Saudi Arabia: Health and agriculture are doing contingency plan to prevent the entry of bird flu virus

05-Feb-2013

Amman - Rai - Ahmed Eagles - decided by the ministries' health and agriculture activate emergency plan precautionary and preventive to prevent the entry of bird flu virus infection to the Kingdom and trapping the disease if moved us infection.

The two ministries decided to declare a state of alert in the face of the virus in the event of discovery of any infection and treated early time (...) Makdtan that situation is worrying that the Ministry of Agriculture report confirming that status of the poultry farms in the Kingdom reassuring. 

 The head of the Primary Health Care in the Ministry of Health Bassem Hijjawi in a press statement after a meeting yesterday held at the Ministry of Agriculture to coordinate together to confront the danger of disease the kingdom of Anfloanz free bird or even suspected cases so far.

Said Hijjawi »Atfguenaaly form a joint committee between the two ministries to تبقيا in constant contact with each other and the author immediately any deaths for any kind of poultry in any place or farm in Saudi Arabia to take the next step which is declared Tfal plans confrontation of the disease before its spread and surround the place where it appears and eliminate ».

Dr Hijjawi revealed that the danger lies in this type of virus (H5N1) is moving from (human - human) was previously unknown transition from birds to humans, which is easy to encircle and destroy the virus.

Despite the announcement by the ministries (health, agriculture) yesterday devoid Jordan of bird flu so far, but he geographically located on the itinerary of millions of migratory birds that are concentrated period passes over territory of the Kingdom during the months February current September and April next, as well as that Jordan does not import large quantities of products poultry, but depends on local production significantly.

And circulated by the Ministry of Health according to Dr. Hijjawi intensify monitoring of diseases in hospitals, health centers and training for doctors and nurses to deal with situations that may be suspected to be infected with bird flu and declare readiness ministry laboratories to perform analyzes for the bird flu virus.

Hijjawi stressed that the Ministry of Health has sufficient stocks of the drug »Altmiflo» counter the disease, noting that the danger will persist as long as the kingdom live atmosphere of continuing winter.

 Jordan was treated in 2006 with infected HP 5 to 1 bird flu in Ajloun were casualties among birds Habash reared homemade authorities have then executed birds region also dealt with human infection for migrant worker Egypt in Governor Karak came infected were isolated and treated for disease until full recovery.

And between Hijjawi that the Ministry of Health are looking forward very cautiously move the virus between countries, noting that the countries of the Middle East free of the virus so far confirmed that the virus re-emerged in Egypt.  

The World Health Organization (WHO) launched a warning to all states after the discovery (5) cases of proven bird flu in Cambodia and moved them from injuries (person to person), which was considered a serious organization and warns of obtaining and B fast Antchar of the deadly disease.

Indicated that the avian influenza virus (H5N1) infects different species of birds and migratory birds and bird flu virus infects human symptoms include general decline body, headache, high body temperature for a period of more than a week and poor digestion and loss of appetite, runny nose, sore and reddened throat and pain severe muscle and joints and bones.

   These symptoms may progress rapidly to respiratory infections and acute pulmonary end to acute respiratory insufficiency and then lead to death.

 

http://rasseen.com/art.php?id=38ef607033af9d8dbaecc1916b00c1ff5a0f35a1 

Opinion Why We Still Need to Think About Bird Flu

By Crawford Kilian, Today, TheTyee.ca

Between Jan. 9 and 15, five people in Cambodia contracted bird flu, and four died of it within a few days -- four young girls and a 35-year-old man. Only the first case, an eight-month-old boy, survived.

This might seem like a minor event, but the World Health Organization sent rapid response teams into the country to help the Cambodian ministry of health. They've been looking for more cases and educating local residents about how to avoid the disease -- even though it's one of the hardest diseases to catch.
"Bird flu" is a vague term: all influenzas come from birds, especially domestic poultry, though they sometimes reach us through pigs and other mammals. The Cambodians had H5N1 flu, which first got our attention when it broke out among chickens and humans in Hong Kong in 1997. That outbreak was stopped by killing every chicken and duck in the region, and banning further imports from the mainland.
Six years later human H5N1 returned, in Vietnam, and since then has sputtered away from Indonesia and South Korea to Egypt and Nigeria.
Between 2003 and the end of 2012, the WHO confirmed no more than 610 human H5N1 cases, most of them in Vietnam, Indonesia and Egypt. This, out of a population of over seven billion, makes it one of the world's rarest diseases.

Rare and dangerous

Its rarity is precisely what makes it so dangerous. Because it evolved to infect birds, H5N1 isn't designed to infect mammals. Humans, therefore, are a "naive" population with almost no immunity to it. That was what scared the health authorities in Hong Kong, and it's what scares the WHO today.
Out of those 610 cases, 360 people died. That means the "case fatality rate" (CFR) was 59 per cent. The CFR varies by country -- it's 35 per cent in Egypt, and 83 per cent in Indonesia. But globally, three out of five people who catch H5N1 will die of it within a very few days.
Cambodia has been reporting H5N1 since 2004. Out of 21 cumulative cases by the end of 2012, 19 died -- a 90 per cent CFR. Last year, though, the country had just two cases and one death.
The five new cases, then, are alarming because they've happened so suddenly and so close together. One was in Phnom Penh, Cambodia's capital. The others were in suburbs and nearby villages. And they continue to be fatal.

