary Research
About GlobalData
Contact Us
Source
About Research N Reports:

Research N Reports is a new age market research firm where we focus on providing information that can be effectively applied. Today being a consumer driven market, companies require information to deal with the complex and dynamic world of choices. Where relying on a sound board firm for your decisions becomes crucial. Research N Reports specializes in industry analysis, market forecasts and as a result getting quality reports covering all verticals, whether be it gaining perspective on current market conditions or being ahead in the cut throat Global competition. Since we excel at business research to help businesses grow, we also offer consulting as an extended arm to our services which only helps us gain more insight into current trends and problems. Consequently we keep evolving as an all-rounder provider of viable information under one roof.

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 The Threat to America That No One is Talking About [Huffpost, 9 July 2017]

By Dr. Sudip Bose

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Our country has to maintain a strategy to use against a potential microbial attack that would strike terror in the hearts of every American if we’re not prepared for it when it hits. And make no mistake, it will come. It’s only a question of when.

Are we ready for the next pandemic? I would say no. We’ve made a start in preparing, but we’re not ready for a full-on microbial assault by any stretch.

According to a 2013 assessment by the World Bank,

“Pathogens with pandemic potential continue to emerge, and most of them are of animal origin (zoonotic). They include, for example, Ebola, H5N1 avian flu, H7N9 avian flu, HIV/AIDS, and two kinds of coronavirus: severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS).”

The World Bank also points out that that:

“The 1918 pandemic flu, the most severe of the four flu pandemics in the last 100 years, infected up to 40 percent of some national populations and killed 50–100 million people.”

Let’s start at the beginning: a pandemic is an epidemic of infectious disease that spreads through human populations across a large region – a country or countries, a continent, or even worldwide — usually resulting in health issues serious enough to cause massive death among those infected.

“If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes.”

That’s a quote from a TED Talk given by Microsoft co-founder Bill Gates in early 2015, only about a year after the start of an Ebola outbreak in West Africa, which ultimately claimed almost 29,000 lives. It’s now two years later, and the warning Gates gave still rings true as a very valid concern. In his talk, he said that there was no need to panic about this, but that, as a country, “we need to get going.”

He may have been right about not needing to panic. But it’s time to get going now.

The big question, though, is how? What do we do? How do we prepare for something that is ultimately unknowable until it hits?

We have a fairly recent example of a viral outbreak that can help us get ready for that fight – the Ebola virus outbreak in West Africa of just a few years ago that I just mentioned. It was an unprecedented epidemic with an unprecedented response that took years to get under control.

The independent medical humanitarian organization, Medecins Sans Frontieres (MSF) – more widely known in the US as Doctors Without Borders – organized a global response to the outbreak. The group is primarily made up of doctors who volunteer their time and expertise to any given global medical threat.

At its peak, MSF employed nearly 4,000 national staff and over 325 expatriate staff to combat the epidemic across the three countries.

In Liberia – just one of the three primary countries where the Ebola outbreak extended to – 189 health care workers died after contracting the virus. That’s one of every 10 workers who dedicated themselves to stopping the spread of the outbreak. Unfortunately, that pales in comparison to the general mortality numbers of the outbreak, which show that of the total 28,636 documented cases of people infected by the Ebola virus between 2014 and January 2016, there was a resulting 11,315 deaths, according to the World Health Organization (WHO).

That’s a mortality rate of nearly 40 percent. Very scary stuff.

According to the non-fiction book, “The Hot Zone,” written by Richard Preston and published in the mid-90s after the Ebola virus first emerged from the jungles of Africa and claimed its first human victim, Preston writes:

“A hot virus from the rain forest lives within a twenty-four-hour plane flight from every city on earth. All of the earth’s cities are connected by a web of airline routes. The web is a network.

Once a virus hits the net, it can shoot anywhere in a day – Paris, Tokyo, New York, Los Angeles — wherever planes fly. Charles Monet and the life form inside him had entered the net.”

Charles Monet was the man initially infected with that life form – the Ebola virus — who Preston was writing about in “The Hot Zone.” Monet was trying to get to a hospital in Nairobi, Kenya, flying aboard a Kenya Airways flight. It was nothing more than luck that Monet didn’t infect anyone on the plane and luck that the virus really didn’t “enter the net” and spread worldwide. And this was some 35 years before the Ebola outbreak in 2014.

The next big viral outbreak doesn’t necessarily have to be something as exotic as an Ebola virus or some other as yet unknown zoonotic pathogen. It could simply be the next strain of influenza – the flu – that we’ve never seen before that could turn deadly. The source could be a natural epidemic, or it could be bio-terrorism.

Here are some of the steps we need to take to avoid at least a major worldwide health scare or at worst a pandemic:

Speed is the first factor. We’ve got to be able to quickly identify the threat and move to treat it as fast as possible. Speed is the ultimate weapon. Identification usually the easy part. Then what, though? How do we minimize the spread of the infection and contain it?

Reserves – in a word – just as in we have now as part of our current military. We need medical reservists who can be called up to handle an infectious outbreak – a US medical dream team ready to be deployed to the hot spots and begin front-line treatment and containment.

We need a group of key epidemiologists also ready to evaluate the disease and formulate a plan for the most effective treatment of the “microbial missile.” We need dedicated researchers who can identify and formulate treatment protocols, develop vaccines and research the most effective ways to eliminate the threat. Modern advances in biology should lessen the turnaround in the time it takes to look at a pathogen and then find a quick path to manufacturing drugs and vaccines at scale that could work against that pathogen or develop a universal treatment protocol to be implemented.

Exercises – practice. Now is the time to identify the personnel who would make up these teams and train them. We need to perform military-like exercises – “germ games” as Bill Gates called them in his TED Talk – to be ready for an outbreak. We’ve invested a lot as a nation to build up our military defenses – people, weapons and weapons platforms, hardware, software, logistics, networks, command structure – all of it. But if the next big threat to US human lives is microbial, what do we have invested right now to stop a major epidemic? Very little.

So we’ve got to get a response team ready. We’ve got to get a preparedness team ready to roll.

WHO is funded to monitor epidemics, but not to take action to stop them. We can’t let that gap go unfilled here in America.

The World Bank estimates that if we have a worldwide flu epidemic, we’d have millions of deaths. And they also say that as a result of the epidemic, global wealth would depreciate by more than $3 trillion. Not million, not billion – trillion.

Invest now. If we invested even a small fraction of that astronomical amount of money in readying to stop such an outbreak, wouldn’t it be worth it? And this kind of investment would evolve significant benefits beyond just being ready for the next pandemic. This should absolutely be a priority. We can build a terrific response system.

Leverage technology. Technology is advancing at such a rapid pace that we’re barely able to keep up with and implement the improvements made on a monthly and yearly basis. So who knows the kind of technology we’d be able to leverage in the future. But even so, currently we can use modern technology that is now as simple and basic as cell phones. Cell phones can get information fed in from the public and can also be used to get information back out instantaneously. Satellite tracking can monitor people movement.

Response. Why not pair the medical people with the military to take advantage of the military’s ability to move quickly in response to a threat? It’s an idea Bill Gates surfaced in his talk, and I would agree with the strategy. There’s not one area of America we couldn’t get to quickly if we paired up the medical personnel with military movement and transportation.

There is a lot of room for progress and a lot we can do to be ready for the next pandemic. And we need to start now.



 Study shows avian flu may infect bats [Wisconsin State Farmer, 8 July 2017]

Bats also can carry diseases that are dangerous to humans, such as rabies

Suresh Kuchipudi, associate professor of virology in Penn State's College of Agricultural Sciences, conducted research to determine if little brown bats can be asymptomatic carriers of avian and human influenza viruses. Here, he infects cells with influenza virus as part of those studies.(Photo: Couirtesy of Sanjana Kuchipudi/Penn State)

UNIVERSITY PARK, PA - Bats, which make up about a third of all mammalian species, play an important role in our ecosystem. They eat bugs that “bug” us, pollinate more than 500 species of plants, including banana and cacao, and distribute the seeds of many other plants.
However, they also can carry diseases that are dangerous to humans, such as rabies.

But they were never thought to host influenza viruses, until researchers studying pathogen diversity in bats in South and Central America identified two new influenza viruses in fruit bats.

Subsequently, researchers in Africa found 30 percent of the bats they tested were infected with a flu virus, although these bats did not show any signs of illness.

These discoveries led Suresh Kuchipudi, associate professor of virology in Penn State’s College of Agricultural Sciences, to ask: Can bats be co-infected with avian and human influenza viruses? If so, can they act as carriers of influenza virus? Do they have the potential to contribute to the emergence of new pandemic influenza strains by mixing these two types of influenza viruses?

To answer these questions, Kuchipudi brought together a multidisciplinary team to conduct research focusing on little brown bats, the most widely spread bat species in North America.

“Although bats are elusive creatures, there is increasing interface between them and humans as a result of wildlife trade, bush-meat hunting, deforestation and urban development,” said Kuchipudi, who works in the college’s Animal Diagnostic Laboratory. “It’s important to determine if bats can allow infection of avian and human flu viruses, and if they could then serve as ‘mixing vessels’ and perhaps create the next pandemic flu virus. Up until now, no one has ever studied influenza virus receptors in bats.”

Influenza infects a wide range of domestic and wild animals. Some are highly specific to one kind of host, but others can be passed between species. “Swine flu” and “avian flu” are examples of previous pandemics in humans caused by influenza viruses that came from animals. Avian flu viruses continue to cause huge economic losses to the poultry industry and can threaten public health if they gain the ability to cross over into humans. Co-existence with another kind of flu virus in some other species, such as a bat, could provide them the genetic material they need to jump species.

“The remarkable thing about influenza viruses is the ability to constantly change and evolve,” Kuchipudi said. “Influenza virus evolution involves mutations in the virus to gain the ability to transmit to a completely different host species.”

With assistance from the Pennsylvania Game Commission, Kuchipudi’s research team screened 20 little brown bats — 10 juvenile and 10 adult — for the presence of influenza receptors using cutting-edge scientific methods involving lectin histochemistry, along with confocal and electron microscopy.

The team tested for the presence of two specific receptors that are responsible for helping human and avian influenza viruses attach to cells. They further investigated whether avian and human flu viruses can bind to bat tissues.

“The study discovered that bats have the receptors in their respiratory and digestive tracts that are able to support binding of avian and human influenza viruses,” said Ruth Nissly, research technician and manager of Kuchipudi’s research lab. “Having both receptors, as in the case of ducks and pigs, is believed to create conditions that enable the virus to mutate and create a new strain, which, in turn, could infect other animals, including humans.”

Despite these findings, Kuchipudi said there is not yet a need to worry about a “bat flu.”

“While the sum of the evidence suggests that bats could play an important role in influenza epidemiology and zoonotic influenza emergence, we do not have sufficient scientific understanding to adequately predict which influenza strains may cause the next pandemic or what hosts they may come from,” he said.

He cited the need for more research on how influenza may manifest itself in bats, as well as for additional surveillance of wild bats.




 India is now free from bird flu [Zee News, 6 July 2017]

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Image for representational purpose only

New Delhi: The government on Thursday has declared the country free from highly pathogenic Avian Influenza ( H5N1 and H5N8), commonly known as bird flu.

During October 2016 and February 2017, the outbreak of this infectious viral disease of birds was reported at various epicentres in nine states and Union Territories.

A statement issued by the Agriculture Ministry said, surveillance has been completed in Delhi, Daman, Madhya Pradesh, Punjab, Haryana, Karnataka, Kerala, Gujarat, Odisha and it showed no evidence of presence of bird flu.

It said, "In view of the above, India has declared itself free from Avian Influenza (H5N8 and H5N1) from 6 June, 2017 and notified the same to World Organisation for Animal Health (OIE)."

The Ministry said that the outbreak of highly pathogenic bird flu was reported in Delhi, Gwalior (MP), Rajpura (Punjab), Hissar (Haryana), Bellary (Karnataka), Alappuzha and Kottayam (Kerala), Ahmedabad (Gujarat), Daman and Khordha and Angul (Odisha).

The statement added, these outbreaks were notified to OIE and the control and containment operations were carried out as per the 'Action plan on preparedness, control and containment of Avian Influenza'.

(With PTI inputs)



 Chicken farm in Taichung hit by avian flu, 2,115 birds culled [Focus Taiwan News Channel (press release), 5 July 2017]

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(Photo courtesy of the Taichung City government)

Taipei, July 5 (CNA) A chicken farm in Taichung has been confirmed to be infected with a subtype of the highly pathogenic H5 avian influenza virus, leading to the culling of 2,115 birds, the city's Animal Protection and Health Inspection Office said Wednesday.

The office said it received a report of abnormal deaths of chickens at a farm in Taichung's Da'an District on Tuesday and immediately collected tissue samples from the animals.

After checking the samples, the office said it was confirmed that the farm had been hit by the virus, which caused the deaths in the chickens.

The farm's other chickens were culled Wednesday, and the farm and its surrounding areas were also sterilized, the office said.

No abnormalities have been detected at other poultry farms within a radius of one to three kilograms of the infected chicken farms, the office added.

As of Tuesday, 153 poultry farms around Taiwan had been hit by highly pathogenic strains of the avian influenza virus, resulting in more than 1.47 million birds being culled, according to data from the Bureau of Animal and Plant Health Inspection and Quarantine under the Council of Agriculture.

(By Chao Li-yen and Elaine Hou)


? Three Mutations Could Help Bird Flu Spread Among Humans [Contagionlive.com, 5 July 2017]

by NICOLA M. PARRY

Scientists have identified 3 mutations that, if they occurred at the same time, could allow the avian influenza strain H7N9 to spread among humans.

Robert P. de Vries, PhD, from Utrecht University, The Netherlands, and Wenjie Peng, PhD, from The Scripps Research Institute, La Jolla, California, and colleagues published the results of their study online recently in PLOS Pathogens.

H7N9 is a subtype of avian influenza virus that usually infects birds. But, it is also a serious threat to human health, and has already crossed the species barrier into humans, causing hundreds of human infections and deaths. These cases have predominantly involved individuals exposed to H7N9-infected birds at poultry markets.

However, in an interview with Contagion[レジスタードトレードマーク], corresponding author James C. Paulson, PhD, professor and co-chair in the Department of Molecular Medicine at The Scripps Research Institute, explained that although the H7N9 virus subtype is infecting humans, it cannot easily spread between them.

Professor Paulson said that the avian virus cannot attach to cells in the lungs of humans. He noted that the virus has a protein called hemagglutinin (HA) that coats its surface and helps the virus bind to receptors on the cells that it infects. According to Professor Paulson, the amino acid structures of HA on human influenza viruses allow the viruses to recognize and bind to the receptors on cells in the human airway. In contrast, the HA in avian H7N9 influenza virus has a different structure and cannot effectively attach to cells in the human respiratory tract.

To effectively spread among humans, the avian virus thus needs to develop specificity to receptors in the human airway.

Yet, although avian H7N9 influenza virus is currently unable to effectively spread between humans, scientists remain concerned that the virus might one day mutate into a form that could easily transmit in this way.

Professor Paulson and colleagues therefore conducted a study to investigate which mutations would allow the virus to attach to human cells.

The researchers analyzed mutations in the H7N9 virus, focusing on a gene that codes for one HA protein known as H7. They investigated changes that would alter the amino acid structure of H7 HA, allowing it to switch to recognize receptors in the human airway.

The researchers found that three specific amino acid mutations in H7 HA allowed the virus to more easily bind to human airway cells in the laboratory. These subtle changes in the protein’s structure thus produced virus strains that switched their target from bird cells to human cells.

As to whether the virus could potentially make this switch in nature, Professor Paulson emphasized that he “took comfort in the fact that the switch required 3 amino acids.”

He went on to note that thousands of genomic sequences of influenza virus are isolated each year from humans and birds. And, although some reported cases have involved one of the three mutations, Professor Paulson stressed that none have involved all three mutations together.

Professor Paulson explained that his team was unable to introduce these mutations into actual H7N9 viruses to determine whether the changes would facilitate aerosol transmission of the virus in laboratory animals. This is because of a moratorium on gain-of-function research, he said. This moratorium currently prevents researchers in the United States from conducting studies that involve mutating viruses in such a way that could make them more likely to transmit in humans.

However, the researchers would like to conduct a study in which they introduce the mutated avian influenza HA gene into a weakened laboratory strain of human influenza virus, and examine how this mutation affects transmission of the virus in laboratory animals. “For this, we would collaborate with a team at a biosafety level 3 facility,” Professor Paulson concluded.



 Standerton farm under quarantine after Avian Influenza outbreak [Ridge Times, 4 July 2017]

The Astral farm, that is affected, is just outside Villiers about 70km from Standerton, and the farm is under quarantine.

The outbreak of Avian Influenza in the area was widely reported on the past week.

According to Mr Gary Arnold, managing director: Agriculture at Astral, strict biosecurity protocols are in place and all measures are taken to prevent further farms from being infected.

The main spread is from wild birds.

Abnormal deaths in the wild bird population around the Villiers area came to the poultry producer’s attention.

The Astral farm, that is affected, is just outside Villiers about 70km from Standerton, and the farm is under quarantine.

Mr Arnold confirmed that another affected farm, 35km from Standerton near Greylingstad, is a commercial table egg operation and this independent farm is under quarantine.

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Avian flu: What you need to know

Here are 11 things you need to know about the first outbreak of type H5N8 avian influenza in South Africa.

・A highly pathogenic avian influenza, type H5N8 has been found on a farm on the Vaal river near Villiers in the Free State.

・The farm has been quarantined and about 28 000 birds are being culled.

・The Mpumalanga Veterinary Authority is assisting with the implementation of the quarantine as well as the culling and disinfecting.

・The outbreak is the first in South African poultry.

・It is possible that the disease has affected ducks and other wild water birds which makes containment difficult.

・The wild birds may have infected the poultry as the farm is situated on the banks of the Vaal river.

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・The strain of influenza does not pose a danger to humans, but appropriate precaution should be taken.

・The South African Poultry Association (SAPA) has given its assurance that the outbreak will have a very limited impact on chicken supply.

・The strain of the virus is from Europe where it has been infecting poultry for more than a year.

・There is no known cure for the virus.

・The virus, that causes respiratory disease, has resulted in hundreds of thousands of commercial birds being culled in Zimbabwe in May which caused major problems for the poultry industry.



 H5N2 avian flu hits more Taiwanese poultry farms [CIDRAP, 4 July 2017]

Taiwan yesterday reported six more highly pathogenic H5N2 outbreaks, all of them involving commercial poultry farms, according to a notification from the World Organization for Animal Health (OIE).

All of the events occurred at locations on the southwest side of the island: three in Yunlin County, two in Tainan City, and one in Pingtung County. The outbreaks began from Jun 22 tl Jun 27, affecting facilities housing ducks, turkeys, native chickens, and geese.

Of 53,085 susceptible birds, the virus killed 5,899, and authorities culled the surviving poultry to curb the spread of the virus.

Taiwan has been battling H5N2 and other avian flu strains since early 2015.


? SFDA imposes temporary ban on Belgian poultry products after avian flu outbreak [Arab News, 4 July 2017]

by Mohammed Rasooldeen

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RIYADH: The Saudi Food and Drug Authority (SFDA) has imposed a temporary ban on the importing of chicken, eggs, and their bi-products from Belgium, following the spread of the H5N8 avian virus in some parts of the country.

The move follows an advisory from the World Health Organization (WHO). An SFDA official said the ban would continue until the threat of the virus was eradicated.

Belgium’s Ambassador Geert Criel told Arab News: “A number of cases of highly pathogenic avian influenza were recently identified in Belgium. Most of the reported cases relate to hobby holdings of captive birds, but two relate to poultry dealers. These dealers, however, do not supply poultry to the commercial sector. Most of the identified cases are linked. As required, Belgium reported these cases to the World Organization for Animal Health.”

He said the Belgian Federal Agency for the Safety of the Food Chain (FASFC) immediately started taking the necessary measures to control and prevent the spread of the disease, when the virus was identified.

Measures included the killing and destruction of birds held by dealers and private owners where the virus was suspected to be, the introduction of a 3 km safety zone where the movement of birds was restricted, and a larger 10 km surveillance zone.

There were also a number of countrywide preventative measures taken.

“The incidents, which mainly concern the hobby sector and do not supply the professional sector, appear to be limited. The number of suspected cases is decreasing sharply. No new cases have been detected in the past 10 days,” the ambassador added.


? France Confirms H5N8 Bird Flu Case Near Belgium Border [The Poultry Site, 3 July 2017]

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FRANCE - France's agriculture ministry confirmed on Friday a new case of bird flu on a poultry farm in the northern Brillon region, near the French-Belgian border.

"A case of highly contagious H5N8 bird flu was confirmed on 30 June on a poultry farm in Brillon," the ministry said in a statement.

The affected poultry was located 15 kilometers from a non-commercial farm in Tournai where 11 cases of avian flu have been detected in June, the ministry added.

"To rapidly stop the virus' spread, protection and surveillance zones are set up immediately... In these areas, movement of all susceptible animals is prohibited and bio-security measures are reinforced," the ministry said.

Earlier this year, France, the main producer of famous foie gras in the European Union, slaughtered 600,000 ducks in its southwest region of Les Landes to prevent avian influenza contamination.

Following a severe strain of H5N8 bird flu hitting several European countries in 2016, France has already imposed precautionary measures to prevent poultry contacts with wild birds and to restrict hunt in high risk areas.


? AVIAN INFLUENZA IN THE NORTH: DRASTIC MEASURES TO PREVENT THE SPREAD [The Siver Times, 2 July 2017]

The prefecture announced on Thursday evening having made the pre-emptive culling of poultry in the municipality of Brillon (North). An outbreak of avian influenza H5N8 identified in one particular, has led the authorities to eliminate the risk represented by the animals of his yard, but also his pigeons.

After you have found a high mortality among his hens, he had warned the authorities, as recommended in an information note distributed in the mailboxes of the inhabitants of Brillon.

Carole Leleu, the mayor of this town of the North, praised her initiative, recalling that he had made the right choice, the only way to halt the disease and its spread in the region. In all likelihood, the contamination would have the origin of the chick or of the pigeons bought at the market of Tournai, in belgium, on the belgian side of the border.

A region on alert

Concerns are growing in the North, on the side of the franco-belgian border. A home had already been identified on the side of our neighbours, leading to the supervision of the six municipalities of the city of lille on Monday : Comines, Halluin, Neuville-en-Ferrain, Roncq, Tourcoing and Wattrelos.

This Tuesday, a new home belgian had been identified, in a particular with poultry, in the border town of Hertain, near Tournai.

“Given the location of the border, the Northern department is putting in place a regulated area which includes the municipalities of Baisieux, Camphin-en-Pevele and Willems “, announced the prefecture. Poultry of the two belgian homes have been destroyed, she added.


? China report 6 additional human H7N9 ‘bird flu’ cases in past week [Outbreak NewsToday, 1 July 2017]

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China /CIA

The National Health and Family Planning Commission of China reported six additional human cases of avian influenza A(H7N9) during the week of June 23 to 29.

The three male and three female patients, aged from 4 to 72, had onset from June 11 to 23.

Four of them are from Yunnan and one each from Guizhou and Shanxi. Among them, five were known to have exposure to poultry or poultry markets.

Hong Kong health officials are advising travelers to the Mainland or other affected areas must avoid visiting wet markets, live poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchasing live or freshly slaughtered poultry, and avoid touching poultry/birds or their droppings. They should strictly observe personal and hand hygiene when visiting any place with live poultry.

Since 2013, 1,548 human H7N9 avian flu cases have been reported, including approximately 30 exported cases in 5 other countries. Half the cases have been reported since Oct. 2016.


? AVIAN INFLUENZA : A HOME QUICKLY DISPOSED OF BRILLON [The Siver Times, 1 July 2017]

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H. Michael Miley/Flickr

The prefecture announced on Thursday evening having made the pre-emptive culling of poultry in the municipality of Brillon (North). An outbreak of avian influenza H5N8 identified in one particular, has led the authorities to eliminate the risk represented by the animals of his yard, but also his pigeons.

After you have found a high mortality among his hens, he had warned the authorities, as recommended in an information note distributed in the mailboxes of the inhabitants of Brillon.

Carole Leleu, the mayor of this town of the North, praised her initiative, recalling that he had made the right choice, the only way to halt the disease and its spread in the region. In all likelihood, the contamination would have the origin of the chick or of the pigeons bought at the market of Tournai, in belgium, on the belgian side of the border.

A region on alert

Concerns are growing in the North, on the side of the franco-belgian border. A home had already been identified on the side of our neighbours, leading to the supervision of the six municipalities of the city of lille on Monday : Comines, Halluin, Neuville-en-Ferrain, Roncq, Tourcoing and Wattrelos.

This Tuesday, a new home belgian had been identified, in a particular with poultry, in the border town of Hertain, near Tournai.

“Given the location of the border, the Northern department is putting in place a regulated area which includes the municipalities of Baisieux, Camphin-en-Pevele and Willems “, announced the prefecture. Poultry of the two belgian homes have been destroyed, she added.


? France confirms case of H5N8 bird flu near Belgium border [Xinhua, 1 July 2017]

PARIS, June 30 (Xinhua) -- France's agriculture ministry confirmed on Friday a new case of bird flu on a poultry farm in the northern Brillon region, near French-Belgian border.

"A case of highly contagious H5N8 bird flu is confirmed on June 30 on a poultry farm in Brillon," the ministry said in a statement.

The affected poultry was located 15 kilometers from a non-commercial farm in Tournai where 11 cases of avian flu have been detected in June, the ministry added.

"To rapidly stop the virus' spread, protection and surveillance zones are set up immediately... In these areas, movement of all susceptible animals is prohibited and bio-security measures are reinforced," the ministry said.

Earlier this year, France, the main producer of famous foie gras in the European Union, slaughtered 600,000 ducks in its southwest region of Les Landes to prevent avian influenza contamination.

Following a severe strain of H5N8 bird flu hitting several European countries in 2016, France has already imposed precautionary measures to prevent poultry contacts with wild birds and to restrict hunt in high risk areas.

Zoonotic Bird Flu News - from 17 till 30 June 2017


? Birds become immune to influenza [Phys.Org, 30 June 2017]

An influenza infection in birds gives a good protection against other subtypes of the virus, like a natural vaccination, according to a new study.

Water birds, in particular mallards, are often carriers of low-pathogenic influenza A virus.

Researchers previously believed that birds infected by one variant of the virus could not benefit from it by building up immunity against other virus subtypes. However, the recent study concludes that mallards infected with a low-pathogenic virus build up significant immunity and resistance to other variants of the same virus.

"It was previously thought that the birds were not particularly good at protecting themselves against subsequent infections, but in fact they manage quite well," says Neus Latorre-Margalef, a biologist at Lund University.

The study conducted by Latorre-Margalef, together with colleagues from the University of Georgia in the US, shows that, after an infection, mallards become partially immune and resistant to influenza infections to which they are later exposed. How high their resistance is depends partly on which viruses are involved, and on how genetically similar they are.

"For future infections, the birds' previous infections are important. Birds which have had influenza could be partially protected against virulent variants such as H5N1 or H5N8," says Neus Latorre-Margalef.

The H5N1 and H5N8 strains are highly pathogenic and those most often associated with avian flu. Just over ten years ago, H5N1 spread around the world from chicken flocks in Southeast Asia. Both domestic poultry flocks and wild bird populations were gravely affected. Humans also became ill, in some cases fatally.

It is unclear why there are more subtypes of influenza among birds than among humans and other mammals. One explanation could be what Neus Latorre-Margalef and her colleagues show in their study: that various viruses compete with one another as birds build up immunity and the duration of infection becomes shorter. The virus then gets a chance to mutate and change.

"We need to understand more about how various viruses and subtypes of the same virus interact, for example when one individual gets infected several times. More knowledge is required for developing more effective vaccines," says Neus Latorre-Margalef.


? South Africa: Minister Senzeni Zokwana - Media Briefing On Avian Influenza Outbreak in South Africa [AllAfrica.com, 30 June 2017]

Media Briefing by Minister Senzeni Zokwana Avian Influenza Outbreak in South Africa

Good morning

The Department alerted poultry owners about the eminent threat of Avian Influenza when
Zimbabwe reported their first case at the end of May. The disease, which at that time had been reported in 14 countries, 2 of which were in Africa, had been confirmed in Zimbabwe making it the third country in Africa to be affected.

Avian Influenza is an influenza virus, and is classified as either highly pathogenic or low pathogenic by the World Organisation for Animal Health. The type that has been reported is the highly pathogenic one and is extremely contagious.

The Department, in its alert notification, called for all chicken keepers to observe basic biosecurity measures in order to prevent contact with wild birds. This can be achieved in commercial farms by improving biosecurity and in free range farms by simply removing feed and water from where it attracts wild birds.

Despite the warnings, the disease still managed to get into our flocks. Two cases, one in a broiler breeder farm in Villiers and another in an egg laying farm in Standerton, were reported since 22nd of June. Both these farms are in the Mpumalanga province. There seems to have been confusion with the location of one farm which is near Villiers, as its closest town. I confirm that this farm is on the Mpumalanga side of the provincial boundary. No cases have been reported so far in the Free State, or in any other province.

Our team of veterinarians has swiftly responded to this threat. We have placed the affected farms under quarantine and the affected birds have been euthanised and the eggs destroyed.

Approximately two hundred and sixty thousand (260 000) birds have been culled.

Section 19 of the Animal Diseases Act, gives the Director Animal Health the legal mandate to compensate for any animals or birds killed by the state pursuant to any disease control measure. The Director of Animal Health will consider each case on its own merit.

There have been several calls to permit vaccination against the disease; I have been advised by my team of experts that this will not be in the best interest of both the country and the producers. Vaccination of birds will create an endemic situation, affect surveillance efforts and affect our export certification because all our trade partners only want products from a country that is free of avian influenza where vaccination is not practised.

In order to contain the disease, our team called for the ban on the sale of live chickens to manage the further spread. This triggered a nation-wide concern since a number of livelihoods had been affected. However this measure was imposed in the interest of the country and the poultry producers at large, and I can assure you that it was not taken lightly.

My team has since met with the Poultry Producers and have devised a solution that will provide the desired disease management outcomes and improve traceability, while ensuring that micro businesses continue with their operations. The buyers or sellers of more than 5 live chickens for any purpose other than direct slaughter at a registered abattoir will be subjected to the following conditions:

1. The sellers of live chickens, including commercial farmers, as well as the traders who buy and resell these chickens must register with the Poultry Disease Management Agency (PDMA). The Director Animal Health, of the DAFF has authorised the PDMA to register and keep records of all parties selling and buying live chickens. The PDMA is an independent organization and all information about the trade of live chickens will be kept strictly confidential.

2. Only registered sellers and buyers are allowed to trade and it is the responsibility of both the seller and the buyer to ensure that their counterpart is registered.

3. Farmers may only sell live chickens certified as healthy by a veterinarian or Animal Health Technician.

4. Traders may only sell healthy chickens and must keep records as prescribed.

5. Sellers and buyers registering with the PDMA would have to sign an undertaking to adhere to the required control measures.

These conditions apply to sellers of live broiler chickens, live spent layer hens, live spent breeder birds, point of lay pullets and any chickens that may fall into these categories. The conditions also apply to any buyers and traders who buy more than 5 live chickens that fall into the above categories.

All stakeholders are implored to comply with the registration and other requirements that are designed to allow the trade of live chickens to continue without compromising animal health.

Depending on the level of compliance that is achieved with these conditions, the Director

Animal Health will review future requirements for blanket bans.

Registration forms for sellers and buyers are available on the DAFF (www.daff.gov.za) and
PDMA (www.poultrydiseases.co.za) websites and further information can also be obtained from the PDMA (at 012 529 8298).

We request utmost cooperation of all affected parties in order to prevent further spread of the current outbreak and enhance the disease management efforts.

The Department wishes to reiterate that the type of virus we are dealing with, does not affect people, as has been confirmed by the World Health Organisation and the World Organisation for Animal Health.

The meat that is on the shelves is safe to eat as it has gone through a process of meat inspection and certified fit for human consumption.

A number of trade partners, have suspended trade of raw meat, eggs and live birds from South Africa. This is mainly because the South African veterinarians have to certify that the country is free of Avian Influenza, and since the 22nd June, they could not provide this certification.

However, processed meat is considered safe for trade, and some countries still accept this.

South Africa introduced the concept of compartments in line with the World Organisation for Animal Health (OIE) guidelines; raw meat, eggs and live birds originating from these compartments have been accepted by most trade partners. Our team is already in negotiations with these trade partners to accept our products from these registered compartments.

Chicken owners, farmers and the public should remain vigilant and all cases of high mortalities in chickens and other birds should be reported to the nearest State Veterinarian.

I wish to thank the Poultry Producers for their cooperation and consistent engagement with the Department. I also wish to thank my team for the swift response and their dedication.

Ke a leboha.


? Avian-flu: Government imposes conditions on live chicken trade [Times Live, 29 June 2017]

BY SIPHO MABENA

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Chickens being sold on the streets of Johannesburg.
Image: Kgaugelo Masweneng

Government has introduced a raft of conditions on the trading of live chickens in an effort to contain an outbreak of avian influenza after an outbreak on two farms in Mpumalanga? where eggs were destroyed and about 260 000 chickens culled last week.

Agriculture? forestry and fisheries minister Senzeni Zokwana said on Thursday that no cases had been reported so far in other provinces? saying a team of veterinarians had swiftly responded to the threat and the farms were quarantined.

Zokwana said as a precautionary measure? buyers or sellers of more than five live chickens for any purpose other than slaughter at a registered abattoir would be subjected to the following conditions:

? Live chicken sellers? including commercial farmers? and traders must register with the Poultry Disease Management Agency (PDMA).

? Only registered traders are allowed to trade. It is the responsibility of the seller and buyer to ensure that their counterpart is registered.

? Farmers may only sell live chickens certified as healthy by a veterinarian or animal health technician.

? Traders may only sell healthy chickens and must keep records as prescribed.

? Sellers and buyers registering with PDMA would have to sign an undertaking to adhere to the required control measures.

Zokwana said these conditions applied to sellers of live broiler chickens? live spent layer hens? live spent breeder birds? point of lay pullets and any chickens that may fall into these categories.

The minister said there had been calls for vaccinations but he had been advised this would not be in the best interest of the country and producers.

He said vaccination would create an endemic situation? affect surveillance efforts and affect export certification as all of the country’s trade partners wanted products from countries where vaccination was not practised.

“In order to contain the disease? our team called for the ban on the sale of live chickens to manage the further spread. This triggered nationwide concern since a number of livelihoods had been affected. However? this measure was imposed in the interest of the country and the poultry producers at large and I can assure you that it was not taken lightly?” the minister said.

Zokwana called for the cooperation of all affected parties in order to prevent any further spread of the current outbreak and enhance disease management.

He said a number of countries had suspended trade of raw meat? eggs and live birds from South Africa.

The minister said this was mainly because South African veterinarians have to certify that the country was free of avian influenza? and since June 22? they could not provide this certification.


? South Africa: Avian Influenza Confirmed in Mpumalanga [allAfrica.com, 28 June 2017]

Pretoria ? The Department of Agriculture, Forestry and Fisheries has confirmed a highly pathogenic avian influenza (HPAI) H5N8 in a broiler breeder site in Mpumalanga.

The department said the affected farm has been quarantined and culling of the affected animals
has been completed.

"The department is conducting forward and backward tracing to trace movement of all poultry in and out of the farm in order to establish the source of the influenza," the department said in a statement.

The department has also established a 30km control zone in Mpumalanga and Free State.

"The two provinces are conducting surveillance in the 30km control zone for other potentially affected properties. All provinces have been notified and are on high alert," the department said.

The following control measures have been implemented to prevent the spread of the disease:
A complete standstill of movement of poultry and poultry products on the infected farm(s).

Nothing is to enter or leave the farm.

Birds at the infected sites will be euthanized humanely.

State Vets are conducting inspections starting with all the farms within a 3km and a further 27 km (30km) radius around the affected farm to gather information on the health status of the birds.

Poultry and poultry products may only move from these farms with a State Veterinary Permit.

"We have placed a general ban on the sale of live spent hens across the country until further notice.

"Our trading partners were formally notified of the outbreak in Mpumalanga. Trading partners require a declaration of country freedom of highly pathogenic avian influenza for trade in fresh poultry meat and unprocessed poultry products, which we are currently unable to provide due to the confirmation of HPAI on the Mpumalanga farm," the department said.

The department added that exports of processed poultry products, live chickens and fresh products from registered poultry compartments will continue, depending on the requirements of the importing countries.

To date, no human cases of infection with avian influenza H5N8 have been reported, however the department warned people handling wild birds, sick or dying poultry to wear protective clothing and wash their hands with disinfectants.

"Meat from healthy poultry is safe for consumption as it is subjected to strict meat inspection processes at abattoirs. We urge people to avoid consumption of birds found dead, dying or sick. No effective treatment for the disease has been found.

"Infected animals must be humanely destroyed and disposed of properly to prevent the disease from spreading. If you suspect your flock has contracted the disease, quarantine the affected birds and area immediately. Notify your nearest State Veterinarian of any suspected cases," the department advised.

HPAI is a rapidly spreading viral disease that can infect many types of birds and is highly contagious.

It exists naturally in many birds and can be transmitted by coming into contact with infected animals or through ingestion of infected food or water.


? Bats have potential to host avian and human influenza viruses, study shows [Penn State News, 28 June 2017]

Suresh Kuchipudi in lab.jpg


UNIVERSITY PARK, Pa. ? Bats, which make up about a third of all mammalian species, play an important role in our ecosystem. They eat bugs that "bug" us, pollinate more than 500 species of plants, including banana and cacao, and distribute the seeds of many other plants.

However, they also can carry diseases that are dangerous to humans, such as rabies.

But they were never thought to host influenza viruses, until researchers studying pathogen diversity in bats in South and Central America identified two new influenza viruses in fruit bats.

Subsequently, researchers in Africa found 30 percent of the bats they tested were infected with a flu virus, although these bats did not show any signs of illness.

These discoveries led Suresh Kuchipudi, associate professor of virology in Penn State's College of Agricultural Sciences, to ask: Can bats be co-infected with avian and human influenza viruses? If so, can they act as carriers of influenza virus? Do they have the potential to contribute to the emergence of new pandemic influenza strains by mixing these two types of influenza viruses?

To answer these questions, Kuchipudi brought together a multidisciplinary team to conduct research focusing on little brown bats, the most widely spread bat species in North America.

"Although bats are elusive creatures, there is increasing interface between them and humans as a result of wildlife trade, bush-meat hunting, deforestation and urban development," said
Kuchipudi, who works in the college's Animal Diagnostic Laboratory. "It's important to determine if bats can allow infection of avian and human flu viruses, and if they could then serve as 'mixing vessels' and perhaps create the next pandemic flu virus. Up until now, no one has ever studied influenza virus receptors in bats."

Influenza infects a wide range of domestic and wild animals. Some are highly specific to one kind of host, but others can be passed between species. "Swine flu" and "avian flu" are examples of previous pandemics in humans caused by influenza viruses that came from animals. Avian flu viruses continue to cause huge economic losses to the poultry industry and can threaten public health if they gain the ability to cross over into humans. Co-existence with another kind of flu virus in some other species, such as a bat, could provide them the genetic material they need to jump species.

"The remarkable thing about influenza viruses is the ability to constantly change and evolve," Kuchipudi said. "Influenza virus evolution involves mutations in the virus to gain the ability to transmit to a completely different host species."

With assistance from the Pennsylvania Game Commission, Kuchipudi's research team screened 20 little brown bats ? 10 juvenile and 10 adult ? for the presence of influenza receptors using cutting-edge scientific methods involving lectin histochemistry, along with confocal and electron microscopy.

The team tested for the presence of two specific receptors that are responsible for helping human and avian influenza viruses attach to cells. They further investigated whether avian and human flu viruses can bind to bat tissues.

"The study discovered that bats have the receptors in their respiratory and digestive tracts that are able to support binding of avian and human influenza viruses," said Ruth Nissly, research technician and manager of Kuchipudi's research lab. "Having both receptors, as in the case of ducks and pigs, is believed to create conditions that enable the virus to mutate and create a new strain, which, in turn, could infect other animals, including humans."

Despite these findings, Kuchipudi said there is not yet a need to worry about a "bat flu.”

"While the sum of the evidence suggests that bats could play an important role in influenza epidemiology and zoonotic influenza emergence, we do not have sufficient scientific understanding to adequately predict which influenza strains may cause the next pandemic or what hosts they may come from," he said.

He cited the need for more research on how influenza may manifest itself in bats, as well as for additional surveillance of wild bats.

Other Penn State researchers on the project were Shubhada Chothe, doctoral candidate in pathobiology, who carried out many of the experiments; Gitanjali Bhushan, undergraduate student in immunology and infectious disease; Yin-Ting Yeh, postdoctoral scholar in physics; Jenny Fisher, clinical assistant professor in veterinary and biomedical sciences; Mauricio Terrones, professor of physics, chemistry and materials science and engineering; and Bhushan M. Jayarao, professor of veterinary and biomedical sciences.

The team also included Justin Brown, wildlife veterinarian with the Pennsylvania Game Commission and adjunct associate professor in veterinary and biomedical sciences; Gregory Turner, wildlife biologist, Pennsylvania Game Commission; Brent Sewall, assistant professor of biology, Temple University; and DeeAnn Reeder, presidential professor of biology, Bucknell University.

The research, funded by Penn State's Veterinary and Biomedical Sciences Department, Eberly College of Science and the U.S. Fish and Wildlife Service was published in April 2017 in Scientific Reports, an online, open access journal from the publishers of Nature.


? Opinion: Proactive approach stems spread of avian flu [Berks Country, 28 June 2017]

by Christian Herr

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Courtesy of PennAg Industries Association | Christian Herr, executive vice president of PennAg Industries Association.

Two years ago, Pennsylvania farmers were just beginning to understand the extent of the devastation of America's worst animal disease outbreak, high pathogenic avian influenza, or HPAI. In winter and early spring of 2015, the Midwest was infected with HPAI. By June 2015, more than 49.5 million chickens and turkeys were dead. Nearly 2,000 veterinarians, state and federal regulators, and special contactors were dispatched to help with the control and cleanup.

The outbreak cost taxpayers, farmers, businesses and consumers more than $3.3 billion.

During this troubling time for American agriculture, farmers in Pennsylvania were witnessing an unprecedented response from our Legislature, state Department of Agriculture, and partners at the University of Pennsylvania School of Veterinary Medicine, or Penn Vet, and Penn State College of Agricultural Sciences.

Our state Legislature invested more money on prevention and preparation than the rest of the states combined. An emergency authorization in case of an outbreak also was approved for the Department of Agriculture, totaling about $27 million. Because of the implementation of an aggressive plan led by Agriculture Secretary Russell Redding and supported by veterinarians and animal health professionals at Penn Vet and Penn State, only a fraction of the legislative appropriation needed to be spent.

This proactive approach was a clear sign that no one wanted to relive the sins of our past. In April 1983, Pennsylvania had its first devastating experience with avian influenza. By the time the disease was finally brought under control, 17 million birds died and $60 million was spent on the cleanup. We learned from that outbreak and successfully defended Pennsylvania against subsequent flare-ups of avian influenza that have devastated other states.

Pennsylvania remains one of the largest and most diverse poultry states in America. Because of that diversity we are one of the most vulnerable to a new outbreak of avian influenza. We have avoided the outbreaks for two reasons: planning and resources.

Pennsylvania's General Assembly always has understood the value of investing in a great animal health system. Its support for the Department of Agriculture, Animal Health Commission, Penn State University and Penn Vet has kept poultry healthy to feed our citizens, and has saved taxpayers and consumers billions.

Recently there has been a lot of discussion about the value of the commonwealth's appropriation to Penn Vet as lawmakers continue to deal with difficult budgetary challenges.

Each year Penn Vet receives about $30 million in state support, and for good reason. Penn Vet is our veterinary school. There is no other in Pennsylvania.

What does Pennsylvania get in exchange for this investment?

A veterinary school that is considered one of the best in the world.

If we have an outbreak of avian influenza in our chickens, or the pseudo-rabies virus in our hogs, we rely on veterinarians and staff at the Penn Vet diagnostic laboratories to guide our response.

When our horses are infected with life-threatening equine herpes virus, the best hope in the world of saving them is Penn Vet. When our cows are having difficulty birthing a new calf or are suffering from an endemic disease like mastitis, it's a veterinarian likely trained at Penn Vet whom we call.

And as every Pennsylvanian who loves their pet knows, when our family cat or dog is diagnosed with cancer or heart disease, we know the best care in the world can be found at Penn Vet.

Not only does state funding support animal health initiatives, but it enables Penn Vet to provide scholarships for students who commit to practicing in some of the most rural areas of our commonwealth. In fact, some counties have just two or even fewer veterinarians. More often than not, those veterinarians are Penn Vet graduates.

We certainly understand fiscal challenges, but we must remain vigilant. Over the past several weeks, avian influenza has been detected in Tennessee, Alabama, Georgia and Kentucky. Needless to say, many farmers and agribusinesses are nervous.

Farmers and animal owners agree: We believe that protecting animal health is a core function of our government. Our commonwealth has been a national leader in that regard, thanks to the efforts of our legislators. Pennsylvania's budgetary support of Penn Vet is one of the best returns on investment in our state budget. Maintaining this investment helps keep poultry, livestock - and humans - healthy.


? Human infection with avian influenza A(H7N9) virus ? China [World Health Organization, 28 June 2017]

On 2 June 2017, the National Health and Family Planning Commission of China (NHFPC) notified WHO of nine additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus in China. On 9 June 2017, the NHFPC notified WHO of 12 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus in mainland China.
Details of the case patients

On 2 June 2017, the NHFPC reported a total of nine human cases of infection with avian influenza A(H7N9) virus. Onset dates ranged from 12 to 29 May 2017. Of these nine case patients, three were female. The median age was 56 years (range 35 to 67 years). The case patients were reported from Anhui (1), Beijing (1), Guangxi (1), Hebei (1), Hubei (1), Shaanxi (1), Shandong (2), and Sichuan (1).

At the time of notification, there was one death. Seven case patients were diagnosed as having either pneumonia (4) or severe pneumonia (3). Eight case patients were reported to have had exposure to poultry or live poultry market, and one case patient had no known poultry exposure.

No case clustering was reported.

On 9 June 2017, the NHFPC notified WHO of 12 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus in mainland China. Onset dates ranged from 20 May to 3 June 2017. Of these 12 cases, four were female. The median age was 40.5 years (range 4 to 68 years). The cases were reported from Anhui (2), Beijing (3), Chongqing (2), Henan (2), Jiangsu (1), Shaanxi (1), and Shandong (1).

At the time of notification, there were no deaths. Ten cases were diagnosed as having either pneumonia (4) or severe pneumonia (6). Nine cases were reported to have had exposure to poultry or live poultry market, two case patients had no known poultry exposure, and one is under investigation.

One cluster was reported, from Shaanxi province, involving a 68-year-old male, with symptom onset on 23 May 2017, and his wife (a 67-year-old with symptom onset on 26 May 2017 and who was included in the cases discussed above which were reported to WHO on 2 June). Both had histories of exposure in Inner Mongolia Autonomous Region to chickens purchased from a market that they raised in their backyard. Some of the chickens died shortly after purchase and the couple both slaughtered some of the other chickens. This is the first time Inner Mongolia
Autonomous Region was reported as the location of likely exposure to the avian influenza A(H7N9) virus. Avian influenza A(H7N9) virus was detected recently for the first time in this region in samples from live bird markets.

To date, a total of 1533 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported through IHR notification since early 2013.

Public health response

The Chinese governments at national and local levels are taking further measures which include:

・Continuing to guide the provinces to strengthen assessment, and prevention and control measures.

・Continuing to strengthen control measures focusing on hygienic management of live poultry markets and cross-regional transportation.

・Conducting detailed source investigations to inform effective prevention and control measures.

・Continuing to detect and treat human infections with avian influenza A(H7N9) early to reduce mortality.

・Continuing to carry out risk communication and issue information notices to provide the public with guidance on self-protection.

・Strengthening virology surveillance to better understand levels of virus contamination in the environment as well as mutations, in order to provide further guidance for prevention and control.

WHO risk assessment

The number of human infections with avian influenza A(H7N9) and the geographical distribution in the fifth epidemic wave (i.e. onset since 1 October 2016) is greater than earlier waves. This suggests that the virus is spreading, and emphasizes that further intensive surveillance and control measures in both human and animal health sector are crucial.

According to the epidemiological curve, the number of reported cases on a weekly basis seems to have peaked in early February and is slowly decreasing. The peak in cases this year corresponds to the timing of the peak in cases in previous years. Most human cases are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, and live poultry vending continues, further human cases can be expected.

Although small clusters of cases of human infection with avian influenza A(H7N9) virus have been reported including those involving patients in the same ward, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore the likelihood of further community level spread is considered low.

Close analysis of the epidemiological situation and further characterization of the most recent viruses are critical to assess associated risk and to adjust risk management measures in a timely manner.

WHO advice

WHO advises that travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live poultry markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling in or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and influenza-like illness (ILI) and to carefully review any unusual patterns, ensure reporting of human infections under the IHR 2005, and continue national health preparedness actions.


? Tainan culls 1,787 turkeys amid avian flu threat [Focus Taiwan News Channel (press release), 27 June 2017]

Taipei, June 27 (CNA) A poultry farm in Tainan's Xiaying District was confirmed on Tuesday to be infected with the highly pathogenic H5N2 avian influenza virus, leading to the culling of 1,787 turkeys, according to the city's Animal Health Inspection and Protection Office.

With the heavy rain earlier this month, the virus keeps re-emerging and continues to pose a serious threat to animal health.

The farm reported an abnormal die off of turkeys to the authorities, the Tainan office said, and samples taken from the farm were then analyzed and tested positive for H5N2 avian flu.

Nearby areas around the farm have been disinfected to prevent further spread of the disease, the office said.

(By Yang Sz-ruei and Evelyn Kao)


? Massive cull planned as new case of bird flu reported [eNCA, 27 June 2017]

? Avian flu: What you need to know [Lowae Velder, 27 June 2017]

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Here are 11 things you need to know about the first outbreak of type H5N8 avian influenza in South Africa.

・A highly pathogenic avian influenza, type H5N8 has been found on a farm on the Vaal river near Villiers in the Free State.

・The farm has been quarantined and about 28 000 birds are being culled.

・The Mpumalanga Veterinary Authority is assisting with the implementation of the quarantine as well as the culling and disinfecting.

・The outbreak is the first in South African poultry.

・It is possible that the disease has affected ducks and other wild water birds which makes containment difficult.

・The wild birds may have infected the poultry as the farm is situated on the banks of the Vaal river.

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・The strain of influenza does not pose a danger to humans, but appropriate precaution should be taken.

・The South African Poultry Association (SAPA) has given its assurance that the outbreak will have a very limited impact on chicken supply.

・The strain of the virus is from Europe where it has been infecting poultry for more than a year.

・There is no known cure for the virus.

・The virus, that causes respiratory disease, has resulted in hundreds of thousands of commercial birds being culled in Zimbabwe in May which caused major problems for the poultry industry.

・check-also this is for the recommended post slider


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JOHANNESBURG 26 June 2017 - eNCA anchor Vuyo Mvoko speaks to Department of Agriculture official Mpho Maja about the infection in chickens in some parts of the country.? Video: eNCA

JOHANNESBURG ? A second case of avian influenza was reported on a layer farm in Val, Standerton, in Mpumalanga, the Department of Agriculture, Forestry and Fisheries said on Monday.

“The virus is the same strain as the initial case reported, but the two farms are not directly linked, meaning this is a separate introduction.

"The farm has been placed under quarantine. More than 25,000 of the infected birds will be culled. Eggs are not allowed to move out of the farm,” spokesperson Bomikazi Molapo said in a statement.

The sale of hens and roosters has been banned across the country.

“The ban of live hens (including roosters) is still in place, to enable the department to assess the extent of the outbreak. We will observe this ban for a period of 14 days and will reassess the situation. It takes approximately four days for the infected bird to show clinical signs of the disease. We have put this measure in place to prevent further unintended spread of the Influenza,” the department said

Molapo said that the department was pleading with commercial and backyard farmers to report any cases of large numbers of birds dying to the nearest state vets so the department can send veterinary officials to investigate and collect of samples for confirmation.

But the government said people do not need to worry about contracting the disease.

African News Agency


? Zim bans poultry imports [Southern Times Africa, 27 June 2017]

by Runyararo Muzavazi, Herald Reporter

Harare-Zimbabwe has banned poultry and poultry products from South Africa following an outbreak of Avian Influenza in Mpumalanga and Free State provinces. Department of veterinary services director Dr Josphat Nyika yesterday confirmed the ban. “The products include hatching eggs, table eggs, frozen chicken and mechanically de-boned meat,” said Dr Nyika. “The ban remains in force for an indefinite period of time up to when the South African veterinary officials would have indicated that the problem has been resolved.”

Government is in the process of mounting a risk-based survey of the wild bird population to establish possible primary source of the Avian Influenza, with an external international specialist support team expected in the country this week.

Either there are no banners, they are disabled or none qualified for this location!

Zimbabwe was hit by an Avian Influenza outbreak earlier this month which left Irvine’s Private Limited’s white meat and egg sub sector under quarantine.

The highly pathogenic virus killed 7 000 chickens, but the company had to de-populate by slaughtering 142 000 birds to prevent the spread of the disease.
Influenza viruses are highly contagious and spread very quickly in susceptible populations.

The viruses naturally occur in wild water birds, but they change dynamically and highly virulent strains can occur from time to time, causing major human and animal illness and death.

Symptoms of Avian Influenza include quick illness and sudden deaths of the chickens. (source:The Herald)


? Avian flu: Zimbabwe bans poultry products from SA [News24, 27 June 2017]

Harare ? Zimbabwe has reportedly banned all poultry products from South Africa following an outbreak of avian flu in Mpumalanga and Free State provinces.

According to the state-owned Herald newspaper, the department of veterinary services director, Dr Josphat Nyika, said the banned products included hatching eggs, table eggs, frozen chicken and mechanically de-boned meat.

"The ban remains in force for an indefinite period of time up to when the South African veterinary official would have indicated that the problem has been resolved," Nyika was quoted as saying.

Avian flu was confirmed in Mpumalanga over the weekend, with the Department of Agriculture, Forestry and Fisheries announcing the ban on the sale of live hens.

''We have placed a general ban on the sale of live hens across the country until further notice,'' department spokesperson Bomikazi Molapo said.

Separate introduction

This was after a highly pathogenic avian influenza (HPAI) H5N8 was confirmed in a broiler breeder site in Mpumalanga on Thursday June 22.

'HPAI is a rapidly spreading viral disease that can infect many types of birds and it is highly contagious. It exists naturally in many birds and can be transmitted by coming into contact with infected animals or through ingestion of infected food or water,'' the department explained.

A second case was confirmed at a farm in Standerton on Monday.

"The virus is the same strain as the initial case reported, but the two farms are not directly linked, meaning this is a separate introduction," said department spokesperson Bomikazi Molapo.

The farm had been placed under quarantine and over 25 000 infected birds would be culled.
Eggs were not allowed to move off the farm.


? South Africa bans sale of live hens to contain bird flu [Reuters, 26 June 2017]

South Africa has banned the sale of live hens throughout the country in a bid to control an outbreak of highly contagious H5N8 bird flu, but no humans have been affected, the government said on Monday.

Exports of processed poultry products, live chickens and fresh produce will continue depending on the requirements of importing countries, the department of agriculture said in a statement.

"To date, no human cases of infection with avian influenza H5N8 have been reported. However, people handling wild birds, sick or dying poultry must wear protective clothing and wash their hands with disinfectants," the department said.

The government said meat from healthy poultry was safe to eat due to strict inspections at abattoirs, though people were urged to avoid eating any birds found dead, dying or sick.

South Africa reported an outbreak this month of H5N8 bird flu on a commercial broiler breeder farm in Mpumalanga province, where about 5,000 birds died and the rest were culled.

The H5N8 strain has been detected in several countries in Europe, Africa and Asia over the past two years, its spread aided by wild bird migrations. Highly pathogenic among fowl, the risk of human infection is low.

South Africa suspended all trade in birds and chicken products from neighboring Zimbabwe earlier this month after it reported an outbreak of the H5N8 bird flu at a poultry farm.

(Reporting by Wendell Roelf; editing by Louise Heavens and David Clarke)


? New case of avian flu confirmed in Mpumalanga [Citizen, 26 June 2017]

The department has urged commercial and backyard farmers to report any cases of large numbers of birds dying to the nearest state vets.

A second case of Avian Influenza was reported in a layer farm in Val, Standerton in Mpumalanga, the department of agriculture, forestry and fisheries said on Monday.

“The Virus is the same strain as the initial case reported, but the two farms are not directly linked, meaning this is a separate introduction. The farm has been placed under quarantine over 25,000 of the infected birds will be culled. Eggs are not allowed to move out of the farm,” spokesperson Bomikazi Molapo said in a statement.

“The Ban of live hens (including roosters) is still in place, to enable the department to assess the extent of the outbreak. We will observe this ban for a period of 14 days and will reassess the situation. It takes approximately four days for the infected bird to show clinical signs of the disease. We have put this measure in place to prevent further unintended spread of the Influenza.”

Molapo said that the department was pleading with commercial and backyard farmers to report any cases of large numbers of birds dying to the nearest state vets so the department can send veterinary officials for follow up investigations and collection of samples for confirmation.


? South Africa: 25,000 birds killed in H5N8 avian influenza outbreak on Mpumalanga farm [Outbreak News Today, 26 June 2017]

by ROBERT HERRIMAN

Officials with the Department of Agriculture, Forestry and Fisheries, Animal Production and Health in Pretoria reported an outbreak of Highly pathogenic avian influenza virus (HPAI) H5N8 on a farm in Dipaleseng, Mpumalanga Province to the World Organisation for Animal Health (OIE) today.

According to the report, 25,000 birds died out of 243,000 susceptible birds.
The following measures have been applied: quarantine, disposal of carcasses and destruction of animal products.

The Department of Agriculture, Forestries and Fisheries (DAFF) is providing veterinary support including diagnostics, surveillance and control measures. Farmers who suspect infection in their poultry should notify the local State Vet office or Extension officer who will visit the farm, investigate the incident and collect samples from the birds to rule out the disease.

The South African National Institute for Communicable Diseases (NICD) says although the risk of transmission of influenza A(H5N8) to humans is extremely low, personal protective equipment including gloves, disposable aprons/clothing and masks capable of preventing inhalation of aerosolized virus particles, should be used by all persons in contact with live or dead infected poultry.

Handwashing with disinfectant soap after contact with birds is essential. Any persons with known or suspected close contact with dead or ill birds that have confirmed A(H5N8) infection and who present with upper or lower respiratory tract symptoms (cough, runny nose, scratchy throat, or pneumonia) and/or conjunctivitis should be investigated.

Clusters of three or more cases of severe respiratory illness (hospitalization or death) which are epidemiologically linked should also be investigated even if there is no documented bird exposure.


? New case of avian flu confirmed on Standerton farm [News24, 26 June 2017]

by Jenna Etheridge,

d52aa951c2f64cd9b6aa94eaba4a928c.jpg


Cape Town ? A second case of avian flu has been confirmed at a farm in Standerton, the Department of Agriculture, Forestry and Fisheries said on Monday.

"The virus is the same strain as the initial case reported, but the two farms are not directly linked, meaning this is a separate introduction," said department spokesperson Bomikazi Molapo.

The farm had been placed under quarantine and over 25 000 infected birds would be culled.

Eggs were not allowed to move off the farm.

Molapo said the ban of live hens (including roosters) was still in place to allow the department to assess the extent of the outbreak.

The ban would be observed for 14 days. The situation would then be reassessed.

