Vietnam: Influenza A/H5N1 overflow from Cambodia, Ho Chi Minh City emergency prevention

02/21/2013

 Translation

Currently, the A/H5N1 flu in Cambodia has spilled over the border, threatening outbreak in the southern provinces.  

-snip-

Bird flu in CPC has overflowed into Vietnam. risk spread, outbreaks in the southern provinces are at a high level, especially in the CPC adjacent provinces of Tay Ninh, Binh Phuoc, Long An.

According to the veterinary VI, in Tay Ninh area bordering with you, have discovered two outbreaks in Tien Thuan and Binh Minh (Ben Cau district).

Illegal trade in poultry operations still rampant

Bird flu spreads, combined with the sale of illegal slaughter occurs widespread throughout the coastal districts increases the risk of disease and food safety in the city.

This seriously affected the epidemiological situation of cattle and public health in the area of ​​Ho Chi Minh City.

Before this situation, the City People's Committee has asked the departments the situation closely livestock management, trade, slaughter cattle and poultry in order to detect early outbreaks, timely treatment, not to spread on a wide.

Thorough handling of the situation of trafficking movement of poultry disease, of unknown origin, not regulations.

Besides, the city asked the health sector to strengthen propaganda against influenza A in humans, prepare facilities, equipment and medicine for the prevention of bird flu in the province south.

http://wap.tinngan.vn/Cum-AH5N1-tran-ve-tu-Campuchia-TP-HCM-khan-cap-phong-chong_0-1-0-384676.html 

Cambodia Case List 2013

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Report Date/Province/District/ Con. Date /Name/DOD

Jan 27/Kampong Speu/Kong Pisei/1-23/35(M)/DOD 1-21

Jan 27/Takeo/Prey Kabass/1-22/15(F)/DOD 1/21

Jan 27/Phnom Penh/Porsenchey/1-22/8(mos)/Recovered

Jan 28/Kampong Speu/Kong Pisei/1-26/17(mos)/DOD 1-28

Jan 29/Kampot/Teouk Chhou/1-28/9(F)/DOD 1-28

Feb 8/Takeo/Prey Kabass/1-22/5(F)/DOD 2-7

Feb 13/Kampot/Angkor Chey/2-11/3 (F)/DOD 2-13

Feb 21/Kampot/Angkor Chey/2-19/2 (M)/DOD 2-19
Feb 26/Kampong Cham/Trung Trang/2-23/35(M)/DOD 2-25

Apr 3/Kampot/4-2/6(M)/

 

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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

Phnom Penh

Date:  1/27/13

Name:  8 month male
From:  Chrey Korng Village, Sangkat Chorm Chao, Khan Porsenchey district, 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

Takeo Province

Date  2/8/13

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.  Touched & ate dead chicken. 

Kampot Province

Date:  2/13/13

Name:  3 yo female

From:  Trapeang Kamphleanh village, Ang Phnom Toch commune, Angkor Chey District, Kampot Province

Adm:  2/6

Hospital:  Kantha Bopha Hospital, fever, abdominal pain, drowsiness

Onset:  2/3 red rash, initially treated by private practioner

Notes:  Recent death of poultry in village, history of contact.  Critical Condition w/severe breathing problems.

Confirmation:  2/11/13

DOD:  2/13/13

Kampot Province

Date:  2/21/13

Name:  2 yo male

From:  Ang Romduol Village, Angkor Chey commune, Angkor Chey district, Kampot Province

Onset:  2/6, runny nose & fever.  Treated by local private practioner.

Adm:  2/18 Kantha Bopha Hospital, Phnom Penh with fever, cough, dyspnea

Confirmation:  2/19/13

DOD:  2/19/13 (18 hours after admission)

Note:  Poultry death in Village.  Eighth death this year.  29^th person to become infected.  26^th to die.  Of the 29 confirmed Cases, 20 were children under 14.  19 of the 29 were Female.

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Kampong Cham Province

Date:  February 26, 2013

Name:  35 (Male)

From:  Kbl Ou Village, Me Sar Chrey commune, Stueng Trang, Kampong Cham Province

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Onset:  2/8  fever; worsened on 2/10 w/frequent cough, dypsnea

Adm:  Local practitioner

Adm:  2/13 Kampong Cham Hosp.  Treated with Tamiflu

Adm:  2/19, Hospital Benh Calmete, Phnom Penh (MOH Statement says 2/21), developed pneumonia

Notes:  Contact with dead Ducks and eating. 

Confirmation:  Positive on2/23/19

DOD:  2/25

Kampot Province

Date:  4/3/13

Name:  6 (M)

From:  Southwest Kampot Province

Onset:

Adm:  3/31 Kantha Bopha Hospital, Phnom Penh

Note:  Critical condition.

