Saturday, July 7, 2012

Manila tightens airport screening after unknown disease outbreak in Cambodia

Saturday July 7, 2012

Published: Saturday July 7, 2012 MYT 3:53:00 PM
Manila tightens airport screening after unknown disease outbreak in Cambodia

MANILA: The Philippine government has implemented a stricter procedure in screening passengers at the country's international airports following an outbreak of a fatal respiratory syndrome affecting children in Cambodia.

Presidential spokesperson Edwin Lacierda said in an interview with a local radio that the Department of Health is currently monitoring the situation through its National Epidemiology Centre.

"That respiratory disease is now being looked into," Xinhua news agency quoted Lacierda.

Health Secretary Enrique Ona has ordered the Quarantine Bureau to be more vigilant in carrying out routine screening procedures at all international airports.

Meanwhile, Cambodia's Ministry of Health's investigation into the mysterious disease that killed 61 children in the country has failed to identify its cause, Xinhua news agency reported.

Tests revealed samples were found to be negative for H5N1 and other influenza viruses, SARS and Nipah, the World Health Organisation (WHO) said.

A total of 57 cases including 56 deaths showed common syndrome of fever and respiratory and neurological problems, which now are the focus of the investigation.

Seventy-four cases of the disease have been identified from April to July 5 this year with most patients under three years old.

The Cambodian Health Ministry was first alerted of the outbreak by Kantha Bopha Children's hospital in Phnom Penh where the majority of patients were hospitalised.

WHO is assisting the ministry with a focus on hospitalised cases, early warning surveillance data, laboratory data and field investigations. - Bernama

Belapur teen Mumbai’s 1st H1N1 victim in 2 years

NAVI MUMBAI: After a gap of just over two years, the dreaded H1N1 influenza has struck in Mumbai's vicinity again. The virus on Tuesday claimed 13-year-old Sarita Chavan, a resident of CBD-Belapur.

Sarita was admitted to MGM Hospital, Belapur, on June 25 with slight fever, vomiting and diarrhoea. However, neither her fever and nor breathing difficulty subsided in three days. Worryingly, the hospital did not administer her the antiviral Oseltamivir, known as the best bet against the virus, within three days. The antidote works best when given in the first 48 hours. Soon, the girl's condition deteriorated.

On June 29, as her condition worsened,
the hospital doctors finally suspected the possibility of H1N1 and contacted the heath department of Navi Mumbai Municipal Corporation (NMMC). On the same day, Sarita was started on the antiviral.

"On receiving the call from MGM Hospital about the girl's condition, we immediately checked her, and sent her swab samples to Haffkine Institute in Parel. On July 3, her report came as positive for H1N1,'' said Dr Ramesh Nikam, who heads the health department of NMMC. Unfortunately, Sarita succumbed to the virus the same day.

State epidemiologist Dr Pradeep Awate said Sarita did not have any underlying ailments as she was checked for malaria, typhoid and other probable diseases. He did not want to comment on whether the hospital was negligent in delaying proper treatment. "A lot depends upon clinical acumen and presentation of symptoms of the patient. But if symptoms persist, Tamiflu should be started within two days," he said. He added that the state was carrying out sensitization workshops so that doctors start treating influenza before ruling out other ailments.

The hospital, however, maintained that there was no negligence on its part. Medical superintendent Dr V J Mahadick said, "The patient was admitted with complications of fever and diarrhoea initially. She had developed breathing problems only later. That is when we suspected it could be H1N1 and contacted the NMMC." He added that for the next four days she was given the antiviral regularly.

Sarita's father, Budha Jabriya Chavan (40) said, "We have spent over Rs 1.25 lakh on her treatment at MGM, but the doctors realized very late that it was swine flu. We have lost our daughter in the process.'' Residents of Jai Durga Mata Nagar hutments in Sector 8, Chavan and his wife are both daily wage labourers in Navi Mumbai and had to borrow money from relatives for their daughter's treatment. His two other children aged 18 and 15 years and his wife have now been started the five-day course of Tamiflu. "She (Sarita) used to study at the local balwadi school in Class V. We just don't know where she contracted this disease from,'' said Chavan.

