H5N1, Bird Flu Updates

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Tracking Bird Flu Cases

Bird flu deserves its own thread for tracking suspected and confirmed cases. It's not the pandemic virus, but it is still an ongoing and significant threat because of its virulence. As Margaret Chan, the Director General of the WHO says, we do not know how H5N1 will react under pressure from the pandemic virus, H1N1. All of the countries with endemic H5N1 are also reporting cases of swine flu. As everyone should know by now, the new concern revolves around what will happen if the two viruses co-infect the same host. Flu viruses exchange genetic material with each other all of the time. Right now we have a pandemic virus that is very transmissible, but does not kill the majority of people infected. Bird flu, on the other hand has a case fatality ratio (CFR) of around 60%.

In the past year, something different began to happen in Egypt. We started seeing many cases of young toddlers infected with mild cases of bird flu there. But, we also saw some older children and adults that had fatal cases. No one has yet explained why the disease began to change in Egypt. Just prior to the beginning of the swine flu cases appearing in the US and Mexico, the WHO was going to send in a team to Egypt to investigate why this was so. And, then the swine flu pandemic began in earnest, leaving this question unanswered. Why this situation has changed in Egypt but not in Indonesia, is most likely very important information.

Egypt continues to try to isolate swine flu cases. At some point, they won't be able to contain that virus, and will have to bow to the inevitable. Nobody knows what will happen then, but the Egyptians are clearly concerned. Remember, this is the country that slaughtered its entire pig population a few months ago to international dismay. Maybe they were right to do so, as we are now finding swine flu in pigs in Canada, Argentina and Australia. Pigs, the perfect mixing vessels for influenzas, may have been harboring the current swine flu for years undetected because they are almost never tested in most countries unless they are sick. This lack of disease surveillance is now being compensated for by a heightened awareness and increased testing of pig herds in many countries.

With all of that being said, here is a translation regarding a new case of bird flu, H5N1 in another child in Egypt. They do not state the child's age in this article, and some translations are saying that this is a male child. They would have isolated her anyway with bird flu, but with swine flu also in Egypt, they are likely to be very worried. Descriptions of these cases almost always mention dead birds being found in the same location. That of course, is going to be helpful in determing which flu they are dealing with at least for now, but maybe not later...

Egypt - Case #82

http://www.flutrackers.com/forum/showpost.php?p=272110&postcount=1

D. Abdel-Rahman Shahin, official spokesman of the Ministry of Health

The Ministry of Health on Sunday, a new human case of bird flu, a girl from a province of Kafr el-Sheikh for a total of 82 case of injuries so far.

A statement by the Ministry of Health said on Sunday that the new situation of the girl child is Muhammad Mustafa Ahmed Rania from the village of "Sidi Ghazi," the Department of Kafr El-Sheikh governorate of Kafr el-Sheikh.

The statement pointed out that the disease developed symptoms on July 24 of this hospital was incorporated in fevers of Kafr el-Sheikh on July 25 with a high temperature, running nose and cough after exposure to dead household birds, suspected of being infected with bird flu.

He also pointed out that the statement was given the drug "Tamiflu" as soon as the suspicion of being infected with the disease and her condition is stable and satisfactory communications are being carried out and procedures for the transfer to the hospital in the capital Cairo for the completion of treatment.

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Sittwe, Burma

http://www.narinjara.com/details.asp?id=2866

Sittwe: Over 1,000 chickens have been culled in Sittwe Township in Arakan State after a tough strain of H5N1 virus was detected at a poultry farm, officials and a witness report.

A witness said, "Many chickens from around ten poultry farms in Tae Chaung Village were culled on Monday. The culling was conducted by the health department. I'd guess over 1,000 chickens were killed by the authority."

The authority has culled chickens from many poultry farms in Bumay Village Tract that are located around one kilometer from the original affected farm.

(hat tip crofsblog)

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South Korea

http://www.arirang.co.kr/News/News_View.asp?nseq=111375&code=Ne2&category=2

A state of emergency has been declared on Tuesday here in Korea as bird flu continues to spread.