Cambodia: #H5Nl Death - Joint Press Release from the Ministry Of Health and the World Health Organization (WHO)

Eighth New Human Case of Avian Influenza H5N1 in Cambodia in 2013

Phnom Penh, 21 February 2013

The Ministry of Health (MoH) of the Kingdom of Cambodia wishes to advise members of the public that one more new human case of avian influenza has been confirmed positive for the H5N1 virus.

The Ministry of Health will continue to keep the public informed of developments via the MoH website www.cdcmoh.gov.kh where relevant health education materials can also be downloaded. For more information on human influenza please call the MoH Influenza Hotline numbers: 115 (free call); 012 488 981 or 089 669 567

The eighth case, a 20-month-old boy from Ang Romduol village, Angkor Chey commune, Angkor Chey district in Kampot province, was found positive for influenza H5N1 on 19 February 2013 by Institut Pasteur du Cambodge.
He developed fever and a runny nose on 6 February 2013 and was initially treated by local private practitioners. His condition worsened and he was admitted to Kantha Bopha Hospital on 18 February 2013 with fever, cough and dyspnea and died on 19 February 2013. There is evidence of recent deaths among poultry in the village.

The boy is the eighth person this year and the 29th person to become infected with H5N1 virus, and the 26th person to die from complications of the disease in Cambodia. Of the 29 confirmed cases, 20 were children under 14, and 19 of the 29 were female. 

"Avian influenza H5N1 remains a serious threat to the health of Cambodians, especially children,” said HE Dr. Mam Bunheng, Minister of Health.

“This is the eighth case of H5N1 infection in humans this year, and children still seem to be most vulnerable. Children are at high risk because they may play where poultry are found and I urge parents and guardians to keep children away from sick or dead poultry and prevent them from playing with chickens and ducks.”

“Parents and guardians must also make sure children wash their hands with soap and water after any contact with poultry. If they have fast or difficult breathing, they should seek medical attention at the nearest health facility and attending physicians must be made aware of any exposure to sick or dead poultry.”

“The greatest risk of exposure to the virus is through the handling and slaughter of infected poultry. Home slaughtering and preparation of sick or dead poultry for food is hazardous: this practice must be stopped.”

The Ministry of Health's Rapid Response Teams (RRTs) have gone to the hospital and the field to identify the boy’s close contacts, any epidemiological linkage among the eight cases and to initiate preventive treatment as required.

In addition, a public health education campaign is being conducted in the village to inform families on how to protect themselves from contracting avian influenza.

The Government's message is: wash hands often; keep children away from poultry; keep poultry away from living areas; do not eat sick poultry; and all poultry eaten should be well cooked.

H5N1 influenza is a flu that normally spreads between sick poultry, but it can sometimes spread from poultry to humans.  Human H5N1 Avian Influenza is a very serious disease that requires hospitalization.  Although the virus currently does not easily spread among humans, if the virus changes it could easily be spread like seasonal influenza.  Hence early recognition of cases is important.

The Ministry of Health will continue to keep the public informed of developments via the MoH website www.cdcmoh.gov.kh where relevant health education materials can also be downloaded.

For more information on human influenza please call the MoH Influenza Hotline numbers: 115 (free call); 012 488 981 or 089 669 567

Hong Kong: Press Release Concerted efforts in enhancing surveillance and control measures for novel coronavirus

 [editing is mine]

Published on: 2013-02-21
     Representatives from the Department of Health (DH) and the Hospital Authority (HA) met today (February 21) to discuss the updated global situation of Severe Respiratory Disease associated with Novel Coronavirus and will work together in enhancing the surveillance and control measures for the disease. This is the fourth special meeting held between the DH and the HA on the issue.

     The surveillance measures currently in place include statutorily notification of Severe Respiratory Disease associated with Novel Coronovirus and enhanced laboratory testing for novel coronavirus in severe respiratory cases with pneumonia with unknown causes, after ruling out common causative agents.

     During the meeting, representatives from the DH and the HA agreed to further enhance the laboratory surveillance for novel coronavirus. For cases of pneumonia with unknown cause, pneumonia cases that require intensive care, clusters of pneumonia or health-care workers with pneumonia, routine testing for novel coronavirus will be carried out irrespective of travel history. These enhanced measures will be carried out starting from tomorrow (February 22).

     Speaking at a media session after the meeting, the Controller of the Centre for Health Protection (CHP) of the DH, Dr Leung Ting-hung, expressed concern on the latest development of the disease in the UK.

     "The mortality of this disease is very high and several instances of human-to-human transmission are likely to have occurred in the Middle East and the UK. However, no sustained transmission or expanding clusters of infection have been identified in any country since the earliest cases traced back to April 2012," Dr Leung said.

     "Doctors are advised to be vigilant and report any suspected cases to the CHP. Health-care workers should exercise appropriate infection control measures at all times. As with the Severe Acute Respiratory Syndrome (SARS) experience, the public should pay particular attention to personal and environmental hygiene and avoid direct contact with animals, birds or poultry," he said, adding that the virus may remain viable in the environment for some time and can be inactivated by 1:99 household bleach.

