H5N1

Boy, 7, infected with H9 avian flu adding to health woes in Hong Kong already battling coronavirus outbreak

Via the South China Morning Post: Boy, 7, infected with H9 avian flu adding to health woes in Hong Kong already battling coronavirus outbreak. Excerpt:

A seven-year-old boy in Hong Kong has been infected with H9 bird flu, adding to the health woes in a city already fearing a wider outbreak of the deadly coronavirus. 

The Centre for Health Protection on Friday confirmed that the boy’s nasal swab tested positive for the strain of avian flu, with the subtype still to be determined. The boy had recently returned to the city from mainland China. 

The centre said the boy had underlying illnesses and developed a cough and runny nose on Tuesday, which turned to a fever on Wednesday. 

He went for treatment at the outpatient ward at the Wang Tau Hom Jockey Club Clinic and was transferred to an isolation ward at Kwong Wah Hospital in Yau Ma Tei for further medical care.

He was admitted to Princess Margaret Hospital’s isolation ward on Thursday, where his condition was stable. 

According to the centre’s preliminary investigations, the patient had visited his grandparents’ home in Shenzhen at the incubation stage of his viral infection. 

Although the family kept poultry in their house, the boy had not come into direct contact with the birds. His family members have not reported any symptoms. 

A Department of Health spokesman said investigations were under way and the relevant medical staff at the clinic, ambulance and hospitals, as well as any possibly affected patients, had been placed under medical observation.

Avian influenza A viruses among occupationally exposed populations, China, 2014–2016

Via Emerging Infectious Diseases: Avian Influenza A Viruses among Occupationally Exposed Populations, China, 2014–2016. The abstract:

To determine the seroprevalence and seroconversion of avian influenza virus (AIV) antibodies in poultry workers, we conducted a seroepidemiologic study in 7 areas of China during December 2014–April 2016. We used viral isolation and reverse transcription PCR to detect AIVs in specimens from live poultry markets. 

We analyzed 2,124 serum samples obtained from 1,407 poultry workers by using hemagglutination inhibition and microneutralization assays. We noted seroprevalence of AIV antibodies for subtypes H9N2, H7N9, H6N1, H5N1-SC29, H5N6, H5N1-SH199, and H6N6. In serum from participants with longitudinal samples, we noted seroconversion, with >4-fold rise in titers, for H9N2, H7N9, H6N1, H5N1-SC29, H6N6, H5N6, and H5N1-SH199 subtypes. We found no evidence of H10N8 subtype. 

The distribution of AIV antibodies provided evidence of asymptomatic infection. We found that AIV antibody prevalence in live poultry markets correlated with increased risk for H7N9 and H9N2 infection among poultry workers.

ECDC CDTR, week 8

ECDC has published Communicable disease threats report, 17-23 February 2019, week 8.

The ECDC Communicable Disease Threats Report (CDTR) is a weekly bulletin for epidemiologists and health professionals on active public health threats. This issue covers the period from 17-23 February 2019 and includes updates on Middle East respiratory syndrome coronavirus (MERS-CoV), chikungunya virus disease and dengue, Ebola virus disease, influenza, Neisseria gonorrhoeae, Salmonella Poona and influenza A(H9N2).

New Year's Eve, 2008

Just out of curiosity, I've checked what I'd been blogging about here on December 31, 2008...ten short years ago.

It was mostly bird flu; the H1N1 "swine flu" pandemic was almost six months in the future, and I hadn't yet realized that bird flu could not be considered apart from an enormous range of global-health issue. (Also in the future: Haiti's cholera, MERS, H7N9, Zika, and urban Ebola.)

So I was reporting on a two-month-old baby in Shenzhen who was recovering from H9N2. The case provoked authorities in Guangdong to tighten inspection of poultry markets.

Indian doctors in Manipur were working "round the clock" to prevent the spread of H5N1 to their city after an outbreak in Assam state.   

In Nigeria, the Bauchi state ministry of health was on the alert for H5N1 as well; it was about that time, I seem to recall, that Nigeria had one human case of H5N1, which had been fatal.

Here in Canada, Ontario was finally making public the rates of hospital-acquired infections from superbugs like C. diff and MRSA.

On New Year's Day, I was reporting a health scare about possible H5N1 in an Indonesian village. And I posted links to the old Flu Wiki Forum (no longer online) and Mike Coston at Avian Flu Diary (still very much online).

Ten years later we're watching a slightly different mix of bacteria and viruses, but the war goes on. It has been my good fortune to follow the war from a safe vantage point, while gaining ever deeper respect for the men and women fighting it from the villages of Asia and Africa and Latin America to the hospitals of Europe and North America. I hope my posts have accurately reported their extraordinary efforts.

Avian influenza A virus infection among workers at live poultry markets, China, 2013–2016

Via Emerging Infectious Diseases: Ahead of Print -Avian Influenza A Virus Infection among Workers at Live Poultry Markets, China, 2013–2016. The abstract:

We conducted a 3-year longitudinal serologic survey on an open cohort of poultry workers, swine workers, and general population controls to assess avian influenza A virus (AIV) seroprevalence and seroincidence and virologic diversity at live poultry markets (LPMs) in Wuxi City, Jiangsu Province, China. 