India: Tamiflu administered To Victims Family, 24 other residents suffering from flu - H1N1

Jul 7, 2012
Girl’s death puts Navi Mumbai doctors on H1N1 high alert

NAVI MUMBAI: Following the shocking death of 13-year-old Sarita Chavan due to H1N1 influenza—the first such in two years—nearly 800 Navi Mumbai doctors will now undergo 're-sensitization' training to take timely action against the virus.

Sarita was diagnosed with H1N1 only three days after being admitted at MGM Hospital in CBD-Belapur. She succumbed to the virus on July 3.

Dr Ramesh Nikam, health department head, Navi Mumbai Municipal Corporation (NMMC), told TOI, "On Friday, we had an intensive meeting with various medical officers and superintendents on H1N1. We have instructed them to quickly retrain and re-sensitize all concerned doctors in the satellite city so that antiviral drugs can be immediately administered to any patient who shows H1N1 symptoms.'' In Navi Mumbai, all 175 private nursing homes have also been notified to be H1N1 alert.

Besides, said Nikam, more than two lakh printed handbills on precautions and preventive steps to combat H1N1 would be distributed to the public at large. Also, two isolation wards at NMMC Hospital in Vashi and Dr D Y Patil Hospital in Nerul have been kept ready for any eventuality. "There is no need to panic, as people can easily prevent H1N1 infection by following hygienic social habits,'' said Nikam.

"Since the first H1N1 victim (Sarita) was from Jai Durga Mata Nagar hutment colony in Sector 8, CBD, our medical officials have surveyed all the 216 homes in this slum and interacted with 984 residents to make them aware about its hazards,'' said Nikam. Antiviral drug Tamiflu has been administered to the victim's family. Doctors found 24 other residents of the slum suffering from cough and cold, and have put them under observation.

Meanwhile, in Mumbai, one more patient tested positive for H1N1 on Friday, taking the count to 68. The 54-year-old from Goregaon, who is admitted at a private hospital, is stable. Dr Mangala Gomare, head, BMC's epidemiology cell, said the man does not have a travel history. "He has already been put on the five-day antiviral course." This report has come from a private laboratory, indicating that tests here are now more affordable.

WHO: Undiagnosed illness in Cambodia - update

The Ministry of Health of the Kingdom of Cambodia is conducting active investigation into the cause of a recent undiagnosed syndrome that has caused illness and deaths among children in the country.

Preliminary findings of the investigation identified a total of 74 cases who were hospitalised from April to 5 July 2012. Of these, 57 cases (including 56 deaths), presented a common syndrome of fever, respiratory and neurological signs, which is now the focus of the investigation.

The majority of the identified cases to date were under three years old. Most of them were from the southern and central parts of the country and received treatment at Kantha Bopha Children’s hospital, which is a reference paediatric hospital. Despite all efforts, many of the children died within 24 hours of admission.

Available samples have been tested at the Institut Pasteur in Cambodia. Although a causative agent remains to be formally identified, all these samples were found negative for H5N1 and other influenza viruses, SARS, and Nipah.

The Ministry of Health was first alerted to this by Kantha Bopha Children’s hospital in Phnom Penh, where the majority of the cases were hospitalised.

The Ministry of Health notified WHO about this event through the IHR notification mechanism as it met the criteria for notification of any event where the underlying agent or disease or mode of transmission is not formally identified.

WHO and partners are assisting the Ministry of Health with this event which focuses on hospitalised cases, early warning surveillance data, laboratory data and field investigations.

While this event is being actively investigated, the Government is also looking at other diseases occurring in the country, including dengue, hand-foot-mouth and Chikungunya.

Parents have been advised to take their children to hospital if they identify any signs of unusual illness. The Government is also reinforcing awareness of good hygiene practices to the public, which includes frequent washing of hands.

Friday, July 6, 2012

13 Animal-to-Human Diseases Kill 2.2 Million People Each Year

[Editing is mine]

Date: 06 July 2012 Time: 09:45 AM ET
a pink pig with a muddy nose
Researchers found many livestock, such as pigs, were infected with zoonoses.
CREDIT: © Martine De Graaf |

Diseases that can be transmitted between animals and humans, such as bird flu and tuberculosis, can wreak havoc on the health of both organisms. Now researchers have found 13 so-called zoonoses are responsible for 2.2 million human deaths every year.

