H5N1

Cambodian man dies from H5N1 avian flu

Thanks to FluTrackers for alerting me to this story. Via Barrons, an AFP report: Cambodian Man Dies From Bird Flu.

A 50-year-old man has died from bird flu in Cambodia, the health ministry said on Sunday, the second death from the virus recorded in the country this year.  

The World Health Organization has called for vigilance after bird flu was detected in mammals, but has stressed that the risk to humans is low.  

The ministry said that tests had confirmed the man -- who has not been named, but is from eastern Svay Rieng province bordering Vietnam -- was positive for bird flu virus H5N1 from October 7.  

Officials did not specify the man's time of death, but said health authorities are "investigating and researching this bird flu case".  

The disease typically spreads from birds to humans through direct contact.  

Officials said they were looking into the source of the infection, and were examining any suspected cases or people who may have been in contact with the victim.  

The ministry said around 50 poultry, some belonging to the man and some owned by his neighbours, had died recently.  

"The dead chickens were shared among villagers to eat," the health ministry statement said.  

The ministry urged villagers to be vigilant about H5N1, which is "still a threat to the health of people, especially children".  

The case is the 58th recorded instance of bird flu since the virus hit Cambodia two decades ago. In February an eleven-year-old girl died from the virus.  

Since late 2021, Europe has been gripped by its worst-ever outbreak of bird flu, with North and South America also experiencing severe outbreaks.  

This has led to the culling of tens of millions of domestic poultry worldwide, many with the H5N1 strain. The global outbreak is also responsible for the deaths of tens of thousands of wild birds.  

The recent detection of the disease in a number of mammals, including foxes, otters, minks, sea lions and even grizzly bears, has sparked concern that humans could be more at risk.

CHP closely monitors human case of avian influenza A(H5N6) on Mainland

Thanks to FluTrackers for alerting me to this report from the Hong Kong Centre for Health Protection: CHP closely monitors human case of avian influenza A(H5N6) on Mainland. Excerpt:

The Centre for Health Protection (CHP) of the Department of Health is today (September 27) closely monitoring a human case of avian influenza A(H5N6) in the Mainland, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.        

The case involves a 68-year-old male living in Chongqing, who had exposure to live domestic poultry before the onset of symptoms. He developed symptoms on August 5 and was admitted for treatment on August 10. He passed away on August 20.        

From 2014 to date, 87 human cases of avian influenza A(H5N6) have been reported by Mainland health authorities.        

"All novel influenza A infections, including H5N6, are notifiable infectious diseases in Hong Kong," a spokesman for the CHP said.        

Travellers to the Mainland or other affected areas must avoid visiting wet markets, live poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchasing live or freshly slaughtered poultry, and avoid touching poultry/birds or their droppings. They should strictly observe personal and hand hygiene when visiting any place with live poultry.        

Travellers returning from affected areas should consult a doctor promptly if symptoms develop, and inform the doctor of their travel history for prompt diagnosis and treatment of potential diseases. It is essential to tell the doctor if they have seen any live poultry during travel, which may imply possible exposure to contaminated environments. This will enable the doctor to assess the possibility of avian influenza and arrange necessary investigations and appropriate treatment in a timely manner.

Finland: Bird flu monitoring for all fur farms starts from minks

Via the Finnish Food Agency: Bird flu monitoring for all fur farms starts from minks. The Google translation:

At the beginning of September, the Finnish Food Agency will start bird flu monitoring for all fur farms. In the first phase of monitoring, the occurrence of the bird flu virus in minks from fur farms is investigated, because bird flu infections in minks pose a greater health risk to humans than bird flu infections in foxes and raccoons. Samples are taken from each of Finland's approximately 130 mink farms.  

Mink is a particularly problematic animal species when it comes to avian influenza virus infections. In the mink's upper respiratory tract, there are receptors that bind both bird and human influenza viruses, which is why mink are susceptible to infections caused by both types of influenza. The simultaneous infection of these viruses in mink can cause the emergence of a new type of virus variant, which may be more susceptible to infecting humans.  

