H5N1

Australia: Dengue fever makes early showing in far north Queensland

Via ABC News: Dengue fever makes early showing in far north Qld. Excerpt:

Health authorities in far north Queensland are warning there could be more confirmed cases of dengue fever in coming days. 

Three people have tested positive to the type one strain of the virus in Cairns in the past week. 

Further north, 15 people have contracted the type three strain around Port Douglas and Miallo since October. 

Dr Steven Donohue from Tropical Public Health Services says there are another four suspected cases. 

He says mosquito control teams have been working in the affected areas. 

"Obviously people, some of them are away and they haven't looked after their yards, or they could be coming back from a tropical country with a fever," he said.

Dr. Mackay on H9N2

Given a totally unfair geographical advantage, Dr. Ian Mackay is already living in 2014. From his antipodean future, he violates the laws of physics by sending this message into the past on his VDU's blog: H9N2 confirmed in 86-year old Hong Kong citizen living in Guangdong province.... Click through for links to his sources.

Influenza A(H9N2) virus, another "bird flu" but this usually causing mild signs and symptoms of infection, has been confirmed in an 86-year old man reported Dec-30. 

The man's underlying illnesses were added to by chills and productive cough from 28-Dec when he was admitted to hospital with a fever. 

Sputum tested positive for H9N2. Not sure if an upper respiratory sample was tested. 

He had no recent contact with poultry and no contacts have shown signs of illness. 

Mild human cases in Hong Kong have previously been reported in 1999, 2003 and 2007 and imported cases in 2008 and 2009. 

As ProMED moderator CP (Craig R. Pringle) noted, enhanced surveillance in the region is likely to continue to pick up all sorts of H and N viruses and variants. Interesting watching these pop up - especially if they remain as mild infections, unlike H7N9 has so far.

Xinhua on Taiwan's second imported H7N9 case

Via Xinhua: Mainland tourist in Taiwan has bird flu.

Taiwan's disease control authorities announced Tuesday that a tourist from the mainland was confirmed with H7N9 avian influenza, the island's second imported case of the virus. 

The 86-year-old man from the Jiangsu Province entered Taiwan on Dec. 17, and showed first symptoms on Dec. 19, and had difficulty in breathing by Dec. 23. He has been hospitalized since Dec. 24. 

The man's two daughters traveling with him have stayed on the island to look after him, show no symptoms. The other 22 from the tour group have returned to the mainland. 

The first imported case of H7N9 in Taiwan occurred in April this year.

Haiyan/Yolanda survivors put on brave face for New Year

Via the Manila Bulletin: Yolanda survivors put on brave face for New Year. Excerpt:

Manila, Philippines – The victims of Yolanda currently living in the “Tent City” in Pasay City try to put on brave faces as they prepare to step into the New Year. But despite their optimism, deep down they said they fear for their future. 

“We all want to go back to Tacloban,” said Alvin Gacos, 32, a professor at the Eastern Visayas State University and a part-time professor at the Leyte Normal University. “We don’t want to just stay here and do nothing. But we are all afraid of starting and rebuilding our lives. Where do we do that? We lost everything. How will we pick up the pieces? And life is hard back there,” he said. 

One of his biggest concerns is the increased prices of basic goods and commodities. “It’s not true that prices are strictly enforced there. It’s impossible to live with the high prices,” he said. 

Alvin recalls sadly how he spent so much money on his house, only to be destroyed within minutes by the super typhoon. This has been the first Christmas and New Year the Gacos family didn’t spend in their own home. 

“We are happy we are together, but it is still different because we are not home,” he admitted. 

They said that although they are well-fed at the Tent City, people like them who have lived by the sea all their lives miss fish the most. “People are so kind and give us food all the time, often chicken and beef. But we can’t help but miss the taste of fish because we used to eat that all the time.” 

Meanwhile 43-year-old Salvador Calvadores is anticipating the New Year will bring so many problems. A father of seven children, he is desperate to find any job in order to feed his family and finish his children’s schooling. He used to be a barangay treasurer and is a single parent. 

This is the fourth national disaster he has endured, and he said he must still alive for a reason –and that is to take care of his family. 

With a heavy heart, he shared that he cries when he thinks of what comes next. “I hide it from my children, but it’s really difficult. I don’t know what they will do without me, and that is why I need to find a job,” he said. 

A woman there said they are in no mood for New Year revelries. “It doesn’t seem appropriate to celebrate, given our situation,” she said. 