Continued:  http://thetyee.ca/Opinion/2013/02/06/Bird-Flu/

Council on Foreign Relations Blog: Ten Years after SARS: Five Myths to Unravel

by Yanzhong Huang
February 4, 2013

Last week, I was in Beijing for an international conference while the city experienced record levels of air pollution. I had a feeling of déjà vu as I saw people wearing face masks. Ten years ago, at the height of the SARS epidemic, a sea of people in white masks—most of them scared migrant workers and university students—flocked to train and bus stations and airports in the hope of fleeing the city. Then, face masks were a symbol of the fear of a deadly and seemingly omnipresent virus that was responsible for 349 deaths and over 5,300 infections in China alone. As the first severe infectious disease to emerge in the twenty-first century, SARS caused the most serious socio-political crisis for the Chinese leadership since the 1989 Tiananmen crackdown.
While SARS wreaked havoc for approximately nine months from November 2002 to August 2003, it is no match for the HIV/AIDS pandemic in terms of duration, which has lasted for more than 30 years. However, SARS has had a lasting impact on our collective psyche. In September 2012, a novel coronavirus was identified in two patients from the Middle East, raising the specter of a new SARS-like outbreak.  To better prepare for the next disease outbreak, it might be necessary to unravel the following myths about SARS and other infections:

Myth #1: Strong political commitment and a centrally coordinated response was the most important factor in the control of SARS in China.
Not really. Once the initial dilly-dallying gave way to decisive and swift state action, resources were effectively mobilized against the epidemic and policy coordination was significantly improved. Yet many of the measures widely credited for stopping the spread of the virus, such as isolation and quarantine, were only implemented after the virus reproduction number or Rt—a critical value below which sustained transmission of the virus is impossible—dropped below one, or when the epidemic was already dying down. According to a study published in Tropical Medicine & International Health, those decisive government measures might have played a role in speeding up the disappearance of SARS or preventing the outbreak in yet unaffected regions, but they “contributed little to the factual containment of the SARS epidemic.”

Myth #2: Those patients who survived SARS lived happily ever after.
Not true. As a novel virus, SARS defied treatment and proved fatal in many cases. Zhong Nanshan, a Guangzhou-based doctor, initiated steroid therapy to treat SARS patients. This therapy, widely used during the SARS outbreak, was believed to have saved the lives of many SARS patients in China—indeed, during the 2009 H1N1 outbreak, steroid glucocorticoid was also used to treat critically-ill H1N1 patients. However, there have been adverse effects of this aggressive treatment. In late 2003, doctors began to suspect that the use of high doses of steroids for an extended duration was responsible for the crippling of hundreds of SARS patients.  According to China Daily, roughly 30 percent of SARS survivors in China who received the therapy have developed severe bone degeneration. A study carried out in the Beijing municipality found that 88 percent of the SARS survivors had symptoms of osteonecrosis, 80 percent were forced to quit their jobs, 60 percent saw their families break up, and about 39 percent suffer from severe depression.

Myth #3:  Government cover-up is no longer a major concern in the post-SARS era.
Not true. The SARS crisis has forced the Chinese leaders to take steps to be more open and transparent in disease reporting and information sharing. Yet as shown in the 2008 hand, foot, and mouth disease (HFMD) outbreak, local government officials found it difficult to adjust their existing behavioral patterns for crisis management, which still value secrecy and inaction. Similar communication problems also bedeviled the government’s response to the 2009 H1N1 outbreak. China’s SARS crusader Zhong Nanshan publicly expressed his distrust in government data on H1N1 fatalities. Political expediency continues to be put before epidemiological reality in sharing disease-related information with the public. The health authorities stopped updating the spread of H1N1 cases between September 30 and October 9, apparently fearing that reporting H1N1 deaths would ruin the celebrations planned for October 1, the National Day that marked the 60th anniversary of the People’s Republic of China. That said, government cover-up and inaction are not unique to China; India’s response to the 2012 dengue fever epidemic was riddled with similar problems.

Myth #4: Poor or failed states pose a bigger infectious disease threat to the international community than stronger developing countries.
Not necessarily. In his thought-provoking book, Weak Links, my colleague and a leading global governance expert, Stewart Patrick, argues that stronger developing countries such as China and Indonesia “may actually pose a bigger infectious disease threat to the United States and the global community than weaker states.” In these countries, the rapid economic development and land use change has significantly increased the chances of human exposure to natural hosts who are carrying novel and lethal viruses of zoonotic origin. Coronaviruses that were implicated in the SARS outbreak, for example, have been detected in multiple species of bats. As described in the movie Contagion, the eating habits in some countries make it more likely for a virus to jump from one species to another. Indeed, In Guangzhou in southern China, 20,000 wild birds are estimated to end up in the human stomach every day. The integration of these countries into the global economy means that a lethal virus can travel at jet speed to other parts of the world. It is no coincidence that SARS was first discovered in Guangdong, a highly developed province with a robust export sector, and arrived in Toronto before it first appeared in Beijing. It also came as no surprise that Cambodia and Myanmar, two of the least developed countries in Asia, were spared by SARS in 2003.

