News Reports for September 25, 2012

Bird Flu Outbreaks Reported Around China

Outbreaks of H5N1 avian influenza (Snip) have occurred across China this year.

Information on bird flu's spread in China was made public in January in a Hong Kong health report to the World Health Organization (WHO), saying that China was one of the 15 affected countries in the world with 18 provinces and cities experiencing H5N1 avian influenza outbreaks. Now, the Guangdong Province Department of Agriculture has also admitted that there is an outbreak.

A 2-year-old boy from Hong Kong contracted bird flu in early June as confirmed by the Department of Health in Hong Kong. A duck sample from Jiangnan Market in the Haizhu District of Guangzhou, Guangdong Province, where the boy had visited in mid-May, was tested positive for the H5N1 virus. Samples from another market in the same district also tested positive (Snip).

In a Sept. 18 announcement the Guangdong Province Department of Agriculture said that the southern region of China was hit by a H5N1 flu epidemic that has infected 14,050 ducks and killed 6,300 birds. In farms in Zhanjiang City, a large urban area in the southwestern part of Guangdong Province, authorities killed 67,500 ducks.

H5N1, a highly pathogenic virus, is an infectious bird disease that can spread to humans who come in contact with infected birds. When people are infected, the mortality rate is about 60 percent, according to the WHO.

In December 2011, over 2,000 chickens died in a few days in Zengcheng, Guangdong Province. Authorities killed 27,500 birds, but Chinese state media denied that the slaughter was to prevent the spread of bird flu.

On Jan. 26, the Centre for Health Protection (CHP) in Hong Kong published The Avian Influenza Report, informing the WHO that China was one of 15 countries in the world affected by H5N1 avian influenza with 18 provinces and cities affected, namely Anhui, Beijing, Fujian, Guangdong, Guangxi, Guizhou, Hong Kong, Hubei, Hunan, Jiangsu, Jiangxi, Liaoning, Shandong, Shanghai, Shanxi, Sichuan, Xinjiang, and Zhejiang. Throughout this year, China's Ministry of Agriculture also reported some H5N1 outbreaks.

(Snip)

Human Cases
In the last two years, two people reportedly died in China from H5N1 infection, according to Chinese authorities, who generally do not disclose the true casualty figures from disasters or epidemics.

A 39-year-old bus-driver named Chen was said to have died from multiple organ failure on Dec. 31, 2011 (Snip). Chen was said to have been the first confirmed human bird flu death in China since 2010.

Another man, also said to have been 39, was reported to have died at Guiyang Medical College Hospital in Guizhou Province on Jan. 19. He was said to have been the first 2012 case of human H5N1 infection in China, and the third in Guizhou Province.

(Snip)

According to the WHO, 60 people worldwide were confirmed positive for H5N1 avian influenza in 2011, and 33 died--a mortality rate of 55 percent. http://www.theepochtimes.com/n...

(Note: I can only imagine how many human cases there have been that we will never know about.)

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 @ Tue Sep 25, 2012 at 07:18:58 AM UTC

India: Swine flu killing doctors now (Madhya Pradesh)

Despite attempts by the state health department to downplay the incidence of swine flu in Madhya Pradesh, the high mortality rate among those afflicted by it is actually alarming. Bhopal tops the death toll with seven out of 28 patients testing positive for H1N1 virus succumbing during treatment. Indore is not far behind, where five of as many patients have died of the dreaded virus.

In fact, the incharge of swine flu cell at the directorate of health, Dr KK Thassu, issued a circular some days ago asking people not to be scared of swine flu as it is no more an epidemic but only an endemic disease which could be cured through medication. At that time, swine flu scare seemed to be receding as most of the suspected swine flu patients were testing negative and those admitted for treatment were responding well at both government and private hospitals. But in the past few days, the situation has changed dramatically.

On Saturday, nine out of 11 samples sent for confirmation of swine flu tested positive, giving a clear indication that the infection was on the rise and facilities for its treatment grossly inadequate.