"It takes approximately four days for the infected bird to show clinical signs of the disease. We have put this measure in place to prevent further unintended spread of the influenza."

HPAI is a rapidly spreading viral disease that can infect many types of birds and is highly contagious.

It exists naturally in many birds and can be transmitted by coming into contact with infected animals or through ingestion of infected food or water, the department explained.

Commercial and backyard farmers were urged to report large numbers of birds dying to the nearest state vet.

This would allow the department to send veterinary officials for a follow-up investigation and to collect samples.


? South Africa: Avian Influenza Confirmed in Mpumalanga [AllAfrica.com, 26 June 2017]

Pretoria ? The Department of Agriculture, Forestry and Fisheries has confirmed a highly pathogenic avian influenza (HPAI) H5N8 in a broiler breeder site in Mpumalanga.

The department said the affected farm has been quarantined and culling of the affected animals has been completed.

"The department is conducting forward and backward tracing to trace movement of all poultry in and out of the farm in order to establish the source of the influenza," the department said in a statement.

The department has also established a 30km control zone in Mpumalanga and Free State.

"The two provinces are conducting surveillance in the 30km control zone for other potentially affected properties. All provinces have been notified and are on high alert," the department said.

The following control measures have been implemented to prevent the spread of the disease:
A complete standstill of movement of poultry and poultry products on the infected farm(s).

Nothing is to enter or leave the farm.

Birds at the infected sites will be euthanized humanely.

State Vets are conducting inspections starting with all the farms within a 3km and a further 27 km (30km) radius around the affected farm to gather information on the health status of the birds.

Poultry and poultry products may only move from these farms with a State Veterinary Permit.

"We have placed a general ban on the sale of live spent hens across the country until further notice.

"Our trading partners were formally notified of the outbreak in Mpumalanga. Trading partners require a declaration of country freedom of highly pathogenic avian influenza for trade in fresh poultry meat and unprocessed poultry products, which we are currently unable to provide due to the confirmation of HPAI on the Mpumalanga farm," the department said.

The department added that exports of processed poultry products, live chickens and fresh products from registered poultry compartments will continue, depending on the requirements of the importing countries.

To date, no human cases of infection with avian influenza H5N8 have been reported, however the department warned people handling wild birds, sick or dying poultry to wear protective clothing and wash their hands with disinfectants.

"Meat from healthy poultry is safe for consumption as it is subjected to strict meat inspection processes at abattoirs. We urge people to avoid consumption of birds found dead, dying or sick.

No effective treatment for the disease has been found.

"Infected animals must be humanely destroyed and disposed of properly to prevent the disease from spreading. If you suspect your flock has contracted the disease, quarantine the affected birds and area immediately. Notify your nearest State Veterinarian of any suspected cases," the department advised.

HPAI is a rapidly spreading viral disease that can infect many types of birds and is highly contagious.

It exists naturally in many birds and can be transmitted by coming into contact with infected animals or through ingestion of infected food or water.


? SA REPORTS OUTBREAK OF H5N8 BIRD FLU IN MPUMALANGA: OIE [Eyewitness News, 26 June 2017]

Some 5,000 birds died of the highly contagious disease and the remainder at the 24,000-birds farm was in the process of being culled.

tyxemojgzs6d1ypma3fg bbb.jpg
Picture: freeimages.com.

JOHANNESBURG - South Africa reported an outbreak of highly pathogenic H5N8 bird flu on a commercial broiler breeder farm in Mpumalanga province, the World Organisation for Animal Health (OIE) said on Thursday, citing a report from the South African farm ministry.

Some 5,000 birds died of the highly contagious disease and the remainder at the 24,000-birds farm was in the process of being culled, the ministry said.

South Africa earlier this month suspended all trade in birds and chicken products from neighboring Zimbabwe after it reported an outbreak of the H5N8 bird flu at a commercial poultry farm.


? South Africa imposes countrywide ban of sale of live hens to contain avian flu [Nasdaq, 26 June 2017]

CAPE TOWN, June 26 (Reuters) - South Africa has placed a
general ban on the sale of live hens throughout the country in a
bid to control an outbreak of highly contagious H5N8 bird flu,
but no humans have been affected, the government said on Monday.

Exports of processed poultry products, live chickens and
fresh produce continues depending on the requirements of
importing countries, the department of agriculture said in a
statement.

(Reporting by Wendell Roelf; Editing by Ed Stoddard)


? Migrating ducks spreading bird flu in SA [Citizen, 26 June 2017]

by Yadhana Jadoo

iStock-519362654.jpg
Picture: iStock

SA has suspended trade in birds and table egg products from Zimbabwe since the outbreak.

Another high-level meeting is taking place tomorrow to assess the risk of bird flu in South Africa after it recently hit Zimbabwe.

It is now almost certain that wild ducks are spreading the disease and are already in the country.

This has been established by research into the outbreak to find the origin of the pathogenic H5N8 strain of avian flu.

The investigations are part of South Africa’s emergency response to mitigate the risk of the virus affecting suppliers.

“We are fairly certain there must be infected birds between the Vaal River and Zimbabwe,” South African Poultry Association (Sapa) CEO Kevin Lovell said.

“We are sure it’s from wild ducks, but we are just not sure which ducks.”

It was established that H5N8 bird flu is the same strain found in parts of Europe. This meant the ducks had migrated from Europe to the Western Cape, where they turn around and go back, Lovell said.

“So there must be infected birds between Zimbabwe and the area of South Africa. They would have flown without stopping between central Zimbabwe to central South Africa.”

Bird faeces was already being sampled, he said, adding that although the disease was being spread by wild birds, it did not necessarily mean they would infect chickens. The task team established to deal with the situation would also update South Africa’s emergency response plan in line with what was working and what not, Lovell said.

“The outbreak is in broiler breeders and they lay the eggs. There is no vertical transmission and no likelihood that any broiler chickens will have the virus.”

And if chickens were infected, the birds would die before reaching the abattoir, he added. The virus does not cause human health concerns. This has been stated by the World Health Organisation on the basis of research.

“So it is not a health problem but a production problem.”

SA suppliers had not seen a slump in sales, Lovell said. He asked the public to report any dead birds they saw to the agriculture, forestry and fisheries department or Sapa, adding: “We need extra eyes and ears on the ground.”

South Africa has suspended trade in birds and table egg products from Zimbabwe since the outbreak. Zimbabwe’s leading egg and poultry producer, Irvine’s, was the supplier most affected, with 7 000 birds killed by the virus.


? Fears UK could face bird flu outbreak even WORSE than 2009 swine flu pandemic [The Sun, 25 June 2017]

By Ellie Cambridge

The virus is two mutations away from widespread human-to-human transmission, scientists have said

nintchdbpict000285589590.jpg
A Public Health England spokesman said research into a vaccine is being carried out in the US and the World Health Organisation

EXPERTS fear a bird flu epidemic to rival the 2009 swine flu outbreak could be on the way to the UK.

The virus is two mutations away from widespread human-to-human transmission, scientists have said.

nintchdbpict000281936716 xxxx.jpg
The bird flu virus has only been caught by humans from birds, or close family members who became infected

The bird flu virus has only been caught by humans from birds, or close family members who became infected.

A stark warning in New Scientist said: “If the virus evolves the ability to spread between humans easily, it will go pandemic and circle the world in weeks.”

It this happens, experts reportedly believe it would be more severe than the swine flu pandemic that hit Britain and affected 800,000 people.

The bird flu virus has only been caught by humans from birds, or close family members who became infected.

The Mirror reports Shadow Health Secretary Jonathan Ashworth said: “Given the severity of the warnings, the Government ought to say what measures it is taking to improve preparedness to deal with an outbreak like this.”


? Live hen sales banned after avian flu detected at Mpumalanga farm [News24, 24 June 2017]

By Jenni Evans

3ba58a1f6fe3402ca20b778a072db882.jpg


Cape Town - The sale of live hens has been banned in South Africa after avian flu was confirmed at a farm in Mpumalanga, the Department of Agriculture, Forestry and Fisheries announced on Saturday.

''We have placed a general ban on the sale of live hens across the country until further notice,'' department spokesperson Bomikazi Molapo said.

This was after a highly pathogenic avian influenza (HPAI) H5N8 was confirmed in a broiler breeder site in Mpumalanga on Thursday June 22.

'HPAI is a rapidly spreading viral disease that can infect many types of birds and it is highly contagious. It exists naturally in many birds and can be transmitted by coming into contact with infected animals or through ingestion of infected food or water,'' the department explained.

The farm, which has not been named yet, has been quarantined and the affected animals have been already been culled there.

Hens are female chickens and those in broiler breeder sites are usually spent after a year, and are sold to small businesses who then sell them on at markets in towns and villages.

The department is tracing the movement of all poultry in and out of the farm in order to establish the source of the Influenza.

A 30km control zone in Mpumalanga and Free State has already been set up and provinces are on high alert.

To contain the situation, the department ordered the following:

- A complete standstill of movement of poultry and poultry products on the infected farm(s). Nothing is to enter or leave the farm;

- Birds at the infected sites will be euthanised humanely;

- State vets are conducting inspections starting with all the farms within a 3 km and a further 27km (30km) radius around the affected farm to gather information on the health status of the birds;

- Poultry and poultry products may only move from these farms with a State Vet Permit;

- Trading partners have been notified and the department is unable currently to issue the declaration of ''country freedom of highly pathogenic avian influenza for trade in fresh poultry meat and unprocessed poultry products'';

- Exports of processed poultry products, live chickens and fresh products from registered poultry compartment will continue depending on the requirements of the importing countries;

No human cases of infection with avian flu H5N8 have been reported, but people handling wild birds, sick or dying poultry must wear protective clothing and wash their hands with disinfectants.

Meat from healthy poultry is safe for consumption as it is subjected to strict meat inspection processes at abattoirs.

The department stressed that people must not eat birds found dead, dying or sick.

There is no effective treatment for the disease yet.

The department asked that infected animals be humanely destroyed and disposed of.

Molapo said the ban on the sale of live hens includes free range hens.

She said chickens already in supermarkets would have been vetted and are safe.


? Bird flu pandemic worse than 2009 swine flu outbreak could be on its way to Britain [Mirror.co.uk, 24 June 2017]

BYNIGEL NELSON

People-participate-in-an-emergency-exercise-on-prevention-and-control-of-H7N9-bird-flu-virus.jpg
A bird flu pandemic could be heading Britain's way, warn scientists (Photo: Reuters)

Shadow Health Secretary Jonathan Ashworth urged the Government to say what measures it is taking to improve preparedness to deal with such an outbreak

Scientists fear a bird flu pandemic worse than the 2009 swine flu outbreak could be heading Britain’s way.

And the UK is making no preparations for a vaccine to prevent it.

Shadow Health Secretary Jonathan Ashworth said: “Given the severity of the warnings, the Government ought to say what measures it is taking to improve preparedness to deal with an outbreak like this.”

More than 1,300 bird flu victims have been identified, mostly in China.

Of those, 476 have died, a rate of more than one in three.

There are also victims in Indonesia, Egypt and Vietnam, and two cases in Canada of people travelling from China.

PROD-Jon-Ashworth.jpg
Jon Ashworth wants the Government to outline what measures it is taking to improve preparedness (Photo: Getty)

The virus, H7N9, has so far only been caught by humans from birds or a close family member who is infected.

But scientists say that it is only two mutations away from widespread human-to-human transmission.

A warning in New Scientist magazine says: “If the virus evolves the ability to spread between humans easily, it will go pandemic and circle the world in weeks.”

Flu experts say if that happens it is likely to be more severe than the H1N1 swine flu pandemic that swept Britain eight years ago.

h7n9-bird-flu-virus.jpg
Jon Ashworth wants the Government to outline what measures it is taking to improve preparedness (Photo: Getty)

They fear it could rival the 1918 pandemic when a bird flu strain killed up to 100million people worldwide.

The 2009 swine flu outbreak in Britain struck 800,000 people and caused more than 280 deaths.

The US Centre for Disease Control said: “It is possible that this latest virus could gain the ability to spread easily and sustainably among people, triggering a global outbreak.”

A Public Health England (PHE) spokesman said, "The risk of the influenza A H7N9 strain to residents in the UK remains very low, and similarly for those travelling to China.

"However, we are monitoring and we advise precautions are taken to protect those travelling against possible infection.

"These precautions include avoiding visiting live animal markets and poultry farms and avoiding contact with animal waste or untreated bird feathers. Only eat thoroughly cooked poultry, egg or duck dishes and always thoroughly wash your hands with soap and warm water. Do not touch dead or dying birds in China and do not bring poultry products back to the UK.”


? SOUTH AFRICANS URGED NOT TO PANIC OVER BIRD FLU OUTBREAK IN MPUMALANGA [Eyewitness News, 23 June 2017]

by Masego Rahlaga

xzlkjcfvlakqa3tnkskz.jpg
According to officials, the H5N8 is highly contagious, the most damaging type and lethal to poultry. Picture: Pixabay.com.

The outbreak of avian flu was first announced in Zimbabwe earlier in June, prompting the South African government to quickly halt imports from that country.

JOHANNESBURG - The Agriculture Ministry and other organisations say South Africans should not panic after an outbreak of avian influenza, otherwise known as bird flu in Mpumalanga.
The outbreak of the H5N8 bird flu was detected in the province on Thursday.

At least 5,000 birds have died of the highly contagious disease and the remainder at the 24,000 birds farm are in the process of being culled.

The outbreak of avian flu was first announced in Zimbabwe earlier in June, prompting the South
African government to quickly halt imports from that country.

However, the government cannot stop wild birds from migrating from Zimbabwe to South Africa.

But the Agriculture Department’s Bomikazi Molapo says there is no need to panic.

“All that needs to be done is for all farmers to adhere to the biosecurity measures.”

The South African Poultry Association’s Kevin Lovell says human beings are safe.

“This particular strain of the disease has been in Europe for well over a year and it hasn’t causee what measures it is taking to improve preparedness (Photo: Getty)

They fear it could rival the 1918 pandemic when a bird flu strain killed up to 100million people worldwide.

The 2009 swine flu outbreak in Britain struck 800,000 people and caused more than 280 deaths.

The US Centre for Disease Control said: “It is possible that this latest virus could gain the ability to spread easily and sustainably among people, triggering a global outbreak.”

A Public Health England (PHE) spokesman said, "The risk of the influenza A H7N9 strain to residents in the UK remains very low, and similarly for those travelling to China.

"However, we are monitoring and we advise precautions are taken to protect those travelling against possible infection.

"These precautions include avoiding visiting live animal markets and poultry farms and avoiding contact with animal waste or untreated bird feathers. Only eat thoroughly cooked poultry, egg or duck dishes and always thoroughly wash your hands with soap and warm water. Do not touch dead or dying birds in China and do not bring poultry products back to the UK.”


? SOUTH AFRICANS URGED NOT TO PANIC OVER BIRD FLU OUTBREAK IN MPUMALANGA [Eyewitness News, 23 June 2017]

by Masego Rahlaga

xzlkjcfvlakqa3tnkskz.jpg
According to officials, the H5N8 is highly contagious, the most damaging type and lethal to poultry. Picture: Pixabay.com.

The outbreak of avian flu was first announced in Zimbabwe earlier in June, prompting the South African government to quickly halt imports from that country.

JOHANNESBURG - The Agriculture Ministry and other organisations say South Africans should not panic after an outbreak of avian influenza, otherwise known as bird flu in Mpumalanga.
The outbreak of the H5N8 bird flu was detected in the province on Thursday.

At least 5,000 birds have died of the highly contagious disease and the remainder at the 24,000 birds farm are in the process of being culled.

The outbreak of avian flu was first announced in Zimbabwe earlier in June, prompting the South
African government to quickly halt imports from that country.

However, the government cannot stop wild birds from migrating from Zimbabwe to South Africa.

But the Agriculture Department’s Bomikazi Molapo says there is no need to panic.

“All that needs to be done is for all farmers to adhere to the biosecurity measures.”

The South African Poultry Association’s Kevin Lovell says human beings are safe.

“This particular strain of the disease has been in Europe for well over a year and it hasn’t caused any problems for people.”

Agrisa’s Johannes Moller said: “It’s certain to say that there’s no danger or real danger for humans.”

There are various strains of avian flu and according to officials the H5N8 is highly contagious, the most damaging type and lethal to poultry.d any problems for people.”

Agrisa’s Johannes Moller said: “It’s certain to say that there’s no danger or real danger for humans.”

There are various strains of avian flu and according to officials the H5N8 is highly contagious, the most damaging type and lethal to poultry.

(Edited by Zamangwane Shange)


? More avian flu outbreaks reported in China, Belgium, Taiwan [CIDRAP 19 June 2017]

In the latest avian flu developments, China's agriculture ministry reported a large die-off related to H7N9 avian influenza in Heilongjiang province in the far northeastern corner of the country, according to an official statement translated and posted by Avian Flu Diary (AFD), an infectious disease news blog.

Though the report didn't specify that it was the highly pathogenic strain, its mention of deaths of 19,500 breeding hens suggests that the more lethal version is involved. Highly pathogenic H7N9 was first detected in Chinese poultry in February and has already spread to some of the country's more northern provinces, such as Inner Mongolia.

In other developments, Belgian officials today reported more highly pathogenic H5N8 outbreaks, according to separate reports from the World Organization for Animal Health (OIE).

The first event began Jun 10 at a trader of birds intended for hobbyists in West Flanders province, killing 500 of 4,047 birds.

The other outbreak involved birds not classified as poultry, a group that includes wild birds. It began Jun 16 in Hainaut province, leading to the deaths of 21 of 26 birds. Both provinces are in western Belgium and the source of the virus in both outbreaks was found to be the introduction of new live animals.

Elsewhere, Taiwan reported four more H5N2 outbreaks, one from the highly pathogenic virus and three from the low-pathogenic version, according to notifications to the OIE.

The highly pathogenic outbreak began Jun 8 at a commercial farm housing native chickens in Yunlin county, killing 2,767 of 14,000 susceptible birds. The start date for the low-pathogenic outbreaks ranged from Jan 13 to Apr 10, affecting commercial farms in three different locations: Chiayi county, Tainan City, and Yunlin county. Between the three low-pathogenic events, the virus killed 3,039 of 50,334 poultry.


? Tainan culls 34,000 chickens amid avian flu threat [Focus Taiwan News Channel (press release), 18 June 2017]

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Photo courtesy of Tainan Animal Health Inspection and Protection Office

Taipei, June 18 (CNA) A poultry farm in Tainan's Xiaying District was confirmed on Sunday to be infected with the highly pathogenic H5N2 avian influenza virus, leading to the culling of 34,072 birds, the city's Animal Health Inspection and Protection Office said.

It was the 14th poultry farm hit by avian influenza subtype H5 in the city this year, according to data released by the Cabinet-level Council of Agriculture (COA).

The farm reported the suspected cases of the disease to authorities on Thursday, the Tainan office said, and samples taken from the farm were then analyzed and confirmed to be avian flu.

Meanwhile, nearby areas around the farm were disinfected to prevent spreading of the disease, it said.

As of 6 p.m. on Sunday, a total of 1,417,429 birds have been destroyed at 144 poultry farms infected with highly pathogenic avian flu viruses across Taiwan since the beginning of the year.

The infected poultry farms have been located in Taoyuan in northern Taiwan; Changhua and Yunlin counties in central Taiwan; Chiayi and Pingtung counties and the cities of Tainan and Kaohsiung in the south; and Yilan and Hualien counties in the east, COA data shows.

(By Yang Sz-ruei and Ko Lin)


? China reports additional H7N9 avian flu, Health officials meet in Hong Kong [Outbreak News Today, 18 June 2017]

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H7N9 avian influenza/ Cynthia S. Goldsmith and Thomas Rowe-CDC

The China National Health and Family Planning Commission reported an additional five human cases of avian influenza A(H7N9), including one death during the week of Jun. 9 through 15.

The four male patients and one female, who came from Beijing, Guangxi, Guizhou, Hunan and Zhejiang and were aged from 41 to 68, had onset from April 25 to June 6. Among them, three were known to have exposure to poultry or poultry markets.

The number of cumulative cases reported since 2013 has risen to 1,533 cases through June 10.

In addition in mid-May, health authorities from Guangdong and Macau visited Hong Kong to discuss the collaboration in the prevention and control of avian influenza.

In the current fifth wave of human infection with avian influenza A(H7N9) since October 2016, over 700 human cases in 25 provinces/municipalities/autonomous regions in Mainland China have been reported. Among these cases, over 60 cases were reported in Guangdong Province.

The participants had in-depth discussions and experience-sharing on the collaboration in the prevention and control of avian influenza and related notification system.

Public health actions in combating avian influenza were discussed during the meeting, including disease surveillance, laboratory surveillance, diagnosis and clinical management, travel health advice and public education, port health measures, preparedness plan and risk communication, poultry import and control, laboratory surveillance on poultry, measures implemented in wholesale poultry market and retail markets.

MERS-CoV News update from 25 May 2017



 NIH issues advisory on prevention, control of MERS for Hajj pilgrims [Geo News, Pakistan, 14 July 2017]

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ISLAMABAD: The National Institute of Health (NIH) Islamabad on Friday issued an advisory for Pakistani citizens regarding prevention and control of Middle East Respiratory Syndrome Corona Virus (MERS-CoV) during upcoming Hajj.

Through this advisory, the NIH directed all concerned authorities, including federal and provincial ministries of religious affairs to take appropriate measures during the upcoming Hajj season in order to prevent the spread of diseases.

According to the advisory, MERS is a viral respiratory disease caused by a novel coronavirus that was first identified in Saudi Arabia in 2012.

The advisory also said that MERS-CoV can spread from infected people to others through close contact, such as caring for or living with an infected person.

Mass gathering such as Hajj provide a basis for the disease to spread easily.

In the wake of MERS-CoV cases in Saudi Arabia, its travel associated international spread and the upcoming Hajj seasons, it is imperative to institute effective prevention and control measures among Pakistani pilgrims.

Emphasising the need to have close collaboration on the pattern of Hajj 2016, the National Institute of Health, recommends the following actions:

・Pilgrims with pre-existing medical conditions such as diabetes, chronic lung disease and immunodeficiency should consult their physicians before travelling to assess whether making the pilgrimage is advisable for them.

・Through health education sessions conducted at each Hajji camp in collaboration with the provincial or area health departments, the departing pilgrims must be informed about the following general health precautions to lower the risk of infection in general:

・Frequent hand washing with soap and water, if soap and water are not available, use an alcohol-based hand sanitizer

・Avoid touching eyes, nose, and mouth after touching common surfaces/hand shake with ill persons

・Avoid close contact with sick people.

・Avoid undercooked meat or food prepared under unsanitary conditions, and wash fruits and vegetables before eating them;

・Maintaining good personal hygiene;

・Avoid unnecessary contact with farm, domestic, and wild animals, especially camels

・Pilgrims developing a significant acute respiratory illness with fever, cough or diarrhoea should be advised to:

・Cover their mouth and nose with a tissue when coughing or sneezing and discard the tissue in the trash after use

・Minimise their contact with others to keep from infecting them

・Returning pilgrims should be advised through a leaflet to seek immediate medical attention if they develop a significant acute respiratory illness with fever and cough during two weeks after their return.



 Woman dies of MERS in Riyadh, raising toll to 683 [Arab News, 14 July 2017]

by MOHAMMED RASOOLDEEN

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RIYADH: A 76-year-old Saudi woman died of Middle East respiratory syndrome coronavirus (MERS) in Riyadh on Tuesday, bringing the total number of deaths due to the virus to 683.

According to an official from the Ministry of Health, the deceased did not have any previous illnesses, nor did she have any contacts with camels.

The patient was treated at a government hospital in Huweiyah, located some 175 km southwest of Riyadh.

Since July 2012, 1,677 patients have been infected by MERS in all parts of the Kingdom. They included 683 deaths, 987 recoveries and seven patients currently under treatment.

Dr. Shin Young-soo, World Health Organization (WHO) regional director for the Western Pacific, advised continued vigilance for any new cases of MERS through early detection and a rapid-response system.

Health care workers are advised to use stringent infection prevention and control measures when treating patients. This includes washing hands before and after contact with patients, and wearing a mask, eye protection, gown and gloves when treating probable or confirmed MERS cases.

Health care workers should note the travel history of people showing symptoms of the virus.

Most MERS patients develop severe to acute respiratory illness with symptoms of fever, cough and shortness of breath. About four out of every 10 patients reported with MERS have died.

There are three major hospitals in Dammam, Riyadh and Jeddah that have been designated as centers to treat MERS patients. In addition to these facilities, the ministry has assigned 20 additional well-equipped hospitals to deal with infected cases.

The ministry has issued warnings for people to stay away from camels. Those who are working on farms have been advised to take maximum precautions against the virus by wearing face masks, isolating infected animals and following basic hygiene principles.

As a general precaution, anyone visiting farms, markets, barns or other places where animals are present should practice general hygiene measures, including regular hand-washing before and after contact with animals, and avoiding sick animals.



 MERS-CoV: The Black Death of the XXI Century waiting to pounce [Pravda, 11 July 2017]

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Predictably, as with the Influenza A H1N1 outbreak, the World Health Organization is taking a cavalier attitude towards MERS-CoV, or Middle East Respiratory Sindrome-related Coronavirus, which appeared in Saudi Arabia in 2012 and in five years has caused 2.027 cases and 710 deaths, a mortality rate of almost 30 per cent.

With Influenza A (H1N1) in 2009/10, the response of the WHO was to sit back and inform us as
the virus went through the six phases until reaching Pandemic status. By then the pharmaceutical industry had prepared billions of doses of an anti-viral medicine which made those involved a fortune (many countries bought up too much stock then destroyed it) and which was linked to neurological disorders and death in a number of cases around the world.

In the last two years there have been around one thousand new laboratory-confirmed cases of MERS-CoV, a unique strain of Coronavirus (which causes the common cold) endemic in the Middle East and linked to contact with camels. However, the virus can be transmitted from human to human and has since spread to the Far East.

The World Health Organization admits that there are proven human-to-human chains of transmission, admits that "the risk of individual travelers becoming infected and bringing the coronavirus back to their country could not be avoided", yet with this highly pathogenic illness (with its 30 per cent mortality rate), the WHO does not recommend any travel restrictions.

Does this make sense? If this deadly disease becomes a global pandemic, which it is threatening to do, it will kill over one third of its victims, becoming the twenty-first century's Black Death.

Can we ask if there is collusion between WHO and the Pharma Lobby?

Once again we see the WHO standing back, stating that the spread of MERS-CoV to the Far East does not constitute a "public health emergency of international concern". So we may ask, how competent is the World Health Organization in handling such outbreaks? Or can we also ask, is there any collusion between the WHO and the pharmaceutical industry in allowing diseases to reach pandemic proportions so that the pharma giants can make billions?

May I make a prediction? Here it is: MERS-CoV will one of these days raise its human-to.human transmission capability until the point at which it is easily transmissable like any common cold or Influenza virus, after all it is a strain of Coronavirus. When this happens, it will break out of its Middle Eastern and Far East bastions and sweep around the world, infecting a third of the population and killing one third of these. All we have to do is to multiply the current number of infections and eaths by one million, and we get 2 billion infected and 700-750 million deaths.

When did MERS-CoV appear?

This disease first appeared in the Arabian Peninsula in September 2012, when it was reported as a SARI (Severe Acute Respiratory Infection). It was originally linked to SARS (Severe Acute Respiratory Syndrome), linked to civets, which broke out in the Far East in 2005 but tests revealed it was caused by a novel form of Coronavirus (the type that causes the common cold).

How many cases have there been?

Originally breaking out in Saudi Arabia, 2.027 laboratory-confirmed cases of MERS-CoV have been recorded, causing 710 deaths (a mortality rate of 30%) in Bahrain, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, United Arab Emirates (UAE), and Yemen (Middle East) and Algeria, Austria, China, Egypt, France, Germany, Greece, Italy, Malaysia, Netherlands, Philippines, Republic of Korea, Thailand, Tunisia, Turkey, United Kingdom (UK), and United States of America (USA) (travel-related cases).

What are the symptoms?

Some cases are asymptomatic (patients do not have any symptoms). Most cases have respiratory symptoms (difficulty in breathing), fever and cough, pneumonia, sometimes diarrhea and in severe cases, respiratory and kidney failure and death.

How dangerous is MERS-CoV?

It kills 30% of those infected and is particularly dangerous for the elderly, those with suppressed immune systems (including transplant patients) or with chronic diseases such as diabetes, cancer or chronic lung disease.

Where does it come from?

It is thought that the disease made a species jump from bats to camels and it is thought that humans can be infected by drinking camel milk or urine or badly cooked camel meat. It is also clear that human-to-human transmission chains have taken place through close contact.

They say it is difficult to catch

Healthcare workers have been infected by coming into close contact with patients, infected patients have passed the illness on to other patients and visitors, so there is a great need for precautions, including education in infection prevention.

Do we know anything about the infection mechanism?

No we do not. Neither do we understand exactly where it comes from, nor do we fully understand the transmission mechanism, nor is there a vaccination or a cure.

Timothy Bancroft-Hinchey

Pravda.Ru

Twitter: @TimothyBHinchey

timothy.hinchey@gmail.com

*Timothy Bancroft-Hinchey has worked as a correspondent, journalist, deputy editor, editor, chief editor, director, project manager, executive director, partner and owner of printed and online daily, weekly, monthly and yearly publications, TV stations and media groups printed, aired and distributed in Angola, Brazil, Cape Verde, East Timor, Guinea-Bissau, Portugal, Mozambique and São Tomé and Principe Isles; the Russian Foreign Ministry publication Dialog and the Cuban Foreign Ministry Official Publications. He has spent the last two decades in humanitarian projects, connecting communities, working to document and catalog disappearing languages, cultures, traditions, working to network with the LGBT communities helping to set up shelters for abused or frightened victims and as Media Partner with UN Women, working to foster the UN Women project to fight against gender violence and to strive for an end to sexism, racism and homophobia. A Vegan, he is also a Media Partner of Humane Society International, fighting for animal rights. He is Director and Chief Editor of the Portuguese version of Pravda.Ru.



 Middle East respiratory syndrome coronavirus (MERS-CoV) – Lebanon [World Health Organization, 4 July 2017]

On 19 June 2017, the national IHR focal point of Lebanon reported one additional case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

Details of the case

A 39-year-old male Lebanese national living in Riyadh, Saudi Arabia developed mild symptoms on 8 June 2017. As the patient was a health care worker and due to enhanced Middle East respiratory syndrome (MERS) surveillance activities ongoing in Riyadh, a nasopharyngeal swab was collected on 11 June 2017 in Riyadh, Saudi Arabia, and tested negative for MERS-CoV by PCR at the Riyadh Regional Laboratory. The case is without a history of comorbid conditions. He does not work in a health care facility with active MERS patients, has not had contact with an identified confirmed MERS case, nor has had known contact with a patient with respiratory illness. He has no history of contact with dromedaries in the 14 days prior to the onset of the symptoms.

On 11 June 2017, the case travelled from Saudi Arabia to Lebanon and reported that he had no symptoms while travelling. On 15 June, he developed gastrointestinal symptoms and a medical investigation was initiated on the same day in Lebanon, whereupon a chest X-ray confirmed the diagnosis of pneumonia. A lower respiratory specimen was collected 16 June 2017 and tested positive for MERS-CoV. The case was reported to Ministry of Public Health on the same day.

The case was placed in home isolation. The case has been asymptomatic since 17 June 2017, and two consecutive nasopharyngeal swabs and one lower respiratory sample were collected and tested negative for MERS-CoV by PCR, on 17, 19 and 23 June 2017, respectively. The patient was released from home isolation on 23 June 2017. All contacts in Lebanon have tested negative for MERS-CoV. Contact tracing in Saudi Arabia and the source of infection are under investigation by the Ministry of Health in Saudi Arabia.

Globally, 2037 laboratory-confirmed cases of infection with MERS-CoV including at least 710 related deaths have been reported to WHO.

Public health response

During the investigation of this case, the Ministry of Public Health evaluated the case and his contacts and implemented measures to limit further human-to-human transmission. These measures included:

・Proper isolation for confirmed cases (home isolation for asymptomatic patients, and in hospital for symptomatic patients).

Active tracing for all contacts of patients, exposed health care workers and community contacts in Lebanon.

・Identification and contact and follow up of contacts in Saudi Arabia and investigation into the patient’s source of infection, in collaboration with the Ministry of Health in Saudi Arabia.

・Identification of high and low risk contacts among health care workers with daily monitoring for all during incubation period of the 14 days, and performing laboratory testing with nasopharyngeal swabs from all exposed health care workers, regardless of the development of symptoms. All tests among contacts have been negative.

・Identification of high and low risk contacts among households with daily monitoring for all during incubation period of the 14 days, and PCR testing for symptomatic contacts. No symptoms were observed among household contacts.

・Enforcement of infection prevention and control measures at the hospital.

・Sending positive specimens to reference labs for confirmation and sequencing.

The Ministry of Public Health in Lebanon is communicating with the Ministry of Health in Saudi Arabia for follow up of health care workers and social contacts of the patient while he was in Saudi Arabia. The patient had not worked in a health care facility where recent MERS cases have been reported, but had initially been tested in Riyadh on 11 June 2017 as part of enhanced surveillance activities in Riyadh due to the clusters of MERS cases previously reported in the Disease Outbreak News published on 13 June 2017, 19 June 2017, and 28 June 2017.

WHO risk assessment

MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed non-sustained human-to-human transmission has occurred mainly in health care settings. This is the second case of laboratory-confirmed MERS-CoV reported from Lebanon. One case of MERS has previously been reported in Lebanon on 8 May 2014 (See Disease Outbreak News published on 15 May 2014).

The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific.

Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.



 Middle East respiratory syndrome coronavirus (MERS-CoV) – Lebanon [CIDRAP, 3 July 2017]

by Lisa Schnirring

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Lebanon's ministry of public health reported a MERS-CoV infection in a man who had recently traveled to Saudi Arabia, marking the country's second such case, as the pace of new illnesses in Saudi Arabia slowed over the past several days.

Lebanese man had been to Saudi Arabia

In a statement recently posted in Arabic on Jun 28, Lebanon's Ministry of Public Health said the man was diagnosed with Middle East respiratory syndrome coronavirus (MERS-CoV) on Jun 16.

He had experienced several days of fever and respiratory symptoms after arriving from Saudi Arabia.

The man is being treated and is currently in good health at his home, where he is being isolated and is undergoing monitoring. The health ministry also said it is monitoring people who were in contact with the patient during travel and at his home in Lebanon.

Lebanon's only other MERS-CoV case, reported in 2014, also involved a man—a Lebanese national who worked as a health provider—who had recently traveled in the Gulf region.

Saudi Arabia developments

Elsewhere, the number of new MERS-CoV infections in Saudi Arabia seems to have slowed following a spate of hospital-related cases in Riyadh, with only one case reported over the last 6 days.

The latest illness was reported in Jul 1, involving a 70-year-old Saudi man from Albaha in the country's southwest, according to a statement from the Saudi Ministry of Health (MOH). The man has symptoms and is in stable condition. He is not a health worker.

Investigators are still reviewing how the man was exposed to the virus.

One more death was noted in a previously reported patient, that of a 70-year-old man from Riyadh who had an underlying health condition, according to a Jun 30 MOH update.

As of today, Saudi Arabia has reported 1,673 cases, including 681 deaths, since MERS-CoV was first detected in humans in 2012. Nine people are still being treated for their infections.



 Middle East Respiratory Syndrome (MERS) – Pipeline Review, H1 2017 [MedGadget, 30 June 2017]

“The Report Middle East Respiratory Syndrome (MERS) – Pipeline Review, H1 2017 provides information on pricing, market analysis, shares, forecast, and company profiles for key industry participants. – MarketResearchReports.biz”

Global Markets Direct’s latest Pharmaceutical and Healthcare disease pipeline guide Middle East Respiratory Syndrome (MERS) – Pipeline Review, H1 2017, provides an overview of the Middle East Respiratory Syndrome (MERS) (Infectious Disease) pipeline landscape.

Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by a coronavirus (MERSCoV). Symptoms include fever, cough and shortness of breath. Other symptoms include nausea, vomiting and diarrhea. Pneumonia is common, and sometimes it cause injury to organs, such as the kidneys. Treatment is aimed at relieving symptoms (joint pain and fever) with fluids and medications.

Report Highlights

Global Markets Direct’s Pharmaceutical and Healthcare latest pipeline guide Middle East Respiratory Syndrome (MERS) – Pipeline Review, H1 2017, provides comprehensive information on the therapeutics under development for Middle East Respiratory Syndrome (MERS) (Infectious Disease), complete with analysis by stage of development, drug target, mechanism of action (MoA), route of administration (RoA) and molecule type. The guide covers the descriptive pharmacological action of the therapeutics, its complete research and development history and latest news and press releases.

The Middle East Respiratory Syndrome (MERS) (Infectious Disease) pipeline guide also reviews of key players involved in therapeutic development for Middle East Respiratory Syndrome (MERS) and features dormant and discontinued projects. The guide covers therapeutics under Development by Companies /Universities /Institutes, the molecules developed by Companies in Phase I, Preclinical and Discovery stages are 2, 10 and 6 respectively. Similarly, the Universities portfolio in Preclinical stages comprises 2 molecules, respectively.

Middle East Respiratory Syndrome (MERS) (Infectious Disease) pipeline guide helps in identifying and tracking emerging players in the market and their portfolios, enhances decision making capabilities and helps to create effective counter strategies to gain competitive advantage. The guide is built using data and information sourced from Global Markets Directs proprietary databases, company/university websites, clinical trial registries, conferences, SEC filings, investor presentations and featured press releases from company/university sites and industry-specific third party sources. Additionally, various dynamic tracking processes ensure that the most recent developments are captured on a real time basis.

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 The World Bank’s “pandemic bonds” are designed so investors pay in the event of an outbreak [Quarts, 30 June 2017]


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Preparation. (Reuters/Mike Segar)

When the Ebola epidemic broke out in West Africa in 2014, in took several months to get large amounts money (around $100 million) to the countries that needed it, according to the World Bank. In that time, thousands of people died. In an effort to fight the next pandemic faster, the World Bank has turned to global financial markets, issuing $425 million in “pandemic bonds” and related derivatives to pay for emergency relief.

The money raised comprises the bulk of a $500 million Pandemic Emergency Financial Facility that will provide funds for poor countries in case of outbreaks of infectious diseases over the next five years. The bonds are designed to transfer the risk of a health crisis in low-income countries to the global financial markets. World Bank president Jim Yong Kim said this will help move away from “the cycle of panic and neglect” that has characterized recent pandemics.

The pandemic bonds work like this: Investors buy the bonds and receive regular coupons payments in return. If there is an outbreak of disease, the investors don’t get their initial money back. There are two varieties of debt, both scheduled to mature in July 2020. The first bond raised $225 million and features an interest rate of around 7%. Payout on the bond is suspended if there is an outbreak of new influenza viruses or coronaviridae (SARS, MERS). The second, riskier bond raised $95 million at an interest rate of more than 11%. This bond keeps investors’ money if there is an outbreak of Filovirus, Coronavirus, Lassa Fever, Rift Valley Fever, and/or Crimean Congo Hemorrhagic Fever. The World Bank also issued $105 million in swap derivatives that work in a similar way.

These bonds are similar to catastrophe bonds, a $90 billion market used by insurance companies to shift risks of hurricanes, earthquakes, and other natural disasters onto the financial markets. The World Bank’s bond sale was 200% oversubscribed, with investors eager to get their hands on the high-yield returns on offer. The majority of buyers were from Europe and included dedicated catastrophe-bond investors, pension funds, and asset managers.

Despite recent innovations, such as a genetic tool that maps how viruses spread in real-time, the world remains unprepared to deal with an epidemic on a global scale. The World Bank estimates that the annual cost of “moderately severe to severe” pandemics is roughly $570 billion, or 0.7% of global GDP. If—or when—there is another severe outbreak, these new bonds are meant to cut the cost, in terms of both human lives and financial resources, of fighting infectious diseases. Ebola killed more than 11,000 people and reduced GDP in Guinea, Liberia, and Sierra Leone by $2.8 billion.



 SAUDI ARABIA 13 patients being treated for MERS in Kingdom [Arab News, 30 June 2017]

BY MOHAMMED RASOOLDEEN

RIYADH: Thirteen patients are being treated for the Middle East Respiratory Syndrome-Corona Virus (MERS-CoV) in government hospitals. Two days ago, a Saudi female, 30, died of the virus, indirectly infected by a camel.

Since June 2012, there have been 1,667 MERS-CoV cases, which included 680 deaths, in various parts of the Kingdom.

According to the World Health Organization (WHO), MERS is a viral respiratory disease that was first identified in Saudi Arabia in 2012. Approximately 80 percent of human cases have been reported by the Kingdom.

The world body said the clinical spectrum of MERS-CoV infection ranges from no symptoms or mild respiratory symptoms to severe acute respiratory disease and death.

A typical presentation of MERS-CoV is fever, cough and shortness of breath. Pneumonia is a common finding, but not always present. Gastrointestinal symptoms, including diarrhea, have also been reported. The virus appears to cause more severe disease in older people, those with chronic conditions such as renal disease, cancer, chronic lung disease and diabetes.

No vaccine or specific treatment is currently available. Treatment is supportive and based on the patient’s clinical condition.

In its report, WHO said: “We know people are infected through contact with infected dromedary camels or infected people. Cases identified outside the Middle East are usually travelers who were infected in the Middle East and then traveled to areas outside the Middle East. On rare occasions, outbreaks have occurred in areas outside the Middle East.”

As a general precaution, anyone visiting farms, markets, barns or other places where dromedary camels and other animals are present should practice general hygiene measures, including regular hand washing before and after touching animals, and should avoid contact with sick animals.

Camel meat and camel milk are nutritious products that can continue to be consumed after pasteurization, cooking or other heat treatments. Animal products that are appropriately processed through cooking or pasteurization are safe for consumption, but should also be handled with care to avoid cross-contamination with uncooked foods.



 Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia [World Health Organization, 28 June 2017]

Between 16 and 23 June 2017, the national IHR Focal Point of Saudi Arabia reported seven additional cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection, including two deaths, and four deaths among previously reported cases.

Details of the cases

Three of the seven newly reported cases are associated with clusters 1 and 3 as reported in the Disease Outbreak News published on 13 June 2017 and 19 June 2017.

Cluster 1

An additional two cases have been reported in this cluster in Riyadh City, Riyadh Region. In total, 34 laboratory-confirmed cases reported to WHO are associated with this cluster.

Cluster 2

No newly reported cases are associated with cluster 2 as reported in the Disease Outbreak News published on 13 June 2017.

Cluster 3

An additional case has been reported in this cluster in Riyadh City, Riyadh Region. Thus far, this cluster involves nine laboratory-confirmed patients.

Globally, 2036 laboratory-confirmed cases of infection with MERS-CoV including at least 710 related deaths have been reported to WHO.

Public health response

The Ministry of Health is evaluating each case and their contacts and is still implementing the measures to limit further human-to-human transmission and bring these outbreaks to a control as described in the DON published on 19 June 2017.

WHO risk assessment

MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed non-sustained human-to-human transmission has occurred mainly in health care settings.

The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting).

WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific.

Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.



 Three new MERS cases diagnosed in Saudi Arabia [CIDRAP 19 June 2017]

The Saudi Arabian Ministry of Health (MOH) confirmed the diagnosis of three new cases of MERS-CoV in recent days, including one case in an asymptomatic healthcare worker at a hospital in Riyadh. At least three hospitals in Riyadh have reported MERS outbreaks this month.

The healthcare worker was diagnosed as having MERS-CoV (Middle East respiratory syndrome coronavirus) on Jun 19. She is a 41-year-old expatriate who is in stable condition.

Yesterday the MOH said a 71-year-old man from Hofuf was in critical condition after being diagnosed with the virus, as was a 22-year-old man from Riyadh. Both men are Saudis, and their sources of infection are listed as primary, meaning it is unlikely they contracted the disease from another person.

The new cases raise Saudi Arabia's MERS totals to 1,653 cases, including 676 deaths. Eighteen people are still being treated for their infections.

In addition, today the World Health Organization (WHO) offered more details on 14 MERS cases identified by the MOH between Jun 11 and 15. One of the patients died, and seven are healthcare workers. The WHO first described the three clusters of MERS outbreaks in Riyadh hospitals on Jun 13.

Nine new cases were associated with cluster 1, a Riyadh hospital described in the Jun 13 update. To date, 32 cases have been linked to this hospital. No new cases have been reported in cluster 2, while cluster 3 has four new cases. To date cluster 3 involves eight healthcare workers.



 Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia [World Health Organization, 19 June 2017]

Between 11 and 15 June 2017, the national IHR Focal Point of Saudi Arabia reported 14 additional cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection including one fatal case among previously reported cases.

Details of the cases
Thirteen of the 14 newly reported cases are associated with clusters 1 and 3 in the Disease Outbreak News published on 13 June 2017. Seven of the 13 newly reported cases are health care workers.

Cluster 1

This Middle East Respiratory Syndrome (MERS) cluster is currently occurring in a hospital, Riyadh city, Riyadh region. An additional nine cases have been reported in this cluster including three health care workers. In total, 32 laboratory-confirmed cases reported to WHO are associated with this cluster to date. All of the asymptomatic cases are in home isolation and all symptomatic cases are isolated on a hospital ward.

Cluster 2

No newly reported cases are associated with cluster 2 as reported in the Disease Outbreak News published on 13 June 2017.

Cluster 3

This MERS cluster is currently occurring in a third hospital in Riyadh city, Riyadh Region. In addition to the cases previously reported in the Disease Outbreak News published on 13 June 2017, the cluster involves four newly reported cases. To date, this cluster involves, including the suspected index case, eight laboratory confirmed patients all of them are health care workers, including the four newly reported cases described in the separate document (see link above).

Globally, 2029 laboratory-confirmed cases of infection with MERS-CoV including at least 704 related deaths have been reported to WHO.

Public health response

The Ministry of Health of Saudi Arabia is evaluating each case and their contacts and implementing measures to limit further human-to-human transmission and bring these outbreaks to a control. These measures include:

・Proper isolation for all confirmed cases (home isolation for asymptomatic patients, in hospital for symptomatic patients).

・Active tracing for all contacts of patients, health care workers and community contacts.

・Identification of high and low risk contacts with daily monitoring for all during incubation period of the 14 days and performing laboratory testing for high risk contacts, regardless of the development of symptoms; multiple laboratory testing is conducted during the follow-up period.

・Regular updating of the line list of cases and contacts and conducting epidemiological analysis of data to identify the source of infection, links between patients and reasons for MERS-CoV spread in the hospitals.

・Investigation of suspected cases between patients and health care workers based on case definition of MERS.

・Enforcement of strict adherence to proper environmental cleaning, disinfection and terminal cleaning and disinfection for hospital environment with special care to the departments where the outbreaks are currently occurring or have occurred.

・Enforcement of visual triage for respiratory diseases in emergency department and outpatient departments and ensure the 24/7 availability of a trained nurse for early detection of patient with respiratory symptoms, and proper documentation in triage form.

・Extensive training of all health care workers on case definition for early detection, implementation of isolation precautions, proper selection, donning and doffing of PPEs, hand hygiene and environmental cleaning and disinfection.

・Ensuring that all health care workers tested for N95 fitting (fit test).

・Ensuring availability of infection prevention supplies including hand sanitizer, PPEs, surface disinfectants, portable HEPA filters and fumigation machines.

・Enforcing the implementing of a policy of not allowing health care workers to travel without medical clearance to prevent the spread of the virus to other countries.

WHO risk assessment

MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed non-sustained human-to-human transmission has occurred mainly in health care settings. Preliminary investigations of the clusters described above indicate that secondary cases are linked to two events where aerosolizing procedures were conducted in crowded medical wards under sub-optimal infection prevention and control conditions.

The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns. Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.



 WHO details Saudi MERS clusters as outbreak grows [CIDRAP, 13 June 2017]

by Stephanie Soucheray

hospital_corridor.jpg
VILevi / iStock

The World Health Organization (WHO) today provided new details on three MERS-CoV clusters in Saudi Arabia involving 32 out of the 35 cases reported between Jun 1 and Jun 10. The clusters are in three different hospitals in Riyadh.

In related news, the Saudi Arabia Ministry of Health (MOH) reported two new healthcare-related MERS-CoV (Middle East respiratory syndrome coronavirus) cases in Riyadh, evidence that the outbreak is not over.

One cluster involves 23 cases

There are 23 cases associated with cluster 1, the WHO said in an update. The index case was a 47-year-old man who was diagnosed as having MERS-CoV on Jun 1. So far, 14 asymptomatic healt care worker contacts, 1 household contact, and 7 other patients in the hospital have also been diagnosed.

Cluster 2 is related to cluster 1, as the first case-patient in a second hospital initially visited the emergency room of the hospital implicated in cluster 1. According to the WHO, he was asymptomatic following the visit in hospital 1, and he continued to receive kidney dialysis sessions in the second hospital. The cluster involves the index case plus five healthcare workers and household contacts.

The third cluster is not related to clusters 1 or 2. To date four cases are associated with this hospital; the index case involves a patient who had camel contact. Three healthcare workers have also been diagnosed.

Though MERS is not easily transmitted between humans, it can spread quickly in the hospital setting, as many patients present with general respiratory illness symptoms, exposing healthcare workers and fellow patients.

Two new cases today

Meanwhile, the Saudi MOH reported two new MERS cases today, both in Riyadh. It's unknown at this time what cluster these cases belong to.

The first patient is a 53-year-old expatriate female healthcare worker. She is symptomatic and is in stable condition.

The second patient is a 58-year-old Saudi man. He contracted the disease as a patient in a hospital. He also has symptoms and is in stable condition.

With these new cases, Saudi Arabia now has 1,636 cases, including 673 deaths. Fifteen people are still being treated for the disease.



 Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia [World Health Organization, 13 Jun 2017]

Between 1 and 10 June 2017, the national IHR focal point of Saudi Arabia reported 35 additional cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection including three fatal cases and one death among previously reported cases (case number 5 in the Disease Outbreak News published on 6 June 2017).

Details of the cases

Detailed information concerning the cases reported can be found in a separate document (see link below).

Thirty-two of the 35 newly reported cases are associated with three simultaneous clusters of MERS, of which two are related. A description of the three clusters is below.

Cluster 1

A cluster of MERS has been identified in a hospital in Riyadh city, Riyadh Region. Twenty three cases associated with this cluster thus far and include the first identified case (a 47-year-old male reported on 1 June), 14 asymptomatic health care worker contacts, one household contact, and seven hospital contacts who were patients.

Cluster 2

This MERS cluster is occurring in a second hospital in Riyadh City, Riyadh Region. This cluster is related to cluster 1 above. The first identified case of this second cluster visited the emergency room of the cluster 1 hospital. He was asymptomatic and following this visit in hospital 1, he continued to receive kidney dialysis sessions in the second hospital. To date, this cluster involves six cases, including the case involved in cluster 1, and secondary household and health care worker contacts.

Cluster 3

This MERS cluster is currently occurring in a third hospital in Riyadh city, Riyadh Region. To date the cluster involves the four cases including the first identified case who reported contacts with dromedary camels and three asymptomatic or mild cases who were health care worker contacts.

Public health response

The Ministry of Health of Saudi Arabia is evaluating each case and their contacts and implementing measures to limit further human-to-human transmission and bring these outbreaks to a control. These measures include:

・Proper isolation for all confirmed cases;

・Active tracing for all contacts of patients, healthcare workers and community contacts;

・Identification of high and low risk contacts with daily monitoring for all during incubation period of the 14 days and performing laboratory testing for high risk contacts, regardless of the development of symptoms;

・Regular updating of the line list of cases and contacts and conducting epidemiological analysis of data to identify the source of infection, links between patients and reasons for human-to-human transmission within hospitals;

・Searching for suspected cases between patients and healthcare workers based on case definition of the disease;

・Enforcement of strict adherence to proper environmental cleaning, disinfection and terminal cleaning and disinfection for hospital environment with special care in departments where the outbreaks are currently occurring or have occurred;

・Enforcement of visual triage for respiratory diseases in emergency department and outpatient departments and ensure the 24/7 availability of a trained nurse for early detection of patients with respiratory symptoms, and proper documentation in triage forms;

・Extensive training of all healthcare workers on case definition for early detection, implementation of isolation precautions, proper selection, donning and doffing of PPEs, hand hygiene and environmental cleaning and disinfection;

・Ensuring that all healthcare workers tested for N95 fitting (fit test);

・Ensuring availability of infection prevention supplies including hand sanitizer, PPEs, surface disinfectants, portable HEPA filters and fumigation machines;

・Enforcing the implementation of a policy of not allowing healthcare workers to travel without medical clearance to prevent the spread of the virus to other countries.

For cases that report contact with dromedary camels, investigations of MERS-CoV infection in dromedaries is conducted by Ministry of Agriculture officials.
Globally, 2015 laboratory-confirmed cases of infection with MERS-CoV including at least 703 related deaths have been reported to WHO since 2012.

WHO risk assessment

MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed human-to-human transmission has occurred mainly in health care settings.

The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). WHO is working closely with the Ministry of Health in Saudi Arabia, continues to monitor the epidemiological situation and viral changes, and conducts risk assessment based on the latest available information. To date, there is no indication that there is sustained human-to-human transmission or that the epidemiologic pattern or viral characteristics are different than what has been reported previously.

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific.

Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.



 Saudi Arabia reports 7 new hospital MERS cases [CIDRAP, 12 Jun 2017]

by Stephanie Soucheray

mers_virus_particles-niaid_0.jpg
NIAID, with Colorado State University

Over the weekend and today, the Saudi Arabian Ministry of Health (MOH) reported seven new cases of MERS-CoV. All the cases are connected to the current hospital outbreaks in Riyadh.
In related news, a new study found that bats harbor thousands of coronaviruses.

Latest Saudi cases

On Jun 10 the MOH said a patient died from MERS-CoV (Middle East respiratory syndrome coronavirus). The 32-year-old Saudi man acquired the virus while he was in the hospital as a patient.

Yesterday five healthcare workers from Riyadh were diagnosed as having MERS-CoV. The three women and two men are all expatriate healthcare workers who contracted the disease on the job. Their ages range from 35 to 57, and all are in stable condition. Only two of the five employees had symptoms.

And today the MOH confirmed that another female expatriate healthcare worker was diagnosed in Riyadh. The woman, 45, was not symptomatic and is currently in stable condition.

WHO on hospital outbreaks

Last week the World Health Organization (WHO) said it was probing at least three healthcare outbreaks of MERS in Saudi Arabia, and a WHO official told CIDRAP News that officials are investigating several unrelated hospital outbreaks in Riyadh.

Today, a new situation report said at least two hospital outbreaks began in Riyadh before June, as well as one in the Assir Region. The clusters are not related.

The report looked at MERS cases in April and May; May 15 was the last date of reporting of a laboratory-confirmed case from these three hospital clusters. So far in June, there have been at least 27 cases of healthcare-acquired MERS reported in Riyadh, among both patients and health workers.

According to the WHO, by the end of May 2017, a total of 1,980 laboratory-confirmed cases of MERS-CoV, including 720 deaths were reported globally. The case-fatality rate was 36.4%.

Saudi Arabia is the host to the majority of these cases. As of today there have been 1,634 cases since 2012. That includes 672 deaths, and 14 cases under treatment. The case-fatality rate in Saudi Arabia is 41.1%.

Bats harbor myriad coronaviruses

In a study that has implications for future MERS-CoV research, scientists working on three continents over the past 5 years have found that bats constitute 98% of the animals found to harbor coronaviruses. The results were published today in Virus Evolution.

Scientists collected samples from 19,192 bats, rodents, non-human primates, and humans, to understand transmission of coronaviruses, which include SARS (severe acute respiratory syndrome) virus and MERS-CoV. Areas with high bat populations had a wider diversity of detectable coronaviruses.

The authors estimate there are 3,204 coronaviruses in bats, and concluded, "Viral richness was strongly correlated with bat richness, suggesting that most CoVs will be found in regions where bat diversity is highest."



 Saudi Arabia registers 35 Mers-CoV cases [Khaleej Times, 11 Jun 2017]

The country has registered 1,577 cases since 2012, including 672 deaths

Saudi Arabia registered 35 Middle East Respiratory Syndrome (MERS) corona virus cases in 15 days, of which 28 developed the infection at health facilities, officials said on Sunday.

Although the Mers corona virus cases are not anymore considered a high health risk like before, the infection could be fatal for those with poor health or chronic diseases, Xinhua news agency reported.

The country has registered 1,577 cases since 2012, including 672 deaths.

Infection control consultant Mohammed Abdulrahman highlighted the need for more awareness on infection control measures at health facilities as most of the new cases could have been prevented.

He urged the elderly to avoid visiting patients at hospitals or be directly associated with camels which are the main source of the virus, because of their weak immune systems.



 MERS: Saudi Arabia reported 6 fatal cases, United Arab Emirates and Qatar report cases [Outbreak News Today, 8 Jun 2017]

by ROBERT HERRIMAN

Middle-East-map.gif


According to a World Health Organization outbreak update published Tuesday, for the five weeks from Apr. 21 through May 29, Saudi Arabia reported an additional 25 Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection cases, including six fatalities.

Twelve of the 25 reported cases during this time period were associated with three simultaneous, yet unrelated clusters of MERS cases in Bisha city, Riyadh city and Wadi Aldwaser city.

In addition to the Saudi Arabia cases, two additional cases were reported in the United Arab Emirates (UAE) and one in Qatar.

On 16 May 2017, two cases of MERS-CoV infection were reported in the United Arab Emirates.

Both cases were reported from Al Ain city and both have reported direct links to dromedary camels. The first case that was identified, a 69-year-old male farmer, is in critical condition in hospital and the second case, a 45-year-old male butcher, is asymptomatic and identified during contact tracing of the first case. Contact tracing and dromedary investigations are ongoing.

On 23 May 2017, one case of MERS-CoV infection was reported in Qatar. The case, a 29 year old male from Doha has reported frequent contact with dromedary camels. The Department of Health Protection and Communicable Disease Control in the Ministry of Public Health and animal health resources are currently carrying out case investigation and contact tracing.

Globally, since September 2012, WHO has been notified of 1980 laboratory-confirmed cases of infection with MERS-CoV including at least 699 related deaths have been reported.



 Saudi Arabia probing several hospital MERS clusters in Riyadh [CIDRAP, 8 Jun 2017]

by Lisa Schnirring |

hospital_monitor.jpg


Saudi Arabia is battling several small unrelated clusters of hospital-related MERS-CoV infections in the capital city of Riyadh, an official with the World Health Organization (WHO) confirmed today, as the country's health ministry reported five new cases in the city.

Maria Van Kerkhove, PhD, an epidemiologist who is the WHO's technical lead for MERS-CoV (Middle East respiratory syndrome coronavirus), the cases are from different Riyadh hospitals. She added that Saudi Arabia's Ministry of Health (MOH) is conducting extensive contact tracing, which includes testing high-risk contacts, even if they don't have symptoms.

Riyadh 1 of 3 cities experiencing clusters

In the month of June, the Saudi MOH has reported 25 MERS cases in Riyadh, 21 with clear links to healthcare settings. The group includes healthcare workers and patients, most of whom have asymptomatic infections. Sources of the clusters are still under investigation. Reports this month also include a case involving primary exposure and another with camel exposure.

A clearer picture of the situation in Riyadh follows an announcement 2 days ago from the WHO about three small hospital clusters in Saudi Arabia with cases reported between Apr 21 and
May 29, including one in Riyadh. The WHO alluded to five cases in the Riyadh cluster: four noted in its latest statement plus the index case-patient, whose illness was described in an earlier report.

Two other hospital clusters—one in Bisha and the other in Wadi ad-Dawasir—aren't connected to each other or to the Riyadh cluster, the WHO said.