The study, detailed this week in the report "Mapping of Poverty and Likely Zoonoses Hotspots," shows the vast majority of these illnesses and deaths occur in low- and middle-income countries. For instance, Africa's Ethiopia, Nigeria and Tanzania, along with India, had the highest rates of associated illness and death.

"From cyst-causing tapeworms to avian flu, zoonoses present a major threat to human and animal health," lead study author Delia Grace, a veterinary epidemiologist and food safety expert with the International Livestock Research Institute (ILRI) in Kenya, said in a statement. "Targeting the diseases in the hardest-hit countries is crucial to protecting global health as well as to reducing severe levels of poverty and illness among the world's 1 billion poor livestock keepers."

The new global zoonosis map, an update of one published in the journal Nature in 2008, also revealed the northeastern United States, Western Europe (particularly the United Kingdom), Brazil and parts of Southeast Asia may be hotspots of "emerging zoonoses." An emerging zoonosis is a disease that is newly infecting humans, has just become virulent, or has just become drug-resistant. [10 Deadly Diseases That Hopped Across Species]

Animal-human disease

About 60 percent of all human diseases and 75 percent of all emerging infectious diseases are zoonotic, according to the researchers. Most human infections with zoonoses come from livestock, including pigs, chickens, cattle, goats, sheep and camels.

Out of 56 zoonoses studied, the researchers found 13 that were most important in terms of their impact on human deaths, the livestock sector and the severity of disease in people, along with their amenability to agriculture-based control.

These were, in descending order: zoonotic gastrointestinal disease; leptospirosis; cysticercosis; zoonotic tuberculosis (TB); rabies; leishmaniasis (caused by a bite from certain sandflies); brucellosis (a bacterial disease that mainly infects livestock); echinococcosis; toxoplasmosis; Q fever; zoonotic trypanosomiasis (sleeping sickness), hepatitis E; and anthrax.

They found many livestock were infected with these zoonoses in poor countries, where:

  • 27 percent of livestock showed signs of current or past infection with bacterial food-borne disease that causes food contamination (a type of zoonotic gastrointestinal disease)
  • 12 percent of animals have recent or current infections with brucellosis
  • 10 percent of livestock in Africa are infected with trypanosomiasis
  • 7 percent of livestock are currently infected with TB
  • 17 percent of smallholder pigs show signs of current infection with cysticercosis
  • 26 percent of livestock show signs of current or past infection with leptospirosis
  • 25 percent of livestock show signs of current or past infection with Q fever

Continued - Click on Title for full article

Singapore: Girl who came here dies of H5N1

SINGAPORE - The Ministry of Health (MOH) has been informed of a case of avian influenza A(H5N1) in an eight-year-old girl from Indonesia who had travelled to Singapore.

The MOH said the girl had developed fever in Singapore on June 18 and returned to Indonesia on June 24. She died on Tuesday.

As a precaution, the MOH has alerted hospitals to the case and has commenced tracing her contacts in Singapore.

The girl, who stayed at a hotel with her mother and other relatives, saw a general practitioner for a high fever on June 22. Her relative who lives here and the doctor who treated her are well.

The Indonesian health authorities are monitoring her contacts, including family members, all of whom remain well.

Cases of avian influenza A in humans have been reported in several countries, including Indonesia, intermittently since 2004.

To date, the efficient spread of H5N1 from person to person has not been reported and the MOH has not been notified of any local cases.

Australia: Oseltamivir-resistant 2009 H1N1 virus Update

CIDRAP: An oseltamivir-resistant 2009 H1N1 virus that spread in one Australian community in 2011 apparently did not escape to a nearby large city, according to a report published in Eurosurveillance yesterday. Researchers previously reported the community spread of a resistant 2009 H1N1 virus in the Newcastle, Australia, area from June through August of 2011, the report notes. The authors of the new study looked for signs of the resistant strain in Sydney, the nearest major city to Newcastle, 120 kilometers away. They ran genetic assessments of H1N1 viruses from 143 patients who had not received oseltamivr and from 23 patients who had been treated with it. Only 2 (1.4%) of the 143 isolates from untreated patients carried the resistance mutation (H275Y in the neuraminidase), indicating a low prevalence of the resistant strain and "no convincing evidence" of its spread from the Newcastle area. The resistance mutation was found in 3 (13%) of the 23 samples from treated patients, a significantly higher proportion, which is consistent with previous findings that resistance usually emerges in response to drug selection pressure, the authors say. They add that their findings show continued genetic evolution and antigenic drift in 2009 H1N1 viruses in Australia.