     Dr Leung also advised travellers returning from novel coronavirus-affected countries with respiratory symptoms to wear facial masks and seek medical attention and reveal their travel histories to doctors. The CHP will closely monitor the situation and update the surveillance criteria and testing strategies accordingly.

     Also speaking at the media session, the Chief Infection Control Officer of the Hospital Authority, Dr Dominic Tsang, added that public hospitals will continue to closely monitor, promptly isolate and perform rapid diagnostic testing of patients based on defined criteria and risk factors identified.

     "Such cases will also be notified to the CHP through existing channels. Health-care workers will be updated once again on the current situation and reminded to adhere to proper infection control measures. Treatment guidelines will be provided to front-line doctors in guiding patient clinical management," Dr Tsang said.

Ends/Thursday, February 21, 2013
Issued at HKT 19:40http://www.info.gov.hk/gia/general/201302/21/P201302210521.htm

Hong Kong: Cluster of 7 Influenza A cases in Caritas Medical Centre, 3 Staff Member since 2/12

The following is issued on behalf of the Hospital Authority:

     The spokesperson for Caritas Medical Centre (CMC) made the following announcement today (February 21):

     A total of four children (three male and one female, aged 4 to 17) and three staff of the developmental and disabilities unit have presented with fever and upper respiratory symptoms since February 12. Influenza tests have been arranged and confirmed three children have been suffered from Influenza A. The concerned children are being treated under isolation. One of them is in serious condition and the others are in stable condition. One staff member is now on sick leave while the other two have recovered and been back to work.

     Infection control measures have been stepped up according to established guidelines. Admission and activities of children who are staying in same dormitory have been suspended while visiting arrangement remains normal. All other children as well as staff in the unit are under close surveillance.

     CMC has reported the cases to the Hospital Authority Head Office and Centre for Health Protection for necessary follow-up.

Ends/Thursday, February 21, 2013
Issued at HKT 20:48

http://www.info.gov.hk/gia/general/201302/21/P201302210529.htm

Exactly How Contagious is the Coronavirus?

[Below is an excerpt from the document, published on February 20th, from the HPA: "Infection Control Advice Novel Coronavirus Cases". The editing below is mine. The whole document can be found as a pdf file link provided at the bottom of page.   I have got to wonder exactly how contagious this is. I also wonder if the family members that visited the Index case (Case #10) and the case that just died (Case #11) wore an FFPE Respirator while in the room?]  

This document outlines infection control and other general advice for personnel who may be involved in receiving and caring for patients, primarily within healthcare settings, who may be infected with a novel coronavirus.
Added/updated: 20 February 2013

Excerpt of document below:

The remainder of this document concerns infection control advice solely for probable or confirmed cases.

Isolation
• Patients requiring admission should be admitted directly to negative-pressure single rooms, if available. If this is not possible then a single room with en-suite facilities should be used. Room doors should be kept closed. Positive pressure, single rooms should not be used.
• If on a critical care unit, the patient should be nursed in a negative pressure room where available, or if not available, a neutral pressure side room with (closed ventilator circuit) should be used.
• Staff should wear protective clothing as detailed below. Rooms should be appropriately decontaminated before being used again (see below: Cleaning). Suitable written information must be placed on the isolation room door indicating the need for respiratory and enteric isolation, though there will be a need to respect patient confidentiality.
• Only essential staff should enter the room.
• A record of all staff that have had contact with a confirmed/probable patient should be kept.

Staff
• Staff must comply with all infection control procedures as detailed above.
• A record of all staff caring for the patient must be maintained. The record sheet should be placed at the door and all staff entering must complete this.
• The use of bank or agency staff should be avoided wherever possible.
• All HCW should be vigilant for any respiratory symptoms in the ten days following last exposure to a case and should not come to work if they have a fever or cough. They should seek advice from their infection control team/occupational health department as per the local policy. Their hospital infection control team and/or local HPU will advise on where they should be medically assessed. During this period, symptomatic healthcare workers should avoid close contact with people both in the hospital and in the general community.


Visitors
• The number of visitors should be restricted.
• Visitors entering the isolation room must wear PPE as previously detailed.
• Visitors must be trained in the appropriate use of protective clothing and hand hygiene.
• A log of all visitors must be kept.
4


Contact tracing
• Follow up of staff contacts of patients will be co-ordinated by the Trust Occupational Health Department.
• Follow up of community contacts of patients will be co-ordinated by the local Health Protection Unit.


