H5N1

China: Outbreaks of flu could come again in March

Via China.org.cn, a China Daily report: Outbreaks of flu could come again in March.

A new wave of flu outbreaks may occur in China in March, but it will be not as serious as the one that hit many parts of the country earlier this winter, an official from the Chinese Center for Disease Control and Prevention said on Tuesday. 

Judging from past experience, smaller peaks of the flu are likely next month, triggered by the change of seasons and heavy population flows after the traditional Chinese New Year holiday, Dong Xiaoping, director of the CDC's global public health center, said at a news conference.  

"However, it is almost certain the next peak will be smaller than the first," he said.  

Mass population migrations - mainly migrant workers going back to their city jobs after the holiday, coupled with students going back to school after the winter vacation - are expected next month, and disease control centers across China are closely monitoring for viruses to forestall major outbreaks, Dong said.  

"The National Health and Family Planning Commission and related authorities have made preparations," he said. "Flu outbreaks in China will continue, but it is not possible for them to develop into a major epidemic like the Spanish flu pandemic between 1914 and 1918."  

China was hit by its worst flu epidemic in recent years this winter, and respiratory departments at major hospitals in many cities found themselves short staffed. More than 273,000 cases were reported in January on the Chinese mainland, including 56 deaths, according to the National Health and Family Planning Commission. 

The number of reported flu cases on the Chinese mainland in January last year was a little over 30,000. It was 23,300 in January 2016. 

The commission has said that the peak season would last until the end of January, when school vacations began. Wang Hesheng, vice-minister in charge of the commission, said earlier this month that the intensity of the flu has declined across China. 

A new wave of flu could hit China in March, and the public should take precautionary measures, including vaccinations, Zhong Nanshan, head of the National Clinical Research Center for Respiratory Disease in Guangzhou, Guangdong province, said in January.  

The new wave may coincide with a wave of human cases of H7N9 bird flu, which is most active between January and March and may have more serious consequences, he warned.  

CDC's Dong said on Tuesday that the two types of flu may coexist in March, but there is no sign that H7N9 would occur in a significant number of human cases anything close to the number of seasonal human flu infections.  

"It may bring some challenges for disease control and prevention, but please be assured that health authorities are very experienced in dealing with such diseases," he said.  

More than 1,500 human cases of bird flu have been reported on the Chinese mainland since 2013, including more than 600 deaths.

Vietnam warns of possible new bird flu outbreaks

Via Xinhua: Vietnam warns of possible new bird flu outbreaks. Interestingly, it doesn't mention H5N1, which was a recurring problem in Vietnam for years.

The Department of Animal Health under the Ministry of Agriculture and Rural Development has warned of a high risk of the return of avian influenza in Vietnam after the epidemic was put under control for a long period of time.  

The department said one hotbed of A/H5N6 bird flu virus had been reported recently in Dai Ban commune, An Duong district, northern Hai Phong city, Vietnam News Agency reported on Monday.

It noted some avian flu strains that have not been reported in Vietnam such as A/H7N9, A/H5N2 and A/H5N8 may enter the country through the transportation, trading and consumption of poultry and poultry products with obscure origin, especially in border provinces and the localities consuming smuggled poultry products. 

The department urged localities to take the initiative in bird flu prevention, crack down on poultry smuggling, and keep a close watch on local situation in order to timely respond to any outbreak. 

Meanwhile, foot-and-mouth and blue-ear diseases are also likely to break out among livestock that are unvaccinated or transported to former hotbeds.  

The animal health agency called on vulnerable localities to augment monitoring, vaccination and control of livestock transportation and slaughtering to minimize risks of disease outbreak and spread.

Influenza A(H7N9) virus antibody responses in survivors one year after infection, China, 2017

Via EID: Ahead of Print -Influenza A(H7N9) Virus Antibody Responses in Survivors 1 Year after Infection, China, 2017. The abstract:

Avian influenza A(H7N9) virus has caused 5 epidemic waves in China since its emergence in 2013. We investigated the dynamic changes of antibody response to this virus over 1 year postinfection in 25 patients in Suzhou City, Jiangsu Province, China, who had laboratory-confirmed infections during the fifth epidemic wave, Oct 1, 2016–February 14, 2017. 

