Saturday, April 17, 2010

Egypt: Injuring a child 7 years of swine flu in Alexandria

Dubai Chamber of follow-up to the swine flu in Alexandria, the emergence of new cases of the disease, which is a child at the age of 7 years, and gum area resident district customs, where it was converted to the fever hospital for treatment.

Egypt: International mission down the government's plan to control the spread of avian influenza

April 17, 2010 14:6

Eng Maged George, Minister of Environment, that the mission of international joint regional office of the United Nations Coordinator for Avian and the Office of the Resident Coordinator of the United Nations in Cairo, will review and evaluate the activities of the Egyptian government in controlling the spread of flu patients «birds and pigs», and to identify areas that need to be development, the minister pointed out that the mission includes a multidisciplinary team from the Food and Agriculture Organization of the United Nations «FAO» and the Organization of the United Nations Children's Fund «UNICEF» The World Health Organization.

He said «George» The Mission reached a number of key actions on four levels, namely administrative structure, strategy and implementation, monitoring and analysis, and these procedures involve producers in the decision-making processes, making it easier to comply with measures to control the disease, and control risks in the poultry house and bird markets living, as well as to update the strategic plans, preparation of a new national plan to control the gradual bird flu in poultry, and to ensure early detection of mutations.

Also reviewed the «George» during his third meeting of the National Committee to combat bird flu, the presence of ministers of agriculture, health, local development and governors of the Greater Cairo, Menoufiya and Western and Qalyubia, Beni Suef and Dakahlia, Fayoum and East, the most important actions taken by the Ministry of Health, and review the national strategy for fight against bird flu, as well as to assess the epidemic situation of avian flu on governorates.

Source: Al Masry Al Youm
Important Disclaimer: -snip-

Friday, April 16, 2010

Lung virus taking its toll on young lives, study finds

15-Apr-2010

A common virus that causes wheezing and pneumonia claims the lives of up to two hundred thousand children worldwide each year, a study has found.

The research, conducted by the University of Edinburgh, also showed that about 3.4 million children require hospital treatment for severe lung infection caused by the bug – respiratory syncytial virus (RSV).

RSV – which infects most children before the age of two – usually causes mild cold-like symptoms, but can lead to serious illness in babies who are born prematurely or who have congenital heart disease.

The study, published in the Lancet journal, confirms that RSV is the single largest cause of lung infection in children. It is the first time that the numbers of children dying globally from RSV before the age of five has been quantified.

The international team analysed unpublished data from developing countries as well as all the published medical research on RSV infection. They found that about 33.8m children become infected with RSV each year and that 99 per cent of RSV-related deaths occur in developing countries.

The team hopes that by identifying the numbers affected by the virus, they may contribute to the development of a vaccine against the infection.

Dr Harish Nair, of the University of Edinburgh's Department of Population Health Studies, said: "Our greatest hope of fighting this virus is to develop a vaccine, but before we can implement an immunisation programme, we need to understand exactly how big a problem RSV poses.

"This is the first time we have gathered information on such a global scale and is the best estimate we have for the number of children dying each year from this preventable illness."

###

For further information, please contact: Anna Borthwick, Press and PR Office, tel 0131 651 4400; email anna.borthwick@ed.ac.uk

Roundup: H1N1, One Year Later

April 13, 2010

Today is the first anniversary of the first known H1N1 death -- that of a government worker in Oaxaca, Mexico -- and there is no shortage of reflection on how the pandemic was addressed.

The Center for Infectious Disease Research and Policy reports, “A committee of experts appointed by the World Health Organization (WHO) convened today to begin evaluating the agency’s and the world’s response to the H1N1 influenza pandemic, with WHO Director-General Margaret Chan urging the group to pull no punches.”

One expert already pulling no punches is Dr. Richard P. Wenzel, professor of internal medicine and a specialist in infectious diseases at Virginia Commonwealth University. Dr. Wenzel writes in today’s New York Times, “While the epidemic never became as deadly as we initially feared, it was not as mild as some experts now believe. What’s more, it exposed some serious shortcomings in the world’s public health response.”

Dr. Wenzel explains that the belief that the H1N1 flu was mild is based on the mortality rate in the U.S. as compared to that of previous seasonal flu viruses,” says ACSH’s Dr. Gilbert Ross. “He argues that statistics from underdeveloped countries were poorly collected, and that the virus may have been much more devastating than is now assumed. This is especially tragic because many of these countries did not have access to the vaccine despite huge surpluses in the U.S. and Europe.”

Experts meeting at the European Congress of Clinical Microbiology and Infectious Diseases are looking ahead. According to AFP:

[University of Rotterdam virologist Albert Osterhaus of the Netherlands] said he was concerned that since the H1N1/A virus, or swine flu, epidemic has somewhat subsided, countries might let down their guard against spreading viruses. “My worry is that we have become a little complacent because of this so-called ‘wimpy’ flu, that we start to forget about the H5N1,” referring to the often more dangerous bird flu virus.

“The AFP cites the WHO figure for worldwide deaths from H1N1 since its outbreak in April 2009 as 16,813,” says ACSH’s Dr. Elizabeth Whelan. “We find that much too low. There were 12,000 deaths in the U.S. alone, and it’s hard to reconcile this data with the analysis of Dr. Wenzel about the virus’ toll on underdeveloped countries.”

“This is a time when everyone is positioning themselves for how we tackle the next pandemic,” says ACSH’s Jeff Stier. “Experts all over the world are talking about what happened and what we should do differently with the next years’ flu viruses. On one hand, we have people saying that it was devastating and the reaction in terms of procuring vaccine was appropriate. On the other hand, there are experts like ACSH Trustee Dr. Henry Miller, who says that the reaction was inefficient and overblown. The first draft of the history of H1N1 is being written.”

Avian Influenza Still Threatens, Warns FAO

Although concerted international action has successfully eliminated the deadly H5N1 avian influenza virus from poultry in almost all the 63 countries it infected at the peak of the world outbreak in 2006, it persists in five nations and thus poses a continuing threat to global animal and human health.

Speaking before the opening of an International Ministerial Conference on Animal and Pandemic Influenza in Hanoi, Viet Nam, on 19 April, FAO's Chief Veterinary Officer, Dr Juan Lubroth, said that despite the considerable success achieved against H5N1 it was entrenched in Egypt, Indonesia, Bangladesh, Vietnam and China.

He said: "The progressive control of H5N1 in such countries remains an international priority. Though public attention shifted to the H1N1 influenza pandemic for most of 2009, H5N1 continues to be a serious menace."

US$20 billion damage

Dr Lubroth continued: "We should not forget that it has killed 292 humans, killed or forced the culling of more than 260 million birds, caused an estimated US$20 billion of economic damage across the globe and devastated livelihoods at the family-farm level. As long as it is present in even one country, there is still a public health risk to be taken seriously."

The H5N1 strain of avian influenza remains established in places where tens of millions of free-ranging domestic ducks are present, significant industrial broiler production exists together with live bird markets, and where human and animal densities are high. "Where those circumstances are present finding effective solutions remains a major challenge," Dr Lubroth said.

