News Reports for August 15, 2012

South Asia: Hot spot for cross-border diseases

New Delhi, Aug 14 (IANS) In South Asia, one of the world's most densely populated regions, deadly diseases from animals, like the nipah virus, brucellosis, anthrax and even avian flu, cross international boundaries with ease.

A fruit bat on the India-Bangladesh border could spread the deadly nipah virus when it licks the juice of the date palm tree being collected by farmers. Likewise, cattle grazing in grasslands spanning borders could carry with them spores of the anthrax disease, or the ticks on them could spread brucellosis. According to experts, zoonotic diseases, transmitted from animals to humans, are able to cross international borders in South Asia due to the porous borders, poor awareness and surveillance mechanisms coupled with high density of population.

Among the diseases spread by animals in South Asia are the plague, scrub typhus, leptospirosis and avian flu. Brucellosis causes abortions in bovines, and sheep and goat. In humans, the fever can be confused with typhoid.

"In South Asia, borders are porous; humans cross over and along with them bring pathogens. We are tropical countries where the human-animal interface is very, very intense," Manish Kakkar, senior public health specialist, Public Health Foundation of India (Snip) said in South Asia, there is a lot of unorganised backyard animal and poultry farming. "Humans and animals come into close contact in these farms. There is poor knowledge of hygienic practices; bio safety standards are not up to the mark; and there is every likelihood of pathogens crossing the borders."

"With its poverty, high population, poor safety practices, it makes the South Asia region a hot spot for zoonotic diseases," said Kakkar, on the sidelines of a meeting on zoonotic diseases organized by One Health Alliance of South Asia (OHASA) attended by delegates from India, Bangladesh, Nepal and Pakistan.

India saw its first outbreak of nipah virus - which affects the neurological and respiratory system and can cause death - in Siliguri in West Bengal in 2000. The saliva and urine of the fruit bats - which were unwitting hosts to the nipah virus - contaminated the date palm juice collected by farmers, thereby spreading the virus to humans, said Jonathan H. Epstein, a disease ecologist.

(Snip) avian flu virus in wild birds finds its way to backyard poultry farms located next to jungles. "Poultry farmers trade the chickens even if they fall sick, and these infect others as well as the humans handling them," (Snip) the increasing population has led to people moving closer to jungles and intruding into wildlife areas, thereby increasing the chances of catching such infections. Also the growing demand for protein has increased the man-animal interaction.

"Half of the infections afflicting humans come from animals," said the expert, adding that many of the infections are emerging or new ones like the West Nile virus, spread by the mosquito. Japanese encephalitis is transmitted by mosquitoes to humans and affects a large number of people in India every year. However, the actual host to the killer virus are pigs and birds, from which it is transmitted to mosquitoes. Continued:  http://in.news.yahoo.com/south...  

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Wed Aug 15, 2012 at 06:17:36 AM UTC

India: Swine flu claims first victim this season (Maharashtra)

PUNE: A 57-year-old man succumbed to the H1N1 influenza on Sunday. "The man (Snip) was admitted to the Sahyadri Munot hospital on August 4 in a critical condition" (Snip)

"He had symptoms of severe cough, cold and fever and was immediately put on a ventilator. His throat swab, sent on August 4, was positive for swine flu". "Although he was receiving treatment, he succumbed at 6.30 pm due to renal failure and other ailments," said the officials. http://timesofindia.indiatimes...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Wed Aug 15, 2012 at 06:30:33 AM UTC

US: U study raises new worries about flu at fairs (Minnesota)

Dr. Jeff Bender admits that he and his colleagues were a strange sight, wandering through the swine barn at the Minnesota State Fair, taking nasal swabs from pigs. But it was all in the name of science. Now Bender, a University of Minnesota veterinarian, has released the results of his study, and it contains a word of caution for anyone planning to visit the State Fair: Even healthy-looking pigs might have the flu.

The study, released Wednesday, comes on the heels of recent reports that more than 150 people in other parts of the country have contracted a new type of swine flu, apparently after contact with pigs at state or county fairs. "This study just shows that viruses are shared between pigs and people," Bender said -- and that it may be harder to spot an infected pig than once thought.

"We were expecting if pigs had virus then they should be [feverish], sick" and easy to screen out, he said. Not anymore. So far, no cases of the new swine flu, known as H3N2v, have been found in Minnesota, according to health officials.

It has mostly affected children in two states: Indiana and Ohio, and is similar to seasonal flu, with symptoms including fever, cough, runny nose and body aches.