Most survivors had relatively robust antibody responses that decreased but remained detectable at 1 year. Antibody response was variable; several survivors had low or undetectable antibody titers. Hemagglutination inhibition titer was >1:40 for <40% of the survivors. Measured in vitro in infected mice, hemagglutination inhibition titer predicted serum protective ability. 

Our findings provide a helpful serologic guideline for identifying subclinical infections and for developing effective vaccines and therapeutics to counter H7N9 virus infections.

Hong Kong: CHP notified of additional human case of avian influenza A (H7N9) in Guangdong

Via the Centre for Health Protection: CHP notified of additional human case of avian influenza A (H7N9) in Guangdong. Excerpt:

The Centre for Health Protection (CHP) of the Department of Health (DH) today (February 12) received notification of an additional human case of avian influenza A(H7N9) from the Health and Family Planning Commission of Guangdong Province, and reminded the public to maintain strict personal, food and environmental hygiene both locally and during travel especially in the upcoming Lunar New Year holidays.

The case occurred in Zhongshan and this is the first case in Guangdong this winter.        

"Based on the seasonal pattern, the activity of avian influenza viruses is expected to be higher in winter. The public should avoid contact with poultry, birds and their droppings and should not visit live poultry markets and farms to prevent avian influenza," a spokesman for the CHP said.   

Since October 2017, three human cases of avian influenza A (H7N9) infections and two other human cases of avian influenza A(H5N6) infections have been reported in the Mainland. Outbreaks of highly pathogenic avian influenza A(H5) in birds and poultry have also occurred in many countries in the past few months.

China: One new human H7N9 case reported in Guangdong province

A report from the Guangdong Provincial Health and Family Planning Commission: H7N9 epidemic in our province stable. The report and then a comment:

According to the statistics of "China Disease Prevention and Control Information System", as of February 10 at 0:00, in 2018, 1 case of H7N9 case was reported in our province (Report of February 10 from Zhongshan City). Surveillance showed no evidence of H7N9 virus changes in human infectivity, virulence and interpersonal transmission. 

Experts suggest that the overall mortality rate of H7N9 patients is about 30-40%, annual winter and spring season for the susceptible season of H7N9 and other avian flu. The public should avoid contact with dead poultry in their daily life and try to avoid direct contact with live poultry. 

People in rural areas should not buy and keep live poultry without quarantine certificate from floating poultry vendors. Those with history of poultry exposure and fever and respiratory symptoms, should wear a mask, report as soon as possible to the local medical institutions, and take the initiative to inform the doctor of poultry exposure history.

Mike Coston at Avian Flu Diary and FluTrackers have this story also, and Mike's post has some useful comments.

Hong Kong: Public urged to stay alert against avian influenza

Via the Centre for Health Protection: Public urged to stay alert against avian influenza. Excerpt:

The Centre for Health Protection (CHP) of the Department of Health today (January 19) urged the public to stay alert against the possible increasing activity of avian influenza in winter and reminded them to maintain strict personal, food and environmental hygiene both locally and during travel especially in the upcoming Lunar New Year holidays.

"Based on the seasonal pattern, the activity of avian influenza viruses is expected to rise in winter. Whether locally or outside Hong Kong, the public should avoid contact with poultry, birds and their droppings and should not visit live poultry markets and farms to protect themselves from avian influenza," a spokesman for the CHP said.

Since October 2017, two human cases of avian influenza A (H7N9) infections and two other human cases of avian influenza A(H5N6) infections have been reported in the Mainland. Outbreaks of highly pathogenic avian influenza A(H5) in birds and poultry have also occurred in many countries in the past few months.

"Apart from avoiding contact with poultry and visits to wet market, live poultry markets or farms, travellers to the Mainland or other affected areas must be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchasing live or freshly slaughtered poultry," the spokesman reminded.