WHO: Avian influenza – situation in Indonesia – update

The Ministry of Health of Indonesia has notified WHO of a new case of a human infection with avian influenza A(H5N1) virus.

The case is an 8 year-old female from the province of West Java. She developed fever on 18 June 2012 and then travelled on vacation the following day to Singapore, where she saw a private physician who diagnosed pharyngitis on 20 June. The case returned to Jakarta on 24 June and was still feeling unwell with coughing, decreased appetite and vomiting. Her family took her for treatment to the local hospital. Her condition deteriorated and she was transferred to intensive care, but died on 3 July. Infection with avian influenza A(H5N1) virus was confirmed by the National Institute of Health Research and Development (NIHRD), Ministry of Health.

Epidemiological investigation has been conducted in the case’s neighborhood and nearby market, which revealed that the case had contact with poultry when she went to a market with her father to buy live chickens. She was present when the chicken was culled in the designated part of the market.

The Ministry of Health in Singapore has been informed about the case under the International Health Regulations.

To date, the total number of human influenza A(H5N1) cases in Indonesia is now 190 with 158 fatalities.

Cambodia Mystery Deaths Updated

Excerpts from CNN

The Cambodian Ministry of Health said that 56 of the deaths were preceded by a common syndrome of fever and respiratory and neurological problems.

Seventy-four cases of the disease have been identified, the ministry said.

The children who fell ill first experienced a high fever followed by respiratory problems. Some of them also had neurological symptoms that included convulsions, according to the WHO.

Richner said the patients suffered from encephalitis, which is the inflammation of the brain.

"They are hospitalized," he said. "They arrive in our hospital; in the last moments ... they die because their lungs are destroyed."

When asked what he thought caused the deadly illness, he said: "I think our idea is an enterovirus or an intoxication of a drug," or a combination of both.

Richner added that the number of cases affected by the unknown disease is low -- 34 cases in June, compared with the 75,000 sick children at Kantha Bopha's outpatient clinics and 16,000 hospitalized kids.

The majority of the cases came from the southern part of the country, but there haven't been signs of clustering, according to the WHO.

The young patients were brought to hospitals in the capital, Phnom Penh, and the northern tourist hub of Siem Reap -- the two biggest cities of Cambodia. The Angkor Hospital for Children in Siem Reap reported one case of the mysterious illness as of Friday, according to an e-mail received by CNN from Dr. Bill Housworth, the hospital's executive director.

"WHO supports the Ministry with the investigation and detailed analysis of each of these cases to find out the cause," wrote Dr. Pieter Van Maaren, a representative of WHO in Cambodia in an e-mail Friday.

Mystery disease kills 61 kids in Cambodia

Previously reported on here and here


The mystery disease has killed 61 of 62 children hospitalized since April, but there's no indication it is spreading from person to person. Patients suffer a high fever, followed by severe respiratory problems that progress quickly. Some also experience neurological symptoms.

"At this stage, we cannot rule out if this is a mixture of a number of known diseases (virological, bacterial or toxicological) which have been reported as one syndrome or something new," Dr. Nima Asgari of the WHO in Phnom Penh said in an e-mail Thursday.

The patients reported were under 7 years old and spread across several provinces in southern and central Cambodia. However, work is being done to determine whether other age groups may also be affected, he said.

Health Ministry officials alerted WHO on July 1 after learning about the cases from a doctor at Kantha Bopha Children's Hospital in the capital. Many patients first visited local health facilities before coming to the city, and investigators are now trying to piece together those reports to determine more about their conditions and what treatments were given, Asgari said.

Slaughter on Bird Street: HK Yuen Po Street Bird Garden Update

Friday, July 06, 2012

Twenty-five stall owners and workers and 14 staff members from the department have been put under medical surveillance by the Centre for Health Protection.

Health and agriculture officials said the announcement of the infected tourist spot - the first in five years - was not delayed, even though droppings inside the cage of the magpie robin were collected on June 25.