The Department of Social Welfare and Development (DSWD) said they had asked the survivors about New Year plans, but the majority opted to just sleep the night away.

WHO on risk of disease outbreaks in South Sudan

WHO has published Internal Displaced People in South Sudan are at great risk of disease outbreaks. Excerpt:

The humanitarian situation in South Sudan has further deteriorated in the past 2 weeks. Since the outbreak of violence in South Sudan on 15 December 2013, the humanitarian needs have quickly been growing with a total of 195 416 persons have been displaced from the 4 states of South Sudan, namely; Central Equatoria, Jonglei, Unity and Upper Nile, and 75 171 of them taking shelter in the UN peace keeping bases in Juba, Bor, Malakal, Bentiu, while an estimated 58 000 others are displaced in Aweriel County Lakes state. 

As a result of this population displacement, there is a looming risk of disease outbreaks especially for water borne diseases, warns WHO. “The poor water, sanitation and hygiene conditions in the camps, coupled with a shortage of health workers\health care providers, poses health risks to thousands of displaced persons in the UN camp bases,” says Dr Abdi Aden Mohammed, the WHO Country Representative in South Sudan. 

“Even with the tremendous efforts made by health partners, sanitation conditions are still inadequate largely due to the large number of people sheltering in UN bases which have insufficient space to house these numbers. Coupled with poor water and sanitation conditions, overcrowding in the camps may create conditions ripe for disease outbreaks,” added Dr Abdi. 

In order to minimize the risks of potential outbreaks, WHO is working closely with health authorities and other health partners including the UNMISS medical team, to identify health workers in the displaced camps who can provide primary health care services, as well as support health education and promotion to all displaced persons. 

To immediately respond to the ongoing crisis, WHO has provided trauma management and emergency health kits to the UNMISS clinics and to other partners engaged in management of trauma cases in the four states. WHO has also provided essential drugs and medical supplies to UNMISS clinics to help them in the management of common illnesses. 

Over 894 wounded people have been treated at Bor, Malakal and Unity UNMISS clinics and other major referral hospitals in the past two weeks. Besides trauma, diarrhoea and malaria are the most common illnesses reported from the IDP camps.

Six new cases of MERS virus hit Saudi Arabia, UAE

Via Reuters: Six new cases of MERS virus hit Saudi Arabia, UAE. The five Saudi cases have already been reported; WHO has officially confirmed them. But the sixth case is new:

In a disease outbreak update, the WHO said the new confirmed case of MERS in the United Arab Emirates (UAE) was in a 59-year-old woman, the wife of a man previously confirmed as being infected. Although she has no adverse symptoms, she is in hospital in isolation, it said.

The woman's husband is presumably the 68-year-old in Sharjah listed in Andrew Rambaut's table. The man was hospitalized on December 14 and died on December 22.

China: 3.33m hectares of land too contaminated to grow food

Via Shanghai Daily: 3.33m hectares of land too contaminated to grow food. Excerpt:

About 3.33 million hectares [8.15 million acres] of China’s farmland is too polluted with heavy metals and other chemicals to grow crops, a government official said yesterday, highlighting the risk facing agriculture after three decades of rapid industrial growth. 

The threat from pollution to China’s food supply has been overshadowed by public alarm at smog and water contamination but is gaining attention following scandals over tainted rice and other crops. 

Wang Shiyuan, vice minister of land and resources, told a news briefing that China was determined to rectify the problem and had committed “tens of billions of yuan” a year to pilot projects aimed at rehabilitating contaminated land and underground water supplies. 

Wang said the polluted farmland was mostly in eastern and central parts of China which have seen rapid economic and industrial development, such as the Yangtze River Delta, the Pearl River Delta, the old industrial base in northeast China and central China’s Hunan Province. 

He said no more planting would be allowed on contaminated farmland as the government was determined to prevent toxic chemicals entering the food chain. 

China’s determination to squeeze as much food and resources as possible from its land has put thousands of farms close to chemical plants, mines and other heavy industries, raising the risks of contamination. 

With food security still the most pressing concern, China is determined to ensure that at least 120 million hectares of land is reserved for agriculture, a policy known as the “bottom line.” The rehabilitation of polluted land is part of that policy. 

A government land survey revealed traces of toxic metals dating back at least a century as well as pesticides banned in the 1980s, and state researchers have said that as much as 70 percent of China’s soil could have problems.