Though MERS-CoV doesn't spread easily from person to person, in hospital settings the virus can lead to multiple secondary cases and can fuel large outbreaks, such as one at a hospital in Riyadh in 2015 that sickened more than 100 people. An outbreak in South Korea in 2015 led to 186 infections in 17 different health facilities.

MERS total likely to grow

Van Kerkhove, who was part of several joint WHO missions to Saudi Arabia and South Korea to probe hospital outbreaks and other issues related to MERS-CoV, said the high number of asymptomatic cases reflects the country's policy of testing high-risk contacts.

Another policy is to place asymptomatic health workers and household contacts with lab-confirmed infections in home isolation to limit onward transmission, she said, adding that symptomatic patients are isolated in the hospital.

Saudi health officials are currently investigating the extent of infection among contacts, the source of infection for each cluster, and any potential links between hospitals, according to Van Kerkhove.

"These investigations are ongoing, and I do expect more cases will be identified, but we have no indication of a change in the epidemiology or virus or any sustained human-to-human transmission," she said. Also, she added that affected hospitals have enhanced their infection prevention and control measures.

Saudi Arabian officials have been open and transparent regarding their actions and interim findings, Van Kerkhove added.

Five new cases today

The five new Riyadh cases reported by the Saudi MOH today include three healthcare workers and two hospital patients. All are healthcare-related infections. Four, however, are asymptomatic.

All the patients are foreigners living in Riyadh, and all are in stable condition.

The health workers are two women, ages 30 and 31, and a man, age 25. He is the only patient exhibiting symptoms. The patients are 58-year-old and 48-year-old men.

The new MERS cases raise the country's total since the outbreak began in 2012 to 1,628, including 671 deaths. Ten patients are still receiving treatment.



 WHO reports 3 Saudi hospital MERS clusters, new cases in UAE, Qatar [CIDRAP, 7 Jun 2017]

by Lisa Schnirring |

oxygenation.jpg


The World Health Organization (WHO) yesterday provided new details about three unrelated hospital MERS-CoV outbreaks that as of May 29 had infected 12 people, and Saudi Arabia's Ministry of Health (MOH) today announced five more cases, including at least four tied to the hospital cluster in Riyadh.

In its overview of MERS-CoV (Middle East respiratory syndrome coronavirus) cases, the WHO also noted what appear to be three new cases in the United Arab Emirates (UAE) and Qatar, all of which involved direct links to camels.

Hospital cluster details

The 12 cases linked to the three hospital outbreaks are part of 25 MERS cases that Saudi Arabia reported to the WHO between Apr 21 and May 29. Four patients are healthcare workers, one from Bisha and three from Riyadh. Six of the 25 illnesses were fatal.

The hospital events have occurred simultaneously and aren't related to each other, and the WHO added that Saudi Arabia's MOH is probing each cases and taking steps to curb further human-to-human transmission.

The first hospital cluster involves a facility in Bisha, a city in southwestern Saudi Arabia. The index patient was a 71-year-old man who died from his infection in early May. Following the case, two secondary healthcare contacts were reported, two men ages 54 and 57.

A hospital in the city of Riyadh is the setting for the second cluster, where the first known patient is a 55-year-old man who was ill during the first half of May and died. Four secondary cases were identified in the middle of May, two men ages 33 and 38 and two women ages 30 and 25.

In April, a MERS-CoV cluster at a hospital in the city of Wadi ad-Dawasir, located in south central Saudi Arabia. The WHO said the outbreak is thought to be over, based on the follow-up period of the contacts. Five illnesses are linked to the cluster; the first case—involving a 55-year-old man—was already reported by the WHO on Apr 27. Today's statement adds four secondary cases: two household contacts (men ages 50 and 58) and two healthcare contacts (men ages 31 and 26).

Five new Saudi cases

In a related development, the Saudi MOH today reported five new MERS cases, all from Riyadh, at least four of them likely linked to the hospital outbreak.

One of the cases is listed as a 35-year-old Saudi woman who is an asymptomatic household contact of a patient infected with MERS-CoV.

The other four were infected in a heathcare setting; three as healthcare workers and one as a patient. All of the healthcare workers are expats, and only one of them has symptoms, a 42-year-old woman who is listed in stable condition. The others are a 45-year-old woman and a 39-year-old man.

The patient who contracted MERS-CoV in the hospital is a 57-year-old Saudi woman who has an asymptomatic infection.

The latest cases raise Saudi Arabia's overall MERS-CoV total to 1,627, including 671 deaths.

Nine people are still being treated for their infections.

UAE and Qatar cases

Both the UAE and Qatar reported MERS-CoV cases over the past several weeks, but the cases reported by the WHO today appear to be new ones.

A pair of infections reported by the UAE involve men from the city of Al Ain who had direct links with camels. One is a 69-year-old farmer who is hospitalized in critical condition, and the other is a 45-year-old butcher whose asymptomatic illness was found during contact tracing following the first case.

The WHO said more contact tracing and investigations in dromedary camels are under way.

Meanwhile, Qatar's case-patient is a 29-year-old man from Doha who has had frequent contact with camels. According to the WHO, the country's health ministry and animal health officials are conducting investigations.

Since September 2012, when the virus was first detected in humans, the WHO has received reports of 1,980 cases and at least 699 deaths.



 Three Saudi hospitals report MERS outbreaks since April, WHO says [Reuters, 6 Jun 2017]

Three Saudi hospitals have reported outbreaks of Middle East Respiratory Syndrome (MERS) since April 21, with 12 people catching the potentially deadly disease from infected patients who later died, the World Health Organization said on Tuesday.

The hospitals were in the capital Riyadh, in Bisha city, and in Wadi al-Dawasir in Riyadh province, the same town that reported a MERS hospital outbreak in April, although the WHO did not say if the new outbreak was related to that.

MERS is thought to be carried by camels and comes from the same family as the coronavirus that caused China's deadly Severe Acute Respiratory Syndrome (SARS) outbreak in 2003.

The WHO said two men in the United Arab Emirates and one man in Qatar also caught the disease last month after contact with camels, bringing the total number of confirmed cases to 1,980 since September 2012, with at least 699 deaths.

Most of the known human-to-human transmission has occurred in healthcare settings, and the WHO has previously said hospitals and medical workers should take stringent precautions as standard to stop the disease spreading.

WHO Director-General Margaret Chan, who steps down on June 30, has criticized Saudi Arabia for allowing MERS to spread in its hospitals, and the WHO has suggested developing a vaccine for camels may be part of the solution.

Last year the failure to spot MERS in a patient in a vascular surgery ward in Saudi Arabia led to more than 49 other people being exposed to the disease.

Although most cases have occurred in Saudi Arabia, a man who had traveled in the Gulf triggered a major outbreak in South Korea in mid-2015, causing 186 cases within two months.

(Reporting by Tom Miles; Editing by Louise Ireland)



 2 years after MERS, Korea still struggles with public health system [Korea Biomedical Review, 25 May 2017]

By Choi Gwang-seok

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Panel members discuss how to improve public health system during a symposium held on the occasion of the second anniversary of Middle East Respiratory Syndrome outbreak, at Seoul National University Cancer Research Institute Wednesday.

Two years have passed since the Middle East Respiratory Syndrome (MERS) threw Koreans into the fear of infectious disease, but Korea’s public health system remains fragile.

Although the government has made some improvements, the country has a long way to go before completing infectious disease-related governance by, for instance, training public health experts and supporting research activities.

These were the prevailing sentiments at a symposium Wednesday to discuss possible reforms in infectious diseases management systems, jointly organized by the Korean Society for Preventive Medicine and the Korean Society of Epidemiology at the Seoul National University Cancer Research Institute.

“We should never forget the lessons we learned from the outbreak and work toward solving problems such as improving the infectious disease management governance system and nurturing public health professionals,” said Kim Hye-kyung김혜경, head of Suwon Public Health Office.

Noting that Korea could learn about the problems and limitations of its public health system through the MERS outbreak, Kim said, “We lacked the proper human resources and organizational structure because we had focused only on the projects carried out by the public health system. We operated a national welfare policy that lacked concentration on the public health system compared to the medical system.”

Kim added that Korea has yet to distinguish the difference between public health and medical care, saying, “We did not understand the importance of public health professionals and their required capabilities.”

The country was not aware of the importance of preparedness concerning infectious diseases on a regular basis due to the lack of interest in the field, Kim said, adding that Korea has begun to recognize the importance of crises preparedness and response only after suffering from the massive losses in the aftermath of MERS.

However, Kim criticized that problems remain although two years have passed since, and systemic improvements that reflect the voices of those in the field should still be made.

In this regard, Kim suggested creating a governance system of central and provincial governments, strengthening the provincial infectious disease management organizations, and implementing systematic training of public health experts.

The provincial government should take responsibility for field command, and the central government should act as the supporter and controller of their efforts, Kim said. The central government should begin to trust local governments, considering that infectious diseases occur mainly in those regions and because the local administrative capacity has improved significantly since 20 years of autonomy.

Other participants at the symposium raised the need for systematic training of public health professionals and support for research on infectious diseases.

Professor Lee Hee-young이희영 of Bundang Seoul National University Hospital분당서울대병원 said,

"We cannot increase our skills without practical experience. The government should fund researchers to go abroad and participate in research on infectious diseases such as Ebola.”

"If we send out public health experts overseas and conduct research on infectious diseases in other regions, we will be able to contribute to the improvement of our country's infectious disease research and coping ability," he added.

Some argue that Korea’s biggest problem in dealing with the infectious disease is governance related, raising the opinion for the Ministry of Health and Welfare to become an independent organization.

"In 2002, the number of health care workers accounted for 40.7 percent of the public officials in the Ministry of Health and Welfare. In 2013, the number decreased to 31 percent, while the number of civil servants in the social welfare sector, and their budget, has steadily increased," said Professor Park Eun-cheol박은철 of Yonsei University College of Medicine.

“Many of the policies we deal with can be efficiently processed by the ministry alone, and there is no significant challenge in the ministry operating as an independent agency,” Park added.

Noting that 61.8 percent OECD countries are separating health and welfare from the central ministry, "Korea should also ensure professionalism by changing the Ministry of Health and Welfare to the Ministry of Health,” he said.

He also commented on the rumor that the current government is pursuing a multi-loan system, saying that although it is not the best solution as separating the ministry into an independent organization, it will be a partial settlement of the problem.

Zoonotic Bird Flu News - from 8 till 16 June 2017



 Mutations identified that enable human transmission of avian flu [News-Medical.net, 16 June 2017]

By Kate Bass, BSc

image.axd.jpg
 Credit: Nixx Photography/Shutterstock.com

A systematic mutation analysis has shown that changes in just three amino acids of the avian influenza H7N9 virus receptor binding protein confers specificity for human cells.

H7N9 is a strain of influenza virus that usually only infects birds. However, in 2013 a human flu outbreak was found to be caused by H7N9 acquired from poultry markets. Although the virus had gained the ability to infect humans, it did not acquire human specificity and so could not transfer between humans. Consequently, closure of the poultry markets stopped the outbreak.

The unprecedented incidence of the flu virus being transmitted to humans from infected poultry raised concerns that the virus may be adapting to a human host. To assess this risk, scientists at The Scripps Research Institute, California assessed which mutations in the H7N9 DNA could allow it to gain human specificity.

The protein on the surface of the flu virus that allows it to attach to host cells is called haemagglutanin and there are several subtypes of this protein (H1 to H16). Typically, only H1, H2 and H3 have been found in flu viruses infecting humans.

Avian flu strains produce H7 that confers binding specificity for birds. Researchers therefore looked for mutations in the DNA of the avian flu virus encoding H7 that would result in a haemagglutanin similar to H1, H2 or H3 being produced. Such mutations would allow H7 to bind to human cells. If the avian flu virus acquired human specificity, it would be able to spread between humans in the same way as human flu strains, which have caused serious pandemics in the past.

Study of the structure of different haemagglutanin subtypes and application of molecular modelling techniques, allowed the team to determine which mutations had the potential to change the H7 amino acid sequence in such as way that the protein would become human specific. They then produced a range of haemagglutanin proteins with different combinations of these identified mutations. The specificity of the engineered haemagglutanins was assessed in an experimental cell line.

Binding tests showed that several forms of haemagglutanin with mutations in three amino acids had a particularly strong affinity for human receptors. This indicated that the H7 specificity had switched from bird cells to human cells as a result of these mutations.

H7 haemagglutinins with the three amino acid changes were also shown to successfully attach to cells in samples of human trachea tissue as was seen in the 2013 outbreak.

In the interest of safety (to avoid the obvious dangers of creating human-specific H7N9 viruses) the team cannot introduce DNA with the triple mutation into H7N9 viruses. The transmission of the mutated virus between animals cannot therefore be tested directly.

However, since the potentially dangerous mutations have now been identified scientists can monitor samples from humans infected with H7N9 for the switch in specificity. Identifying avian flu strains that are likely to have the ability to transfer between humans will allow preventative actions to be taken before a pandemic arises.
Sources:

・de Vries RP, Peng W, Grant OC, Thompson AJ, Zhu X, Bouwman KM, et al. (2017) Three mutations switch H7N9 influenza to human-type receptor specificity. PLoS Pathog 13(6): e1006390. Available at http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1006390

・PLOS Pathogens news release 15 June 2017. Available at https://eurekalert.org/pub_releases/2017-06/p-sim060717.php



 Avian Flu Fast Facts [ErieTVNews, 16 June 2017]

(CNN) -- Here's a look at avian flu.

Avian influenza, also called avian flu or bird flu, is an illness that usually affects only birds.

The official name for the most commonly seen and most deadly form of the virus is called "Influenza A (H5N1)," or the "H5N1 virus."

People have killed hundreds of millions of birds around the world in an attempt to control the spread of the avian flu.

There are many different strains of avian flu: 16 H subtypes and 9 N subtypes. Only those labeled H5, H7 and H10 have caused deaths in humans.

Diagnosis/Treatment:

Most cases of human bird flu infections are due to contact with infected poultry or surfaces that are contaminated with infected bird excretions: saliva, nasal secretions and feces.

The CDC recommends oral oseltamivir (brand name: Tamiflu), inhaled zanamivir (brand name: Relenza) and intravenous permavir (brand name: Rapivab) for the treatment of human illness associated with avian flu. As strains and lineages of the Avian Influenza viruses continue to change, monitoring for the best treatments are ongoing.

Symptoms of avian flu include fever, cough, sore throat and sometimes severe respiratory diseases and pneumonia.

The mortality rate is nearly 60% for infected humans.

Timeline:

Early 1900s -The avian flu is first identified in Italy.

1961 - The H5N1 strain is first isolated in birds in South Africa.

December 1983 - Chickens in Pennsylvania and Virginia are exposed to the avian flu, and more than five million birds are killed to stop the disease from spreading.

May 1997 - Eighteen people are infected by the H5N1 strain in Hong Kong, and six die. These are the first documented cases of human infection. Hong Kong destroys its entire poultry population (1.5 million birds) in three days.

1999 - Two children in Hong Kong are infected by the H9N2 strain.

February 2003 - Eighty-four people in the Netherlands are affected by the H7N7 strain of the virus, and one dies.

February 2, 2004 - The World Health Organization (WHO) is investigating possible human-to-human transmission among a family in Vietnam. Three family members have died of the illness, and one has recovered. One member had no contact with infected poultry while the others did.

February 7, 2004 - Twelve thousand chickens are slaughtered in Kent County, Delaware, after they are found to be infected with the H7 virus.

February 23, 2004 - A flock of 6,600 broiler chickens in Gonzalez County, Texas, is destroyed after being diagnosed with an "extremely infectious and fatal" form of bird flu, the H5N2 strain.

February 5, 2005 - The Cambodian Health Ministry and WHO confirm the first human death in Cambodia (the H1N1 strain, on January 30, 2005).

October 7, 2005 - The avian flu reaches Europe. Romanian officials quarantine a village of about 30 people after three dead ducks there test positive for bird flu.

November 12, 2005 - A one-year-old boy in Thailand tests positive for the lethal H5N1 strain of avian influenza.

November 16, 2005 - WHO confirms two human cases of bird flu in China, including a female poultry worker who died from the H5N1 strain.

November 17, 2005 - Two deaths are confirmed in Indonesia from the H5N1 strain of avian influenza.

January 1, 2006 - A Turkish teenager dies of the H5N1 strain of avian influenza in Istanbul, and later that week, two of his sisters follow.

January 17, 2006 - A 15-year-old girl from northern Iraq dies after contracting bird flu.

February 20, 2006 - The French Health Ministry confirms that a duck in central France had the H5N1 strain of avian flu.

February 20, 2006 - Vietnam becomes the first country to successfully contain the disease. A country is considered disease-free when no new cases are reported in 21 days.

March 12, 2006 - Officials in Cameroon confirm cases of the H5N1 strain. The avian flu has now reached four African countries.

March 13, 2006 - The avian flu is confirmed by officials in Myanmar (Burma).

May 11, 2006 - Djibouti announces its first cases of H5N1 - several birds and one human.

December 20, 2011 - The US Department of Health and Human Services releases a statement saying that the government is urging scientific journals to omit details from research they intend to publish on the transfer of H5N1 among mammals. There is concern that the information could be misused by terrorists.

July 31, 2012 - Scientists announce that H3N8, a new strain of avian flu, caused the death of more than 160 baby seals in New England in 2011.

March 2013 - The official Chinese news agency Xinhua reports that two people in China have died after falling ill with a strain of bird flu, H7N9, not detected before in humans.

December 6, 2013 - A 73-year-old woman infected with H10N8 dies in China, the first human fatality from this strain.

January 8, 2014 - Canadian health officials confirm that a resident from Alberta has died from H5N1 avian flu, the first case of the virus in North America. It is also the first case of H5N1 infection ever imported by a traveler into a country where the virus is not present in poultry.

April 20, 2015 - Officials say more than five million hens will be euthanized after bird flu was detected at a commercial laying facility in northwest Iowa. According to the US Department of Agriculture, close to eight million cases of bird flu have been detected in 13 states since December. Health officials say there is little to no risk for transmission to humans with respect to H5N2. No human infections with the virus have ever been detected.

January 15, 2016 - The US Department of Agriculture confirms that a commercial turkey farm in Dubois County, Indiana, has tested positive for the H7N8 strain of avian influenza.

January 24, 2017 - Britain's Department for Environment, Food & Rural Affairs release a statement confirming that a case of H5N8 avian flu has been detected in a flock of farmed breeding pheasants in Preston, UK. The flock is estimated to contain around 10,000 birds. The statement adds that a number of those birds have died, and the remaining live birds at the premises are being "humanely" killed because of disease.

February 12, 2017 - A number of provinces in China have shut down their live poultry markets to prevent the spread of avian flu after a surge in the number of infections from the H7N9 strain. At least six provinces have reported human cases of H7N9 influenza this year, according to Chinese state media, Xinhua.

March 5-7, 2017 - The USDA confirms that a commercial chicken farm in Tennessee has tested positive for the H7N9 strain of avian flu, but says it is genetically different from the H7N9 lineage out of China. The 73,500-bird flock in Lincoln County will be euthanized, according to Tyson Foods.

May 20, 2017 - The Center for Health Protection in Hong Kong reports there have been 697 new cases of human infection from avian influenza A (H7N9) since October 2016 in mainland China.

May 24, 2017 - Since February of 2013 there have been 1,525 confirmed human cases and 579 deaths from the H7N9 strain of avian flu, according to the Food and Agriculture Organization of the United Nations.



 Scientists make H7N9 mutations discovery [vet times, 16 June 2017]

by David Woodmansey

June16_avian-flu_Fotolia-5second_MAIN-350x233.jpg
H7N9 is not capable of spreading sustainably from human to human, but scientists are concerned it could mutate to do so. IMAGE: Fotolia/5second.

An international team of scientists has identified several genetic mutations that could, should they arise, potentially allow the avian influenza strain H7N9 to cross the species barrier and spread between humans.

H7N9 is not capable of spreading sustainably from human to human, but scientists are concerned it could mutate to do so. IMAGE: Fotolia/5second.

H7N9 is a strain of flu virus that normally infects birds, but has spread to at least 779 humans in a number of outbreaks related to poultry markets.

The virus is not capable of spreading sustainably from human to human, but scientists are concerned it could potentially mutate into a form that can.

To investigate this possibility, James Paulson and colleagues from the Scripps Research Institute in California, US analysed mutations that could occur in H7N9’s genome.

Virus proteins

In flu strains that circulate in avian viruses, different subtypes exist of a protein called haemagglutinin, ranging from H1 to H16. So far, three subtypes have been found in human flu viruses – H1, H2 and H3.

In this research, efforts were focused on a gene that codes for H7, which is found on the surface of flu viruses and allows them to latch on to host cells.

As with other avian flu viruses, H7N9 is specific for receptors on bird cells, but not receptors on human cells. However, a transition to human specificity could enable H7N9 to circulate among humans, just like other human flu strains that have caused pandemics in the past.

Molecular modelling

Using molecular modelling and knowledge of haemagglutinin’s structure, the team identified mutations that would change the protein’s amino acid sequence, causing a switch to human specificity.

They then produced the haemagglutinin with different combinations of these mutations in an experimental cell line, as testing the mutations in H7N9 viruses themselves can be dangerous.

From these cells, scientists harvested the mutant haemagglutinin proteins, and tested how strongly they bound to human-type and bird-type receptors.

It was found several forms with mutations in three amino acids bound far more strongly to human receptors, which meant they had switched specificity from bird to human. The triple-mutant H7 haemagglutinins also successfully latched on to cells in samples of human trachea tissue.

Safety regulations

Safety regulations prohibit introducing these mutations to actual H7N9 viruses, limiting scientists’ ability to test their effects in animals.

Nonetheless, the research team suggests keeping an eye out for the development of these mutations in humans infected with H7N9 could help trigger a timely response to prevent potential spread.

Their findings are published in PLOS Pathogens.☞ Three mutations switch H7N9 influenza  



 Scientists find mutations that may help bird flu jump to humans [Cosmos, 16 June 2017]

Three amino acids in a single protein are all that stand between us and an avian influenza epidemic, writes Andrew Masterson.

Contrib_AndrewMasterson.jpg
ANDREW MASTERSON is an author and journalist based in Melbourne, Australia.

In May the World Health Organisation (WHO) confirmed 26 cases of avian influenza in humans.
The cases all stemmed from China, and while most were people who had been in contact with live poultry, two were not.

It is those last two cases that set off alarm bells for public health authorities around the world, because it is possible they contracted the virus – known as H7N9 – from another human.

At present, few cases of human-to-human H7N9 transmission have ever been recorded, and the position of the WHO authorities is that the virus is currently incapable of sustained transmission between people. The very real possibility that it might at some point acquire a mutation that enables easy person-to-person spread is, however, the stuff of epidemiological nightmares.

Understanding exactly how that might happen is now a significant step closer thanks to investigations carried out at The Scripps Research Institute in California, US, and published in the journal PLOS Pathogens.

A team of scientists led by James Paulson looked at mutations that could occur in the genome of H7N9. In particular, they looked at a protein called hemagglutanin, which is found on the surface of all influenza viruses and is known to play a key role in facilitating entry into host cells.

There are several different subtypes of influenza hemagglutanin, numbered H1 to H16. Each has a specific amino acid sequence that allows it to bind to receptors on particular types of cells. Human influenza viruses, for instance, have so far all been found to have hemagglutanin sequences H1, H2 and H3.

In contrast, avian flu viruses have sequences that bind primarily to bird cells. To become capable of person-to-person spread these would have to change structure to allow strong attachment to human tissue.

To see whether this was possible, Paulson and colleagues cultured hemagglutanin in an experimental cell line, identifying and propagating amino acid mutations in the process.

They discovered several different combinations of three amino acid changes that altered the hemagglutanin’s specificity from bird to human cells. A second experiment revealed the mutated protein was capable of latching onto human trachea tissue.

Further experiments, using animals to test how inducing the changes affected H7N9 virulence, were not possible, because safety regulations prohibit inducing such change in actual flu viruses.

Nevertheless, the scientists recommend checking future laboratory-confirmed human avian flu cases to see if any such mutations have occurred in the virus’s hemagglutanin coating.

If it has, they say, it could provide an early warning that the nightmare potential of avian flu is on the brink of being realised.



 A Few Genetic Tweaks To Chinese Bird Flu Virus Could Fuel A Human Pandemic [KUCB, 15 June 2017]

By NELL GREENFIELDBOYCE

A study published Thursday shows how a bird flu virus that's sickening and killing people in China could mutate to potentially become more contagious.

Just three changes could be enough to do the trick, scientists report in the journal PLOS Pathogens.

And the news comes just as federal officials are getting ready to lift a moratorium on controversial lab experiments that would deliberately create flu viruses with mutations like these.

Public health officials have been worried about this bird flu virus, called H7N9, because it's known to have infected more than 1,500 people — and killed 40 percent of them. So far, unlike other strains that more commonly infect humans, this deadly virus does not spread easily between people.

The fear is that if it mutates in a way that lets it spread more easily, the virus will sweep around the globe and take a heavy toll, because people's immune systems haven't ever been exposed to this type of flu before. Past pandemics caused by novel flu viruses jumping from animals or birds into people have killed millions.

"As scientists we're interested in how the virus works," says Jim Paulson, a biologist at The Scripps Research Institute. "We're trying to just understand the virus so that we can be prepared."

That's why he and his colleagues recently tinkered with a piece of the H7N9 flu — a protein that lets the virus latch onto cells. It's thought to be important for determining which species the virus can infect.

"So it's not the whole virus," says Paulson. "It's just a piece — just a fragment — that we can then study for its properties."

What they studied is how different changes affected the virus' ability to bind to receptors found on the surface of human cells.

It turns out that three small mutations made the fragment bind far more strongly to receptors found on human cells than to receptors from bird cells. Scientists know, from studying strains that led to past pandemics, that this kind of switch appears to be involved in enabling a bird flu virus to become transmissible between people.

"All we've done is to look at one of the properties that we're pretty certain is important," says
Paulson, who cautions that additional genetic mutations might be necessary for this virus to become more contagious in humans. "So, just because we've changed the one property doesn't mean that that property alone is sufficient to let the virus transmit."

One way of finding out would be to test the effect of these mutations in the actual H7N9 virus.

And he and a colleague did put in a proposal to the National Institutes of Health to modify the virus to explore what changes could make it transmissible among lab animals.

"And then the moratorium came out and so it wasn't reviewed," says Paulson.

That unusual moratorium, announced by the White House in 2014, halted federally funded research that might make flu viruses more dangerous.

It came after more than two years of debate among scientists about whether these experiments are too risky. Critics argue that the information gained isn't worth the possibility that a lab-created mutant flu might escape the lab, either by accident or because someone intentionally used it as a bioweapon. They argue that scientists shouldn't be in the business of taking deadly viruses and making them even worse.

"These are all legitimate concerns, in my view," says Paulson. Because of those concerns, he now wants to test these genetic changes — not in the H7N9 virus itself, but rather in a weakened strain of flu that can move from ferret to ferret, the lab stand-in for people in flu studies.

And it probably won't be long before he can propose such an experiment to the NIH, because the Department of Health and Human Services is almost finished with drafting a new policy that spells out how officials will review this type of flu experiment in the future.

"As soon as that policy is finalized, the moratorium will be lifted and NIH will move forward in concordance with that new policy. Our expectation is it will be very soon," says Carrie Wolinetz, acting chief of staff and associate director for science policy at the NIH. "We want to make sure that there is an appropriate level of review to seriously consider the balance of that benefit/risk equation in a way that allows us move forward responsibly."

One scientist who's been critical of deliberately creating potential pandemic pathogens is David
Relman, a biologist at Stanford. If a scientist wanted to test the effect of these recently-identified mutations in a weakened lab strain of flu, he says, "I would be much more accepting of that kind of experiment."

But if researchers wanted to make these genetic changes in the actual H7N9 virus, he says, "I would be very hesitant, were they to want to do that. In fact, I would be reluctant to have them do that."

Relman notes that a policy guidance released in the last days of the Obama administration says work that could create a highly virulent, highly transmissible virus requires special scrutiny.

"Now, the part I don't agree with," he says, "is they don't come right out and say, 'Let's not do that."

Other researchers, like Ron Fouchier of Erasmus Medical Center in the Netherlands, who receives NIH funding, have publicly argued for the need to modify H7N9 in the lab to see exactly what this virus might be capable of. They believe such research is essential to truly understand the threat.

"The rest of the world is moving forward with this type of experiment already," says Fouchier, whose genetic experiments with a different bird flu virus sparked a public outcry in 2011.

"And so the U. S. can either join or not join. It's up to them, but the work will continue," he says.

"I'm pretty sure that the U. S. government will start funding this research again," Fouchier says, "because this is clearly important work. In the flu field, this is one of the most important questions to be addressed: How do we identify, among thousands of viruses that cause outbreaks, those viruses that are going to cause the next pandemic?"

He's hoping to learn more about how officials will handle all this when a network of federally funded flu researchers meets next month in Atlanta.

AUDIE CORNISH, HOST:

Public health officials are increasingly worried about a strain of bird flu virus that's circulating in China. In the last nine months it's sickened more than 700 people, and about 40 percent of them died. Now a team of researchers from the U.S. and the Netherlands has new information on what might cause this virus to start spreading more widely. NPR's Nell Greenfieldboyce reports.

NELL GREENFIELDBOYCE, BYLINE: Right now people seem to get the H7N9 bird flu virus from, well, birds. It isn't capable of spreading from person to person to person to person. But what if that changed?

JAMES PAULSON: We're trying to just understand the virus so that we can be prepared.

GREENFIELDBOYCE: Jim Paulson is a biologist at the Scripps Research Institute. He and some colleagues recently tinkered with a piece of this bird flu, a protein that lets the virus latch on to cells.

PAULSON: So it's not the whole virus. It's just a fragment that we can then study for its properties.

GREENFIELDBOYCE: They found that it only takes three little changes to make this protein capable of hooking on to human cells. That could help the virus start spreading between people, although Paulson cautions that other changes might be necessary.

PAULSON: There may be several other genes that are important for transmission that we don't know about.

GREENFIELDBOYCE: Now, one way of finding out would be to make those three changes in the actual virus in a highly secure lab and see what happens. Does it become contagious in lab animals? Well, scientists like Paulson can't do that experiment because in 2014 the Obama administration stopped all federally funded work that might make flu viruses more dangerous.

That's because critics argued that scientists shouldn't be in the business of deliberately making deadly flu viruses even worse. What if a lab-made virus escaped or got stolen for use as a bioweapon?

PAULSON: I admit that - you know, that some people have real reservations about it. I mean, these are all legitimate concerns, in my view.

GREENFIELDBOYCE: That's why Paulson wants to test these mutations not in the deadly H7N9 bird flu virus itself but rather in a weakened flu virus. And that may soon be possible.

Government officials are drafting a new system for how they'll review flu experiments to decide what can go forward. Carrie Wolinetz is associate director for science policy at the National Institutes of Health, which funds flu research. She says once that policy is finished the moratorium will be lifted.

CARRIE WOLINETZ: Our expectation is it will be very soon.

GREENFIELDBOYCE: It's not clear what exactly will be permitted under the new policy. And after years of debate, it seems like scientists still have reached no consensus on how to balance the risks and the benefits. David Relman is a biologist at Stanford University. He'd be OK with putting these mutations in a weakened virus, but putting them in the H7N9 virus...

DAVID RELMAN: I would be very hesitant to see them do that experiment and try it out.

GREENFIELDBOYCE: Other scientists say we have to experiment with H7N9. Ron Fouchier is a virologist at Erasmus Medical Center in the Netherlands who studies flu with U.S. funding. He says at the end of the day you need to alter the real flu virus you're worried about to know what it's really capable of. He thinks U.S. officials will agree. But even if they don't...

RON FOUCHIER: The rest of the world is moving forward with this type of experiment already. And so the U.S. can either join or not join. It's up to them. But the work will continue.

GREENFIELDBOYCE: He hopes that officials will reveal more about their plans when federally funded flu researchers meet next month in Atlanta. Nell Greenfieldboyce, NPR News.

(SOUNDBITE OF COLD CAVE SONG, "LOVE COMES CLOSE") Transcript provided by NPR, Copyright NPR.



 Changes to bird flu virus could make human transmission more likely, scientists say [STAT, 15 June 2017]

By HELEN BRANSWELL

GettyImages-477718693-2048x1152.jpg
MARK RALSTON/AFP/GETTY IMAGES

The H7N9 bird flu virus has influenza scientists on edge, due to an unexpected surge of human infections — hundreds of cases — caused by the virus this spring.

Some new scientific findings aren’t likely to ratchet down those concerns.

Scientists at the Scripps Institute in La Jolla, Calif., reported Thursday that the accumulation of several mutations in the main gene on the virus’s surface may be able to give H7N9 the ability to spread like human flu viruses do, passing from person to person through coughing and sneezing. The study, funded by the National Institutes of Health, was published in the journal PLOS Pathogens.

Currently H7N9 is a poultry virus, infecting chickens and some other birds in China. Nearly 1,500 people are known to have contracted the virus from contact with chickens since the virus first emerged in 2013, but to date H7N9 hasn’t spread easily among humans.

Other scientists lauded the work, but everyone, including the scientists behind the new research, cautioned that just because something can be done in a laboratory doesn’t mean it will come to pass in nature.

“We take these kinds of things seriously. But historically we know that it is never as simple as that,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

“So we’ve got to be careful that we separate the elegance of the science and the likelihood or not … and [what] the ultimate effect of something like this would be. Because it is a very complicated issue. And just to reduce it to one mutation or two mutations and then all of a sudden you’re in the middle of a pandemic is a bit of an overreach.”

Fauci wasn’t suggesting the Scripps team made that claim; it didn’t.

Rather, the team found that two different combinations of mutations — each made up of three changes — could in theory profoundly alter the H7N9 virus.

Flu viruses attach to receptors found on the cells of their intended victims. Bird flu viruses attach to one type of receptor. The cells found in the human upper respiratory tract — where a flu infection takes hold — are mostly lined with a different type of receptor, which explains why these viruses don’t easily infect people.

The Scripps team, however, found that by tweaking the genetic code of H7N9’s hemagglutinin gene, they could change the receptors the virus latched on to, from the bird type to the human version.

The proteins made by the two modified hemagglutinin genes attached as well to human receptors as the human virus H1N1, which caused the 2009 flu pandemic, noted Ron Fouchier, a leading influenza virologist from Erasmus Medical Center in Rotterdam, the Netherlands.

Fouchier, who has done work trying to see how H5N1 bird flu viruses could adapt to infect people, was not involved in this study.

The Scripps researchers figured out how to tweak the gene by applying what is known about flu viruses that have successfully been transmitted among people over the last half-century, as well as by studying the crystal structure of the virus. In essence, it was like custom designing a key to fit a lock.

They tried a number of combinations. Two in particular bound very well to the receptors found in human airways.

“Two combinations looked really very good. … Or really bad,” said Jim Paulson, senior author of the paper and co-chairman of Scripps’s department of molecular biology.

His team did the work, though, using only one gene of the eight-gene virus, testing the protein it generates on specially prepared glass slides.

They and others would like to see what would happen if they made these changes to a whole H7N9 virus and then tested it in ferrets, animals which serve as a proxy for people in flu research. Bird flu viruses don’t spread easily from ferret to ferret; if a modified H7N9 virus did, that would suggest it might do the same in people.

But there has been a moratorium in the United States — and among scientists elsewhere funded by U.S. government money — against doing this type of research, known as “gain of function” work or “dual use research of concern.” The latter term relates to research that might be used by malevolent actors to produce a pathogen that could be unleashed as a weapon of bioterrorism.

The moratorium resulted from alarm that arose when Fouchier and a separate team of researchers at the University of Wisconsin, Madison, tried in 2012 to publish studies that showed mutations that would be needed to the H5N1 hemagglutinin that could render transmissible among people. Those papers were eventually published but the debate over such work was and remains heated.

Fouchier said testing H7N9 viruses including the mutations identified by the Scripps team is at the top of the list of studies he plans to undertake if he can get approval for the work.

“These are the absolute critical viruses to do this with. These are a continuous threat,” he told STAT.

A new U.S. government policy for this type of work — renamed “pathogens of pandemic potential care and oversight” — is in the works. But the funding pause for such research on influenza and a couple of other types of viruses remains in effect, Ryan Bayha, of the National Institute of Health’s Office of Science Policy, said in an email.

Policy guidance from the White House Office of Science and Technology Policy issued in early
January requires the department to conduct independent reviews of grant applications in which this kind of research is proposed. Bayha said the department is still setting up that review process; he could not say when the work is expected to be finished.

For now, researchers who want to test these two combinations of mutations must wait. And that means no one can say for sure if these mutations — if they were to evolve in the real world — would turn H7N9 into a virus that targets people.

“People believe that it’s important and have actually shown in some cases that it is important,” Paulson said. “But until we actually test it, we’re really not sure.”



 Scientists create mutant bird flu to prepare for possibility of deadly global pandemic [The Independent, 15 June 2017]

by Katie Forste

'We need to know what the virus could do in nature, so we can be alert and aware if we start seeing these changes,' says professor

A worker places a chicken in a bin during a cull in Hong Kong in 2014 after the deadly H7N9 virus was discovered in poultry imported from China AFP

Deadly strains of bird flu have so far largely been caught by people who work closely with poultry – but scientists fear the virus could mutate and cause the world’s next devastating pandemic if it begins to spread from human to human.

In a bid to stay one step ahead of the disease and prepare for a potentially disastrous outbreak before it happens, researchers have created their own mutations in a lab that could allow the virus to infiltrate human lungs.

Professor James Paulson of The Scripps Research Institute in California and his team conducted their experiments on a key protein that peppers the surface of the virus and binds to the cells it infects.

The scientists did not alter the virus itself due to the extreme danger posed by such infectious agents, which if unleashed could potentially cause a man-made global pandemic.

"We need to know what the virus could do in nature, so we can be alert and aware if we start seeing these changes," Professor Paulson told The Independent.

"The virus is infecting humans, but it hasn't yet transmitted from human to human."

The study, published in the journal Public Library of Science Pathogens, described how subtle alterations to the protein's genetic programming produced strains that switched their target from bird to human cells.

The mutant proteins latched onto cells taken from human trachea tissue – suggesting they could infiltrate human airways.

Ducks culled at a farm near Nafferton, East Yorkshire where a strain of bird flu was confirmed in 2014 (Getty)

“H7N9 avian influenza virus is widespread in chickens in China and infects human exposed to live poultry but does not yet transmit from person to person,” said Professor Wendy Barclay,

Chair in Influenza virology at Imperial College London, who was not involved in the research.

”So the question now is, could the virus recapitulate this switch in nature?“

Professor Barclay said the study could help create a vaccine to prevent a deadly outbreak on the scale of historical pandemics such as the Black Death, which killed more than 75 million people in the 14th century.



 Few Genetic Tweaks To Chinese Bird Flu Virus Could Fuel A Human Pandemic [NPR, 15 June 2017]

by NELL GREENFIELDBOYCE

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A sometimes lethal strain of H7N9 bird flu that has infected about 1,500 people in China doesn't spread easily among humans — yet. But research published Thursday suggests just a few genetic mutations might be enough to make it quite contagious.
Pasieka/Science Source

A study published Thursday shows how a bird flu virus that's sickening and killing people in China could mutate to potentially become more contagious.

Just three changes could be enough to do the trick, scientists report in the journal PLOS Pathogens.

And the news comes just as federal officials are getting ready to lift a moratorium on controversial lab experiments that would deliberately create flu viruses with mutations like these.

Public health officials have been worried about this bird flu virus, called H7N9, because it's known to have infected more than 1,500 people — and killed 40 percent of them. So far, unlike other strains that more commonly infect humans, this deadly virus does not spread easily between people.

The fear is that if it mutates in a way that lets it spread more easily, the virus will sweep around the globe and take a heavy toll, because people's immune systems haven't ever been exposed to this type of flu before. Past pandemics caused by novel flu viruses jumping from animals or birds into people have killed millions.

"As scientists we're interested in how the virus works," says Jim Paulson, a biologist at The Scripps Research Institute. "We're trying to just understand the virus so that we can be prepared."

That's why he and his colleagues recently tinkered with a piece of the H7N9 flu — a protein that lets the virus latch onto cells. It's thought to be important for determining which species the virus can infect.

"So it's not the whole virus," says Paulson. "It's just a piece — just a fragment — that we can then study for its properties."

What they studied is how different changes affected the virus' ability to bind to receptors found on the surface of human cells.

It turns out that three small mutations made the fragment bind far more strongly to receptors found on human cells than to receptors from bird cells. Scientists know, from studying strains that led to past pandemics, that this kind of switch appears to be involved in enabling a bird flu virus to become transmissible between people.

"All we've done is to look at one of the properties that we're pretty certain is important," says Paulson, who cautions that additional genetic mutations might be necessary for this virus to become more contagious in humans. "So, just because we've changed the one property doesn't mean that that property alone is sufficient to let the virus transmit."

One way of finding out would be to test the effect of these mutations in the actual H7N9 virus.

And he and a colleague did put in a proposal to the National Institutes of Health to modify the virus to explore what changes could make it transmissible among lab animals.

"And then the moratorium came out and so it wasn't reviewed," says Paulson.

That unusual moratorium, announced by the White House in 2014, halted federally funded research that might make flu viruses more dangerous.

It came after more than two years of debate among scientists about whether these experiments are too risky. Critics argue that the information gained isn't worth the possibility that a lab-created mutant flu might escape the lab, either by accident or because someone intentionally used it as a bioweapon. They argue that scientists shouldn't be in the business of taking deadly viruses and making them even worse.

"These are all legitimate concerns, in my view," says Paulson. Because of those concerns, he now wants to test these genetic changes — not in the H7N9 virus itself, but rather in a weakened strain of flu that can move from ferret to ferret, the lab stand-in for people in flu studies.

And it probably won't be long before he can propose such an experiment to the NIH, because the Department of Health and Human Services is almost finished with drafting a new policy that spells out how officials will review this type of flu experiment in the future.

"As soon as that policy is finalized, the moratorium will be lifted and NIH will move forward in concordance with that new policy. Our expectation is it will be very soon," says Carrie Wolinetz, acting chief of staff and associate director for science policy at the NIH. "We want to make sure that there is an appropriate level of review to seriously consider the balance of that benefit/risk equation in a way that allows us move forward responsibly."

One scientist who's been critical of deliberately creating potential pandemic pathogens is David Relman, a biologist at Stanford. If a scientist wanted to test the effect of these recently-identified mutations in a weakened lab strain of flu, he says, "I would be much more accepting of that kind of experiment."

But if researchers wanted to make these genetic changes in the actual H7N9 virus, he says, "I would be very hesitant, were they to want to do that. In fact, I would be reluctant to have them do that."

Relman notes that a policy guidance released in the last days of the Obama administration says work that could create a highly virulent, highly transmissible virus requires special scrutiny.

"Now, the part I don't agree with," he says, "is they don't come right out and say, 'Let's not do that."

Other researchers, like Ron Fouchier of Erasmus Medical Center in the Netherlands, who receives NIH funding, have publicly argued for the need to modify H7N9 in the lab to see exactly what this virus might be capable of. They believe such research is essential to truly understand the threat.

"The rest of the world is moving forward with this type of experiment already," says Fouchier, whose genetic experiments with a different bird flu virus sparked a public outcry in 2011.

"And so the U. S. can either join or not join. It's up to them, but the work will continue," he says.

"I'm pretty sure that the U. S. government will start funding this research again," Fouchier says, "because this is clearly important work. In the flu field, this is one of the most important questions to be addressed: How do we identify, among thousands of viruses that cause outbreaks, those viruses that are going to cause the next pandemic?"

He's hoping to learn more about how officials will handle all this when a network of federally funded flu researchers meets next month in Atlanta.



 Bird flu could spread more easily among humans through 3 mutations: researchers [CBC.ca, 15 June 2017]

'The chances of all 3 occurring together is relatively low,' one expert says

Scientists have identified three mutations that, if they occurred at the same time in nature, could turn a strain of bird flu now circulating in China into a potential pandemic virus that could spread among people.

The flu strain, known as H7N9, now mostly infects birds. But it has infected at least 779 people in outbreaks in and around China, mainly related to poultry markets.

The World Health Organization said earlier this year that all bird flu viruses need constant monitoring, warning that their constantly changing nature makes them "a persistent and significant threat to public health."

At the moment, the H7N9 virus does not have the capability to spread sustainably from person to person. But scientists are worried it could at any time mutate into a form that does.

To assess this risk, researchers led by James Paulson of the Scripps Research Institute in California looked at mutations that could potentially take place in the H7N9 virus's genome.

They focused on the H7 hemagglutanin, a protein on the flu virus surface that allows it to latch onto host cells.

The team's findings, published in the journal PLoS Pathogens on Thursday, showed that in laboratory tests, mutations in three amino acids made the virus more able to bind to human cells — suggesting these changes are key to making the virus more dangerous to people.

No cause for immediate alarm

Scientists not directly involved in this study said its findings were important, but should not cause immediate alarm.

"This study will help us to monitor the risk posed by bird flu in a more informed way, and increasing our knowledge of which changes in bird flu viruses could be potentially dangerous will be very useful in surveillance," said Fiona Culley, an expert in respiratory immunology at Imperial College London.

She noted that while "some of the individual mutations have been seen naturally … these combinations of mutations have not," and added: "The chances of all three occurring together is relatively low."

Wendy Barclay, a virologist and flu specialist also at Imperial, said the study's findings were important in showing why H7N9 bird flu should be kept under intense surveillance.

"These studies keep H7N9 virus high on the list of viruses we should be concerned about," she said. "The more people infected, the higher the chance that the lethal combination of mutations could occur."

China reported 37 human deaths from H7N9 in May, up from 24 in April.



 Study identifies H7N9 mutations that could ease spread among humans [CIDRAP, 15 June 2017]

Researchers looking for mutations that might make H7N9 avian influenza more easily transmissible among people identified three amino acid changes that would make the virus more likely to bind to human airway receptors. A team of researchers from the United States, including those from The Scripps Research Institute, and the Netherlands reported its findings today in PLoS Pathogens.

The scientists focused on mutations that could occur in the H7 hemagglutinin (HA) protein, which allows the virus to latch onto host cells. They didn't test the mutations in H7N9 viruses, because of gain-of-function rules and concerns. Rather, they used molecular modeling and knowledge of the HA structure to flag mutations that have the capacity to make the virus more specific to human, rather than avian, airway receptors. Then they produced an HA with different combinations of the mutations in an experimental cell line (not H7N9) and tested how strongly they bound to human and avian receptors.

The team found that mutations in three amino acids bound more strongly to human receptors, signaling a specificity switch from bird to human types. In another experiment, they found that the H7 mutants also attached to cells from human tracheal tissue.

The researchers concluded that understanding the mutations that might allow the virus to spread more easily in humans is a useful tool for surveillance in poultry and humans, as their identification may serve as an early warning.

"Three mutations switch H7N9 influenza to human-type receptor specificity"
Three mutations  



 DRC, Belgium, Nigeria report more avian flu outbreaks [CIDRAP, 15 June 2017]

The Democratic Republic of Congo (DRC) yesterday reported 11 more highly pathogenic H5N8 avian flu outbreaks, all in village ducks and chickens in Ituri province, according to a report to the World Organization for Animal Health (OIE).

The location of the latest outbreaks is the same area in the DRC's northeastern corner where H5N8 was initially reported in late May, which signaled the DRC's first outbreaks involving the subtype. Over the past few months H5N8 has turned up in a handful of African nations.

The new events had start dates ranging from May 17 to Jun 3. The virus killed 6,927 of 17,272 susceptible birds, and the survivors were slated for culling.

In other H5N8 developments, Belgium reported three more outbreaks in wild birds, officials said today in an OIE notification. The events began from Jun 13 to Jun 15, affecting locations in Luxembourg, Hainaut, and West Flanders provinces. The virus killed 45 of 101 susceptible birds, and the rest were destroyed as part of the response measures.

The outbreaks follow a Jun 2 report of an outbreak involving a family of birds that includes pheasants and quail.

Elsewhere, Nigeria reported one new H5N1 outbreak in backyard poultry, according to a report today from the OIE. The event began on May 15 in Adamawa state in the east, killing 50 of 200 layers.



 China reports more high-path H7N9 outbreaks in poultry [CIDRAP, 14 June 2017]

by Lisa Schnirring

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In the latest avian flu developments, China reports more highly pathogenic H7N9 outbreaks in three provinces, and South Korea continues to battle a flare-up of H5N8 activity, according to the latest notifications from the World Organization for Animal Health (OIE).

H7N9 outbreaks continue in China

Chinese health officials detailed four outbreaks in two OIE reports. Two occurred in different locations in Inner Mongolia province in the north, one at a large layer farm that began on May 21, killing 35,526 of 406,756 susceptible poultry. The remaining birds were culled to curb the spread of the virus.

The other outbreak began Jun 5 at a poultry farm in Inner Mongolia's Jiuyuan district, which led to the loss of 55,023 birds, including 2,056 that died from the disease.

Officials also reported outbreaks that began in March in two provinces in southern China, including a positive sample from a poultry farm in Guangxi province and a positive sample from a livestock market in Fujian province. The OIE report didn't include details about the number of susceptible birds or populations culled.

Officials detected the highly pathogenic form of H7N9 for the first time in poultry in February, in birds in Guangdong province's live-poultry markets. Since then, the virus has sparked outbreaks at poultry farms in several provinces, including some in northern China.

In a related development, China recently announced that it will begin testing the first vaccine against H7N9 in early July, China Daily reported today. The vaccine, developed by the Chinese Academy of Agricultural Sciences Harbin Veterinary Research Institute, will be given to chickens, ducks, and geese in Guangdong and Guangxi provinces.

According to the report, the locations were selected because they are major poultry trade centers and have battled both highly pathogenic and low-pathogenic H7N9 viruses.

H5N8 in South Korea, Zimbabwe, Luxembourg

Meanwhile, several more highly pathogenic H5N8 outbreaks were reported by South Korea, with a few more cropping up in Luxembourg and Zimbabwe.

In South Korea, officials reported 16 more outbreaks that began from Jun 3 to Jun 7, all but two involving backyard birds. Affected areas included seven towns in North Jeolla province, four on Jeju island, three in the Ulsan metropolitan area, and one each in South Gyeongsang province and the city of Busan.

Of 2,776 birds at the multiple locations, the virus killed 59, and authorities destroyed the remaining birds as part of the response to the outbreaks.

Details on the other countries reporting more H5N8 detections:

・Luxembourg reported four more outbreaks involving poultry farms in four different cantons, Capellen, Diekirch, Luxembourg, and Mersch, with start dates ranging from May 30 to Jun 2, according to a Jun 9 report to the OIE. The virus killed 76 birds and led to the culling of 787 more.

・Zimbabwe's veterinary ministry said H5N8 spread to two more self-contained units housing 91,000 birds on a broiler farm where the virus was reported for the first time earlier this month, according to a Jun 11 OIE report. The event has now affected three of the facility's eight sites, and officials suspect the virus spread though shared equipment and vehicles. All birds at the two additional sites have been destroyed.

Libya confirms more low-path H7

Elsewhere, Libya reported another low-pathogenic H7 outbreak, this time at a farm in Marj district in the country's northeast, according to an OIE report today.

The farm housed 220 birds, including ducks, geese, pigeons, and egg-laying chickens. The virus was detected during general surveillance. The birds were culled and authorities disinfected the farm.

The H7 detection is the second such event in Libya since the middle of May, when authorities reported a similar finding at a farm in Gharyan district in the northwest.



 Avian flu has been confirmed in chickens in south Norfolk [Smallholder, 11 Jun 2017]

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Free range chickens

The UK’s deputy chief veterinary officer has confirmed H5N8 avian flu in a small flock of chickens and geese at a premises near Diss, South Norfolk.

A three kilometre protection zone and a ten kilometre surveillance zone have been put in place around the infected premises to limit the risk of the disease spreading.

The flock is estimated to contain approximately 35 birds.

A number have died and the remaining live birds at the premises are being humanely culled.

A full investigation is under way to determine the source of the infection.

Public Health England advises that the risk to public health from the virus is very low and the Food Standards Agency is clear that bird flu does not pose a food safety risk for UK consumers.

Keepers are urged to continue to be vigilant and look out for the signs of avian flu in their flocks, informing the Animal and Plant Health Agency should they suspect infection.

Read the latest advice and information on avian flu in the UK, including actions to reduce the risk of the disease spreading, advice for anyone who keeps poultry or captive birds and details of previous cases.



 H7N9 avian influenza: 12 more cases reported in China [Outbreak News Today, 10 Jun 2017]

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Influenza A (H7N9) virus/CDC

The Chinese National Health and Family Planning Commission announced an additional 12 human cases of avian influenza A(H7N9) from June 2 to 8.

The eight male and four female patients, aged from 4 to 68, had onset from May 20 to June 3.

Three of them are from Beijing, two each from Anhui, Chongqing and Henan, and one each from Jiangsu, Shaanxi and Shandong.

Two cases reported in Beijing were likely infected in Hebei and Shanxi while the case reported in Shaanxi was likely infected in Inner Mongolia Autonomous Region. Among them, nine were known to have exposure to poultry, poultry markets or mobile stalls.

Travelers to affected areas of China must avoid visiting wet markets, live poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchase of live or freshly slaughtered poultry, and avoid touching poultry/birds or their droppings. They should strictly observe personal and hand hygiene when visiting any place with live poultry.



 Avian Flu Threat Re-emerges [Agri News, 8 Jun 2017]

by Ashley Langreck

Flock-keepers urged to step up biosecurity

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INDIANAPOLIS — After the Indiana poultry industry experienced outbreaks of highly pathogenic avian influenza in 2015 and 2016, the Indiana State Board of Animal Health is encouraging producers to watch their flocks closely for symptoms of the illness, as well take precautions to stop another outbreak.

Kyle Shipman, a veterinarian with the BOAH who specializes in avian health and field operations, said that since the outbreak, the industry has continued to be on a heightened alert for any symptoms in poultry that are consistent with avian influenza, especially highly pathogenic avian influenza.

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Shipman

“A telltale sign of highly pathogenic avian influenza in domestic poultry is seen through an increase in mortality. Producers will see large amounts of their birds die for no reason,” Shipman said.

One way for producers to help the industry stay ahead of the disease in Indiana is to report any unusual symptoms their birds have to the Healthy Bird hotline, which can be accessed at healthybirds.aphis.usda.gov.

Shipman said poultry experts will look at the information submitted and call the producers if any of the symptoms are consistent or even suspicious of high or low pathogenic avian influenza.

Looming Threat

“High pathogenic avian influenza is found in chickens, turkeys or anything domestic, and it causes death. Low-path avian influenza presents in a form that does not kill, but it lingers,” Shipman said, adding that the influenza could cause respiratory issues or a bird with avian flu could appear healthy and not present symptoms of the disease, but still be spreading it from bird to bird.

The most common way that low-path avian flu is transmitted, he warned, is by wild waterfowl.

“Cross contamination of fecal matter from wild waterfowl into an environment with domestic poultry can cause low-path flu to spread,” he said.

Shipman urges poultry producers to make sure that they, as well as their flocks, maintain minimum contact with wild waterfowl.

“Producers may need to put up a fence so their birds can’t come in contact with some of the same sources and areas where waterfowl commingle,” Shipman said, adding that another good preventative measure would be for producers to dedicate one particular pair of shoes that they only wear when they are working with their flocks.

He also advised that if a producer visits another poultry farm, they should try to avoid contact with their birds for up to 72 hours to help decrease the potential for the spread of avian influenza.



 Human infection with avian influenza A(H7N9) virus – China World Health Organization, 8 Jun 2017]

On 19 May 2017, the National Health and Family Planning Commission of China (NHFPC) notified WHO of 17 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus in China. On 26 May 2017, the NHFPC notified WHO of nine additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus in China.

Details of the case patients

On 19 May 2017, the NHFPC reported a total of 17 human cases of infection with avian influenza A(H7N9) virus. Onset dates of the cases ranged from 29 April to 13 May 2017. Of these 17 case patients, six were female. The median age was 56 years (range 30 to 84 years). The case patients were reported from Anhui (1), Beijing (1), Chongqing (1), Hebei (6), Hunan (1), Jiangsu (1), Shaanxi (1), Shanxi (1), Shandong (2), Sichuan (1), Zhejiang (1). This is the first case reported in Shanxi. At the time of notification, there were two deaths, 15 case patients were diagnosed as having either pneumonia (6) or severe pneumonia (9). Sixteen case patients were reported to have had exposure to poultry or live poultry market, and one had no known poultry exposure. No case clustering was reported.

On 26 May 2017, the NHFPC reported nine human cases of infection with avian influenza A(H7N9) virus. Onset dates ranged from 7 to 24 May 2017. All nine case patients were male. The median age was 63 years (range 36 to 74 years). The case patients were reported from Beijing (1), Hebei (1), Jiangsu (1), Shanxi (1), Shandong (1), Sichuan (3), Zhejiang (1). At the time of notification, there were no deaths, nine cases were diagnosed as having either pneumonia (2) or severe pneumonia (7). Eight cases were reported to have had exposure to poultry or live poultry market, and one had no known poultry exposure. No case clustering was reported.

Public health response

The Chinese governments at national and local levels are taking further measures which include:

・Continuing to guide the provinces to strengthen assessment, and prevention and control measures.

・Continuing to strengthen control measures focusing on hygienic management of live poultry markets and cross-regional transportation.

・Conducting detailed source investigations to inform effective prevention and control measures.

・Continuing to detect and treat human infections with avian influenza A(H7N9) early to reduce mortality.

・Continuing to carry out risk communication and issue information notices to provide the public with guidance on self-protection.

・Strengthening virology surveillance to better understand levels of virus contamination in the environment as well as mutations, in order to provide further guidance for prevention and control.

WHO risk assessment

The number of human infections with avian influenza A(H7N9) and the geographical distribution in the fifth epidemic wave (i.e. onset since 1 October 2016) is greater than earlier waves. This suggests that the virus is spreading, and emphasizes that further intensive surveillance and control measures in both human and animal health sector are crucial.

Most human cases are exposed to avian influenza A(H7N9) virus through contact with infected
poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, and live poultry vending continues, further human cases can be expected. Although small clusters of cases of human infection with avian influenza A(H7N9) virus have been reported including those involving patients in the same ward, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore the likelihood of further community level spread is considered low.

Close analysis of the epidemiological situation and further characterization of the most recent viruses are critical to assess associated risk and to adjust risk management measures in a timely manner.

WHO advice

WHO advises that travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live poultry markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling in or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and influenza-like illness (ILI) and to carefully review any unusual patterns, ensure reporting of human infections under the IHR 2005, and continue national health preparedness actions.



 Bird flu: FG asks farms to step up bio-security nationwide [Daily Trust, 8 Jun 2017]

By Vincent A. Yusuf & Mulikatu Mukaila



The Federal Government has said there is no any current case of bird flu in the Federal Capital Territory (FCT) as widely reported in the media, but asked farms nationwide to step up bio-security.

Dr Gideon Mshelbwala, the Director of Veterinary and Pest Control Services, Federal Ministry of Agriculture and Rural Development, told Daily Trust on Tuesday in a telephone interview on the update of the disease.

“What we said last week was not that there is current outbreak in the FCT. There is no current outbreak. What we said is that, so far in 2017, those are the states that have experienced outbreak from January till now. But from 2014 to 2016 we have about 26 states. But from January this year till date, only seven states have reported cases and they have their own different dates. The last state that reported to us is Kaduna, on May 30. But there is no any current case in the FCT.”

Dr. Mshelbwala listed the states affected by the outbreak of the disease from January to May 2017 to include Bauchi, Kano, Katsina, Nasarawa, Plateau, FCT and Kaduna,

He said that the disease had spread across 26 states of the federation and the FCT since it started in 2008, affecting 800 farms in no fewer than 123 local government areas.