Another remarkable aspect of swine flu scare this season is the fact that a number of doctors are also catching the infection. Two doctors of LBS Hospital in Bhopal tested positive for swine flu on Monday. In Jabalpur, two doctors including the dean of Netaji Subhash Chandra Bose Medical College are being treated for swine flu. Another doctor in the city, who had tested positive for the disease, has since been discharged. But to their credit, doctors in Jabalpur have not allowed any swine flu patient to die though number of persons testing positive in the confirmation test is more or less the same as Bhopal and Indore -- 26 to be precise.

In the wake of a growing number of doctors catching the infection, the directorate of health has made it mandatory for all the doctors and paramedical staff coming in direct contact with swine flu patients to get themselves vaccinated.

"We are calling it focal outbreak as the disease is prevalent more in specific pockets while not so in other areas. In Maharashtra, the situation is worse. Over 1,100 people have tested positive and 68 deaths reported due to swine flu and there it has been declared an epidemic. In MP too, the situation is worsening. Climate is also conducive for growth of H1N1 virus but to say that we are ill-prepared won't be correct. Had it been so, there would have been more patients and more casualities," Dr Thassu told. Continued:  http://www.hindustantimes.com/...

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 @ Tue Sep 25, 2012 at 07:33:43 AM UTC

This gets more and more confusing...

If they are quoting their doctors correctly:

asking people not to be scared of swine flu as it is no more an epidemic but only an endemic disease which could be cured through medication

then there is a dire need for a medical class in Flu viruses!! That's kind of scary...are the numbers in Maharashtra new? That is a lot, but if that's a large county (like, say, Texas), it might still be a small proportion.... I sure wish they could get some international doctors or researchers in there and get some solid information about this!

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by: Cathy M @ Tue Sep 25, 2012 at 14:08:55 PM UTC

[ Parent ]

It's hard to know.

From wikip

"Madhya Pradesh is the second largest state in the country by area. With over 75 million inhabitants, it is the sixth largest state in India by population.

Madhya Pradesh is home to a large tribal population, which has been largely cut-off from the mainstream development. This makes MP one of the least developed states in India."

This means that not only is there a huge population, (Texas 25 million, UK 63 million) the people are relatively isolated from international travel until recently. This might mean that they haven't the same level of exposure to flu strains as say someone from Dallas. There's also been a huge explosion in the size of the middle class. I suspect that these news stories are aimed at a group of people who can both afford medical care and have the time to worry about influenza as opposed to malaria, dengue, cholera, etc. We are also seeing English language versions of the sorts of stories that may have always been around but we didn't see them.

I have a friend who has Indian relatives and when she visits she always catches something. Her relatives are very err... frank about health matters and ask her in depth about the state of her diarrhoea. It might be a cultural thing to discuss illness, and not just her nosy and slightly mad relatives.

Maharashtra has a population of 96,752,247 which is even bigger. It is the wealthiest state in India, contributing 15% of the country's industrial output and 13.3% of its GDP.

That makes it more cosmopolitan but even more populous.

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by: UK - Bird @ Tue Sep 25, 2012 at 15:42:29 PM UTC

[ Parent ]

Are we looking at a mutation

This is worrisome:

death toll with seven out of 28 patients testing positive for H1N1 virus succumbing during treatment.

That's a CFR of 25%, isn't it?

Why should it suddenly spike so much higher in this area?

The 1917 flu pandemic started off not so bad either, then suddenly changed to a super bug. Granted it seemingly did so in the second go round rather than the third, but since pandemics don't happen that often we don't really have set parameters for their behavior, so...kinda concerned here.

Always have a plan B.

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by: maryinhawaii @ Wed Sep 26, 2012 at 00:52:43 AM UTC

[ Parent ]

Not unless those tested positive are the only cases

I seem to remember that hospital cases were expected to be about 1% of all cases in UK flu pandemic assumptions. Of course we know what they say about the word assume.