According to the agriculture ministry, the flu is spreading rapidly throughout South Jeolla and Gyeonggi provinces.

As preventive measures, chicken and ducks within a three-kilometer radius of the affected farms will be put down, and sales of these animals will be banned in traditional markets starting Thursday until the 27th of this month.

http://arkanoidlegent.blogspot.com/2011/01/south-korea-reports-23-new-bird-flu.html

There were 23 new outbreaks of H5N1 highly pathogenic avian influenza (HPAI), across the western side of the country, particularly in the far south-west.

The authorities sent Follow Up Report No. 4 dated 17 January to the World Organisation for Animal Health (OIE).

All outbreaks reported were on farms and started between 6 and 13 January. Most were on ducks farms in the regions of Jeollabuk-do (North Jeolla), Chungcheongnam-do (South Chungcheong) and Gyeonggi-do."

(both links courtesy of crofsblog)

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Lampung, and West Java, Indonesia

http://birdflucorner.wordpress.com/2011/01/17/lampung-and-west-java-bird-flu-endemic-in-birds/

Kalianda - Desa (village) Sidomakmur, Kecamatan (sub-district) Way Panji in Lampung Province stated as bird flu endemic area after 17 chickens and 4 swans had suddenly died. Confirmation was done through rapid test by Livestock Service.

Indramayu - Livestock Service (Distankan) stated fifty percent of Kabupaten Indramayu, West Java province, as bird flu endemic area.

The disease is feared to spread among birds during rainy season. According to 2011 data of Distankan Kabupaten Indramayu, of 31 sub-districts, 18 are bird flu endemic. The endemic status was made based on the bird death data.

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http://crofsblogs.typepad.com/h5n1/2011/01/korea-quarantine-officials-mentally-traumatized.html

As I read this, I was remembering that every living pig was culled in Egypt because of swine flu, and milions of birds have been exterminated because of bird flu in the affected areas

The Koreans have been especially thorough in culling all living animals whenever H5N1, avian influenza hit regions of their country. It does not surprise me that the cullers would suffer emotional trauma from mass extermination of animals and birds. It must be truly terrible to be involved in so much killing, and to bury these animals alive...Is it possible to kill thousands of animals in a humane way?

Via The Korea Times, a disturbing report: Quarantine officials mentally traumatized. While the story deals with culling pigs and cattle, I suspect the same effects are experienced by those destroying poultry in Korea's latest B2B H5N1 outbreak: Excerpt:

Nearly 70 percent of government officials, who participated in the slaughter or the live burial of animals on farms infected with foot-and-mouth disease (FMD), are suffering severe mental trauma, a survey showed Friday.

The results came amid soaring criticism that quarantine officials have buried hundreds of thousands of cows and pigs alive. The authorities explained the inhumane action was inevitable with the spread of the disease outpacing the authorities’ slaughter capacity before a proper burial.

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Japan Escalates Bird Flu Battle

We are talking millions of birds at risk. Such an incredible waste if they must be destroyed...

http://afludiary.blogspot.com/2011/01/japan-escalates-bird-flu-battle.html

After the discovery of H5N1 at a second Miyazaki Prefecture poultry farm over the weekend (see sidebar news item), the decision has been made to cull another 400,000 birds in a bid to contain the virus.

The number of chickens within these quarantine zones varies depending upon the news source. Estimates run anywhere from 1.5 million to 4 million birds.

As Japan battles this latest outbreak, the Hong Kong government has announced the immediate suspension of the processing of applications for the import of poultry and poultry products from Japan.

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EID Journal: H5N1 Branching Out

http://afludiary.blogspot.com/2011/01/eid-journal-h5n1-branching-out.html

In the relatively short history of the H5N1 bird flu virus, the huge bird die off in 2005 at Qinghai lake was a watershed moment. Up until then, the H5N1 virus had been pretty much limited to southeast Asia; Hong Kong, Vietnam, Thailand, Laos, and China.

But suddenly, and unexpectedly, we learned that waterfowl (brown headed gulls, cormorants, ducks, geese, etc.) – species that normally carry avian flu viruses with little ill effect – had died by the thousands at Qinghai lake.

