JANuary 07 Health Alerts
31/01/07
The government of Nigeria has announced the death from suspected avian influenza infection in a 22-year-old female from Lagos. She died on 16 January 2007. The mother of the 22-year-old died on 4 January with similar symptoms.
Preliminary tests on the samples from the 22-year-old were positive for influenza A/H5. Samples have now been sent to a WHO Collaborating Centre for Reference and Research on Influenza for confirmation. Results are expected shortly. No samples were taken from the mother.
Contacts have been followed up and have shown no symptoms at twice the incubation period for avian influenza infection. Samples have been tested from these contacts as well as from three other suspected cases, including one fatal case and have all been negative in preliminary tests. These samples have also been sent to a WHO Collaborating Centre for Reference and Research on Influenza.
New outbreak reported in Russia
31/01/07
The last official report on cases of H5N1 infection in the Siberian region was in August 2006. Russian press is now quoting an official of the country’s agricultural inspection agency as saying that the virus has been uncovered in poultry at three locations in the southern Krasnodar region.
Avian Influenza - Situation in Indonesia - update 5
29/01/07
The Ministry of Health of Indonesia has announced a new case of human infection of H5N1 avian influenza. A 6-year-old female from Magelang District in Central Java Province developed symptoms on 8 January and died in hospital on 19 January. Initial investigations into the source of her infection indicate exposure to dead poultry.
Of the 81 cases confirmed to date in Indonesia, 63 have been fatal.
Deadly H5N1 may be brewing in cats
29/01/07
Source: New Scientist, print edition [edited]
<http://www.newscientist.com/article/mg19325883.800?DCMP=NLC-nletter&nsref=mg19325883.800>
The discovery, announced last week, that the H5N1 bird flu virus is widespread in cats in locations across Indonesia has refocused attention on the danger that the deadly virus could be mutating into a form that can infect humans far more easily.
In the 1st survey of its kind, an Indonesian scientist has found that in areas where there have been outbreaks of H5N1 in poultry and humans, one in 5 cats have been infected with the virus and survived. This suggests that as outbreaks continue to flare across Asia and Africa, H5N1 will have vastly more opportunities to adapt to mammals than had been supposed.
Chairul Anwar Nidom of Airlangga University in Surabaya, Indonesia, told journalists last week that he had taken blood samples from 500 stray cats near poultry markets in 4 areas of Java, including the capital, Jakarta, and one area in Sumatra, all of which have recently had outbreaks of H5N1 in poultry and people.
Of these cats, 20 per cent carried antibodies to H5N1. This does not mean that they were still carrying the virus, only that they had been infected, probably through eating birds that had H5N.
Nidom's findings are the 1st to indicate what proportion of cats can become infected by H5N1. No cats have been tested in Hong Kong or China. In Bangkok, Thailand all the cats in one household are known to have died of H5N1 in 2004. Tigers and leopards in Thai zoos also died, while last year [2006], 2 cats near an outbreak in poultry and people in Iraq were confirmed to have died of H5N1, as were 3 German cats that ate wild birds. In Austria, cats were infected but remained healthy
(New Scientist, 18 Mar 2006, p 6).
Hungary reports reappearance
29/01/07
In a report to the World Organisation for Animal Health on 24 January the Acting Chief veterinary Officer for Hungary has confirmed an outbreak of H5N1 avian influenza in geese on a farm in southern Hungary.
This is the first report of the reappearance of highly pathogenic avian influenza in Europe this year.
Avian Influenza - Situation in Egypt - update 2
22/01/07
The Egyptian Ministry of Health and Population has announced a new human case of avian influenza A(H5N1) virus infection. The case was confirmed by the Egyptian Central Public Health Laboratory and by the US Naval Medical Research Unit No.3 (NAMRU-3).
The 27-year-old woman from Beni Sweif Governate developed symptoms on 9 January 2007 and died in hospital on 19 January.
Initial investigations indicate the presence of sick and dead poultry at her residence in the days prior to the onset of illness.
Of the 19 cases confirmed to date in Egypt, 11 have been fatal.
Avian Influenza - Situation in Indonesia - update 4
22/01/07
The Ministry of Health of Indonesia has announced a new case of human infection of H5N1 avian influenza. A 26-year-old woman from West Java Province developed symptoms on 11 January and died in hospital on 19 January. Initial investigations of the source of her infection indicate that the woman had been involved in the slaughter of sick chickens in the days prior to symptom onset.
Of the 80 cases confirmed to date in Indonesia, 62 have been fatal.
Avian Influenza - Reduced drug susceptibility reported
22/01/07
The World Health organization has reported evidence of a reduced drug susceptibility found in 2 persons recently reported with H5N1 infections in Egypt.
Laboratory testing of samples from these cases showed a mutation of the virus, with moderately reduced susceptibility to the antiviral drug oseltamivir (Tamiflu) The patients – a 16 year old female and a 25 year old male from the same household;d in Gjharbiyah province had received oseltamivir two days after onset of the illness but both died in hospital.
