H5N1

Indonesia: Food poisoning behind mystery illness

Recent reports have described an Indonesian village suffering an outbreak of a mysterious and often fatal illness. Now, Antara tells us: Indonesia says food poisoning behind mystery illness. Excerpt:

Initial investigations into a mystery illness that killed ten people in an Indonesian village have suggested that food poisoning was the cause rather than a contagious disease, the health minister said on Tuesday.

Victims of the illness in the Central Java village had eaten a locally made fermented soybean dish commonly sold door-to-door, Minister Siti Fadillah Supari was quoted by Reuters as telling a news conference.

Supari said victims showed signs of acute liver dysfunction, which had led to multiple organ failure in some cases.

"This is clearly a single-source incident. It is not an outbreak," she said.

Officials previously said the illness had spread fast through the village but did not appear to have any obvious infection pattern. Thirteen people are still undergoing treatment in hospitals in the provincial capital, Semarang.

I Nyoman Kandun, head of the health ministry's disease control unit, told the news conference that samples had tested positive for a type of bacteria.

"All samples tested positively for pseudomonas cocovenenans, drawing strong suspicions the illness was caused by the dish," the official said.

Burma: B2B H5N1 is spreading

Via People's Daily Online: New H5N1 bird flu case confirmed in Myanmar. Excerpt:

A new bird flu case has occurred in Myanmar's Bago division, the United Nations Food and Agricultural Organization (FAO) Yangon Office confirmed Tuesday.

A poultry farm in the Letpadan township of the division, 136 km north of Yangon, was detected with the avian influenza on last Thursday, the FAO representative told Xinhua.

Confirming on Tuesday that the virus is H5N1, the Myanmar livestock authorities have taken measures including culling of a total of 3,800 birds, he said.

Before the case, H5N1 virus were found in two poultry farms in Thanphyuzayat, southeastern Mon state earlier on last Tuesday and over 300 chickens in the farms were slaughtered.

Local related departments are cooperating in preventing the disease from further spreading.

In June, some four bird flu cases occurred at farms in three townships of Hmawby, Insein and Bago. That residual virus was found during the post-outbreak surveillance period which ran from May 7 to June 9, earlier reports said, adding that during that period, a total of nearly 2,000 chickens were culled for risk prevention.

Maldives issues a travel advisory

Via the Republic of Maldives official website: DPH warns Maldivians not to go to bird flu infected areas in India. Excerpt:

The Department of Public Health (DPH) has warned locals travelling abroad not to go to areas of India where cases bird flu has been reported.

According to a statement issued by the DPH, confirmed cases of bird flu have so far been reported in the northern areas of India. The statement also urged Maldivians to consult a doctor if they begin showing symptoms of bird flu and to give information about where they had travelled to health service providers.

The DPH also said that they were testing eggs being imported into the country for bird flu. In addition the Food and Drug Authority was also checking all poultry products being imported into the country.

The Food and Drug Authority said that eggs were not usually imported from India but that they were checking poultry products being imported from countries that have confirmed to have had bird flu cases.

Estimating H2H transmission of H5N1

It's been a contentious issue for years: Has avian flu ever moved from human to human? Outbreaks of H5N1 in family clusters have looked suspicious.

A forthcoming article in Emerging Infectious Diseases suggests that it did in Sumatra with the Ginting family in April and May 2006, but not with the Kocyigit family in Turkey four months earlier.

Via CIDRAP: Detecting Human-to-Human Transmission of Avian Influenza A (H5N1). Here's the abstract, re-paragraphed:

Highly pathogenic avian influenza A (HPAI) subtype H5N1 has caused family case clusters, mostly in Southeast Asia, that could be due to human-to-human transmission. Should this virus, or another zoonotic influenza virus, gain the ability of sustained human-to-human transmission, an influenza pandemic could result.

We used statistical methods to test whether observed clusters of HPAI (H5N1)
illnesses in families in northern Sumatra, Indonesia, and eastern Turkey were due to human-to-human transmission. Given that human-to-human transmission occurs, we estimate the infection secondary attack rates (SARs) and the local basic reproductive number, R0.

We find statistical evidence of human-to-human transmission (p = 0.009) in Sumatra but not in Turkey (p = 0.114). For Sumatra, the estimated household SAR was 29% (95% confidence interval [CI] 15–51). The estimated lower limit on the local R0 was 1.14 (95% CI 0.61–2.14).

Effective HPAI (H5N1) surveillance, containment response, and field evaluation are essential to monitor and contain potential pandemic strains.

I don't pretend to understand all this, but perhaps more informed persons will be able to analyze it.

Tourism vs. avian flu

Via Scoop, a New Zealand news source, a discouraging little news release from the UN World Tourism Organization: Tourism Vs. Avian Flu Defences, Simulation. Excerpt:

The second UNWTO regional Avian and Human Influenza Simulation (AHI) was actively supported by the government of Indonesia and the Association of Southeast Asian Nations (ASEAN). It attracted 70 participants from more than 15 countries and several UN Agencies.

The group modelled the impact of an evolving pandemic in the Asia Pacific region, replicating the roles of government departments, the tourism industry, international bodies and other stakeholders, including tourists themselves. It followed a similar exercise held in Paris in March, which focused on Europe, the Middle East and Africa.

In opening the event, the Secretary-General of the Indonesian Ministry of Culture and Tourism, Sapta Nirwandar, and the Executive Chairman of the Indonesian National Coordination Committee on Avian Flu, Bayu Khrisnamurti, stressed the value of international cooperation and its help in increasing the integration of Tourism issues in national coordination programmes.

With an estimated 10 million people travelling abroad at any given time and many more within their own countries, UNWTO keeps a close watch on health risks generally and AHI specifically. While there has been no change in the level of AHI alerts issued by the World Health Organization, the Tourism sector is already taking action to be fully aware of the potential dangers and to prepare effectively.