He noted that the very process of economic and population growth, including intensified agricultural production, fostered the emergence of new infectious diseases as ever larger numbers of animals and humans occupied delicate ecosystems.

Humans at risk

Dr Lubroth said: "It is clear that humans will continue to become exposed to a variety of influenza viruses originating in animals, and even if the severity and magnitude of resulting outbreaks remains unpredictable we know that pressures are building."

FAO, WHO and the Paris-based World Organization for Animal Health (OIE), who led international efforts against H5N1, should take a leading role in finding a definitive solution to the problem. At the same time, the three agencies should also collaborate to strengthen international defences against emerging infectious diseases, Dr Lubroth added.

The Hanoi ministerial conference is intended to marshal international cooperation against future infectious diseases drawing on experience gained in responses to pandemic A/H1N1 influenza and H5N1 avian influenza.

Crisis-hopping

Dr Lubroth concluded: "We must stop hopping from one crisis situation to the next. We have to do a better job of forecasting and monitoring the drivers that promote the emergence and spread of diseases, and institute improved risk management.

"We must be able to tackle problems at source before they become regional, continental or global threats."

As well as discussing the H1N1 pandemic and H5N1, the Hanoi conference will seek to advance the UN-led 'One World, One Health' Strategic Framework for reducing the risks of emerging infectious diseases.

Bird flu: Deadly threat 'persists in five countries'

Rome, 16 April (AKI) – The deadly H5N1 avian flu virus has been eradicated in almost all the 63 countries it infected at the peak of the world outbreak in 2006, but persists in five countries and poses a continuing threat to global animal and human health.

The United Nations' Food and Agriculture Organisation's chief veterinary officer, Juan Lubroth said despite the considerable success achieved against H5N1 bird flu virus, it remained in Egypt, Indonesia, Bangladesh, Vietnam and China.

The progressive control of H5N1 in such countries remains an international priority,Lubroth said.

Though public attention shifted to the H1N1 influenza pandemic for most of 2009, H5N1 continues to be a serious menace.

He was speaking ahead of an international conference on animal and pandemic influenza to be held in Vietnam on Monday.

We should not forget that it has killed 292 humans, killed or forced the culling of more than 260 million birds, caused an estimated 20 billion dollars of economic damage across the globe and devastated livelihoods at the family-farm level," he said in a statement.

"As long as it is present in even one country, there is still a public health risk to be taken seriously.”

The H5N1 strain of avian influenza remains established in places where tens of millions of domestic ducks are found and there is significant industrial broiler production.

The H5N1 virus was first shown to have passed from birds to humans in 1997, during an outbreak of avian influenza among poultry in Hong Kong.

More than 90 per cent of birds who get H5N1 die, and mortality among humans is also high.

Isolation and characterization of highly pathogenic avian influenza virus subtype H5N1 from donkeys

Submission date 2 February 2010
Publication date 14 April 2010
1 Department of Virology, Faculty of Veterinary Medicine, Beni-Suef University, Beni-
Suef 62511 Egypt
2 Division of Virology, Department of Microbiology, College of Medicine and Medical
Sciences, Taif University, Al-Taif, Saudi Arabia
3 Department of Hygiene, Management & Zoonoses, Faculty of Veterinary Medicine,
Beni-Suef University, Beni-Suef 62511 Egypt
4 Department of Poultry Diseases, Faculty of Veterinary Medicine, Beni-Suef
University, Beni-Suef 62511 Egypt


Abstract
BACKGROUND: The highly pathogenic H5N1 is a major avian pathogen that crosses species barriers and seriously affects humans as well as some mammals. It mutates in an intensified manner and is considered a potential candidate for the possible next pandemic with all the catastrophic consequences.
METHODS: Nasal swabs were collected from donkeys suffered from respiratory distress. The virus was isolated from the pooled nasal swabs in specific pathogen free embryonated chicken eggs (SPF-ECE). Reverse transcriptase polymerase chain reaction (RT-PCR) and sequencing of both haemagglutingin and neuraminidase were performed. H5 seroconversion was screened using haemagglutination inhibition (HI) assay on 105 donkey serum samples.
RESULTS: We demonstrated that H5N1 jumped from poultry to another mammalian host; donkeys. Phylogenetic analysis showed that the virus clustered within the lineage of H5N1 from Egypt, closely related to 2009 isolates. It harboured few genetic changes compared to the closely related viruses from avian and humans. The neuraminidase lacks oseltamivir resistant mutations. Interestingly, HI screening for antibodies to H5 haemagglutinins in donkeys revealed high exposure rate.
CONCLUSIONS: These findings extend the host range of the H5N1 influenza virus, possess implications for influenza virus epidemiology and highlight the need for the systematic surveillance of H5N1 in animals in the vicinity of backyard poultry units especially in endemic areas.

Excerpts:
pg. 5/21:
Methods
Virus isolation
Nasal swabs were collected from three infected animals from Aborady village, El-Wasta locality, Beni-Suef Governorate.

pg. 8/21:
The disease recoded on 24th March 2009, 1wk after an outbreak of
H5N1 infection in poultry in the village, where many donkeys suffered from the same
clinical manifestations in an epidemic manner. The virus was isolated from a pool of
nasal discharge from three affected animals.

pg. 8/21:
The haemagglutinin gene was found to be closely related to
A/chicken/Egypt/0894-NLQP/2008, A/Egypt/N00605/2009 and
A/chicken/Egypt/092-NLQP/2009 while the neuraminidase gene of the current
strain is closely related to A/Egypt/N03450/2009 and A/Egypt/N05056/2009.
However, none of these strains were isolated from localities near to Beni-Suef.

pg. 10/21:
Conclusion
We did note the incidence of clinical infections of donkeys with HPAIV (H5N1) in
disease endemic regions where the probability of intimate contact between poultry
and donkeys is high. Furthermore, H5 seroconversion by naturally exposed donkeys
was evidenced. Although the disease did not constitute a real threat to donkeys, it
raises the concern of different issues including the route of transmission to donkeys,
whether being from aerosol exposure of pulverized infected birds droppings or
contaminated feeds and water or because of contact with infected birds. Second, the
role of donkeys in spreading H5N1 virus to birds, humans other mammals includingequines needs to be assessed.

New UN And World Bank Report Urges Sustained Momentum To Tackle Human, Animal Influenza Traits

Source: United Nations
Published Friday, 16 April, 2010 - 10:29

While there has been substantial global progress towards pandemic preparedness in recent years, it is vital to maintain that momentum to respond effectively to existing and possible future threats, according to a new study by the United Nations and the World Bank.

Continued global vigilance for infectious disease outbreaks and pandemics is of critical importance for health security and well-being,” says the report, entitled “Animal and pandemic influenza: a framework for sustaining momentum.”

The report notes that an estimated 75 per cent of new human diseases originate in animals and an average of two new animal diseases with cross-over capabilities emerge every year.

The emergence of three major epidemiological events into the first decade of the new century – SARS, H5N1 avian influenza and H1N1 pandemic influenza – is an indication of the rate at which threats may continue to arise, it adds.

