H5N1

Hong Kong: Cambodian eggs banned

Via the Hong Kong government website: Cambodian eggs banned.

The Centre for Food Safety has banned the import of poultry eggs from Cambodia due to an avian influenza outbreak in a village there.   

It issued the order today after being notified of the H5N1 outbreak by the World Organisation for Animal Health.   

The centre said Hong Kong does not import live poultry or poultry meat from Cambodia, but 170,000 poultry eggs were imported from there last year.   

It said it will closely monitor the latest situation in Cambodia, and maintain close contact with major local egg importers, distributors and supermarkets.

Pakistan: Two anti-polio workers killed in Upper Kurram explosion

Via Dawn.com: Two anti-polio workers killed in Upper Kurram explosion. Excerpt:

PARACHINAR: An explosion in Upper Kurram tribal region killed two anti-polio workers on Thursday, DawnNews reported. 

Government administrator Yousuf Rahim says the men were going to a village to vaccinate children when the bomb hit their motorcycle in Upper Kurram tribal region on Thursday. 

Although it’s unclear whether the workers were the actual target, it was the second attack this week against polio workers. On Tuesday, gunmen riding on a motorcycle killed a policeman protecting a polio vaccination team.

US: Flu panic grips the fashion world

Via The New York Times: Illness Walks the Runway. Excerpt:

A top fashion designer quarantines a sneezing underling, forcing her to work in a closet. An industry P.R. executive makes colleagues douse their hands with Purell. Germ-phobic magazine editors are powerblasting offices with antiseptic wipes and Lysol. 

While all eyes are on the models, top, those behind the scenes hope to avoid being struck by sickness. Such is the dread gripping the fashion world as it prepares for New York Fashion Week, beginning Feb. 7, with a killer flu and a stomach-bug norovirus on the loose. 

The eight-day event, when fashionistas from around the world pack into small spaces to attend runway shows and parties — only to cram onto the same flights and repeat the process in London, Milan and Paris — is always an occasion for sickness paranoia. In past years, sniffles in the front row could prompt icy stares and social ostracism. 

But with this season’s flu panic, the fear is approaching hysteria. Stressed-out designers recoil in horror if someone coughs within earshot. Frail models shiver their way between fittings, terrified someone will spy their runny noses. And frenemies everywhere are reconsidering the wisdom of the double-cheek kiss, the standard greeting of the global fashion tribe. Air kissing seems safe for now. 

“This will be the season where everyone in fashion becomes mysteriously nonaffectionate,” said Laura Brown, executive editor of Harper’s Bazaar. Staff members in her West 57th Street offices, she added, have been scouring doorknobs with sanitizing wipes. “We can give a nudge and a wink instead.” 

To be fair, much of the paranoia is founded. According to the Centers for Disease Control and Prevention, deaths from the current flu season reached “epidemic” levels, in part because of an unusually severe flu strain. Adding to the flulike epidemic is a surging new strain of norovirus, which can cause sudden diarrhea and projectile vomiting, and the worst whooping cough outbreak in 60 years.

Haiti: Forecasting cholera on the village level

Dr. James Wilson runs the Haiti Epidemic Advisory System (HEAS) blog, where this very interesting post appeared today: Village Level Cholera Forecast Validation. Excerpt:

Basically, the forecasts vs. the actual outcomes for:   

1)    Anse-Rouge was outstanding with three peaks in both, and with both the timing and the amplitudes of the 2nd and 3rd peaks right on. 

2)    Gonaives was solid with three peaks in both but only okay as the timing and amplitude of the 1st and 3rd peaks are off while that of the 2nd peak was right on.   

3)    Marmelade was solid with three peaks in both and okay as the timing and amplitude of the 1st and 3rd peaks are right on while that of the very broad 2nd peak was off.   

4)    TerrNeuve was off in the timing of the peaks, but the amplitudes of the peaks were solid and the number of peaks, with six predicted and six occurring, was outstanding.   

5)    Ennery was very good as both the timing and amplitudes of the actual and predicted 5th peaks were right on, however while the forecast was for four peaks and there were five actual, the predicted 3rd  peak fell between the 3rd and 4th actual peaks, the agreement was not too bad overall. Additionally, considering the relatively high and low numbers of actual and predicted cases, the comparison is very good.   

6)    Grosmorne was okay considering the low number of cases.   

7)    St. Michel shows a mixed outcome as the only one peak was predicted and the timing and amplitude of that peak vs. the actual realization was outstanding, however the forecast missed the 2nd and 3rd peaks entirely.

Click through for his discussion and the graphs that it's based on. 

Cambodia: H5N1 surveillance in live poultry markets, 2011

Via this month's Emerging Infectious Diseases, a very timely article: Influenza A(H5N1) Virus Surveillance at Live Poultry Markets, Cambodia, 2011. The introduction:

Highly pathogenic avian influenza (HPAI) A(H5N1) virus was first detected in 2004 in Cambodia. Since then, outbreaks of subtype H5N1 infection among poultry have been regularly detected, and 21 human cases associated with 19 deaths have been recorded. In Cambodia, where poultry vaccination is not allowed, illegal poultry trade has been a repeated source of reintroduction of the virus. 

Surveillance for subtype H5N1 virus at live poultry markets (LPMs) has been conducted in Cambodia by inoculating cloacal or throat swab specimens from poultry into embryonated chicken eggs; however, virus has rarely been detected by this method (S. Sorn, unpub. data). 