Last week, the chief veterinarian, while speaking on the bird flu situation from 2014 to date, said that there were no scientifically proven vaccines for bird flu yet but stressed that the Federal Government was adopting “quarantine, movement control, de-contamination and bio-security measures to curb the spread.”

He lamented that some poultry farmers had very poor bio-security practice which made it difficult to stamp out the spread of the disease.

“Our national action plan encourages proper regulation of the poultry industry and enforcement of annual registration of all actors along the poultry value chain, including farmers, traders, egg merchants and feed millers.

“It also encourages the creation of veterinary extension services to facilitate the control and proper inspection of poultry and poultry products,” he said.

The Acting Secretary of the FCT Agricultural and Rural Development (ARDS) Secretariat, Dr. Musa Aliyu, has debunked the rumour that there was an outbreak of bird flu disease in the FCT.
He stated this yesterday while briefing newsmen in Abuja.

Aliyu said, “There is no such epidemic in Abuja but if anyone observes any unusual sign, please let us know immediately, because we have our men in the field to take charge.”



 SA suspends Zimbabwe chicken imports after bird flu outbreak [The Star, 8 Jun 2017]

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"The H5N8 strain has been detected in several countries in Europe, Africa and Asia over the past two years." /REUTERS

South Africa has suspended imports of birds and chicken products from neighbouring Zimbabwe after it reported an outbreak of highly pathogenic H5N8 bird flu at a poultry farm, the agriculture department said on Thursday.

The H5N8 strain has been detected in several countries in Europe, Africa and Asia over the past two years, its spread aided by wild bird migrations. Highly pathogenic among fowl, the risk of human infection is low, according to the World Health Organisation,

"We have heightened inspections of all consignments, including all private and public vehicles at all our ports of entry, especially in and out of Zimbabwe," South Africa's department of agriculture said in a statement.

It said veterinary authorities in the rural province of Limpopo that borders Zimbabwe "are on high alert and have increased their surveillance especially in backyard chickens."

Botswana's ministry of agriculture and food security also said in a statement that it was suspending the import of domesticated and wild birds and their products from Zimbabwe, while local media reported Mozambique had imposed a similar ban.

The virus was detected on a farm with 2 million birds in Lanark, Zimbabwe, and killed 7,845 animals, the World Organisation for Animal Health (OIE) said last week.



 Bird Flu in China Infecting Younger Victims, Research Shows [Sixth Tone, 8 Jun 2017]

by David Paulk

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Lancet paper indicates H7N9 virus is becoming more pathogenic in poultry and more widespread in humans.

As China faces its largest bird flu epidemic on record, a group of predominantly Chinese researchers last week published a paper in British medical journal The Lancet in which they concluded that H7N9 is spreading from urban to rural areas and increasingly affecting younger victims, suggesting potentially worrying changes in the virus’s epidemiology.

Avian influenza viruses can be carried by poultry and wild aquatic birds and transmitted to humans, often through contact with infected chickens or ducks. Cases of human-to-human transmission are rare. Infections can cause conjunctivitis, flu-like symptoms, pneumonia, and — in about 40 percent of cases — death. According to the World Health Organization, 1,486 laboratory-confirmed cases have been reported in China since early 2013, and this winter the country saw a record number of infections. The authors of the Lancet article believe H7N9, which is found almost exclusively in China, has undergone genetic mutations that change the way it affects humans.

Initially, H7N9 disproportionately affected the elderly and their less robust immune systems, as well as city-dwellers who frequented poultry markets, where birds that carried the virus were still sold because they did not show symptoms of infection. The duration of epidemic waves, which roughly overlap with each winter, was shorter, and the risk of death lower.

In recent years, however, more middle-aged adults (57 percent in the 2016-2017 wave compared with 41 percent in 2013) and more people in rural or semi-urban areas (over 60 percent since 2015-2016 compared with 39 percent in 2013) are becoming infected.

“A large epidemic in 2016-17 prompted concerns that the epidemiology of the virus might have changed, increasing the threat of a pandemic,” wrote the authors of the paper. One of these changes, according to Lisa Schnirring of the Center for Infectious Disease Research and Policy at the University of Minnesota, is a mutation that confers resistance to neuraminidase inhibitors, a common anti-viral flu treatment, and which may explain the highly pathogenic strain found today.

The research team compiled their data from an electronic database managed by the China Center for Disease Control and Prevention. They found that there were 447 laboratory-confirmed cases of H7N9 between Oct. 1, 2016 — the date marking the beginning of the fifth wave — and Feb. 23 of this year. While the fifth wave is still ongoing, this figure already exceeds the 306 infections detected during the 2013-2014 epidemic, the second-highest on record.

Chinese law requires that every case of bird flu be reported to the China CDC within 24 hours.

In May, China’s National Health and Family Planning Commission, the agency that oversees health services for residents of and visitors to the mainland, reported an additional 23 cases of H7N9 to the WHO. Occurring over almost four weeks from April to May, the cases spanned 11 provinces, autonomous regions, and municipalities. Seven resulted in death and 15 in pneumonia of varying degrees of severity. Only one case was deemed mild.

Ben Cowling, a professor at Hong Kong University’s School of Public Health and one of the co-authors of the Lancet study, told Sixth Tone that because some cases of bird flu in humans are mild or untested, the number of confirmed infections is somewhat misleading. “There could be many more unreported infections by at least one order of magnitude,” he said. By this logic, the actual number of fifth-wave infections is likely closer to 4,470 than 447.

To Cowling, the most plausible explanation for the rise in confirmed infections this season has to do with the weather. H7N9 prefers colder temperatures, and with the Chinese winter beginning early in 2016, the virus has been able to “spread more widely, earlier, and reach a higher prevalence in poultry,” with the higher risk to humans being a secondary effect.

When cases of bird flu are detected in China, it is not uncommon for local authorities to close down poultry markets, where many victims become exposed to the virus. But this may actually be part of the problem, as research has shown that vendors denied the chance to sell their blighted birds in one place may simply move on to another where oversight is less strict, potentially spreading the virus further.

Virulence of H7N9 in humans has remained relatively stable in recent years, but in birds, it seems to have increased — a trend experts like Cowling say may actually be a boon. “This [newly emerging strain] has been easier to control because outbreaks of the virus are obvious to poultry farmers and traders,” he said, referring to the now-observable symptoms in some infected birds. “If all circulating H7N9 viruses became highly pathogenic, they would be much easier for health authorities to deal with.”

Until recently, infected chickens and ducks exhibited few if any symptoms of the virus, allowing it to spread stealthily through poultry populations. In fact, infections were rarely detected until farmers performed random checks on their stock of birds. Even when farmers became aware of the virus, there was little to stop them from selling the infected but asymptomatic animals.

Richard Webby and Yang Zifeng, authors of a Lancet editorial published alongside the research team’s paper, wrote that while there is still no evidence of sustained human-to-human transmission of H7N9, signs of the virus’s propagation in China are mounting. “If one considers human beings the canaries in the coal mine,” they wrote, “these findings imply that the virus is more widespread in poultry.”

“Experts agree that it is not a question of if, but when, the virus will adapt in ways that facilitate sustained human-to-human transmission,” said Bernhard Schwartländer, the WHO’s representative in China, echoing the concerns of Webby, Yang, and others. He told Sixth Tone it is “imperative” that the country’s policymakers identify effective methods to contain the virus, such as market closures and poultry vaccinations, and implement them “before the seasonal peak next winter.”

The WHO has advised people in affected areas to wash their hands often and avoid direct contact with birds at places like markets and poultry farms. Chinese state news agency Xinhua has recommended that consumers make sure the poultry they buy comes with a quarantine certificate.

Avian viruses like H7N9 will remain an ongoing concern for countries like China, where they are able to cause a large number of human infections by spreading mostly undetected in poultry, said Cowling. With such pervasive and prolonged exposure to people, he added, the virus is being given ample opportunity to stay one step ahead of human immune systems. If a substantial genetic shift were to occur, he said, the implications would be “potentially disastrous.”

Editor: Kevin Schoenmakers.

(Header image: A quarantine officer inspects a live chicken at a poultry farm in Xiangyang, Hubei province, Feb. 3, 2017. Rui Mu/VCG)



 South Africa suspends Zimbabwe chicken imports after bird flu outbreak [Reuters 8 Jun 2017]

South Africa said on Thursday it was suspending all trade in birds and chicken products from neighboring Zimbabwe after it reported an outbreak of highly pathogenic H5N8 bird flu at a commercial poultry farm.

"We have heightened inspections of all consignments, including all private and public vehicles at all our ports of entry, especially in and out of Zimbabwe," South Africa's department of agriculture said in a statement.

(Reporting by Ed Stoddard; editing by Jason Neely)



 Bird flu in SA: 140 million chickens could be destroyed [Citizen, 8 Jun 2017]

by Yadhana Jadoo

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There are fears that the avian flu outbreak in Zimbabwe could spread across the border.

South Africa could run the risk of losing 140 million chickens that face the H5N8 strain of bird flu should the virus cross the border with Zimbabwe where the country’s poultry have been affected since an outbreak there last week.

With Botswana having banned poultry imports from Zimbabwe, highly concerned suppliers in South Africa are now fearing their livestock is in jeopardy.

A high-level meeting is expected to take place tomorrow with all stakeholders, including government, according to the South African Poultry Association (Sapa).
Sapa has most of South Africa’s largest poultry producers as members.

They are anxious about the bird flu outbreak, says Sapa CEO Kevin Lovell – who also sits on the global expert panel on industry-driven avian influenza.

“We knew about this before the official announcement, and have been involved with various stakeholders. South Africa has never had a highly pathogenic avian influenza in chickens, and neither has Zimbabwe.”

The Herald reported that Zimbabwean egg and poultry producer Irvine’s was heavily affected by the outbreak as 7 000 of its birds were killed by the virus and a further 140 000 were euthanised for preventive measures.

Putting the number at 140 million chickens in South Africa that face potential euthanasia if “a disaster occurs”, Lovell added there are moreover a “good million backyard birds” being kept by people from all walks of life – some who see it as a hobby.

“And it affects everyone equally – it’s going to be a big issue in terms of businesses if it is spreads to South Africa.”

The risk, however, depends on how widely the virus is spread.

Currently, research is being conducted to identify the “family tree” of the virus and if it is being spread by wild birds moving over borders or by human activity, Lovell said.

“If it is from wild birds, the risk for South Africa is higher. But if it is by human activity or interaction, with people crossing borders, then it is easier to manage. We have to do the CSI stuff to find out the history of this.

“If it is brought in by wild birds it is difficult to stop their movement, but practical to manage.”

That practicality includes closing off the farms, euthanising the birds and halting any movement in a 10km radius. There will also be heightened testing.

Lovell added that should the virus enter South Africa, the longest-living birds, including breeding birds, were most likely to be affected first.

“It’s not here yet but industry is not taking this lightly – and we do have good systems in place.”

These systems, due to South Africa never experiencing such an avian pandemic, have however never been tested.

Lovell could not make a definitive statement on whether South Africa could end up importing chickens from the US as per the African Growth and Opportunity Act, should poultry be affected.

Some concerns related to this are that South Africa will become the dumping ground for unwanted US poultry.

The meeting tomorrow is expected to include stakeholders from national and provincial government, veterinarians, academics and representatives from the industry.

Discussions will focus on the early detection of where the virus comes from and prevention measures. Containment and management of the disease will also be looked at, he said.

The agriculture, forestry and fisheries department had not commented by the time of going to print.

Humans not immune

According to the World Health Organisation (WHO), humans can be infected with the H5N8 virus, but the likelihood is low, “based on limited information obtained to date”.

“To date, no human cases of infection with influenza [H5N8] have been detected,” the WHO says.

“However, human cases of infection with related… [H5N6] viruses have been detected and reported in China.

“Though human infections with [H5] viruses are rare and generally occur in individuals exposed to sick or dead, infected birds, they can lead to severe illness or death in humans.”
Info

Despite the risk of human infection being low, the WHO advises that you:

・Avoid contact with any birds, poultry or wild birds, or other animals that are sick or found dead, and report them to the relevant authorities.
・Wash hands properly with soap or a suitable disinfectant.
・Follow good food safety and good food hygiene practices.



 SA POULTRY ASSOCIATION CONCERNED OVER BIRD FLU IN ZIMBABWE [Eyewitness News, 8 Jun 2017]

by Masego Rahlaga

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Picture: Freeimages.com

Suppliers in SA are highly concerned that their livestock is in jeopardy following an outbreak of avian flu in Zimbabwe.

JOHANNESBURG - The South African Poultry Association says its concerned about the possibility of South Africa losing 140 million chickens to bird flu should the virus spread from Zimbabwe.

Zimbabwe announced an outbreak of the H5N8 strain of bird flu at a poultry farm east of Harare last week and Botswana has already banned poultry imports from that country.

Mozambique followed soon after.

Suppliers in South Africa are now highly concerned that their livestock is in jeopardy following an outbreak of avian flu on a poultry farm in Zimbabwe.

At least 715,000 chickens died in the Mashonaland province due to the virus.

The South African Poultry Association's Kevin Lovell says they're not taking the matter lightly and systems are in place to stop any possible danger.

“We are most certainly worried, this is the first time that Zimbabwe has had a highly pathogenic avian influenza in its chickens. It had in ostriches once before as has South Africa. But we’ve never had it in South Africa in chicken either and that means we are still at risk.”

Lovell says they are working with government as well.

“Government has had a contingency plan in the event of an avian influenza outbreak since the mid-2000s.”

He says that research is currently being conducted to determine whether the virus is being spread by wild birds moving over borders or by human activity.

(Edited by Winnie Theletsane)

Zoonotic Bird Flu News - from 23 May till 7 June 2017



 Culls, poultry transport ban as S. Korea fights bird flu outbreak [PhysOrg, 7 Jun 2017]

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South Korean health officials prepare to bury chickens at a farm in Jeju after the bird flu virus hit

South Korea has imposed a temporary nationwide ban on poultry transportation as it struggles to contain an outbreak of the highly pathogenic H5N8 virus, which has led to the slaughter of some 190,000 birds.

The first case in this outbreak of the virus was confirmed in the southern island of Jeju on June 2, and four more cases have been confirmed in different locations across the country.

On Tuesday, Seoul raised the national bird flu alert to its highest level, as it ordere more than 180,000 chickens, ducks and other birds be culled, the agriculture ministry said.

"We hope that the outbreak will be contained soon with the bird flu alert raised to the top 'grave' level," a ministry official told AFP.

"Grave" is the final step on the four-level alert system, and means officials can ban any movements of vehicles carrying birds, shut poultry stores or animal slaughterhouses, vaccinate poultry, and disinfect any vehicles on the road.

Under the 24-hour poultry transport ban that took effect Wednesday, all birds—and bird farmers—were banned from travelling, with farms subjected to disinfection.

The worst outbreak of another strain—H5N6, the most highly contagious strain of avian flu ever to hit the South—was recorded late last year when a record 30 million birds were slaughtered, which sent egg prices soaring.

The World Health Organization warned earlier this year that the strain has caused "severe infection" in humans.

theworstoutb.jpg
The worst outbreak of the highly contagious strain of avian flu ever to hit South Korea was recorded late last year when a record 30 million birds were slaughtered, which sent egg prices soaring

Read more at: https://phys.org/news/2017-06-culls-poultry-korea-bird-flu.html#jCp


 Bird flu: Kaduna government sensitises poultry farmers [The Guardian, 7 Jun 2017]

bird-flu Bird flu- Kaduna .jpg
Williams said that the state had already embarked on massive radio and TV campaigns to sensitise poultry farmers to good practices and other measures that would curb the spread of the poultry disease.

The Kaduna State Government says it has started a massive sensitisation campaign in about 400 poultry farms to curtail the spread of Avian Influenza, or Bird Flu, in the state.Dr Abel Williams, Desk Officer, Avian Influenza Control Project, Kaduna State, said this on Thursday in an interview with News Agency of Nigeria (NAN) in Kaduna.

Williams said that the state had already embarked on massive radio and TV campaigns to sensitise poultry farmers to good practices and other measures that would curb the spread of the poultry disease.

He said that the government had taken some decontamination measures, adding that over 23,000 birds had been depopulated from affected farms as at May 30.Williams said the state officials had depopulated 16,000 birds in the poultry farms, adding, however, that no fewer than 7,000 birds had been killed by the plague before the cases were reported.

He said that the bird flu outbreak was confirmed in some farms in parts of Chikun and Igabi Local Government Areas between January and May this year.He said that 8,000 birds were depopulated in the first outbreak in January; 12,000 birds in March and additional 1,200 birds were depopulated as at May 30.

Williams said that officials were closely monitoring other poultry farms across the state, so as to curtail the spread of the disease to farms, which were hitherto not affected by the outbreak.He said that the government had approved funds for officials to embark on the decontamination of the farms and ensure best practices.

He, however, expressed concern over the delay in the payment of compensation to no fewer than 39 farmers, who were affected by a similar Avian Influenza outbreak in the state some years ago.

Williams said that due to the delay, farmers were becoming reluctant to announce an outbreak of the disease in their farms.He noted the farmers preferred to sell off their birds whenever when they showed symptoms of the disease.

However, Dr Gideon Mshelbwala of Veterinary and Pest Control Services, Federal Ministry of Agriculture and Rural Development, recently said that N674 million compensation had been paid to 269 farmers, who were earlier affected by the disease, across the country.

NAN reports that the Federal Government on Friday announced the outbreak of Avian Influenza in the FCT and seven states of the country.Officials of Federal Ministry of Agriculture and Rural Development listed Kaduna, Bauchi, Kano, Katsina, Nasarawa and Plateau states as well as the FCT as those areas that were worst hit in the latest outbreak as at May 30.



 Botswana bans imports of poultry products from Zimbabwe [Journalducameroun.com - English - (press release) (registration), 6 Jun 2017]

Botswana on Tuesday banned imports of domesticated and wild birds and their products from neighbouring Zimbabwe following the outbreak of avian influenza.In a statement, Botswana director of veterinary services, Letlhogile Modisa said poultry feed from Zimbabwe has also been banned with immediate effect.

“All permits issued or importing the listed items are cancelled with immediate effect. The documents are to be returned to the nearest veterinary office,” he said.

It is reported that some 7,845 animals have been killed while another 75,155 birds were culled following the bird flu outbreak in Zimbabwe.

The virus was detected on a farm, which is close to a small dam where there are a number of different migratory waterfowl, suspected to be the source of infection.

Zimbabwe joins the Democratic Republic of Congo as countries were they have been reported cases of an outbreak.



 Botswana Bans Zimbabwe Poultry Imports [VOA Zimbabwe, 6 Jun 2017]

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WASHINGTON —

Botswana has banned all poultry imports from Zimbabwe following the outbreak of avian influenza.

In a statement posted on its website and Facebook pages, the government of Botswana said,

“The public is informed that an outbreak of Avian Influenza has been reported in Zimbabwe."

As a result, said the government, the import of domesticated and wild birds, their products (meat, eggs, feathers etc) and poultry feed from Zimbabwe is banned with immediate effect.

“All import permits issued for importing the listed items are canceled with immediate effect.

The documents are to be returned to the nearest veterinary office. The public will be updated on this developing situation.”



 BIRD FLU: Botswana Bans Zim Poultry [ZimEye - Zimbabwe News, 6 Jun 2017]

Below is statement by the government of Bostwana stating that it has banned poultry from Zimbabwe.

BOTSWANA BANS IMPORTS OF POULTRY PRODUCTS FROM ZIMBABWE DUE TO OUTBREAK

The Public is informed that an outbreak of Avian INFLUENZA has been reported in Zimbabwe.

As a result, the import of domesticated and wild birds, their products (meat, eggs, feathers etc) and poultry feed from Zimbabwe is banned with immediate effect.

All import permits issued for importing the listed items are cancelled with immediate effect.

The documents are to be returned to the nearest veterinary office.

The public will be updated on this developing situation.



 Poultry producer culls 140,000 birds after avian flu outbreak in Zimbabwe [Xinhua, 6 Jun 2017]

HARARE, June 6 (Xinhua) -- One of Zimbabwe's biggest poultry producers, Irvine's Private Limited, has culled 140,000 birds following an outbreak of avian influenza at its premises which killed 7,000 others, as the government quarantined the affected site to prevent the spread of the virus.

A press statement published by the company Tuesday said that the company had identified and contained a form of avian flu on an isolated site just outside Harare.

"Irvine's, together with the Zimbabwe Veterinary Department, have responded by placing the affected site under quarantine and the entire flock that was affected has been culled and disposed of in accordance with the relevant veterinary regulations," the company said.

Avian flu is a virus that occurs naturally among wild aquatic birds and affects domestic poultry and other birds and animals.

Principal director in the Department of Livestock and Veterinary Services Unesu Obatolu-Ushewokunze told state media that the outbreak involved the serotype H5 N8 of the avian flu virus which had been spreading around the world since 2010 but had not shown any risk to humans.

"All trade partners, veterinary authorities of neighboring countries and the World Organization for Animal Health have been notified as necessary," she said.



 Zimbabwe: Avian Influenza Outbreak Hits Irvine's [AllAfrica.com, 6 Jun 2017]

Government has put major poultry producer, Irvine's Private Limited's white meat and egg sub-sector under quarantine following an outbreak of avian influenza that left thousands of birds dead.

The highly pathogenic virus killed 7 000 birds and the company had to depopulate by slaughtering an additional 140 000 birds to prevent the spread of the disease.

Avian influenza is fatal in affected birds with nearly a 70 percent death rate.

The current outbreak at Irvine's does not seem to affect people.

In a statement yesterday, Ministry of Agriculture, Mechanisation and Irrigation Development's Department of Livestock and Veterinary Services Principal Director, Dr Unesu Ushewokunze-Obatolu, confirmed the outbreak.

She said Government had placed affected units of the compartment under quarantine and movement standstill.

"Affected units have been depopulated with stringent sanitary measures imposed. All trade partners, veterinary authorities of neighbouring countries and the World Organisation for Animal Health (OIE) have been notified as necessary," she said.

"Poultry keeping enterprises are urged to enhance their bio-security measures to promote tight and continuous separation from wild birds, while the exact source, thought to be wild ducks and geese in a nearby water body, is being investigated," she said.

Dr Ushewokunze-Obatolu said the outbreak of avian influenza involved the serotype H5 N8 of the Avian Influenza virus, which had been spreading in a second wave around the world since 2010.


The virus has been re-introduced to Europe from Asia, where it remained in continuous circulation and was detected in Uganda, among other countries in Africa, earlier this year.

"Influenza viruses are highly contagious and therefore spread very quickly in susceptible populations. The viruses occur naturally in wild water birds. However, the viruses change dynamically and highly virulent strains can occur from time to time, causing major human and animal illness and death," she said.

"Unlike other serotypes, which have caused concern in past years, H5 N8 wherever it has occurred recently, has not shown any risk to humans," she said.

Symptoms of avian influenza include quick illness and sudden deaths.

Agriculture, Mechanisation and Irrigation Development Minister Dr Joseph Made, yesterday warned farmers against undermining authorities such as the Department of Veterinary Services and animal health departments.

"This concerns animal and plant diseases. To minimise the spread of diseases, farmers should respect various authorities that deal with plant and animal quarantine," he said.We can all see what is happening to the varied weather conditions. We have come out of continuous rains from summer to winter; we had floods, torrential rains and in some pockets outbreaks of anthrax."

He said while rains were good, farmers should watch out for a number of diseases.

"When authorities give warnings to the public they should be respected so we can deal with situations that have been brought about by the varied weather conditions.

"The DVS is monitoring areas to look at avian influenza. Farmers should be on high alert and report to authorities any unusual occurrences such as sudden deaths of livestock and even wildlife. Farmers should report to extension officers," he said.



 Analysis of H7N9 in China finds age, geographic shifts [CIDRAP, 5 Jun 2017]

by Lisa Schnirring

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estivillml / iStock

A detailed epidemiologic analysis of illnesses in China's fifth and biggest wave of H7N9 avian influenza activity, still under way, found a few shifts in the epidemiologic pattern, with middle-age adults more likely to be infected and the reach of the disease extending from urban to more rural areas.

So far, reassuringly, the disease in humans doesn't seem more severe than the earlier four waves. A research team based in China published its findings in the Jun 2 early online edition of The Lancet Infectious Diseases.

More middle-aged, rural adults affected

The group's review includes 1,220 lab-confirmed cases reported since February 2013 when the first H7N9 infections were detected in humans. For the fifth wave, they include 447 cases reported in mainland China as of Feb 23. Since then, the country has reported many more cases, with a number of northern provinces affected, some of which have reported their first human illnesses.

Notably, the fifth wave began earlier than usual and has seen not only an unprecedented number of illnesses—at least 722 cases so far, compared with 319 in the next-largest wave.

But the current wave has also witnessed the emergence of a highly pathogenic version of H7N9 in poultry and in humans that contains genetic mutations, including one for resistance to neuraminidase inhibitors, the most commonly used flu antivirals.

When the virus first emerged in humans in 2013, older people were the hardest-hit group. According to the new analysis, however, the proportion of cases in middle-aged adults has increased steadily, from 41% during the first wave to 57% in the fifth wave.

During the first three waves of H7N9 illnesses, large percentage of the human cases were among those living urban areas. But over the past two waves, the proportions of cases from semi-urban and rural residents has grown, making up about 60% of the cases, reflecting a steady rise from 39% reported during the first wave.

When the researchers looked at cases by geographic location, they found that in affected provinces, the virus had spread to more districts and counties, a sign of broader spread.

Possible explanations for changes

The early start to the latest H7N9 wave might be linked to environmental changes, such as weather conditions, but more research is needed to tease out seasonality factors, the team reported.

Wider geographic expansion suggests that H7N9 viruses have extended their reach in poultry since the first human infections were detected, perhaps a consequence of its circulating in poultry as a low-pathogenic strain that causes few if any symptoms in birds. Researchers said that closure of live-poultry markets in areas where human cases were detected could have moved infected ready-for-market poultry into areas with no or less strict market closure rules.

The increase in human cases likely means that H7N9 prevalence in poultry is probably higher than before, the group wrote, adding that exposure patterns might change with the emergence of the highly pathogenic strain.

The risk of death from H7N9 has increased across the five waves, but the researchers didn't see a significant difference between fatality rates in the fourth and fifth waves. Antiviral therapy started slightly earlier for patients hospitalized with H7N9 over the past two waves, but that improvement wasn't paired with a reduced fatality risk.

Experts alarmed by rural shift

In an accompanying editorial, two virologists said the size of the fifth wave and the transition to a highly pathogenic form in poultry raise several questions, especially regarding what has changed and if the changes have a bearing on pandemic risk. The authors are Richard Webby, PhD, with St. Jude Children's Research Hospital in Memphis, and Zifeng Yang, MD, PhD, with State Key Laboratory of Respiratory Disease in China.

They said so far, there is little to suggest that H7N9 viruses on their own have become a greater threat. The two noted, however, that the most worrisome finding is the shift from urban to semi-urban and rural areas.

"If one considers human beings the canaries in the coal mine, these findings imply that the virus is more widespread in poultry," Webby and Yang wrote. They added that another possible explanation might be that the genetic shift might make the virus more infectious for waterfowl, though no evidence suggests that has happened.

Spread of the virus to provinces such as Guangxi that have extensive water bodies increases the chance of waterfowl exposure, they noted. "But how much of the above is speculation and how much is likely to be true? Herein lies the biggest unknown in the A H7N9 story."

True prevalence of H7N9 in Chinese birds isn't known, and other factors, even ones at the provincial level, might explain some of the features of the unprecedented fifth wave, they wrote.



 South Korea raises bird flu alert to maximum from June 6 to contain virus [Channel New Asia, 5 Jun 2017]

SEOUL: South Korea's agriculture ministry said on Monday it will raise its bird flu alert level to the maximum as a case found on Saturday was confirmed to be the highly pathogenic strain H5N8.

The first case of avian influenza since early April was confirmed on Saturday in a small backyard flock of farm birds on the southern island of Jeju, rekindling bird flu fears nationwide.

This is the second time that South Korea has raised the country's bird flu alert level to the maximum. It raised the alert level to the maximum for the first time ever when an outbreak was confirmed in November last year.

(Reporting By Jane Chung; Editing by Tom Hogue)



 Highly Pathogenic Avian Influenza Confirmed in Busan [The Korea Bizwirw, 5 Jun 2017]

Highly Pathogenic Avian Influenza .jpg
(image: Yonhap)

SEOUL/JEJU ISLAND, Jun. 5 (Korea Bizwire) — South Korea’s agricultural ministry said Sunday it has confirmed a case of a highly pathogenic avian flu in the southern port city of Busan.

The Ministry of Agriculture, Food and Rural Affairs said it reached the conclusion after conducting detailed tests on a poultry farm with 6,000 birds.

The farm had purchased 650 Korean Ogol Chickens last month from Gunsan in the country’s southwestern region. Some of the birds died off suddenly, which caused quarantine officials to check the farm.

The ministry is set to conduct a more comprehensive probe while culling all birds at the infected farm as well as restricting movement in the area to contain further outbreaks.

Up till Sunday, poultry from Gunsan was sold to Busan, Jeju, Paju and Yangsan. The government is currently seeking to find out if birds originating from the city had been shipped to other regions as well.

Park Bong-kyun, the quarantine chief of the ministry, later pinpointed the southern city of Jeongeup as the origin of the avian influenza’s breakout.

The virus is believed to have affected Gunsan when chickens sold to a Jeongeup farm were recalled after some of them died, the official said. Reports of dead chickens from Gunsan farm skyrocketed following the recall, he said.

Another official from the ministry said it has confirmed the major destinations of the chickens sold from Gunsan, but will still take more time to locate all the buyers.

South Korea’s southern resort island of Jeju also said earlier in the day that it culled some 10,000 chickens and ducks amid concerns over the spread of avian influenza.

Agriculture Minister Kim Jae-soo highlighted efforts to prevent further spread of the flu.

“At this stage, the most important thing is to prevent the avian influenza from proliferation,” Kim said in a meeting of officials in Jeju Island. He instructed officials to inform chicken farm owners of the importance of speedy reports of suspicious cases of the flu.
(Yonhap)



 S. Korea to raise bird flu alert status to highest; highly pathogenic avian influenza confirmed [The Korea Times US, 5 Jun 2017]

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Health authorities in Gunsan, North Jeolla Province quarantine a chicken farm on June 3, 2017, after a suspected case of avian influenza was reported. (Yonhap)

SEJONG, June 5 (Yonhap) — South Korea plans to raise the avian influenza alert status to the highest level, government officials said Monday, as it confirmed a case of highly pathogenic avian flu on the country’s southern resort island of Jeju.

Officials said they will issue the warning Tuesday and ban all poultry farmers across the country from moving poultry for 24 hours starting Wednesday.

The move came hours after the Ministry of Agriculture, Food and Rural Affairs said tests showed the virus that hit a poultry farm with seven chickens was confirmed to be the H5N8 subtype.

Highly pathogenic avian influenza refers to viruses that cause severe disease in birds and result in high death rates, according to the World Health Organization.

The farm reported to the authorities after five Korean Ogol Chickens it purchased from a traditional market in Gunsan in the country’s southwestern region last month all died. Three other chickens it originally had also died.

Some 3,600 out of 6,900 chickens from the Gunsan farm have been sold throughout the country, including in Busan, Jeju, Paju and Yangsan, according to the ministry.

A total of 31,913 chickens from 18 related farms have been culled so far, regardless of their test results.

The ministry is restricting movement in the area to contain further outbreaks.

Meanwhile, South Korean health authorities said that there is very low risk that the avian influenza virus strain in the country will infect humans. South Korea has yet to report any human infection by the flu.



 Highly pathogenic avian influenza confirmed in Jeju [The Korea Herald, 5 Jun 2017]

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Health authorities in Gunsan, North Jeolla Province quarantine a chicken farm on June 3, 2017, after a suspected case of avian influenza was reported. (Yonhap)

South Korea's agricultural ministry said Monday it has confirmed a case of highly pathogenic avian flu on the country's southern resort island of Jeju.

The Ministry of Agriculture, Food and Rural Affairs said tests showed the virus that hit a poultry farm with seven chickens was confirmed to be the H5N8 subtype.

Highly pathogenic avian influenza refers to viruses that cause severe disease in birds and result in high death rates, according to the World Health Organization.

The farm reported to the authorities after five Korean Ogol Chickens it purchased from a traditional market in Gunsan in the country's southwestern region last month all died. Three other chickens it originally had also died.

Some 3,600 out of 6,900 chickens from the Gunsan farm have been sold throughout the country, according to the ministry.

On Sunday, a poultry farm with some 6,000 birds in the southern port city of Busan tested positive for the flu. The farm had purchased 650 Korean Ogol Chickens in Gunsan.

Up till Sunday, poultry from Gunsan was sold to eight cities and counties including Busan, Jeju, Paju and Yangsan. A total of 31,913 chickens from 18 related farms have been culled so far, regardless of their test results.

The ministry is restricting movement in the area to contain further outbreaks.

Meanwhile, South Korean health authorities said that there is very low risk that the avian influenza virus strain in the country will infect humans. South Korea has yet to report any human infection by the flu. (Yonhap)



 Avian flu outbreak confirmed at Norfolk farm [BBC News.com, 4 Jun 2017]

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A full investigation is under way to find the source of the infection

Avian flu has been confirmed in chickens and geese at a farm in south Norfolk.

The UK's deputy chief veterinary officer said the H5N8 strain had infected around 35 birds at a farm near Diss.

A number of the birds have died and the remaining are to be culled.

A full investigation is under way to find the source of the infection. The risk to the public is said to be low.

The exact location of the outbreak has not been revealed.

But a 3km protection zone and 10km surveillance zone have been put in place around the infected premises.

In February this year, around 23,000 chickens were destroyed at Bridge Farm in Redgrave on the Suffolk and Norfolk border after an outbreak of H5N8 avian influenza virus.




 UK: Avian influenza confirmed at a farm near Diss, South Norfolk [poultrymed, 3 Jun 2017]

The UK’s Deputy Chief Veterinary Officer has confirmed H5N8 avian influenza in a small flock of chickens and geese at a premises near Diss, South Norfolk. A 3 km Protection Zone and a 10 km Surveillance Zone have been put in place around the infected premises to limit the risk of the disease spreading.

The flock is estimated to contain approximately 35 birds. A number have died and the remaining live birds at the premises are being humanely culled. A full investigation is under way to determine the source of the infection.



 South Korea raises bird flu alert after confirming first case since April [Reuters, 3 Jun 2017]

South Korea said on Saturday it will raise the bird flu alert level to the second highest after small flocks of farm birds tested positive for the H5N8 virus, the first in the country since early April.

Asia's fourth-largest economy has been hit hard by the spread of the highly contagious avian influenza since the first case in the recent outbreak was confirmed in November last year, prompting the country to cull nearly 38 million farm birds, or over a fifth of its total poultry population.

The Ministry of Agriculture, Food and Rural Affairs had downgraded its bird flu alert to normal as no new cases had emerged since April 4.

Although the bird flu epidemic has been on the wane, the fresh case of the avian influenza was confirmed in a small backyard flock of farm birds on the southern island of Jeju, said a ministry official who declined to be identified.

In the wake of the new discovery, the ministry will strengthen prevention measures in an effort to contain the spread of the virus, the ministry official said.

Some 12,000 farm birds near the infected farm would be slaughtered as a precaution, the official added.

The agriculture ministry also said in a statement that a full investigation was under way to determine the source of the infection.

(Reporting by Jane Chung; Editing by Jacqueline Wong)



 Avian influenza in Luxemburg [poultrymed, 2 Jun 2017]

Avian influenza outbreak has been confirmed at three poultry farms in Luxembourg. The virus was detected at farms in Keispelt, Niederfeulen and Schrassig.To limit the spread of the disease to other farms, the transport of live poultry has been banned for a week.

Luxembourg's Ministry of Agriculture, Viticulture and Consumer Protection said farmers should report all abnormal poultry deaths immediately to a vet. It also recommended that poultry be kept indoors, and be fed and watered inside a building.



 China reports H7N9 avian influenza case in Inner Mongolia Autonomous Region [Outbreak News Today, 2 Jun 2017]

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Image/CDC

The Health and Family Planning Commission of Inner Mongolia Autonomous Region reported their first human case of avian influenza A(H7N9) in a male patient from Wuyuan County of Bayannur City.

Health officials say the patient is in stable condition and the source of infection was probably poultry reared in his place of residence.

Since March 2013 through May 27, 2017, there were a total of 1512 human cases of avian influenza A(H7N9) reported globally. Since October 2016, 714 cases have been recorded in Mainland China.

Most human cases are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, and live poultry vending continues, further human cases can be expected.

Although small clusters of cases of human infection with avian influenza A(H7N9) virus have been reported including those involving patients in the same ward, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans.

Travelers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live poultry markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with feces from poultry or other animals. Travelers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices.



 Mizoram bird flu alert; bans import of chicken and pig [The Northeast Today, 2 Jun 2017]

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Deputy commissioners of all districts in Mizoram — bordering Myanmar and Bangladesh — have issued orders banning import of birds, chicken and pigs from neighbouring countries.

The deputy commissioners of Champhai, Aizawl, Lunglei, Lawngtlai, Siaha and Mamit issued the orders after receiving warning from the central government, saying that bird flu has been prevalent in China.

Veterinarians said import of pigs and piglets was also banned as pigs are carriers of the avian influenza virus.



 China H7N9 total grows by 8; studies detail virus mutations [CIDRAP, 2 Jun 2017]

by Lisa Schnirring

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sudok1 / iStock

Reflecting continued slow decline of H7N9 avian flu cases in China, eight new illnesses were reported this week, as research teams from the country published new studies that provide an early glimpse of the epidemiology and clinical features of the highly pathogenic variant that recently emerged in poultry and is also infecting people.

New H7N9 cases

The eight latest H7N9 cases from China noted today in a regular update from Hong Kong's Centre for Health Protection (CHP) are down slightly from nine cases reported last week.

Among the new batch of illnesses, six patients had known exposure to poultry, poultry markets, or mobile stalls. No deaths were reported.

All of the sick people are adults with illness onsets ranging from May 12 to May 29, and five are men.

The patients are from seven different provinces that make up a broad geographic area, which with late-season northward spread has been a unique feature of China's fifth and biggest wave of H7N9 activity, which began in October and is still under way. Affected provinces are Shandong, Anhui, Guangxi, Hebei, Hubei, Shaanxi, and Sichuan.

The CHP said the new case-patient reported from Shaanxi province, located in northern China, was probably infected in Inner Mongolia province, which a few days ago announced its first-ever local H7N9 case and had recently reported its first outbreaks in live-market poultry.

In its fifth wave, China has now reported at least 722 H7N9 cases, at least 205 of them fatal.

The second-largest wave, in 2013-14, saw 319 reported cases.

Threat from sick, dead poultry

Two early-release studies published in Emerging Infectious Diseases yesterday shed more light on the new highly pathogenic strain infecting poultry, which has also been detected in some patients, raising questions about whether the illness pattern for people is different from what China has seen with the low-pathogenic version of H7N9 avian flu.

Last month, Chinese researchers reported that highly pathogenic H7N9 has a slightly increased binding preference for human airway receptors compared with the low-pathogenic form.
In one of the new studies, researchers from China and their counterparts at the US Centers for Disease Control and Prevention examined eight case-patients from three provinces in southern China (Guangdong, Hunan, and Guangxi) who had highly pathogenic H7N9 infections and compared the clinical and epidemiologic findings with patterns seen for low-pathogenic H7N9.

According to their preliminary findings, infection with highly pathogenic H7N9 was associated with exposure to sick and dead poultry in rural areas. Those patients were hospitalized earlier than those infected with low-pathogenic H7N9, but otherwise showed similar patterns and disease severity.

The researchers said the low number of highly pathogenic H7N9 cases limited their power to detect differences between the two patient groups. They said their findings might suggest more rapid disease progression and greater severity, because they saw higher mortality and shorter intervals between illness onset and death for those who were sick with the highly pathogenic virus, but the differences weren't statistically significant.

Case involves antiviral resistance

In the second report, a team from China described the clinical course and genetic findings in a 56-year-old Guangdong province man who died from a highly pathogenic H7N9 virus that showed a marker for resistance to neuraminidase inhibitors (NIs), the antiviral drugs commonly used to treat influenza.

The man, who had underlying medical conditions, got sick in early January. Before he became ill, he noticed that some of his backyard chickens were sick and dying. Some of the birds were slaughtered, cooked, and eaten by the man and his family.

Four days after symptoms began, the man was hospitalized with pneumonia and given the NI oseltamivir (Tamiflu) because of the contact he had with poultry. His condition deteriorated, and he was placed on a ventilator and given peramivir, another NI, in the intensive care unit, where he died a few weeks later.

Phylogenetic analysis of an H7N9 isolated collected on day 6 of his illness, 2 days after oseltamivir treatment began, revealed a hemagglutinin marker that suggested the virus might be highly pathogenic in poultry and was similar to mutations seen in recent human cases in Taiwan and Guangdong province.

The researchers said viruses from two other patients with the highly pathogenic H7N9 mutation also had the resistance marker, and all three patients probably acquired it after oseltamivir treatment began. They added that the mutation likely contributed to the treatment failure.

Other factors may have contributed to the man's poor outcome, the group wrote, including his underlying conditions as well as a heart attack and secondary infections from antibiotic-resistant bacteria while hospitalized.

The authors concluded that so far the clinical features don't appear different from those of earlier infections with low-pathogenic H7N9, and no evidence was seen of systemic infection.

They added, however, that heightened surveillance is needed to determine the extent of the two mutations.



 Zimbabwe reports H5N8 bird flu at poultry farm: OIE [Reuters, 2 Jun 2017]

Zimbabwe has reported an outbreak of highly pathogenic H5N8 bird flu at a commercial poultry farm in Mashonaland East province, the World Organisation for Animal Health (OIE) said on Friday.

The virus was detected on a farm with 2 million birds in Lanark and killed 7,845 animals.

Another 75,155 birds were culled, the Paris-based OIE said, citing a report from the Zimbabwe's livestock and veterinary services.

"The affected site is close to a small dam where there are a number of different migratory waterfowl, which are tentatively suspected to be (the) source of infection," the report said.

(Reporting by Gus Trompiz; Editing by Bate Felix)



 OIE: ZIMBABWE REPORTS H5N8 BIRD FLU AT POULTRY FARM [Eyewitness News, 2 Jun 2017]

The virus was detected on a farm with 2 million birds in Lanark and killed 7,845 animals.

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FILE: Picture: AFP.

PARIS - Zimbabwe has reported an outbreak of highly pathogenic H5N8 bird flu at a commercial poultry farm in Mashonaland East province, the World Organisation for Animal Health (OIE) said on Friday.

The virus was detected on a farm with 2 million birds in Lanark and killed 7,845 animals.

Another 75,155 birds were culled, the Paris-based OIE said, citing a report from the Zimbabwe’s livestock and veterinary services.

“The affected site is close to a small dam where there is a number of different migratory waterfowl, which are tentatively suspected to be the source of infection,” the report said.



 Hong Kong bans DRC poultry meat and products over bird flu outbreak [africanews, 1 Jun 2017]

by Abdur Rahman Alfa Shaban

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Hong Kong has announced a ban on all imports of poultry meat and products (including eggs) from the Democratic Republic of Congo following a bird flu outbreak.

According to the authorities, the move was to protect public health in the Chinese leading commercial trading center.

The Center for Food Safety (CFS) said its decision was connected to the notification by the World Organization for Animal Health (OIE) about outbreaks of high pathogenic H5 avian influenza in the DRC.

“The CFS has contacted the Congolese authorities over the issue and will closely monitor information issued by the OIE on avian influenza outbreaks. Appropriate action will be taken in response to the development of the situation,” a spokesman said.

Three outbreaks of the flu was detected among poultry in the northeastern province of Ituri, the OIE said on Wednesday.

The virus was detected among ducks and hens in three villages near the border with Uganda, the OIE said, citing a report from the Congolese agriculture ministry.

The H5N8 strain of bird flu was present in Uganda, the OIE added, without specifying what type of H5 bird flu had been detected in Congo.



 Bird flu scare: Mizoram districts ban import of chicken, pigs [Hindustan Times, 1 Jun 2017]

Mizoram has received a warning from the central government about recent reports of bird flu in China.

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Import of chicken has been banned in Mizoram’s districts after reports of bird flu in China.(AFP/ Representational Photo)

Deputy commissioners of all districts in Mizoram — bordering Myanmar and Bangladesh — have issued orders banning import of birds, chicken and pigs from neighbouring countries.

The deputy commissioners of Champhai, Aizawl, Lunglei, Lawngtlai, Siaha and Mamit issued the orders after receiving warning from the central government, saying that bird flu has been prevalent in China.

Veterinarians said import of pigs and piglets was also banned as pigs are carriers of the avian influenza virus.



 Shaanxi reports new H7N9 human case [Xinhua, 31 May 2017]

XI'AN, May 31 (Xinhua) -- Northwest China's Shaanxi Province Wednesday reported a new human infection of the H7N9 bird flu virus, bringing the number of infections to six in the province.

The 62-year-old female from Inner Mongolia showed symptoms including a fever and cough after having contact with dead poultry and was confirmed as infected in the city of Yulin Wednesday.

Also on Wednesday, the local government in the city's Yuyang District reported more than 20,000 chickens had died from an outbreak of H7N9 bird flu at a private poultry company.
H7N9 is a bird flu strain first reported to have infected humans in China in March 2013.

According to the National Health and Family Planning Commission, in March, 96 H7N9 infections and 47 deaths were reported nationwide. In April, 81 infections and 24 deaths were reported.



 20,000 Chickens Die From Bird Flu Outbreak In China [NDTV, 31 May 2017]

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More than 20,000 chickens died of bird flu outbreak at a poultry farm in NorthWest China(Reuters)

The H7N9 bird flu virus spread within a private poultry company, the government of Yuyang district, Yulin city said in a statement, adding that chickens started dying on May 25.

BEIJING: More than 20,000 chickens have died from a bird flu outbreak at a poultry farm in northwest China's Shaanxi Province, a media report said today.

The H7N9 bird flu virus spread within a private poultry company, the government of Yuyang district, Yulin city said in a statement, adding that chickens started dying from May 25.

A three-kilometre-radius area has been closed for disinfection, and the area will be closed for 21 days starting from yesterday, state-run Xinhua news agency reported.

All poultry within the area will be culled and all poultry trading sites have been closed, the statement said.The company is located in Niujialiang Township.

H7N9 is a bird flu strain which was first reported to have infected humans in China in March 2013. Infections are most likely to strike in winter and spring.

According to the National Health and Family Planning Commission, in March, 96 H7N9 infections and 47 deaths were reported nationwide.

In April, 81 infections and 24 deaths were reported.



 Bird flu outbreak in Shaanxi province kills 20,000 chickens [Reuters, 31 May 2017]

More than 20,000 chickens died from an outbreak of H7N9 bird flu in northwest China's Shaanxi province, official media said on Wednesday citing a local government statement.

The outbreak occurred at an egg farm run by Lvxiangyuan Ecology Co based in Yulin, a city of more than 3 million people.

A three-kilometer-radius area has been closed for disinfection, said the Xinhua report, and all poultry in the area will be culled. Poultry trading sites have been shut down.

The H7N9 bird flu has claimed the lives of more than 200 people in China in the first four months of this year, almost three times higher than the fatalities from the strain for all of 2016.

Around 400,000 birds have been culled in China since last October following outbreaks of bird flu and live poultry markets around the country have been shut down.

(Reporting by Dominique Patton; Editing by Sunil Nair)



 Over 20,000 chickens die in flu outbreak in China [Xinhua, 31 May 2017]

XI'AN, May 31 (Xinhua) -- More than 20,000 chickens died from an outbreak of H7N9 bird flu in northwest China's Shaanxi Province, the local government said on Wednesday.

The bird flu virus spread within the Yuyang Lyuxiangyuan Eco Co., Ltd., a private poultry company, the government of Yuyang District, Yulin City said in a statement.

Chickens started dying on May 25, it said. A three-kilometer-radius area has been closed for disinfection, and the area will be closed for 21 days starting on Tuesday, the statement said.

All poultry within the area will be culled and all poultry trading sites in the area have been closed, the statement said.

The company is located in Niujialiang Township.

H7N9 is a bird flu strain first reported to have infected humans in China in March 2013. Infections are most likely to strike in winter and spring.

According to the National Health and Family Planning Commission, in March, 96 H7N9 infections and 47 deaths were reported nationwide. In April, 81 infections and 24 deaths were reported.



 DRC reports its first high-path H5 avian flu outbreaks [CIDRAP, 31 May 2017]

by Lisa Schnirring

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The Democratic Republic of Congo (DRC) recently reported its first highly pathogenic H5 avian flu outbreaks, suspected to be the H5N8 subtype, as Italy reported another H5N8 outbreak in poultry, China announced a large H7N9 outbreak at a commercial farm, and the Netherlands reported H5N5 in wild birds.

The DRC outbreaks are well east of the Ebola outbreak area and are near the country's border with Uganda, which earlier this year reported H5N8 outbreaks in wild birds and poultry.

DRC outbreaks struck mainly ducks

In a May 26 report to the World Organization for Animal Health (OIE) that was recently posted, the DRC's agriculture ministry reported three H5 outbreaks that began on Apr 25 in village birds in Ituri province in the country's northeast near Lake Albert. Officials said the villagers mostly raise ducks and that mortality was higher in ducks than in hens; 21 ducks and 1 hen tested positive for H5.

Among the three locations, the virus killed 12,756 of 20,936 susceptible birds, and authorities had begun culling surviving birds.

DRC officials noted that H5N8 outbreaks have occurred in neighboring Uganda and that brisk poultry and poultry product trade occurs between the two countries. Officials have stepped up surveillance, and investigations are planned for Ituri province's other territories.

If H5N8 is confirmed as the subtype, the DRC would be the sixth African nation to report the virus. The others are Cameroon, Niger, Nigeria, Tunisia, and Uganda.

Italy reports H5N8 outbreak at turkey farm

In Europe, though H5N8 activity has declined sharply over the past few months, Italy today reported a new outbreak in poultry, according to a report today to the OIE.

The event began on May 29, striking a commercial fattening turkey farm in Lombardy region in northwest Italy. Of 17,152 birds at the facility, the virus killed 1,889, and culling steps have been initiated.

H7N9 in China; H5N5 in the Netherlands

In other outbreak developments, Chinese agriculture officials announced that H7N9, presumably the newly emerged highly pathogenic type, has struck a commercial poultry farm in Shaanxi province in the northwest, Xinhua, China's state news agency, reported today.

The outbreak began on May 25 when farm workers noted poultry deaths. The facility is located in Yulin City, which borders three other Chinese provinces: Inner Mongolia, Shanxi, and Ningxia.

Remaining poultry are slated for culling, and authorities have shuttered poultry trading sites in the area, Xinhua said.

Elsewhere, the Netherlands government yesterday announced the detection of highly pathogenic H5N5 in two wild geese found dead in the city of Utrecht, located in the central part of the country, according to an official statement translated and posted by Avian Flu Diary (AFD), an infectious disease news blog.

Nearly a dozen European countries have reported H5N5 outbreaks over the past several months. In earlier reports, officials had said H5N5 is a reassortment of H5N8 that was first reported by European countries at the end of 2016.



 Avian flu threat re-emerges [Agri News, 27 May 2017]

Flock-keepers urged to step up biosecurity

INDIANAPOLIS — Now is the time for poultry owners to be especially diligent about protecting their birds from avian influenza as migratory waterfowl travel north for the summer.

The Indiana State Board of Animal Health encourages poultry owners to incorporate good biosecurity practices to keep their birds healthy.

Avian influenza is a virus that can infect chickens, turkeys, pheasants, quail, ducks, geese and guinea fowl, as well as a wide variety of other birds.

Wild waterfowl and shorebirds are natural hosts for the virus. Infected waterfowl and shorebirds usually show no signs of illness and they shed the virus into their environment.

Avian influenza viruses can be classified into low pathogenic and highly pathogenic forms based on the severity of the illness they cause. Most AI virus strains are LPAI and typically cause little or no clinical signs in infected birds.

HPAI is an extremely infectious and fatal form of the disease for domestic poultry. HPAI can strike poultry quickly with little warning. Once the virus is established, only the highest levels of biosecurity can prevent the rapid spread from flock to flock.

Birds affected with HPAI may show one or more of the following signs:

・Sudden death without clinical signs.
・Lack of energy and appetite.
・Swelling of the head, eyelids, comb, wattles and hocks.
・Purple discoloration of the wattles, combs and legs.
・Gasping.
・Diarrhea.

Poultry owners are encouraged to monitor their birds for any signs of illness or unexplained death. If you suspect your poultry may have HPAI, contact your veterinarian, the Healthy Birds Hotline at 866-536-7593 or the Purdue University Animal Disease Diagnostic Laboratory at 765-494-7440.

Introductions of HPAI originate from wild birds, especially waterfowl. Poultry that are raised outdoors with access to a pond, wetland or grass where waterfowl congregate are at a greater risk of contracting HPAI.

Flocks infected with HPAI can then spread the virus to new flocks through movement of birds, manure, equipment and people. HPAI viruses can exist in bird waste for several months, especially under conditions of high moisture and low temperature.

Information about Indiana’s poultry requirements and disease information is available on BOAH’s website at: www.in.gov/boah/2721.htm.



 Avian flu threat re-emerges [Agri News, 26 May 2017]

Flock-keepers urged to step up biosecurity

INDIANAPOLIS — Now is the time for poultry owners to be especially diligent about protecting their birds from avian influenza as migratory waterfowl travel north for the summer.

The Indiana State Board of Animal Health encourages poultry owners to incorporate good biosecurity practices to keep their birds healthy.

Avian influenza is a virus that can infect chickens, turkeys, pheasants, quail, ducks, geese and guinea fowl, as well as a wide variety of other birds.

Wild waterfowl and shorebirds are natural hosts for the virus. Infected waterfowl and shorebirds usually show no signs of illness and they shed the virus into their environment.

Avian influenza viruses can be classified into low pathogenic and highly pathogenic forms based on the severity of the illness they cause. Most AI virus strains are LPAI and typically cause little or no clinical signs in infected birds.

HPAI is an extremely infectious and fatal form of the disease for domestic poultry. HPAI can strike poultry quickly with little warning. Once the virus is established, only the highest levels of biosecurity can prevent the rapid spread from flock to flock.

Birds affected with HPAI may show one or more of the following signs:

・Sudden death without clinical signs.
・Lack of energy and appetite.
・Swelling of the head, eyelids, comb, wattles and hocks.
・Purple discoloration of the wattles, combs and legs.
・Gasping.
・Diarrhea.

Poultry owners are encouraged to monitor their birds for any signs of illness or unexplained death. If you suspect your poultry may have HPAI, contact your veterinarian, the Healthy Birds Hotline at 866-536-7593 or the Purdue University Animal Disease Diagnostic Laboratory at 765-494-7440.

Introductions of HPAI originate from wild birds, especially waterfowl. Poultry that are raised outdoors with access to a pond, wetland or grass where waterfowl congregate are at a greater risk of contracting HPAI.

Flocks infected with HPAI can then spread the virus to new flocks through movement of birds, manure, equipment and people. HPAI viruses can exist in bird waste for several months, especially under conditions of high moisture and low temperature.

Information about Indiana’s poultry requirements and disease information is available on BOAH’s website at: www.in.gov/boah/2721.htm.

Key biosecurity recommendations

・Have a biosecurity plan and adhere to it.
・Restrict access to the flock by people, pets, wildlife and rodents.
・Do not use pond or stream water to provide drinking water for birds unless the water is treated.
・Do not keep feed where wild birds can access it.
・Keep poultry pens and housing clean.
・Keep feed bins covered and stored in a location that is not accessible to wildlife, birds and rodents.
・Do not share birds or equipment with neighbors.
・Keep new birds separate from the flock for 30 days to verify they are healthy.
・Know the warning signs of infectious diseases.
・Do not take infected birds to market or exhibitions or fairs.



 Avian flu surveillance efforts. Credit: Province of British Columbia [UN Dispatch, 26 May 2017]

by Alanna Shaikh

For the first time, a new strain of bird flu was transmitted human-to-human. This is highly unusual–and could be the first sign of new global pandemic.

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In 1918, the world was rocked by pandemic flu. A virulent strain of influenza, H1N1 influenza swept across the whole planet. A fifth of the world’s population was infected, and 20-40 million people died. It killed more people than World War One.

We haven’t seen pandemic influenza on that scale since then, but it’s been because of luck, not skill. Our globalized world is actually at a greater risk for pandemic than we were in 1918.

Thanks to air travel, people travel farther, faster, and more often than they did a century ago. In just the last decade, we’ve seen Ebola cross borders, Zika infect a new continent, and a 2009 H1N1 pandemic that had a thankfully, inexplicably, low mortality rate.

So far, however, we haven’t seen a truly devastating flu epidemic in humans. Mild forms of the flu have been very contagious, and do routinely cross borders and infect large numbers of people, but they’re mild. People get unpleasantly sick, and the very young and very old may die, but the mortality rates are not unusually high. At the same time, we’ve experience some very deadly forms of the flu. Avian influenza, known as H7N9, kills 40% of people who are infected.

That’s a mortality rate to fear – H1N1 had a mortality rate of 2-5% in 1918. However, avian influenza is not contagious from person to person – it spreads bird to person.

The pandemic of 1918 was both highly contagious and highly deadly. We haven’t seen that in the last hundred-something years.

Which brings us to last week, when a Chinese medical journal reported a human-to-human transmission of H7N9. H7N9, as mentioned, has a mortality rate of about 40%. Its impact on humans has been mitigated by the fact that it only spreads from birds. Family members can care for each other without fear.

Last week, though, China reported a case of H7N9 that appears to have spread person to person, not bird to person. The infected patient had no contact with birds or live bird markets, and he had no underlying medical condition. He was a healthy 62-year-old man, who helped a family member hospitalized with H7N9 to use the bathroom. Genetic analysis of the infecting virus indicates that he was infected with the same strain of virus that infected his family member.

This could be a sign that H7N9 is evolving into a virus that spreads among people. A highly contagious virus that has a 40% mortality rate. By way of comparison, Ebola is a highly contagious virus with a 50% mortality rate that spreads among people. There is serious potential here for global catastrophe.

It’s not doomsday yet. Helping someone use the toilet is a very intimate act; that means a contagious virus, but not necessarily highly contagious. Spreading in that kind of close quarters does not mean it will spread in schools or markets. And according to the epidemiological report,

“There were a lot of family members in the ward, but he was the only one who was in close contact with the index case, and he was the only one confirmed H7N9.” So even being in the same room with an infected person does not necessarily mean infection.

The WHO has called for increased surveillance efforts for H7N9, but it isn’t quite ringing the alarm. While these human cases are a sign of an evolving virus, it hasn’t so far evolved into the danger zone. Their analysis states that “current epidemiological and virologic evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore the likelihood of further community level spread is considered low.”

The US Centers for Disease Control and Prevention (CDC) is less certain. According to acting director Anne Schuchat, “This one hasn’t (evolved) yet. But that’s why we’re keeping our eye on it. Because it has the capacity to evolve and change.”

If you’re watching viruses, though, you’re watching this one.



 H7N9 virus: Planning for the next pandemic [MultiBriefs Exclusive (blog), 24 May 2017]

by Christina Thielst

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Most public health officials agree that the next pandemic is not a matter of if, but when will it arrive in the United States. And they have been closely watching China and the H7N9 virus.
Since March 2013, China has reported human infections from an Asian-lineage avian influenza A virus — H7N9. Annual epidemics of sporadic human infections have occurred there each year, with the latest (the fifth) being the largest to date. Those infected suffer from severe respiratory illness.