Sustaining momentum,” states the report, “will require a strategic use of resources and a move away from emergency response-driven projects and special, single-focus initiatives, to long-term capacity-building.”

The report will be taken up by delegates from over 80 countries when they meet at the International Ministerial Conference on Animal and Pandemic Influenza, which will be held in Hanoi, Viet Nam, from 20 to 21 April.

This is a really significant conference,” David Nabarro, Senior UN System Influenza Coordinator, told reporters in New York, noting that the gathering will take stock of where the world is with regard to bird flu and the H1N1 virus, review preparedness and consider lessons learned from countries with successful control efforts.

The threats from bird flu and H1N1 are not over yet, he noted, stressing the need for further measures to ensure an effective global response.

We have to find ways to put the work on bird flu and on pandemics more into the routine business of ministries of health and ministries of agriculture, into the routine work of disaster preparedness units in countries,” he stated. “And so an important element of the discussions in Hanoi will be the way forward.

Part of the work in Hanoi, he added, will be to consider whether or not extra preparedness is necessary to ensure that those who look after animal health and those that look after human health are working together well enough to prepare for disease threats that come from animals.

A key question, he noted, is: “Are we well enough organized as a world to be prepared for diseases that can jump from the animal kingdom and lead to sickness and possibly quite widespread suffering among humans?”

Thursday, April 15, 2010

Vietnam: Bac Kan Case Summary

[I was out of town from 4/9 - 4/13. This is the summary I have put together after piecing information together.]

Bac Kan Province

Trung Van Hoa (22) – Confirmed Case #6 – Index Case

From: Na Cao Hamlet, Nhu Co Commune, Cho Moi District

3/27 – began fever, cough

3/30 – Adm. Cho Moi district hospital, X-ray shows normal lungs

Next 3 days, new symptoms of difficulty breathing, X-ray shows both lungs with lesions

4/2 – Transferred to Bac Kan Provincial Hospital. Symptoms progress to respiratory failure. X-ray shows widespread damage to both lungs. Samples taken @ 21 hours on 4/2, sample shows confirmed H5N1.

4/3 – Dept. of Health directs coordination with DPC to all organizations.

4/4 – National Inst. Of Hygiene & Epidemiology sends missions to support Bac Kan flu A (H5N1). From investigation finds people’s awareness of H5N1 is very low, (eat sick poultry, don’t report sick/dead birds, throws poultry in river/streams. Initiative in prevention of H5N1 on local level is not high.

Directive for districts according to Decision No. 1812: Upon death, cremation.

Notes:

4/5/10:

4 other people in Nhu Co Commune show simlar symptoms. Under quarantine and treated at Bac Kan provincial hospital, in stable condition. The 22 yo is in critical condition. Index Case: history of eating sick chickens.

4/9/10:

Nguyen Thi Thanh Thu (27 mos old) – confirmed Case #7

Adm: 4/4 Cho Moi District Medical Ctr.–

Onset: 4/2 -

From: Na Cao

Confirmation: 4/7

Notes: 2nd and 3rd test came back negative. [http://tinyurl.com/yyerexm http://tinyurl.com/y6g4e5y]

General Notes:

4/11:

21 Cases taking Tamiflu.

- 14 cases are stable health

- 7 admitted to the District Health Center, fever cough, diarrhea

- 5 other family members hospitalized w/cough, fever, trouble breathing.

- All 6 had contact with Index Case or contact w/sick poultry (consumed).

- Total 8 cases of cough fever, difficulty breathing – suspected H5N1. Discharged from hospital 4/13. Awaiting test results. Tests are negative.

District has been given 700 doses of Tamiflu, protection equipment, & medical supplies.

1,000 poultry and aquatic birds destroyed in Tong Co village, Yen Dinh. Tests confirmed positive for H5N1.

3 checkpoints set up, preventing movement of poultry vehicles, spraying vehicles.

4/15:

33 people (visitors, neighbors, nurses, physicians, relatives) tested and results are negative. (throat swabs). They were monitored for over 16 days.

Wednesday, April 14, 2010

Swallow bird flu deaths in Vietnam

CetakEmail
Updated April 15, 2010 10:27:40


Vietnamese authorities say two people died in the region north of the country after H5N1 bird flu virus.

They're doing tests on 11 other people who came in a state of fever to determine whether they are infected.

They were all local residents in the same community in the province of Bac Kan.

Areas of the diseased area is very worrying because it means the virus, H5N1, in this case, was able to spread among humans.

But a health official said there was no evidence to conclude the occurrence of infection from human-to-human.

Local media reports said the dead birds have been seen in the township and the patient may have had contact with sick poultry.

Infectious diseases and diseases with increased seasonal traffic

(According to Security Capital)

(ANTD) - Nearly half of this month, the dangerous diseases are very complex evolution. H1N1 influenza, dengue fever has spread, cholera and influenza A/H5N1 in humans have returned, while some diseases are also increasing transfer season.


Patients with respiratory diseases, viral fever increases due to weather

Not appear cluster cases

From 5 to 8-4, Bac Kan Province Health Department has confirmed two patients in rural Cao Na (As can commune, Cho Moi) infected with influenza A/H5N1 in a critical condition.
House of 2 patients only about 100m apart.

The recognition of two patients suffering from the same village influenza A/H5N1 outbreaks signal a cluster cases, more dangerous, it also warned of the spread from human to human influenza A/H5N1. Dr. Tran Nhu Duong - Deputy Director of the Institute of Hygiene and Epidemiology, said the Institute has appointed two working groups to epidemiological investigation in this village.
Results showed that the two patients are exposed to infected poultry, but had no previous contact with each other.

From early April until now in Ho Chi Minh City recorded four consecutive cases of cholera. In the north, the Hanoi Bac Ninh turn also recorded cholera patients. Dr. Nguyen Huy Nga - Department of Preventive Medicine that the risk of cholera outbreaks in the future are great.

In addition, other localities are still scattered all recorded cases of dengue fever (SXH). From the beginning of the year, Hanoi alone has recorded over 130 cases SXH, up significantly from last year ...

Fortunately, the time of this outbreak have all been controlled in time, the beam is not recorded cases of cholera, influenza A/H5N1, SXH. However, because of weather changes, and in many places still exist cholera bacteria in the environment so that experts fear in summer outbreak could be more dangerous diseases.

Fever virus increased due to weather

Dr. Tran Nhu Duong said, usually fever virus increases in winter-spring, but this weather in the north very high humidity, sunshine again after a few consecutive days of rain appeared to create very favorable conditions for virus growth. Thus, recently in the North, the disease transmitted by respiratory viruses are increasing, including fever virus in both adults and children.

Epidemic spread through the powerful working environment, as crowded schools, offices ... Patients usually have fever virus merely expressed through symptoms such as fever, headache, fatigue, usually after 3-5 days will go away. Patients with viral fever accompanied by other symptoms such as cough, Libya ... symptoms must be treated because there is no specific treatment for viral fever.