After outbreaks of subtype H5N1 virus in poultry, the viral genome can be detected for >1 week in environmental samples from the outbreak area; thus, environmental surfaces are potential sources of virus transmission to humans and animals. 

LPMs have also been reported as sources of virus involved in human subtype H5N1 infection (7–9). Birds sold at LPMs can originate from many regions of a country; thus, conducting surveillance for subtype H5N1 virus at these markets would probably be an effective way to monitor the circulation of virus within a country. 

It has been recommended that samples of drinking water shared by birds maintained within the same cage and samples of poultry feces be used to detect virus within LPMs. We performed this study to determine whether subtype H5N1 virus circulation in Cambodia could be better monitored by using environmental sampling in LPMs.

I suspect that the rapid response teams around Phnom Penh are doing something very much like this.

Cambodia: Plan outlined to prevent spread of H5N1

Thanks to Joshua Wilwohl for tweeting the link to this report in his paper, The Cambodia Daily: Plans Outlined to Prevent Spread of H5N1. 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.

MSPP: The general situation of cholera in Haiti, January 2013

On January 28 MSPP published, as a PDF, a document on its website saying that the general situation of cholera in Haiti is stable in January 2013. This is the first official statement I have seen in over two years of following the outbreak. I can't copy and paste it into Google Translate, so here's my attempt at a rough translation from French (please correct my errors):

MSPP reports that cholera continues to fluctuate over the whole national territory, with hot spots of activity in the departments of Artibonite, Sud, and Sud Est. 

Between week 42 of 2010 and week 2 of 2013, the situation is as follows: 639,610 cumulative cases; 353,288 hospitalizations (54% of cases seen), with 7,962 deaths. Of these, 5,090 were in hospitals (hospitali case fatality rate: 1.4%).

In week 2 of 2013, MSPP has recorded 1,379 cholera cases, 905 hospitalizations, 24 deaths (20 in hospital) for an overall CFR of  1.7% and a hospital CFR of 2.2%. The daily death toll in 2010 was between 100 and 150; in 2013 the daily average has fallen to fewer than 2.

These encouraging results are thanks to the strategy adopted by the ministry. Cholera being a diarrheic illness, the ministry integrated health institutions and oral rehydration points. Thanks to these measures, cholera morbidity has fallen greatly.

In congratulating healthcare workers, the ministry is confident that the disease can be quickly eradicated if we intensify combat on all fronts to stop its spread; to make potable water available, to build latrines, and to encourage scrupulous respect for the rules of hygiene.

MSPP calls on everyone to help eradicate cholera and restore the situation before 2010.

Dr. Florence D. Guillaume, Minister

CIDRAP: Flu news scan for January 30

Via CIDRAP: FLU NEWS SCAN: H5N1 in Cambodia, gene variant and severe flu, FDA warning for flu claims. Click through for the full report and relevant links. Excerpt:

Cambodian officials have confirmed an outbreak of H5N1 avian flu in backyard poultry in a village where a young girl died of the disease this week, according to a report filed with the World Organization for Animal Health (OIE) today. 

The outbreak began Jan 9, killed 67 birds, and led to the culling of 436 others in Prey Nheat village in Kampong Speu province not far from Phnom Penh. Officials have also curbed movement of poultry in the area and have disinfected the affected premises, the report said. 

Yesterday Cambodia's Ministry of Health confirmed that a 17-month-old girl from the village died of H5N1 avian flu on Jan 28, and last week the agency reported that a 35-year-old man from an unspecified area of Kampong Speu died from the disease on Jan 21.

H5N1 research and the media

Via the Columbia Journalism Review: The bird-flu blues. The issue in this interesting story is the conflict between scientists and the media over embargoed announcements. Excerpt:

Reporters didn’t have much time to react to the news that scientists in some countries will soon resume research on a deadly avian flu virus that was suspended last year amid concerns about safety and terrorism. 

The journals Science and Nature, which published the announcement in tandem on January 23, gave journalists only 24 hours advance notice that they would do so—an unusually short lead time—provoking charges that they didn’t give allow enough time to gather reactions to the decision.

Maybe we'll get a follow-up story on the blog Embargo Watch, which deals with just such issues. In the meantime, Helen Branswell on Twitter is not persuaded.

Uganda: Cholera hits six villages in Nebbi district

Via New Vision: Cholera hits six villages in Nebbi district. Excerpt:

A cholera epidemic has hit six villages in Dei parish, Panyimur sub-county in Nebbi district. According to the Uganda Red Cross (URC) the epidemic attacked the area this month. 

The URC head of communications, Catherine Ntabadde, said the disease followed a case at Dei Heath Centre II in Nebbi on January 17, where a business woman called Consolate Akum from Ogwedo village from Buliisa district was admitted at the health centre and was found with signs of excessive watery diarrhoea. 

“She was later moved to her home by her relatives from where two other children in the neighbourhood of Dei and Munduryema villages developed similar symptoms and died shortly after,” Ntabadde noted. 

She said medical reports indicate that it was cholera, which killed them and has eventually spread throughout the six villages of the parish and other neighbouring areas of Buliisa. 

The affected villages include; Dei, Dei A, Dei B, Dei C, Dei centre and Namutangna village. 

She noted that 28 cases of cholera had been registered since January when the outbreak was reported. 

“Many of the cases have been discharged and only three are still admitted at Dei Health Centre II for surveillance,” she added.