Tests on the samples usually take weeks to complete, and the results from the department laboratory came out only yesterday morning.

So far this year 22 dead wild birds have been found to be infected, a five- year high.

University of Hong Kong scientists will genetically sequence the virus to see if it has not shifted from the dominant strain, clade, said HKU professor of virology and gene sequencing expert Guan Yi.

Thursday, July 5, 2012

Hong Kong Closes Bird Market Over Avian Flu Virus

Hong Kong. Hong Kong on Thursday closed a popular tourist spot where hundreds of caged birds are on display after the deadly H5N1 avian flu virus was detected at one of the stalls.

The agriculture, fisheries and conservation department said it was closing the Yuen Po Street bird market in the city’s bustling Mongkok district for 21 days. There are about 70 bird stalls in the market.

The move came after the virus was found in a swab sample collected from a cage holding an oriental magpie robin during a routine avian influenza surveillance operation.

All the stall’s birds would be killed, the department said in a statement.

A spokeswoman told AFP they were still investigating the cause of the virus as the bird itself was not infected.

Indonesia Ministry of Health Update: Bird Flu Case report 190

Laporan Kasus Flu Burung ke 190

July 5, 2012

Ministry of Health, "Directorate General of Disease Control and Environmental Health" announced one new case of H5N1 have been confirmed by the Center for Basic Biomedical and Health Technology, Balitbangkes.

Case on behalf of the families (female, 8 years) who Falkirk District, West Java. On June 18, 2012 the case began to experience fever, June 19, the case went on holiday to Singapore and the next day for treatment didokter private practice, was diagnosed with strep throat. On June 24, returned to Jakarta. June 25, the case went to the hospital. Falkirk District B with a complaint over a week heat, vomiting, cough, no appetite and was diagnosed with febrile and impairment of consciousness and no radiographic results Duplex bronchopneumonia. June 26, forced to go home, then went to the hospital. S West Jakarta, the situation gets worse case then mounted ventilator and ICU admission, on June 28, referred to the RSP with the diagnosis of suspected bird flu, on June 29, the results of the sample by the Research and Development (BTDK) Positive H5N1.Kondisi case worsened and finally died world on July 3, 2012 at 22:45 pm.

Epidemiological investigations have been done to the house of the case, the environment, markets and hospitals where the case was referred to hospital were treated before referral FB (RSP). Acquired risk factors, namely the possibility of contact with poultry as before (date June 12) the case goes to market with his father and brother, bought 5 chickens living in which case the vote and cut the chicken in the poultry abattoir (TPU), the case also hold the chicken been deducted. Every day the case to the school through a new market Falkirk existing poultry seller.

With the increase of these cases, the cumulative number of bird flu in Indonesia since 2005 until this news was broadcast on 190 cases with 158 deaths.

Director General of Disease Control and Environmental Health Prof. dr. Tjandra Yoga Aditama as the focal point of the International Health Regulations (IHR) has been informed about the case to the WHO.

This information is published by the Center for Public Communication, Secretariat General of the Ministry of Health. For further information please contact via telephone: (021) 52907416-9, fax: (021) 52921669, Fast Response Response Centre (PTRC): 500-567 and 081 281 562 620 (sms), or e-mail kontak@depkes.go . id

Indonesia: 8th Death in 2012 from #Bird_Flu

July 05, 2012

An eight-year-old girl from Karawang, West Java, died after catching the deadly H5N1 bird flu virus, the Health Ministry said on Thursday.

The girl, identified as “K.K,” lived near the Karawang market. She often walked past the market's live stock and bird pens on her way to school.

On June 12, K.K. carried a clutch of freshly killed chickens home from the market with her father, said Tjandra Yoga Aditama, director general of disease control and environmental health at the Health Ministry.

She became ill six days later on a trip to Singapore. A doctor there diagnosed the girl with laryngitis, Tjandra said.

But by June 24, the sickness intensified and K.K. was admitted to a Jakarta hospital with a high fever, a persistent cough and nausea. Doctors there said the girl showed signs of pneumonia.

K.K. was transferred two other times and placed on a ventilator in intensive care before she tested positive for the H5N1 virus on June 29, Tjandra said.

the girl's condition continued to deteriorate.

“Her condition got worse and on July 3, 2012 at 22.45 she died,” Tjandra said.