To proactively prevent dangerous infectious diseases in general, infectious diseases in the time of season in particular, the Department of Preventive Medicine and Environmental strongly recommends people make personal hygiene, environmental sanitation, Wash hands with soap before eating and after using the toilet;

Ensure food safety, implementation of drinking boiled cooked, use clean water to prevent infectious diseases through the gastrointestinal tract, especially the prevention of cholera; In epidemic areas, the family should not eat large organizations People ...

Hot weather, risk of cholera outbreak

15/04/2010 06:39

(
(HNM) - Afternoon 14-4, the Steering Committee for prevention and, meeting at the Ministry of Health. Dr. Tran Nhu Duong, Deputy Director of Institute of Hygiene and Epidemiology INVESTMENT, said last week, the discovery of two patients infected with influenza A/H5N1 house only 100 meters apart along rural Cao Na (As can commune, Cho Moi district, Bac Kan province) in a critical condition has led epidemiologists suspected influenza A/H5N1 spread from person to person
. But the results of epidemiological investigation showed that these two patients with a history of contact with infected birds and had never met before.

At present, although four new localities recorded cholera patients but the medical experts identified the risk of an outbreak of cholera to the big time. The cause is translated by the unusually hot weather in the South in those days was favorable conditions for developing cholera. Heat leads to lack of clean water supplies have caused many people do not use water hygiene, the risk of cholera rise. Plus, the food in hot and humid conditions are not good storage has harmful bacteria, especially cholera bacteria arise. Thus, Nguyen Huy Nga, director of the Department of Preventive Medicine and Environment recommends people make so strictly cooked diet, drink boiled, minimize food sidewalks, no street maintenance hygiene, environmental sanitation, personal cleanliness, hand washing habits created with soap before eating and after using the toilet
Thursday, 15/04/2010, 07:43


TP - Yesterday afternoon, at a meeting National Steering Committee against pandemic influenza in humans, Dr.. Tran Nhu Duong - Deputy Director of Central Hygiene and Epidemiology confirmed, influenza A/H5N1 has not spread from person to person.

Through investigation of the Institute on two cases of influenza A/H5N1 has been recorded in Na Tao village, As can commune, Cho Moi, Bac Kan province, has not detected the infection from person to person.

Report of two working groups in Bac Kan Institute showed that two patients at about 100 meters apart but there is no direct contact with each other.

Currently 33 people, including relatives, visitors, neighbors, nurses, physicians have contact with patients are taking swabs Throat swabs tested and monitored over 16 days, no case is the expression of disease, the test results were negative.
Avian flu in 2 patients, 11 were blood tests
Wednesday, April 14, 2010
HANOI (TH) - Two people in northern Vietnam have bird flu caused by H5N1 virus, and health authorities say 11 people are another blood test for infection if they have malignant disease or not.

These patients are said to hospital with high fever, usually a sign of very sick people and all cases of avian influenza.






A woman sitting in front of caged chickens, she sold the roadside in the suburbs of Hanoi.
Information for H5N1 avian influenza has infected two people in Vietnam.
(Image: Hoang Dinh Nam / AFP / Getty Images)



According to health authorities, two people were confirmed bird flu as a man and a 22-year-old girl just 27 months. All of these persons live in Bac Kan province.

"All patients have been isolated and the experiment was conducted to find the cause of the disease." Liu Xuan Hoa, director of the Medical Center of Cho Moi in Bac Kan said, "This child girl infected with bird flu in a village with a man ill be testing confirmed the H5N1 virus. "

According to local sources, four of whom were hospital patients.

Bird flu casualty rate to 60% if not treated early and properly. Viral disease also spreads easily from birds to humans through contact or air.

The press in Vietnam for bird deaths in villages that have seen and some patients may have eaten infected poultry or contact with infected poultry. This question leads to the two people being tested and identified H5N1 infection have the same infectious source.

"We do not have evidence to conclude this is a case of infection from person to person." Mr. Hoa said.

Since early this year had two cases where patients died of bird flu in Vietnam, a woman who is 38 years old, the other is a 3-year-old girl. H5N1 virus spreads easily to other poultry or birds or ducks and geese. Very few people infected.

From 2003 to now, the world had 493 people infected with 292 deaths or 60%. Vietnam has officially announced 59 people dead. Most victims have direct contact with sick poultry.

Millions of poultry types of service in Vietnam have died or been culled since the H5N1 virus.

AVIAN INFLUENZA, HUMAN (30): VIET NAM (BAC KAN), CLUSTER SUSPECTED


[1]
Date: Wed 14 Apr 2010
Source: Reuters AlertNet [edited]
<http://www.alertnet.org/thenews/newsdesk/TOE63D045.htm>


Two people in northern Viet Nam have been infected with the H5N1 bird
flu virus [avian influenza A(H5N1) virus], and health authorities are
carrying out tests to see if 11 others who have come down with fever
have been infected. The 2 who tested positive -- a 22-year-old man
and a 27-month-old baby girl -- as well as the 11 suspected cases are
all residents in the same commune in Bac Kan province [see also:
Avian influenza, human (29): Viet Nam (BK), cluster, susp. 20100412.1188].

"All the patients have been isolated, and tests were taken to verify
the reason of their sickness," said Deputy Director Luu Xuan Hoa of
the Cho Moi Medical Centre in Bac Kan province. "She (the baby) is a
neighbour of the 1st man who has tested positive for the H5N1 virus,
while others live in the same hamlet," he said. Four people on the
suspect list have been discharged.

Disease clusters are a special concern because it may mean the agent
in this case, the avian influenza A(H5N1) virus, which kills up to 60
percent of those it infects, is gaining the ability to jump from
person to person. Vietnamese media, however, reported that dead
poultry had been seen in the village and that the patients had either
eaten or come in contact with sick birds. This opens the possibility
that the 2 patients may have been infected by the same source. "We
have no evidence to conclude that there is a human-to-human
infection," Hoa said. Viet Nam had 2 bird flu deaths earlier this
year [2010], a 38-year-old woman and a 3-year-old girl.

The H5N1 virus once was a disease confined largely to birds, only
rarely infecting people. Since 2003, it has infected 493 people,
killing 292, or nearly 60 percent, with Viet Nam reporting 59 deaths
[among 117 cases, not including the 2 cases described in this report.
- Mod.CP]. Almost all these infections were believed to have taken
place directly from bird to human.

There have been 2 sizeable clusters -- one in which 8 family members
died on the Indonesian island of Sumatra in 2006 and another in
Turkey in which 8 people were infected and 4 died. In the Sumatra
case, the virus [affected] 2 generations and then stopped; a
37-year-old woman was believed to have infected her 10-year-old
nephew who went on to infect his father.

Another smaller probable case of human-to-human transmission occurred
in Thailand in 2004, where a mother died after tending to her sick
daughter for hours.

[Byline: Ho Binh Minh]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

******
[2]
Date: Tue 13 Apr 2010
Source: CIDRP News [edited]
<http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/apr1310avian.html>


Two patients who are part of a suspected H5N1 avian influenza case
cluster in northern Viet Nam's Bac Kan province are still
hospitalized, with 11 others isolated for flu-like symptoms, health
officials said today [13 Apr 2010]. The 2 hospitalized patients
include a 22-year-old man and a 27-month-old girl whose confirmed
infections were previously reported by the Vietnamese media.