Myth #5: Infectious disease outbreaks remain the primary public health concern in the Asia-Pacific region.
Wrong. According to the World Health Organization, non-communicable diseases or NCDs, which includes cancer, cardiovascular diseases, chronic respiratory diseases, and diabetes, are the most frequent causes of death in most countries in the region. Today, NCDs account for 85 percent of mortality in China and 70 percent of total disease burden. Indeed, even in sub-regions of Asia-Pacific that are still facing the double burden of communicable and non-communicable diseases, NCDs will soon be the predominant cause of mortality. According to the World Bank, the share of total deaths attributable to NCDs will increase to 72 percent in 2030 from 51 percent in South Asia in 2008.
Since 2003, tremendous progress has indeed been made in improving global health security, especially in areas of capacity building for disease surveillance and response. However, our ability to effectively address the next SARS-like disease outbreak is still constrained by our lack of understanding of the evolving biological and political worlds.

http://blogs.cfr.org/asia/2013/02/04/ten-years-after-sars-five-myths-to-unravel/

Vietnam: Border provinces watch for avian flu

2/6/13
The warning was released after the World Health Organisation in Cambodia confirmed that five Cambodian people had contracted the disease since the beginning of the year, of which four died. One of two areas hit by the disease was near the Viet Nam border.
The provinces were asked to tighten international medical quarantine procedures, detect cases with high or acute respiration inflammation and isolate suspected cases for timely treatment in an effort to keep the lethal H5N1 virus from spreading to Viet Nam.
Provinces were also requested to collaborate with agricultural sectors to strengthen the supervision of both domestic and imported poultry.
The health ministry also asked medical units to prepare medicines, chemicals and facilities to deal with outbreaks, if any, and to keep an eye on people coming from Cambodia to Viet Nam for signs of the flu.
The public should be warned of measures to stay safe from the virus, and veterinary units and local authorities should plan together the supervision of an avian influenza H5N1 outbreak in poultry, should it occur.
Department deputy director Tran Thanh Duong said the outbreak of avian influenza H5N1 in Cambodia was a significant threat to Viet Nam.
The disease could spread to Viet Nam through many channels, such as trade border exchange, poultry smuggling or wild birds moving between the two countries, Duong said.
The eight border provinces are Kon Tum, Gia Lai, Dak Lak, Dak Nong in the Tay Nguyen (Central Highlands) and Binh Phuoc, Tay Ninh, Long An, Dong Thap and An Giang in the south.
Last year, bird flu hit seven provinces of Viet Nam and claimed two deaths.
Ministry of Health statistics say that 121 H5N1 cases have been reported in Viet Nam since 2003. Of that number, 61 resulted in death.

Thailand: Teams of govt vets monitor for avian flu

2/5/13

The Department of National Parks, Wildlife and Plant Conservation has resumed its nationwide campaign to randomly test birds for the deadly avian influenza virus (H5N1), to ensure Thailand is free from further outbreaks.

Over 300 barn swallows were collected from Silom by a veterinarian team from the department.

In checking the birds' health to detect H5N1 virus, they also collected bird saliva and dropping samples, to be sent for lab tests at the National Institute of Animal Health and Kasetsart University.

The lab results should be known next week, deputy director of the department Teerapat Prayoonsit said, while leading the team of 100 veterinarians to catch birds in Silom.

Continued:  http://www.nationmultimedia.com/national/Teams-of-govt-vets-monitor-for-avian-flu-30199431.html

Vietnam warns border areas with Cambodia of avian influenza threat

2/5/13
HANOI, Feb. 5 — The Vietnamese Ministry of Health has warned eight provinces near the border with Cambodia of a threat coming from the avian influenza H5N1 that has killed four Cambodians this year, reported by Vietnam’s state-run news agency on Tuesday.
The warning was released after those deaths were confirmed by the World Health Organization (WHO) in Cambodia, saying four out of five Cambodian people contracted with bird flu had died since the beginning of this year, and that one of two areas hit by the disease is close to the Vietnam border.
The ministry instructed related provinces to strictly tighten international medical quarantine procedures so as to keep the lethal H5N1 virus from spreading to Vietnam.
Prevention and control measures must be implemented by the local authorities to strengthen supervision of both domestic and imported poultry.
Last year, bird flu hit seven Vietnamese provinces and killed two people.
Vietnam has reported 121 H5N1 cases since 2003, of which there were 61 deaths, said the report.