Protective clothing
To be worn by ALL staff and visitors entering the room (see appendix 1: putting on and removing personal protective equipment)
• Long sleeved, fluid-repellent disposable gown – the possibility of staff wearing scrubs underneath would obviate problems with laundering of uniforms and other clothing.
• Non-sterile surgical gloves.
• An FFP3 respirator conforming to EN149:2001 to be worn by all personnel carrying out clinical care, visitors or staff in the room during aerosol generating procedures. Fit testing must be undertaken before using this equipment. Refer to DH poster: How to fit test an FFP3 respirator.  [added by me:  Definition Aerosol-generating procedures (AGP) are procedures that stimulate coughing and promote the generation of aerosols.  I was very curious about the FFP3 mask, so I did some research.  Below is a screen shot & link:]

Link:  http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CFEQFjAC&url=http%3A%2F%2Fwww.directa.co.uk%2Fproduct_datasheets%2Fffp.pdf&ei=yRgmUfWiF-ng2QWcmYCQBQ&usg=AFQjCNEOywY0NSF6rywA-jIgVkPhflKvug&sig2=zih-H3sYdtecW4JFPe-4Sg&bvm=bv.42661473,d.b2I&cad=rja

• Every time a respirator is used it should be fit-checked. Refer to DH poster: How to fit and fit check an FFP3 respirator.
• Eye protection (prescription glasses do not provide adequate protection against droplets, sprays and splashes).
It is vital that the protective clothing described above is worn for all airway management, including intubation

Hand hygiene
• This is essential before and after all patient contact, removal of protective clothing and cleaning of the environment.
• Use soap and water or use alcohol hand rub if hands are socially clean
• Rings (other than a plain smooth band), wrist watches and wrist jewellery must not be worn by staff.

http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317136232722

Vietnam: Department of Preventive Medicine A/H5N1 flu prevention guide

February 20, 2013
When symptoms such as fever, cough, shortness of breath related to avian people immediately to the nearest medical facility for examination and treatment.

The complicated development of A/H5N1 flu are returned in a number of countries and regions Hong Kong (China), Cambodia, Vietnam ... aim of A/H5N1 flu spread from poultry to humans and reduce mortality, Preventive Medicine Department (Ministry of Health) strongly recommends people make good some of the following measures:

- Do not transport, purchase and sale of poultry and poultry products of unknown origin.

- Ensure cooked, boiled drinking; wash hands with soap before eating.

- Upon detection of sick poultry, died absolutely slaughtered and use that to notify local authorities handled promptly.

- When you have symptoms of fever, cough, shortness of breath related to avian influenza immediately to the nearest medical facility for examination and treatment.

http://www.baomoi.com/Home/SucKhoe/alobacsi.vn/Cuc-Y-te-du-phong-huong-dan-phong-chong-cum-AH5N1/10427621.epi 

Vietnam: Ho Chi Minh City: Emergency #H5N1 flu prevention

2/21/13

(Reuters) - Influenza A/H5N1 from Cambodia has spilled over the border threatened outbreak in the southern provinces. Before this situation, the city asked the departments to enhance disease prevention, strictly handle violations.

 

Continued  http://dantri.com.vn/suc-khoe/tphcm-khan-cap-phong-chong-cum-ah5n1-698778.htm

Cambodia: #H5N1 Human Death 2 yo from neighboring commune of most previous case

Translated
Excerpt
...Boys in Angkor Chey Commune, was taken to a hospital in Phnom Penh after the sick at least five days. Before that, a 3-year-old girl in neighboring communes with Angkor Chey has died of bird flu on 13/2.

Cambodia: Another Human Fatality Making 8 Total

PHNOM PENH, Feb. 21 — Cambodia reported on Thursday that another 2-year-old boy died of Avian Influenza H5N1, bringing the death toll to seven and the number of cases to eight in 2013.
The toddler lived in Angkor Chey district of Southwestern Kampot province. He died of the virus in the early hours of Tuesday morning at the Kantha Bopha Hospital in Phnom Penh, 18 hours after he was admitted, Dr. Denis Laurent, deputy director of Kantha Bopha Children’s Hospital, told Xinhua over telephone on Thursday.
“He passed away even though our doctors did all their best to save him,” he said.
Last week, a 3-year-old girl from the same district also died of the virus at the hospital.
The country sees the worst outbreak of the virus this year since the disease was first identified in Jan. 2004. To date, the country has reported 29 human cases of the virus, killing 26 people.

Hong Kong: No human infection with novel coronavirus identified so far in Hong Kong

[hat-tip Flu Trackers]
Press  Release
In response to media enquiries on a rumour concerning human infection with novel coronavirus in Hong Kong, a spokesperson for the Centre for Health Protection (CHP) of the Department of Health today (February 20) clarified that no human infection with this virus has been identified so far in Hong Kong.

     "According to the World Health Organization (WHO), of the total 12 confirmed cases of Novel Coronavirus globally, three recently confirmed cases have been diagnosed in the UK," the spokesperson said.

     According to the latest information from the European Centre for Disease Prevention and Control (ECDC) and the Health Protection Agency (HPA) of the UK, a male UK resident (Case 10) with confirmed novel coronavirus infection who had travelled to Pakistan and the Middle East, developed respiratory symptoms on January 24 and then had arrived unwell in the UK on January 28. While staying with his family at home, his condition deteriorated and he was admitted to hospital under intensive care.