Hoang Van Linh, deputy director of northern Bac Kan's health
department, told the news service that some of the isolated group
includes relatives of the 2 hospitalized patients. Hoang said the 11
people in isolation recovered after treatment with oseltamivir
(Tamiflu) and that he is awaiting test results to see if any were
infected with avian influenza A(H5N1) virus. The man was hospitalized
on 2 Apr 2010 and remains under care, and the toddler, admitted on 4
Apr 2010, is in stable condition.

Viet Nam's Health Ministry, in a Web posting, said dead chickens were
reported at the homes of the 2 hospitalized patients and that the
toddler's family reportedly slaughtered and ate some of the infected
poultry. A provincial infectious disease official said that all of
the isolated patients had contact with sick birds.

Bac Kan province, a mountainous area in northern Viet Nam, was among
2 areas cited in H5N1 outbreak reports that the country's agriculture
ministry submitted to the World Organization for Animal Health (OIE)
on 10 Apr 2010. The outbreak in Bac Kan started on 19 Mar 2010,
killing 318 of 550 birds in the affected village. The remaining 142
birds were destroyed to control the spread of the virus. The country
also reported that the virus struck birds in a village in Quang Ninh
province, located on Viet Nam's northeastern coast, killing 1231 of
1554 birds. The remaining poultry were destroyed. An investigation
into the source of the events suggested that introduction of new
animals, illegal movement of birds, and fomites were linked to the 2
avian influenza A(H5N1) virus outbreaks, the OIE report stated.

Geographic and family H5N1 clusters are relatively rare, and they
raise fears that the virus has improved its ability to infect humans,
which could increase the risk that the virus could become a pandemic
flu strain. For example, a cluster of confirmed and suspected H5N1
cases occurred in northwestern Pakistan in late 2007. The World
Health Organization (WHO) investigation revealed that the virus
probably spread among 4 brothers and went no further.

Also in late 2007, the father of a Chinese man who died of an H5N1
infection was hospitalized with avian influenza A(H5N1) virus
infection. Reports at the time were unclear about the men's exposure
to sick and dead birds.

Despite periodic reports of clusters, human-to-human transmission of
avian influenza A(H5N1) virus, though suspected in some instances,
has been confirmed in the laboratory only once, in a North Sumatra,
Indonesia family in 2006. That cluster involved 7 cases, 6 of them
fatal. A WHO investigation into the illnesses revealed that the virus
mutated slightly when it infected a 10-year-old boy, who then passed
the same virus to his father.

[Byline: Lisa Schnirring]
--
Communicated by:
ProMED-mail <
promed@promedmail.org>

[Little new information has become available since the previous
report, and it is still unclear whether the avian influenza A (H5N1)
virus infection of the 22-year-old man and the 27-month-old child
have been officially confirmed. If the diagnosis has been confirmed
officially, the number of cases in Viet Nam will have risen to 119
since the beginning of the outbreak in 2003, the number of fatalities
remaining 59.

Likewise, no further information has emerged concerning the diagnosis
of the other 11 members of the suspected cluster (all of whom have
been treated and discharged). Nor is there any information to exclude
the likelihood of transmission directly from infected poultry or to
favour the possibility of human-to-human transmission of infection.
Further information is awaited.


Bac Kan province can be located in the map of the Northern Region of
Viet Nam at: <http://www.angelfire.com/co/hongnam/vnmap.html>. The
HealthMap/ProMED-mail interactive map of Viet Nam can be accessed at
<http://healthmap.org/r/01aL>. - Mod.CP]

Proactive in prevention and influenza A (H5N1) and acute diarrhea caused by cholera

On 15-04-2010 04:23




-------------------------------------------------- ------------------------------
ND - At the meeting, the National Steering Committee on prevention of human pandemic influenza 14-4 pm, Dr. Nguyen Huy Nga, Director of Preventive Medicine and Environment (MOH) said: The localities should take in prevention as well as close monitoring of epidemic situation of avian influenza A (H5N1) and influenza A (H1N1).


Especially in many localities are still scattered appearance of avian influenza. Results of investigation and supervision of the Institute of Hygiene and Epidemiology in Central As can commune, Cho Moi district (Bac Can), where last week two cases of influenza A (H5N1) showed no evidence of service Influenza A (H5N1) infection among humans. Both cases have exposed here separately, not in direct contact with each other, and 33 who have direct contact with these two patients have tested negative for influenza A (H5N1).


According to statistics, up to now has four local puong detecting people with acute diarrhea caused by cholera risk. However, the risk of an outbreak of cholera is very large. Most southern regions, unusually hot sunny days of favorable conditions for developing cholera. Heat leads to lack of clean water supplies have caused many people do not use water hygiene risk caused cholera to rise. More food is hot and humid conditions are not good storage has harmful bacteria, especially cholera bacteria arise. Thus, enhanced surveillance to detect early, timely handling of the outbreak, people need to ensure food safety and hygiene, environmental sanitation, personal hygiene.

PF11 Blog: HA 190E Polymorphism Potential from Avian Influenza into Pandemic H1N1 (PF11)

2010-04-13

HA 190E Polymorphism Potential from Avian Influenza into Pandemic H1N1 (PF11)

Current trending indicates a reportable potential for the D190E polymorphism on the Hemagglutinin of PF11. This change may enhance Vaccine Escape from the currently selected vaccine target candidate, CA/07 X181.

Each of two codings, GAg & GAa, may emerge due to the combinational influence of Avian H5N1, H6N1 and H9N2.

190E (GAg)
  • 10% probability of HA 190E (GAg) into PF11 within 30 days.
  • 33% probability of HA 190E (GAg) into PF11 within 60 days.
  • 85% probability of HA 190E (GAg) into PF11 within 210 days.

190E (GAa)
  • 20% probability of HA 190E (GAa) into PF11 within 180 days.
  • 33% probability of HA 190E (GAa) into PF11 within 210 days.

These probabilities will be updated as additional data is made public. Transparency at this stage of the pandemic is essential. Release of sequences and clinical data of a finer detail and higher quantity will allow information-based decisions.

As this particular Avian Influenza change may generate substantial clinical variance on certain backgrounds, we urge the producers of sequences to immediately publish this polymorphism upon discovery.

UAE: Dir. Gen. of Environment - Temporary Ban on Poultry From Romania

From the Federation of Arab News Agency.

Dubai, April 14 WAM / issued by HE Obaid Mohammed Juma Al Matrooshi, Director General of Ministry of Environment and Water on behalf a decision on the temporary ban on the importation of all annua

2010-04-14 - WAM

This decision is based on Ministerial Decree No. / 448 / for the year 2009 on the lifting of the ban on the importation of all live birds and poultry, wild and ornamental birds, their products and offal from the countries of North and South America and Europe, except for regions where cases of bird flu in addition to the note by Quarantine Department in the Ministry and based on information received from the World Organization for Animal Health, which reports the appearance of an outbreak of avian influenza strain fierce in the State of Romania.