WHO Avian influenza – situation in Cambodia – update

1 February 2013 - The Ministry of Health (MoH) of the Kingdom of Cambodia reported five new human cases of avian influenza that were confirmed positive for the H5N1 virus in January 2013.
Case details include an 8 month old male from Phnom Penh with onset 9 Jan 2013, a 17 year old female from Takeo Province with onset 11 January, a 35 year old male from Kong Pisey district, Kampong Speu Province with onset 13 January, a 17 month old female from Kong Pisey district, Kampong Speu Province with onset 13 January and a 9 year old female from Toeuk Chhou district, Kampot province with onset on 15 January 2013.
The cases all presented with fever, cough and other ILI symptoms. Four of the cases died, with 1 case, the 8 month old male, recovering after only experiencing mild ILI. Laboratory samples were tested by the National Institute of Public Health's laboratory and by the Institut Pasteur du Cambodge.
Preliminary evidence does not support human-to-human transmission and four of the cases are known to have had close contact with sick/dead poultry.
The Ministry of Health's Rapid Response Teams (RRT) have gone to the hospitals and the field to identify the patients’ close contacts, any epidemiological linkage among the five cases and initiate preventive treatment as required. In addition, public health education campaigns are being conducted in the villages to inform families on how to protect themselves from contracting avian influenza. The teams are checking records for evidence of increased ILI activity in the local health centres or any increase in number of SARI cases from the affected areas. Results from testing of those who have ILI symptoms among close contacts for A/H5N1 influenza to date were negative. There is enhanced surveillance for ILI and SARI in local health centre and hospital for a further two weeks. Health education messages have been distributed to the community. The World Health Organization is actively assisting the Ministry of Health in their investigations.

http://www.who.int/csr/don/2013_02_01/en/index.html 

Vietnam: World Press Freedom - 2nd on list after China for degradation of journalists

[Coincidentally, we have 4 human cases reported of H5N1 Bird Flu out of Vietnam in 2012, and that was last winter.]:

 Vietnam continues ranked 172/179 countries assessed on the charts on the World Press Freedom Index 2013 by Reporters Without Borders (RSF) implementation. Protection of human rights organizations based in France commented that the press freedom situation in Vietnam is increasingly severe degradation and Vietnam from the third position has jumped to second in the list of countries imprisoned many netizens in the world, after China. During an interview with Tra Mi the English language, Benjamin Ismail, Director for Asia-Pacific in the organization RSF, said :

 -snip-

We also update the number of netizens imprisoned in Vietnam for the new information that we can confirm. Vietnam is the second country in the world has the most imprisoned netizens, behind only China. To compare the proportion of the population, Vietnam is the world's biggest prison for netizens. Last year, Vietnam ranked third in the list of countries imprisoned many netizens in the world, after China and Iran, but jumped to second in the past year.At present, Vietnam has 34 netizens imprisoned and at least 12 bloggers, netizens have been sentenced to the sentence up to the maximum 13 years in prison while the number of journalists or netizens imprisoned in years ago was about 19 ​​people. This proves that the suppression of the Communist Party of Vietnam for freedom of the press and freedom of expression of citizens rising. VOA: The point is considered the most notable on the situation of freedom newspapers in Vietnam in the past year, sir?

Continued:  http://www.voatiengviet.com/content/vietnam-thuoc-muoi-nam-co-nen-tu-do-bao-chi-te-nhat-the-gioi/1593610.html

Cambodia: Cases Are Not Linked

January 31, 2013
Excerpt:

Government officials met Tuesday in Phnom Penh to outline a strategy to prevent the spread of bird flu as millions prepare to travel from the provinces—where five cases of the virus have been reported in the past two weeks—to attend the late King Father No­ro­dom Sihanouk’s cremation in Phnom Penh.

The meeting was attended by the Ministry of Agriculture, the Ministry of Health, the World Health Organization (WHO), the Food and Agriculture Organi­za­tion and the Center for Disease Control (CDC).

“These are poor people coming from provinces. There is some likelihood they will bring their own food and own poultry,” Son­ny Krishnan, spokesman for the WHO in Cambodia, said of the es­ti­mated 1.5 million people who are expected to arrive for the cremation on February 4.

“We are advising them that if you have to cook chicken, cook it well. We do hope animal health people will do inspections on the movement of poultry,” Mr. Krish­nan said.

The WHO on Tuesday confirmed that four people have died in the past two weeks from the H5N1 virus, also called bird flu, and that they all became infected from contact with live poultry. An 8-month-old boy from Phnom Penh’s Pur Sen­chey district survived infection from the normally lethal virus.

The WHO noted that in all ca­s­es, chickens were reported as be­ing sick or dying in the area, and that no entomological link be­tween the five reported cases had been found.

 Continued:  http://www.cambodiadaily.com/news/plans-outlined-to-prevent-spread-of-h5n1-8722/

CIDRAP Flu News Scan for January 30th

hat-tip H5N1 Crofs Blog:

http://crofsblogs.typepad.com/h5n1/2013/01/cidrap-flu-news-scan-for-january-30.html

Cambodia: Contacts of Victims Monitored

1/30/13
Excerpt:

The WHO's Krishnan said health teams have monitored the condition of people who came in contact with the victims, adding that all had tested negative for the virus. The government has also boosted the number of television and radio spots warning of avian flu and telling people how to protect themselves, and staff at health clinics in the affected provinces will receive refresher training on avian flu in February.
 
Population influx
However, two imminent events will add to the challenges of containing the spread of the disease.

The first is the February 4 cremation of Norodom Sihanouk, the country's revered former king, in Phnom Penh. The government expects that more than a million people will travel to the capital to pay their respects. Many will bring food, including live poultry.

The other is Chinese New Year on February 10. In preparation for the festival, large numbers of chickens and ducks are usually transported ahead of that date to markets in the cities and towns.