This mutation has previously been identified in Viet Nam in one case in 2005. because the clinical level of resistance of these mutations is not yet well established and are not associated with any known change in the transmissibility of the are not associated with any known change in the transmissibility WHO is not making any changes in antiviral treatment recommendations. The public health implications at this time are limited. These findings do not indicate a need for a change in phase level. The WHO pandemic preparedness level remains at 3.
Avian Influenza - World wide winter resurgence of Avian Influenza
17/01/07
Against the background of continuing outbreaks in Indonesia (the World health Organisation confirming another 3 human cases in its update of 15 January) had been the encouraging dearth of reports in other countries. Then in November – see Alert on this website of 28/11/06 - new outbreaks were reported from South Korea followed by reports from Vietnam where the virus has been found in poultry in Mekong delta provinces. In Thailand the first report in more than 5 months came when the Ministry of Agriculture announced this week that birds were being culled to contain an outbreak in Phitsanulok province. In Japan an outbreak has occurred on a farm in the Miyazaki prefecture of Kyushu resulting in the culling of more than 8000 poultry. The virus has been identified in a dead goshawk in Hong Kong and in China a human case occurred in December although there have been no confirmed reports of major outbreaks in birds since August.
In Africa three human deaths from the disease in Egypt in late December indicates that the avian population is still infected and Egyptian officials report their frustration at rural residents who hide chickens and ducks in their homes. In Nigeria, where no human case has been reported, there have been many unconfirmed news stories on outbreaks but on 12 th January officials confirmed that the virus had been identified on farms in Sokoto and Katsina states in the north of the country and intensive control measures are in place..
A winter season resurgence of avian influenza has been expected given the pattern since 2003. It is speculated that this is the result of wild bird migrations but this is a theory which remains controversial.Another intriguing aspect of the disease is highlighted by reports from South Korea that antibodies to the H5N1 virus has been found in some poultry workers who have never had any signs of the disease. Elsewhere in Asia asymptomatic infection has been rare to non-existent. Sub-typing of the virus shows that the Korean infections have been due to the V genotype whereas the predominant virus in other parts of Asia has belonged to the Z genotype. This has led to speculation that there may be sub-types of the H5N1 virus of varying virulence.
Avian Influenza - Situation in Indonesia
15/01/07
The Ministry of Health of Indonesia has confirmed the death of a 22-year-old woman from Tangerang City, Banten Province. The woman, whose infection was announced on 12 January, died later that day.
The Ministry of Health has also confirmed two additional cases of human infection of H5N1 avian influenza.
A 22-year-old woman from South Jakarta developed symptoms on 6 January 2007 and died on 12 January 2007. Investigations into the source of her exposure found reports of bird deaths near her home in the days prior to symptom onset.
The 18-year-old son of the 37-year-old woman from Tangerang City, Banten Province has now also been confirmed as infected with H5N1 avian influenza. He remains in hospital in a critical condition. Investigations into the source of his infection indicate similar environmental exposure as his mother.
Of the 79 cases confirmed to date in Indonesia, 61 have been fatal.
Avian Influenza - Situation in China - WHO update
11/01/07
The Ministry of Health in China has confirmed a case of human infection with the H5N1 avian influenza virus. The case is a 37 years old man from Tunxi in Anhui Province. He became symptomatic on 10 December 2006 and was hospitalised on 17 December 2006. The patient was discharged on 6 January and is recovering well.
Information provided to WHO indicates that he was a farmer and may have kept a number of birds in his back yard. No information on possible exposure to diseased birds as the source of his infection is presently available, but an investigation is under way. Close contacts were placed under medical observation but are all well and were released on 29th December.
Of the 22 cases confirmed to date in China, 14 have been fatal.
Avian Influenza - Situation in Indonesia - WHO update
11/01/07
The Ministry of Health in Indonesia has confirmed an additional two cases of human infection with the H5N1 avian influenza virus.
The first newly-confirmed case is a 14 year old male from West Jakarta. He developed symptoms on 31 December 2006 and was hospitalized on 4 January 2007. He remains hospitalized. Deaths among poultry in the neighbourhood have recently been reported. The source of exposure is currently under investigation.
The second case is a 37 year old female from Tangerang, Banten Province. She developed symptoms on 1 January 2007 and was hospitalized on 6 January 2007. She remains in intensive care. Initial investigations suggest sick poultry as the possible source of infection.
Of the 76 cases confirmed to date in Indonesia, 57 have been fatal.
Avian Influenza - Human Case in Indonesia
09/01/07
Source: Reuter’s AlertNet
A 14-year-old boy has tested positive for bird flu in Indonesia, the country's 1st case of the virus in almost 2 months, a Health Ministry official said on Sun 7 Jan 2007. The boy, from Tangerang in West Java, was hospitalized in Jakarta after he suffered from bird-flu-like symptoms on 1 Jan 2007.The boy had been in contact with ducks but officials are still investigating the case.
According to the most recent World Health Organisation cumulative case count, this case will become the 75th in Indonesia, raising the global total as of 27 Dec 2006 to 262. The death toll remains at 57 for Indonesia and 157 overall.