Public health officials around the world are concerned because of H7N9's virulence: 88 percent of those infected developed pneumonia, 68 percent were admitted to an intensive care unit, and 41 percent died. Most identified cases resulted after exposure to poultry, but there has also been some limited person-to-person spread in China.

While the current risk of the H7N9 virus to the public's health is low, there is a real concern for its pandemic potential. After just a few mutations, the virus could evolve into one easily spread through communities until there is a global outbreak.

In fact, of the novel influenza A viruses that are of special concern to public health, Asian-lineage H7N9 virus is rated by the Influenza Risk Assessment Tool (IRAT) as having the greatest potential to cause a pandemic, as well as potentially posing the greatest risk to severely impact public health.

The CDC has interim guidance available, along with modeling tools to assist local health officials and health administrators in anticipating the scope and magnitude of any potential event. For example, FluSurge 2.0 estimates the surge in demand for hospital-based services during an influenza pandemic scenario, including number of hospitalizations and deaths.

It also compares the potential impact with a hospital's existing capacity for hospitalization, intensive care and ventilator support. Health professionals then have more realistic site-specific data and potential impacts to improve upon their planning and exercise activities.

The 2017-18 flu season is just a few short months away, so this summer is a great time for ambulatory, long-term and acute care facilities to revisit their surge plans and update or improve upon their preparedness, based upon an H7N9 scenario. Nine important areas to address for this type of a surge event are:

・Activation, operation and location of triage, holding, treatment and fatality areas

・Assessment of security vulnerabilities and limiting access to facilities

・Plans for maintaining critical and essential services

・Protocols for expanding patient capacity and tracking

・Estimates and sources of essential supplies, equipment, furnishings and pharmaceuticals

・Plans for large-scale prophylaxis and vaccination

・Protocols for long-term management and disposition of deceased patients

・Protocols for prioritization of resources when demand exceeds the resources available

・Establishment of standards of care during crisis, along with policies and procedures for the allocation of scarce resources

Even if the H7N9 virus doesn't begin spreading through communities or become a threat to the U.S., the investment of time and energy into planning for a surge of patients with influenza is productive. The review of existing plans with a specific event in mind can make gaps and weaknesses more apparent and contribute to processes running smoother during the next event — when it does arrive.



 Human infection with avian influenza A(H7N9) virus – China [World Health Organization, 23 May 2017]

On 13 May 2017, the National Health and Family Planning Commission of China (NHFPC) notified WHO of 23 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus in China.

Details of the case patients

Onset dates ranged from 11 April to 6 May 2017. Of these 23 case patients, ten were female. The median age was 58 years (range 31 to 83 years). The case patients were reported from Beijing (2), Fujian (1), Gansu (1), Hebei (5), Henan (3), Hubei (1), Jiangsu (2), Shaanxi (3), Sichuan (3), Tianjin (1), and Zhejiang (1).

At the time of notification, there were seven deaths, 15 case patients were diagnosed as having either pneumonia (5) or severe pneumonia (10), and one case was mild. Nineteen case patients were reported to have had exposure to poultry or live poultry market, one case patient was reported to have visited a patient with avian influenza A(H7N9) in the hospital, one case patient was reported to have had both exposure to live poultry and a contact with a confirmed case, and two were reported to have had no known poultry exposure.

Two clusters were reported:

・A 63-year-old male from Xi’an, Shaanxi Province. He had symptom onset on 29 April 2017 and was admitted to hospital on 2 May. His symptoms were mild. He had visited a confirmed case in the hospital, a 62-year-old male from Shaanxi Province with symptom onset on 18 April 2017 and who was previously reported to WHO on 5 May.

・A 37-year-old female from Chengde, Hebei Province. She had symptom onset on 2 May 2017 and was admitted to hospital on 3 May with pneumonia. She raised backyard poultry before her onset. She also had contact with a confirmed case, her mother, a 62-year-old with symptom onset on 16 April 2017 and who was previously reported to WHO on 5 May.

To date, a total of 1486 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported through IHR notification since early 2013.

Public health response

The Chinese governments at national and local levels are taking further measures, mainly including:

・Convening a video conference with some key epidemic provinces to provide avian influenza A(H7N9) epidemic information and guidance on strengthening risk assessment and prevention and control measures.

・Continuing to strengthen control measures with a focus on hygienic management of live poultry markets and cross-regional transportation.

・Conducting detailed source investigations to inform effective prevention and control measures.

・Continuing to detect and treat cases of human infection with avian influenza A(H7N9) early to reduce mortality.

・Continuing to carry out risk communication and issue information notices to provide the public with guidance on self-protection.

・Strengthening virology surveillance to better understand levels of virus contamination in the environment as well as mutations, in order to provide further guidance for prevention and control.

WHO risk assessment

The number of human infections with avian influenza A(H7N9) and the geographical distribution in the fifth epidemic wave (i.e. onset since 1 October 2016) is greater than in earlier waves.

This suggests that the virus is spreading, and emphasizes that further intensive surveillance and control measures in both the human and animal health sector are crucial.

Most case patients are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, and live poultry vending continues, further human infections can be expected. Although small clusters of human infection with avian influenza A(H7N9) virus have been reported including those involving patients in the same ward, current epidemiological and virologic evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore the likelihood of further community level spread is considered low.

Close analysis of the epidemiological situation and further characterization of the most recent viruses are critical to assess associated risk and to adjust risk management measures in a timely manner.

WHO advice

WHO advises that travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live poultry markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling in or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and influenza-like illness (ILI) and to carefully review any unusual patterns, ensure reporting of human infections under the IHR 2005, and continue national health preparedness actions.

Ebola outbreak News from 19 May 2017



 Lessons learned from the final Ebola outbreak in Guinea [STAT, 26 May 2017]

By NGOZI ERONDU

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Villagers wait for a distribution of sanitization supplies from UNICEF in the school in Meliandou, some 400 miles southeast of the capital of Guinea, during the Ebola outbreak in 2014. JEROME DELAY)/AP

In mid-March of 2016, I was a new field epidemiologist working in the West African country of Guinea. The Ebola epidemic seemed to be over: We were just 11 days away from being Ebola-free for 90 days, which would mark the official end of the country’s epidemic. Then field coordinator Dr. Angelo Loua walked into our small World Health Organization field office in the southeast region of N’zerekore and announced that an 8-year-old girl had just tested positive for Ebola.

“Please pray for us, it’s Ebola,” I texted my friends and family with confirmation of my worst fears.

In most accounts of the Ebola outbreak, Guinea’s experience is overlooked. Yet it was in Guinea in March 2014 that that the plague began, gripping seven of its eight regions, and from where it spread to Liberia and Sierra Leone. Ebola infected more than 28,000 people and killed more than 11,000 before it was declared over on June 9, 2016.

By early spring of 2016, most of the international organizations that had mobilized to fight the Ebola pandemic had called home their workers. Our field team managed to grow quickly from fewer than 20 staffers to more than 100, including local Guineans and international responders such as my teammates from the US Centers for Disease Control and Prevention. Most of the responders had worked in the region throughout the three-year outbreak. I was fresh out of grad school, completely frightened but ready to help.

That day in N’zerekore I left behind the academic world of epidemiology theory for real-world disease-control strategies such as contact tracing and monitoring. That meant searching for individuals who could eventually become Ebola victims, all somehow linked to a little girl who would not survive.

Her village, Koropara, had first seen Ebola more than two years before when 15 villagers died from the disease; 10 infected individuals survived. (We later learned that the new flare-up was caused by the still-infected sperm of one of the survivors being transmitted to an uninfected individual.)

What we knew at the time was that the N’zerekore region, where Koropara is located, was infamously known as the place where villagers killed eight members of a health team trying to raise awareness about Ebola in September 2014. This attack was attributed to widespread local distrust of government workers and unfounded fears that the medical teams were spreading the disease rather than trying to stop it.

This legacy of local resistance seemed as persistent as the virus. We learned of the child’s illness through local gossip rather than through the community alert networks that had been established, so it took critical extra days to reach the child. It also took military intervention — soldier-escorts protecting the health teams — and repeated assurances of safety by the local medical staff to the child and her community.

Guinea is, by some measures, less developed than Liberia and Sierra Leone, though all three countries were — and still are — among the world’s poorest nations. In 2014, Guinea’s health system was so fragmented and poorly resourced that Ebola spread undetected for three months. Back then, the government spent a mere $9 per capita on health, with fewer than three health workers for every 20,000 people. This meant that the type of expertise required to detect, assess, report, and respond to potential public health threats was largely nonexistent.

These realities became tremendous obstacles in the scramble to set up and resource Ebola treatment units. Shortly after the disease was detected, President Alpha Condé commissioned hundreds of freshly graduated medical students to become frontline soldiers in the fight against Ebola. This helped turn the tide, as local Guineans supported by international experts became field epidemiologists, infection control specialists, and health communication professionals.

In Koropara, I was impressed by how government health workers and their partners rebuilt community trust through communication and transparency. Instead of establishing their headquarters in a big city some distance away from the outbreak’s epicenter, as had been done before, this time the Ebola responders set up a tent village to house staff and serve as ground zero for all response activities just a few meters away from Koropara, close to where most of the suspected cases lived. That resulted in exceptional community collaboration. Many of those who had been in contact with the girl voluntarily quarantined themselves, received vaccinations, and let us monitor their health for the duration of the flare-up.

Our team, led by Dr. Iya Condé, a gregarious young Guinean doctor, regularly visited the family of a woman who died from Ebola. When her mother — who had washed her dead child’s body in preparation for her funeral — began to show signs of infection, the family reported it to us.

They were grateful, not defiant, when she was transported to the treatment unit. And we mourned together when she died.

This innovative approach to integrating the community into the response rapidly shifted the situation from crisis to recovery. This final Ebola episode was suppressed in 21 days, with just 10 fatalities. By the end of the flare-up, 98 percent of all contacts and 100 percent of high-risk contacts — nearly 200 households throughout four villages — had been successfully monitored.

The newly elected new WHO director-general, Tedros Adhanom Ghebreyesus, is the first African to hold that post. As the former minister of health in Ethiopia, he should understand the impact of integrating community members into health programs. This is increasingly important as experts continue to warn that the world is not ready for the next Ebola-like outbreak. The global health community is currently in the middle of several battles, including dispatching more vaccine to combat a yellow fever outbreak in South America, monitoring avian flu outbreaks around the world, and supporting mothers valiantly raising babies affected by Zika while working to prevent new infections.

Lessons learned from the Ebola outbreak in Guinea emphasize the value of a strong local and tailored response to outbreaks, when possible. Guinea’s fight against Ebola is a story of innovation, humility, and dedication. The country gave the world the wake-up call about the disease, and then offered solutions to take into the future. These include trained local responders, adequately staffed personnel at village health facilities, and a well-informed and engaged community.

Koropara taught us that in the fight against infectious disease outbreaks, community support and input are some of the best weapons for winning the war.

Ngozi Erondu, PhD, is an infectious disease epidemiologist and assistant professor at the London School of Hygiene and Tropical Medicine. She is an expert in health systems research in low- and middle-income countries and a 2017 Aspen New Voices Fellow.



 Genetic Testing Underway on Virus Behind New Ebola Outbreak [Voice of America, 26 May 2017]

by Sora Halake

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FILE - Health workers wash their hands after taking a blood specimen from a child to test for the Ebola virus in a area were a 17-year old boy died from the virus on the outskirts of Monrovia, Liberia, June 30, 2015.

Tests are underway to determine the genetic sequence of the Ebola virus behind an outbreak in central Africa, a U.S. Centers for Disease Control researcher said Friday.

Dr. Barbara Knust, an epidemiologist, told VOA's Horn of Africa service that scientists are looking for "clues" about where this strain of Ebola originated and how to treat it.

"That could help [us] understand how this virus is related to other viruses that have caused other Ebola outbreaks," she said.

The latest Ebola outbreak is in northern Democratic Republic of the Congo, in a remote area near the border with the Central African Republic. The World Health Organization said that as of May 24, Ebola had killed four people in the area and the number of suspected cases stood at 44.

The Ebola virus, which causes a type of hemorrhagic fever, killed more than 11,000 people across the West African countries of Guinea, Liberia and Sierra Leone in 2014 and 2015.

Resources 'mobilized quickly'

Staff from the CDC, the WHO, the Congolese Ministry of Health and other agencies are in Congo's Bas Uele province, working to contain the spread of the virus. Knust said the international response was going "fine."

"The responders involved in this outbreak very certainly are taking it seriously and the resources have been mobilized quickly," she said. "At least at this point of time [it] appears that it was detected fairly early, although that information is forthcoming. There is some hope it will remain a limited outbreak."

She said there had been discussion of using experimental treatments used in the West African outbreak, but that the Congolese government had not given its approval.

Dr. Galma Guyo, a disease control specialist in Nairobi, was part of an African Union team that responded to the Ebola outbreak in Liberia. He warned that the DRC's location in the center of Africa could allow the virus there to spread across borders.

"There is a possibility that the viruses can easily spread and be hard to detect due to the remoteness of the region, too," he said.



 Could pigs be involved in Congo's new Ebola outbreak? [Science Magazine, 26 May 2017]

By Kai Kupferschmidt, Jon Cohen

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Red Cross workers gathered in Likati at the outbreak's center to help with response.

It might all just be a big coincidence. But scientists and public health officials are investigating whether pigs are somehow involved in the Ebola outbreak now underway in a remote region of the Democratic Republic of the Congo (DRC). If so, it would add a new—but not totally unexpected—chapter to the virus's turbulent history.

Scientists' interest stems from two data points. An epidemiological investigation has indicated that the first person to fall sick was a hunter who had come into contact with a wild boar carcass. And 84 pigs have recently died in eight villages in Nambwa, the epicenter of the current outbreak, according to a report issued yesterday by the DRC's Ministry of Health. Researchers have taken samples from those animals, according to the report, which says a "protocol for investigation of unusual deaths reported in pigs is under development.”

“I’m doubtful that the pigs actually carry Ebola, but we have to test them,” says epidemiologist Fabian Leendertz of the Robert Koch Institute in Berlin, who has been consulted by the Institute of National Biomedical Research in Kinshasa about the potential link. Indeed, pigs in the DRC frequently die from other pathogens; the country often has outbreaks of African swine fever, which has a very high mortality rate. “Ebola is not even the prime suspect,” says Anne Rimoin, an epidemiologist from the University of California, Los Angeles, who has worked in the DRC for 15 years and is there now.

Still, a role for pigs would not come as a complete scientific shock. In 2009, researchers reported in Science that they had isolated an Ebola strain called Reston from pigs in the Philippines that were suffering from a severe respiratory syndrome. Ebola Reston has never been found to cause human disease, but the study found that some pig farmers had antibodies to the virus as well, suggesting that they had been in contact with it.

In 2011, a team by virologist Gary Kobinger of the Public Health Agency of Canada in Winnipeg reported that Ebola Zaire—the strain implicated in the current outbreak as well as the massive West African epidemic—could sicken pigs in the lab as well, and that the virus transmitted easily between pigs housed in the same cubicle. "This observation raises the possibility that pigs are capable of shedding relatively high viral loads into the environment," the researchers wrote. A year later, the group reported that pigs could also pass on Ebola Zaire to monkeys through aerosol. That suggested they might be able to transmit it to humans as well—but nobody knows if that has ever happened. Most Ebola outbreaks are believed to start when a human comes into contact with a bat or a primate infected with the virus.

The Ministry of Health (MoH) report notes that Kobinger has arrived in the country with “new reagents.” ScienceInsider could not reach Kobinger for comment.

If so many pigs in the Nambwa area were infected with Ebola, you'd expect to see more human cases, says Vincent Munster, a virologist at the National Institute of Allergy and Infectious Diseases in Hamilton, Montana, who's also preparing a mission to the DRC. "That said, one needs to remain open," Munster says. "This surely warrants a more thorough investigation."

The first patient or "index case" was a hunter aged 45 who died; his case has been confirmed as Ebola. Both Leendertz and Rimoin say they were told that he had contact with a boar before falling ill. But Rimoin stresses that he may have been in contact with other species as well.

Wild pigs are scavengers, and one possibility is that a wild boar was infected through contact with an ape carcass and passed the infection on to the hunter, Leendertz says. Domestic pigs might then have picked up the infection from humans. That is at least as likely as the opposite possibility: that Ebola has spread in domestic pigs and the animals passed it on to humans. “You can still draw the arrows in either direction,” Leendertz says.

To find a "smoking gun” that links pigs to this outbreak, Rimoin says, researchers would need to find Ebola viruses in pigs and show that the genetic sequence closely matched the one in humans. No virus has yet been sequenced from the two confirmed human cases.

The outbreak is in Bas-Uélé province in the northeast of the country; investigating it has been very difficult because the area is so remote. Only two of several dozen human samples so far have tested positive for the virus, and no healthcare workers have fallen ill—which is odd in Ebola outbreaks. There are currently three "probable" and 37 "suspected" cases in seven villages, and four apparently related deaths. Nearly 300 contacts of cases are being monitored.

Meanwhile, an ethics committee in the DRC yesterday approved a clinical study of an Ebola vaccine that might be able to end the outbreak more quickly. The vaccine, produced by Merck, showed promising results during the epidemic in a Guinea study, but remains unlicensed, which is why it can only be used in a formal trial. If the DRC government decides to deploy the vaccine—in addition to standard containment efforts already underway—the trial will be run jointly by MoH and Epicentre, the research arm of Doctors Without Borders.



 Ebola outbreak in Central Africa, officials scramble to control virus' spread [Fox News, 26 May 2017]

By Andrew O'Reilly

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In this 2014 photo provided by the Samaritan's Purse aid organization, Dr. Kent Brantly, left, treats an Ebola patient at the Samaritan's Purse Ebola Case Management Center in Monrovia, Liberia. (AP Photo/Samaritan's Purse)

Global health officials are monitoring a possible resurgence of the Ebola virus in the Democratic Republic of Congo amid reports of an outbreak of the feared contagion near the country’s northern border.

Public health officials in the DRC have reported at least 43 cases of suspected Ebola and four deaths. While only two of the cases have been positively confirmed in a laboratory to be Ebola, experts at the World Health Organization and the United States’ Center for Disease Control and Prevention are closely monitoring the situation and teams are already in the isolated region in an attempt to contain the outbreak.

‘‘The Likati health district is in a remote area, but contact tracing is essential to contain the outbreak in its focus; the DRC can rely on very experienced health workers for this purpose,” Yokouidé Allarangar, WHO representative in the DRC, said in a statement earlier this month.

This is the eighth epidemic of Ebola in the DRC since the discovery of the virus in 1976 and comes just three years after an outbreak in West Africa killed over 11,000 people and created a global panic. It is still unclear how Ebola outbreaks begin, but researchers theorize that it could come from people eating infected pieces of “bush meat” – the meat of primates and other wild animals sold in local markets – or from bats carrying the carrying the virus.

The DRC may have past experience dealing with Ebola outbreaks, but experts contend that the remoteness of the outbreaks’ hot zone – the northeastern Bas-Uélé province – and the country’s ongoing civil conflict make efforts to contain the virus’ spread difficult.

“The logistics are difficult,” Jesse Goodman, director of Georgetown University’s Center on Medical Product Access, Safety and Stewardship, told Fox News. “It’s a real challenge, but they have identified the area and are tracking a large number of contacts.”

The area – located over 300 miles from the DRC capital of Kinshasa - has very few passable roads and bridges open during this time of the year, so helicopters are required to bring teams and equipment to the town of Likati, where motorcycles take over. Health workers have already built two mobile labs, but a generator in one failed and had to be replaced.

What the 2014 outbreak taught us is two things: Ebola is not going away and we can’t let our guard down.
- Dr. Jesse Goodman of Georgetown University

The DRC’s government, along with the research arm of Paris-based Doctors Without Borders, submitted to an ethical review board on Wednesday a formal trial protocol for an unlicensed vaccine. If approved, the vaccine – developed by Merck and stored in the U.S. – could make it to at-risk people within two weeks. To speed the process, WHO recently issued a “donor alert,” requesting a six-month budget of $10.5 million to support the vaccine study and to fund surveillance, infection prevention, social mobilization and decontamination efforts.

Adding to the difficulty in accessing the region is the ongoing ethnic conflict between the Tutsi-controlled government under President Joseph Kabila, who refused to leave office at the end of his term last year, and the Hutu rebel group, the Democratic Forces for the Liberation of Rwanda.

“The political problems they are struggling with are frequently situations that make it difficult to fight any type of viral breakout,” Goodman said. “The unrest creates rich soil for an outbreak.”

Amid militia clashes and numerous violent protests – one in December left more than 50 people dead – the DRC saw more people leave their homes in 2016 than anywhere else in the world.

According to the most recent report by the Internal Displacement Monitoring Centre, 992,000 people fled the violence in 2016, compared to 824,000 in Syria, 659,000 in Iraq and 653,000 in Afghanistan.

“DRC’s crisis is often overlooked by media and an international community focused on the latest disaster or conflict to capture their attention,” the IDMC report stated. “This will have dire consequences for several million people in desperate need of assistance. The country has been in conflict for the best part of 20 years, but evidence shows that the situation for the most vulnerable has deteriorated severely in recent years.”

While the remoteness of the region experiencing the outbreak may pose challenges in treating and identifying those infected with Ebola, experts contend that the isolation could also play to their advantage by slowing the spread of infection. Still, they warn, even though the current outbreak is small and isolated, it needs to be carefully monitored to the neighboring war-torn nations of South Sudan and the Central African Republic.

“What the 2014 outbreak taught us is two things,” Goodman said. “Ebola is not going away and we can’t let our guard down.”




 Ebola outbreak may be smaller than feared, WHO indicates [STAT, 25 May 2017]

By HELEN BRANSWELL

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FREDERICK A. MURPHY/CDC

There are signs that the Ebola outbreak in the Democratic Republic of Congo may not be as big as was once feared, World Health Organization officials indicated Thursday.

Fourteen suspected cases have tested negative for the deadly virus, Alison Clements-Hunt, a WHO spokeswoman currently in Likati, the epicenter of the response, told STAT in an interview.

So far there have been two confirmed cases, four probable cases, and four deaths. Another 40 people are currently listed as suspected cases, said Clements-Hunt. Roughly 300 people who are contacts of known or suspected cases are being monitored to see if they develop symptoms.

Clements-Hunt cautioned, though, that in an outbreak the net is cast wide to try to find anyone who might have Ebola, so that they can be isolated and tested. People who are sick with Ebola but are missed by surveillance can infect family members; if they die and are buried in traditional burial rites, those attending funerals can also be infected.

In the early stages of Ebola, symptoms are vague and could be misattributed to other conditions. In an outbreak, it is not uncommon for some suspect cases to later test positive for malaria, say, and negative for Ebola.

A mobile laboratory is now operating in Likati, Clements-Hunt said. That will speed up the process of determining the actual scale of the outbreak. A response team of about 50 people from the DRC ministry of health, WHO, UNICEF, and Doctors Without Borders are in Likati, she said.

Among those who tested negative are five people who were being cared for in the Ebola treatment unit that was set up in Likati, Clements-Hunt said. Four have been released; one is still sick with something else and needs medical care.

Given what appears to be the limited scope of the outbreak, the use of an experimental Ebola vaccine may not be required.

“For the time, there doesn’t seem that there was really a necessity to do so. I hope it remains the case,” Dr. Marie-Paule Kieny, a WHO assistant director-general, told STAT.

That said, Kieny confirmed planning continues to allow for deployment of vaccine, if the government of DRC asks for it. But it may not, she acknowledged.

“The logistics, all the preparations are moving forward, but you can imagine that without indication that this is spreading, that the government may decide that maybe it’s not reasonable to start a big vaccination operation. And actually, you don’t know who you would vaccinate,”
Kieny said from Geneva.

The logistics of getting the vaccine to this remote part of DRC would be substantial. Clements-Hunt said getting from one village to another in this part of the country is incredibly difficult; there are no roads and response workers are being ferried along jungle paths on motorbikes.

“This is in the middle of nowhere,” said Kieny. ‘’It’s not a routine operation, so in order to go for it, they must be really sure that this is worth it.”

Some observers have questioned why the experimental Ebola vaccine, which was tested in Guinea in 2015, hasn’t been immediately sent to the DRC. There have been reports the government was hesitant about using an unlicensed product.

Kieny said this outbreak has galvanized awareness among the organizations that respond to Ebola outbreaks that the groundwork for use of the vaccine must be laid in advance in at-risk countries — places where Ebola outbreaks have happened in the past.

Regulatory agencies need to be asked to pre-approve vaccine use in emergencies; ethics committees that greenlight emergency use authorizations have to be asked to do this work in advance.

“This will move ahead as soon as this event is closed,” Kieny said. “After that we are having discussions about finalizing the preparations, making sure the protocol has been submitted in all the countries.”

An earlier version of this story incorrectly stated the surname of WHO spokeswoman Alison Clements-Hunt.



 South Sudan State Partially Closes Border in Ebola Scare [Voice of America, 23 May 2017]

by John Tanza

27918D85-05CE-4989-B60B-827F4A7521EF_cx0_cy4_cw0_w650_r1_s.jpg
FILE - A health worker sprays a colleague with disinfectant during a training session for Congolese health workers to deal with Ebola virus in Kinshasa, Oct. 21, 2014.

State authorities in South Sudan closed part of their border with the Democratic Republic of the Congo last week in an effort to prevent the spread of the deadly Ebola outbreak, declared by the World Health Organization in a remote, northern part of the DRC two weeks ago.

The WHO has confirmed that four people have died from the disease in the DRC. Lino Utu, deputy governor of Tambura state, said the movement of people and goods between the two countries at the border town of Ezo had been restricted until further notice.

"We closed the border temporarily because of Ebola," Utu said. "We have been told it has been found in DR-Congo. If we leave the border open, it can trickle down to Tambura state."

He said the area along the border with the DRC had been teeming with activity, "because it is where the people from the Democratic Republic of the Congo bring in their goods, and also the people from Tambura state bring in their goods. It's a big market."

Uto said doctors have confirmed that Ebola can be found in bushmeat, so state officials have temporarily banned the sale of all bushmeat in the markets.

"We cannot allow bushmeat to be sold any longer because people can easily contract Ebola from meat," Utu said.

ECADB52C-6986-41C4-804F-CCE34C57CAC7_w650_r0_s.jpg
FILE - A woman sells monkey meat in a market in Kisangani, Democratic Republic of Congo, April 15, 2004.

The minister of health was informed about Tambura's move to close the border at Ezo on Tuesday.

Utu said international health workers, including those with the WHO, are partnering with local officials to educate the public about how Ebola is spread. "This is awareness that has been going on and on and on," he added.

Utu is appealing to the WHO to send experts to Tambura to screen people for the deadly virus "and advise us in other areas as far as how Ebola is contracted and how we can prevent the spread of Ebola," he said, adding, "I really need them to come to us on the ground in Tambura state."

Authorities in Gbudue state, which also runs along the DRC, have banned the sale of bushmeat in Yambio markets, but have kept border crossing points open. The Gbudue state minister for information, Gibson Bullen Wande, said wildlife officials are creating awareness about the dangers of eating bushmeat. He said state officials and nongovernmental organization health partners have trained and deployed health workers along the border to monitor movement of traders. "We have also left some medical workers along those areas to let them monitor," he said.

Bullen said as far as he is concerned, it is the responsibility of the national government to decide whether to close the border between the two countries.

On Tuesday, the state director of wildlife went on the air to warn people against eating bushmeat.

"We are going to ban the sale of all bushmeat or any trading of the bushmeat [because] those are the things that people get Ebola from," Bullen said.



 EBOLA VIRUS IN DR CONGO: CDC NOT READY TO ISSUE TRAVEL ADVISORY Newsweek, 19 May 2017]

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British health workers lift a newly admitted Ebola patient onto a wheeled stretcher in to the Kerry town Ebola treatment centre outside Freetown December 22, 2014. Ebola is back, this time in the Democratic Republic of Congo.
BAZ RATNER/REUTERS

The U.S. Centers for Disease Control and Prevention (CDC) is still mulling over whether to issue a travel advisory regarding the developing Ebola outbreak in the Democratic Republic of Congo. When asked whether the agency planned to recommend restricting travel to the country and surrounding regions, a spokesperson from the CDC told Newsweek “not at this point.”

The agency says several factors are considered when deciding on the timing of a travel advisory, “including the size of the outbreak and number of people infected. As we learn more that will guide the decision to issue an advisory or not,” the CDC spokesperson added. "It comes down to risk/threat assessment and so far risk does not warrant advisory."

So far there are 29 suspected or confirmed cases of Ebola in the DR Congo, and at least three confirmed deaths, according to the World Health Organization (WHO). There are rumors as well that one suspected case of the virus (not yet laboratory confirmed) cropped up in South Sudan at the border of DR Congo.

If there is Ebola in South Sudan, it might mean an alarming start to a larger outbreak that will likely continue for some time, says Dr. Daniel Lucey, a spokesperson for the Infectious Diseases Society of America, an Ebola expert and senior scholar with the O'Neill Institute for National and Global Health Law at Georgetown University. Lucey says the 2014 epidemic in West Africa that sickened 28,646 and killed 11,323 as of March 2016, taught us that the virus becomes more difficult to contain once it shows up in a new country. That outbreak which was said to begin in Guinea spread in a matter of months to Liberia and Sierra Leone.

“The crossing of borders means you have to have a regional response and not just a national response. It adds another layer,” says Lucey. Handling any outbreak of an infectious disease takes huge coordination between public health officials, health care workers, local governments and international organizations. “That can be hard to do for one country, but then you have to do it for two or three it’s a new level of complexity.”

Health officials confirmed the first case in the DR Congo on April 21, which is in a remote area in the province of Bas-Uele in the northeastern part of the country. “It’s a huge human and logistical challenge. Affected populations are located in areas only reachable by helicopter or by moto-bike,” Dr. Nafissa Dan-Bouzoua, the medical manager in the DR Congo for the Alliance for International Medical Action, told Newsweek.

The WHO still has yet to issue any travel restrictions or advisories to the DR Congo. Because the area is remote the WHO has deemed the risk assessment for this event is “high” at the national level, medium at the regional level and low at the global level. There have been two previous Ebola outbreaks in the DR Congo, according to the WHO. One occurred in 1976. The second, in 2014, killed 49 people.

However, some countries are choosing to take precautions. According to the WHO, as of May 18, seven countries have enforced entry screening at airports and ports of entry. These include Kenya, Nigeria, Rwanda, South Africa, the United Republic of Tanzania, Zambia and Zimbabwe. Rwanda issued a travel advisory strongly recommending against travel to the DR Congo. The United Kingdom also recommends against traveling in the areas around the epicenter of the epidemic. Two countries (Kenya and Rwanda) implemented information checking arrival for passengers with travel history from and through the DR Congo. According to Mashable NG, the government in Liberia issued orders to screen all arriving passengers at Murtala Muhammed International Airport.

WHO did confirm that reports from earlier this week of a border closure by South Sudan were false. However, as a precaution earlier this week, South Sudanese officials began to set up medical support services at the border, particularly the airport in Juba and border-crossing checkpoints.

But South Sudanese officials have been on high alert for the potential for Ebola outbreak, especially because outbreaks have occurred in the past: In 2004, the WHO confirmed 20 cases, including five deaths from Ebola, were in Yambio County in southern Sudan.

Last month, health officials became concerned when more than two dozen people fell ill with symptoms of bloody diarrhea (a common symptom of Ebola). However, the rush of illnesses were suspected to be linked to dysentery caused by the bacteria Shigella.

Symptoms of Ebola include fever, headache, muscle pain. At a later, acute phase some patients have internal bleeding that causes vomiting or coughing up blood. The virus has between a 20- and 90-percent fatality rate based on the public health reponse.

Addressing an Ebola outbreak requires setting up temporary medical facilities that adhere to certain regulations. It takes the local on-the-ground work of epidemiologists and other public health care personnel who are familiar with the arduous process of contact-tracing needed to stop the train of transmission. The WHO reports there are some 400 people who were likely to have been exposed to people who have the virus in DR Congo, and that means locating each and every one of them to monitor their health and test them for the virus. Lucey is confident this won’t be the end of contact-tracing: “I would predict that in another couple days there will be more than 400 contacts.”

Meanwhile, the WHO is awaiting a greenlight from the DR Congo health and regulatory agencies to import a supply of an experimental Ebola vaccine, produced by Merck and known as rVSV-ZEBOV. According to a study conducted in 2015 in Guinea that involved 11,841 people, the vaccine can prevent illness in people who have been exposed to the virus. But Lucey says researchers still aren’t completely certain how long the vaccine remains effective once a person receives it.



 Number Of Suspected Ebola Cases In Congo Up To 29; WHO Says $10M Needed For Initial Response, Control Efforts [Kaiser Family Foundation, 19 May 2017]

Associated Press: Number of suspected Ebola cases in Congo now up to 29

“The World Health Organization says Congo now faces 29 suspected cases of the deadly Ebola virus. WHO spokesman Christian Lindmeier on Friday said the number includes two laboratory-confirmed deaths…” (5/19).

CIDRAP News: WHO: Ebola vaccine could be deployed within a week

“In a telebriefing [Thursday] on the Democratic Republic of Congo’s Ebola outbreak, World Health Organization (WHO) officials said while the country has yet to make a formal request for the Ebola vaccine, such a requisition could be fulfilled within one week…” (Soucheray, 5/18).

NBC News: Ebola in Democratic Republic of Congo to Cost $10 Million, WHO Says

“… ‘There are only 20 kilometers (12 miles) of paved roads in this area and virtually no functioning telecommunications,’ WHO’s Dr. Peter Salama told a news conference. ‘As of now we do not know the full extent of the outbreak’…” (Fox, 5/18).

New York Times: Suspected Cases of Ebola Rise to 29 in Democratic Republic of Congo

“…Dr. Peter Salama, the executive director of the organization’s health emergencies program, said at a briefing that it was essential to ‘never, ever underestimate Ebola’ and to ‘make sure we have a no-regrets approach to this outbreak’…” (Grady, 5/18).

ScienceInsider: As Ebola outbreak grows, question of using vaccine becomes more urgent

“As health officials and aid workers head to a remote corner of the Democratic Republic of the Congo to respond to an outbreak of Ebola virus disease, a key question remains: Will the government authorize the use of a promising experimental vaccine? The vaccine had stunning results in a clinical trial in Guinea in 2015, but it has yet to be licensed for broad use…” (Cohen, 5/18).

TIME: Ebola Is Back. Here Are the Challenges Ahead

“…The response to the outbreak is being led by the Democratic Republic of Congo’s Ministry of Health and WHO, with partners including the World Food Programme, UNICEF, and the Red Cross. Priorities currently include a heavy focus on surveillance: getting the best information about the people who have been affected and tracking those who may have been affected, as well as managing and isolating Ebola cases and engaging local communities…” (Samuelson, 5/18).

U.N. News Centre: Experts race against clock to quell Ebola outbreak in remote DR Congo province — U.N.

“…Meanwhile, the first Ebola treatment center has been established in the Likati General Hospital. Protective gear has been dispatched to health workers and a mobile lab is being constructed and then deployed to the area. Immediate repairs to air strips and telecommunications are also being carried out. The first six months of the operation are expected to cost $10 million…” (5/18).

Ebola outbreak News from 15 till 18 May 2017




 Ebola in Democratic Republic of Congo to Cost $10 Million, WHO Says [NBCNews.com, 18 May 2017]

by MAGGIE FOX

A fresh outbreak of Ebola in the Democratic Republic of Congo (DRC) will cost $10 million to fight, and it could take months because victims are in such a remote and disrupted part of the country, the World Health Organization said Thursday.

At least 20 people are sick and three have been killed by the virus, WHO officials said. They are the first case — a 39-year-old man — a person who cared for him and a man who drove him on a motorcycle to get help.

"There are only 20 kilometers (12 miles) of paved roads in this area and virtually no functioning telecommunications," WHO's Dr. Peter Salama told a news conference.

"As of now we do not know the full extent of the outbreak."

WHO needs governments to help it and the Democratic Republic of Congo fix airstrips, roads and set up clinics — and all that just to even get a grip on how bad the outbreak is, Salama said.

Work is under way to get approval and facilities in place to use an experimental Ebola vaccine in the area.

Ebola has been causing sporadic outbreaks in various parts of Africa since 1976. The first and only epidemic was in 2014-2016 in Guinea, Liberia and Sierra Leone — a part of the continent where Ebola had never been seen before. It infected at least 28,000 people and killed more than 11,000 before it was brought under control.

This is the DRC's eighth Ebola outbreak.

"We believe that the DRC's government has strong experience … and a proven track record of handling Ebola outbreaks," Salama said.

An Ebola vaccine was tried out in West Africa but there were not enough cases to show how well it worked. That vaccine is not yet approved by any government authority but Salama said it could be used under compassionate use circumstances if the DRC government agrees.

But it will be hard to get it to the affected area in the north of the country because of the lack of roads and electricity. The vaccine must be kept at -80 degrees C. "This is going to be an enormous challenge," Salama said.

And the Lord's Resistance Army, a violent and disruptive armed group, has been operating in the area, WHO added.

Despite the problems, Medecins Sans Frontieres, a nonprofit aid group also known as MSF or Doctors Without Borders, has already set up one treatment center, said Dr. Matshidiso Moeti, WHO regional director for Africa.

"I have been very encouraged by this rapid reponse," Moeti told the news conference.

And, she said, polio vaccination teams were already in place, giving everyone a head start. "They have been the people who are leading surveillance in the country," Moeti said.



 US health secretary visits Liberia, where Ebola killed 4,800 [New Jersey Herald, 18 May 2017]

By JONATHAN PAYE-LAYLEH

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US Secretary of Health and Human Services Tom Price, right, walks Thursday May 18, 2017 through a densely-populated and heavily congested Monrovia, Liberia, slum community which was quarantined in 2014 when Ebola struck there killing dozens. This is Price's first visit outside the US since assuming the position. (AP Photo/Jonathan Paye-Layleh)
The Associated Press

MONROVIA, Liberia (AP) — U.S. Health and Human Services Secretary Tom Price on Thursday made his first trip overseas to Liberia, the West African country where Ebola killed more than 4,800 people.

Price praised Liberia for its "remarkable cooperation" on health care issues. The U.S. sent troops into the country to intervene to help stop the outbreak, which killed more than 11,300 people, mostly in Liberia, Sierra Leone and Guinea.

The World Health Organization declared an end to the world's deadliest outbreak of the virus in June. Now a new outbreak, the first since the one in West Africa, has been blamed for three deaths in a remote area of Congo.

Price, who did not address the latest outbreak, toured the West Point community that was hit hard by the hemorrhagic fever in 2014. Dr. Mosoka Fallah, a Liberian health ministry official, told Price there had been resistance from people there to report for testing.

"People said the Ebola situation was one-way traffic ... people go to the (Ebola Treatment Units) but don't come back alive," Fallah said.

Ebola survivor Mohammed Kromah told Price how he spent almost two months at a treatment center. He showed the U.S. official his Ebola-free certificate, which was greeted with wide applause.

Price also met with health workers at Redemption Hospital, where Liberia's first Ebola death was recorded in 2014.

"I was so moved when we were at West Point, with Dr. Fallah sharing his story and the emotion of the same setting, where the remarkable challenge of Ebola, the Ebola crisis, played out right in their community," he told The Associated Press.

He praised survivors, saying "we celebrate their victory over Ebola."

Price promised to highlight the U.S.-Liberia partnership that helped defeat Ebola when he attends the upcoming G-20 health summit in Berlin.



 Ebola Is Back. Here Are the Challenges Ahead [TIME, 19 May 2017]

by Kate Samuelson

An outbreak of Ebola has emerged in the Democratic Republic of Congo, and hundreds could be affected, the World Health Organization (WHO) has confirmed. The risk assessment is high at a national level, medium at a regional level and currently low at a global level, said Peter Salama, WHO's executive director for health emergencies, during a telephone briefing.

Three people have died out of about 20 suspected and confirmed Ebola cases, with the outbreak centered in Bas-Uele, a province in the northeast of the Democratic Republic of Congo, on the border of the Central African Republic and close to South Sudan. So far, the aid workers have identified more than 400 contacts of Ebola cases and are attempting to track them down. (Another outbreak of a disease that shares similar features to Ebola, including vomiting and nausea, has appeared several hundred kilometers away from Bas-Uele, but WHO does not believe the two incidents are linked.)

The Bas-Uele province is remote with poorly built roads and virtually no functioning telecommunications, Salama said, making it a difficult place for aid workers to access.

Additionally, it has been subject to insecurity and displacement, particularly due to the ongoing conflict in the Central African Republic. The Lord's Resistance Army, a rebel group active in central Africa, is believed to have been active in the area.

"We cannot underestimate the logistical and practical challenges associated with this response at a very remote part of the country," Salama said on the call. "As of now we do not know the full extent of the outbreak, and as we deploy teams over the next few weeks, we’ll begin to understand more and more exactly what we are dealing with."

The response to the outbreak is being led by the Democratic Republic of Congo's Ministry of Health and WHO, with partners including the World Food Program, UNICEF and the Red Cross. Priorities currently include a heavy focus on surveillance: getting the best information about the people who have been affected and tracking those who may have been affected, as well as managing and isolating Ebola cases and engaging local communities.

The first Ebola treatment center was recently established in Likati, and the construction and deployment of a mobile lab is in process. Health and care workers are also being provided with protective equipment.

"We believe that the Democratic Republic of Congo's government has strong experience in dealing successfully with and a proven track record of managing Ebola outbreaks," Salama said.

" We’ve also learned never ever to underestimate the Ebola virus disease and we will be remaining vigilant and ensuring we have no regrets in our approach to this outbreak as we move forward."

WHO was criticized for its slow and ineffective response to Ebola when it struck West Africa in 2014. In a statement in 2015, WHO said the incident "served as a reminder that the world, including WHO, is ill-prepared for a large and sustained disease outbreak."

WHO then promised to introduce a series of reforms, including the establishment of a contingency fund to enable the organization to respond more rapidly to disease outbreaks.

This fund has been deployed by WHO to help tackle the current crisis in the Democratic Republic of Congo.

However, Salama explained that WHO anticipates that the need for funding will soon outstrip the amount of money in the contingency fund. "[For] the first six months [we] will need about 10 million dollars, not just for WHO but for all partners responding," he said.

WHO is also hoping to use vaccinations as a tool to fight the outbreak. Although there is currently no licensed vaccine for the Ebola virus disease, there is a "very promising vaccine candidate " known as rVSV-ZEBOV that showed efficacy and safety during a trial conducted in Guinea, in West Africa, in 2015.

In order to employ it as an experimental vaccine, WHO needs to seek the permission of the national regulatory authority in the Democratic Republic of Congo to use the treatment under what Salama called an "expanded access framework for compassionate use."

The vaccinations, which will not be provided to the general population but only to current cases' contacts, need to be kept at -80 degrees centigrade. "As you can imagine, in an area without telecommunications, without road access [and] without live-scale electrification, this is going to be an enormous challenge," said Salama. "We are committed to working with the Democratic Republic of Congo...and the other partner agencies to implement the vaccination campaign, should the government give it the green light."

While WHO waits for the vaccines to be approved, the organization is making sure the treatment can be used immediately after permission has been granted by working with Guinea's government to move equipment over and discovering the outbreak's epidemiology. "The vaccine can move very quickly, so as soon as we have the logistics in place... then the vaccine can be shipped [over from the U.S.]," said D r. Matshidiso Rebecca Moeti, WHO's Regional Director for Africa. "[We are] putting all these preparations in place so it can go at that speed as soon as we get the green light."

Moeti said she felt positive about WHO's response so far. "I'm very optimistic it is going to get us to where we'd like to be: a controlled, short-lived outbreak of Ebola as they have seen in the past in this country."



 Suspected Cases of Ebola Rise to 29 in Democratic Republic of Congo [New York Times, 18 May 2017]

By DENISE GRADY

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Medical workers treating a patient suspected of having Ebola in the Democratic Republic of Congo in 2007. Credit Ascale Zinten/Doctors Without Borders, via Agence France-Presse — Getty Images


The number of suspected cases of Ebola has risen to 29 from nine in less than a week in an isolated part of Democratic Republic of Congo, where three people have died from the disease since April 22, the World Health Organization said on Thursday.

The W.H.O. was criticized for responding too slowly to an outbreak in West Africa in 2014 that left more than 11,000 people dead, and Dr. Peter Salama, the executive director of the organization’s health emergencies program, said at a briefing that it was essential to “never, ever underestimate Ebola” and to “make sure we have a no-regrets approach to this outbreak.”

The risk from the outbreak is “high at the national level,” the W.H.O. said, because the disease was so severe and was spreading in a remote area in northeastern Congo with “suboptimal surveillance” and limited access to health care.

“Risk at the regional level is moderate due to the proximity of international borders and the recent influx of refugees from Central African Republic,” the organization said, but it nonetheless described the global risk as low because the area is so remote.

About a week ago, in addition to the nine suspected cases, 125 patients who had come into close contact with the disease were being monitored. Now about 400 patients are being followed, even as nine new cases were reported on Thursday, according to the W.H.O.

The Ebola virus causes fever, bleeding, vomiting and diarrhea, and it spreads easily by contact with bodily fluids. The death rate is high, often surpassing 50 percent, particularly with the Zaire strain, which has been confirmed in two cases in this outbreak.

The outbreak was reported in a densely forested part of Bas-Uele Province, near the border with the Central African Republic. Cases have occurred in four separate parts of a region called the Likati health zone.

Aid groups and the W.H.O. have struggled to reach the affected area, which has no paved roads and can be reached only by a motorcycle ride through the forest, or by helicopter or light aircraft.

The first known case occurred on April 22, when a 39-year-old man who had fever, vomiting, diarrhea and bleeding died on the way to a hospital in the Likati zone. The person caring for him and a motorcyclist who transported him also died.

The first six months of the response to the outbreak are expected to cost the W.H.O. and aid groups $10 million, Dr. Salama said at the briefing. He said telecommunications networks would have to be established and airstrips repaired so that aid workers can provide the necessary medical care.

The W.H.O., aid groups and the Congolese government are discussing the possibility of using an experimental Ebola vaccine, made by the American pharmaceutical company Merck, that proved effective in Guinea.

The response would involve a “ring vaccination,” in which contacts of patients, contacts of contacts, and health workers would be vaccinated. There would be no mass public vaccination.

The vaccine has not yet been licensed, and its use would require permission on several fronts. Nonetheless, Dr. Salama said that if permission were granted, the vaccine could be made available in a week or so. Other experimental antiviral drugs may also be considered.


The Ebola virus is considered endemic in the Democratic Republic of Congo, where eight outbreaks, the largest involving about 300 patients, have been recorded since 1976.

The country “has considerable experience and capacity in confronting these outbreaks,” Dr. Daniel Bausch, an Ebola expert at the W.H.O., said in an email. He added, “I think there is a very good probability that control can be rapidly achieved.”

Dr. Salama said that aid workers had reached a town in the Likati zone, which was as close as they had been able to come to the epicenter of the outbreak. He said aid groups were setting up centers for treatment and isolation, and mobile labs.

The first aid group to arrive was the Alliance for International Medical Action, which was already in the region, responding to cholera.

In a telephone interview from Conakry, Guinea, the group’s executive director, Matthew Cleary, said that seven people who were believed to have contracted Ebola had been taken to a district hospital in the Likati zone that was not equipped to deal with the virus.

“It’s urgent to get them into a proper isolation center,” Mr. Cleary said, adding that the group is preparing to build a treatment unit. It will include windows that allow families to see patients, a response to past outbreaks in which people feared and sometimes shunned sealed-up isolation units into which patients seemed to disappear.

Brienne Prusak, a spokeswoman for Doctors Without Borders said on Wednesday that the group had sent a team of about 20 doctors, nurses and other experts to the Likati zone, and that it was still trying to figure out how to reach the epicenter.

“Transport is extremely difficult in the area, and helicopter flights may be the only way to get there,” she said by email. “We considered motorbikes but are now thinking of helicopters because we need to get so many materials there. We’re expecting to get to the epicenter by the weekend.”

The Centers for Disease Control and Prevention in the United States is also sending a renowned Ebola expert, Dr. Pierre Rollin, to Congo, along with epidemiologists, a spokeswoman said.

Correction: May 18, 2017

An earlier version of this article referred imprecisely to treatment units for Ebola being built by the Alliance for International Medical Action. While a unit is planned, construction has not yet begun.



 DRC Ebola outbreak: Lessons from West Africa [Vanguard, 17 May 2017]

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THE return of the Ebola Virus Disease to the Democratic Republic of Congo, DRC, soon after the devastating West African Ebola epidemic has raised fears about the possibility of another disaster in the making.

In this piece, Dr. Terence Gibson, a Consultant Physician at Guys and St Thomas NHS Foundation Trust, London who was a Consultant Physician at Connaught Hospital in Freetown, Sierra Leone between 2014-16 writes about the issues surrounding the Ebola response, and why a stronger leadership of the World Health Organisation is required to translate policy across continents.

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Terry Gibson

With a new outbreak of Ebola cases being announced last week in the Democratic Republic of Congo, I am reminded of early 2014 when I took up a position as a consultant physician in the largest hospital in Freetown.

I was a volunteer member of the Kings Sierra Leone Partnership, dedicated to supporting the development of clinical services and both undergraduate and postgraduate education.

In a country of just over six million people, there was an acute shortage of health workers and just 150 doctors nationally.

For two months the pattern of my professional life was familiar; a mix of daily ward rounds, teaching and organizing seminars for house officers.

The diagnostic facilities were poor and treatment options limited by availability and patients’ ability to pay.

Shadow cast: In neighboring Guinea, an outbreak of Ebola erupted in March and cast a shadow over Sierra Leone.

Ebola had never been seen in the region and the country and health infrastructure was not prepared for the seismic shock that was about to come.

Public posters did appear in May advocating that those with blood stained vomiting or diarrhea report to a hospital. These symptoms were amongst the least likely early symptoms of Ebola.

Denial

As cases trickled into the East of the country, to many in Freetown it seemed too distant to cause an immediate worry. Denial of the disease led to inaction.

Amongst the first practical moves of preparedness in Freetown, the Kings Partnership, in collaboration with the hospital authority, converted a surgical observation area into an isolation unit, a step emulated throughout the city and neighboring districts much later.

By summer, denial was overtaken by panic as deaths mounted. NGOs packed up and left, schools and colleges were closed, airlines withdrew services.

There was a shock when the national clinical lead against Ebola died of the disease, followed soon by one of my two physician colleagues. Health workers around the country began dying in disproportionate numbers despite increasing availability of protective garments.

The house officers at my hospital went on strike and many deserted. For the next several months the local medical workforce continued to decline until bolstered by clinicians from elsewhere.

Ebola treatment centres began to appear run by international volunteers and supported by outside agencies and governments.

But it was too late to avoid the spectacle of corpses lying outside and within the hospital as remaining staff bravely maintained an inpatient service for all the other diseases. Separating and isolating suspected Ebola from the main body of patients was a risky priority and more doctors and nurses were to die while performing their duty.

The isolation unit at the hospital where I worked was staffed by volunteer Sierra Leone nurses and health workers from the UK and elsewhere, sponsored by the Kings Sierra Leone Partnership.

When cases were confirmed they were transferred to treatment centres of which there was only one in the first few months and that was a five-hour drive from Freetown.

Plateau of cases

By the end of 2014 the number of Ebola cases appeared to be reaching a plateau at the same time as isolation and treatment centres were expanding.

As the number of beds grew so did the admission of suspects who proved not to have Ebola. Throughout the epidemic, the many diseases sharing characteristics of Ebola such as fever, delirium or diarrhea were denied best treatment until cleared of Ebola.

Many of those that died are not included in the official statistics, because they were hidden cases that involved secret burials.

Weak leadership and fear of offending the national pride of the Sierra Leone government may or may not have accounted for the invisibility of the WHO on the ground during this period. As a clinician who was there at the beginning and at the end, I was puzzled by the slow response of the WHO.

Personal interaction: My only personal interaction with the organization was as the disease frequency was in decline and the number of WHO officials was increasing.

A policy of quarantining all those who had contact with initially unsuspected positive cases unless wearing full personal protective clothing was introduced by WHO and enforced by the suddenly numerous and zealous officers on site.

Those of us who had been exposed inadvertently on several occasions survived because of simple infection control precautions and the monitoring of body temperature.

We wished that they had been present six months earlier when the disease was running rampant.

Then, strict quarantine and monitoring would have been sensible but now the measures were seen as too late to make any real impact.

For those of us involved in clinical care during this period, the role of WHO in leading the effort to contain and manage Ebola seemed chaotic from start to finish.

Systemic failure: Ebola exposed a systemic failure at the highest level of the organization.

Now that there is going to be a fresh head of the organization, there is an opportunity to ensure that such dilatory and inept behavior are not repeated should similar circumstances such as the Ebola pandemic recur.

To this end, a candidate with personal experience of clinical medicine and its challenges, who can translate this into policy across continents and who is unafraid of confronting national governments when appropriate should be appointed.

As far as I can see, Dr. Sania Nishtar is the standout candidate that matches this criteria and would be an effective leader to deal with future Ebola outbreaks.

As well as accelerating the reforms within WHO, it is critical that we learn the lessons of past outbreaks and move quickly to stop the DRC outbreak and save lives.



 WHO Confirms Ebola Outbreak in the Democratic Republic of Congo [Infectious Disease Advisor (registration), 17 May 2017]

There are now 3 confirmed deaths from the Ebola outbreak in the Democratic Republic of Congo (DRC), reported by the World Health Organization (WHO) last week.1

Reuters reports that WHO health officials are trying to trace 125 people possibly linked to the confirmed cases in the Bas-Uele province in northeastern Congo.2

A candidate vaccine for the Ebola virus, rVSV-ZEBOV, has been found highly effective in preventing virus development in exposed people. Researchers of the study, published in The Lancet, monitored areas in Africa where the 2015 Ebola virus outbreak occurred. Results showed that immediate vaccination was highly effective in protecting vaccinated and unvaccinated individuals.3

The DRC government has not yet requested use of the candidate vaccine for the current outbreak.

References

1. Mohney G. New Ebola outbreak leaves 3 dead in Democratic Republic of Congo [news release]. ABC News. http://abcnews.go.com/Health/ebola-outbreak-leaves-dead-democratic-republic-congo/story?id=47437034 Published May 16, 2017. Accessed May 16, 2017.

2. Ross A. WHO confirms second Ebola case in Congo outbreak [news release]. Reuters. http://www.reuters.com/article/us-health-ebola-congo-idUSKCN18A0ZP Published May 14, 2017. Accessed May 16, 2017.

3. Henao-Restrepo AM, Camacho A, Longini AM, et al. Efficacy and effectiveness of an rVSV-vectored vaccine in preventin Ebola virus disease: final results from the Guinea ring vaccination open-label, cluster randomized trial (Ebola Ça Suffit). Lancet. 2017;389:505-518. doi: 10.1016/S0140-6736(16)32621-6



 Speed, coordination key to curbing DRC’s Ebola outbreak [The Star, Kenya, 17 May 2017]

By THE CONVERSATION

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 Healthcare workers prepare to disinfect an ambulance transporting a newly admitted Ebola patient at the entrance to the Save the Children Kerry Town Ebola treatment centre outside Freetown, Sierra Leone, December 22, 2014. /REUTERS

Three people have died and more than 125 are suspected to be infected with the Ebola virus in the Democratic Republic of Congo (DRC). The outbreak comes less than two years after the most deadly spread of the disease in West Africa. Jacqueline Weyer explains how the outbreak compares to those in the past.

Are there any links between this outbreak and the one that hit West Africa between 2014 and 2016?

There isn’t an expectation that a direct link will be found between the outbreak in West Africa and the one in the DRC. Sequencing data will reveal more information, most importantly the strain of the virus involved and how it relates to Ebola viruses reported in previous outbreaks.

The Ebola virus is known to occur in the DRC and outbreaks are not entirely unexpected. In fact the virus derives its name from the Ebola river in the northern Democratic Republic of Congo.

There have been more Ebola outbreaks in the DRC than in any other country. Over the past ten years there have been four: 2007, 2008-2009, 2012 and in 2014.

Nevertheless, whatever the virus or strain involved, outbreaks of viral hemorrhagic fever are always concerning. The unavailability of proven prophylaxis, effective treatment and high mortality rates are the reasons why these diseases are feared.

Outbreaks like this also often occur in areas that are impoverished. This poses particularly tough challenges in managing cases and containing an outbreak.

What is the difference between an outbreak and an epidemic? At which point will the outbreak become an epidemic?

The two terms actually have the same definition and are often used interchangeably. Both imply an increase in the number of cases of a disease occurring in a population at a specific time, or if there’s an expectation that the disease will spread.

The term “outbreak” is sometimes used when describing an event that happens suddenly and is limited in size and to a particular area. Epidemic, on the other hand, is used to describe a more profuse and dispersed disease event over time. But the line is grey.

What word is used is less important than the fact that outbreaks of viral hemorrhagic fever are always concerning.

What lessons have been learnt from previous outbreaks?

A swift response is critical to containing an outbreak. One major challenge in West Africa was the delay in recognising the outbreak. This meant that the disease was already spreading profusely which made it more complicated to contain the outbreak.

Containment efforts are complex and require many pieces of a puzzle to be put together to achieve success. This includes:

・supporting hospitals to limit transmission of the virus to health care workers while treating patients,

・engaging with communities so that they can understand the problem, and participate and support the containment efforts themselves,

・and active case tracing to identify potential contacts and new cases in order to ultimately interrupt the chain of transmission.

All these efforts have to be supported by adequate communication and logistics. The quicker all these actions can come together, the better the outcome of the containment effort.

Parts of the DRC are still plagued by violence. How would this exacerbate the current outbreak?

The violence in the country has had a massive impact on the availability of health care services.

This is obviously a challenge and could hamper international efforts as relief workers and containment teams find it hard to reach the areas in need.

The good news is the country has experience in dealing with Ebola outbreaks, including some in country laboratory capacity for testing samples from suspected cases.

It’s still early days and much depends on how the situation unfolds in the DRC. But there are good examples of the challenges of delivering health care in conflict zones. There are many initiatives and strategies for trying to ensure safe delivery of and access to health care in conflict zones by many governmental and non-governmental agencies around the world. The situations in Syria and South Sudan come to mind.



 Undetected Ebola infection in international healthcare workers very unlikely [Science Daily, 16 May 2017]

'Near miss' exposure incidents put deployed staff at risk

Undiagnosed Ebola virus infection was probably very rare in international workers who were deployed during the 2013-2015 outbreak of the virus in West Africa, despite mild and asymptomatic cases of Ebola being known to occur, according to new research published in the journal PLOS Medicine.

As part of the study, more than 250 UK and Ireland healthcare and other workers were tested for Ebola virus antibodies after returning from West Africa -- no evidence of missed infections was found. This suggests that the vast majority of volunteers were kept safe by Personal Protective Equipment (PPE) and the Ebola treatment centre procedures in place.

However, the study also found that potentially avoidable events putting frontline workers at risk of infection were quite common during the outbreak, with one in six participants classified as having 'near miss' exposure events.

In what is believed to be the first study of the prevalence of Ebola infection in international responders the research team, led by the London School of Hygiene & Tropical Medicine and funded by the Wellcome Trust, enrolled 300 UK and Ireland healthcare and other frontline workers¹ for the study and sent them oral fluid collection devices.

Among the 268 respondents who returned their samples, 99% showed negative results on an antibody test which the authors had already proved gave very accurate results in Sierra Leone2.

The remaining two people, who had no known exposure or symptoms, had positive results, but follow-up testing using different methods was negative, making Ebola virus infection very unlikely.The research team, led by the London School of Hygiene & Tropical Medicine and funded by the Wellcome Trust, enrolled 300 UK and Ireland healthcare and other frontline workers¹ for the study and sent them oral fluid collection devices.