Either event could promote the spread of the disease. On Tuesday, government and UN health experts met to work out how best to prevent that. Krishnan said officials would hand out information leaflets to people coming to the capital to warn them of the risks and advise them how to avoid contracting the disease. That includes not eating birds that have died from illness, and cooking poultry thoroughly.

Most of the efforts underway are designed to ensure that people do not get infected with avian flu in the first place. Once they do, the chances of recovery are slim - not least due to the country's weak healthcare system. In total, 23 Cambodians out of 26 infected to date with avian flu have died - a fatality rate close on 90 percent, and well above the global figure of nearly 60 percent.
http://www.dw.de/bird-flu-spreads-in-cambodia/a-16559672

Egypt: 6 Human Cases H5N1 in 2012

1/29/13
The Ministry of Health and Population for the death of a woman in Beheira, a result bird flu, bringing the total dead within a year since January 2012 to January 2013, is 6 cases, and that a decrease of 63% from the same period a year which preceded, bringing the total number of deaths since the emergence of the disease in 2006 to 61 cases.

http://almogaz.com/news/politics/2013/01/29/694280

2009 H1N1 Pandemic Infected 1 in 5 People, Experts Estimate

January 29, 2013
At least 20% of all people, and almost half (46%) of all children aged 5 to 19 years, were infected with H1N1 influenza during the first year of the 2009 pandemic, according to a meta-analysis of data from 27 seroepidemiological studies. The studies analyzed approximately 90,000 serologic samples from 19 countries including the United States, United Kingdom, Australia, Canada, China, and India.
Maria D. Van Kerhove, PhD, a liaison between the Global Influenza Programme at the World Health Organization in Geneva, Switzerland, and the Medical Research Council Centre for Outbreak Analysis and Modelling at Imperial College London in the United Kingdom, and colleagues published their findings in an article published online January 21 in Influenza and Other Respiratory Viruses.
Before the pandemic, the overall age-adjusted prevalence of elevated cross-reactive H1N1pandemic (pdm) antibodies was 5% (95% confidence interval [CI], 3% - 7%). The prevalence increased as individuals aged (0 - 4 years old, 1% [95% CI, 0.3% - 4%]; 5 - 19 years old, 4% [95% CI, 1% - 9%]; 20 - 44 years old, 5% [95% CI, 3% - 8%]; and 45 - 64 years old, 5% [95% CI, 2% - 9%]). Prevalence was the highest in individuals at least 65 years old (14%; 95% CI, 8% - 24%).

Continued:  http://www.medscape.com/viewarticle/778445

New Norovirus Strain Causing Most Norovirus Outbreaks in United States

Monday, 28 January 2013
Excerpt:

Not yet known if strain will cause more outbreaks than previous years

Atlanta, GA--(ENEWSPF)--January 28, 2013. A new strain of norovirus called GII.4 Sydney was the leading cause of norovirus outbreaks in the United States from September to December 2012, according to a study published in Morbidity and Mortality Weekly Report released by the Centers for Disease Control and Prevention. The new strain was detected in Australia in March 2012, and caused outbreaks in that country and several other countries.

CDC researchers analyzed 2012 data collected through CaliciNet on norovirus strains associated with outbreaks in the United States. They found that of the 266 norovirus outbreaks reported during the last four months of 2012, 141 were caused by the GII.4 Sydney strain.

“The new strain spread rapidly across the United States from September to December 2012,” said Dr. Aron Hall, epidemiologist, CDC’s Division of Viral Diseases (DVD). “The proportion of reported outbreaks caused by this strain increased dramatically from 19 percent in September to 58 percent in December.”

Continued:  http://www.enewspf.com/latest-news/health-and-fitness/39868-new-norovirus-strain-causing-most-norovirus-outbreaks-in-united-states.html

Norovirus: Georgia - Atlanta

1/29/13
Excerpt:

ATLANTA —

Fulton County health officials say they've investigated several outbreaks of norovirus associated with food service workers.
CBS Atlanta reports (http://bit.ly/YcZjRJ) that the Fulton County Department of Health and Wellness has investigated several outbreaks of the gastrointestinal disease associated with food service establishments in the county, which is home to Atlanta.
Symptoms include nausea, vomiting, diarrhea and stomach cramping. Some people may have fever, chills, headache, muscle aches and a general sense of tiredness
Continued:  http://www.ajc.com/ap/ap/health/health-officials-probe-norovirus-cases/nT846/

1/29/13
Excerpt:

Health services issues warning about new strain of norovirus

Metro Atlanta restaurants are on high alert after Fulton County health officials issued a norovirus warning on Tuesday.
"There are 20 people that we have definitely been able to link to these specific outbreaks. I would anticipate that is a very tiny tip of a very large iceberg," said Fulton County Medical Director Dr. Matthew McKenna.

Continued:  http://www.cbsatlanta.com/story/20755656/health-services-issues-warning-about-new-strain-of-norovirus

Norovirus: Washington D.C.

1/29/13
Excerpt:

The worst flu season in years is giving way to another highly contagious infection. It is a new strain of the norovirus, and so far, thousands of people across the country, including hundreds in our area, have been sickened.