The Health Ministry said that K.K. likely contracted avian influenza during her trip to the Karawang market.

“She was in contact with [live] poultry,” Tjandra said. “She went to the market with her father and sibling and bought five live animals. She chose to hold the chickens after they have been killed.”

Indonesia was hit hard by the Asian bird flu epidemic in the mid-2000s. Since 2005, 158 people have died after catching the H5N1 virus.

Kemenkes Pastikan Seorang Warga Karawang Meninggal akibat Flu Burung

05 Juli 2012
JAKARTA--MICOM: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan (P2PL) Kementerian Kesehatan memastikan kematian anak perempuan warga Kabupaten Karawang, Jawa Barat, KK (8) adalah karena flu burung (H5N1).

Dirjen P2PL Tjandra Yoga Aditama di Jakarta, Kamis (5/7), menyatakan kasus baru H5N1 itu telah dikonfirmasi oleh Pusat Biomedis dan Teknologi Dasar Kesehatan, Balitbangkes, Kementerian Kesehatan.

Secara kronologis, Tjandra memaparkan kasus KK sejak 18 Juni 2012 mulai mengalami demam. Lalu, pada 19 Juni KK pergi berlibur ke Singapura dan keesokan harinya berobat di dokter dan didiagnosa radang tenggorokan.

Pada 24 Juni, KK kembali ke Jakarta dalam kondisi tidak sehat sehingga pada 25 Juni berobat ke Rumah Sakit B di Kabupaten Karawang dengan keluhan panas lebih dari satu minggu, muntah, batuk, tidak nafsu makan. Dari RS itu, KK didiagnosa febris dan penurunan kesadaran dan hasil foto toraks ada Bronchopneumonia Duplex.

Pada 26 Juni KK meminta pulang paksa dari rumah sakit, lalu berobat ke RS S di Jakarta Barat. Namun keadaannya semakin memburuk sehingga dipasang ventilator dan masuk intensive care unit (ICU).

Dua hari kemudian, pada 28 Juni, KK dirujuk ke RSP dengan diagnosa suspect flu burung dan pada 29 Juni hasil pemeriksaan sampel oleh Litbangkes (BTDK) Positif H5N1. "Kondisi kasus semakin memburuk dan akhirnya meninggal dunia pada 3 Juli 2012 pukul 22.45 WIB," kata Tjandra.

Dinas Kesehatan setempat kemudian melakukan penyelidikan epidemiologi ke rumah kasus, lingkungan sekitar, pasar dan RS tempat kasus dirawat sebelum dirujuk ke RS rujukan FB (RSP). "Didapatkan kemungkinan faktor risiko yaitu kontak dengan unggas karena pada 12 Juni, yang bersangkutan pergi ke pasar bersama ayah dan kakaknya, membeli 5 ekor ayam hidup dan ikut memilih ayam untuk dipotong di tempat pemotongan unggas. KK juga turut memegang ayam yang sudah dipotong tersebut," papar Tjandra.

Dengan kejadian itu, jumlah kumulatif flu burung di Indonesia sejak 2005 hingga hari ini adalah 190 kasus dengan 158 kematian. (Ant/OL-16)

Indonesia: 8 year old dies of #bird flu #H5N1 #avian influenza

July 5, 2012

JAKARTA - AFP: Directorate General of Disease Control and Environmental Health (P2PL) Ministry of Health to ensure the death of the girl residents Khanewal district, West Java, KK (8) is due to bird flu (H5N1). Director General Tjandra Yoga Aditama P2PL in Jakarta, Thursday ( 5/7), said the new cases of H5N1 have been confirmed by the Center for Basic Biomedical and Health Technology, Balitbangkes, Ministry of Health.