New Zealand: Measles case confirmed in Auckland

Via TVNZ: Measles case confirmed in Auckland. Excerpt:

The first measles case in Auckland since June 2012 has been confirmed, prompted a warning from health officials. 

The person contracted measles while in Sydney earlier this month for the 2013 hip-hop competition. 

The Auckland Regional Public Health Service (Arphs) says teams from elsewhere in New Zealand attended the event. 

Arphs is following up with those who had contact with the infected person, alerting health professionals and emergency departments, and updating the Ministry of Health. 

Measles symptoms start with a high fever, which develops about 10 days after exposure, followed by a runny nose, cough, red eyes and small white spots inside the mouth. A red blotchy rash on the neck and face appears three or four days later before spreading to the rest of the body. 

Medical Officer of Health Catherine Jackson says measles is extremely infectious and can cause serious complications. 

"Auckland's last major measles outbreak in 2011 demonstrates how quickly the disease can spread," Dr Jackson said. "One infected child resulted in nearly 500 cases and 80 hospital admissions."

Hong Kong: NDM-1 case under CHP investigation

The Centre for Health Protection has published Case of NDM-1 Carbapenemase-producing Enterobacteriaceae under CHP investigation. Excerpt:

The Public Health Laboratory Services Branch (PHLSB) of the Centre for Health Protection (CHP) of the Department of Health confirmed today (December 31) a case of New Delhi metallo-β-lactamase-1 (NDM-1) Carbapenemase-producing Enterobacteriaceae in an 86-year-old woman.      

The patient, with chronic medical condition, lives in Hong Kong. She travelled to Guangdong on December 14 and was admitted to a local hospital between December 16 and 20 for shortness of breath. She was subsequently admitted to United Christian Hospital for further treatment upon her return to Hong Kong on December 20. Her current condition is stable.      

The patient's rectal swab yielded NDM-1 Carbapenemase-producing Enterobacteriaceae as confirmed by the PHLSB.      

CHP's investigation is on-going.      

This is the 36th detected case of NDM Carbapenemase-producing Enterobacteriaceae in Hong Kong.      

NDM is an enzyme which can inactivate carbapenems and other beta-lactams such as penicillins. Bacteria harbouring this NDM gene are commonly resistant to multiple antimicrobials, limiting therapeutic options and rendering severe clinical infections difficult to treat. Most bacteria with the NDM enzyme remain susceptible to two types of antibiotics, colistin and tigecycline.      

Infections vary from being asymptomatic to potentially life-threatening or fatal. The level of risk depends on which part of the body is affected by the infection, and the general health of the patient.

Hong Kong: CHP H9N2 update, December 31

(Thanks to Mary Marshall for alerting me to the typo in the headline!) The Centre for Health Protection has published Epidemiological investigation and follow-up actions by CHP on confirmed human case of avian influenza A(H9N2). Excerpt:

The Centre for Health Protection (CHP) of the Department of Health (DH) today (December 31) provided an update on the confirmed human case of avian influenza A(H9N2) affecting a man aged 86.      

"The epidemiological investigations, enhanced disease surveillance, port health measures and health education against avian influenza are all ongoing," a spokesman for the DH said.      

The patient's home contact in Shenzhen has remained asymptomatic.      

The 51 health-care workers (HCWs) of North District Hospital (NDH) and the ambulance service remain under medical surveillance. Among them, an HCW of NDH presented with productive cough and sore throat and the respiratory specimen tested negative for the influenza A virus upon testing by the CHP's Public Health Laboratory Services Branch (PHLSB).      

The officer who handled the patient upon his entry at Lo Wu Border Control Point is also asymptomatic. He has been put under medical surveillance. So far, there are no newly located contacts.      

As the patient was staying in Shenzhen for the whole incubation period, the case is classified as an imported one. The CHP has passed investigation findings to the health authority of Guangdong for follow-up.      

"Upon analysis by the PHLSB, the genes of the virus were determined to be of avian origin. They do not show significant differences from avian influenza viruses detected in Hong Kong and the Mainland in recent years. There is no evidence of genetic reassortment with genes of human influenza origin or resistance to the antiviral Tamiflu. We will continue to liaise and share the gene sequence with other health authorities based on established arrangements," the spokesman remarked.      

The public is advised to avoid contact with poultry and wild birds, including chickens, ducks and sparrows.      

"Travellers, especially those returning from avian influenza-affected areas and provinces with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Health-care professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas and provinces," the spokesman advised.