The resolution that, in order to ensure healthy conditions for humans and animals in the state of animal diseases leak any infectious or contagious imported temporarily prohibited until further notice, the importation of all kinds of living tamed, wild and ornamental birds, their products and their offal from Romania.

It will also manage the stone and the concerned organizational units in the ministry in coordination with the relevant authorities to implement this decision based on what the public interest and to the epidemiological situation changed when the State of Romania, in accordance with the guidelines of the International Organization for Animal Health.
/ R / or /

New UN study urges sustained momentum to tackle human, animal influenza threats




David Nabarro, Senior UN System Coordinator for Avian and Human Influenza


14 April 2010 – While there has been substantial global progress towards pandemic preparedness in recent years, it is vital to maintain that momentum to respond effectively to existing and possible future threats, according to a new study by the United Nations and the World Bank.

Continued global vigilance for infectious disease outbreaks and pandemics is of critical importance for health security and well-being,” says the report, entitled “Animal and pandemic influenza: a framework for sustaining momentum.”
The report notes that an estimated 75 per cent of new human diseases originate in animals and an average of two new animal diseases with cross-over capabilities emerge every year.
The emergence of three major epidemiological events into the first decade of the new century – SARS, H5N1 avian influenza and H1N1 pandemic influenza – is an indication of the rate at which threats may continue to arise, it adds.
Sustaining momentum,” states the report, “will require a strategic use of resources and a move away from emergency response-driven projects and special, single-focus initiatives, to long-term capacity-building.”
The report will be taken up by delegates from over 80 countries when they meet at the International Ministerial Conference on Animal and Pandemic Influenza, which will be held in Hanoi, Viet Nam, from 20 to 21 April.
“This is a really significant conference,” David Nabarro, Senior UN System Influenza Coordinator, told reporters in New York, noting that the gathering will take stock of where the world is with regard to bird flu and the H1N1 virus, review preparedness and consider lessons learned from countries with successful control efforts.
The threats from bird flu and H1N1 are not over yet, he noted, stressing the need for further measures to ensure an effective global response.
“We have to find ways to put the work on bird flu and on pandemics more into the routine business of ministries of health and ministries of agriculture, into the routine work of disaster preparedness units in countries,” he stated. “And so an important element of the discussions in Hanoi will be the way forward.”
Part of the work in Hanoi, he added, will be to consider whether or not extra preparedness is necessary to ensure that those who look after animal health and those that look after human health are working together well enough to prepare for disease threats that come from animals. A key question, he noted, is: “Are we well enough organized as a world to be prepared for diseases that can jump from the animal kingdom and lead to sickness and possibly quite widespread suffering among humans?”

No evidence of influenza A/H5N1 infection from person to person

At the meeting of the National Steering Committee against pandemic influenza in the afternoon 14 / 4 at the Ministry of Health, Dr. Tran Nhu Duong, Vice Director of the Central Hygiene and Epidemiology Institute, said the institute's investigation of two cases of influenza A/H5N1 has been recorded in Na Tao village, As can commune, Cho Moi, Bac Kan Province not detect evidence of infections from person to person. According to two reports of working groups of the Institute in Bac Kan, two patients at about 100 meters apart but there is no direct contact with each other. 33 people have contact with patients on two samples have been tested and are negative for influenza A/H5N1. 2 patients were exposed to bird flu alone.

Isolation and characterization of highly pathogenic avian influenza virus subtype H5N1 from donkeys

The highly pathogenic H5N1 is a major avian pathogen that crosses species barriers and seriously affects humans as well as some mammals. It mutates in an intensified manner and is considered a potential candidate for the possible next pandemic with all the catastrophic consequences.

Methods: Nasal swabs were collected from donkeys suffered from respiratory distress.

The virus was isolated from the pooled nasal swabs in specific pathogen free embryonated chicken eggs (SPF-ECE). Reverse transcriptase polymerase chain reaction (RT-PCR) and sequencing of both haemagglutingin and neuraminidase were performed.

H5 seroconversion was screened using haemagglutination inhibition (HI) assay on 105 donkey serum samples.

Results: We demonstrated that H5N1 jumped from poultry to another mammalian host; donkeys. Phylogenetic analysis showed that the virus clustered within the lineage of H5N1 from Egypt, closely related to 2009 isolates.

It harboured few genetic changes compared to the closely related viruses from avian and humans. The neuraminidase lacks oseltamivir resistant mutations.

Interestingly, HI screening for antibodies to H5 haemagglutinins in donkeys revealed high exposure rate.

Conclusions: These findings extend the host range of the H5N1 influenza virus, possess implications for influenza virus epidemiology and highlight the need for the systematic surveillance of H5N1 in animals in the vicinity of backyard poultry units especially in endemic areas.

Author: Ahmed Abdel-MoneimAhmad Abdel-GhanySalama Shany
Credits/Source: Journal of Biomedical Science 2010, 17:25

Vietnam-Expert warns of rising risk of food poisoning outbreak


Updated April, 14 2010 09:46:54
Email Print



HA NOI — The Ministry of Health has warned about the high risk of acute diarrhoea outbreaks in many areas of Viet Nam during the summer.
"The nation is facing a high risk of an acute diarrhoea outbreak, especially in rural areas or where food does not meet safety standards," said Nguyen Huy Nga, Director of the Preventive Medicine and Environment Department on Monday.
Nga's statement came after his department reported on Monday that a patient, who was suffering from acute diarrhoea, was being treated in Bac Ninh Province. There have also been reported cases in Ha Noi, HCM City and An Giang.
The 50-year-old patient from Luong Tai District, Bac Ninh Province ate pig's blood pudding only a few days before experiencing diarrhoea symptoms.
Local health authorities said that the patient has recovered, but his home is being quarantined.
The HCM City's Pasteur Institute also said that there were four acute diarrhoea patients in Districts 8 and 5 last week. The city's health authorities said that they have not discovered the source of the infection.
Health authorities recommended people to continue to practice personal hygiene, eat cooked food and drink water that had been boiled to prevent the spread of acute diarrhoea. — VNS

United Arab Emirates bans poultry imports from Romania {Corrected Country}

[I have corrected the Title of this post, from Egypt to the UAE...sorry for the mistake]

Environment temporarily banning the importation of all types of poultry and feathers from Romania
Apr 14, 2010 - 04:24 -
Ministry of Environment / Birds in Romania / temporary ban

Dubai, April 14 WAM / issued by HE Obaid Mohammed Juma Al Matrooshi, Director General of the Ministry of Environment and Water on behalf a decision on temporarily banning the importation of all types of domestic and wild birds and pet birds and feathers from the State of Romania.

This decision is based on Ministerial Decree No. / 448 / for the year 2009 on the lifting of the ban on the importation of all live birds and poultry, wild and ornamental birds, their products and offal from the countries of North and South America and Europe, except for regions where cases of bird flu in addition to the note by Quarantine Department in the Ministry and based on information received from the World Organization for Animal Health, which reports the appearance of an outbreak of avian influenza strain fierce in the State of Romania.