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by: UK - Bird @ Wed Sep 26, 2012 at 17:14:22 PM UTC

[ Parent ]

India: 5 more samples test positive for H1N1 (Madhya Pradesh)

BHOPAL: Swine flu cases in the city continue to rise with five more people samples testing positive for the H1N1 infection on Monday. The fresh confirmed cases have taken the number of persons testing positive to 34 in Bhopal. Of the five confirmed cases, three are from Bhopal. However, no death has been reported in the past 24 hours. With two dozen people still in critical condition in Bhopal alone, integrated disease surveillance project (IDSP) office sent 13 swab samples of suspected swine flu cases. Seven people died of swine flu in the city this year. Continued: 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 @ Tue Sep 25, 2012 at 07:50:31 AM UTC

Saudi Arabia SARS-CoV Cases Raise Concerns

Recombinomics Commentary

The HPA has compared the sequencing of the virus isolate from the 49 year old Qatari national with that of a virus sequenced previously by the Erasmus University Medical Centre, Netherlands. This latter isolate was obtained from lung tissue of a fatal case earlier this year in a 60 year-old Saudi national. This comparison indicated 99.5% identity, with one nucleotide mismatch over the regions compared.

The above comments from the Health Protection Agency in the UK describe the re-emergence of SARS (Snip). The HPA has only sequenced 200 BP, which is virtually identical to the same region for the earlier case from Saudi Arabia.  The larger sequence from the Netherlands indicates the current virus is related to bat cornonaviruses, which are the same group as the SARS-CoV which emerged in 2002.

In 2002 sequences from SARS-CoV were released almost in real time and were quickly designated as novel. (Snip)  

Media reports have already claimed that these isolates are distinct from the SARS-CoV from 2002/2003, but that distinction is far from clear because of similarities with bat CoV, which has been cited as the natural reservoir for the 2002/2003 outbreaks. 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 @ Tue Sep 25, 2012 at 08:16:04 AM UTC

Saudi Arabia SARS-CoV Closely Related To Bat Coronaviruses

Recombinomics Commentary

The virus RNA was tested also in Dr. Ron Fouchier's laboratory in the Netherlands and was confirmed to be a new member of the beta group of corononaviruses, closely related to bat coronaviruses.

The above comments from Ali Mohamed Zaki of Dr Fakeeh hospital in Jeddah, Saudi Arabia (as posted at ProMED) indicate the SARS CoV from the fatal case in Saudi Arabia is closely related to the SARS CoV that caused the SARS outbreaks in 2002 and 2003.  The more recent case (Qatar via Saudi Arabia was 99.5% identical based on a short sequence of about 200 BP, as noted by the HPA in the UK.  This second cases is in critical condition with renal failure, which was also confirmed in the index case.  Additional severe cases from the Middle East are under investigation.

(Snip)  The international spread in February, 2002 was largely linked to a physician who had been infected after treating cases in Guangdong Province.  He came to Hong Kong for a wedding and stayed in room 911 at the Metropole Hotel where he infected multiple visitors / tourists on the 9th floor, who spread the virus to Hong Kong, Singapore, Vietnam (Hanoi), and Canada (Toronto).

The link of the rapid spread outside of mainland China to a single case raises concerns that the two confirmed and multiple suspect cases linked to Saudi Arabia may represent a similar situation.  The SARS-CoV from the 2002 outbreak had been infecting patients in Guangdong Province in late 2001, but the Hong Kong physician precipitated the global expansion, raising concerns that the upcoming Hajj in Saudi Arabia may pose a significant world health risk. (Snip) 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 @ Tue Sep 25, 2012 at 08:21:46 AM UTC

[ Parent ]

Saudi Arabia SARS-CoV Case Fatality Rate Raises Concerns

Recombinomics Commentary

We are also aware of a small number of other cases of serious respiratory illness in the Middle East in the past three months, one of whom was treated in the UK but has since died.

The above comments from the UK Health Protection Agency increases concerns based on a high case fatality rate (CFR) for the novel SARS-CoV confirmed in two cases (60M and 49M).  Although the above fatal case has not been SARS-CoV confirmed, the similarity with the current case (infected in the Middle East and flown to the UK for treatment) raises concerns that the above fatal case and the current critical case may be related.