Read more: http://www.myfoxdc.com/story/20757612/new-strain-of-norovirus-hitting-area#ixzz2JPcc8Sm8

Norovirus: Indiana

January 29, 2013
Excerpt:

PRINCETON—With 43 reported deaths to date, the flu season is Indiana’s deadliest in five years, but state health officials say the symptoms some people may be having aren’t influenza afterall; rather, they may have the norovirus or “stomach flu.”
The Indiana State Dept. of Health reported a new strain of norovirus is making its way across throughout Europe and North America. The new strain, GII.4 Sydney, originated in Australia.

http://www.tristate-media.com/pdclarion/article_badbcfa4-69d4-11e2-9d6f-001a4bcf887a.html 

Norovirus: New Jersey

January 29, 2013
Excerpts:

Sick and tired: Stomach virus spreads across N.J. on heels of flu spike

State health officials report a spike in outbreaks of the norovirus, a disease that has no connection to the influenza virus that has sent three times as many New Jerseyans to local emergency rooms than last year.

http://www.nj.com/news/index.ssf/2013/01/stomach_flu_spreading_through.html

FAO: Flashback: US increases funding to combat influenza and emerging disease threats

	US increases funding to combat influenza and emerging disease threats
	Continued partnership will strengthen countries' preparedness, surveillance and response

October 2012
Excerpt:

Funding will also go to regional coordination to combat avian influenza and to support surveillance and prevention in Cambodia, Lao PDR, Nepal and Myanmar, which are threatened by the disease's continuing persistence in neighbouring countries. 

These countries continue to have sporadic outbreaks, indicating the H5N1 virus continues to circulate in poultry and remains a threat to poultry production, human health and the livelihoods of millions of vulnerable farmers who depend on poultry raising for their basic food needs and a means of making a living.

"The US Government has been key in generating international support to combat avian influenza and to reduce the chances for a human pandemic by assisting FAO and others to address the threat in animals before it spills over into humans. Such support for basic prevention measures is rare, yet most sensible and cost effective," said FAO Chief Veterinary Officer Juan Lubroth.

Emerging pandemic threats

Thanks in large part to the USAID-FAO partnership, since avian influenza grew to proportions of a global crisis between 2004 and 2006, the scientific community has gained a deeper understanding of what drives disease emergence and thus the measures to take to prevent disease. 

Due to the speed with which animal-origin pathogens such as H5N1, severe acute respiratory syndrome (SARS) in 2002-2003 and the H1N1 influenza pandemic in 2009, caused by a virus that had combined elements of avian, swine and human origin, USAID launched its "Emerging Pandemic Threats (EPT) programme.

Through EPT's "Identify" component, support is funnelled to countries to strengthen the capacities of national and regional laboratory networks to diagnose and characterize different types of influenza virus threats. 

This continues to be especially important in Southeast Asia, where new virus strains continue to emerge, which can eventually develop into a direct threat for human health and perpetuate poultry losses. In addition, as viruses adapt, poultry vaccines against H5N1 can lose their effectiveness, leaving domestic poultry vulnerable to disease.

http://www.fao.org/news/story/en/item/163271/icode/

FAO: World risks new bird flu surge if countries drop their guard

29 January 2013, Rome - The world risks a repeat of the disastrous 2006 bird flu outbreaks unless surveillance and control of this and other dangerous animal diseases is strengthened globally, FAO warns.

"The continuing international economic downturn means less money is available for prevention of H5N1 bird flu and other threats of animal origin.  This is not only true for international organizations but also countries themselves," says FAO Chief Veterinary Officer Juan Lubroth.  "Even though everyone knows that prevention is better than cure, I am worried because in the current climate governments are unable to keep up their guard."

Continued strict vigilance is required, however, given that large reservoirs of the H5N1 virus still exist in some countries in Asia and the Middle East, in which the disease has become endemic. Without adequate controls, it could easily spread globally as it did at its peak in 2006, when  63 countries were affected. 

Investing makes sense

Investing more in prevention makes economic sense given the huge toll inflicted by a full-scale pandemic. Between 2003 and 2011 the disease killed or forced the culling of more than 400 million domestic chickens and ducks and caused an estimated $20 billion of economic damage.

Like several animal diseases, H5N1 can also be transmitted to humans. Between 2003 and 2011, it infected over 500 people and killed more than 300, according to the World Health Organization.  

"I see inaction in the face of very real threats to the health of animals and people," Lubroth says.

This is all the more regrettable as it has been shown that appropriate measures can completely eliminate H5N1 from the poultry sector and thus protect human health and welfare. Domestic poultry are now virus-free in most of the 63 countries infected in 2006, including Turkey, Hong Kong, Thailand and Nigeria. And, after many years of hard work and international financial commitment, substantial headway is finally being made against bird flu in Indonesia.

Growing threat

Another growing threat is Peste des Petits Ruminants, or PPR, a highly contagious disease that can decimate flocks of sheep and goats. "It is currently expanding in sub-Saharan Africa - causing havoc in the Democratic Republic of Congo among other countries - and is just starting to spill over into southern Africa," Lubroth says. "The damage could well be huge".