The simulation helped to identify possible gaps in response systems and to understand the pressures and dynamics in a real-world situation.

It underscored the need for:
• good planning,
• clear communications,
• a fully prepared and trained work force, and
• unambiguous procedures for customer and workplace safety.

I teach in my college's tourism programs, so maybe I'm taking this too personally. But what a wretched collection of clichés and truisms! About the only ones missing were
• overdue for a pandemic
• when not if
• experts fear
• the situation is under control, and
• no need to panic

Four years ago, SARS imploded the tourism industry over vast stretches of the planet, including Canada. If you carefully read the excerpt above, the message is that the industry learned nothing from that experience, and the "simulation" only reminded the participants of how ill-prepared they are.

It also reminds me of how ill-prepared my students will be to deal with such problems, and classes start on September 5.

India suspects Myanmar as source of Manipur outbreak

Thanks to Bird Flu Breaking News for this Times of India story: Manipur bird flu outbreak: Finger points to Myanmar. Excerpt:

With close to two lakh [200,000] birds culled in the northeast State of Manipur, fingers are now being pointed to Myanmar from where the affected birds may have entered India through the 1600-km long porous border.

The Centre has already alerted neighbouring Mizoram to check illegal smuggling of hens from across Myanmar where incidents of bird flu outbreak have been more often.

Manipur, along with Mizoram, Nagaland and Arunachal Pradesh, shares border with Myanmar.

"Government of India has issued an advisory to the northeast States to restrain from imposing any restriction on the Inter-State movement of poultry and poultry product and intensify surveillance especially vigilance on the border with the countries that have reported outbreak of avian influenza," a release from the ministry of Agriculture stated.

A day before India confirmed the outbreak of bird flu on July 25 after samples sent by
Chingmeirong Ira poultry farm in Manipur's East Imphal district tested positive, there were reports of its outbreak in south Myanmar.

There were also reports of bird flu outbreak in Myanmar during February, April and June this year, and the latest outbreak is reported as recent as Monday in southeast Myanmar.

The UK's bird flu guardians

Via Shooting UK: The UK's bird flu guardians. Excerpt:

Wildfowlers heading out to the marshes for the start of the new season tomorrow will be a key element in the UK's defence against the prospect of bird flu this winter.

Fowlers are central to the Government's monitoring system. Dr Peter Marshall, research officer at BASC, told ST: "Monitoring of shot birds up and down the country by wildfowling clubs will hopefully help to warn us of the presence of bird flu. We're actually running a wider shot-bird surveillance programme similar to the one we ran last year in conjunction with DEFRA. This year we'll be surveying larger numbers of sites.

"The key thing is for people to watch out for unusual numbers of dead birds — the key species being swans, duck and also geese."

New outbreak in Manipur

Via Kangla Online, a report from the Imphal Free Press: Culling tally reaches 137,944; mass fowl deaths reported at Khurai farm. Excerpt:

Even as culling of birds continued for a fifth day today in the greater Imphal area, another case of mass sickness and deaths of chickens has been reported at a farm at Khurai.

According to sources in the veterinary department, the unusual sickness and deaths of the birds, with what are described as bird flu symptoms, had taken place a few days back, but went unreported at the time, although the farm had been covered in the culling operations. Some of the sick birds had in fact been culled unknowingly.

The sources said after the farm owners finally reported the matter, veterinary teams have collected faecal samples of the dead birds and have sent the same for verification.

In the meantime, culling operations continued apace today, with a total of 11,350 birds culled in 34 localities in both Imphal East and Imphal West district today.

Since the start of culling operations on July 26, a total of 1,37,944 birds including chickens, ducks and other domesticated birds have been culled, while 20249 eggs and 11615 kgs of poultry feeds have been disposed off safely till today, veterinary department sources said.

Altogether 16 ducks imported from Vietnam reared at the Imphal Raj Bhavan today were also culled by a veterinary RRT today. The state governor`s residence falls within the culling zone.

Veterinary officials also said that the culling operations within the core 5 km radius zone was planned to be completed by today, but due to the bird population turning out to be well in excess of the official estimates, the operations will be continuing for the time being.

In a related story, Kangla Online quotes the health minister as saying no human cases have yet been found in Manipur and "the situation is well under control."

Could H5N1 return to the Urals?

Via RIA Novosti: Emergencies ministry warns of bird flu outbreak in Urals in Aug. Excerpt:

The Russian Ministry for Emergency Situations warned Tuesday of a danger of bird flu outbreaks in August in the Chelyabinsk Region, in the south Urals.

"Bird flu outbreaks are not impossible in August in the Chelyabinsk Region. In 2005, three out of the seven registered bird flu outbreaks occurred in August," a spokesman said.

Vietnamese woman dies of bird flu

A reader alerted me to this sad story. Via the The Age, an Australian news source: Vietnamese woman dies of bird flu. Excerpt:

A Vietnamese woman who was seven months pregnant has died of bird flu, the country's third human death from the virus this year, doctors say.

"She died on Saturday," said Doctor Tran Thuy Hanh, chief of the Bach Mai hospital where the 22-year-old woman was taken last week from a farm in the northern province of Ha Tay, the largest poultry supplier to Hanoi.

Hanh gave no further details of the woman, who had been confirmed to have contracted the H5N1 virus by laboratory tests in Vietnam.

The World Health Organisation (WHO) has not confirmed she had bird flu, which killed a 28-year-old woman from northern Vietnam last month.

A doctor in Ha Tay province said there were no bird flu outbreaks in the area where the latest victim lived.

"It made us difficult to pin down how she became infected," he said.

"Earlier she bought a chicken leg of unknown origin for a meal in the family but nobody else got sick."