The index case (60M) showed symptoms three months ago and died in Saudi Arabia, but the critical case is much more current (developed symptoms in Qatar on September 3 after travel to Saudi Arabia) and the disease onset dates for the "other cases of serious respiratory illness in the Middle East" has not been released. However, confirmation of SARS-CoV in the above fatal case would produce a CFR of 67%, which would be a significant concern. 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 @ Tue Sep 25, 2012 at 20:27:13 PM UTC

[ Parent ]

Canada: CSHB Encourages Swine Workers to Get Flu Vaccinations

With the onset of flu-season, the Canadian Swine Health Board is recommending pork producers take steps to protect their pigs and themselves by getting seasonal flu vaccinations.

(Snip)

To encourange swine workers to be vaccinated the Canadian Swine Health Board will host a flu vaccination clinic as part of the 2012 Canadian Swine Health Forum October 17th and 18th in Winnipeg.

Dr. Dan Hurnik, the chair of the Canadian Swine Health Board's Long Term Disease Risk Management Committee and a member of the faculty of the Atlantic Veterinary College at the University of Prince Edward Island, says often people don't get vaccinated because it's inconvenient. http://www.farmscape.com/f2Sho...

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 @ Tue Sep 25, 2012 at 08:33:01 AM UTC

New Coronavirus Revives SARS Memories

A man critically ill in a British hospital has a novel coronavirus, a relative of the pathogen that caused the 2002-2003 outbreak of severe acute respiratory syndrome (SARS), according to the U.K.'s Health Protection Agency. It's the second time the virus has been found -- it was previously identified in a patient who died in Saudi Arabia 3 months ago, the agency reported.

The critically ill patient, a 49-year-old man originally from Qatar, had recently traveled to Saudi Arabia and had become ill Sept. 3. He was admitted to intensive care in Doha, Qatar, on Sept. 7 with a respiratory illness and renal failure and was subsequently airlifted to the U.K. on Sept. 11.

Sequencing suggested the viruses isolated from the two patients are 99.5% identical, with just one nucleotide mismatched over the regions that were compared (Snip).

"We appear to have two cases with coronaviruses that are clearly related, suggesting a common source," commented Donald Low, MD, of Mount Sinai Hospital in Toronto, who was one of the leaders in the battle against SARS. But it's too early to say what the impact of the novel virus will be on the public, Low told MedPage Today. He noted that the early signs of SARS were relatively innocuous. "It percolated along," Low said, with a few cases here and there. "It was only when it got into the hospital setting, where there was lack of adequate infection control, that it really started going."

But coronaviruses are RNA viruses and notoriously given to genetic variation; sometime early in the outbreak the SARS virus had a genetic change that made it more infectious -- something that investigators will keep an eye out for in the new virus. Much about the new virus remains unclear, according to the UK public health agency, including where it comes from, how widespread it is, how contagious it is, and how to treat it.

"The virus has so far only been identified in two cases of acute, serious respiratory illness who presented with fever, cough, shortness of breath, and breathing difficulties," (Snip)

"At this point it is not clear whether these cases are typical of infection with this virus or whether it could be circulating more widely, but causing a milder illness, and only very rarely causing a severe illness," the statement continued. Low said it's possible that the two cases represent the first detected signs of a wider but milder outbreak that has remained in the shadows, but that seems unlikely, given surveillance systems that are "incredibly better" than they were a decade ago.

(Snip)

Nonetheless, the findings are worrisome, especially since the annual Hajj pilgrimage to Mecca is set to begin soon and will bring millions of people to the Middle East. (Snip) http://www.medpagetoday.com/In...

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 @ Tue Sep 25, 2012 at 09:12:39 AM UTC

Canada: Ontario reports first pig-to-human H1N1 case

Toronto Star

The first case in Ontario of a human contracting the H1N1 variant influenza virus from a pig has been confirmed, the province's Chief Medical Officer said Tuesday.

"It is a first for us in Ontario," Dr. Arlene King told the Star Tuesday.

King said an adult male, who is in critical but stable condition in hospital, came down with symptoms of the influenza virus strain after close contact with pigs either in Canada or the U.S. The case was confirmed Sept. 23 after laboratory tests were conducted.

King flatly refused to say where the case was confirmed.

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by: pogge @ Tue Sep 25, 2012 at 15:54:17 PM UTC

Add'l coverage: New type of swine flu detected in Ontario, not related to U.S. outbreaks

Canadian Press via Globe and Mail:

Ontario has found a case of an infection with a new swine flu virus, in a man who had close contact with pigs.