"The irony is that a perfectly good vaccine exists for PPR, but few people are using it," he adds.  Along with tight finances, lack of political will, and poor planning and coordination are other reasons why PPR and other animal diseases are often allowed to spread.

Investing in prevention means improving hygiene practices, market and border controls, and health security in farms and markets. It includes equipping laboratories and training staff to diagnose and respond to disease outbreaks, and in organizing efficient extension services to serve farmers' needs.

Despite tight budgets, international organizations should also try to do more through concerted action. "We need to come together to find ways to ensure the safety of the global food chain," Lubroth urges. 

"The costs - and the dangers - of not acting are just too high."  
  
http://www.fao.org/news/story/en/item/168885/icode/

Cambodia: Poultry From Same Lot Likely Infected; Increased Trading for Chinese New Year

1/29/13
Excerpt:

The three infections in two weeks compares starkly with 2012, when just three people were diagnosed with avian influenza in the entire year, down from eight cases in 2011. All three cases in 2012 led to the death of the patient.

The WHO, the Ministry of Health and animal health experts from the Ministry of Agriculture are currently trying to find a link between the three latest cases, said the WHO’s Sonny Krishnan.

It was likely that the avian influenza originated from the same group of poultry, but spread over three provinces due to increased trading in chickens before the forthcoming Chinese New Year on February 8, Mr. Krishnan said.

“What happens is that people get poultry from surrounding villages and if they can’t sell it, it’s transferred somewhere else,” he said.

“So Chinese New Year is a probable reason why the cases are so spread out.”

Cambodia: #H5N1 Avian Influenza Human Cases List

As you can see from this map, Kampot Province is directly below Kampong Speu.  The 9 yo is from Kampot.

Kampong Speu​

Date 1/27/13

Name:  35(M)
From:  Trapeang Sla village, Preah Nipean commune,  Kong Pisey district, Kampong Speu
Onset:  1/13
Adm:  Treated by private practioner
Adm:  1/21
Hospital:  Khmer-Soviet Friendship Hosp. Phnom Penh, sym's fever, dyspnea
DOD:   1/21
Notes:  Prepared sick chicken for food prior to being sick.
Confirmation:  1/23/13 - Positive

Takeo

Date:  1/27/13

Name:  15(F)
From:  Snao village, Prey Kabass district, Takeo Province
Onset:  1/11/13
Adm:  Treated by private practioner.
Hospital:  Kantha Bopha
Adm:  1/17/13 sym's fever & shortness of breath.
DOD:  1/21/13
Notes:  Previous dead poultry in village.  Prepared sick chicken for food prior to being sick.
Confirmed:  1/22/13 - Positive

Name:  5 yo female
From:  Angk Krasang Village, Prey Lvea commune, Prey Kabass district, Takeo Province.
Onset:  1/25
Adm:  local private practitioner
Adm:  1/31 with fever, cough & dyspnoea
Hospital:  Kantha Bopha Hospital
Confirmed:  Positive, diagnosed on 2/7
DOD:  2/7
Notes:  recent deaths of poultry in village. 

Phnom Penh

Date:  1/27/13

Name:  8 month male
From:  Chrey Korng Village, Sangkat Chorm Chao, Khan Por Sen Chey, Phnom Penh
Onset:  1/8/13Hospital:  National Pediatric Hosp.
Adm:  1/9 sym's fever, cough, runny nose, vomiting.
Notes:  Samples sent on 1/11.  History of contact with poultry.
DOD:  survived and recovered
Confirmed:  1/22/13 - positive

Kampong Speu

Date 1/28/13
Name:  17 month girl
From:  Kong Pisei district, Prey Nhat commune, Kampong Speu
Onset:  1/13, fever, runny nose, vomiting
Adm:  private practitioner
Adm:  1/17 fever, cough, somnolence & dyspnoea 
Hospital: Kantha Bopha Phnom PenhNotes:  Recent poultry death in village.  Contact with poultry.
DOD:  1/28
Confirmed:  Positive 1/26

Kampot Province

Date 1/29/13

Name:  9 yo girl
From:  Thmei village, Thmei commune, Toeuk Chhou district, Kampot Province
Onset:  1/19, fever, cough
Adm:  Initially treated by a private practitioner
Adm:  1/27
Hospital:  Kantha Bopha with fever, cough, somnolence and dyspnoea
DOD:  1/28
Notes:   Poultry dead around village.
Confirmed:  Positive - 1/28

Cambodia: Two New Bird Flu Deaths

1/29/13

PHNOM PENH: Two Cambodian girls have died from bird flu, health authorities said Tuesday, raising the toll from the deadly infection in the kingdom to four so far this year.

The victims, a 17-month-old girl and a nine-year-old girl, from the southern provinces of Kampot and Kampong Speu, died Monday in hospital, the World Health Organization said in a joint statement with the Cambodian health ministry.

Tests on the girls, whose villages had recorded recent deaths among poultry, confirmed they had contracted the H5N1 strain of avian influenza, the statement added.

Last week Cambodia said two people -- a 15-year-old girl and a 35-year-old man, had died from the H5N1 strain contracted while preparing infected chicken.

Continued  here

Cambodia: MOH Update - Fourth & Fifth New Human Cases of Avian Influenza H5N1

1/29/13
Today we received another Press Release from the Ministry of Health of Cambodia and the World Health Organization.  Two more cases have been confirmed positive for H5N1 virus.