     On February 6, a male household member (Case 11) who had contact with Case 10 from his arrival until hospital admission felt unwell. This patient had an existing medical condition that might have made him more susceptible to a severe respiratory infection. His respiratory condition deteriorated and he was admitted to hospital where he was under intensive care but subsequently died.

     The latest confirmed case (Case 12) is a younger female family member, who only had exposure to Case 10 while he was in hospital. She became ill on February 5 with a typical influenza-like illness which did not require hospital admission. She has now fully recovered.

     Cases 11 and 12 were likely infected through human-to-human transmission, although the exact route of transmission is still under investigation by the UK authority. The presence of an intermediary case or fomite spread are possible.

     "According to the ECDC, close follow-up of approximately 200 health-care workers, family members and other contacts of cases in Europe and the Middle East has not yet found other demonstrated instances of human-to-human transmission. So far, no sustained transmissions or expanding clusters of infections have been identified in any country," the spokesperson remarked.

     "Members of the public are advised to maintain good personal and environmental hygiene and avoid direct contact with animals, birds or poultry," said the spokesperson, adding that the virus may remain viable in the environment for some time and can be inactivated by 1:99 household bleach.

     He also advised travellers returning from novel coronavirus-affected countries with respiratory symptoms to wear facial masks and seek medical attention and reveal their travel histories to doctors.

     "The CHP will stay vigilant and continue to work closely with the WHO and other overseas health authorities to monitor the latest developments of this novel infectious disease," he said.

     "Locally, the CHP will continue its surveillance mechanism with public and private hospitals, practising doctors and the airport for any suspected cases of Novel Coronavirus associated with Severe Respiratory Disease," he added.
Ends/Wednesday, February 20, 2013
Issued at HKT 19:26

http://www.info.gov.hk/gia/general/201302/20/P201302200513.htm

Vietnam: People to medical surge

[Seems to be O.K.  Posted here for future reference]

02/19/2013

Czech Hospital (Hai Phong) the number of patients to medical east doubled, tripled normal because many people try to wait out the new holiday visit.

Afternoon on 18.2, in the examination of the hospital has a large number of patients waiting to turn. BV English Czech leader said, in the day, more than 860 patients visit the hospital-east twice normal.contrast to the busy in the large hospital emergency to direct even Tet, the clinic treatment facility 2 Cau Dat Ngo Quyen district of Hospital, health stations wards Le Loi (Ngo Quyen district) at than 14h-way 18.2 is still in closed condition then install. while in the in HCM City as Cho Ray Hospital, 1 Children, 2, Trung Vuong Nguyen Tri Phuong, 115 ... People, patient to congestion as the days before Tet. 1 Children's Hospital representative said that, every year, too-except the emergency first-visit patients often disagree as many abstain to BV those days early. As leaders of the Department of Health, although long stay on but more BV Stagger disease to early prone overload, should have arranged online and work from earlier in order to treat the backlog. In Orthopedic Hospital Trauma-alone, Cho Ray Hospital, the surgical cases date from before the festival was moved to the specified surgery on the first working day of the new year. While BV "breathable" the first day, on the other hand, at the Emergency Department of Cho Ray Hospital is always in a state of overload traffic accident on the city and in the province flock. 

http://laodong.com.vn/Y-te/Nguoi-den-kham-benh-tang-dot-bien/102768.bld 

Vietnam: Children en masse hospitalized after Tet

[Everything seems to be o.k.  Posted here for future referencing]

02/21/2013 After the long New Year holiday, at Children's Hospital 1 and 2, the number of children en masse to medical and hospitalization strong. Every day, in 2 Children's Hospital, the number of children to see up to nearly 9000. Not only patients in Ho Chi Minh City from the neighboring provinces such as: Binh Duong, Dong Nai, Long An and Ba Ria-Vung Tau also flocked to visit. Day 19.2, at 1 Children's Hospital, the clinic full of people and wait for medical procedures.

According to the General Plan BV, the number of patients registered examination of more than 4,700 cases. Number of patients are treated at the hospital for up to 1,000 children. Also at Children's Hospital 2, the amount of patients flock BV examination and treatment is also increasing rapidly. Dr. Trinh Huu Tung, Head of Planning General Children's Hospital 2, said, in 18 and 19.2, every day, the number of patients to examination at more than 4000 times. majority of children examined and hospitalized diseases festival season such as: digestion, respiration. In addition, the number of child examination infectious diseases, ear, nose and throat also account for the relatively high number. Through disease investigation, the doctor said the cause of digestive disorders is because they eat too many sweets, jams, soft drinks during the holiday.

In addition, children with respiratory infections due to changes in the weather while traveling, visiting home, go out late at night ... and infected with the virus. Quantity patients to examination in fact much higher due to the child's family clinic, district hospital, private hospital or home treatment. Until they become severe leading to examination and treatment in hospital. expected, according to the BS, the number of patients with respiratory, digestive diseases will continue to increase as children go back to school, especially in children preschool age due to changes in lifestyle, diet.