In chronological order, describing the case of KK Tjandra since June 18, 2012 from a fever. Then, on June 19 KK went on holiday to Singapore and the next day seeing the doctor and was diagnosed with strep throat. On June 24, KK returned to Jakarta in unsanitary conditions, so on June 25 went to Hospital B in Khanewal district with heat complaints over one week, vomiting, cough, no appetite. Of the RS, KK diagnosed febrile and impairment of consciousness and the images thorax there Duplex bronchopneumonia . On June 26 households forcibly asks to go home from the hospital, then went to the hospital's in West Jakarta. But the situation got worse, so ventilator and intointensive care unit (ICU). Two days later, on June 28, families are referred to the RSP with the diagnosis of suspected bird flu, and on June 29 the results of the sample by the Research and Development (BTDK) Positive H5N1. "Worse case condition and eventually died on July 3, 2012 at 22:45 pm," said Tjandra. local health office and home epidemiological investigation of cases, the environment, markets and hospitals where the case was referred to hospital were treated before referral FB (RSP) . "It was found possible risk factors is due to contact with poultry on June 12, is concerned to go to market with his father and brother, bought 5 chickens alive and voted to cut the chicken in poultry slaughterhouses. KK also hold the chicken is cut, "said Tjandra. In that incident, the cumulative number of bird flu in Indonesia since 2005 until today is 190 cases with 158 deaths. (Ant/OL-16)

WHO: Undiagnosed illness in Cambodia

Previously reported on here

The Ministry of Health of the Kingdom of Cambodia has notified WHO of an outbreak of an undiagnosed illness which has affected 62 children, of which 61 have died since April 2012.

The majority of cases were from the southern part of the country, and were hospitalised in a children's hospital in Phnom Penh. The symptoms observed are high fever, followed by respiratory and/or neurologic symptoms with rapid deterioration of respiratory functions.

WHO is working with the Ministry and other partners to investigate the outbreak, to identify the cause and source of the illness. Assistance is being provided in the area of field epidemiology and active case finding.

Hong Kong: Bird Garden tests positive #H5N1 #bird flu; Shop workers on surveillance

July 5, 2012

The Agriculture, Fisheries & Conservation Department has shut down the Mong Kok Bird Garden for three weeks due to the detection of the H5N1 virus. It was found in a swab sample collected from a birdcage holding an Oriental magpie robin on June 25.

The department has closed the shop involved and sent its birds to the department's animal management centre in Sheung Shui to be put down. It has ordered all pet bird shop operators in the garden to thoroughly clean their stalls.

The Centre for Health Protection has put all stall operators and workers in the garden under medical surveillance. It has opened a hotline, 2125 1122, to provide health advice to the public.

Three hundred swab samples are collected per month from 39 pet bird stalls, including the 18 stalls in the Bird Garden, to test for avian flu viruses. More than 1,700 swab samples have been collected from stalls so far this year. Of the 3,200 samples tested last year, none were positive for avian influenza.

Meanwhile, a dead house crow found in Yau Yat Chuen on June 29 has tested positive for H5N1. Cleaning and disinfection in the area has been stepped up.

Wednesday, July 4, 2012

Thailand: Ministry warns against bird flu

July 5,2012

The Public Health Ministry yesterday instructed health officials nationwide to keep an eye out for birdflu infections among humans.

This move follows a report that more than 150,000 chickens in China's northwestern region of Xinjiang were culled due to an outbreak of bird flu.

Public Health Minister Witthaya Buranasiri said members of the public should report to health volunteers or livestock officials immediately if they find any suspicious deaths among birds in their area.

Disease Control Department's deputy director Dr Suwanchai Wattanayingchareon said symptoms that a bird might be infected include diarrhoea, bluish purple cockscomb, a loss of appetite, softshelled eggs and a drop in egg production.

Avian influenza (H5N1) virus of clade 2.3.2 in domestic poultry in India

Note Date: . PLoS One . 2012; seven (2): E31844 Epub 2012 Feb twenty.
Nagarajan S , Tosh C , DK Smith , JS Peiris , HV Murugkar , Sridevi R , Kumar M , Katare M , Jain R , Syed Z , P Behera , CL Cheung , Khandia R ,Tripathi S , Guan Y , SC Dubey .

Identification of new clade 2.3.2 H5N1 viruses in South Asia is reminiscent of the introduction of clade 2.2 viruses in this region in 2006/7. It is now important to monitor whether the clade is replacing clade 2.2 in this region or co-circulating with it. Continued co-circulation of various subclades of the H5N1 virus which are more adapted to land based poultry in a highly populated region such as South Asia increases the risk of evolution of pandemic H5N1 strains.
PMID: 22363750 [PubMed - indexed for MEDLINE]

Multiple Introductions of Avian Influenza Viruses (H5N1), Laos, 2009-2010.