Something had obviously changed with the virus.

And over the next 18 months, this new clade managed to spread widely – likely on the wings of migratory birds - across Asia, and into Europe and Africa.

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Experts warn avian flu could persist in Japan

http://www.asahi.com/english/TKY201101270244.html

Actually, I don't know why they seemed surprised by the possibility of birds flying south to Japan.

This is the 5th outbreak in two months, and 150,000 birds will be culled.

So far, highly pathogenic viruses were believed to be brought to Japan by migratory birds arriving in early spring from Southeast Asia, where bird flu is widespread.

But after a highly pathogenic H5N1 strain, closely connected to one found in Mongolia, was detected in wild duck droppings in Hokkaido last October, experts started to suspect northern routes of infection.

"There is a possibility that migratory birds infected in Russia and elsewhere are flying south (to Japan)," said Koichi Otsuki, an avian flu expert at Kyoto Sangyo University.

(hat tip CIDRAP)

The Bird Flu Situation in Egypt

For those of you who are not aware the Egyptian Government cut off all internet access into and out of Egypt because of the civil unrest two days ago (link). This means that there are no news reports on suspected bird flu cases nor is the official Egypt Ministry of Health site on line. see http://www.mohp.gov.eg/

The 122nd human case of bird flu in Egypt was reported on January 26 (link). Egypt now only lags Indonesia in the number of human infections among all of the world's countries. Right now we are in the middle of "bird flu" season in Egypt.

The lack of timely health information and information on bird flu infections from Egypt is a grave public concern for people all over the world.

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H5N1 S227R In 2011 Whooper Swan In Hokkaido Japan

http://www.recombinomics.com/News/02031101/H5N1_S227R_Japan.html

Some acquisitions of H5N1 increase concerns about the possibility of transmission of the virus to humans in Japan, but given the severity of the culling in both Japan and Korea, I am thinking this will not go anywhere though we could see some cullers have positive cultures. It is also likely that they would be be protected with prophylactic Tamiflu. I don't think that they would allow any chance of human to human spread.

With that said, if the environment, (such as the water) is contaminated in the areas where wild birds are bringing the virus in, what can they do about that?

A 2011 H5N1 sequence, A/whooper swan/Hokkaido/4/2011, has been released by Hokkaido University at Genbank. The sequence is clade 2.3.2, as expected, but it has the receptor binding domain change S227R.

In 2005, the acquisition of S227N by clade 2.2 was predicted, based recombination between donor sequences in H9N2 in the Middle East and Qinghai H5N1. The ability of H5N1 with S227N to bind to human receptors led to the prediction of human cases in the Middle East, which was confirmed in the sequence from the index cases in Turkey in 2006. S227N was in two of the four human sequences in Turkey and appeared in subsequent human H5N1 sequences in Egypt.

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Japan: Fifth Prefecture Hit with Bird Flu

http://afludiary.blogspot.com/2011/02/japan-5th-prefecture-hit-with-bird-flu.html

The spread of the H5N1 avian flu virus among poultry in Japan continues, with chickens testing positive yesterday in a fifth prefecture - Oita - for the virus.

Reportedly 8,100 chickens have been culled and access and movement of poultry is restricted within a 10-kilometer radius of the infected farm.

WHO confirms 122nd avian influenza case in Egypt

The Ministry of Health of Egypt has announced a case of human infection with avian influenza A(H5N1) virus. A 7 year-old male from Gharbia Governorate, developed symptoms on 20 January and was hospitalized on 20 January. He is in a stable condition.
http://www.who.int/csr/don/2011_02_02/en/index.html
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Bangladesh

http://www.bdnews24.com/details.php?id=186363&cid=2

Some 8,000 chickens of a poultry farm, infected with the H5N1 virus, in Kishoreganj have been culled.

The culled chickens, from Mozammel Haque's poultry farm at Bagadia village of Sadar Upazila, were buried on Thursday noon under the supervision of the district livestock department.

(hat tip crofsblog)

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