Dr. Hoang Le Phuc, head of gastroenterology 1 Children's Hospital, said, to prevent gastrointestinal diseases during this time, the parents do not children should eat foods such as bread, jam left over after the holidays. Need cooked, boiled drinking and children should not eat food that has fans reheated several times. When children with gastrointestinal disorders, prolonged diarrhea should not use money to buy medicines for children that have to go to health facilities for inspection and the BS specific medications. "Diarrhoea is usually because the child infected with a virus or bacteria in the intestinal tract. Need for children to eat the full age-appropriate nutrition, split a meal several times, insert slowly with a spoon because children easily vomiting. Since the disease is spread through the fecal - oral so to prevent diarrhea Notes food hygiene ... "- BS Blessed recommended.

http://laodong.com.vn/Y-te/Tre-un-un-nhap-vien-sau-tet/103020.bld

Hong Kong: CHP rejects coronavirus claims

February 20, 2013

The Centre for Health Protection today clarified that no human novel coronavirus case has been identified in Hong Kong so far.

The centre issued the statement today in response to media enquiries on an alleged coronavirus case in the city.

The centre said, according to the World Health Organisation, of the 12 total confirmed global cases, three recently confirmed cases have been diagnosed in the UK.

According to the latest information from the European Centre for Disease Prevention & Control, investigation of 200 healthcare workers, family members and other contacts of cases in Europe and the Middle East, has not yet found other instances of human-to-human transmission.

No sustained transmissions or expanding clusters of infections have so far been identified in any country.

The centre said it will stay vigilant and work closely with the WHO and other overseas health authorities to monitor the situation.

It advised the public to maintain good personal and environmental hygiene and avoid direct contact with animals, birds or poultry, adding that the virus may remain in the environment for some time and can be inactivated by 1:99 household bleach.

It advised travellers returning from novel coronavirus-affected countries with respiratory symptoms to wear facial masks, seek medical attention and reveal their travel history to doctors.

http://www.news.gov.hk/en/categories/health/html/2013/02/20130220_184732.shtml?pickList=ticker

Hong Kong: Boy ill with severe influenza A

February 20, 2013

The Centre for Health Protection is investigating a case of severe paediatric Influenza A affecting a 15-year-old boy.

He fell ill on February 17 and was admitted to Caritas Medical Centre yesterday.

He tested positive for Influenza A, and is in serious condition.

He was in the Mainland from February 7 to 16.

His family contacts are asymptomatic.

http://www.news.gov.hk/en/categories/health/html/2013/02/20130220_193135.shtml?pickList=ticker

Mansour: Egypt recorded the highest rate of infection of bird flu, according to the report "World Health"

[Since January 16, 2013, we have had 10 reported cases of Human #H5N1 Avian Influenza, including Egypt, as I posted here at the blog.]

2/20/13

Said Dr. Hussein Mansour, head of food safety device that, according to the World Health Organization report, Egypt recorded 169 human cases of bird flu virus

Mansour said that the virus, according to the organization led to the death of the 60 cases until the end of 2012

Mansour pointed out that Egypt recorded the highest rate of infection of bird flu in the period from 2009 to 2012

http://www.ardbalady.com/poultry_farms/28531.html 

Egypt: Book housewife Shebin Hospital Menoufia after being infected with bird Flu

Translation
February 20, 2013 

Detained hospital fevers Shebin, a housewife called "Rasha Mohamed", 31 years old resident of the village of Alaptanon the Shebin Center, because معانتها high temperature and difficulty in urination, and suspected of being infected bird flu virus.

At the same time the Directorate of Health Affairs to maintain, take a sample of her blood and sent to the central laboratory of the Ministry of Health for analysis.

It also announced the Directorate of Veterinary Medicine, for that reason injured woman, came as a result of exposure to dead birds, and that samples were taken for analysis was notified stakeholders "Veterinary Medicine - Agriculture - Local Unit", to go to the residence in question, accompanied by the necessary forces to take preventive measures in place in this regard.

http://elbadil.com/egypt-cities/2013/02/20/111290 

Egypt: #H5N1 in Poultry in Menoufia

Translated
2/20/13
Declared director Mderihtab Veterinary Menoufia Wednesday morning, the discovery of a new focus for bird flu poultry farm in the village facility Sultan بمنوف. said Dr. Mohammed Kabbani, Director of the Directorate of Veterinary Medicine, has been discernible samples from birds from the infected farm king Mahrous Ahmed Mr. analyzed through campaigns organized by the Directorate Beef and provincial centers. Kabbani noted that positive samples result of infection, and it is currently being culled and buried roads with health cleanse the farm, and take a sample of her contacts analyzed to make sure the illness or not.

http://tinyurl.com/apqw2m6

Revised interim case definition for reporting to WHO – novel coronavirus

Interim case definition as of 19 February 2013

Update

Based on additional information received since the original recommendations were published, WHO has updated its case definition for novel coronavirus. WHO will continue to review and revise guidance related to novel coronavirus as more information becomes available.
Recommendations for surveillance are also being revised on the basis of additional information and will be posted as soon as possible.