The first phase of the monitoring is to be completed by the end of October, after which we will move on to the monitoring and sampling of the fox and raccoon kennels. Blood samples are taken from fur farms for antibody tests, and animals that have died or are euthanized by themselves are taken to detect the virus. Samples are taken by municipal veterinarians and samplers authorized by the Food Agency. The samples are examined in the Food Agency's laboratory. The samples are also examined for the presence of the coronavirus (SARS-CoV-2) at the same time.  

The infection was found in 25 fur farms  

The bird flu epidemic started in fur farms in Ostrobothnia in mid-July. The first infected fur farm was found in the Food Agency's laboratory tests on July 13, and since then bird flu infections have been confirmed at a total of 25 fur farms.  

For these shelters, shelter-specific reports on the infection situation have been made and a total of approximately 120,000 animals have been ordered to be euthanized. Termination orders have been issued to 13 shelters so far, and terminations are still ongoing in one shelter. In total, there are approximately 400 fur farms in Finland, which are estimated to have 1.3 million fur animals. After the autumn skinning, there are about 300,000 animals left in the shelters.  

In controlling animal disease epidemics, the most important thing is to identify animal farms where there are animals affected by the disease. In the monitoring of animal diseases, diseases are best found by examining sick or recently dead animals, because in them the infection is most likely to be active and the probability of finding the cause of the disease is also the highest. By killing infected and exposed animals, the infection pressure can be reduced in the most effective way.  

Monitoring of various animal diseases is carried out continuously at the Food Agency, and the need to expand the monitoring program is evaluated as necessary. Regarding bird flu, it has been decided to investigate all fur farms.

Eurosurveillance: Highly pathogenic avian influenza A(H5N1) virus infection on multiple fur farms in the South and Central Ostrobothnia regions of Finland, July 2023

Via Eurosurveillance, a report on the explosive spread of H5N1 in Finland: Highly pathogenic avian influenza A(H5N1) virus infection on multiple fur farms in the South and Central Ostrobothnia regions of Finland, July 2023. The introduction:

Highly pathogenic avian influenza (HPAI) A(H5N1) virus belonging to clade 2.3.4.4b has since the end of April 2023 caused widespread outbreaks in wild and domestic birds in 25 countries in Europe. In wild birds, black-headed gulls have been heavily affected, with mass deaths observed in many places, including in Finland. 

First reported on 14 July, an outbreak of avian influenza among farmed foxes, minks and raccoon dogs occurred in the regions of South and Central Ostrobothnia and is still ongoing. Up to 27 July, animals on 20 farms have been affected. Here, we provide an initial description of the outbreak and control measures taken, and discuss the source, potential reasons for and consequences of the outbreak.

The Finnish Food Authority is ordering all minks to be put down at fur farms with diagnosed avian influenza infections

Via the Finnish Food Authority: The Finnish Food Authority is ordering all minks to be put down at fur farms with diagnosed avian influenza infections.

The Finnish Food Authority has specified the euthanasia criteria for fur animals infected with avian influenza. The decision states that all minks will be put down at fur farms with diagnosed avian influenza infections. This policy decision on minks by the Finnish Food Authority also takes into account the view of the Finnish Institute for Health and Welfare (THL). The decisions to put down foxes and raccoon dogs will still be made on a case-by-case basis.  

Mink is an especially problematic species when it comes to avian influenza infections. This is due to the fact that minks’ upper respiratory tracts contain receptors that can bind to both avian and human influenza viruses, which makes minks sensitive to infections caused by both types of influenza. Minks can therefore be more effective than other mammals as an intermediate host for avian influenza, enabling the virus to mutate more effectively into a form that will infect humans. To prevent such variants of the virus, it is important to put down all minks at infected fur farms. 

With regard to decisions on putting down foxes and raccoon dogs, the Finnish Food Authority may order all or some of the foxes and raccoon dogs at a fur farm to be put down. This decision is impacted by the extent and intensity of the symptoms of avian influenza at the farm. It is also possible that no immediate euthanasia order will be issued for the animals at a farm if symptoms and increased mortality have stopped at the farm. 