Of 964 poultry workers, 9 (0.93%) were seropositive for subtype H7N9 virus, 18 (1.87%) for H9N2, and 18 (1.87%) for H5N1. Of 468 poultry workers followed longitudinally, 2 (0.43%), 13 (2.78%), and 7 (1.5%) seroconverted, respectively; incidence was 1.27, 8.28, and 4.46/1,000 person-years for H7N9, H9N2, and H5N1 viruses, respectively. Longitudinal surveillance of AIVs at 9 LPMs revealed high co-circulation of H9, H7, and H5 subtypes. We detected AIVs in 726 (23.3%) of 3,121 samples and identified a high diversity (10 subtypes) of new genetic constellations and reassortant viruses. 

These data suggest that stronger surveillance for AIVs within LPMs and high-risk populations is imperative.

WHO: Influenza at the human-animal interface, January 26-March 2

Thanks to Kickingbird at Flu in China for linking to this WHO report: Influenza at the human-animal interface, Summary and assessment, 26 January to 2 March 2018. This is a long and informative report. The summary:

• New infections: Since the previous update, new human infections with avian influenza A(H7N4), A(H7N9) and A(H9N2) viruses were reported.

• Risk assessment: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, and the likelihood of sustained human-to-human transmission of these viruses remains low. Further human infections with viruses of animal origin are expected.

• Risk management: Selection of new candidate vaccine viruses (CVVs) for zoonotic influenza for influenza pandemic preparedness purposes was done during a recent WHO consultation.

• IHR compliance: All human infections caused by a new influenza subtype are required to be reported under the International Health Regulations (IHR, 2005). This includes any influenza A virus that has demonstrated the capacity to infect a human and its haemagglutinin gene (or protein) is not a mutated form of those, i.e. A(H1) or A(H3), circulating widely in the human population. Information from these notifications is critical to inform risk assessments for influenza at the human-animal interface.

Egypt slaughters 17,500 poultry after bird flu outbreak reported

Via Egypt Today, a December 31 report: Egypt slaughters 17.5K poultry after bird flu outbreak reported. Excerpt:

Egypt has slaughtered more than 17,500 poultry in a farm where bird flu cases were reported in the Dakahlia governorate (Delta), said Head of Veterinary Medicine Directorate, Abdel Moneim Al Mongy, on Saturday. 

After taking samples from infected poultry, vets buried the dead and slaughtered poultry to control the spread of viruses, Mongy added in remarks to Al-Watan newspaper. 

Dakahlia’s Mit Ghamr and Gharbyia’s Santa cities were ranked as the most dangerous places, as they have the virus, he continued. 

During the veterinary inspection, the vets reported new H5N2, H8N2, H9N2 and IB strains. The fact that these strains are appearing for the first time in Egypt has made the situation all the more serious. 

“After the death of my poultry, I informed the Veterinary Medicine (Directorate) immediately,” the owner of the farm, Maged Atman, confirmed. The government should produce local veterinary medicine to cure the local virus strains and stop exporting drugs for strains not existing in Egypt, Mongy stated.

The virus first appeared in Egypt in 2006, and caused 41 deaths during 2015. Most cases are detected in impoverished rural areas that raise poultry.

See also this FluTrackers report, posted yesterday. H8N2 is a new strain to me. 

China: Hunan reports one human H9N2 AIV case in Changsha

Via Flu in China, a report from the Government Information Bureau of Macau SAR: China: Hunan reported one human H9N2 AIV case in Changsha.

According to the BOH of Macau S.A.R., the authority of mainland notified BOH that one human H9N2 AIV case reported in Hunan province, the 20 month old female, lived in Changsha city of Hunan province, now in mild condition, had visited the local live poultry market prior to the onset of symptoms on 27th Nov.

China: H7N9, H9N2 cases reported in Beijing

Via Flu in China: China: Beijing human AIV (H7N9,H9N2) cases report.

According to the Beijing CDC, Beijing has reported total of 19 human H7N9 AIV cases since 2017. 11 of them were local cases(57.9%), 8 of them were imported cases (42.1%). All 11 local cases reported in the second quarter of 2017, includes 9 cases in April and 2 cases in May (37-year-old female and 60-year-old female), all local patients were residents of rural area. 

Recently, Beijing also reported a human H9N2 AIV case, the 32-year-old male, outdoor worker, had symptoms such as fever, cough, sore throat, stuffy and running nose, chills, fatigue, headache, muscular soreness. He is now fully recovered.

China: First documented case of avian influenza (H5N1) virus infection in a lion

Via Emerging Microbes & Infections: First documented case of avian influenza (H5N1) virus infection in a lion. The conclusion:

In summary, we documented the first infection of a lion with a highly pathogenic H5N1 AIV, expanding the host range of AIV. This virus was a reassortant from circulating H5N1/H9N2 viruses and remained prevalent among poultry. Since this virus was highly virulent to the lion and that AIV has been reported to cause deaths in tigers and leopards, we believe that captive animals are under certain risk of AIV infections, and increased surveillance is needed to track and chart the ongoing evolution of circulating AIV with respect to their potential to infect susceptible mammalian hosts.