(Snip) In Minnesota, State Fair officials say they've stepped up precautions in advance of the hundreds of thousands of visitors who will begin descending on the fairgrounds on opening day, Aug. 23. Veterinarians plan to check the livestock when they arrive and will monitor the pigs more frequently than in the past, said Brienna Schuette, a State Fair spokeswoman. (Snip) The Minnesota Department of Health, in fact, suggests that people at high risk for flu should consider avoiding the swine exhibit entirely. That includes children younger than 5, pregnant women, people 65 and older and those with chronic conditions.

(Snip) In his study, Bender tested pigs at the Minnesota State Fair in 2009, during the height of the H1N1 flu pandemic sweeping the country. At the time, the flu was so widespread that there was even an outbreak among 4-H members during the State Fair. (Snip) The scientists found that 11 of the 57 pigs swabbed at the Minnesota State Fair -- 19 percent -- had the H1N1 flu virus. By comparison, the year before, none of the 47 pigs tested had the flu.

(Snip) two exhibitors -- a girl and her father -- fell ill with the flu during the fair. Three of their pigs tested positive as well. In this case, though, Bender believes that the people, not the pigs, were to blame. "What we do know is that there was a lot of circulating virus in people," he said. "Our suspicion is there probably was an exhibitor who brought it in and shared it with the pigs."

His study is being published in the August issue of the journal Emerging Infectious Diseases. http://www.startribune.com/lif...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Wed Aug 15, 2012 at 06:47:19 AM UTC

US: Minnesota State Fair officials on the look out for new strain of swine flu

Pigs with barking coughs and runny noses won't go unnoticed at this year's Minnesota State Fair. That's the word from Fair officials who say surveillance by veterinarians will be stepped up given recent concerns about a new strain of swine flu that's been circulating in Indiana and Ohio.

"State Fair veterinarians are going to be monitoring very closely any hogs that have flu-like symptoms," said Brad Rugg, director of animal science programs for 4H, during an interview Tuesday, Aug. 14.

"There's always surveillance, but now it's much more structured," added Rugg, whose group includes about 300 exhibitors scheduled to show pigs at the State Fair. "There will be many more visits to the hog barn, and up and down the hog aisles as well." Continued: http://www.twincities.com/loca...  

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Wed Aug 15, 2012 at 07:02:04 AM UTC

[ Parent ]

SustEfficient Human Community Spread of H3N2v

Recombinomics Commentary

Now, for a little context. CDC understands that people are concerned as to the rapid jump in the number of H3N2 cases compared with last week. At this point, there's no evidence of sustained efficient human-to-human spread in the community.

The above comments from the August 9, 2012 telebriefing on H3N2v have striking similarities to WHO comments on the 2009 H1N1pdm09 pandemic when it was spreading in Europe, Asia, and Australia.  The first two cases had been identified in southern California in children who had no contact with swine or each other (samples collected in late March, 2009).  Subsequent sequence data from Mexico and Canada confirmed that the same H1N1pdm09 had spread throughout North America, and the report of 150 symptomatic cases at a Queens high school confirmed that the H1N1pdm09 had spread efficiently in April.

However, although the above events clearly signaled a pandemic, a pandemic was not declared until June 11, 2009 because the community transmission had not been demonstrated in Europe, Asia, or Australia.  The delay in confirmation in community transmission was largely linked to limited and biased testing.  Countries were screening arriving passengers at airports for fever, which led to detection of H1N1pdm09. Epidemiological studies focused on these confirmed cases, but H1N1pdm09 contacts were not considered "community transmission" because of linkage to the arriving passengers.

However, the airport screening only detected a small fraction of H1N1pdm09 cases, because half of the infections did not lead to high fevers.  Moreover, those infected 1-2 prior to flying developed high fevers after passing through screening, while others had decreased their fever by using medications to treat their flu symptoms.  Thus, although there was community spread by cases who were not identified in the screenings, but the community spread was not initially detected because resources were concentrated on testing airport passengers. As a result, almost all H1N1[dm09 cases were linked to air travel and flight attendants on the arriving planes, but the H1N1pdm09 cases were not attributed to the airplane or flight attendant linkage, because it was well known that almost all testing was focused on arriving passengers.

This linkage is similar to the current detection of H3N2v at livestock fairs, because those are the cases that are being testing.  Mild ILI cases without direct or indirect swine are not being tested, which leads to heavily biased sampling and an artificial and unscientific linkage, which then leads to more biased testing and more artificial links and an explosion of media myths on H3N2v jumping from swine to humans at agricultural fairs.