However, the restrictions on fur farms imposed by the Regional State Administrative Agency and the measures to prevent the spread of the disease will remain in force at all the farms where avian influenza has been detected. If some animals at an infected farm have not been ordered to be put down, additional samples will be taken repeatedly from the animals at those farms to monitor the infection situation. Euthanasia decisions may be extended later on the basis of the results.  

Euthanasia order issued for three fur farms  

So far, the Finnish Food Authority has issued euthanasia orders for the animals of three fur farms. Preparations for new euthanasia orders are continuing this week. The Finnish Food Authority is not publishing information on the fur farms that have been issued euthanasia orders.  

Animal owners have the right to claim compensation from state funds for animals put down by an order issued by the Finnish Food Authority. The amount of compensation is still undetermined.  

Avian influenza had been diagnosed at twenty fur farms by the end of July. Samples from four farms are currently being analysed.

WHO: Influenza A(H5N1) in cats – Poland

A WHO DON, published July 16: Influenza A(H5N1) in cats – Poland. Excerpt:

Situation at a glance 

On 27 June 2023, the IHR National Focal Point of Poland notified WHO of unusual deaths in cats across the country. As of 11 July, 47 samples have been tested from 46 cats and one captive caracal, of which 29 were found to be positive for influenza A (H5N1). Fourteen cats are reported to have been euthanized, and a further 11 died, with the last death reported on 30 June. The source of the exposure of cats to the virus is currently unknown and epizootic investigations are ongoing.  

Sporadic infection of cats with A(H5N1) has previously been reported, but this is the first report of a high numbers of infected cats over a wide geographical area within a country.  

As of 12 July, no human contacts of A(H5N1) positive cats have reported symptoms, and the surveillance period for all contacts is now complete.  

The risk of human infections following exposure to infected cats at the national level is assessed as low for the general population, and low to moderate for cat owners and those occupationally exposed to H5N1-infected cats (such as veterinarians) without the use of appropriate personal protective equipment.  

WHO continues to monitor the situation and work in close collaboration with the animal and public health sectors, regional agencies, the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (WOAH), and other partner agencies in Poland.  

Description of situation  

On 27 June 2023, the IHR National Focal Point of Poland notified WHO of unusual deaths in cats across the country. As of 11 July 2023, a total of 47 samples have been tested from 46 cats and one caracal (Caracal caracal). Of these 47 samples, 29 (62%) were positive for influenza A(H5N1). Positive samples were reported from 13 geographical areas within the country.  

Some cats developed severe symptoms including difficulty in breathing, bloody diarrhoea, and neurological signs, with rapid deterioration and death in some cases. In total, 20 cats had neurological signs, 19 had respiratory signs, and 17 had both neurological and respiratory signs.   

Fourteen cats are reported to have been euthanized, and a further 11 died.  Post-mortem exams on a small number of cats are suggestive of pneumonia. According to the information available, the last known death among cats was reported on 30 June.      

Genomic analysis of 19 viruses sequenced from this outbreak showed that they all belonged to the H5 clade 2.3.4.4b and were highly related to each other. Also, the viruses are similar to influenza A(H5N1) clade 2.3.4.4b viruses which have been circulating in wild birds and which caused outbreaks in poultry recently in Poland.   

The source of exposure of cats to the virus is currently unknown and epizootic investigations are ongoing. There are several possibilities for the source of infection, among which the cats could have had direct or indirect contact with infected birds or their environments, ate infected birds, or ate food contaminated with the virus. Authorities are investigating all potential sources and to date have not ruled out any. Of the 25 cats for which the information is available, two were outdoor cats, 18 were indoor with access to a balcony, terrace, or backyard, and five were indoor cats with no access to the outside environment. Seven cats are reported to have had the opportunity for contact with wild birds.   

This is the first report of high numbers of cats infected with avian influenza A(H5N1) spread over a wide geographical area within any country.  Sporadic infections in domestic cats with A(H5N1) viruses, including A(H5N1) H5 clade 2.3.4.4b viruses, have been reported previously, following close contact of the cats with infected birds or from ingesting meat of infected birds.