Hong Kong: CHP notified of human case of avian influenza A(H7N9) in Xinjiang

Via the Centre for Health Protection: CHP notified of human case of avian influenza A(H7N9) in Xinjiang. Excerpt:

The Centre for Health Protection (CHP) of the Department of Health is today (January 12) monitoring a notification from the National Health and Family Planning Commission that an additional human case of avian influenza A(H7N9) was recorded from January 6 to 12 in Xinjiang Uygur Autonomous Region, and strongly urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.        

A 72-year-old male patient in Korla City died on January 10. He had contact with live poultry before the onset of symptoms.        

"Based on the seasonal pattern, the activity of avian influenza viruses is expected to increase in winter. The public should avoid contact with poultry, birds and their droppings and should not visit live poultry markets and farms to prevent avian influenza," a spokesman for the CHP said.

China: Poultry market in Jiangxi closed for H7N9 cleanup

Via China Daily, a report from the China Jiangxi Network: Strengthen source control to do a good job H7N9 bird flu prevention and control work. Note that the story doesn't say H7N9 was actually found in the market or in its poultry, but the implication is strong. The Google translation:

In order to further control the source, earnestly prevent and control H7N9 bird flu and ensure people's health and life safety. January 2, Anyuan County Xinshan market live poultry trading point to carry out the focus of rectification and clean-up work. 　　

On the first day off, Xin Shan Market did not find the phenomenon of selling live poultry. Although the poultry trading market has been closed down, individual chickens and stalls can still be seen selling chickens and ducks that have already been slaughtered. In addition, poultry manure and litter remained in the poultry trading venues have not yet been cleared and the sanitation situation is worrying. Leave hidden dangers. 　　

In response to these problems, the Municipal Supervision Bureau jointly organized the remediation team of urban management, agricultural and food services, the health planning committee, public security and fire protection departments to conduct inspections during the breakout period, publicize the common sense of bird flu prevention and control to the public, Carpet cleaning of rubbish, and comprehensive disinfection of livestock and poultry slaughter tools in live poultry stalls. Through centralized regulation and clean-up, the environmental hygiene at the trading point has been greatly improved, putting an end to the hidden dangers of bird flu. 　　

For the suspension, the general public and businesses have expressed their support. 　　

It is learned that from January 2 to January 16, Anyuan County has closed all trading places for live poultry throughout the county from January 1 to January 16, and the inflow and trading of live birds is strictly prohibited. Live poultry are not allowed to be sold outside the market. After that, the county H7N9 bird flu prevention and control work will continue to be further promoted.

China: Yunnan reports one human H7N9 AIV case in Kunming

Via Flu in China, a December 2 report from the HFPC of Yunnan: China: Yunnan reported one human H7N9 AIV case in Kunming.

According to the HFPC of Yunnan province on 2nd Dec 2017, one human H7N9 AIV case was reported in Kunming city on 30th Nov. 

The 64-year-old male lived in Xundian county of Kunming city, had raised more than ten chickens in his own home. Several chickens died prior to the patient´s onset of symptoms. Epidemiological investigation revealed that he had contact history with live and dead chickens and chicken manure. Now the patient remains in hospital for quarantine and treatment. All close contacts were under medical monitoring and no one showed ILI symptoms so far. 

The news did not reveal the pathogenic type(HP or LP) of the H7N9 virus in this case.This is the first H7N9 human case reported in Yunnan since this winter. 

Clusters of human infection and human-to-human transmission of avian influenza A(H7N9) virus, 2013–2017

Via Emerging Infectious Diseases: Ahead of Print -Clusters of Human Infection and Human-to-Human Transmission of Avian Influenza A(H7N9) Virus, 2013–2017. The abstract:

To detect changes in human-to-human transmission of influenza A(H7N9) virus, we analyzed characteristics of 40 clusters of case-patients during 5 epidemics in China in 2013–2017. Similarities in number and size of clusters and proportion of clusters with probable human-to-human transmission across all epidemics suggest no change in human-to-human transmission risk.