The fourth case, I have already posted on.  A 17-month girl, from Prey Nheat village, Prey Nheat Commune, Kong Pisey district in Kampong Speu Province.
Onset:  1/13, fever, cough, runny nose, vomiting
Adm:  Initially treated by a private practitioner
Adm:  1/17
Hospital:  Kantha Bopha with fever, cough, somnolence & dyspnoea
DOD:  1/28
Notes:  Poultry dead around village, contact with sick poultry
Confirmed:  Positive - 1/26

The fifth case:
Name:  9 yo girl
From:  Thmei village, Thmei commune, Toeuk Chhou district, Kampot Province
Onset:  1/19, fever, cough
Adm:  Initially treated by a private practitioner
Adm:  1/27
Hospital:  Kantha Bopha with fever, cough, somnolence and dyspnoea
DOD:  1/28
Notes:   Poultry dead around village.
Confirmed:  Positive - 1/28

For the full Press Release click  here

Cambodia: Update on 4th Human Case #H5N1

[The 35yo male that died, was also from Kong Pisei district.  He was from Preah Nipean commune.]

Excerpts:
An official on the Ministry of Health’s human influenza hotline and a commune chief said yesterday a two-year-old girl from Kampong Speu was diagnosed with H5N1 on Saturday after being admitted to Kantha Bopha hospital in Phnom Penh, where a 15-year-old girl died of the virus last Monday.

Due to less-rigorous monitoring of the disease in other hospitals, the cases seen in Kantha Bopha hospital were likely just the “tip of the iceberg”, said Dr Philippe Buchy, head of the virology unit at the Institut Pasteur du Cambodge, the medical research centre that tested the recent cases. 

Local health officials had buried the burned birds outside the village, sprayed the village and distributed medicine to eradicate the virus, he said.

Officials in Kong Pisei district’s Prey Nhat commune, in Kampong Speu province, the home of the two-year-old confirmed on Saturday to be the fourth case of the year, were pushing similar measures, according to commune chief Chan Sun.

Sun said a lot of poultry in the commune tended to get sick during the dry season, and officials had told villagers not to cook or touch sick or dead birds.  

“They have to burn and bury the dead poultry,” he said. “We have also prohibited poultry buyers who usually come into the commune from buying chickens in the commune for a while until we are sure everything is safe.”

More than 40 chickens at the infected toddler’s house had fallen sick and died, and, as with the other three cases this month, health officials suspect contact with poultry had caused her to become ill.

“Health officials went to the girl’s and her neighbours’ houses this morning to spray and distribute medicines, and they tested some poultry,” Sun said. 

Cambodia: 4 Human Cases #H5N1 In One Month

PHNOM PENH — Two Cambodians have already died from bird flu in 2013, making a worrying start to the year.

Now a two-year-old Cambodian girl is in a serious condition in Phnom Penh after being hospitalized with the H5N1 virus, also known as avian, or bird, flu.

Sonny Inbaraj Krishnan, the communications officer for the World Health Organization in Phnom Penh, says the development has health professionals concerned.

“This is the fourth case this month of human influenza H5N1," Krishnan said. "Last year we had three cases, so within one month in the new year we've got four cases, and we're quite concerned about that.”
-snip-
Over the weekend officials culled and burned more than 4,000 chickens and ducks in the village that was home to the 15-year-old victim.  
-snip-
“Well our specific worry is that this H5N1 virus could undergo what we call a recombination and then re-assortment with another influenza virus," he explained, "and that could give rise to a new virus that is transmittable between humans - so that’s our main concern.”

Cambodia is a predominantly agricultural nation, and every village has its chickens and ducks. Health ministry staff are monitoring those who came into contact with the patients who were infected, and teams from the agriculture ministry are testing poultry in the affected villages and destroying sick birds.

http://www.voanews.com/content/new-bird-flu-case-raises-fears-in-cambodia/1592100.html 
 

Cambodia Ministry of Health Statement on 1/25/13

 This is a Press release dated 1/25/13. 

Joint Press Release Between The Ministry of Health Kingdom of Cambodia and the World Health Organization (WHO).

The Statement goes on to say the first case was an 8 month old from Chrey Korng Village, Sangkat Chorm Chao, Khan Por Sen Chey, Phnom Penh.  He developed symptoms on 1/8, was brought to the hospital on 1/9, samples were sent on 1/11, with results on 1/22. 

The 2nd case, a 15 year old female was from Snao Village, Snao Commune, Prey Kabass district in Takeo Province.  She becameill on 1/11, was initially treated by a private practitioner, and admitted to hospital on the 1th.  She died on the 21st.

The 3rd case was a 35 year old man from Trapeang Sla village, Preah Nipean commune, Kong Pisey district, Kampong Speu province.  He has his first symptoms on 1/13, was hospitalized on 1/21.  Being treated by a private practitioner beforehand.  He died shortly after the samples were taken, which was on 1/21/13.

There is a campaign underway to educate the public on avian influenza.  They are also checking close contacts, any epidemiological linkage among the three cases.

The whole statement can be found here.