WHO: Ongoing avian influenza outbreaks in animals pose risk to humans

A WHO news release: Ongoing avian influenza outbreaks in animals pose risk to humans. Excerpt:

The current outbreaks of avian influenza (also called “bird flu”) have caused devastation in animal populations, including poultry, wild birds, and some mammals, and harmed farmers’ livelihoods and the food trade. Although largely affecting animals, these outbreaks pose ongoing risks to humans.   

The Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH) are urging countries to work together across sectors to save as many animals as possible and to protect people.   

Avian influenza viruses normally spread among birds, but the increasing number of H5N1 avian influenza detections among mammals—which are biologically closer to humans than birds are—raises concern that the virus might adapt to infect humans more easily. In addition, some mammals may act as mixing vessels for influenza viruses, leading to the emergence of new viruses that could be more harmful to animals and humans.   

The goose/Guangdong-lineage of H5N1 avian influenza viruses first emerged in 1996 and has been causing outbreaks in birds since then. Since 2020, a variant of these viruses belonging to the H5 clade 2.3.4.4b has led to an unprecedented number of deaths in wild birds and poultry in many countries in Africa, Asia and Europe. In 2021, the virus spread to North America, and in 2022, to Central and South America.   

In 2022, 67 countries in five continents reported H5N1 high pathogenicity avian influenza outbreaks in poultry and wild birds to WOAH, with more than 131 million domestic poultry lost due to death or culling in affected farms and villages. In 2023, another 14 countries reported outbreaks, mainly in the Americas, as the disease continues to spread. Several mass death events have been reported in wild birds, caused by influenza A(H5N1) clade 2.3.4.4b viruses.   

Monitoring the recent surge in outbreaks among mammals  

Recently, there have been increasing reports of deadly outbreaks among mammals also caused by influenza A(H5)—including influenza A(H5N1)—viruses. 10 countries across three continents have reported outbreaks in mammals to WOAH since 2022. There are likely to be more countries where outbreaks have not yet been detected or reported.  

Both land and sea mammals have been affected, including outbreaks in farmed mink in Spain, seals in the United States of America, and sea lions in Peru and Chile, with at least 26 species known to have been affected. H5N1 viruses have also been detected in domestic animals such as cats and dogs in several countries, with recent detections of H5N1 in cats announced by authorities in Poland.  

“There is a recent paradigm change in the ecology and epidemiology of avian influenza which has heightened global concern as the disease spread to new geographical regions and caused unusual wild bird die-offs, and alarming rise in mammalian cases,” said Dr Gregorio Torres, Head of the Science Department at WOAH.  

Assessing the risk to humans  

Sporadic influenza A(H5N1) clade 2.3.4.4b virus detections in humans have also been reported, but remain very rare, with 8 cases reported since December 2021. Infections in humans can cause severe disease with a high mortality rate. The human cases detected thus far are mostly linked to close contact with infected birds and contaminated environments.   

"With the information available so far, the virus does not appear to be able to transmit from one person to another easily, but vigilance is needed to identify any evolution in the virus that can change that,” said Dr Sylvie Briand, Director of Epidemic and Pandemic Preparedness and Prevention, WHO.  

“WHO is working closely with FAO and WOAH, and laboratory networks to monitor the evolution of these viruses, looking for signals of any change that could be more dangerous to humans. We encourage all countries to increase their ability to monitor these viruses and to detect any human cases. This is especially important as the virus is now affecting countries with limited prior experience in avian flu surveillance."  

Studies are underway to identify any changes in the virus that may help the virus to spread more easily among mammals, including humans. 

ECDC: Enhanced surveillance of severe avian influenza virus infections in hospital settings in the EU/EEA

ECDC has published Enhanced surveillance of severe avian influenza virus infections in hospital settings in the EU/EEA. Click or tap through to download the PDF. The executive summary:

Avian influenza virus outbreaks are continuing during the summer months, causing mass mortality in sea-breeding bird colonies, including gulls. A larger exposure of human population to sick or dead birds and mammals is expected to occur. Transmission to humans cannot be excluded when avian influenza is circulating in wild birds and mammals and people are directly exposed without wearing protective equipment. 