Among the 268 respondents who returned their samples, 99% showed negative results on an antibody test which the authors had already proved gave very accurate results in Sierra Leone2. The remaining two people, who had no known exposure or symptoms, had positive results, but follow-up testing using different methods was negative, making Ebola virus infection very unlikely.

Lead author Dr Catherine Houlihan from the London School of Hygiene & Tropical Medicine and UCL said: "The 2013-2015 Ebola outbreak was unprecedented -- the commitment and bravery of those who volunteered saved many lives.

We know a small number of international health workers were infected with the virus but we thought it was possible that some infections had been missed, as we know asymptomatic or unrecognised infections can occur.

However, our research suggests undetected infection in this group is, at most, a very rare event, and that the Personal Protective Equipment did its job well."

Participants, who included clinicians, laboratory workers and epidemiologists, also completed an online survey which asked if they experienced possible exposure to Ebola virus while in West Africa.

Using 268 respondents' descriptions, 16% (43 people) were identified as having 'near miss' exposure events.

27 respondents reported experiencing very low-risk incidents³ such as having a facemask dislodged. Ten were identified as having low-risk exposure events which were classified as having direct physical contact with an Ebola patient who does not have vomiting, diarrhea, or bleeding.

Five faced an intermediate risk incident with one respondent reporting 'being vomited on while wearing just gloves' and not full PPE, and one experienced the high-risk incident of a 'sharp injury with a broken vial of medication inside the 'red zone' with dirty and contaminated gloves'.

The antibody tests showed that none of these individuals had any evidence of infection with Ebola.

Participants reported PPE suits torn by catching on doorways or corners, PPE breaches in Ebola laboratories, such as torn outer gloves, as well as the additional anxiety and distress these incidents caused them.

Dr Catherine Houlihan said: "The scale of the outbreak meant frontline workers faced demanding and draining circumstances.

Participants have given crucial insights which provide valuable lessons for future Ebola outbreaks.

Regular debriefing after work in the clinical red zone or laboratory, and blame-free reporting of near misses, should be part of routine practice in emergency treatment response work.

Simple changes such as banning glass vials in the red zone could reduce the number of staff experiencing skin lacerations, and further testing of the robustness and fit of PPE suits, could potentially save health workers' lives in the future."

Participants, who were based mostly in Sierra Leone, were also asked whether they experienced fever or diarrhoea while in West Africa or within one month of their return, and if so whether they were tested for Ebola virus at the time.

Despite symptoms in 21% (57/268) of the respondents, 70% were not tested, with those still in West Africa much less likely to receive a test -- 11 out of 17 who fell ill on their return were tested, but just one person out of 21 who fell ill in West Africa was tested.

Dr Houlihan said: "This study provides reassuring evidence about the lack of Ebola infection in individuals who had not previously been tested for the virus. However, the high proportion of health workers who didn't get tested when falling ill in West Africa, coupled with returnees' potential exposure to Ebola, are a concern.

Although we don't know how many health workers reported being ill and were assessed to decide if they needed to be tested, protocols for the management of possible exposure to the virus, and for the management of illness, may need reviewing and to be standardised across organisations that deploy staff to outbreaks.

"Importantly, these protocols must be applicable to national as well as international staff. West African responders worked in large numbers from the early stages of the epidemic right through to its conclusion, and were undoubtedly at the highest risk.

We must also ensure that every individual who works in these high-risk settings receives strong support and is thoroughly trained ahead of starting work, including on the use of PPE, how to reduce risk in and out of the red zone, and what to do if they think they have been exposed or if they become unwell."

The authors acknowledge limitations of the study including that not all returning responders were included and participants were not a random sample. It is therefore possible that those who knew of possible exposures, or who had had symptoms, were particularly keen to participate. Since these were the people who were most likely to have been infected, the absence of undiagnosed infections is reassuring.

Story Source:
Materials provided by London School of Hygiene & Tropical Medicine. Note: Content may be edited for style and length.

Journal References:

・Glynn et al. Asymptomatic infection and unrecognised Ebola virus disease in Ebola-affected households in Sierra Leone: a cross-sectional study using a new non-invasive assay for antibodies to Ebola virus. Lancet Infect Diseases, 2017 DOI: 10.1016/S1473-3099(17)30111

・Catherine F. Houlihan, Catherine R. McGowan, Steve Dicks, Marc Baguelin, David A. J. Moore, David Mabey, Chrissy h. Roberts, Alex Kumar, Dhan Samuel, Richard Tedder, Judith R. Glynn. Ebola exposure, illness experience, and Ebola antibody prevalence in international responders to the West African Ebola epidemic 2014-2016: A cross-sectional study. PLOS Medicine, 2017 DOI: 10.1371/journal.pmed.100



 WHO Suspects A Fourth Person Died Of Ebola In Congo [HuffPost, 21 May 2017]

by Eline Gordts

Aid workers are having trouble accessing the remote region in the country’s north.

A fourth person is believed to have died of Ebola in an outbreak of the disease in the Democratic Republic of Congo, the World Health Organization said on Sunday.

The WHO first confirmed the discovery of the new outbreak on May 12, after a 39-year-old man who had died on his way to the hospital in a remote region of Bas-Uele province in late April was confirmed to have suffered from the deadly disease.

Since then, there have been 37 suspected cases, Eugene Kabambi, the WHO’s spokesman in Congo, told Reuters on Sunday. Four of those 37 cases have resulted in death and two have been confirmed as Ebola, another two cases, including the latest death, are considered probable, the spokesman added.

Because Ebola is highly contagious, authorities are now monitoring more than 400 people who came into contact with suspected patients. Just last week, authorities were only tracking about 200 people.

The outbreak is wreaking havoc at the national level but its overall global risk is low, the WHO said in a conference call last week. With few paved roads, the affected area in Bas-Uele is isolated and difficult to access. The 870 miles journey there from the Congolese capital, Kinshasa, takes about three days. “We cannot underestimate the logistic and practical challenges associated with this response in a very remote and insecure part of the country,” Peter Salama, the WHO’s executive director for health emergencies said during the call.

“As of now, we do not know the full extent of the outbreak, and as we deploy teams over the next few weeks, we will begin to understand... exactly what we’re dealing with,” Salama added.

So far, teams of aid workers have accessed the area by helicopters and small aircrafts and have set up a mobile testing laboratory, the Associated Press reported.

While its location has made it difficult for aid workers to reach the area, it has also slowed the spread of the disease over a larger area, Kabambi, the WHO spokesman, told HuffPost.

Congo has suffered through seven other Ebola outbreaks since the discovery of the disease in 1976. However, none were as deadly as the outbreak in West Africa between 2013 and 2016.

Frequent regional travel there helped spread the disease throughout Liberia, Guinea and Sierra Leone, ultimately killing more than 11,000 people.

The WHO is working with Congolese authorities to explore the possibility of deploying an experimental vaccine to Bas-Uele. The vaccine was developed following the West Africa outbreak and was successfully tested in Guinea in 2015.



 EBOLA OUTBREAK: THE MOST EFFECTIVE WAYS TO MINIMIZE THE SPREAD OF THE DEADLY DISEASE [Newsweek, 16 May 2017]

BY JESSICA FIRGER

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Health workers carry the body of a suspected Ebola victim for burial at a cemetery in Freetown, Sierra Leone, in 2014. A new paper identifies the key measures for minimizing the number of deaths from future outbreaks. BAZ RATNER/REUTERS

Once again Ebola is making headlines, after the World Health Organization announced Saturday that a number of incidences of the virus have been detected in the Democratic Republic of Congo. So far, there have been three deaths, nine lab-confirmed cases and more than a dozen suspected cases of the Ebola virus in DR Congo. Health officials consider the situation in DR Congo an outbreak. And this crisis is occurring only a year after public health officials declared West Africa Ebola-free. That catastrophic outbreak, which began in 2014, caused 28,646 cases and took the lives of 11,323 as of March 2016.

The 2014 outbreak in Sierra Leone, Liberia and Guinea quickly spiraled out of control, but it provided plenty of information on which interventions are most effective, and that could keep the current situation in DR Congo under control. Plenty of public health organizations and officials, epidemiologists and government agencies have since proposed (and published) frameworks for minimizing the number of fatalities should more outbreaks occur.

A group of researchers, led by the University of Warwick in the U.K., attempted to make sense of all of the recommendations. A multidisciplinary team—composed of experts in a number of field including epidemiology, biostatistics and zoonotics—evaluated 37 existing public health models for managing future Ebola outbreaks. Their systematic analysis, published this week in the Proceedings of the National Academy of Sciences, attempts to pinpoint the specific protocols germane to minimizing the effects of Ebola on a community.

“For large-scale Ebola outbreaks, control strategies must be implemented to reduce the risk of spread and the number of fatalities,” says Michael Tildesley, an associate professor of epidemiology at Warwick University and coauthor of the study. “However, in any outbreak, resources are limited and it may be necessary to prioritize efforts to one intervention over another.”

Tildesley and his fellow researchers found consistently throughout their analysis that the most effective protocols involve educating people on how to reduce disease transmission in the community and at funerals. While strategies to improve hospital safety are important (such as appropriate donning and doffing of personal protective gear), these measures don’t actually stop the outbreak. The researchers say that following this model could reduce the number of deaths from an outbreak by as much as 10 percent.

The number of cases currently in the DR Congo is still relatively low, which means the information in this study is not immediately relevant, says Tildesley. But in any small outbreak of an infectious disease there’s always a risk for more locally transmitted cases. “The situation should be monitored, and if there is a significant increase in the number of cases then our work can help inform control,” he says. “In the current outbreak, given the low number of cases, there is no significant pressure on allocating resources. However, in the large scale outbreak from 2014, there were so many cases that it may have become necessary to work out how to distribute a limited number of resources.”

As with other infectious disease outbreaks, strong public health messaging is key to preventing transmission. In the case of Ebola, this includes encouraging small measures such as hand-washing and educating the public on how Ebola is spread. Other useful efforts include providing household sanitation kits and encouraging people who are sick with the virus to not leave their home.

Other research that emerged from the 2014 epidemic confirmed that the viral load in a sick person is highest at the point of acute illness, which is when a person usually dies. Shortly after death, the body is highly contagious. This is when burial preparations are typically underway. In African cultures, family and community members typically touch and wash the body of a loved in preparation for burial. During West Africa’s epidemic, many community members were resistant to following guidelines for new burial practices that minimize transmission of the virus. Despite efforts by the government in Sierra Leone, reports continued to circulate that people in communities hit by the virus were still conducting unsafe and secret burials rather than adopting medical burial protocols.

The Ebola virus is spread from person-to-person through contact with bodily fluids. The virus has been previously detected through lab testing in blood, semen, vaginal secretions, stool, saliva and breast milk. It can be transmitted through casual contact, from mother-to-child and also during sex.



 Vets in Africa Help Prevent Spread of Ebola and Other Zoonotic Diseases [International Atomic Energy Agency, 15 May 2017]

by Laura Gil, IAEA Office of Public Information and Communication


Yaoundé, Cameroon and Bangui, Central African Republic — An animal as tiny as a bat can carry up to 137 different virus species. Many of these, including Ebola, can be transmitted to humans.

After years of studying bats and other animals in the jungles of central Africa, scientists are joining forces under IAEA projects to prevent the spread of diseases that can be transmitted from animals to humans, known as zoonotic diseases.

“Around 75% of human diseases originate from animals, which is why it is so important to stop them at the animal level,” said Abel Wade, Director of the National Veterinary Laboratory in Yaoundé, Cameroon. “Nuclear-derived technology helps us do this.”

Around 75% of human diseases originate from animals, which is why it is so important to stop them at the animal level. Nuclear-derived technology helps us do this
Abel Wade, Director, National Veterinary Laboratory (LANAVET), Yaoundé, Cameroon

During the Ebola epidemic of 2014, the IAEA quickly reacted to provide specialized diagnostic equipment to help Sierra Leone in its efforts to combat the virus. With the immediate crisis over, the focus now is on longer term prevention. The IAEA, in cooperation with the Food and Agriculture Organization of the United Nations (FAO) and through funding from the Peaceful Uses Initiative (PUI) and from the African Regional Cooperative Agreement for Research, Development and Training related to Nuclear Science and Technology (AFRA), is helping countries use nuclear-derived techniques to detect zoonotic diseases and respond to them.

To African countries facing the threat of new outbreaks, the IAEA’s help in equipping their laboratories and training their scientists in the use of these techniques and the corresponding biosafety measures has been critical. Polymerase chain reaction (PCR) technology, for example, allows the identification of viruses such as Ebola within a few hours and with a high degree of accuracy (see Nuclear-derived techniques for detecting animal diseases). Early diagnosis helps curtail the spread of a disease by making it possible to rapidly isolate and treat infected animals and patients earlier.

“With this technology we’re better prepared to respond at the first sign of a disease,” said Emmanuel Nakouné, Scientific Director at the Institut Pasteur in Bangui, Central African Republic. “But if one country’s surveillance is weak, it can put the whole region in danger. That’s why we’re working together to strengthen surveillance throughout the region.”

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Regional cooperation

In 1999, Nakouné spent three weeks in the jungle in south-west Central African Republic living with the local pygmies until he found a potential source of the Ebola virus: rodents. Back in his lab, he used the PCR technique to discover that these were the animals that were transmitting the virus to humans in that area.

Early March he hosted Wade for a week of information exchange and joint work.

“The ongoing information exchange between various disciplines and different countries is an exemplary case of knowledge transfer under the United Nations-supported One Health approach,” said Michel Warnau, who is in charge of the technical cooperation project on Emerging Zoonotic Diseases at the IAEA. “For example, Wade is learning how doctors in Bangui spotted Ebola in the early 2000s and a monkey pox outbreak more recently using nuclear-derived techniques. Vice versa, Wade is sharing his expertise and experience in stopping the spread of a dangerous zoonotic disease that affected Cameroon.”

During his tour of central Africa, the Cameroonian veterinarian had a tale to share.

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Abel Wade (left), Director of the National Veterinary Laboratory in Yaoundé, Cameroon, and Emmanuel Nakouné (right), Scientific Director at the Institut Pasteur in Bangui, Central African Republic, at the Institut Pasteur. (Photo: L. Gil)

Controlling the 2016 bird flu

In mid-2016, a farm complex near Yaoundé lost 15 000 chickens. Veterinary scientists from LANAVET — Cameroon’s National Veterinary Laboratory — collected samples of the dead chickens and took them to their laboratory in Yaoundé, which was almost completely furnished through the IAEA’s Peaceful Uses Initiative. The vets used nuclear-derived techniques, such as PCR and ELISA (see Nuclear-derived techniques for detecting animal diseases), to discover that they were witnessing an outbreak of H5N1 avian influenza, a dangerous disease that can also be transmitted to humans.

“As soon as we detected it, we informed all the relevant ministries, the army, everyone,” Wade said during a presentation to researchers from the University of Bangui. After imposing all necessary sanitary measures, killing all exposed animals, disinfecting all affected farms and halting chicken trade, Cameroonians managed to stop the outbreak.

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It was a success, but at a significant cost to the country, Wade said. At the peak of the outbreak, farmers in western Cameroon were losing FCFA 6 billion (EUR 9 million) every day. Animal diseases can present devastating consequences to farmers, families and communities. Once they identify the animal disease in the lab, veterinarians can provide farmers with drugs or vaccines, but in some cases — like avian influenza — killing the flock is the only way to stop the spread.

Wade’s message to researchers from the University of Bangui was clear: “Nuclear-derived diagnostic techniques allow us to detect the virus early but once you’ve identified the disease, you need to act. Farmers might suffer economic losses, but saving one human life is priceless.”

Guimdo Tshicitoing Guy Flaubert, owner of a chicken farm on the outskirts of Yaoundé, was still losing animals seven months after the outbreak when he called the LANAVET scientists for help. After they used PCR and ELISA to discover that his chickens were not dying due to avian influenza, Guy Flaubert could sleep again. “I could’ve tried everything but I would’ve never got to the real cause of the problem by myself,” he said. “There are things only these machines can see.”

Thanks to the precision that LANAVET’s molecular diagnostics laboratory offered during the avian influenza crisis, more and more farmers are reaching out for help. In 2016 alone, 230 farmers took dead or sick animals to LANAVET in Yaoundé for examination.

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In Bangui, Wade learnt how PCR can be used to identify a relatively new disease spotted in the jungles of the Democratic Republic of the Congo (DRC): monkey pox, a virus of rodents and primates that also causes smallpox-like symptoms in humans. In recent years, monkey pox has re-emerged in several countries, including the Central African Republic.

At his next stop in Ndjamena, Chad, Wade learnt about his peers’ experience in using nuclear-derived techniques to identify rabies and tuberculosis and endeavoured to establish the collaboration so crucial for the surveillance and control of Ebola and other animal diseases that can be transmitted to humans.

In sub-Saharan Africa, the majority of pathogens are still unknown, Wade said, emphasizing the need to collaborate. “In the world, a new disease appears or an old one re-emerges every four months. We cannot control this if we work alone. We need to share our expertise in using these powerful, life-saving techniques. Remember that a life saved in the Central African Republic means many lives saved in Africa.”

THE SCIENCE

Nuclear-derived techniques for detecting animal diseases

The enzyme-linked immunosorbent assay (ELISA) and the polymerase chain reaction (PCR) are two nuclear-derived techniques commonly used for disease diagnosis.

ELISA is easy to setup and use, which makes it suitable for any veterinary laboratory. Scientists place a diluted serum sample from an animal on a prepared dish and if the sample contains the suspected disease, it causes an enzyme in the fluid to change the liquid’s colours confirming the presence of the disease. ELISA is often used for initial tests, but it has a limited sensitivity and specificity and cannot be used to identify virus strains.

PCR is a technique involving more sophisticated equipment and procedures than ELISA, and is highly sensitive and accurate, making it well-suited for identifying virus strains and bacteria. This technique uses an enzyme to replicate, or amplify, a specific genetic region of a pathogen’s DNA billion-fold in just half an hour. Scientists then detect and monitor this DNA amplification through either radioisotopes or by counting fluorescent molecules attached specifically to the created gene sequences.

Both methods originally worked with radioisotopes and now apply enzymes instead, which has helped the IAEA and its partners to refine and streamline the testing process.



 Officials Confirm Second Case of Ebola in Congo Outbreak [TIME, 15 May 2017]

by Tara John

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Hygienists wearing protective suits disinfect the toilets of the Ebola treatment centre in Lokolia, on October 5, 2014. Kathy Katayi—AFP/Getty Images

A second case of Ebola was confirmed in the Democratic Republic of Congo by the World Health Organization on Sunday, following an outbreak of 17 suspected cases last week.

WHO's Congo spokesman Eugene Kabambi told /react-text Reuters that health officials are scrambling to trace 125 people believed to be linked to the identified cases in Bas-Uele province, a remote northeastern province near the border of the Central African Republic. Three people out of the 19 suspected and confirmed cases have died, he said.

It is unclear how the first victim — only identified as a male — died, although the virus has been linked to infected bushmeat from bats and monkeys.

According to the health organization, this is eight outbreak of the virus since its 1976 discovery near the Congo's River Ebola. The latest outbreak comes a year after the end of an epidemic that took more than 11,000 lives in West Africa.



 Study: Most Effective Measures Identified for Containing Ebola [Voice of America, 15 May 2017]

by Jessica Berman

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People pass a banner reading "Stop Ebola," forming part of Sierra Leone's Ebola-free campaign in the city of Freetown, Sierra Leone, Jan. 15, 2016.

WASHINGTON —

A small outbreak of Ebola virus in Democratic Republic of the Congo is causing alarm among public health officials. A new study outlining containment strategies may help prevent an epidemic similar to the one that engulfed a number of western African countries two years ago.

In the timely report, published in the journal Proceedings of the National Academy of Sciences, an international team of researchers culled 37 studies for the most effective containment strategies.

Pennsylvania State University biology professor Katriona Shea, co-author of the study, said, "The best strategy that we found out of the five that we looked at were funeral containment and public information campaigns [for the] sort of care in the community."

Ebola virus is spread through coming into contact with the bodily fluids of infected individuals.

Shea said investigators found the No. 1 way to prevent transmission was for loved ones to avoid washing bodies of the deceased prior to burial.

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FILE - The Ebola virus treatment center in Paynesville, Liberia, July 16, 2015.

Shea said that information is best conveyed through public health campaigns that also stress the importance of handwashing, personal hygiene and self-quarantine in high-transmission areas.

Don't wait to get treatment

People suspected of being infected with Ebola, the report found, should also not hesitate to go to the hospital or clinic for evaluation and treatment. But researchers concluded building more hospitals in response to an epidemic to be the least effective way to prevent spread of Ebola within communities.

Shea said investigators undertook the study in response to the Ebola epidemic of 2014-2015, when 28,646 people became infected. Of these, 11,323 people died in Guinea, Liberia and Sierra Leone died as of March 2016, according to the report.

Forty cases of the disease were also reported in the DRC.

Using the prevention strategies outlined in the study and the incidence data from the epidemic, researchers estimated that there would have been a reduction of 3,266 cases of Ebola and 1,633 lives saved.

No consensus on containment

At the height of the epidemic, Shea said there was no consensus on the best ways to contain the Ebola epidemic, and that's why researchers decided to look into the matter.

"We really wanted to try to do something. Many of us have children, and were moved by stories, individual horrors and so forth," she said. "Others of us felt something we did scientifically might contribute to making the future outbreaks less horrific."

There are now three confirmed Ebola deaths in a remote part of the DRC. Public health officials are reportedly investigating a total of nine suspicious cases of the deadly viral infection.

With the virus once again threatening to become a public health menace, Shea said it's not too early to begin taking aggressive measures to prevent another Ebola epidemic.



 Lessons from Ebola: New approach improves disease outbreak management [EurekAlert (press release), 13 May 2017]

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IMAGE: THIS IS A COLORIZED TRANSMISSION ELECTRON MICROGRAPH OF AN EBOLA VIRUS VIRION, CREATED BY CDC MICROBIOLOGIST FREDERICK A. MURPHY CREDIT CDC

A new approach to information gathering could allow scientists to quickly identify the most effective way to manage a disease outbreak, an advance that could save lives. Developed by an international team of researchers led by Penn State scientists using insights from the 2014 Ebola outbreak, the method pinpoints critical pieces of missing information required to improve management decisions during an outbreak. A paper describing the approach appears the week of May 15, 2017, in the journal Proceedings of the National Academy of Sciences.

"When a disease outbreak happens, there is a lot of information that you just don't know: who will get sick, how will the disease spread, what will make things worse or better? But you still have to act," said Katriona Shea, Alumni Professor of Biology at Penn State and senior author of the study. "Our approach allows us to make better decisions about how to manage an outbreak in the face of uncertainty, saving lives."

The new method provides a way to prioritize information gathering by applying a "value of information" analysis -- a method used in economics and wildlife management to identify critical questions that need to be answered in order to improve decisions.

"Our approach synthesizes data from many models and provides two important pieces of information," said Shou-Li Li, postdoctoral researcher at Penn State and first author of the paper. "It identifies the best course of action, given what we know now, and highlights the gaps in our knowledge that actually matter to the selection of intervention strategies."

Because the approach can be used in real time as understanding of the outbreak evolves and as new models to understand outbreak dynamics are created, the researchers believe it can streamline the decision-making process for policymakers. "It could guide the management of outbreaks where rapid decision-making is critical, including diseases we know a lot about, like influenza, those that we don't know a lot about, like Zika, and those that we don't yet know exist," Shea said.

Uncertainty about the Ebola outbreak in 2014 led to widely differing predictions of how many people would contract the virus, with estimates ranging from a few thousand to over a million cases. "The difference between the projections and the actual size of the 2014 Ebola outbreak caused intense public debate," said Li. "But rather than focusing on how big the outbreak would be, our study focused on what to do to keep it small."

The study revealed key pieces of missing information that were more important than the number of cases for selecting the best course of action to manage the outbreak. "Although the number of cases may be important for determining management strategies for other outbreaks, that was not really the case with Ebola," said Shea. "For Ebola, it turns out that the models didn't disagree as much as everyone thought they did. Despite huge disagreement over the number of cases, the models used to make these predictions overwhelmingly agreed on the best course of action to slow the outbreak."

Of the 37 models of Ebola outbreak dynamics that the research team evaluated, the majority consistently ranked two commonly proposed management strategies as the most effective: reducing transmission rates at funerals and reducing transmission rates in the community. For example, the outbreak could be best contained by ensuring safe burials, providing household sanitation kits, encouraging sick individuals to remain at home, and increasing community awareness. Strategies that focused on reducing transmission at hospitals or increasing hospitalization rates would not be as effective.

"Obviously it's going to help the outcome for individual patients to have better quality of care," said Shea, "but it might not stop the outbreak. Ultimately, we focused on what you should do to stop the outbreak as effectively as possible. Our method provides a way to pin down what you need to learn about first."

"Responding to a fast-moving disease threat such as an Ebola outbreak means having to make decisions with less-than-perfect information," said Sam Scheiner, a program director in the National Science Foundation's Division of Environmental Biology, which funded the research.

"This study provides a new, important tool for decision-makers in such situations."

###

In addition to Shea and Li, the research team from Penn State includes faculty members Ottar Bjørnstad and Matthew Ferrari and undergraduate student Riley Mummah. The research team also includes Michael Runge from the USGS Patuxent Wildlife Research Center; Christopher Fonnesbeck from Vanderbilt University School of Medicine; and Michael Tildesley and William Probert from the University of Warwick.

This research was funded by the National Science Foundation, the National Institutes of Health, and the U.K. Biotechnology and Biological Sciences Research Council and was supported by the Huck Institutes of the Life Sciences.

CONTACTS:
Katriona Shea: k-shea@psu.edu, +61 (0)4476 15575 (currently in Australia)
Matthew Ferrari: mjf283@psu.edu, +1 814-865-6080
Barbara K. Kennedy (PIO): BarbaraKennedy@psu.edu, +1 814-863-4682



 WHO TRACKS 125 PEOPLE NEWLY INFECTED WITH EBOLA IN DRC [Eyewitness News, 15 May 2017]

The outbreak comes a year after the end of an epidemic in West Africa that killed more than 11,000 people.

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An MSF medical worker, wearing protective clothing at an MSF Ebola treatment facility in Kailahun, on 15 August 2014. Picture: AFP.

CAPE TOWN – The World Health Organisation says it's tracking 125 people believed to have been infected with the Ebola virus in the DRC.
Three people have already died in a new outbreak.

Health professionals are targeting the country's remote north-eastern province of Bas-Uele.
It is unclear how the first victim an adult male caught the virus.

The outbreak comes a year after the end of an epidemic in West Africa that killed more than 11,000 people in Guinea, Sierra Leone and Liberia since 2013.



 RETURN OF KILLER VIRUS World Health Organisation confirms second case of Ebola in Democratic Republic of Congo [The Sun, 15 May 2017]

By Lizzie Parry

Three people have died out of 19 suspected and confirmed cases, health officials said

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A SECOND case of the deadly Ebola virus has been confirmed in Democratic Republic of Congo, the World Health Organisation said.

One man has died from the disease, while two other people who came into contact with him have also died, though tests have yet to confirm their cause of death.

The World Health Organisation has confirmed two cases of Ebola in Democratic Republic of Congo, one of whom has died

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The outbreak comes just a year after the deadliest outbreak in history was declared over. Pictured, a Liberian health worker in a burial squad in Monrovia, in October 2014

So far health officials are investigating 17 suspected cases of the virus following an outbreak last week.

They are trying to trace 125 people thought to be linked to the cases identified in the remote north eastern province of Bas-Uele, which is near the border with Central African Republic.

Three people have so far died among the 19 suspected and confirmed cases, WHO’s Congo spokesman Eugene Kabambi said.

The first confirmed case was reported on April 22 in a 45-year-old man.

The WHO said he was transported by taxi to hospital and was declared dead on arrival.

The driver also fell ill and later died.

A third person who cared for the first case also became ill and has subsequently died.
However, to date only the first death has been confirmed as linked to Ebola.

Zoonotic Bird Flu News - from 12 till 22 May 2017



 China Confirms 16 New H7N9 Cases; 2 Fatal [ThePoultrySite.com, 22 May 2017]

CHINA - The number of new H7N9 avian flu cases in China declined this week, with 16 infections reported through 17 May, down from 23 the previous week, Hong Kong's Centre for Health Protection (CHP) said today in its regular update.

Though illnesses declined, the newly reported cases reflect steady ongoing activity, despite the onset of warmer weather, with illnesses distributed across a number of provinces, especially in the north.

China is experiencing an unprecedented number of H7N9 cases in its fifth and biggest wave of activity, which has also been notable for the emergence of a highly pathogenic strain of the virus in poultry, which has also infected some humans.

First cases in Shanxi province

China's 16 new H7N9 illnesses were reported from 12 May to 17 May, and two patients died from their infections.

All of the patients are adults, a pattern common for human H7N9 cases. Ages range from 30 to 84; 11 are men and 5 are women. Illness onsets range from 29 April to 13 May.

The virus infected people in eight different provinces and the cities of Beijing and Chongqing.

Six were from Hebei province in the north.

The cases reported last week also reflect the first ever H7N9 case in Shanxi province, also in northern China. In an announcement earlier this week, the CHP said the province's first case involves a 66-year-old woman from Datong who is hospitalized in serious condition.

Fifteen of the people had known exposure to poultry, poultry markets, or mobile stalls, all known risk factors for contracting H7N9.

The new cases appear to put China at or slightly above 700 during the fifth wave, which began in October 2016.

Threat from wider geographic spread

Last week, the World Health Organization (WHO) posted an update on H7N9 cases reported from China through 5 May. No clusters were reported in the 24 cases covered by the report.
In its risk assessment, the WHO said the number of infections and geographic distribution in the fifth wave is greater than in earlier waves, which suggests the virus is spreading. It added that the developments underscore the need for more intensive surveillance and control measures, in both the human health and animal health sectors.

Since H7N9 was first detected in humans in 2013, 1,463 cases have been reported to the WHO.



 Officials: 'Stepped Up' Biosecurity limited spread of Avian flu [Wisconsin State Farmer, 21 May 2017]

by Samantha Nash,

Wisconsin lost around 10 percent of its egg laying hens in 2015, a portion of the nearly two million chickens, turkeys and other commercial poultry stock euthanized in the state during an outbreak of the highly pathogenic H5N2 avian influenza virus that devastated the poultry industry across the Upper Midwest that year. While a handful of isolated cases made headlines in early 2017, the threat they posed was mitigated by lessons learned from the 2015 outbreak, according to University of Wisconsin-Extension poultry specialist Ron Kean.

"We had never faced a situation like this before, so there was a steep learning curve," Kean said about the 2015 outbreak. "I think there is some evidence that the quick response helped end the outbreak more quickly than what might have happened. Subsequent outbreaks in other states have no doubt learned from this response, and — fingers crossed — these have been fairly isolated incidences."

Wild birds

The case of avian flu that infected a Barron County turkey flock in March 2017 was a low pathogenic H5N2 strain commonly found in wild birds, said Paul McGraw, state veterinarian with the Wisconsin Department of Agriculture, Trade and Consumer Protection. Diseases like avian influenza are generally passed to domestic birds by their wild counterparts, although the virus also transferred between flocks during the 2015 outbreak, particularly in states like Iowa and Minnesota with a higher density of poultry farms than Wisconsin.

Keeping domestic stock isolated from wild birds and their droppings is the means of prevention favored by the poultry industry, said Kean, although outdoor production methods like free-range or yarding can make this tactic difficult. Even at indoor facilities, workers and equipment may transmit pathogens from wild birds or other facilities that can infect an otherwise isolated flock.

Biosecurity

Following the 2015 outbreak, commercial poultry flocks were required to implement a biosecurity plan in order to have future losses from depopulation covered by the U.S.

Department of Agriculture. With indemnity on the line, McGraw said the poultry industry has worked with the USDA to improve surveillance and testing practices. In Wisconsin, officials adapted an instant command system, previously used to depopulate smaller operations like deer farms, to improve response times.

"The… turkey flock that tested positive in Wisconsin was detected just from routine surveillance before there were even any sick birds," McGraw said. "We were able to get in there and get that flock depopulated before they were shedding a lot of virus around."

Other changes, Kean explained, included poultry farm perimeter fencing and tire washes for vehicles on their premises. A biosecurity protocol known as the Danish entry system implemented by some farms outlines a "clean" area where the birds are kept, and an outside "dirty" area. Any objects crossing this boundary must be cleaned and disinfected, with workers required to change clothing and shoes, and wash their hands before entering barns. Many facilities have also made changes to traffic patterns, keeping vehicles away from areas where birds are housed as much as possible.

Impact on industry

Despite the fluctuation in prices and shortage of poultry products following the 2015 epidemic, Kean said the poultry industry has mostly recovered. International trade bans led to a drop in exports from the U.S., temporarily decreasing the price of chicken meat, but egg and turkey prices were quite high immediately following the outbreak. Egg prices have dropped, Kean speculates, possibly due to decreased demand after consumers found alternatives or decreased the amount of eggs used in their products.

McGraw said flocks in Wisconsin have returned to levels seen prior to the large-scale culling of poultry flocks required during the outbreak to stem the spread of disease. While isolated cases of H7N9 avian influenza in Tennessee, Alabama, Georgia and Kentucky prompted such depopulations in those states in early 2017, McGraw said the chance of seeing new cases drops as the weather warms, and the likelihood of another 2015-level outbreak decreases further still.

"That was a unique virus. it was very highly pathogenic, I think even when it was coming from the wild birds, McGraw said. "Hopefully with our industry's stepped-up biosecurity, we can prevent something like that from happening again in the future."



 Two Chinese cities close poultry markets after H7N9 bird flu infection [The Straits Times, 21 May 2017]

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Poultry markets in Zigong, Sichuan province, and Binzhou, Shandong province, have been shut after H7N9 cases were reported. PHOTO: REUTERS

BEIJING (REUTERS) - China will shut poultry markets in certain districts of two cities after H7N9 bird flu infections were detected, state media reported on Sunday (May 21), the latest incidents in this year's more severe outbreak of the virus.

A 44-year-old man who sold poultry at a farmers market in south-western Sichuan province's Zigong city was diagnosed with H7N9, China News Service reported. Local authorities announced a one-month halt to poultry markets in the city's Ziliujing district from midnight on Monday.

Separately, a 74-year old man who had visited poultry markets in Shandong province's Binzhou city was also diagnosed with H7N9, China Central Television reported. Binzhou authorities will temporarily halt poultry markets in three of its districts.

Bird flu can jump from poultry to humans. Human cases of bird flu have been unusually high for China since last year, with three times more fatalities from H7N9 in the first four months of the year than in all of 2016. But deaths fell in April for the third consecutive month.



 Two Chinese cities close poultry markets after H7N9 bird flu infections [Reuters, 21 May 2017]

China will shut poultry markets in certain districts of two cities after H7N9 bird flu infections were detected, state media reported on Sunday, the latest incidents in this year's more severe outbreak of the virus.

A 44-year-old man who sold poultry at a farmers market in southwestern Sichuan province's Zigong city was diagnosed with H7N9, China News Service reported. Local authorities announced a one-month halt to poultry markets in the city's Ziliujing district from midnight on Monday.

Separately, a 74-year old man who had visited poultry markets in Shandong province's Binzhou city was also diagnosed with H7N9, China Central Television reported. Binzhou authorities will temporarily halt poultry markets in three of its districts.

Bird flu can jump from poultry to humans. Human cases of bird flu have been unusually high for China since last year, with three times more fatalities from H7N9 in the first four months of the year than in all of 2016. But deaths fell in April for the third consecutive month.

(Reporting by Jake Spring and Hallie Gu; Editing by Clelia Oziel)



 China confirms 16 new H7N9 cases, 2 fatal [CIDRAP, 19 May 2017]

by Lisa Schnirring

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josephbergen / Flickr cc

The number of new H7N9 avian flu cases in China declined this week, with 16 infections reported through May 17, down from 23 the previous week, Hong Kong's Centre for Health Protection (CHP) said today in its regular update.

Though illnesses declined, the newly reported cases reflect steady ongoing activity, despite the onset of warmer weather, with illnesses distributed across a number of provinces, especially in the north.

China is experiencing an unprecedented number of H7N9 cases in its fifth and biggest wave of activity, which has also been notable for the emergence of a highly pathogenic strain of the virus in poultry, which has also infected some humans.

First cases in Shanxi province

China's 16 new H7N9 illnesses were reported from May 12 to May 17, and two patients died from their infections.

All of the patients are adults, a pattern common for human H7N9 cases. Ages range from 30 to 84; 11 are men and 5 are women. Illness onsets range from Apr 29 to May 13.

The virus infected people in eight different provinces and the cities of Beijing and Chongqing.

Six were from Hebei province in the north. The cases reported today also reflect the first ever H7N9 case in Shanxi province, also in northern China. In an announcement earlier this week, the CHP said the province's first case involves a 66-year-old woman from Datong who is hospitalized in serious condition.

Fifteen of the people had known exposure to poultry, poultry markets, or mobile stalls, all known risk factors for contracting H7N9.

The new cases appear to put China at or slightly above 700 during the fifth wave, which began in October 2016.

Threat from wider geographic spread

Yesterday the World Health Organization (WHO) posted an update on H7N9 cases reported from China through May 5. No clusters were reported in the 24 cases covered by the report.
In its risk assessment, the WHO said the number of infections and geographic distribution in the fifth wave is greater than in earlier waves, which suggests the virus is spreading. It added that the developments underscore the need for more intensive surveillance and control measures, in both the human health and animal health sectors.

Since H7N9 was first detected in humans in 2013, 1,463 cases have been reported to the WHO.



 Human infection with avian influenza A(H7N9) virus – China [World Health Organization, 18 May 2017]

On 5 May 2017, the National Health and Family Planning Commission of China (NHFPC) notified WHO of 24 additional laboratory-confirmed human infections with avian influenza A(H7N9) virus in China.

Details of the cases

Onset dates ranged from 14 to 29 April 2017. Of these 24 case patients, nine were female.

The median age was 56.5 years (range 25 to 82 years). The case patients were reported from Anhui (1), Beijing (1), Chongqing (2), Gansu (1), Guangxi (1), Hebei (7), Henan (1), Hubei (1), Hunan (1), Jiangsu (1), Sichuan (6) and Shaanxi (1). This is the first case reported in Shaanxi since the virus emerged in 2013.

At the time of notification, there were nine deaths, 13 case patients were diagnosed as having either pneumonia (2) or severe pneumonia (11), and two case patients were still being investigated. Nineteen case patients were reported to have had exposure to poultry or live poultry market, and two had no known poultry exposure. The exposure history was still being investigated for three case patients. No case clustering was reported.

To date, a total of 1463 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported through IHR notification since early 2013.

Public health response

Considering the increase in the number of human infections since December 2016, the Chinese government at national and local levels is taking further measures which include:

・Strengthening risk assessment and guidance on prevention and control focusing on the most affected and newly affected areas;

・Continuing to strengthen control measures focusing on hygienic management of live poultry markets and cross-regional transportation;

・Conducting detailed source investigations to inform effective prevention and control measures;

・Continuing to detect and treat human infections with avian influenza A(H7N9) early to reduce mortality;

・Continuing to carry out risk communication and issue information notices to provide the public with guidance on self-protection; and

・Strengthening virology surveillance to better understand levels of virus contamination in the environment as well as mutations, in order to provide further guidance for prevention and control.

WHO risk assessment

The number of human infections with avian influenza A(H7N9) and the geographical distribution in the fifth epidemic wave (i.e. onset since 1 October 2016) is greater than in earlier waves.

This suggests that the virus is spreading, and emphasizes that further intensive surveillance and control measures in both the human and animal health sector are crucial.

Most case patients are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, and live poultry vending continues, further human infections can be expected. Although small clusters of human infection with avian influenza A(H7N9) virus have been reported including those involving patients in the same ward, current epidemiological and virologic evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore the likelihood of further community level spread is considered low.

Close analysis of the epidemiological situation and further characterization of the most recent viruses are critical to assess associated risk and to adjust risk management measures in a timely manner.

WHO advice

WHO advises that travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live poultry markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling in or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and influenza-like illness (ILI) and to carefully review any unusual patterns, ensure reporting of human infections under the IHR 2005, and continue national health preparedness actions.



 Bird Flu Is Back, And So Is The Inhumane Killing Of Animals [HuffPost, 17 May 2017]

The American Veterinary Medical Association has proposed to allow killing by the most gruesome methods, including baking and burying animals alive.

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Killing foam spreads over a flock of chickens

Avian influenza, or “bird flu,” returned to the United States in March, two years after the disease was responsible for the worst animal disease outbreak in U.S. history, with the deaths of nearly 50 million chickens and turkeys and $4-5 billion in economic losses experienced by the poultry industry. Thus far, the extent of the 2017 outbreak has been far more limited, affecting birds at approximately one dozen poultry operations in the South and upper Midwest. While no new detections have been reported in nearly two months, a comeback is possible this fall when wild birds begin their migration south.

Birds exposed to even mild strains of bird flu are typically ordered to be killed by federal and/or state agricultural officials. The most common methods used to “depopulate” flocks are carbon dioxide gas (for killing caged egg-laying hens) and water-based foam (for killing floor-reared chickens and turkeys). Both methods are known to be stressful to animals and can lead to a prolonged time until death.

Following the 2015 outbreak, the U.S. Department of Agriculture approved the use of an even more inhumane method—ventilation shutdown—where producers turn off the ventilation system to remove airflow and turn up the heat to 100-120 degrees Fahrenheit. The birds die from heat stress, after experiencing what is likely to be extreme suffering for up to three hours.

This truly gruesome method of killing animals has not been sanctioned by any veterinary authority.

Until now.

In January, the American Veterinary Medical Association released draft guidelines for the depopulation of animals that include ventilation shutdown. Because the USDA generally relies on the AVMA for guidance, it is likely these guidelines will determine the methods to be used to kill animals for future disease outbreaks. Not only do the guidelines allow the ventilation shutdown method to kill birds, they also permit live burial of birds and the use of ventilation shutdown for the killing of pigs.

Although it seems pretty obvious that ventilation shutdown and live burial would cause significant suffering, no research has been conducted to determine their actual impact on animal welfare. This alone should rule out their use. Moreover, these methods are not recognized by the depopulation guidelines of the World Organization for Animal Health, the international authority on animal diseases.

All other veterinary authorities appear to have taken the position that these methods should be avoided under any circumstance. In fact, other than burning animals to death, it is difficult to imagine how the AVMA could have come up with anything worse.

Animal viruses, such as avian influenza, must be taken seriously. Even mild strains can have a catastrophic impact, as they have the ability to mutate into strains capable of killing not just animals, but humans, as well. The primary responsibility for national security and public health rests with government agencies, however, not the AVMA. If government agencies feel that killing animals by horrific methods is indicated under certain circumstances, then they have the authority to order it. Use of these methods shouldn’t be sanctioned in advance by a professional association representing individuals sworn to protect animals from suffering.

The AVMA is allowing the use of ventilation shutdown because the USDA has determined that increased depopulation capacity, when combined with other actions such as better carcass disposal and improved biosecurity, could result in lower producer losses and reduced indemnity costs for the federal government. And nothing is faster or cheaper than flipping a switch to turn off the animals’ air.

By proposing obviously inhumane killing methods, the AVMA is enabling the animal agriculture industry to act irresponsibly in the way it raises animals. The poultry industry is well aware that the need to depopulate flocks occurs periodically; yet, it continues to design and construct massive buildings that confine tens and even hundreds of thousands of birds without consideration of how the animals will be protected in emergency situations, or how they will be humanely killed, if that becomes necessary.

The factory-farming industry likes to scapegoat organic and higher-welfare farming by suggesting that allowing animals access to the outside leads to disease outbreaks. However, a connection between the two isn’t supported by the facts and, in reality, the opposite is more likely to be true. Research demonstrates that mutation of milder strains of bird flu into more virulent ones occurs more commonly in crowded, indoor poultry operations.

According to the USDA, in the 2015 outbreak, 10 times as many cases of bird flu were detected in commercial operations as in backyard flocks. And last month, officials in South Korea—where bird flu hit especially hard this year—announced the results of a data analysis showing that poultry operations housing more than 100,000 chickens were 548 times more likely to be affected by bird flu than those with fewer than 4,000 chickens.

If the AVMA sincerely believes it is permitting cruel methods of killing in order to protect human and animal health, then it should also feel compelled to actively seek less inhumane methods, and it should call out industrialized farming for raising animals in crowded, filthy conditions that facilitate the spread of disease. Otherwise, it gives the appearance of merely carrying water for the animal agriculture industry.

Dena Jones is director of the farm animal program at the Animal Welfare Institute (AWI).



 CHP closely monitors first human case of avian influenza A(H7N9) in Shanxi [satPRnews (press release), 17 May 2017]

BY KAROL RUTKOWSKI

The Centre for Health Protection (CHP) of the Department of Health is today (May 17) closely monitoring the first human cases of avian influenza A(H7N9) in Shanxi, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.

According to the Health and Family Planning Commission of Shanxi Province, the patient is a woman, aged 66, in Datong. She is in a serious condition.

Travellers to the Mainland or other affected areas must avoid visiting wet markets, live poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchase of live or freshly slaughtered poultry, and avoid touching poultry/birds or their droppings. They should strictly observe personal and hand hygiene when visiting any place with live poultry.

Travellers returning from affected areas should consult a doctor promptly if symptoms develop, and inform the doctor of their travel history for prompt diagnosis and treatment of potential diseases. It is essential to tell the doctor if they have seen any live poultry during travel, which may imply possible exposure to contaminated environments. This will enable the doctor to assess the possibility of avian influenza and arrange necessary investigations and appropriate treatment in a timely manner.

While local surveillance, prevention and control measures are in place, the CHP will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments.

The CHP’s Port Health Office conducts health surveillance measures at all boundary control points. Thermal imaging systems are in place for body temperature checks on inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up.

The display of posters and broadcasting of health messages in departure and arrival halls as health education for travellers is under way. The travel industry and other stakeholders are regularly updated on the latest information.

The public should maintain strict personal, hand, food and environmental hygiene and take heed of the advice below while handling poultry:



 China bird flu: 1st H7N9 avian flu case reported in Shanxi Province [Outbreak News Today, 17 May 2017]

by ROBERT HERRIMAN

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H7N9 avian influenza
Image/Cynthia S. Goldsmith and Thomas Rowe

According to the Health and Family Planning Commission of Shanxi Province, a 66-year-old woman from Datong, Shanxi Province has contracted avian influenza A(H7N9), becoming the first such human case in the province.

The patient is currently in serious but stable condition.

Experts from the Chinese CDC and the provincial CDC were sent to Datong to help with treatment of the patient as well as investigation and prevention work for the disease.

Since March 2013 through May 13, 2017, there were a total of 1486 human cases of avian influenza A(H7N9) reported globally. Since October 2016, 680 cases have been recorded in Mainland China.

Most human cases are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, and live poultry vending continues, further human cases can be expected.

Although small clusters of cases of human infection with avian influenza A(H7N9) virus have been reported including those involving patients in the same ward, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans.

Travelers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live poultry markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with feces from poultry or other animals. Travelers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices.



 Central China reports new H7N9 case [Xinhua, 16 May 2017]

CHANGSHA, May 16 (Xinhua) -- A new case of H7N9 infection was reported in central China's Hunan Province, local authorities said Tuesday.

The patient, a 39-year-old man, is receiving treatment at a hospital in Xiangxiang. Live poultry trading has been suspended across the city, according to local authorities.

H7N9 is a bird flu strain first reported to have infected humans in China in March 2013. Infections are most likely to occur in winter and spring.

Disease control and prevention experts have said that the H7N9 virus is not transmitted from person to person.

Experts recommend that people avoid contact with live or dead birds, and only buy poultry with quarantine certificates.



 USDA has made progress in protecting against avian influenza, evaluation still needed [Homeland Preparedness News, 16 May 2017]

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The U.S. Department of Agriculture (USDA) has taken numerous steps to reduce the risk of avian influenza, but needs a plan to evaluate its efforts going forward, according to a recent report issued by the U.S. Government Accountability Office (GAO).

In preparing its report, GAO was asked to examine how outbreaks of avian influenza have affected human health, animal health and the U.S. economy; the extent to which the USDA has taken action to address risks for future outbreaks; and the ongoing challenges federal agencies face in mitigating the harmful effects of avian influenza.

While the disease rarely affects human populations, only accounting for approximately 2,100 infections and 800 deaths since 1997, the effects on commercial poultry can be devastating.

From December 2014 to June 2015, more than 50 million birds died from the disease. After that outbreak, USDA identified 15 areas with lessons learned from its response efforts.

One specific lesson learned was that there were not enough skilled personnel available for depopulating infected poultry, leaving more opportunities for the disease to spread elsewhere in flocks. While the department had made some progress, GAO’s report said it has not evaluated the extent to which it has fixed its previous issues, such as encouraging states to form depopulation teams. GAO also said it did not find any plan from the USDA to begin evaluating its efforts.

The report also found that federal actions to protect poultry relied on voluntary actions by a wide range of poultry producers to take routine preventative measures, known as biosecurity.

USDA currently has two major projects underway to encourage more biosecurity-related efforts.

GAO recommended that the USDA develop a plan to evaluate the effectiveness of its corrective actions. The USDA agreed with the recommendation.



 Poultry farmers threaten to sell flu infected birds [Graphic Online, 16 May 2017]

by MACLEAN KWOFI

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Poultry farmers threaten to sell flu infected birds

Poultry farmers across the country have threatened not to report any cases of bird flu incidence on their farms for fear that their birds will be culled and compensation will not be paid to them.

This follows the inability of the government to pay the farmers about GH¢11 million as compensation for culling 111,000 birds during the Avian influenza (bird flu) outbreak two years ago.

Already, some of the farmers have carried out their threat and are rushing infected birds to the market for sale as soon as they detect signs of bird flu on their farms.

The Parliamentary Select Committee on Food, Agriculture and Cocoa Affairs approved GH¢11 million as compensation for the poultry farmers whose birds were culled (destroyed). Out of the amount, the farmers claim only GH¢1 million was paid as compensation to 25 farmers.

The Graphic Business has gathered also that most of the farmers have decided to defy the reporting regime and now send their birds to the market as soon as they see signs of the disease in their farms, regardless that the disease is a deadly strain of a virus that attacks poultry and is fatal for human consumption.

The deadly H5N1 virus or bird flu has killed people worldwide, particularly in Asia and the Middle East, since 2013.

Cost so far

The Veterinary Services Directorate of the Ministry of Food and Agricultural (MoFA) has described the development as unfortunate because it was likely to lead to an epidemic if the government did not act fast.

Available figures from the Veterinary Services Directorate show that the disease has affected about 66 poultry farms across the country as of May this year, with the recent occurrence in January.

So far, the country has lost huge sums of money due to the culling of 111,000 birds, various quantities of eggs and some bags of feed since the outbreak was first recorded in May 2015.

Farmers on government’s throat

The Secretary of the Techiman Poultry Farmers Association, Mr Emmanuel Soglizu, who spoke to the Graphic Business in Accra, blamed the government for not doing enough to support the ailing poultry industry.

He stated that the government had not provided the needed support in the creation of awareness on the disease since its outbreak two years ago.

Mr Soglizu minced no words when he announced plans of the farmers to defy the reporting regime as a protest against the government to cough the rest of the funds earmarked for compensation.

“After all, they (government) can only know about the disease when we the farmers report it to them. Therefore, we are going to advise ourselves,” he said.

He noted that if robust measures were not implemented to halt the spread of the highly pathogenic Avian influenza, the poultry industry would collapse.

The secretary, therefore, called on the government to provide a detailed explanation as to how the funds earmarked for the compensation was used to combat the disease.

Affected farmers

An affected farmer, Mr Abraham Odei Tetteh, recounted how he lost his entire poultry farm as a result of the disease, with a firm assurance of receiving compensation, but said he had still not received anything from the government two years after the outbreak.

That situation, he indicated, had totally collapsed his poultry business.

“I am a pensioner and I have children in school. Poultry farming is my only source of income and now that all my birds have been destroyed I cannot tell how I will be able to survive,” Mr Tetteh said with sorrow.

He said he would join any action to press home his concerns to put pressure on the government for the compensation to be paid.

Another farmer, Mr John Attipoe, who also lost his birds through government’s measures to control the disease, said the compensation was needed to help farmers settle their debts.

“If the essence of the compensation was to enable the beneficiaries invest the funds back into poultry production, why then are they keeping our money,” he quizzed.

“For me, the Veterinary Services Directorate destroyed about 20,000 of my birds and promised the government will compensate me but until now I have not heard anything again from either the government or the directorate,” Mr Attipoe said.

Veterinary loses moral right

When contacted, the Deputy Chief Veterinary Officer of the Veterinary Service Directorate, Dr Kingsley Micky Aryee, said the government’s inaction on paying compensation to the farmers was undermining the operations of the health supervisory directorate of the industry.

“Looking at the trend ofevent for the past two years, the Veterinary Service Directorate does not have the moral right to go out there and tell any farmer to do this or that because their birds were culled and they have not been compensated,” he stressed.

Asked about the threat issued by poultry farmers not to report cases of the disease, he said it was quit unfortunate, but the situation might lead to a likely epidemic if the government did not take action.

“In fact, the farmers on a number of occasions have told us they will not report the incidence anymore, and they will restock their farms contrary to the directive for them to stop as part of measures to control the disease,” he said.

Essence of compensation

Dr Aryee said the introduction of the compensation was to help encourage poultry farmers to report any outbreak of the bird flu early and contribute to efforts to contain the disease.

According to him, the government was fully aware of the importance of the compensation payment to affected poultry farmers in the wake of the outbreak of bird flu in the country.

All efforts to reach the Ministry of Food and Agriculture (MoFA) to react to the issue did not yield fruit.



 Report: US unready for bird flu [Arkansas Online, 14 May 2017]

By LENA H. SUN

More needs to be done to avert a pandemic, GAO says

WASHINGTON -- If the United States were suddenly facing a potential avian influenza pandemic, just one U.S. manufacturer could be counted on to make human pandemic flu vaccine here. And although the chickens that lay the eggs used in the process are themselves susceptible to the virus, until an emergency arises, only voluntary and often inadequate measures by poultry producers are in place to protect flocks, according to a new Government Accountability Office report.

The report, scheduled for release this week, comes at a time of heightened public health worries about bird flu. One of the deadliest strains, H7N9, is causing a surge in human infections in China this season. Of the nearly 200 people who have died, most had direct contact with poultry or poultry markets.

Health officials worldwide are closely monitoring the disease's spread because of the big increase in cases and worrisome changes in the virus. Of all emerging influenza viruses, H7N9 has the greatest potential to cause a pandemic if it evolves to spread easily from human to human. It also poses the greatest risk to cause serious disease.

Controlling the virus in poultry is the main way to reduce human infection and prevent a pandemic, the accountability office report says. It focuses primarily on U.S. Department of Agriculture actions after bird flu outbreaks in 2014 and 2016, which resulted in the deaths of millions of domesticated poultry in 15 states and $2 billion in costs to the federal government and U.S. economy. Despite the lessons learned, the report concludes that federal agencies face "ongoing challenges and associated issues" in mitigating the potential harm of avian influenza.
Bird flu outbreaks this spring in Tennessee, Alabama and Kentucky have led officials to euthanize more than 200,000 animals. Those viruses are different from the H7N9 virus currently spreading in Asia, according to USDA officials.

Among the report's findings:

• Unless the agency is responding to an emergency, the Agriculture Department doesn't have the authority to require poultry producers to take preventive biosecurity measures to keep avian influenza from spreading from farm to farm. When the agency asked 850 poultry producers to turn in self-assessments on such measures, less than 60 percent said they had key practices in place to reduce contamination -- such as having workers shower or change into clean clothes immediately after arriving at a poultry site to reduce the risk of introducing a bird flu virus.

The report noted that commercial flocks raised outdoors and backyard flocks are at greater risk of contact with wild birds infected with avian influenza. These include poultry certified by the USDA as organically raised, which means turkeys and chickens that had access to outdoor space.

• Pandemic influenza vaccines for humans can be made using several technologies, but the most common approach relies on growing virus cultures in fertilized chicken eggs. The Department of Health and Human Services has a stockpile of influenza vaccines supplied by four companies, the report notes, but only one company has an egg-based vaccine-manufacturing facility in the United States.

In the event of an influenza pandemic, the government may not be able to rely on foreign countries to allow exports of pandemic vaccine, the report warns. "Therefore, the U.S. government considers the one U.S.-based company as the only dependable manufacturer for producing egg-based vaccine for rapid pandemic mitigation," it says.

HHS has had a three-year, $42 million contract with that company to protect the egg-supply chain and ensure a supply of vaccine-quality fertilized eggs. The contract expires in September, according to the report, which does not identify the company or its location.

Department officials and company representatives told the GAO that the company controls the risk of bird flu by limiting the density of birds on each farm that provides it with eggs and by periodically testing the flocks for avian influenza. While the 2014 and 2016 outbreaks did not affect this egg supply, a previous outbreak of highly dangerous avian influenza caused the deaths of laying hens and reduced the company's supply of eggs by about 50 percent, the report says.

• One way to track the potential for the spread of avian influenza is to look for the virus in pigs, which act as an intermediate host or "mixing vessel" in which flu viruses can recombine to pose new threats to humans. In 2009, H1N1 swine flu caused a global pandemic. But funding for a voluntary surveillance program that gathers data on the types of influenza viruses circulating in pigs will run out of money by Sept. 30, the report says.

The USDA program, which is the only federal source of data for influenza surveillance in pigs, relies on $25 million transferred from HHS. But President Donald Trump administration's preliminary budget proposal for fiscal 2018 cuts the USDA's budget by 21 percent and that of HHS by 18 percent.

• The Agriculture Department, which is responsible for preventing, controlling and eradicating diseases from poultry and livestock, has taken hundreds of corrective actions since the 2014 and 2016 bird flu outbreaks but has not evaluated their impact. In those outbreaks, for example, states and poultry producers encountered barriers to transporting bird carcasses to landfills. Federal officials provided guidance and training to help producers and states develop disposal plans but never assessed whether either was effective.

The department, which reviewed a draft of the report, said it agreed with the GAO's recommendation for it to develop a plan for evaluating completed corrective actions.

The office's report was requested by the House Energy and Commerce Committee.

In a statement, its investigations subcommittee chairman, Tim Murphy, R-Pa., and ranking Democrat, Diana DeGette, Colo., said: "We know the devastating impacts of a global pandemic.

Now it's up to the Department of Agriculture to make sure we are prepared and have a plan to combat this threat. Further, ensuring the effectiveness of their plans and procedures ... is just as important as the plans and procedures themselves."



 Avian flu: What poultry owners need to know [Batesville Herald Tribune, 14 May 2017]

Now is the time for poultry owners to be especially diligent about protecting their birds from avian influenza as migratory waterfowl travel north for the summer. The Indiana State Board of Animal Health (BOAH) encourages poultry owners to incorporate good biosecurity practices to keep their birds healthy.

Avian influenza (AI) is a virus that can infect chickens, turkeys, pheasants, quail, ducks, geese and guinea fowl, as well as a wide variety of other birds. Wild waterfowl and shorebirds are natural hosts for the virus. Infected waterfowl and shorebirds usually show no signs of illness and they shed the virus into their environment.

The viruses can be classified into low pathogenic (LPAI) and highly pathogenic (HPAI) forms based on the severity of the illness they cause. Most AI virus strains are LPAI and typically cause little or no clinical signs in infected birds. HPAI is an extremely infectious and fatal form of the disease for domestic poultry. HPAI can strike poultry quickly with little warning. Once the virus is established, only the highest levels of biosecurity can prevent the rapid spread from flock to flock.