The infection was caused by an H1N1-variant virus, which is not the swine flu virus that has been jumping from pigs to people in the United States this summer.

'Cos we just had to put Be Different at the top of our list of things to do.

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by: pogge @ Tue Sep 25, 2012 at 18:40:03 PM UTC

[ Parent ]

UK: Viral outbreak puts doctors on alert

The World Health Organization is keeping a close eye on a disease outbreak in Saudi Arabia caused by a virus in the same family as the one that caused SARS. There have been two confirmed infections with the new coronavirus and tests results are pending on a third suspected case, according to media reports from the Middle East. Two of those three people have died.

While word of a coronavirus outbreak immediately brings SARS to mind, there is too little information at this point to say whether this is anything more than a blip on the viral radar. Still, with pilgrims beginning to gather in Saudi Arabia for next month's Hajj, the public health community is on alert.

"As with any new virus, this is of concern to us and we're watching it very closely," WHO spokesperson Gregory Hartl said Sunday.

There are a large number of coronaviruses. Some infect animals, others infect birds and still others infect people. In humans, coronaviruses typically cause colds. But a coronavirus was also the cause of the 2003 outbreak of severe acute respiratory syndrome or SARS, which killed 44 people in Toronto and about 775 people worldwide.

The new coronavirus reportedly causes severe pneumonia and kidney failure.

One of the confirmed cases is in intensive care in a hospital in London, Britain's Health Protection Agency said Sunday. A statement from the WHO said the person is a 49-year-old man from Qatar who had travelled to Saudi Arabia before he became sick. He was admitted to intensive care in Doha on Sept. 7, but was transferred to Britain by air ambulance on Sept. 11.

"Given that this is a novel coronavirus, WHO is currently in the process of obtaining further information to determine the public health implications of these two confirmed cases," the WHO statement said. It did not refer to the third suspect case.

(Snip)

"Preliminary enquiries have revealed no evidence of illness in contacts of these two cases, including health-care workers," the British agency's release stated. "Based on what we know about other coronaviruses, many of these contacts will already have passed the period when they could have caught the virus from the infected person." (Snip)

the British agency's release said there have been other cases of serious respiratory illness in the Middle East over the past three months, including in another person who was treated in Britain. That person has since died, the HPA said.

"This person's illness is also being investigated although there is no evidence at present to suggest that it is caused by the same virus or linked to the other two cases. No other confirmed cases have been identified to date in the UK."

A report on the discovery of the new coronavirus appeared last week on ProMED-mail, an Internet-based system for monitoring infectious diseases around the world.

Dr. Ali Mohamed Zaki, a microbiologist from a hospital in Jeddah, revealed that a new coronavirus had been recovered from a 60-year-old man suffering from pneumonia and renal failure. Zaki said the new virus was part of a group of coronaviruses that are closely related to bat coronaviruses. Tests to confirm that the virus is indeed a newly identified one were conducted at the lab of Dutch microbiologist Ron Fouchier, a leading influenza researcher at the Erasmus Medical Centre in Rotterdam.

In an email Sunday, Fouchier said his team compared the genetic sequence of the virus they received from Zaki to that isolated from the patient in London. "The two pieces were 99.5 per cent identical. Although it thus seems that the two cases were caused by the same virus, this is still a premature conclusion," he wrote, cautioning his team had only a small sample of sequence data from the London case to compare to their virus.

(Snip)

This year's Hajj is expected to take place between Oct. 24 and 29, but according to the Saudi Arabian government's Ministry of Hajj website, the first day for pilgrims to begin to arrive in the Kingdom was Sept. 17. The annual Islamic pilgrimage draws hundreds of thousands to the Saudi city of Mecca. The Hajj is one of several large global events - the Olympics are another - that are a constant source of concern for public health officials because of their capacity to spread diseases to many parts of the globe. http://www.canada.com/Viral+ou...

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 @ Tue Sep 25, 2012 at 18:53:46 PM UTC

Please post new news stories to...

News Reports for September 26, 2012

Thank you!

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by: AlohaOR @ Wed Sep 26, 2012 at 04:19:50 AM UTC