During the summer months, infections with seasonal influenza viruses are considered to be very limited, and only a few patients with severe disease caused by the seasonal influenza virus are expected to be admitted to hospitals. 

 To identify sporadic severe human infections with avian influenza virus in hospital settings, the following approach is proposed: People admitted to hospitals with respiratory symptoms should be asked about exposure to birds (wild birds or poultry) or other wild animals (dead or alive) in the two weeks before admission. 

Consider testing for influenza virus hospitalised patients with unexplained viral encephalitis/ meningoencephalitis lacking the aetiological agent diagnosis. All influenza A-positive samples from hospitalised patients should be subtyped for seasonal influenza viruses A(H1)pdm09 and A(H3). Samples positive for influenza type A virus but negative for A(H1)pdm09 or A(H3) should be immediately sent to national influenza reference laboratories for further analysis and H5 testing.

CHP closely monitors human case of avian influenza A(H5N6) in Mainland

Thanks to FluTrackers for alerting me to this report from the Hong Kong Centre for Health Protection: CHP closely monitors human case of avian influenza A(H5N6) in Mainland. Excerpt:

The Centre for Health Protection (CHP) of the Department of Health is today (June 5) closely monitoring a human case of avian influenza A(H5N6) in the Mainland, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.        

The case involves a 54-year-old female living in Nanchong, Sichuan, who had exposure to live domestic poultry before the onset of symptoms. She developed symptoms on May 19 and was admitted for treatment on the same day. She is in serious condition.        

From 2014 to date, 84 human cases of avian influenza A(H5N6) have been reported by Mainland health authorities.        

"All novel influenza A infections, including H5N6, are notifiable infectious diseases in Hong Kong," a spokesman for the CHP said.      

Travellers to the Mainland or other affected areas must avoid visiting wet markets, live poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchasing live or freshly slaughtered poultry, and avoid touching poultry/birds or their droppings. They should strictly observe personal and hand hygiene when visiting any place with live poultry.      

Travellers returning from affected areas should consult a doctor promptly if symptoms develop, and inform the doctor of their travel history for prompt diagnosis and treatment of potential diseases. It is essential to tell the doctor if they have seen any live poultry during travel, which may imply possible exposure to contaminated environments. This will enable the doctor to assess the possibility of avian influenza and arrange necessary investigations and appropriate treatment in a timely manner.

Animal health body urges bird flu vaccination to avoid pandemic

Via Reuters: Animal health body urges bird flu vaccination to avoid pandemic. Excerpt:

PARIS, May 21 (Reuters) - Governments should consider vaccinating birds against bird flu to avoid the virus - which has already killed hundreds of millions of birds and infected mammals worldwide - turning into a new pandemic, the head of the World Animal Health Organisation (WOAH) said.  

The severity of the current outbreak of avian influenza, commonly called bird flu, and the economic and personal damage it has caused, has led governments to reconsider vaccinating poultry. However, some, like the United States, remain reluctant mainly because of the trade curbs this would entail.

"We are coming out of a COVID crisis where every country realised the hypothesis of a pandemic was real," WOAH Director General Monique Eloit told Reuters in an interview.  

"Since almost every country that does international trade has now been infected, maybe it's time to discuss vaccination, in addition to systematic culling which remains the main tool (to control the disease)," she said.  

The WOAH is holding a five-day general session from Sunday, and will be focus on global control of highly pathogenic avian influenza, or HPAI. 

A WOAH survey showed only 25% of its member states would accept imports of products from poultry vaccinated against HPAI.  

The European Union's 27 member states agreed last year to implement a bird flu vaccine strategy. France is set to be the first one, starting with ducks in the autumn.  

"If a bloc like the EU, which is a large exporter, starts moving in that direction, it will have a ricochet impact," Eloit said.  

The U.S. department of Agriculture (USDA) told Reuters on Friday that "in the interest of leaving no stone unturned in the fight against HPAI, USDA continues to research vaccine options that can protect poultry from this persistent threat".  

However, it still considers biosecurity measures to be the most effective tool for mitigating the virus in commercial flocks, it said in emailed answers.