Birds affected with highly pathogenic avian influenza may show one or more of these signs:

• Sudden death without clinical signs
• Lack of energy and appetite
• Swelling of the head, eyelids, comb, wattles and hocks
• Purple discoloration of the wattles, combs and legs
• Gasping
• Diarrhea

Poultry owners are encouraged to monitor their birds for any signs of illness or unexplained death.

If producers suspect their poultry may have HPAI, they should call a veterinarian, the Healthy Birds Hotline at 866-536-7593 or Purdue University Animal Disease Diagnostic Laboratory at 765-494-7440.

Biosecurity

Introductions of HPAI originate from wild birds, especially waterfowl. Poultry that are raised outdoors with access to a pond, wetland or grass where waterfowl congregate are at a greater risk of contracting the illness. Flocks infected with HPAI can then spread the virus to new flocks through movement of birds, manure, equipment and people. HPAI viruses can exist in bird waste for several months, especially under conditions of high moisture and low temperature.

Key biosecurity recommendations:
• Have a biosecurity plan and adhere to it.
• Restrict access to the flock by people, pets, wildlife and rodents.
• Do not use pond or stream water to provide drinking water for birds unless the water is treated.

• Do not keep feed where wild birds can access it.
Keep poultry pens and housing clean.
• Keep feed bins covered and stored in a location that is not accessible to wildlife, birds and rodents.
• Do not share birds or equipment with neighbors.
• Keep new birds separate from the flock for 30 days to verify they are healthy.
• Know the warning signs of infectious diseases.
• Do not take infected birds to market or exhibitions or fairs.
Information about Indiana’s poultry requirements and disease information is available on BOAH’s website at www.in.gov/boah/2721.htm.




 A suspected person‑to‑person transmission of avian influenza A (H7N9) [poultrymed, 13 May 2017]

Since throat swab specimens obtained from three adult Chinese patients were confirmed as an avian‑origin influenza A (H7N9) virus by local Centers for Disease Control and Prevention (CDC) in China in 2013, many confirmed cases have been reported in Mainland of China.

Although family and hospital clusters with confirmed or suspected avian H7N9 virus infection were previously reported and person‑to‑person transmission was put forward, human infection of H7N9 appears to be associated with exposure to infected live poultry or contaminated environments and no clear evidence has proved that it could transmit from person to person.

Now, a group of chinese researchers report a case confirmed with H7N9 after intimately contact with his H7N9 ward mate, it may be the first case infected between ward mates in a ward. The index case patient 66‑year‑old male with hypertension and type II diabetes for more than 10 years, had visited a live‑poultry market (LPM) to buy food every day within 10 days before his illness onset and had no direct contact with live poultry in the market.

Case 2 (index case’s ward mate), a 62‑year‑old male with no underlying disease, The second case in this report had physical contact with the index case when assisting the index case to the bathroom (it lasted for 10 min) and had no history of exposure to live poultry or LPMs before the illness onset. There were a lot of family members in the ward, but he was the only one who was in close contact with the index case, and he was the only one confirmed H7N9 besides the index case. To the best of our knowledge, the case indicates that it is human‑to‑human transmission happened in a ward with detailed epidemiological, clinical, virological data, and genome analyses of two collected H7N9 virus.

Reference:
Zhang ZH, Meng LS, Kong DH, Liu J, Li SZ, Zhou C, Sun J, Song RJ, Wu JJ
Chin Med J (2017) May 20;130(10):1255-1256



 US falling short on bird flu preparation, report finds [CNN, 12 May 2017]

By Faith Karimi

(CNN)If an avian influenza pandemic ever hit the United States, there's only one dependable manufacturer in the country capable of making a vaccine, a government watchdog reports.

"The US government may not be able to rely on foreign countries to allow exports of pandemic vaccine because each country will likely prioritize those vaccines for its own population," the nonpartisan Government Accountability Office said in a new report.

These forms of the virus mainly infect birds, but certain strains have mutated to transmit from birds to humans, meaning an outbreak among humans is possible -- and the US may not be ready.

About 90 to 95% of the national stockpile of pandemic influenza vaccines is derived from eggs, the report says, and while the vaccines are supplied by four companies, only one has an egg-based vaccine facility in the US.

"The US government considers the one US-based company as the only dependable manufacturer for producing egg-based vaccines for rapid pandemic mitigation," the report says.

The report comes two months after China began confirming human infections of one avian influenza strain, H7N9.

Health officials are monitoring the cases in China, especially since the number of people infected exceeds previous instances in the nation, Dr. Wenqing Zhang of the World Health Organization told CNN in an earlier report.

Vaccines threatened

In the US, the source of vaccines is at risk, according to the report.

An outbreak of avian influenza could threaten the very same poultry that produce the eggs used in the production of human vaccines, it said.

"Protecting the chickens that lay the eggs needed to produce human pandemic influenza vaccines is an issue for federal agencies because these birds, like others, are susceptible to avian influenza," the report says.

The US Department of Agriculture relies on poultry farmers to ensure security guidelines are in place, and many are not ensuring their flocks are protected, it said.

The report also noted that US agriculture officials reviewed the biosecurity practices of 850 poultry producers and found that less than 60% had a place for employees who work at a poultry site to shower or change, increasing the chances of contamination.

Billions lost

About 50 million birds died or were killed in the outbreak of avian flu in the US in 2014 and 2015. It cost the US economy between $1 billion and $3.3 billion, the report said.

While the US Department of Agriculture took measures to address lessons learned from that outbreak, it has not evaluated their effectiveness, the report noted.

Measures taken included creating a joint biosecurity website with the US Poultry and Egg Association and urging producers to make biosecurity a priority. US officials also provided guidance and training after they found out that some poultry producers had difficulty transporting bird carcasses to landfills due to federal and state rules restricting the movement of such cargo.

The GAO recommended that the department set up a plan to evaluate the effectiveness of its corrective measures.

US officials have a three-year, $42 million contract with the vaccine manufacturing company in the US to protect its egg-supply chain and ensure it has a supply that can be used for vaccines.

The contract expires in September, according to the report, which said that Health and Human Services officials are confident the company has a secure biosecurity program.

Poultry outbreaks

Symptoms of avian influenza, also known as bird flu, include fever, cough, sore throat and sometimes pneumonia. The infection can be treated with antiviral medications.

The official name for the most common and deadliest form of the virus is Influenza A (H5N1), or the "H5N1 virus."

The strain of bird flu reported to be circulating in humans in China since February -- H7N9 -- was first detected in March 2013, at which point it had previously not been seen in humans.
Hundreds of millions of birds have been killed worldwide in an attempt to control the spread of the avian flu.

There are many different strains of avian flu but only those labeled H5, H7 and H10 are known to have caused deaths in humans to date.



 China reports 23 more H7N9 cases, 7 fatal [CIDRAP, 12 May 2017]

By Lisa Schnirring

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shankar s. / Flickr cc

Reports of new H7N9 avian flu cases in China continued at a steady pace last week, with 23 more cases reported. Many of the new cases are in the north, which has reported a late-season surge, according to an update today from Hong Kong's Centre for Health Protection (CHP).

China is in its fifth and by far largest wave of H7N9 illnesses, a season that has been marked by a shift to a highly pathogenic form of the virus in poultry and a wider distribution of human cases beyond the poultry production areas of the southeastern provinces.

Cases persist as summer nears

China's 23 new cases were reported from May 5 to May 11, and 7 of the patients died from their infections. Illness onsets range from Apr 11 to May 6. The weekly number of cases appeared to be dropping in March and April but have edged up since then. This week's total is similar to the 22 illnesses the country reported last week.

Patient ages range from 31 to 83 years, and 13 are men and 10 are women. Investigations revealed that 20 of the people had contact with poultry or had visited poultry markets or mobile poultry stalls.

Cases were reported from eight provinces, plus the northern cities of Beijing and Tianjin. Five cases were in Hebei province in the north, and three provinces each reported three new infections: Henan and Shaanxi in central China, and Sichuan in the southwest.

The latest week's worth of cases pushes China's total in the fifth wave to nearly 700, at least 203 of them fatal.

Vietnam braces for H7N9 threat

In other avian flu developments, Vietnam's government is stepping up its preparedness efforts against the virus amid wider spread of H7N9 in China, including border provinces, Vietnam
News Service (VNS) reported today. Officials called for more intensive measures to control the trade and consumption of poultry from unknown sources, especially birds smuggled from neighboring China.

The country's preventive medicine department on May 10 warned of disease spread in south and southeast China, including Yunnan and Guangxi provinces, which border Vietnam.

According to the report, the health ministry has sped up training of health officers and of inspection and control activities in the border provinces.

Vietnam has been battling recent H5N1 and H5N6 outbreaks in poultry, but it has never detected H7N9.

Egypt reports H5N1 case

Elsewhere, Egypt recently reported a human H5N1 avian flu case, involving a 35-year-old man from Cairo, according to a May 8 notification from the United Nations Food and Agriculture Organization (FAO). No other details were available.

H5N1 is endemic in Egyptian poultry, and so far this year the country has reported three human cases.




 VN threatened by new strain of bird flu [Viet Nam News, 12 May 2017]

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People join a drill held in northern Lạng Sơn Province to destroy suspected poultry with H7N9 virus. — VNA/VNS Photo

HÀ NỘI — The Prime Minister and ministries of Health and Agriculture and Rural Development are calling for intensive measures to curb the trafficking, trade and consumption of unknown poultry, especially birds smuggled from China, where avian influenza A (H7N9) continues to spread.

The Preventive Medicine Department under the health ministry announced Wednesday that the avian influenza A (H7N9) is spreading rapidly south and southeast China, including Yunnan and Guangxi provinces--which both share borders with Việt Nam.

The World Health Organisation (WHO) and Food and Agriculture Organisation (FAO) detected changes of H7N9 virus from low pathogenicity to high pathogenicity in poultry and humans.

WHO found H7N9 virus with high pathogenicity in two patients in Guangdong and Taiwan. FAO found high pathogenicity of H7N9 in 41 poultry samples.

With low pathogenicity, H7N9 virus may cause mild or no illness in poultry while with high pathogenicity, the virus can lead to high bird mortality and spread 100-1,000 times faster than low-pathogenicity virus.

So far, there has not been any evidence that the new strain of H7N9 causes more rapid human-to-human transfer. Therefore, WHO have not recommended changing the flu treatment scheme.

According to the Preventive Medicine Department, the health ministry has sped up instruction and training to health officers as well as inspections on disease prevention and control in provinces.

The department recommended people not consume ill/dead poultry or unknown origin. Neither should they kill, traffic or trade unknown-origin poultry.

When detecting ill/dead poultry, people should contact authorities. When having symptoms like fever, cough, chest pain or breathing difficulty after contacting with poultry, people must go to see doctor for immediate treatment.

Flu A (H7N9) was first detected in China in March, 2013 and has surged in five epidemic waves.

The fifth wave onset began in October 2016, and it has been the greatest one, with 541 human infections with avian influenza A (H7N9) in 17 provinces of China. — VNS




 CHP notified of human cases of avian influenza A(H7N9) in Mainland [CHP Notification, 12 May 2017]

The Centre for Health Protection (CHP) of the Department of Health today (May 12) is monitoring notification from the National Health and Family Planning Commission that 23 additional human cases of avian influenza A(H7N9), including seven deaths, were recorded from May 5 to 11, and strongly urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.

The 13 male and 10 female patients, aged 31 to 83, had onset from April 11 to May 6, of whom five were from Hebei; three each from Henan, Shaanxi and Sichuan; two each from Beijing and Jiangsu; and one each from Fujian, Gansu, Hubei, Tianjin and Zhejiang. Among them, 20 were known to have exposure to poultry, poultry markets or mobile stalls.

Travellers to the Mainland or other affected areas must avoid visiting wet markets, live poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchase of live or freshly slaughtered poultry, and avoid touching poultry/birds or their droppings. They should strictly observe personal and hand hygiene when visiting any place with live poultry.

Travellers returning from affected areas should consult a doctor promptly if symptoms develop, and inform the doctor of their travel history for prompt diagnosis and treatment of potential diseases. It is essential to tell the doctor if they have seen any live poultry during travel, which may imply possible exposure to contaminated environments. This will enable the doctor to assess the possibility of avian influenza and arrange necessary investigations and appropriate treatment in a timely manner.

While local surveillance, prevention and control measures are in place, the CHP will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments.

The CHP's Port Health Office conducts health surveillance measures at all boundary control points. Thermal imaging systems are in place for body temperature checks on inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up.

The display of posters and broadcasting of health messages in departure and arrival halls as health education for travellers is under way. The travel industry and other stakeholders are regularly updated on the latest information.

The public should maintain strict personal, hand, food and environmental hygiene and take heed of the advice below while handling poultry:

・Avoid touching poultry, birds, animals or their droppings;

・When buying live chickens, do not touch them and their droppings. Do not blow at their bottoms. Wash eggs with detergent if soiled with faecal matter and cook and consume them immediately. Always wash hands thoroughly with soap and water after handling chickens and eggs;

・Eggs should be cooked well until the white and yolk become firm. Do not eat raw eggs or dip cooked food into any sauce with raw eggs. Poultry should be cooked thoroughly. If there is pinkish juice running from the cooked poultry or the middle part of its bone is still red, the poultry should be cooked again until fully done;

・Wash hands frequently, especially before touching the mouth, nose or eyes, before handling food or eating, and after going to the toilet, touching public installations or equipment such as escalator handrails, elevator control panels or door knobs, or when hands are dirtied by respiratory secretions after coughing or sneezing; and

・Wear a mask if fever or respiratory symptoms develop, when going to a hospital or clinic, or while taking care of patients with fever or respiratory symptoms.

The public may visit the CHP's pages for more information: the avian influenza page, the weekly Avian Influenza Report, global statistics and affected areas of avian influenza, the Facebook Page and the YouTube Channel.

Zoonotic Bird Flu News - from 5 till 11 May 2017



 GAO Wants USDA to Better Reduce Risks of Bird Flu Outbreak [DTN The Progressive Farmer (registration) (blog), 11 May 2017]

by Chris Clayton

The Government Accountability Office has been taking a closer look lately at how USDA handles foreign animal diseases.

The GAO released a report Thursday looking at how USDA responded to the 2014 H5N2 highly-pathogenic avian influenza outbreak that led to the deaths of roughly 50 million commercial poultry due to the flu or euthanasia. The outbreak, considered the largest animal-disease outbreak in U.S. history, cost somewhere between $1 billion and $3.3 billion.

USDA reported 15 areas with lessons from the avian influenza outbreaks and came up with 308 corrective actions. The GAO found, however, that USDA has not evaluated the extent to which corrective actions have been completed. One problem, for instance, was the difficulty finding skilled people to cull the mass volumes of flocks. This led to delays and possibly spreading of the virus. So far, USDA hasn't worked to encourage states to identify teams or businesses that can quickly "depopulate" farms. The GAO noted USDA "does not have plans for doing so."

The GAO cited USDA needs to develop a plan for following through on its corrective actions. ☞ AVIAN INFLUENZA  

Members of the House Energy and Commerce Oversight and Investigations Subcommittee issued a news release about the GAO report, stating USDA needs to do more to reduce the risks of another bird flu outbreak. Chairman Tim Murphy, R-Pa., and Ranking Member Diana DeGette, D-Colo., told The Washington Post, “We know the devastating impacts of a global pandemic. Now it’s up to the Department of Agriculture to make sure we are prepared and have a plan to combat this threat. Further, ensuring the effectiveness of their plans and procedures are just as important as the plans and procedures themselves.”

The report also dovetails into a push by the livestock industry to create and fund a vaccine bank in the 2018 farm bill so USDA could rapidly respond to livestock and poultry outbreaks.

The GAO report also comes just weeks after the office analyzed USDA's evaluation of foreign animal health systems.



 AVIAN INFLUENZA: USDA Has Taken Actions to Reduce Risks but Needs a Plan to Evaluate Its Efforts [Government Accountability Office, 11 May 2017]

Avian influenza is an extremely infectious and potentially fatal disease in poultry. In 2014 and 2016, outbreaks in the U.S. led to the death of more than 50 million chickens, turkeys, and other birds, and cost billions of dollars.

Controlling avian influenza viruses in poultry is crucial to preventing those viruses from evolving to infect people.

The U.S. Department of Agriculture has taken actions to address lessons learned from its responses to the outbreaks, such as encouraging states to form response teams. However, it does not have a plan to evaluate the effectiveness its efforts. We recommended that USDA develop such a plan.

Approximate Number of Birds Killed as a Result of the 2014 Outbreak of Highly Pathogenic Avian Influenza, by State

rId14_image4.png


What GAO Found

When avian influenza outbreaks occur, they can have significant effects on human and animal health and the U.S. economy. With regard to human health, avian influenza rarely affects humans, but the World Health Organization estimates that two particular types of the virus have caused more than 2,100 human infections and more than 800 deaths since 1997, primarily in Asia and the Middle East. With regard to animal health, avian influenza outbreaks can lead to large numbers of poultry deaths as a result of efforts to control and prevent the spread of the disease. For example, from December 2014 to June 2015, more than 50 million birds were destroyed in the largest outbreak in U.S. history. The effect of avian influenza on the health of other animal species varies. Swine are susceptible to both avian and human influenza viruses that, if mixed, could create a new virus to which humans are vulnerable. An outbreak can also have significant economic consequences; for example, the economic impacts of the 2014 outbreak in the United States have been estimated to range from $1.0 to $3.3 billion.

USDA identified 15 areas with lessons learned from its responses to the 2014 and 2016 outbreaks of avian influenza and 308 associated corrective actions. For example, one lesson learned in the area of depopulation (mass culling of flocks) is that there were not enough skilled personnel available for depopulating infected poultry, leading to delays and possibly increasing the spread of disease. USDA has identified as completed about 70 percent of the 308 corrective actions to address all of the lessons learned. However, the agency has not evaluated the extent to which completed corrective actions—such as encouraging states to form depopulation teams—have helped resolve the problems identified, and it does not have plans for doing so. GAO has previously found that agencies may use evaluations to ascertain the success of corrective actions, and that a well-developed plan for conducting evaluations can help ensure that agencies obtain the information necessary to make effective program and policy decisions.

Such a plan would help USDA ascertain the effectiveness of the actions it took to resolve problems identified during recent outbreaks.

On the basis of GAO's analysis of federal efforts to respond to outbreaks and of stakeholders' views, GAO identified ongoing challenges and associated issues that federal agencies face in mitigating the potential harmful effects of avian influenza. For example:

One challenge is that federal efforts to protect poultry from avian influenza rely on voluntary actions by a wide range of poultry producers to take routine preventative measures—known as biosecurity— to protect their flocks from disease. USDA has two major initiatives under way to encourage improvements to biosecurity.

An associated issue that federal agencies face is that the chickens used to produce the eggs needed to manufacture critical human influenza vaccine are susceptible to influenza outbreaks. The Department of Health and Human Services is supporting the development of new vaccine manufacturing technologies to reduce reliance on eggs.

Why GAO Did This Study

Avian influenza is an extremely infectious and potentially fatal disease in poultry. In 2014 and 2016, two outbreaks of avian influenza led to the deaths of millions of poultry in 15 states and prompted emergency spending to control the disease. While the health risk to humans is low, humans have been infected with these viruses, sometimes fatally. A spike in fatal human infections in Asia began in late 2016.

GAO was asked to review several issues related to avian influenza. This report examines (1) how outbreaks of avian influenza have affected human health, animal health, and the U.S. economy, (2) the extent to which USDA has taken actions to address any lessons learned from its responses to the outbreaks in 2014 and 2016, and how it plans to evaluate the actions' effectiveness, and (3) ongoing challenges and associated issues, if any, federal agencies face in their efforts to mitigate the potential harmful effects of avian influenza. GAO reviewed global and domestic data on the effects of avian influenza and USDA reports and corrective action data associated with its responses to the recent outbreaks, and interviewed federal officials and stakeholders from state agencies and the poultry industry.

What GAO Recommends

GAO recommends that USDA develop a plan for evaluating the effectiveness of the corrective actions it has taken. USDA agreed with GAO's recommendation.
For more information, contact Steve Morris at (202) 512-3841 or morriss@gao.gov.

Recommendation for Executive Action

Recommendation: The Secretary of Agriculture should direct the Administrator of the Animal and Plant Health Inspection Service to develop a plan for evaluating completed corrective actions to determine their effectiveness and, as appropriate, consider whether any completed corrective actions require validation through simulations or exercises.
Agency Affected: Department of Agriculture

Report to Congressional Requesters  

Recommendations database  




 High risk areas of the north-west hit by latest bird flu measures [FG Insight, 11 May 2017]


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A new localised AIPZ will be put in place in targeted areas of Lancashire, Cumbria and Merseyside due to ‘heightened risk’.

Confirmation of the disease in the nine chickens and ducks near Thornton, Wyre came only two days after a flock of 30 chickens was wiped out in the same area.

A 3km protection zone and a 10km surveillance zone has been put in place and a full investigation is underway.
Any birds not already dead will be culled.

Officials have not yet confirmed whether the two sites are connected.

The outbreaks came less than a week after Defra chief vet Nigel Gibbens had his ‘fingers crossed’ after the announcement to relax bird flu measures on May 15.

He warned twitter followers the industry was ‘still at risk’ and ‘biosecurity remains imperative’.

Plans to lift the Avian Influenza Prevention Zone (AIPZ) will continue as planned on May 15, apart from in ‘targeted areas’ of Lancashire, Cumbria and Merseyside due to what Defra have branded a ‘heightened risk’.

Defra chief vet Nigel Gibbens confirmed the recent outbreak in Wyre, Lancashire was strong to suggest risk of bird flu remained in circulation in wild resident birds or present in the environment.

A new and more targeted AIPZ will be introduced to replace the England-wide AIPZ lifted next week in the below areas:
• Barrow-in-Furness
• South Lakeland
• Lancaster
• Blackpool
• Wyre
• Fylde
• Preston
• Sefton
• West Lancashire
• South Ribble
• Chorley

Keepers in the affected areas have been urged to continue to practise existing mandatory disease prevention measures, including minimising movement in and out of enclosures, cleaning footwear, ensuring the cleanliness of the environment and feeding birds indoors.

Poultry gatherings also remain banned until further notice.



 CDC Head Watching Bird Flu From China [Atlanta Jewish Times, 11 May 2017]

BY DAVID R. COHEN

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CDC developing new vaccine for H7N9 in case bird flu begins to spread from person to person.

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Acting CDC Director Anne Schuchat is in charge until a permanent director is nominated by President Donald Trump and confirmed by the Senate.

One of the most pressing public health issues in 2017 isn’t the Zika virus or Ebola, according to the director of the Centers for Disease Control and Prevention; it’s the flu.

Anne Schuchat, who became the CDC’s acting director after Tom Frieden resigned at the start of President Donald Trump’s administration, said Zika remains at the top of the organization’s list of concerns, but a new strain of flu from China, H7N9, has disastrous potential if it reaches the United States.

“We’ve been tracking it since 2013 when it emerged. Most of the human cases result from contact with live birds, and 40 percent of infections result in death, and almost everyone that gets it needs to go to an intensive care unit,” Schuchat said. “What’s scary right now is that in the fifth year of this we are seeing the strains change and adapt away from the vaccine we produced against it.”

The CDC is working on a new vaccine for H7N9 in case the strain starts spreading from person to person instead of bird to person.

“One of the reasons we have people working in 60 countries is because a threat anywhere is a threat everywhere,” Schuchat said. “So we always have to take flu strains seriously because the threat of a global pandemic could be a catastrophe.”

Schuchat, who grew up in a Conservative Jewish family in Washington, was working at the CDC in 2009 when H1N1 slammed the United States. Several Jewish summer camps, including Camp Coleman in Cleveland, were forced to cancel sessions because of the outbreak.

The flu is usually invisible in the summer in the United States, but in 2009 a new strain was detected in late spring and caused a large wave of infections, leading to those camp cancellations. When school started back in the fall, H1N1 took off.

“It was pretty disruptive,” Schuchat said. “But we were lucky in 2009 because most elderly people were already protected against it from a strain they had when they were young.”

Schuchat, who has worked at the CDC since 1988, is hardly the Clifton Road-based agency’s first Jewish director. Frieden, who was director from 2009 to 2017, is Jewish, as is Jeffrey Koplan, the director from 1998 to 2002.

Frieden played a key role in fighting the 2014 Ebola outbreak in West Africa. Koplan was the director during the 2001 anthrax attacks and spurred anti-terrorist improvements to the CDC infrastructure.

Asked why she thinks three of the past four CDC directors have been Jewish, Schuchat said her family put an emphasis on education when she was growing up.

“I certainly grew up in a family that was really focused on education and achievement,” she said. “My parents really valued the opportunities they got. My dad grew up when there were quotas for Jewish people at universities. I’m just so grateful to have this opportunity to lead.”

In nearly 30 years at the CDC, Schuchat has experienced numerous public health scares. A main character in the 2011 medical disaster film “Contagion,” Erin Mears, is partially based on Schuchat. Kate Winslet, who played Mears, consulted with Schuchat while preparing for the role.

Interim directors are not usually appointed permanent CDC directors, but Julie Gerberding, who was part of the interim management team after Koplan resigned, was appointed to the main role.

“This is a temporary position for me,” Schuchat said, “but it’s really been great to represent the agency in different ways and to contribute. This is such a special place. People are so passionate about protecting people, and the chance to serve in a leadership role here is really a privilege.”

Koplan, who is now the vice president for global health at Emory University and worked with Schuchat at the CDC, praised the acting director.

“She’s a highly skilled, talented public health professional who does superb work,” Koplan said. “She has the highest integrity, makes wise decisions based on carefully reviewing the evidence and the data, and has worked on a wide range of difficult infectious disease issues.”



 Abstracts: Bird Flu, Albatross, Robots, and More [Undark Magazine, 11 May 2017]

BY Kate Telma

A roundup of science news from around the web — and around the world.

• A new strain of avian influenza is causing a wave of deaths in China. The Government Accountability Office reports that if a flu pandemic reached the U.S., only one manufacturer could be counted on to make vaccines, which are harvested from fertilized eggs. (Washington Post)

albatrosses.jpg
Albatross on Española Island in the Galápagos.
Visual by putneymark/CC

• A group at the British Antarctic Survey takes birdwatching to the next level by using satellites to track albatross on remote islands. (The Atlantic)

• An often overlooked risk of firearms is exposure to tiny particles of toxic lead. A new policy at the Department of Defense lowers its employees’ allowable exposure to 20 micrograms of lead per deciliter of blood, three times as restrictive as its previous standard. (NPR)

• The White House is set to appoint two governors, a congressman in recovery, and a Harvard addiction researcher to its bipartisan Commission on Combating Drug Addiction and the Opioid Crisis. Critics say the issue has already been thoroughly studied and many expert recommendations already made, including an extensive surgeon general’s report last year. (STAT)

• Scientists at MIT are using robots to teach other robots — a glimpse into the future of robotic reinforcement learning. (Wired)

• People with HIV are living to an average age of 78, 10 years longer than those who contracted the virus in the mid-90’s, suggests a new study in Lancet HIV. The study, which looked at people across 18 countries, demonstrates that current therapies are working but that people with HIV still don’t live as long as those without. (Time)

• A blind mountain climber uses a device that enables his tongue to sense the rock face, restoring the hand-to-eye climbing coordination he had before losing his sight. (The New Yorker)

• Chinese scientists are calling for a crackdown on a booming market in counterfeit reagents — substances used in chemical or biological tests — that waste time and materials and could undermine the country’s efforts to become a world leader in science. (Nature)

• Experts, advisers, and diplomats urge President Trump not to abandon the Paris climate agreement. They call it a less rigorous, more flexible plan than its predecessor, the Kyoto Protocol, and say there are few compelling reasons to leave. (New York Times)

• And finally, wandering street vendors arrange blister packs of pills into towering sculptures and dole out medical advice on the streets of Port-au-Prince, Haiti. (National Geographic)



 USDA Unsure if Bird Flu Guidelines are Helping, GAO Finds [NBCNews.com, 11 May 2017]

by NIKITA BIRYUKOV

U.S. agriculture officials do not actually know if they are doing enough to protect people and poultry from avian influenza, a government watchdog reported Thursday.

The U.S. Department of Agriculture is still relying on poultry producers to voluntarily follow security guidelines, and many still are not doing everything they are supposed to do to protect their flocks, the non-partisan Government Accountability Office says in the report.

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An Indian health worker wrings the neck of a chicken during a culling operation after chicks were found to be infected with H5N1 avian influenza NOAH SEELAM / AFP - Getty Images

About 50 million birds died or were slaughtered in the outbreak of highly pathogenic H5N2 avian flu that spread to several states in 2014 and 2015, costing the U.S. economy an estimated $1 billion to $3.3 billion.

There have been smaller outbreaks since. The spread of bird flu threatens chicken and egg production but is also worrying because the viruses can infection people, too, sometimes. And worse, the technology to make flu vaccines to protect people from new outbreaks largely rely on chicken eggs.

Members of Congress asked the GAO to look into what USDA had done to improve U.S. farming practices.

It found the department had taken hundreds of actions, but had done too little to determine whether they were effective. And it found some big holes still in what poultry producers were doing.

Fewer than 60 percent of the 850 poultry producers surveyed had biosecurity officers or training in place, the GAO found. And less than 60 percent divided their poultry processing lines or provided employees a place to shower or change clothing before working on a poultry site, raising risks that workers could spread the virus around a plant or from one facility to another.

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Avian flu outbreaks in 2014 and 2016 killed millions of birds. Gaizka Iroz / AFP - Getty Images file

The USDA has created training programs and sought to encourage producers to improve security and hygiene with an interim rule that would keep them from being reimbursed for birds culled because of an outbreak.

According to the GAO's report, these measures - and more than 300 others added after the 2014 outbreaks, some of which are ongoing - have not been tested to see if they are effective. The USDA agreed with the report's single recommendation that it develop a plan to determine the worth of the measures.

The GAO pointed to another problem -- wild birds.

Experts believe wild birds carry the viruses into the U.S. from Asia, and then spread them from one region of the U.S. to another. There is little that people can do to prevent that, the report says.

A bird surveillance program run jointly by the USDA and the Department of the Interior found roughly 0.12 percent of more than 88,000 wild birds surveyed carried a highly pathogenic strain of avian influenza of the same lineage that caused the 2014 and 2016 outbreaks.

None of the U.S. strains has spread to people, but two strains known as H7N9 and H5N1 have infected hundreds of people in China. Scientists fear one of these strains will mutate to become more infectious and might cause a pandemic of potentially deadly flu.

"We know the devastating impacts of a global pandemic. Now it's up to the Department of Agriculture to make sure we are prepared and have a plan to combat this threat," Tim Murphy, a Pennsylvania Republican, and Diana DeGette, a Colorado Democrat on the House Energy and Commerce subcommittee that ordered the report said in a joint statement.

The GAO said the issue of egg production was particularly worrying.

By Lena H. Sun.jpg
The Avian influenza virus is harvested from a chicken egg as part of a diagnostic process in this undated image. Erica Spackman / USDA via Reuters file

"The virus could infect poultry needed to produce eggs used in manufacturing critical human vaccines against pandemic influenza," the report notes. Domestic production of the vaccine would grind to a halt. And during a pandemic, foreign nations may not export the vaccines to the United States, instead preferring to save them for their own populations.

The Department of Health and Human Services contracted with a private company last year "to protect the egg supply chain and ensure a year-round supply of vaccine-quality fertilized eggs." HHS is also working to help companies develop ways to make flu vaccines without the use of eggs.

GAO said there's another problem, too. Flu viruses can infect pigs, and pigs can be infected both by human and by bird flu viruses. "Federal funding will soon be exhausted for a voluntary surveillance program that gathers information about the presence of influenza viruses in swine that could pose a threat to human health," the report notes.



 With bird flu surging, U.S. needs to do more to prevent possible pandemic, GAO says [Washington Post, 11 May 2017]

By Lena H. Sun

By Lena H. Sun.jpg
The avian influenza virus is harvested from a chicken egg as part of a diagnostic process. (Erica Spackman/USDA/Reuters)

If the United States were suddenly facing a potential avian influenza pandemic, just one U.S. manufacturer could be counted on to make human pandemic flu vaccine here. And although the chickens that lay the eggs used in the process are themselves susceptible to the virus, until an emergency arises only voluntary and often inadequate measures by poultry producers are in place to protect flocks, according to a new Government Accountability Office report.

The report, scheduled for release next week, comes at a time of heightened public health worries about bird flu. One of the deadliest strains, H7N9, is causing a surge in human infections in China this season. Of the nearly 200 people who have died, most had direct contact with poultry or poultry markets.

Health officials worldwide are closely monitoring the disease's spread because of the big increase in cases and worrisome changes in the virus. Of all emerging influenza viruses, this strain of H7N9 has the greatest potential to cause a pandemic if it evolves to spread easily from human to human. It also poses the greatest risk to cause serious disease.

Controlling the virus in poultry is the main way to reduce human infection and prevent a pandemic, the GAO report says. It focuses primarily on Agriculture Department actions after bird flu outbreaks in 2014 and 2016, which resulted in the deaths of millions of domesticated poultry in 15 states and $2 billion in costs to the federal government and U.S. economy. Despite the lessons learned, the report concludes that federal agencies face “ongoing challenges and associated issues” in mitigating the potential harm of avian influenza.

Bird flu outbreaks this spring in Tennessee, Alabama and Kentucky have led officials to euthanize more than 200,000 animals. They are different from the strain of the H7N9 virus currently spreading in Asia, according to Agriculture officials.

Among the report's findings:

• Unless the agency is responding to an emergency, the Agriculture Department doesn’t have the authority to require poultry producers to take preventive biosecurity measures to keep avian influenza from spreading from farm to farm. When the agency asked 850 poultry producers to turn in self-assessments on such measures, less than 60 percent said they had key practices in place to reduce contamination — such as having workers shower or change into clean clothes immediately after arriving at a poultry site to reduce the risk of introducing a bird flu virus.

The report noted that commercial flocks raised outdoors and backyard flocks are at greater risk of contact with wild birds infected with avian influenza. These include poultry certified by the USDA as organically raised, which means turkeys and chickens that had access to outdoor space.

• Pandemic influenza vaccines for humans can be made using several technologies, but the most common approach relies on growing virus cultures in fertilized chicken eggs. The Department of Health and Human Services has a stockpile of influenza vaccines supplied by four companies, the report notes, but only one company has an egg-based vaccine manufacturing facility in the United States.

In the event of an influenza pandemic, the government may not be able to rely on foreign countries to allow exports of pandemic vaccine, the report warns. “Therefore, the U.S. government considers the one U.S.-based company as the only dependable manufacturer for producing egg-based vaccine for rapid pandemic mitigation,” it says.

HHS has had a three-year, $42 million contract with that company to protect the egg-supply chain and ensure a supply of vaccine-quality fertilized eggs. The contract expires in September, according to the report, which does not identify the company or its location. HHS officials and company representatives told the GAO that the company controls the risk of bird flu by limiting the density of birds on each farm that provides it with eggs and by periodically testing the flocks for avian influenza. While the 2014 and 2016 outbreaks did not affect this egg supply, a previous outbreak of highly dangerous avian influenza caused the deaths of laying hens and reduced the company's supply of eggs by about 50 percent, the report says.

• One way to track the potential for the spread of avian influenza is to look for the virus in pigs, which act as an intermediate host or “mixing vessel” in which flu viruses can recombine to pose new threats to humans. In 2009, H1N1 swine flu caused a global pandemic. But funding for a voluntary surveillance program that gathers data on the types of influenza viruses circulating in pigs will run out of money by Sept. 30, the report says.

The Agriculture program, which is the only federal source of data for influenza surveillance in pigs, relies on $25 million transferred from HHS. But the Trump administration’s preliminary budget proposal for fiscal 2018 cuts Agriculture's budget by 21 percent and that of HHS by 18 percent.

• The Agriculture Department, which is responsible for preventing, controlling and eradicating diseases from poultry and livestock, has taken hundreds of corrective actions since the 2014 and 2016 bird flu outbreaks but has not evaluated their impact. In those outbreaks, for example, states and poultry producers encountered barriers to transporting bird carcasses to landfills. Federal officials provided guidance and training to help producers and states develop disposal plans but never assessed whether either was effective.

The department, which reviewed a draft of the report, said it agreed with the GAO’s recommendation for it to develop a plan for evaluating completed corrective actions.

The GAO report was requested by the House Energy and Commerce Committee. In a statement, its investigations subcommittee chairman, Tim Murphy (R-Pa.), and ranking Democrat, Diana DeGette (Colo.) said: “We know the devastating impacts of a global pandemic.

Now it’s up to the Department of Agriculture to make sure we are prepared and have a plan to combat this threat. Further, ensuring the effectiveness of their plans and procedures are is just as important as the plans and procedures themselves.”



 Deadly Bird Flu Strain H7N9 Could be Next Pandemic [Laboratory Equipment, 9 May 2017]

by Seth Augenstein

cdc-influenza-h7n9-lab-workers.jpg
 A CDC Scientist harvests H7N9 virus that has been grown for sharing with partner laboratories for research purposes. Photo: CDC

It’s been a century since the last worldwide influenza pandemic. The Spanish Influenza of 1918 spread across the globe in the waning days of World War I, killing tens of millions of people.

The next pandemic-level strain could be brewing in China, according to health officials. It’s a bird flu strain that has demonstrated 41 percent mortality in recent epidemics. Currently in its fifth epidemic, it’s become more widespread than ever – and it’s changing, according to world health officials.

The good news is that the H7N9 virus has so far shown limited human-to-human transmission.

The bad news is that this fifth epidemic of the influenza strain, though mostly transmitted by poultry, is the largest yet.

“The H7N9 virus continues to have the greatest potential to cause a pandemic of known emerging influenza A viruses, and H7N9 viruses are considered to be the influenza A virus with the greatest potential public health impact,” the CDC recently announced.

Last week the World Health Organization reported 623 infections in humans,. The total cumulative number of infections to date is 1,421 since the strain was identified in 2013.

The first four epidemics proved how virulent the virus truly is, according to international authorities. From the first four epidemics, 88 percent of patients came down with pneumonia, 68 percent were admitted to an intensive care unit – and a full 41 percent died.

The fifth epidemic also appears to have diverged into two distinct lineages, from the Pearl River Delta and the Yangtze River Delta. The strain has changed ultimately at the molecular level – and for the worse, according to the CDC.

“Samples from the fifth epidemic demonstrate that these viruses contain a four-amino acid insertion in a host protease cleavage site in the HA protein that is characteristic of highly-pathogenic avian influenza viruses,” they write.

But there are positive developments. Several candidate vaccine viruses are in development.

Most importantly so far, almost all the human infections have been linked to exposure to poultry, they added.

“Although some limited human-to-human spread continues to be identified, no sustained human-to-human H7N9 transmission has been observed,” they write.

CDC and the World Health Organization are not warning travelers yet. But they said that monitoring continues, and that they will issue safeguards and cautionary recommendations when appropriate.

“CDC, China and global health partners will continue to closely monitor the H7N9 virus situation in China and will continue to conduct risk assessments as the situation evolves,” they concluded. “CDC does not have any new or special recommendations for the U.S. public at this time regarding H7N9. CDC will keep you updated. Stay informed.”

This past flu season, tens of millions of birds were culled in Asia, but that was mostly due to the H5N6 strain, which was more prevalent last year than the H7N9.



 Human infection with avian influenza A(H7N9) virus – China [World Health Organization, 9 May 2017]

On 30 April 2017, the National Health and Family Planning Commission of China (NHFPC) notified WHO of 18 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus in mainland China.

Details of the cases

Onset dates ranged from 6 to 23 April 2017. Of these 18 cases, eight were female. The median age was 58 years old (age range among the cases is 4 to 74 years old). The cases were reported from Beijing (2), Chongqing (1), Fujian (1), Gansu (1), Guangdong (2), Henan (1), Hunan (1), Jiangsu (1), Jilin (1), Shandong (2), and Sichuan (5).

At the time of notification, there were three deaths, 14 cases were diagnosed as having either pneumonia (4) or severe pneumonia (10), and one case was diagnosed as mild. Seventeen cases were reported to have had exposure to poultry or live poultry market. One was reported to have had no known poultry exposure.

To date, a total of 1439 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported through IHR notification since early 2013.

Public health response

Considering the increase in the number of human cases since December 2016, the Chinese government at national and local levels is taking further measures which include:

・Strengthening risk assessment and guidance on prevention and control for northern provinces, which are reporting increasing cases. On April 24, the NHFPC convened a videoconference on avian influenza A(H7N9) prevention and control for 11 northern provinces.

・Continuing to strengthen control measures with focus on hygienic management of live poultry markets and cross-regional transportation.

・Conducting detailed source investigation to inform targeted prevention and control measures.

・Continuing to detect and treat cases of human infection with avian influenza A(H7N9) early to reduce mortality.

・Continuing to carry out risk communication and issue information notices to provide the public with guidance on self-protection.

・Strengthening virology surveillance to better understand virus contamination levels and mutations, in order to provide further guidance for prevention and control.

WHO risk assessment

The number of human infections with avian influenza A(H7N9) in the fifth epidemic wave (i.e. onset since 1 October 2016) is greater than the numbers of human cases reported in earlier waves.

Human infections with the avian influenza A(H7N9) virus remain unusual. Close observation of the epidemiological situation and further characterization of the most recent human viruses are critical to assess associated risk and to adjust risk management measures in a timely manner.

Most human cases are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, and live poultry vending continues, further human cases can be expected. Although small clusters of cases of human infection with avian influenza A(H7N9) virus have been reported including those involving patients in the same ward, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore the likelihood of further community level spread is considered low.

WHO advice

WHO advises that travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live poultry markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling in or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and influenza-like illness (ILI) and to carefully review any unusual patterns, ensure reporting of human infections under the IHR 2005, and continue national health preparedness actions.



 Chickens at Taipei market infected with bird flu [Taipei Times, 9 May 2017]

Five batches of chicken slaughtered at a wholesale poultry market in Taipei have been confirmed to be infected with avian influenza subtype H5, the Taipei City Animal Protection Office said yesterday.

Veterinarians at the market on Saturday night and early on Sunday notified the office about suspected avian flu symptoms in the chickens, including skin anomalies and internal bleeding.

The office sent the suspected chickens to a laboratory for inspection and disinfected the market, it said.

The office also suspended slaughtering operations for 24 hours and seized 304 chickens that had been slaughtered.

The chickens came from poultry farms in the Kaohsiung metropolitan area and Miaoli, Pingtung and Yunlin counties, Animal Protection Office Director Yen I-feng (嚴一峰) said, adding that the office has alerted authorities in the areas, telling them that the farms should be inspected.

The seized chickens were destroyed, Yen said.

The spread of avian influenza would slow down with rising temperatures, the office said, but added that isolated cases are still being discovered, and urged people to eat only well-cooked poultry and eggs and buy certified products.

The Centers for Disease Control last week announced that an outbreak of the highly pathogenic H5N6 avian influenza A virus that began in February was under control.



 Bird classes abandoned as Otley falls victim to avian flu [Yorkshire Post, 9 May 2017]

bird-classes-abandoned.jpg
oultry Judge Jeff Maddock at the 2015 Otley Show

The Otley Show, the region’s first big agricultural event of the season, has been forced to cancel its poultry section, following the confirmation of two cases of avian flu in Lancashire.

Organisers of the one-day show on May 20, the oldest of its type in the UK, had previously indicated that the classes would remain open and had extended the deadline for entries, but said today they were acting “in the absence of any firm instruction or guidance from Defra”.

The show’s pigeon and egg sections will go ahead as planned. Jon Grubb, welfare officer for the show’s poultry classes, which normally attract around 400 entries, said: “All on the poultry committee have pushed as hard as we can to stage a poultry show if at all possible, but the situation as it stands means that we can not reasonably expect to hold a poultry show without an unacceptable degree of risk.”

The latest case of avian flu was confirmed in a backyard flock of nine chickens and ducks at Thornton, near Blackpool, last weekend. It followed the culling of around 30 birds at a small chicken farm nearby. Public Health England said the risk to public health from the virus was “very low” and the Food Standards Agency has stressed that bird flu does not pose a food safety risk for consumers.

Defra said after the second outbreak: “The UK’s deputy chief veterinary officer has confirmed H5N8 avian flu in a backyard flock of chickens and ducks near Thornton, Wyre, Lancashire. “A 3km protection zone and a 10km surveillance zone have been put in place around the infected premises to limit the risk of the disease spreading.”

The H5N8 strain was identified in farmed and wild birds last December, and has been confirmed at farms in Northumberland, Suffolk, Lancashire and Lincolnshire, and in backyard flocks in North Yorkshire and Carmarthenshire.

A wild buzzard in North Yorkshire was also found to be infected. An “influenza prevention zone” is in place across England and requires all keepers, whether commercial or pet owners, to restrict movement in and out of bird enclosures, and to feed birds indoors.

A ban on poultry gatherings is in place until May 15. Defra says it expects to lift it next week, “subject to some additional identity and health checks and biosecurity measures”.



 Two Lancashire backyard flocks hit by bird flu in two days [FG Insight, 8 May 2017]

FGInsight.jpg


Confirmation of the disease in the nine chickens and ducks near Thornton, Wyre came only two days after a flock of 30 chickens was wiped out in the same area.

A 3km protection zone and a 10km surveillance zone has been put in place and a full investigation is underway.

Any birds not already dead will be culled.

Officials have not yet confirmed whether the two sites are connected.

The outbreaks came less than a week after Defra chief vet Nigel Gibbens had his ‘fingers crossed’ after the announcement to relax bird flu measures on May 15.

He warned twitter followers the industry was ‘still at risk’ and ‘biosecurity remains imperative’.

Decision to lift the AIPZ on May 15 remains under review.



 AVIAN INFLUENZA FOUND IN MEXICO [KTIC, 8 May 2017]

Mexico-Flag.jpg


The World Organization for Animal Health reports that highly contagious H7N3 avian influenza was confirmed Thursday at a farm in west-central Mexico. The virus was discovered in a flock of 15,000 birds that had been vaccinated and did not show any clinical signs of the disease, according to agriculture officials in Mexico.

Reuters reports that the farm is under quarantine and the birds were sent to a nearby slaughterhouse. Mexico’s agriculture sanitation authority said the outbreak occurred in the same area where the virus was detected in 2012 and was discovered as part of a supervision program aimed at freeing the country of the disease.

In March, a highly pathogenic strain of bird flu was found in a chicken breeder flock on a Tennessee farm contracted to Tyson Foods Inc, the first discovered in the United States this year. Different strains of avian flu have been detected across Asia, Europe, Africa and in the United States in recent months, leading to the culling of millions of birds.



 Two bird flu cases confirmed in the UK [Irish Independent, 8 May 2017]

by Ciaran Moran

24 NEWS ENVIRONMENT Bimm.jpg
Poultry flock owners should remain vigilant for any signs of disease in their flocks Photo: Andrew Milligan/PA Wire

The second outbreak of bird flu in two days has been confirmed at a Lancashire farm.

The H5N8 strain of avian flu was confirmed in a small backyard flock of chickens and ducks at the farm near Thornton-Cleveleys, Wyre, Lancashire.

It follows the discovery of the disease in a flock of about 30 chickens at a nearby farm on Thursday.

A spokeswoman for the Department for Environment, Food and Rural Affairs (Defra) said: "The flock contains nine birds. A number had died and the remaining live birds at the premises will be humanely culled.

"A full investigation is under way to determine the source of the infection."

A 3km protection zone and a 10km surveillance zone have been put in place around the infected premises to limit the risk of the disease spreading.

The risk to public health from the virus was very low, Public Health England said, while the Food Standards Agency said it did not pose a food safety risk.



 Second out-break of Avian flu found in flock near Thornton [Blackpool Gazette, 8 May 2017]

by DARIA NEKLESA

Second out-break of Avian.jpg


A second case of Avian flu has been confirmed in a backyard flock of chickens and ducks near Thornton says The UK’s Deputy Chief Veterinary Officer.

It is understood that the flock contained nine birds, a number of which have since died and the rest will be humanely culled.

Public Health England advises that the risk to public health from the virus is very low and the Food Standards Agency is clear that bird flu does not pose a food safety risk for UK consumers.

In a statement DEFRA said: "The UK’s Deputy Chief Veterinary Officer has confirmed H5N8 avian flu in a backyard flock of chickens and ducks near Thornton, Wyre, Lancashire.

"A 3 km Protection Zone and a 10 km Surveillance Zone have been put in place around the infected premises to limit the risk of the disease spreading. We have published full details of the controls in place."

This case follows the culling of around 30 birds at a small chicken farm in Thornton after bird flu was detected last week.



 Chickens culled as bird flu found at second Lancashire farm [BBC News, 7 May 2017]

_95913949_mediaitem95913948Chickens.jpg
The Food Standards Agency said the disease was not a risk to food safety

A second outbreak of avian flu in two days has been found at Lancashire farms, the Department for Environment, Food and Rural Affairs (Defra) said.

The H5N8 strain was confirmed in a small backyard flock of chickens and ducks near Thornton-Cleveleys.

It follows the culling of about 30 birds at a nearby farm on Thursday.

Defra said a 3km protection zone and 10km surveillance zone had been put in place around the premises to limit the risk of the disease spreading.

The Food Standards Agency said the disease was not a risk to food safety.

Public Health England said the risk to public health from the virus was very low.

A spokeswoman for Defra said the flock contained nine birds, a number of which had died while the remaining live birds will be humanely culled.

"A full investigation is under way to determine the source of the infection," she said.

In January, there were a number of other outbreaks of the virus, including at farms in Wyre in Lancashire, Lincolnshire, North Yorkshire and Carmarthenshire.

What is bird flu?

There are two types of bird flu, the most serious of which - known as highly pathogenic avian influenza (HPAI) - is often fatal in birds

A less serious version - low pathogenic avian influenza (LPAI) - can cause mild breathing problems but affected birds do not always show clear signs of infection

The NHS website says no humans have been infected with bird flu in the UK



 Bird flu outbreak at second Lancashire farm [NW Evening Mail, 7 May 2017]

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A second case of bird flu has been detected

The second outbreak of bird flu in two days has been confirmed at a Lancashire farm.

The H5N8 strain of avian flu was confirmed in a small backyard flock of chickens and ducks at the farm near Thornton-Cleveleys, Wyre, Lancashire.

It follows the discovery of the disease in a flock of about 30 chickens at a nearby farm on Thursday.

A spokeswoman for the Department for Environment, Food and Rural Affairs (Defra) said: "The flock contains nine birds. A number had died and the remaining live birds at the premises will be humanely culled.

"A full investigation is under way to determine the source of the infection."

A 3km protection zone and a 10km surveillance zone have been put in place around the infected premises to limit the risk of the disease spreading.

The risk to public health from the virus was very low, Public Health England said, while the Food Standards Agency said it did not pose a food safety risk.



 Second UK bird flu outbreak confirmed [ITV News, 7 May 2017]

stream_imgSecond UK .jpg
Both outbreaks were reported in Lancashire Credit: Joe Giddens/PA

Two outbreaks of bird flu have been reported within just days of each other in Lancashire.

The discovery of the H5N8 strain of the disease in the flocks of two nearby farms was confirmed by the Department for Environment, Food and Rural Affairs (Defra).

It comes after a number of birds in a flock of about 30 chickens died at a farm near Thornton on Thursday and a small backyard flock of chickens and ducks at a nearby farm near Thornton-Cleveleys was confirmed to also have avian flu on Saturday.

A Defra spokeswoman said "a full investigation is under way to determine the source of the infection" and confirmed a 3km protection zone and a 10km surveillance zone have been put in place around the infected premises to limit the risk of the disease spreading.

Public Health England made assurances that the risk to public health from the virus was very low and the Food Standards Agency said it did not pose a food safety risk.



 Adaptation of Avian Influenza Virus to a Swine Host [Pork Magazine, 5 May 2017]

By Bourret V, Lyall J, Frost SDW, Teillaud A, Smith CA, Leclaire S, Fu J, Gandon S, Guérin JL, and Tiley LS

Baby pigs 600 x 690.jpg


The emergence of pathogenic RNA viruses into new hosts can have dramatic consequences for both livestock and public health. Here we characterize the viral genetic changes that were observed in a previous study which experimentally adapted a field isolate of duck influenza virus to swine respiratory cells. Both pre-existing and de novo mutations were selected during this adaptation.

We compare the in vitro growth dynamics of the adapted virus with those of the original strain as well as all possible reassortants using reverse genetics. This full factorial design showed that viral gene segments are involved in complex epistatic interactions on virus fitness, including negative and sign epistasis. We also identify two point mutations at positions 67 and 113 of the HA2 subunit of the hemagglutinin protein conferring a fast growth phenotype on the naïve avian virus in swine cells.

These HA2 mutations enhance the pH dependent, HA-mediated membrane fusion. A global H1 maximum-likelihood phylogenetic analysis, combined with comprehensive ancestry reconstruction and tests for directional selection, confirmed the field relevance of the mutation at position 113 of HA2. Most notably, this mutation was associated with the establishment of the H1 'avian-like' swine influenza lineage, regarded as the most likely to cause the next influenza pandemic in humans.

This multidisciplinary approach to study the genetics of viral adaptation provides unique insights on the underlying processes leading to influenza emergence in a new host species, and identifies specific targets for future surveillance and functional studies.



 Mexico: H7N3 avian influenza reported on Jalisco farm [Outbreak News Today, 5 May 2017]

by ROBERT HERRIMAN

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Jalisco, Mexico
Public domain image/ Metamario

An outbreak of highly pathogenic avian influenza (HPAI) serotype H7N3 was reported to the World Organisation for Animal Health (OIE) Friday by Joaquin Braulio Delgadillo Alvarez, Director General of Animal Health, National Service of Health and Agrifood Quality (SENASICA), Ministry of Agriculture, Stockbreeding, Rural Development, Fisheries and Food, Mexico.

The outbreak started on Apr. 18 on a farm in Tepatitlan de Morelos, Jalisco State, which was detected through active surveillance. Of the 151,000 susceptible birds, 10 cases were confirmed. The source of the outbreak in unknown at this time.

The bird flu virus was confirmed at the Level 3 Biosecurity Laboratory, SENASICA.

Following active surveillance on-going in Altos de Jalisco area, H7N3 avian influenza virus was isolated in a commercial layer farm. The flock had been vaccinated against the disease 18 weeks beforehand; birds did not show any clinical signs. A 3 km outbreak area and a 10 km area around the outbreak were established, and 3 other farms from the same company, that are empty, were identified in the area around the outbreak.

The farm is under quarantine and the birds were sent to an authorized slaughterhouse near the site. Epidemiological investigation is on-going.

Officials applied the following measures to the outbreak:

Movement control inside the country;
quarantine;
zoning;
vaccination prohibited;
no treatment of affected animals

Measures to be applied:

disinfection/ disinfestations;
stamping out
and official destruction of animals products.

Jalisco is a western Mexican state fringing the Pacific Ocean.



 China reports 24 more H7N9 avian flu cases, 9 fatal [CIDRAP, 5 May 2017]

by Lisa Schnirring

avian_flu_chick_testing.jpg
Merrimon/iStock

China continues to see a steady pace of new H7N9 avian flu infections late into the season, with 24 cases reported over the past week, including at least one from a province that had never reported one before.

Hong Kong's Centre for Health Protection (CHP) typically publishes a report in English on the most recent week's worth of cases from the mainland, but today the only hint of a weekly total came in a report in Chinese from Xinhua, China's state news agency.

This week's total reflects an increase from 17 reported from China last week.

Citing Chinese national health officials, the report said the 24 cases were reported between Apr 28 and May 4 and that 9 of the infections were fatal. A translation of the Xinhua report was posted by FluTrackers, an infectious disease news message board. The report offered no other details about the newly infected patients or the affected provinces.

Shaanxi province's first cases

Yesterday, however, the CHP said it was monitoring two new cases from the mainland, that of a 62-year-old man from Shaanxi, the province's first such case. The province is located in northwestern China. The man died from his illness.

Today Xinhua reported a second case from Shaanxi province, involving a 63-year-old man who was hospitalized.

The CHP also noted another H7N9 patient in the city of Chongqing, a 25-year-old woman who is hospitalized. Chongqing is in southwestern China.

China is currently in its fifth and by far its largest wave of H7N9 infections, an event that has been marked by wider geographic spread and the detection of a highly pathogenic form of the virus in poultry.

Separate reports flagged by infectious disease news tracking sources suggest that new cases in Hebei province, which had reported only a few H7N9 cases, are likely part of China's weekly H7N9 total. Hebei province is in northern China and is not far from Beijing, which has also reported a surge of recent cases.

Provincial officials in Hebei province announced six new cases between Apr 28 and May 4, according to a statement translated and posted by FluTrackers.

Farm outbreak

In a likely related development, China's agriculture ministry today announced an H7N9 outbreak at a poultry breeding farm in Hebei province, which killed 5,000 chickens and led to the culling of 80,057 more, according to a statement translated and posted by Avian Flu Diary (AFD), an infectious disease news blog.

China has now reported at least 680 cases during the fifth wave, including at least 197 deaths.



 Risk of bird flu remains as Lancashire backyard flock hit [FarmersWeekly, 5 May 2017]

by Tony McDougal

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Defra has confirmed a further case of avian influenza in England just a week after announcing that all restrictions surrounding AI were to be lifted on 15 May.

Chief veterinary officer Nigel Gibbens confirmed the case of H5N8 avian flu had been found in a small backyard flock of chickens near Thornton, Wyre, Lancashire.

The case is close to a previous outbreak of the virus among pheasants and other game birds near Pilling, Wyre, which led to the culling of 10,000 birds at the end of January.

The new 10km surveillance zone is understood to include the area of the January outbreak.
Defra said the backyard flock contained about 30 birds. A number had died from the virus and the remaining live birds at the premises were being humanely culled.

It added that a full investigation was under way to determine the source of the infection, but the outbreak – which follows the lifting of restrictions on free-range birds being kept indoors – has concerned the industry.

Writing on Twitter, Mr Gibbens said biosecurity was vital in the battle against the disease. “It shows that we’re still at risk and biosecurity remains imperative.”

Stay vigilant – NFU

NFU poultry adviser Gary Ford said: “The AI risk has not gone away. All poultry keepers please ensure you continue to have very high standards of biosecurity in place. The risk remains out there.”

Richard Griffiths, British Poultry Council chief executive, said: “The poultrymeat industry has shown an exemplary level of patience since the first case of bird flu was declared in December last year and we have been working tremendously hard towards implementing effective solutions to deal with the outbreak.

“The health of our birds remains the top priority for BPC members up and down the country and we will continue practicing the highest level of biosecurity.”

Defra said the proposed lifting of the ban on poultry gatherings on 15 May was under review.

A spokesman told Poultry World: “We have always said we would keep the issue under review if we had further cases of bird flu. This is now under review and we hope to be able to give a clear position in the next couple of days.”



 Bird flu outbreak at Lancashire farm [ITV News, 5 May 2017]

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Bird flu outbreak at Lancashire farm
Photo: Press Association

A case of avian flu has been confirmed at farm in Lancashire.

The department for Environment, Food and Rural Affairs confirmed the outbreak of the H5N8 strain of the disease in a small backyard flock of chickens.

A number of birds have died at the farm near Thornton and the rest are expected to be culled.

A three kilometre protection zone has been put in place and an investigation is underway to determine the source of the infection.

Public Health England advises that the risk to public health from the virus is very low and the
Food Standards Agency is clear that bird flu does not pose a food safety risk for UK consumers.



 What Lincolnshire farmers need to know about latest bird flu outbreak [Lincolnshire Echo, 5 May 2017]

By Elaine Davies

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 Farmers have been advised to be vigilant after a case of bird flu has been confirmed in Lancashire

Farmers have been warned to be vigilant after a fresh outbreak of bird flu has been confirmed.

DEFRA confirmed a case of H5N8 has been registered at a farm in Thornton, Wyre, Lancashire and a 3km protection zone and a 10km surveillance zone is in place.