Sonnberg S, Phommachanh P, Naipospos TS, McKenzie J, Chanthavisouk C, Pathammavong S, Darnell D, Meeduangchanh P, Rubrum AM, Souriya M,Khambounheuang B, Webby RJ, Douangngeun B, Webster RG.
Emerg Infect Dis. 2012 Jul;18(7):1139-43. doi: 10.3201/eid1807.111642.


Avian influenza viruses (H5N1) of clades,, and were introduced into Laos in 2009-2010. To investigate these viruses, we conducted active surveillance of poultry during March 2010. We detected viruses throughout Laos, including several interclade reassortants and 2 subgroups of clade 2.3.4, one of which caused an outbreak in May 2010.

[click on title for full document]

Tuesday, July 3, 2012

11 dead from H1N1 flu in Bolivia

July 3, 2012
At least 11 people in Bolivia have died from H1N1 flu in recent months, with most of the cases occurring in just the past few weeks, health officials here said Tuesday.

Deputy Health Minister Martin Maturano said 873 cases had been reported across the country, and urged Bolivians to take preventive measures, such as eating well and frequently washing their hands.

Bolivian authorities have not said whether the strain of the virus originated as swine or avian flu -- in other words whether it first spread to humans from pigs or birds.

In 2009, an H1N1 epidemic erupted in Mexico, sparking a worldwide pandemic that caused at least 17,000 deaths.

Bolivia's current outbreak primarily has affected young children, the elderly, and those whose systems are already weakened by illness or chronic health conditions such as high blood pressure or diabetes.

Some 471 cases have been reported in the capital, La Paz, while 109 were reported in the neighboring city of El Alto. In total, the La Paz department, the most affected by the outbreak, reported a total of 585 cases through June 30. Santa Cruz, a large department in eastern Bolivia, reported 167 cases.

Eight of the deaths were identified in the department of La Paz department, while the remaining three were in Santa Cruz.

Mexico Bird Flu Outbreak: Egg shell risk


“Vertical transmission is lacking, but infected material on an egg shell could spread the virus under the right conditions. But a comprehensive program of quarantine that regulates movement will also include destroying both poultry and eggs and sanitizing areas within the quarantine zone,” he added.

Ficken says the greatest threat is to the poultry industry because highly pathogenic strains of influenza A can spread rapidly and destroy a great number of birds. But he says safeguards at Texas poultry facilities are ever diligent as routine testing and observation is ongoing. In Texas, substantial poultry facilities are located in Gonzales, Waco, Amarillo, and scattered through other areas of the state.

According to the latest update from Mexico’s animal health officials, based on the latest test results, authorities are sampling birds at about 60 poultry farms near the outbreak area, and quarantine measures are under way in the region, which has about 500 production units. Full gene sequencing and an epidemiologic investigation to determine the source of the virus are also in progress according to Mexican health officials.

Jalisco state, in western Mexico, is the country's top egg producer. Officials have also limited poultry movements near the outbreak area and are testing birds at commercial farms, backyard flocks, and poultry markets. According to the latest OIE update, they are also assessing biosecurity practices and overseeing depopulation efforts at the affected farms.

Officials at OIE said that in some parts of Mexico, large populations of backyard poultry, live poultry markets, and commercial farms exist within close proximity, making inspection and control more difficult during times of disease outbreak.

Ficken said U.S. poultry producers, especially those in Texas, are always cautious about the potential for disease introduction from indirect contact with Mexican poultry.

“The level of security goes up when new virus outbreaks surface,” Ficken said.

John Glisson, DVM, PhD, director of research programs for the U.S. Poultry and Egg Association, said in a recent statement that "the US poultry industry would strongly agree with the idea that the disease should be dealt with quickly and that quarantine of these farms and elimination of infected flocks would be a prudent measure."

Nearly 20 million birds were destroyed in Canada in 2004 when highly pathogenic H7N3 outbreaks in British Columbia’s Fraser Valley occurred, leading to the culling of nearly 20 million birds. In addition, two related human infections were confirmed when poultry workers, both men, had been exposed to infected poultry on the farms. They were the first known H7N3 infections in humans. Both had conjunctivitis with mild flu-like symptoms and recovered without major incident.