The resolution that, in order to ensure healthy conditions for humans and animals in the state of animal diseases leak any infectious or contagious imported temporarily prohibited until further notice, the importation of all kinds of living tamed, wild and ornamental birds, their products and their offal from Romania.

It will also manage the stone and the concerned organizational units in the ministry in coordination with the relevant authorities to implement this decision based on what the public interest and to the epidemiological situation changed when the State of Romania, in accordance with the guidelines of the International Organization for Animal Health.

Egypt: Gov. Port Said Critical of Gaps in H5N1 Detection

Wednesday, April 14th, 2010

Said Mustafa Abdel Latif Said Governor of Port Said, the gaps in the control of avian flu still exists and poultry list within the cordon of the city and the buildings and courtyards district climate and flowers, which confirms that there is some kind of relaxation in the elimination of breeding birds, especially the towers bathroom located on the roofs of buildings, proposed special study area combines these towers.

This came during a meeting of the Higher Committee to combat bird flu on Tuesday night the Executive Council headed by the governor and Nashwa Moses, assistant secretary general of the Port Said Governorate, and directors of veterinary medicine and health affairs, agriculture, and district heads.

The Governor said: "I hope to see farm land equal to that we need to analysis of the soil to make sure they are free of viruses", calling for the transfer of the remaining farms outside the cordon of the city.

The Governor emphasized that the abattoir to the common birds and livestock processing plant has to benefit from the outputs extracted to preserve the environment and public spending even Aechtlt waste water, industrial wastewater and the lack of suffering from environmental pollution, explaining that he has full control on poultry. Referring to define the objective and basic guidelines for building strategies and plans for the early detection of the virus mutating relevant human and animal health.

On the other hand, he turned conservative on the issue of entry of livestock, quarantine, refusing to carry the stone in Port Said, pointing out that if the entry of livestock to the Sinai will be sent by the Al-Arish, said the Director of Veterinary Medicine: "I am not claimed enter quarantine Port at all, and acetic stone will benefit you, "emphasizing the Higher Committee for Resistance to disease, avian flu that has a system of thought, and imagination.

Egypt: 10 bird flu attack of thousands of birds at a farm Menoufia

Tuesday, April 13, 2010

Dr. Ahmed Fouad, director of the Directorate of Veterinary Medicine Menoufia, it was discovered the focus of a new positive infected with bird flu in one poultry farms in Sadat City, was found injured 10 thousand chickens from (used for breeding) age 66 a week, after the result of analysis of samples were confirmed contracting the disease.

He added. Fuad had been taking samples from farm workers and contacts for analysis, and make sure not to have the disease, with an undertaking of officials from the farm to keep their birds and security forces imposed a blockade around the farm to prevent the smuggling of infected birds.

Uncovered local council Monofiya that more than 50% of poultry farms to maintain operating without a license, the Council stressed that the number of veterinarians is not enough to immunize third of the quantities of birds and demanded the immediate closure and final Farms unlicensed, when the emergence of positive cases in the farms licensed or anywhere else.

Two goals from bird flu in Vietnam and conducting tests on 11 cases

[This story is out of Egypt]

Vietnam: Commentary: What if this was a mutation or a combination of H5N1 & H1N1?

What if this was a mutation or a combination of H5N1 & H1N1. What if it mutated to become more transmissible and was more lethal?
Do you want to wait for the English language AP Reports, or do you want to rely on the translated material from the Country?

9 days – from the initial story to the first AP report.

Thank you Treyfish. Going into Countries and translating their news, and bringing it to our attention, takes dedication, patience, and is very time consuming.

Monday, April 5th:

Treyfish broke the story of the 22 yo, confirmed. Also 4 others hospitalized.

http://pandemicinformationnews.blogspot.com/2010/04/vietnam-h5n1-human-confirmed-case4.html

We waited 4 days.

Friday, April 9th:

Treyfish broke the story of 9 more cases (suspected) hospitalized, with shortness of breath, fever, cough. 5 of them family members.

We waited 4 more days.

The first AP Report came on April 13th.
http://hosted.ap.org/dynamic/stories/A/AS_VIETNAM_BIRD_FLU_ASOL-?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2010-04-13-09-35-27

Today, April 14th, we have a few more AP Reports….
Reuters: http://www.alertnet.org/thenews/newsdesk/TOE63D045.htm

Yahoo News: http://ca.news.yahoo.com/s/capress/100413/health/health_as_vietnam_bird_flu_1

9 days – from the initial story to the first AP report.

Still waiting to hear from CDC, WHO, Embassies...etc. 9 days and counting.....

Vietnam: Increase in Hospitalizations from Respiratory, Fever, Heat Related

04/14/2010 03:08
Excerpt:

On 13 / 4, although near the end of day, amount of patients waiting at the clinic of the Hospital (Hospital), Nguyen Trai (HCMC) is crowded....

Doctor Ly Le Thanh, director of the hospital, said: "In those days, the weather is harsh, hot, the volume of patients admitted to hospital inpatient treatment increased more than 100 cases in 13 / 4 768 hospitalized patients. Most elderly patients with blood pressure fluctuation when the hot sun, and then as heart disease, lung disease, respiratory problems ...".

Nguyen Tri Phuong Hospital said patients admitted to hospital volume increased in recent days, 13.4 days in 623 patients with inpatient treatment. Similarly, a leading Hospital Thu Duc area confirmed on a number of diseases related to heat up as experience fever, feeling the sun, viral infection, or due to weather ... (14 Youth / 4).

Vietnam: Ministry of Health Website Update H5N1

Announcement 494/TB-DPMT on 09/4/2010 by Ministry of Health Regarding the second case positive for influenza virus A (H5) in Bac Kan

NOTICE
Regarding the second case positive for influenza virus A (H5) in Bac Kan
Department of Preventive Medicine and Environment announced Monday cases positive for influenza virus A (H5) in Bac Kan province as follows:

Female patients, 02 years old Address: Nà Tào, village Như Cố, district Chợ Mới, Bac Kan. Onset of disease manifestation on 02/4/2010 with 40 0 C high fever, cough, sore throat, runny nose. On 04/4/2010 patients the home were taken to hospital treatment Cho Moi district.

On 07/4/2010, Institute of Hygiene and Epidemiology answer test results positive for influenza virus A (H5).

Currently, patient health is stable, no fever, difficulty breathing and being managed, treated in hospital in Cho Moi, Bac Kan.

Initial epidemiological investigation showed that, at home and around the area where patients are living with sick poultry phenomenon / death, families slaughter sick birds to eat.

Department of Preventive Medicine and Environment continue to strongly recommend that people perform some of the following measures:

1. When detected poultry sickness, death is not absolute slaughter and use that to immediately notify local authorities handled promptly;

2. Air transport, trade in poultry of unknown origin, especially in areas with bird flu outbreak on ensuring cooked, boiled drinking, washing hands with soap before eating and after using the bathroom students;

3. When you have a fever, cough, breathing problems related to bird flu soon have to nearest medical facility to be examined and treated promptly.