Farmers across Lincolnshire are now being urged to take action if they keep birds.



 Chickens culled as bird flu found at Lancashire farm [BBC News, 5 May 2017]

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 The Food Standards Agency said the disease was not a risk to food safety

About 30 birds are to be culled after avian flu was found at a poultry farm, the Department for Environment, Food and Rural Affairs (Defra) has said.

The H5N8 strain was confirmed in a small backyard flock of chickens at the farm near Thornton,
Lancashire by Defra's chief veterinary officer.

Restrictions have been put in place around the infected premises to limit the risk of the disease spreading.

The Food Standards Agency said the disease was not a risk to food safety.

Public Health England said the risk to public health from the virus was very low.

A spokesman for Defra said a number of the birds had died and the remaining live birds were being humanely culled.

In January, there were a number of other outbreaks of the virus, including at farms in Wyre in Lancashire, Lincolnshire, North Yorkshire and Carmarthenshire.

What is bird flu?

・There are two types of bird flu, the most serious of which - known as highly pathogenic avian influenza (HPAI) - is often fatal in birds

・A less serious version - low pathogenic avian influenza (LPAI) - can cause mild breathing problems but affected birds do not always show clear signs of infection
The NHS website says no humans have been infected with bird flu in the UK



 China culls 80,000 birds in Hebei to tackle spreading bird flu [Reuters 5 May 2017]

China has culled 80,000 chickens in the country's north after detecting an outbreak of H7N9 bird flu on a farm of layer hens, said the agriculture ministry on Friday.

Five thousand hens on the farm in Xingtai in Hebei province died in late April, said the ministry, and another 8,500 hens were infected with the disease.

After confirming infection with the H7N9 virus, authorities ordered the culling of 80,057 poultry. The outbreak is under control, added the statement.

Infection with bird flu usually peaks during winter months and tails off in the spring but cases of H7N9 have been unusually high in the country since last year.

More than 200 people have died since last October and new cases continue to be reported, with the latest fatality occurring in Shaanxi province this week.

Outbreaks among birds have spread northwards, and the virus has evolved from a low pathogenic one into one with more serious symptoms.

(Reporting by Dominique Patton; Editing by Elaine Hardcastle)



 How we are breeding the next swine flu or bird flu [Crikey (registration), 5 May 2017]

Australia's factory farming system is a perfect breeding ground for virulent, fatal disease, writes science writer Geoff Russell.

Bernard Keane did well to summarise the recent Productivity Commission “Regulation of Agriculture” report’s chapter on animal welfare. It’s 61 pages in an 800-page report, but there were a few more relevant chapters that are crucial to understanding how agriculture is and isn’t regulated in Australia. Probably the most important is that on biosecurity, and it demonstrates how easily the Productivity Commission can be led astray.

Keane notes that the commission brings animal welfare within its remit by putting numbers on the costs and benefits to the community of changing the way factories treat animals. I use the word “factories” because well over half of the meat eaten here comes from animals you’d never see in any drive through the Australian bush, except perhaps on the back of trucks. But to economists, animal suffering is of no consequence unless consumers put a monetary value on it.

Even if you choose to play by these commission rules, there are clear costs associated with factory (and traditional) farming of animals that the Commission simply ignores. Swine flu emerged from a mix of human, pig and chicken viruses on factory farms in the US in the late 1990s. It percolated away, picking up little bits of RNA here and there, before starting to kill people en masse in 2009. RNA viruses like influenza are intrinsically less stable and more prone to mutation than DNA viruses.

Swine flu might not have been born here, but it could have been, and the next pandemic influenza may well be. The relative sizes of the US, Australian and Chinese industries mean that such diseases are more likely to emerge there than here. But we all have to pay when it hits our shores.

What’s the cost? In it’s first 12 months swine flu killed 284,000 people globally. Unlike ordinary flu, it didn’t just kill the elderly on the cusp of death anyway, but 80% of its victims were under 65 years old. So we aren’t talking about future risks of events that have never happened. These risks have a real body count. Australia has a good hospital system and did better than many countries, but this influenza still killed an estimated 300 people younger than 65.
Economists aren’t normally shy about putting a value on human deaths, but the commission fails to do so.

How did swine flu emerge? And why is this relevant to commission considerations? To answer that, you need to understand some of the kinds of processes that can yield a new disease.
Here’s a method scientists use to reliably breed killer diseases. Infect a chicken with a harmless flu virus isolated from a waterbird. The chicken’s immune system will begin to kill the viral particles. After a few days, the particles that aren’t dead are the ones that have evaded the chicken’s immune system. Kill the chicken, grind up the lungs and you have something where the virus particles are, on average, a little more dangerous than the initial population you used to infect the chicken. Use this to infect a second chicken. In the time it takes the chicken to mobilise its immune system, the virus will multiply, and after a few days, the particles that are still poor at evading the immune cells will be dead, leaving just the nastiest viral particles. Do this over and over and eventually the virus will start to kill. In one such experiment, by the 24th passage through the 24th batch of chickens, the virus had evolved into a killer that killed 100% of the last batch of chickens.

Once a virus enters a chicken or pig factory, it begins a similar kind of cycling. It may arrive with the pigs or chickens and start off harmless, but it might not stay that way. A factory farm isn’t quite as efficient as a laboratory, but it is still very good at providing excellent conditions to encourage a virus to become deadly. Crowding causes stress and stress depresses immune function. Chickens in a broiler shed live in their feces for their entire lives. One gram of droppings from a chicken infected with bird flu can contain enough virus to infect the entire shed.

As of March this year, 77 countries were infected with 13 strains of avian influenza. Perhaps the next human pandemic will come from one of these, or, more likely, from some currently benign virus that isn’t yet causing enough symptoms to be noticed. Australia has had its own outbreaks of avian influenza in 1976, 1985, 1992, 1995, 1997, and 2010 and 2012.

So the commission chapter on biosecurity is an exercise in inverted logic. The issue isn’t how do we protect factory farms from things that might infect them. These are intrinsically leaky facilities and this is a distributed problem. Distributed problems are, by their nature tough to solve. You could protect one facility with robust safeguards, or perhaps 50, but there are more than 2500 chicken sheds in Australia, each holding 40,000 birds.

The real biosecurity challenge is how to protect people from the new diseases that evolve on factory farms; these are a potent source of totally new viral strains, not simply a conduit. The environment supplies the viral raw material, that’s true, but the factory farming conditions provide the conditions to amplify pathogenicity. This is not a particularly subtle distinction, and it shouldn’t have been missed by the commission.

So how did the PC miss this? There are 34 mentions of “trespass” in the 800-page report, including sub-sections devoted entirely to this topic. In contrast, avian influenza gets two passing references and no sections. So the commission wasted a whole lot of time on a trivial issue and totally missed an issue with literally fatal consequences. Clearly, the bleating and moaning by factory farming bodies about people exposing what goes on behind closed doors has distracted the commission from the main game.

Similarly missing in action is any systematic treatment of food poisoning. It gets a single mention in relation to salmonella from eggs, but what about the 31,000 hospitalisations for food poisoning, the majority of which will have been from animal products, either directly or indirectly when infection is spread to plant materials on cutting boards, knives and the like.

There is a significant part of our health sector that is no more than a hidden subsidy for our animal industries. Again, this is perfectly capable of being analysed and costed within the PC framework, but it wasn’t. Keane highlights the excellent treatment in the commission report of the way in which the animal industries control and subvert any attempt at regulation. But the commission itself has fallen victim to the tricks of the industry in letting them set the agenda on biosecurity and waste so much time on trespass and the resulting ag-gag laws while neglecting much bigger issues.

*Geoff Russell is the author of Greenjacked: The derailing of environmental action on climate change



 Farmers warned of ‘recurring’ bird flu threat after outbreak in Sweden [FG Insight, 5 May 2017]

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Poultry keepers have been told to remain on stand-by after officials warned bird flu could become a ‘recurring threat’.

Despite a drop in active disease levels of the H5N8 strain throughout the UK, a recent outbreak of bird flu in Sweden has prompted renewed concerns it could circulate once again.

NFU Scotland poultry policy manager Penny Middleton said the extent of disease seen this winter had ‘been unprecedented but could be the start of a recurring pattern’.

She said: “There is work needed to be done this summer to assess how we handle such situations in the future and for keepers to consider carefully their contingency plans and resilience to face similar situations in the future.”

Restrictions throughout the UK are expected to be relaxed by the end of the month but Defra chief veterinary officer Nigel Gibbens urged keepers to continue to follow best practice on biosecurity and remain vigilant for signs of the disease.

Officials confirmed the risk level would be kept under review but said the current risk should be assessed as low, meaning ‘outbreaks are rare but can occur occasionally’.

The statement added: “As time passes, with no further cases and despite the heightened exposure we can be more confident the risk has significantly reduced to approach levels prior to the current epizootic.”

It came as Northumberland County Show confirmed the cancellation of its poultry section due to ‘continuing restrictions’.

Chairman James Wardle said the decision followed ‘much thought and consideration’.

Disappointed

He added: “We are disappointed and saddened to not welcome the usual magnificent display of soft- and hard-feathered chickens and waterfowl, but we hope visitors will enjoy the egg show which will still be taking place.”

Tom Forgrave, Ulster Farmers’ Union chairman, supported the decision by the Department of Agriculture, Environment and Rural Affairs to extend its prevention zone until May 31.

He added: “The priority for bird keepers is the safety of their flock and they will continue to act responsibly in order to protect their birds.”



 Mexico reports H7N3 bird flu outbreak on commercial farm [Malay Mail Online, 5 May 2017]

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Health officers cull poultry at a wholesale market after a spot check at a local street market revealed the presence of H7N9 bird flu virus, in Hong Kong June 7, 2016. — Reuters pic

MEXICO CITY, May 5 — Mexico has reported an outbreak of the highly contagious H7N3 bird flu virus on a commercial farm in the state of Jalisco, the World Organisation for Animal Health (OIE) said yesterday, citing a report from Mexico’s agriculture ministry.

The virus, which does not pose a serious danger to people, was detected among laying hens in a flock of 15,000 birds that had been vaccinated and did not show any clinical signs of the disease, the Paris-based OIE said in a notification.

The farm, located in the town of Tepatitlan de Morelos, is under quarantine and the birds have been sent to a slaughterhouse near the site, it said.

Mexico’s agriculture ministry did not immediately respond to a request for comment. Mexico is a major chicken exporter.

In March, a highly pathogenic strain of bird flu was found in a chicken breeder flock on a Tennessee farm contracted to Tyson Foods Inc, the first discovered in the United States this year. — Reuters

Zoonotic Swine Flu News - from 1 Apr 2017



 Swine flu cases on the rise [The Hindu, 7 May 2017]

B. Madhu Gopal

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Concern over shortage of testing kits at virology lab

The death of a man, reportedly due to swine flu (H1N1), has once again put the focus on the dreaded disease, which is spreading panic among the people whenever there is an outbreak.

Doctors, however, refuse to confirm it as swine flu death.

“He also had other complications besides swine flu and we can declare it as death due to swine flu only when the person dies after being affected by swine flu alone,” said a medical officer.

The most distressing part of swine flu is that it can be confused with normal flu as both have similar symptoms.

Coming to the testing part, though Visakhapatnam has a virology lab at Andhra Medical College (AMC), the meagre allocation of funds and shortage of ‘testing kits’ are coming in the way of its effective functioning.

“An amount of Rs. 2 lakh was sanctioned under the Integrated Disease Surveillance Programme (IDSP) last year, which did not suffice our requirements in view of the growing number of samples being sent for collection. The testing kits have to be procured from Chennai and they supply the kits only after payment of advance. Last time I gave personal guarantee only after which the kits were supplied but I cannot do it every time,” AMC Principal P.V. Sudhakar said when the issue of shortage of kits at the lab was brought to his notice.

“The IDSP authorities have advised us to utilise the Hospital Development Society Fund. This cannot be done without the permission of the government. The lab is also undertaking the testing of samples coming from cases admitted at private hospitals also but it may no longer be possible to do so,” says Dr. Sudhakar.

The Government Hospital for Chest and Communicable Diseases (GHCCD) has two ventilators and isolation wards for treatment of swine flu patients but the complaint from patients and their relatives is that they are far from adequate to meet the growing requirements.

‘Enough ventilators’

“The existing ventilators are enough to meet the present needs as we get not more than two cases of swine flu on an average every day. Preference is given to swine flu patients over others as there are small ventilators to take care of other cases,” says GHCCD Superintendent G. Sambasiva Rao.

“In view of the shortage of testing kits we are sending the swabs to the virology lab at Tirupati for testing. There are delays in getting the reports due to courier and other problems. A total of 47 cases have tested ‘positive’ in the district so far this year,” says the Swine Flu Nodal Officer L. Kalyan Prasad.



 H1N1 claims first life in Kolkata, death toll reaches 3 Bengal [India Blooms News Service, 6 May 2017]

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Kolkata, May 6 (IBNS): The death toll from swine flu in West Bengal has risen to three as a 56-year-old man from Kolkata reportedly died of H1N1 influenza at a city hospital on Friday

According to reports, Arup Halder, a resident of city's Ekbalpore area, was tested positive for swine flu (H1N1) few days ago and he died at the privately-run Woodland Hospital in south Kolkata's Alipore area on Friday night.

Earlier last week, a 28-year-old woman and a minor girl from West Bengal's Nadia district died of swine flu in two private hospitals in Kolkata.

"We are looking into the matter and all privately-run hospitals in Kolkata and West Bengal have been directed to inform the government about swine flu cases," a senior official of state's health department told IBNS.

(Reporting by Deepayan Sinha)



 Swine flu claimed 185 lives in first 3 months of 2017 [The Asian Age, 6 May 2017]

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As a precautionary measure, instructions have been given to all state and civic-run hospitals.

They said that fluctuating temperature and decrease in immunity could be the reasons for the spurt in swine flu cases.

Mumbai: There has been a spurt in recorded deaths caused by swine flu (H1N1) in the first three months of this year in Maharashtra. The viral infection claimed 85 lives in the first three months of 2017 while there were only 25 deaths in the corresponding period of 2016.

According to health minister, Dr Deepak Sawant, “There is a rise in swine flu but we are treating it. There has been no change in the virus and we are still continuing with tablets of Oseltamivir.”

Of the 7 lakh patients screened for swine flu till date, 887 positive cases have been recorded and 11,940 persons were treated and discharged with another 18 people on ventilator, said health officials in the state. They said that fluctuating temperature and decrease in immunity could be the reasons for the spurt in swine flu cases. As a precautionary measure, instructions have been given to all state and civic-run hospitals.

Dr Sawant told The Asian Age, “We have been undertaking stronger screening for all cases reported to us and surveillance for all viral infections. We have started with vaccinating high-risk groups such as expecting mothers, and people suffering from diabetes and high blood pressure.”

Appealing to people, Dr Sawant said, “Please do not ignore early symptoms of swine flu such as fever, cold, cough and body ache. Avoid self medication and seek medical assistance immediately.” Civic hospital authorities have sent letters to both public and private hospitals to be watchful of H1N1 cases and report immediately if any swine flu symptoms are reported.



 H1N1 claims first victim in Kolkata this year; toll rises to 3 in West Bengal [Times of India, 6 May 2017]

KOLKATA: Swine flu took the first life in Kolkata this year on Friday. A 56-year-old man died in Woodlands Nursing Home in Alipore, less than a week after another patient succumbed to H1N1 last Saturday.

While deceased Arup Haldar was from Kolkata, the other two swine flu victims this year were from Nadia's Kalyani and Taherpur, respectively.

Haldar was brought to Woodlands on Wednesday. According to hospital sources, he was critical by the time he was wheeled in. Along with shortness of breath, Haldar was admitted with bouts of vomiting, loose motions and coughing.

"The patient was a diabetic and was on insulin. His condition kept deteriorating and he was put on ventilation and haemodialysis support within hours of admission," said a source in Woodlands.

Suspecting it to be a case of H1N1, the hospital sent his swab samples and it tested positive. Further investigations revealed evidence of pneumonia, sepsis and multi-organ failure.

"We put in our best efforts to save the patient. Unfortunately, he died within 48 hours of admission," the source said.

H1N1 already claimed two lives in April. Four-year-old Soham Ghosh became the first victim, staying admitted in AMRI Hospital Mukundapur for about three weeks before passing away.

The second death, a week later, was of a Kalyani resident. Homemaker Sima Ghosh, who died at AMRI Hospital, Salt Lake, on April 29, was referred from a local nursing home in a serious condition on April 17.

Virologists and doctors warn that those vulnerable to the infection should take extreme precaution. The virus is highly contagious and attacks people with certain health conditions more aggressively.

If the virus infects a healthy adult, the infection mostly is not noticeable as the symptoms are like those of no-rmal influenza.

According to doctors, diabetics are among the most susceptible. Others vulnerable to the virus include people with chronic ailments of heart, lungs, kidneys, immuno-compromised people like cancer patients on chemotherapy, the elderly, children and pregnant.

Doctors said the vaccine against H1N1 is available and those who fall into the vulnerable category should take the shot once a year.



 Swine Flu reported in Jharsuguda [Pragativadi, 4 May 2017]

Swine-Flu Swine Flu bb.jpg


Belpahar: A 36 year old man was reportedly tested positive for H1N1 virus (Swine flu) for the first time in Belpahar area of Jharsuguda district.

The breakout of the deadly disease was reported in 2012. Swine Flu was reported from other parts of the state. Now for the first time Belpahar has witnessed its first swine flu incident.

The patient was identified as Mukesh Agarwal. As per sources, Agarwal is now under treatment at a private hospital in Bhubaneswar where his condition remained critical. He was placed under intense care in the ICU.

His family members claimed that Agarwal’s health began to deteriorate after he took ill a week back. He became weaker with each passing day. Family members initially suspected of sunstroke and overwork due to which he became weak and admitted him to a local hospital.

However, there was no improvement in his conditions. Later, he was taken to Jahangir Gandhi Hospital. Again, he had to be shifted to a nursing home in Burla for further treatment as his condition kept worsening. However, doctors failed to diagnose his disease and sent him to a private hospital in Bhubaneswar. Nothing was confirmed by doctors while a relative said Agarwal’s medical reports suggested that he was affected by swine flu.

The incident has created panic among the locals. Locals even suspect that Agarwal of being infected with the disease after coming in contact with H1N1 virus-affected person while he was travelling outside the state.



 101 affected by swine flu in West Bengal since January [The Hindu, 4 May 2017]

Cases mostly from Kolkata, North 24 Parganas

At least 101 people have been affected with the Swine flu (H1N1 influenza virus) in West Bengal since January, a senior health official said on Wednesday.

Two persons also suspected to have died of the disease, though it is yet to be confirmed, the official said. The incidences were reported mostly from the city (36) and North 24 Parganas district (33), State Health Services Director Biswaranjan Satpathy told PTI.

Stray cases

He said that there were one or two stray cases reported from Howrah and Hooghly districts as well.

“There have been 101 cases of Swine Flu infection in West Bengal since January. Out of these, seven persons were from other States while the rest 94 were from West Bengal,” Mr. Satpathy said.

On the number of deaths from Swine Flu, the health official said, “So far we have received reports of two suspected cases of Swine Flu deaths. We are waiting for the death report to be sure of the cause.”

According to Mr. Satpathy, presently 10 persons, including four admitted on Wednesday, with the H1N1 virus infection were undergoing treatment at different hospitals in the State.

Swine flu is a respiratory disease caused by influenza viruses that infect the respiratory tract of pigs and result in a barking cough, decreased appetite, nasal secretions, and listless behaviour; the virus can be transmitted to humans.

When contacted, Kolkata Municipal Corporation MMIC (Health) Atin Ghosh, said that there were only eight cases reported from the city in a month’s time.

“Out of the eight cases reported from the city, seven have recuperated. Only one aged person from the city is undergoing treatment for Swine Flu,” Mr. Ghosh confirmed.

There have been no new cases of Swine Flu infection from the city for the last couple of days, he said.



 Swine Flu On The Rise: All You Need To Know About H1N1 Virus [Boom Live, 4 May 2017]

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Swine flu has returned and this time it has claimed the life of an 18-month old in Mumbai. The boy, a resident of Worli in Mumbai succumbed to the virus on 28th April. The infant was treated in a hospital for a few days but his condition deteriorated. A total of 21 Swine flu cases have been reported by Mumbai’s civic body between January and April, say several newspaper reports.

But, the worst hit this time appear to be Maharashtra where the flu has claimed 85 lives in the first three months of this year, up from the 25 deaths recorded throughout 2016, reports Hindustan Times.

23 lives have been lost in Kerala alone, according to several news reports on May 1, 2017. “This year, the prevalence has gone up to 27%. This is the eighth year since the Influenza A H1N1 pandemic of 2009 and this virus is now part of our seasonal influenza viruses. Some cases should be expected every year,” says Amar Fettle, State Nodal Officer for H1N1, reports The Hindu.

While there are no official consolidated numbers of Swine Flu cases across the country, several hundred cases have been detected in West Bengal, Maharashtra and many of the north Indian states.

Here are 5 things to know about Swine Flu.

1) What is Swine Flu?

Swine flu is also known pig influenza or H1N1 influenza. It is a respiratory disease caused by the influenza virus that infects the respiratory tract of pigs. Influenza viruses that infect pigs may be different from human influenza viruses. In addition, because pigs are susceptible to avian, human and swine influenza viruses, they potentially may be infected with influenza viruses from different species (e.g., ducks and humans) at the same time. If this happens, it is possible for the genes of these viruses to mix and create a new virus. This type of major change in the influenza A viruses is known as antigenic shift. If this new virus causes illness in people and can be transmitted easily from person-to-person, an influenza pandemic can occur. This is what happened in 2009 when an influenza A H1N1 virus with swine, avian and human genes emerged in the spring of 2009 and caused the first pandemic in more than 40 years.

Source: Centers for Disease Control and Prevention

2) Is the H1N1 strain similar to the one found post 2009?

Does not look like, if the National Institute of Virology (NIV) based in Pune are to be believed. The NIV say they have isolated a new strain called the Michigan strain, that has been in circulation in the US since the last two years. This strain, different from the California strain found in 2009 has now found its way to India.

3) How does H1N1 spread?

Influenza viruses can be directly transmitted from pigs to people and from people to pigs. These infections have most commonly been reported after close proximity to infected pigs, such as in pig barns and livestock exhibits housing pigs at fairs. Infected pig cough or sneeze and droplets with influenza virus in them can spread through the air. If these droplets land in your nose or mouth, or are inhaled, you can be infected. There is also some evidence that you might get infected by touching a surface with virus on it and then touching your mouth or nose. A third way to possibly get infected is to inhale droplets or dust containing influenza virus. Scientists aren’t really sure which of these ways of spread is the most common.

Human-to-human transmission of variant flu viruses also has occurred, though this method of spread has been limited. This kind of transmission is thought to occur in the same way that seasonal flu transmits in people, which is mainly through coughing or sneezing by people who are infected. People also may become infected by touching something with flu viruses on it and then touching their mouth or nose. It’s important to note that in most cases, variant flu viruses have not shown the ability to spread easily and sustainably from person to person.

Pregnant women and those already suffering from a disease have a higher risk of getting the flu. Once cured, there are chances that the flu may lead into other serious problems like breathing problems, pneumonia, etc.

Source: Centers for Disease Control and Prevention

4) What are the symptoms of Swine Flu?

The symptoms of swine flu are similar to regular flu. Fever, cough, nasal secretions, fatigue, chills, sore throat and headache are some of the common symptoms.

5) What are the precautions one can take?

Anyone experiencing the above symptoms should see a doctor. As all the symptoms of Swine flu and seasonal flu are the same, there are medical tests that need to be performed to determine the type of flu. Doctors advise those having these symptoms to stay at home to prevent the spread of the disease. Those with regular flu are more likely to get it. It is still unclear if vaccines that were used on a preventive basis for the previous strain of H1N1 can still be used to fight the disease.



 Gurgaon: Hospitals on alert after suspected swine flu cases reported [Hindustan Times, 5 May 2017]

Gurgaon residents have been advised to cover their mouths while sneezing or coughing

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All private hospitals in the city have been asked by the health department to report all confirmed cases of H1N1 flu to the district civil surgeon.(Parveen Kumar/HT PHOTO)

Hospitals in the city have geared up to prevent a swine flu outbreak after the city recorded a sharp spike in suspected cases of the highly contagious disease in a week.

All private hospitals in the city have been asked by the health department to report all confirmed cases of H1N1 flu to the district civil surgeon.

Though the virus was dormant for the past two years, it has suddenly become active this month.

During 2014, 37 cases of H1N1 were reported in Gurgaon. However, there were no casualties.

“The numbers of patients with symptoms of swine flu have increased over the last week. We have an isolation ward at the hospital and the drug, Tamiflu, is also in stock. We are geared up to deal with any kind of emergencies,” said Kanta Goyal, chief medical officer, civil hospital, Gurgaon.

All private hospitals have also made required arrangements to deal with swine flu cases.

“Swine flu virus gets active during the change of season. They spread either by direct contact with the infected person or with infected objects. Hand hygiene and social distancing are two key ways to prevent spread of the infection,” Rajesh Kumar, senior consultant, Internal Medicine, Paras hospital Gurgaon.

Doctors have advised residents to take precautions and cover their mouth and nose while sneezing. The symptoms of the disease include high temperature, tiredness, headache, sore throat, loss of appetite, diarrhoea and vomiting.

At present, the city has patients down with suspected category A and B swine flu.

The H1N1 virus is categorized under three categories. Patients diagosed with ‘Category A’ do not require testing for H1N1. The symptoms are mild fever, sore throat, cough, body ache, headache, nausea and diarrhoea. They are generally not advised to stay at home in isolation or are prescribed Tamiflu.

While, in ‘Category B’, the patients have high fever along with other symptoms of category A.

In Category C, the patients report symptoms of both Category A and B and are most below 5 or more than 60 years of age. They also run the risk of breathlessness and chest pain. They are mostly kept in isolation wards at hospitals.

Swine flu: Dos and Dont’s

Wash your hands properly and regularly

Use sanitisers, especially those that are alcohol based, for washing hands

Avoid crowded places in case the disease breaks out

If you feel any symptoms, stay at home and consult a doctor

Common symptoms

High fever

Sore throat, cough and cold

Breathlessness and tiredness

Headache

Loss of appetite, diarrhea or vomiting

When to go for the test?

If cough, cold and fever persist for more than three days along with breathlessness, visit a doctor. Also, stay away from people to avoid spread of infection.

How much time does it take to obtain reports?

The report is normally given in 24 hours.

In case of emergency cases, the report can be prepared in 5-6 hours.

What is the treatment available?

Doctors usually prescribe the antiviral drug, Tamiflu, to reduce the severity of symptoms.



 After a lull, swine flu strikes again, 1 dead [Times of India, 4 May 2017]


by V Kamalakara Rao

Visakhapatnam: A 52-year-old man with swine flu died in a corporate hospital at Ramnagar on Wednesday. Official sources from the department of medical and health said the victim came to the city from West Bengal on Sunday with severe health condition. He did not respond to the emergency treatment and died on Wednesday at around 3.30 am.

Health officials said the person was a businessman by profession and got infected with the disease 20 days back. The officials said they were now getting cases from Odisha and West Bengal. Meanwhile, as people throng theatres to watch Baahubali 2, health officials warn of spike in the outbreak of swine flu. Health officials said large gathering at theatre halls and the recently held Chandanotsavam atop Simhachalam hill are two incidents which could result in the spread of the swine flu virus in the city.

L Kalyan Prasad, Visakhapatnam district epidemiologist for Integrated Disease Surveillance Programme (IDSP) and in-charge of swine flu cases, told TOI that the H1N1 virus was still prevalent in the city with five people undergoing treatment at corporate hospitals. The virus is more active in cold climes. The air conditioning in theatres provide scope for the spread the virus, said Kalyan Prasad. "Overall, we are suspecting the spread of swine flu due to these two factors. We tested more than 250 cases from north coastal AP and neighbouring states like Odisha and finally confirmed 63 as positive from January 1 till date. We have reported two deaths including each one in January and April," Kalyan Prasad said. TP Anantham, manager of Leela Mahal and secretary of Visakhapatnam Film Exhibitors Association, said the initial mad rush at theatres was gradually decreasing. Regarding health issues, he said the theatre management takes steps to ensure the theatres and toilets are clean before every show.

However, to prevent spread of swine flu and other diseases, the audience should be more responsible and take preventive measures like wearing masks in public places, he said.

Anantham said Visakhapatnam city has nearly 35 single screen theatres and 18 multiplexes. Except two theatres, all theatres have AC. Dr KV Ram Kumar, managing director of Lakshmi Gayatri Hospital in the city, said, "People should not feel shy to wear mask in public places. They should at least place a handkerchief on their mouth and nose to avoid infection from viruses.

People also should always keep washing their hands before eating anything." In 2015, Visakhapatnam district registered 44 positive cases and 3 deaths due to swine flu. In 2014, two people died of swine flu in Visakhapatnam district and there were no reported cases in 2016.



 Telangana: 22 died of swine flu since August [Deccan Chronicle, 3 May 2017]

Adequate stock of testing kits and medicines were available at different hospitals in the state.

Hyderabad: Twenty-two people have lost their lives in Telangana state due to swine flu and related complications since August last year, the government said on Tuesday.

As many as 10,232 samples had been tested since August 1 and 1,446 of them tested positive for the H1N1 virus, the government said in a bulletin on swine flu.

It said 35 samples were tested on Tuesday and four of them were positive. No deaths were reported Monday.

Doctors are still puzzled by the presence of the virus in the intense heat of summer. It was assumed that the swine flu virus generally strikes when the weather is cool.

Adequate stock of testing kits and medicines were available at different hospitals in the state, the bulletin added.



 Swine Flu affects 101 people since January [Outlook India, 3 May 2017]

There have been no new cases of Swine Flu infection from the city for the last couple of days, Ghosh said adding that the civic body has been keeping a close watch in every ward of the city

kolkata, May 3 At least 101 people have been affected with the Swine Flu (H1N1 influenza virus) in West Bengal since January, a senior health official said today.

Two persons also died suspectedly of the disease, though it is yet to be confirmed, the official said.

The incidences were reported mostly from the city (36) and North 24 Parganas district (33), state Health Services Director Biswaranjan Satpathy told PTI.

He said that there were one or two stray cases reported from Howrah and Hooghly districts as well.

"There have been 101 cases of Swine Flu infection in West Bengal since January. Out of these, seven persons were from other states while the rest 94 were from West Bengal," Satpathy said.

On the number of deaths from Swine Flu, the health official said, "So far we have received reports of two suspected cases of Swine Flu deaths. We are waiting for the death report to be sure of the cause."

According to Satpathy, presently 10 persons, including four admitted today, with the H1N1 virus infection were undergoing treatment at different hospitals in the state.

Swine flu is a respiratory disease caused by influenza viruses that infect the respiratory tract of pigs and result in a barking cough, decreased appetite, nasal secretions, and listless behaviour; the virus can be transmitted to humans.

When contacted, Kolkata Municipal Corporation MMIC (Health) Atin Ghosh, said that there were only eight cases reported from the city in a month's time.

"Out of the eight cases reported from the city, seven have recuperated. Only one aged person from the city is undergoing treatment for Swine Flu," Ghosh confirmed.

There have been no new cases of Swine Flu infection from the city for the last couple of days, Ghosh said adding that the civic body has been keeping a close watch in every ward of the city.



 Swine Flu cases on the rise despite heat wave [The Hans India, 2 May 2017]

Ongole: The medical and health officials in Prakasam district observed a rise in the swine flu cases in the district for the past two weeks despite heat wave. District medical and health officer J Yasmin asked the public to take preventive measures if they observe any symptoms of the disease and join Rajiv Gandhi Institute of Medical Sciences in Ongole for better and early treatment.

Swine flu is a respiratory disease caused by influenza viruses. Its symptoms include fever, cough, sore throat, chills, weakness, body and stomach aches. The disease spreads with skin to skin contact, airborne respiratory droplets, saliva or even touching a contaminated surface. The affected patient should be isolated immediately and the nearby people should be given vaccines to stop spreading the disease.

Though the symptoms of swine flu are common in other diseases, the people suffering from them are asked to consult a doctor immediately. If necessary, the doctor can send a sample for the confirmation and gives treatment accordingly.

Since January, the Prakasam district officials collected 42 swabs suspecting swine flu and sent to Sri Venkateswara Institute of Medical Sciences (SVIMS) in Tirupati. The SVIMS informed the officials that 20 of the samples were tested positive with swine flu. In the affected, seven people died and the remaining patients were crured.

Dr J Yasmin, the DMHO for Prakasam district said, “It is not that every patient whose sample is collected is a swine flu positive and every swine flu positive patient died is due to swine flu only. In the seven people died with swine flu in the district, four people are already suffering from cardiac disease and one person was suffering from bronchial asthma.

Though most of the positive patients are working in other districts like Krishna and Guntur districts and came to their native Prakasam district for treatment, we are taking preventive measures immediately in the area surrounding their home and vaccinating immediate family and others who they are closely associated with. As the patients are joining private hospitals first for treatment, we are offering vaccination to the staff of those hospitals, if a positive case is registered.

We have observed the positives cases are registering from coastal area of the district from places like Chirala, Ongole, Chimakurti and Podili mainly and taking up awareness as well as preventive measures in them.”Swine flu virus cannot live in hot atmospheric conditions. But the medical and health officials observed an increase in the number of suspect cases for the past two weeks in those days when high temperatures were registered.



 18-month-old becomes Mumbai's first swine flu casualty in two years [Times of India, 2 May 2017]

by Malathy Iyer

MUMBAI: An 18-month-old boy became the first casualty of the H1N1 virus, previously known as swine flu, in the city in the last two years.

The virus hasn't been active in the city though it has claimed 165 lives in rest of the state since January 1, 2017. "While the state has registered 844 positive cases in this period, Mumbai hasn't seen many cases,'' confirmed Dr Pradeep Awate of the state health department's epidemiological cell. BMC confirmed that only 21 cases have been reported in the city since January 1.

BMC officials said that the 18-month-old passed away due to complications of an H1N1 infection at the Kasturba Hospital, near Saat Raasta, on Saturday. He had diarrhea, vomiting and fever. "These generic symptoms prevented an early diagnosis of the flu," said a senior BMC official. The child was admitted to two hospitals before he was transferred to the BMC-run Kasturba Hospital in a severe condition. "He was a ventilator by the time he was brought to Kasturba Hospital,'' said a doctor.



 Swine flu claims 22 lives in Telangana since August last year [The Indian Express, 2 May 2017]

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As many as 10,232 samples have been tested since August 1 and 1,446 of them tested positive for H1N1 virus, government said in a bulletin on swine flu. (Representational Image)

Twenty-two people have lost their lives in Telangana due to swine flu and related complications since August last year, the government said on Tuesday.

The death toll is till May 1.

As many as 10,232 samples have been tested since August 1 and 1,446 of them tested positive for the H1N1 virus, the government said in a bulletin on swine flu.

It said 35 samples were tested on Monday and four of them were positive. No deaths were reported on Monday.

Adequate stock of testing kits and medicines were available at different hospitals in the state, the bulletin added.

For all the latest India News, download Indian Express App now



 Melbourne woman catches swine flu in China [Herald Sun, 2 May 2017]

by Luke Costin

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Kerri and Sam Cosma. Picture: Sherran Evans Out & About

A MELBOURNE grandmother who contracted swine flu while visiting family in China is fighting for life in hospital.
Kerri Cosma contracted the H1N1 influenza virus some time after arriving in China on April 13 and her condition rapidly declined, her husband says on an online fundraiser.

The personal trainer was placed in an induced coma in a Nanjing hospital early on April 23, Sam Cosma says.

“Kerri is currently doing really well and is receiving the best care possible. We do not know when she will be stable enough to fly home to Melbourne.”

Daughter Emma Madigan said she was told her mother was dying as she was hooked up to a life support machine last Saturday.

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Kerri Cosma. Picture: Facebook

She said when tests came back positive for H1N1, her mother was put in full isolation and both doctors and family had to wear full body suits to go into the room.

“It was really distressing to watch,” she told 3AW on Monday.

“She’s in a much better position than she was in last Saturday.”

While the family says travel insurance will cover Ms Cosma’s medical costs, they are raising funds to cover loss of wages and the expense of rehabilitation and getting her family to her bedside.
— AAP



 Kerala: Swine flu claims 23 lives in 2017, 300-400 cases recorded [Daily News & Analysis, 1 May 2017]

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Representational Image (File Photo)

H1N1 virus has seen a rise in the entire south Indian region said a State Nodal Officer for H1N1.

H1N1 influenza has claimed 23 lives in Kerala so far in 2017 with the state recording higher incidence of the flu compared to the previous year, a health department officials said.

A total of 300-400 swine flu cases had been confirmed so far across the state and out of them as many as 23 people had died, they said.

State Nodal Officer for H1N1 Amar Fettle said the increase in the incidence of the disease this year was registered not only in Kerala but also in entire south India. Stating that there was no need for any panic, he said necessary steps had been taken to check the spread of the flu.

All government hospitals, including primary health centres, have been equipped with enough quantity of medicines and guidelines issued with regard to the treatment.

"This year, 27 per cent of samples of throat swabs tested from affected people were found to be positive for H1N1," Fettle told PTI. The official said the influenza was first spotted in the state in 2009. Since then, the disease had become a seasonal one in the region.

"People suffering from diabetes, asthma, cardiovascular issues, cancer and HIV among others
and pregnant women are considered to be the high risk or vulnerable group," he said.

Detailing the state health department's preparedness in this regard, he said the latest information, updates and guidelines about H1N1 was available in the official website of the Directorate of Health Services. Anybody, including private hospitals, can avail the service of state-run 'Disha', 24X7 tele-helpline, to get necessary information and treatment protocol related to the disease, he said. A programme to sensitise and create awareness about various aspects of the disease is already on in government hospitals, he said.

The official also wanted people, affected with common cold and suspected fever, to stay at home and take plenty of hot and nourishing fluids.



 Influenza update - 288 [World Health Organization, 1 May 2017]


01 May 2017, - Update number 288, based on data up to 16 April, 2017

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Summary

Influenza activity in the temperate zone of the northern hemisphere continued to decrease. Influenza activity remained low in the temperate zone of the southern hemisphere. Worldwide, influenza A(H3N2) and B viruses were predominant, with an increased proportion of influenza B viruses detected in recent weeks.

・In North America, overall influenza activity continued to decrease. In Canada, influenza A(H3N2) viruses continued to be the most common subtype of influenza detected, followed by influenza B virus; in Mexico, all seasonal influenza types/subtypes were detected; in the United States of America influenza B virus was predominant.

・In Europe, influenza activity continued to decrease to low levels, with detections of predominantly influenza B viruses in Northern and Eastern Europe. Influenza-like illness (ILI) and severe acute respiratory infection (SARI) indicators were generally low or below baseline in most countries.

・In Northern Africa, influenza activity remained low. Sporadic detections of influenza A(H3N2) viruses were reported in Tunisia.

・In Western Asia, influenza activity continued to decrease with influenza B viruses predominant in the region. SARI levels continued to decrease in Georgia, while remained stable in Armenia. In Oman, low influenza activity was reported with influenza A(H1N1)pdm09 virus predominant.

・In Central Asia, ILI and SARI activities continued to decrease; influenza virus detections were also low.

・In East Asia, influenza activity continued to be reported with all seasonal influenza types/subtypes detected in the region. In both Northern and Southern China, influenza A(H1N1)pdm09 virus detections increased in recent weeks. Influenza B virus detections continued to be reported in Southern China and the Republic of Korea; influenza B Victoria lineage was predominant in Southern China.

・In the Caribbean and Central America countries, respiratory virus activity remained low.

・In tropical South America, influenza activity increased slightly with influenza A(H3N2) viruses predominating. Other respiratory virus activities remained low in general, except in Colombia where elevated activity of respiratory syncytial virus (RSV) continued to be reported.

・In Western Africa, low levels of influenza activity continued to be reported in Côte d’Ivoire, Ghana, Senegal and Sierra Leone, with all seasonal influenza types/subtypes co-circulating in the region. In Eastern Africa, increased detections of influenza A(H3N2)and B viruses were reported in Madagascar and Tanzania in the recent weeks.

・In Southern Asia, influenza activity continued to be reported although it appeared to be decreasing. In India and the Maldives, influenza A(H1N1)pdm09 continued to be reported. In Pakistan, sporadic cases of influenza A(H3N2) viruses were reported in the recent weeks. In Bhutan, ILI levels and influenza activity appeared to decrease, with influenza A(H3N2) and B viruses circulating.

・In South East Asia, influenza activity remained low, with all seasonal influenza types/subtypes detected in the region.

・In the temperate zone of the Southern Hemisphere, influenza activity was at inter-seasonal levels. In Chile, ILI activity increased but has not reached the seasonal threshold in recent weeks, consistent with past seasonal trends.

・National Influenza Centres (NICs) and other national influenza laboratories from 95 countries, areas or territories reported data to FluNet for the time period from 03 April 2017 to 16 April 2017 (data as of 2017-04-27 11:16:47 UTC).The WHO GISRS laboratories tested more than 109373 specimens during that time period. 14597 were positive for influenza viruses, of which 6108 (41.8%) were typed as influenza A and 8489 (58.2%) as influenza B. Of the sub-typed influenza A viruses, 1358 (42.5%) were influenza A(H1N1)pdm09 and 1834 (57.5%) were influenza A(H3N2). Of the characterized B viruses, 747 (49.3%) belonged to the B-Yamagata lineage and 767 (50.7%) to the B-Victoria lineage.



 Here's how to fence yourself against swine flu [Economic Times, 10 Apr 2017]

By Dr Manohar KN

The number of swine flu (H1N1) cases in the first three months of this year has already crossed the total number of cases reported in all of 2016. This reporting of cases only represents the tip of the iceberg because of two reasons -clinically it is impossible to differentiate H1N1 from normal flu and the lab facility to conduct the test is not freely available (may not be needed too).

SURVIVAL OF THE FITTEST

No other organism can claim to have taken these words more seriously than the flu virus. By the unique mechanism of Antigenic Shift and Drift -change in the structure of viral protein to hoodwink the host defence -the flu virus reinvents itself into a more lethal form than the existing strain. This resultant loss of defence memory of the host results in rapid and devastating spread of flu from time to time, lead ing to a pandemic. The influenza virus is of three types A,B & C. Only the influenza A virus can affect species other than human beings, including birds and animals. H1N1 virus is a Type A influenza virus with a reassortment of human, avian and swine proteins, hence it is called the Swine Flu Virus.

SPREAD

People who have flu can spread it one day before they have any symptoms and as many as seven days after they get sick. Kids can be contagious for as long as 10 days.

I) DIRECT SPREAD `Droplet' Spread

Droplets containing the virus produced when coughing, sneezing and talking get deposited in the mouth, nose and eyes.

II) INDIRECT SPREAD

Touching the mouth, nose and eyes after touching contaminated surface.

The virus can survive on hard surfaces for a few hours (that is, on desks, chairs, door handles, etc).

SYMPTOMS

The symptoms are similar to those of seasonal flu. They are fever, cough, sore throat, muscle aches, joint pains, fatigue, diarrhoea and vomiting. Patients may experience some or all of these symptoms and may be contagious before symptoms are seen.

HIGH-RISK GROUPS

Children below five years of age and adults over 60 are at a greater risk of contracting the infection. Being in crowded places, at tending to someone with flu, caring for the sick and being exposed to school or hospital environments add to the risk Those pregnant, obese, diabetic, having cardiovascular disease, asthma and COPD should be extra cautious.

TREATMENT

Reassuring the public that H1N1 is not fatal in all cases and that most cases respond to simple measures is important. Early recognition of complications of respiratory distress is also crucial.

Most patients do not require any specific measures and are treated as normal flu cases. Based on the associated risk factors and presence of warning symptoms, other patients are categorised into A, B and C.

Besides supportive treatment, categories B and C should be treated with antiflu medication; it is important to recognise and treat the complications as well.

Some of the same antiviral drugs that are used to treat seasonal flu also work against H1N1 swine flu. Oseltamivir (Tamiflu), peramivir (Rapivab), and zanamivir (Relenza) are the drugs that are effective. It is important to note that these drugs work best when used within 48 hours of onset of symptoms.

We should discourage the routine use of antiflu drugs. The overprescription of these medicines is most often unnecessary and starting beyond 72 hours may not be helpful.

Antibiotics are useful only in case of secondary bacterial infection.

PREVENTION

While swine flu isn't as scary as it seemed a few years ago, it's still important to protect yourself against it. Here are some things you can do to stay healthy:

A) VACCINE

Flu vaccine can be taken as a shot or as a nasal spray. The injections have more predictable response compared to sprays.

B) OTHER METHODS

i) Wash your hands periodically with soap and water. You can use an alcohol based hand sanitiser too.

ii) Cover your nose and mouth while coughing and sneezing.

iii) Don't touch your eyes, nose or mouth.

iv) Avoid people who are sick.

v) Mask, as a prevention of spread, is more useful when the patient wears it rather than close contacts wearing it.

vi) Close contacts (of H1N1 cases) can take oseltamivir once a day for 10 days, after consulting a doctor.

Resting at home when sick is the most important thing to do to minimise the spread in the community and for a speedy recovery .

--The writer is a consultant physician at Manipal Hospitals, Bengaluru.



 Three-yr-old succumbs to swine flu, 23 on ventilator [Times of India, 10 Apr 2017]

PUNE: A three-year-old succumbed to swine flu at a private hospital here on Sunday, taking the number of H1N1 casualties to 30 since the beginning of the year.

Currently, the condition of another 23 patients is critical. They are on ventilator at various hospitals across the city.

The girl, a resident of Ghodegaon in Ahmednagar district, developed influenza-like symptoms on March 26. She was running a temperature and was throwing up on March 26. By March 29, she also developed cold and cough, followed by drowsiness and breathlessness a day later.

She was initially treated by a general physician in the neighbourhood.

Eventually, she was admitted to a hospital in Ahmednagar on April 3. Her condition worsened and so she was moved to KEM Hospital in Pune on April 5 and was put on ventilator support two days later. However, she suffered a cardiac arrest due to swine flu-induced pneumonia with acute respiratory distress syndrome and died around 10.45pm on April 7. The toddler had tested positive for swine flu.

The girl's case does not stand in isolation. The civic health department's recent analysis of swine flu mortality this year clearly reveals that children below the age of 10 years and adults in the productive age bracket of 31-50 years are most vulnerable to swine flu.

Senior paediatrician Jayant Navarange explained, "Children, mainly below five years of age, are not exposed to H1N1 or any other influenza virus so their natural immunity is yet to develop.

Also, children in the 5-10-year age group have are in close contact with classmates, increasing their chances of being infected"



 H1N1 DEATH TOLL RISES TO 13 IN STATE. IS IT A MINI EPIDEMIC? [Bangalore Mirror, 9 Apr 2017]

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Probable minor mutation in the virus has led to a scare of swine flu (H1N1) epidemic in the state. The H1N1 death toll in the state has risen to 13 after two deaths were reported on March 3 from different districts. The last recorded death toll was 10, but within a week three deaths have been reported from different parts of the state.

Since January this year, a total of 1,793 people have tested positive for H1N1.

While the area within Bruhat Bengaluru Mahanagara Palike (BBMP) limits has witnessed two deaths till date, with the number of positive cases reaching 758, Bengaluru Urban district has 192 positive cases and Bengaluru Rural six, although no deaths have been reported here.

The total number of positive swine flu cases (1,793) in the state has risen exponentially from last year’s 110 positive cases -- a whopping 170 per cent increase in the number of positive cases as per Karnataka Health and Family Welfare data released on March 7.

A health department official said that at the local level, special clinics are being operated to contain the outbreak. Swab samples are being collected from all the patients who are reporting fever of two days and more. These samples are sent to designated labs to confirm if they are suffering from swine flu or not.

WORRISOME

However, a senior health department official told Bangalore Mirror that the trend is a worrisome one as most swine-flu cases in Karnataka are reported during the winter season and the virus is not effective in high temperatures. But despite mercury rising in the state, the outbreak is not containing itself.

Earlier the experts from National Institute of Virology attributed the sudden spurt to a minor antigenic drift in the H1N1 virus that causes an epidemic. An antigenic drift is the process by which two or more different strains of a virus, or strains of two or more different viruses, combine to form a new subtype of the virus having a mixture of the surface antigens of the two or more original strains. Experts believe this has led to local outbreaks, especially in the South Indian states. However, they have ruled out major mutation of the virus.

This year, the patients contracting the deadly influenza (swine flu, or H1N1) are either minors or elders.



 Swine flu spreads in East Godavari [The Hans India, 9 Apr 2017]

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Kakinada: In the tough summer phase, the heat sensitive H1N1 virus has been spreading in East Godavari resulting in two deaths and thee positive cases in the district in the last five days.According to district medical authorities V. Girija Rani of Rajamahendravaram and Ch. Veeraraju of Kuyyeru in Tallarevu Mandal died on April 4 due to swine flu.

In the last three days 14 suspected cases have been identified at various places in the district. Of these 3 tested positive for swine flu [Swab test], six tested negative and result of tests for the remaining five suspected cases are expected from PCR lab at Visakhapatnam in a day or two.

Apart from Kakinada and Rajamahendravaram government hospitals, PHC at Oobalanka in Ravulapalem, mandal in the district has the facilities to treat the H1N1 cases. In this connection Dr K. Chandrayya East Godavari Dist Medical and Health Officer [DMHO] advised people to avoid attending festivities and crowded places besides travelling in AC buses and AC trains to the maximum extent to avoid spread of virus.

He also advised people to opt for frequent hand wash and avoid hand shake to prevent the spread of the virus. The DMHO also revealed that the district medical authorities are fully geared up to treat H1 N1, with 200 doses of medicine and treatment facility at Kakinada, Rajamahendravaram with ten bed isolated ward facility and at Oobalanka PHC in the district.

Dr. U. Sudheer, in charge superintendent of KGGH observed that tough the J1N1 virus is heat sensitive the same has been spreading in the present heat wave conditions. Dr Sudheer revealed that the virus as per observations is found active till eight hours in atmospheric conditions. He advised the people to take medical opinion in case of cold, headache and fever symptoms for H1N1.



 Two test positive for swine flu [The Hindu, 9 Apr 2017]

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Troubled times:A woman, suspected to be suffering from swine flu, at the GH in Kakinada on Saturday. By Arrangement SPECIAL ARRANGEMENT

GH doctors on alert; reports of three patients awaited

Doctors at the Government General Hospital (GH) here are on a high alert with two patients testing positive for swine flu.

In the last week, five patients, including a seven-year-old boy, have been admitted with symptoms of the disease. Their nasal swabs have been sent to the regional laboratory in Visakhapatnam.

According to the laboratory reports, two women, one aged 28 and another 33, have tested positive for the virus. Reports of the remaining three patients are awaited.

Of the five, three are from Ramachandrapuram and one each from Kakinada and Appanapalli village in the Konaseema region.


“Three of them are undergoing treatment in the ENT special ward. The two who have tested positive are being shifted to the TB ward for better treatment,” says M. Raghavendra Rao, GGH superintendent. “We have adequate stock of medicines and oxygen cylinders. One of the two patients who tested positive has been put on ventilator,” he adds. Meanwhile, managements of private hospitals are cautious in admitting persons with symptoms of swine flu. If initial screening indicates the presence of the virus, the patients are referred to the GH.

Awareness drive

The district administration has swung into action to create awareness among the people about the spread of the disease. It is advising people to wear nose masks and consult a doctor if they have constant cold coupled with headache.



 Six-month-old dies of swine flu [The Hindu, 9 Apr 2017]

Virus causing infection among children even in summer

Amidst concerns of swine flu virus mutations, a six-month child succumbed to the virus at the State-run Gandhi Hospital on Saturday.

Hospital authorities said the child had been admitted for a congenital heart problem at the hospital about four days ago and had also shown lung problems including pneumonia.

Subsequent swine flu testing had confirmed an infection. The boy was later shifted to the swine flu ward at the hospital where he died on Saturday morning.

“We are seeing that the virus is causing infection in children even in summer. This was not the case before. Samples are being sent to the National Institute of Virology to determine if the virus has mutated,” hospital superintendent Shravan Kumar said.The hospital has 13 cases of infection, all in children, in its swine flu ward. Five of these cases had been referred by other hospitals on Friday night.

Children infected

Four of the five referrals were from Niloufer Hospital. A paediatrician at Niloufer Hospital too expressed concern.

“We cannot treat positive cases at Niloufer as it lacks a well-equipped swine flu ward. Once we receive positive confirmation of swine flu, we shift the child to Gandhi Hospital,” the doctor said.



 Swine flu patient dies [The Hans India, 3 Apr 2017]

Visakhapatnam: Zulfikar Ali Khan (35), who was undergoing treatment for swine flu in a private hospital on the Beach Road in Vizag, died on Sunday.

This is the second death in the state this year.According to Shaik Nagur, a relative of Khan, the patient developed swine flu symptoms 10 days ago. His kidneys also failed and he was undergoing dialysis in the private hospital.



 Man succumbs to swine flu [The Hindu, 3 Apr 2017]

by B. Madhu Gopal

Govt. hospitals did not admithim, allege his relatives

A man died of swine flu at a private hospital in the city on Sunday. The man, Zulfikar Ali Khan (35) of Gowri Nagar, Kancharapalem, was undergoing treatment for the past 11 days.

The victim’s relatives alleged negligence on the part of government hospitals stating that they did not admit him on the plea of lack of ventilators.

The medical authorities, however, said they had gone by the word of someone at the Government Hospital for Chest and Communicable Diseases (GHCCD) after making enquiries, without even bringing the patient.

“Zulfikar was diagnosed with fever 16 days ago. We took him to a private hospital and when normal drugs failed to bring down the temperature even after two days, the doctor suspected typhoid and suggested tests.

Meanwhile, on the suggestion of a relative, we took him to a private hospital on March 22. The doctors there told us that the case was critical and the patient needs ventilator support,” recalled Md. Kaisar Ali Khan, a close relative of the victim. “We took him to the GHCCD in the ambulance.

We went into the GHCCD as the ambulance waited outside and showed the reports to a lady doctor, who was examining patients there. She told us that the patient needs ventilator support, which was not readily available.

Though the doctor agreed to admit the patient, she told us that we would have to bear the risk,” Mr. Kaisar said.

“We shifted Zulfikar to another hospital, where he was put on ventilator support. A senior doctor suspected swine flu and Zulfikar’s blood sample was sent to Mumbai on March 23 and we got online confirmation of swine flu on March 25,” he said.

“Zulfikar used to run a small school in the city and a private coaching centre for competitive examinations. The government doctors should at least guide patients in the right direction, if they run short of facilities, which they failed to do,” alleged another relative Sk. Nagur.

District Medical and Health Officer J. Sarojini said that Zulfikar had renal problems and was a dialysis patient. Swine flu was detected incidentally and he tested positive. The patient was not taken to the GHCCD and his relatives merely made enquiries and left.



 51-year-old woman dies of swine flu [Times of India, 3 Apr 2017]

RAJKOT: A 51-year-old woman from Upleta taluka succumbed to the swine flu virus in Rajkot Civil Hospital on Sunday, taking the death toll due to this deadly H1N1 virus in the region to six this year.

The victim Hansaben, a resident of Kharachiya village near Upleta was admitted to the hospital on March 29 with symptoms of swine flu. On March 30, she tested positive for the disease.

Earlier, 35-year-old Kanchan Dabhi, a resident of Kotadiyavadi area in Jetpur town of Rajkot district, had died of swine flu in the civil hospital on March 11.

Before that, the virus had claimed Chetna Trivedi (5), resident of Shiv Kunj at Rain Nagar of Rajkot city, Chaturben Hinshu (65), resident of Krushnanagar in Rajkot and Kanta Bodar (52), resident of Kothariya Road in the city.



 Rising death toll from dengue and H1N1 [The Sunday Times Sri Lanka, 2 Apr 2017]

The prevailing unusual weather conditions are contributing towards rising deaths due to dengue and H1N1 influenza, health officials warned yesterday. With the death toll due to dengue rising to 53 in three months and the number of cases increasing to 27,898 the Dengue Control Unit has issued health warnings to 11 districts.

They are Colombo, Gampaha, Kalutara, Galle, Matara, Hambantota, Batticaloa, Trincomalee, Jaffna, Ratnapura and Kegalle. Last month, 9,004 dengue cases were reported to hospitals in contrast to 2,696 cases in March last year. Alongside dengue, H1N1 influenza has also seen an increase island wide.

The influenza virus that was said to have subsided has, however, spread to parts of the Central Province. Central Province Health Services Director Dr. Shanthi Samarasinghe told the Sunday Times that in the Province 115 patients were confirmed positive for the H1N1 virus while 17 deaths had bee reported in the Kandy and Matale districts districts in the first three months of the year.

Dr. Samarasinghe said the most vulnerable were the people suffering from chronic illnesses.

“The virus is a communicable disease. Therefore, it could spread fast. The people have to take precautions,” she said. She added that awareness programmes were being carried out by health officials and they were able to control the outbreak to some extent.

The Health Ministry’s Consultant Epidemiologist Dr. Samitha Ginige said that while the unusual weather pattern contributed to dengue, another factor was the improper waste disposal. He said the transmission of virus can take several patterns in different regions and at the moment the South East Asian Region is experiencing an extended outbreak.

Last year, 90 dengue related deaths were reported in the country with 55,150 cases.



 At 63, deaths from swine flu this year is the highest in Maharashtra [Free Press Journal, 1 Apr 2017]

By Aftab Khan and Agencies

Swine-Flu By Aftab Khan and Agencies.jpg


Nashik/New Delhi: Swine flu has claimed 160 lives in various parts of the country in the first three months of this year. And the highest number of deaths 63 have been reported from Maharashtra.

Union Minister of State for Health Anupriya Patel in a written reply in Lok Sabha on Friday said between January 1 to March 26, 160 people died from swine flu, while 6,062 cases were registered.

In Maharashtra, the dreaded disease continues to take lives in Nashik with 15 deaths reported from the city and the district in the last 3 months. District and state medical authorities have swung into action as swine flu thrives in the heat.

“The Nashik Civil Hospital and rural hospitals in the district have screened over 11,765 patients,” Dr S Jagdale, civil surgeon at the hospital.

Jagdale said that they had urged even private practitioners in the district to screen patients carefully. “The symptoms of swine flu and common flu are similar but still we have urged doctors to gauge the cases and begin treatment immediately,” he told Free Press Journal.

Medical authorities are stressing on the fact that doctors recognise the symptoms and begin early treatment. The government has said it will take action against any negligence on part of the doctors. “If the treatment is delayed, the patient becomes unresponsive to medicines. In fact, we will be sending notices to two doctors, who delayed the treatment of a patient by five days,” Dr Jagdale said.

The surgeon said that medicines used for treating swine flu patients like Tamiflu have been made available in most pharmacies.

Nashik Municipal Corporation health officer Dr Vijay Dekate told Free Press, “We are also working on educating the people about the disease. Delay in treatment can be fatal.” He said that eight persons have been admitted at the civil hospital and 198 patients treated in the last 3 months.



 Swine flu death toll 16 till March [Times of India, 1 Apr 2017]

NASHIK: Swine flu has claimed 16 lives from across the district from January to March this year. The steady rise in the number cases has been a cause of great concern for citizens and the civic administration of late.

Altogether 60 patients of swine flu have been reported from January till date, with 50 reported in March alone. Of the 60 patients, 25 were from the Nashik Municipal Corporation (NMC) limits and 35 were reported from outside the city. Four of the 16 deaths are from the city and 12 are from other areas in the district.

"We are maintaining a good stock of medicines. Our staff is continuing with awareness campaigns at our urban public health centres, hospitals and among the public. We will pep up our campaign soon," an NMC official said.
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