Case definitions for reporting

Confirmed Case

A person with laboratory confirmation of infection with the novel coronavirus.

Probable Case

• A person with an acute respiratory infection* with clinical, radiological, or histopathological evidence of pulmonary parenchymal disease (e.g. pneumonia or Acute Respiratory Distress Syndrome, (ARDS)); AND
• no possibility of laboratory confirmation for novel coronavirus either because the patient or samples are not available for testing; AND
• close contact** with a laboratory-confirmed case.

Reporting:

WHO requests that confirmed and probable cases be reported within 24 hours of being classified as such, through the regional Contact Point for International Health Regulations at the appropriate WHO Regional Office.

---

* This may include but is not limited to cases with a history of fever or measured fever.
** Close contact includes:

• anyone who provided care for the patient, including a health care worker or family member, or who had other similarly close physical contact;
• anyone who stayed at the same place (e.g. lived with, visited) as a probable or confirmed case while the case was symptomatic. 

http://www.who.int/csr/disease/coronavirus_infections/case_definition/en/index.html

Efficient Replication of the Novel Human Betacoronavirus EMC on Primary Human Epithelium Highlights Its Zoonotic Potential

[Editing is mine] http://mbio.asm.org/content/4/1/e00611-12
ABSTRACT
The recent emergence of a novel human coronavirus (HCoV-EMC) in the Middle East raised considerable concerns, as it is associated with severe acute pneumonia, renal failure, and fatal outcome and thus resembles the clinical presentation of severe acute respiratory syndrome (SARS) observed in 2002 and 2003. Like SARS-CoV, HCoV-EMC is of zoonotic origin and closely related to bat coronaviruses. The human airway epithelium (HAE) represents the entry point and primary target tissue for respiratory viruses and is highly relevant for assessing the zoonotic potential of emerging respiratory viruses, such as HCoV-EMC. Here, we show that pseudostratified HAE cultures derived from different donors are highly permissive to HCoV-EMC infection, and by using reverse transcription (RT)-PCR and RNAseq data, we experimentally determined the identity of seven HCoV-EMC subgenomic mRNAs. Although the HAE cells were readily responsive to type I and type III interferon (IFN), we observed neither a pronounced inflammatory cytokine nor any detectable IFN responses following HCoV-EMC, SARS-CoV, or HCoV-229E infection, suggesting that innate immune evasion mechanisms and putative IFN antagonists of HCoV-EMC are operational in the new host. Importantly, however, we demonstrate that both type I and type III IFN can efficiently reduce HCoV-EMC replication in HAE cultures, providing a possible treatment option in cases of suspected HCoV-EMC infection.

 IMPORTANCE
A novel human coronavirus, HCoV-EMC, has recently been described to be associated with severe respiratory tract infection and fatalities, similar to severe acute respiratory syndrome (SARS) observed during the 2002-2003 epidemic. Closely related coronaviruses replicate in bats, suggesting that, like SARS-CoV, HCoV-EMC is of zoonotic origin. Since the animal reservoir and circumstances of zoonotic transmission are yet elusive, it is critically important to assess potential species barriers of HCoV-EMC infection. An important first barrier against invading respiratory pathogens is the epithelium, representing the entry point and primary target tissue of respiratory viruses. We show that human bronchial epithelia are highly susceptible to HCoV-EMC infection. Furthermore, HCoV-EMC, like other coronaviruses, evades innate immune recognition, reflected by the lack of interferon and minimal inflammatory cytokine expression following infection. Importantly, type I and type III interferon treatment can efficiently reduce HCoV-EMC replication in the human airway epithelium, providing a possible avenue for treatment of emerging virus infections. Footnotes E.K., H.R.J., and D.M. contributed equally to this work. R.D. and V.T. contributed equally to this work. Citation Kindler E, Jónsdóttir HR, Muth D, Hamming OJ, Hartmann R, Rodriguez R, Geffers R, Fouchier RAM, Drosten C, Müller MA, Dijkman R, Thiel V. 2013. Efficient replication of the novel human betacoronavirus EMC on primary human epithelium highlights its zoonotic potential. mBio 4(1):e00611-12. doi:10.1128/mBio.00611-12. Received 20 December 2012 Accepted 4 February 2013 Published 19 February 2013

1. Eveline Kindler^a,
2. Hulda R. Jónsdóttir^a,
3. Doreen Muth^b,
4. Ole J. Hamming^c,
5. Rune Hartmann^c,
6. Regulo Rodriguez^d,
7. Robert Geffers^e,
8. Ron A. M. Fouchier^f,
9. Christian Drosten^b,
10. Marcel A. Müller^b,
11. Ronald Dijkman^a,
12. Volker Thiel^a,g