KT. Director
Deputy Director
(Signed)
Nguyen Van Binh
Date 12/04/2010


Tuesday, April 13, 2010

Vietnam awaits more test results in suspected H5N1 cluster

Apr 13, 2010 (CIDRAP News) – Two patients who are part of a suspected H5N1 avian influenza case cluster in northern Vietnam's Bac Kan province are still hospitalized, with 11 others isolated for flu-like symptoms, health officials said today.

The two hospitalized patients include a 22-year-old man and a 27-month-old girl whose confirmed infections were previously reported by the Vietnamese media, the Associated Press (AP) reported today.

Hoang Van Linh, deputy director of northern Bac Kan's health department, told the news service that some of the isolated group includes relatives of the two hospitalized patients. Hoang said the 11 people in isolation recovered after treatment with oseltamivir (Tamiflu) and that he is awaiting test results to see if any were infected with the H5N1 virus.

The man was hospitalized on Apr 2 and remains under care, and the toddler, admitted Apr 4, is in stable condition, he told the AP.

FluTrackers, an Internet message board that translates foreign-language news reports on infectious disease events, has been following local coverage of the suspected cluster for the past several days. Though FluTrackers and other infectious disease blogs warn readers to interpret translated reports with caution, they have noted that most of the information coming out of Vietnam about the cluster has been consistent.

Vietnam's health ministry, in a Web posting, said dead chickens were reported at the homes of the two hospitalized patients and that the toddler's family reportedly slaughtered and ate some of the infected poultry, according to the AP report. A provincial infectious disease official told the AP that all of the isolated patients had contact with sick birds.

Bac Kan province, a mountainous area in northern Vietnam, was among two areas cited in H5N1 outbreak reports that the country's agriculture ministry submitted to the World Organization for Animal Health (OIE) on Apr 10. The outbreak in Bac Kan started on Mar 19, killing 318 of 550 birds in the affected village. The remaining 142 birds were destroyed to control the spread of the virus.

The country also reported that the virus struck birds in a village in Quang Ninh province, located on Vietnam's northeastern coast, killing 1,231 of 1,554 birds. The remaining poultry were destroyed.

An investigation into the source of the events suggested that introduction of new animals, illegal movement of birds, and fomites were linked to the two H5N1 outbreaks, the OIE report said.

Geographic and family H5N1 clusters are relatively rare, and they raise fears that the virus has improved its ability to infect humans, which could increase the risk that the virus could become a pandemic flu strain.

For example, a cluster of confirmed and suspected H5N1 cases occurred in northwestern Pakistan in late 2007. The World Health Organization (WHO) investigation revealed that the virus probably spread among four brothers and went no further.

Also in late 2007 the father of a Chinese man who died of an H5N1 infection was hospitalized with H5N1 avian flu. Reports at the time were unclear about the men's exposure to sick and dead birds.

Despite periodic reports of clusters, human-to-human transmission of the H5N1 virus, though suspected in some instances, has been confirmed in the laboratory only once, in a North Sumatra, Indonesia, family in 2006. The cluster involved seven cases, six of them fatal. A WHO investigation into the illnesses revealed that the virus mutated slightly when it infected a 10-year-old boy, who then passed the same virus to his father.

See also:

Apr 13 AP story

FluTrackers suspected Vietnam case cluster thread

Apr 10 OIE report

Apr 9 CIDRAP News story "WHO confirms Egyptian H5N1 death, Vietnam probes possible cluster"

Jun 26, 2006, CIDRAP News story "H5N1 mutation showed human transmission in Indonesia"

Vietnam confirms 2 bird flu cases; 11 quarantined

TRAN VAN MINH 0 Comments Published: April 13, 2010


HANOI, Vietnam (AP) — Two Vietnamese from a poor, mountainous area have been infected with bird flu, and 11 others were quarantined with flulike symptoms, health officials said Tuesday.


A 22-year-old man and a 27-month-old girl remain hospitalized after testing positive for the H5N1 virus, said Hoang Van Linh, deputy director of northern Bac Kan province's health department. He said the 11 others, some of whom were relatives of the confirmed cases, had fallen ill with fever, coughing and shortness of breath.

They were given the antiviral Tamiflu and have since recovered. He said they were tested for bird flu, but the results have not come back.

Dead chickens were reported at the homes of the two patients, and the toddler's family is believed to have slaughtered and eaten some of the infected poultry, according to the Ministry of Health's Web site. Ly Quoc Khach, an infectious disease official from the provincial health department, said all 11 people, members of the Tay and Nung ethnic minorities, had contact with the sick birds, and he said he did not believe there would be any reason to fear possible human-to-human transmission if they did test positive.

The 22-year-old man remains on a respirator after being hospitalized April 2, while the toddler, who was admitted two days later, is in stable condition, Hoang said. All of the sick people's homes in Ma Tao commune have since been disinfected, and the infected poultry have been slaughtered, Ly said.

Vietnam has been hit with a spate of fresh H5N1 outbreaks among poultry, and two people have died from the disease this year, according to the World health Organization, which confirms 59 deaths since late 2003.

The disease remains rare among people, with most cases linked to direct contact with infected poultry. But experts have long feared the virulent virus could mutate into a form that allows it to spread easily among people, possibly igniting a pandemic.

hattip alert

Announced bird flu outbreaks Tuesday in Bac Can

On 13-04-2010 17:22



-------------------------------------------------- ------------------------------
NDDT - After the test samples of animal health diagnostic center Central, 13-4, this afternoon, Bac Can province has announced the outbreak of avian influenza (H5N1) in the Stock and Rural Total Male Bouquet of Yen Dinh, Cho Moi district. So, Bac Can province has had three outbreaks of H5N1 avian influenza since 6-4 days now.


The decision is announced the bird flu-affected areas is also clearly threatening the seven villages in Yen Dinh and the entire town of New Market. To combat bird flu spread out wide, up to this point, Cho Moi district has set up four checkpoints in the route out to the outbreak, destroying more than 5,200 birds, spraying chemical disinfection identical in six communes disinfection, vaccination for nearly 22 thousand birds in the vicinity.


So far eight people have symptoms of cough, sore throat, fever, treated at health centers and from Cho Moi has returned home.

Monday, April 12, 2010

8 patients with suspected influenza A (H5N1) at the district hospital treatment are discharged from hospital


11:23 '13/04/2010 (GMT +7)

Up to date 11 / 4, Cho Moi district has two cases are positive for influenza A (H5N1) and 11 cases have expressed doubts as cough, fever, dyspnea, diarrhea. The remaining patients treated at the Medical Center district is going well.





After 1 week of treatment on 12 / 4 has 8 patient discharge. Through treatment with 3 tests, the patients have tested negative for influenza A (H5N1), health status going well, no doubt the expression as: cough, fever, difficulty breathing .

Particularly the case of Nguyen Thi Thanh Thu patients - patients who have tested positive for influenza A (H5N1), was tested through the 2nd and 3rd have tested negative for influenza A (H5N1) . Currently the patient is being continued monitoring and treatment in the future.

Also, in the commune health stations are having the same two cases expressed doubts have been treated, follow the regimen of health.