The H3N2v detected in July is distinct from the initial H3N2v cases in 2011, and the novel sub-clade was not widely detected in swine prior to the July outbreaks.  Moreover, like the high school in Queens in 2009, the clusters are large.  200 symptomatic cases linked to the Gallia Junior County Fair were tested using an influenza A rapid test, and 69 of the 200 cases were positive.  A subset was sent to the Ohio Department of Health, and thus far H3N2v has been confirmed in 11, which is similar to the initial data on cases at the 2009 Queens high school.

These large clusters, in combination with confirmed cases in 11 counties in Ohio and 18 counties in Indiana leaves little doubt that there is efficient human-to-human spread in the community. Continued: http://www.recombinomics.com/N...  

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Wed Aug 15, 2012 at 06:55:23 AM UTC

The correct title of this article is:

"Sustained Efficient Human Community Spread of H3N2v"
Sorry for the mistake.  

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Wed Aug 15, 2012 at 06:59:31 AM UTC

[ Parent ]

Ah, but I like SustEfficient!

I think you've invented a cool new word! I like the sound and the effect of it! ;-) Merriam Webster, here she comes!

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by: Cathy M @ Wed Aug 15, 2012 at 13:40:40 PM UTC

[ Parent ]

LOL

It was just one of my usual screw-ups! I have to do that every once in a while just to make sure all of you are paying attention.

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by: NewsDiary @ Thu Aug 16, 2012 at 00:23:45 AM UTC

[ Parent ]

That comment was posted by me.

Just double checking to see if all of you are paying attention! LOL

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Thu Aug 16, 2012 at 00:34:18 AM UTC

[ Parent ]

US: CDC H3N2v Testing Bias Raises Pandemic Concerns

Recombinomics Commentary

H3N2v virus infection cannot be distinguished by clinical features from seasonal influenza A or B virus infection, or from infection with other respiratory viruses that can cause influenza-like illness (fever and either cough or sore throat). Therefore, the key to suspecting H3N2v virus infection in an ill patient at this time is to elicit an epidemiological link to recent swine exposure in the week prior to illness onset:

Direct contact (raising pigs, feeding pigs, cleaning pig waste) or indirect exposure to pigs - visiting a pig farm, walking through a swine barn at a county fair, etc.), especially if pigs were known to be ill; or

Close contact (within 2 meters or approximately 6 feet) to an ill person who had recent swine exposure.

A patient with influenza-like illness and an epidemiological link to recent swine exposure should be considered a probable H3N2v case.

The above comments are from the CDC's instruction to physicians regarding human H3N2v cases.  This document will increase the heavy bias in H3N2v testing, which is largely limited to cases with direct or indirect swine exposure.  The instructions are similar to those announced after earlier detection of H3n2v cases, but the large number of cases identified in Indiana and Ohio will be more widely noted.

However, the sequences from the confirmed H3N2v cases in Indiana and Ohio are distinct from the first 10 H3N2v cases identified in 2011, due to the replacement of the NA gene, which had an H1N2 swine lineage, with an NA which has circulated in H3N2 swine.

This change (Snip) was initially detected in a large cluster in West Virginia, which did not have swine contact or exposure.  The outbreak led to a series of CDC announcements, but the H3N2v was not detected during the height of the 2011-2012 flu season.

(Snip) in late March H3N2v was identified in Utah, and the NA sequence matched the West Virginia sub-clade. Although this sub-clade was rarely detected in swine, and not detected in any swine samples collected prior to the outbreak in West Virginia, it was also detected in the July isolates in Hawaii, Indiana, and Ohio, signaling human adaptation and spread.

This H3N2v could also infect swine, so the July fairs did lead to H3N2v infections in swine, based on CDC descriptions of the outbreaks, although sequences from the July swine isolates have not been released.  The most recent H3n2v swine isolates were from Ohio, but all four isolates matched the 2011 human cases and were easily distinguished from the cases in West Virginia as well as the 2012 human isolates.

Thus, the sequence data supports a sub-clade that has adapted to humans, but all 2012 isolate have direct or indirect linkage to swine, which is due to the heavy testing bias.