+ Author Affiliations

1. Institute of Immunobiology, Kantonal Hospital, St. Gallen, Switzerland^a;
2. Institute of Virology, University of Bonn Medical Center, Bonn, Germany^b;
3. Department of Molecular Biology and Genetics, Centre for Structural Biology, University of Aarhus, Aarhus, Denmark^c;
4. Institute of Pathology, Kantonal Hospital, St. Gallen, Switzerland^d;
5. Genome Analytics Group, Helmholtz Center for Infection Research, Braunschweig, Germany^e;
6. Viroscience Lab, Erasmus Medical Center, Rotterdam, The Netherlands^f;
7. Vetsuisse Faculty, University of Zürich, Zürich, Switzerland^g

1. Address correspondence to Ronald Dijkman, Ronald.Dijkman@kssg.ch, or Volker Thiel, Volker.Thiel@kssg.ch.

1. Editor Michael Buchmeier, University of California, Irvine
   
   

Coronavirus: Does Not Trigger an Innate Immune Response; Adaptation to Human Lungs Complete

[an additional excerpt from The Canadian Press article in the previous post]


The source of the new virus is still unknown. As such, there are many unanswered — and currently unanswerable — questions about how much of a risk the virus poses to people. No one can say at this point whether it will fade away, continue to trigger the occasional infection or start to spread easily from person to person.

But the question of whether the virus would need to evolve more to gain the power to infect human lungs does seem to have been answered.

"If an animal virus gets into the human population, one assumes that some adaptation is needed," Thiel said.

"As we have seen for instance for SARS, there was a phase of adaptation to the human cells, to the receptor. And obviously that is not needed for this new coronavirus."

Still, he cautioned that just because the virus can easily infect human lung cells doesn't mean it has all the tools it would need to take off and spread widely among people.

"We have shown that the airway cells can easily be infected. But this does not mean that the virus can easily be transmitted," Thiel said. "I think this distinction is important."

The study also found that all three coronaviruses seem to be able to slip past the immune system because they don't trigger much of an innate immune response. The innate immune system is the so-called first line of defence.

New coronavirus tested in human lung cells

The Canadian Press Posted: Feb 19, 2013 4:18 PM ET

Excerpt:

The new coronavirus can easily infect the cells of the airways of the human lung and in fact is as adept at doing so as a common cold virus, a new study reports.
The authors say the findings suggest this new virus is already well-adapted to being a human pathogen.

The new research finding was published in the journal mBio on Tuesday, the same day British health officials announced that the new coronavirus had taken another life. The unidentified man's death brings to six the number of people confirmed to have died from the new infection.

The man, who had another illness that may have made him more susceptible to infection, is believed to have been infected by a relative, a British resident who became ill while travelling recently in Pakistan and Saudi Arabia. The father remains in serious condition in hospital.

Continued:  http://www.cbc.ca/news/health/story/2013/02/19/coronavirus-infections.html

Why the swine flu situation in India is bad

Nirmalya Dutta, Feb 20, 2013

There’s something very familiar with the way swine flu news filters in from around the country. As the temperatures dip, the authorities of various states claim that the situation is under control, there is enough stock of medicine, enough laboratories to test the virus, enough wards in government hospitals to keep the victims isolated, etc. etc… ad nauseum. Despite this, news of deaths and positive cases of swine continues.

Since the 2009 pandemic, there is clearly no strategy in place to prevent the disease from spreading. At best, the state government’s initiatives can be termed as treating the victims. The problem with the swine flu H1N1 virus is that it’s becoming more and more difficult to diagnose and treat due to several viral strains that have been traced such as H1N1, H3N1 and H3N2.

Why India is more vulnerable to swine flu?
India is even more vulnerable because of its climate. While in most countries the swine flu virus makes an appearance during the winter season, in India it surfaces twice a year – during the monsoon and winter seasons. Add to that the fact, that our population density is very high, public places and transport is overcrowded and there’s utter disregard for sanitation and hygiene. There’s also a lack of awareness about the disease and many people still believe that virus spreads from pigs. The swine flu situation actually points out the deficiencies of India’s public health system.

What needs to be done?  

(continued)  http://health.india.com/diseases-conditions/why-the-swine-flu-situation-in-india-is-bad/

Researchers Discover Migratory Route of Mallards, Carriers of Bird Flu

Video (in English)
February 20, 2013
Excerpt of video transcript:

...The tracking devices showed that the mallards had flown around 300 kilometers north,… passing through the Yalu River and into China to arrive in inner Mongolia, where they spent the summer.
After six months, the birds flew back past China and the Yalu River to arrive at the river in Ah-san...


http://www.arirang.co.kr/Player/News_Vod.asp?code=News&nSeq=144187