Seasonal influenza is rare in the summer in the United States, and cases are likely to be due to H3N2v, especially in younger patients.  However, the CDC has not acknowledged the NA sequence differences between the the 2012 and 2011 human cases, or the size of the cluster in West Virginia. Continued: http://www.recombinomics.com/N...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Wed Aug 15, 2012 at 07:18:03 AM UTC

California H3N2v Health Alert - PCR Testing of All ILI Cases

Recombinomics Commentary

Current recommendations

During the summer months, encourage influenza testing in the following:

All persons with * influenza-like illness (ILI) *, including severely ill/fatal cases and outpatients

Acute respiratory outbreaks

ILI in persons with recent swine exposures

ILI in persons who can be epidemiologically linked to confirmed cases of novel or variant influenza.

* Influenza-like illness = fever (>100°F or 37.8°C) and cough and/or sore throat, in the absence of a known cause*

The above recommendations are from and August 10, 2012 Health Alert Update by the California Department of Public Health (CDPH).  Testing involves RT-PCR testing and the CDPH is acknowledged for its proactive position of testing of all ILI cases (including outpatients) during the summer months, when seasonal influenza levels are low, and probabilities for detection of H3N2v cases without swine exposure are high.

The Indiana and Ohio explosion of confirmed H3N2v human cases (Snip), which was first detected that the West Virginia day care center where confirmed cases had no swine contact or exposure, strongly suggests that the novel sub-clade is transmitting in human populations independent of swine exposure.

In addition to the explosion of confirmed cases in Indiana and Ohio, a recent case from Maui, Hawaii (Snip) was also due to infection involving the novel sub-clade, which also infected the first 2012 confirmed H3N2v case (Snip) (Utah).

(Snip) RT-PCR testing of all summer ILI cases should be implemented by all fifty states. http://www.recombinomics.com/N...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Wed Aug 15, 2012 at 07:42:42 AM UTC

US: Study finds flu in healthy-looking pigs at state fairs

Aug 15, 2012 (CIDRAP News) - Testing of a sampling of pigs shown at the Minnesota State Fair during the 2009 H1N1 influenza pandemic revealed that 19% of them were infected with flu viruses, even though they looked healthy, according to a new study.

The findings highlight the challenges of preventing pigs and humans from passing flu viruses back and forth at fairs and swine shows, especially this summer when several states are tracking human illnesses from a novel H3N2 virus that has been detected in both pigs and people.

The study, which appears today in Emerging Infectious Diseases (EID), was conducted by researchers from the University of Florida, University of Minnesota, South Dakota State University, and University of Iowa, along with scientists from the US Centers for Disease Control and Prevention (CDC).

With the goal of watching for influenza A viruses in show pigs, the group recruited people ages 7 and older who were showing pigs at the Minnesota State Fair in 2008 and 2009 and the South Dakota State Fair in 2009. Participants filled out a questionnaire and allowed the researchers to collect nasal swab samples from their pigs. Just over 70% of participants were male, and the median age was 34.9 years. About a quarter of the pig handlers were younger than 18.

They used the CDC's real-time reverse transcription polymerase chain reaction (rRT-PCR) tests to screen the samples for influenza A viruses. Blinded samples were sent to the Minnesota Veterinary Diagnostic Laboratory in St. Paul, where rRT-PCR testing for matrix, hemagglutinin, and neuraminidase genes was done, and specimens were sent to the National Veterinary Services Laboratory in Ames, Iowa, for molecular and genetic sequencing studies.

Specimens were collected from 149 pigs, including 47 and 57, respectively, from the Minnesota State Fair in 2008 and 2009 and 45 from the 2009 South Dakota State Fair. All of them were assessed as healthy by a veterinarian before they were cleared to enter their shows.

In 2008, investigators found no evidence of influenza A, but 12 (12%) of the 102 sampled collected in 2009 tested positive. These included 11 (19%) of the 57 samples from the 2009 Minnesota State Fair, which coincided with the second wave of the 2009 H1N1 pandemic.

Culturing yielded seven flu isolates. The CDC sequenced 5 of the 7 isolates and found that four were similar to the 2009 H1N1 sequences. They classified the fifth isolate, which came from a pig at the 2009 South Dakota State Fair, as a triple-reassortant H1N2, similar to recent US swine isolates.

A phone survey of the study participants found that two had experienced flulike illnesses within 7 days after being at the fair. One was a man who got sick a day after his pigs arrived at the fair; and the other was his daughter, who started having symptoms on the last day of the fair. The child's three pigs all tested positive for influenza A. Continued: http://www.cidrap.umn.edu/cidr...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Thu Aug 16, 2012 at 00:31:56 AM UTC

Please post new news stories to...

News Reports for August 16, 2012

Thank you!

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Thu Aug 16, 2012 at 05:01:42 AM UTC