Thursday, January 18, 2018

UK: DEFRA Expands Bird Flu Prevention Zone As More Infected Birds Are Found


Just over a week after 17 dead birds were discovered in Dorset (see UK: DEFRA Announcement On H5N6 In 17 Wild Birds In Dorset), the UK's DEFRA today has announced the discovery of 13 dead birds in Warwickshire, nearly 200 km to the north.

We also learn today that the total number of birds found infected in Dorset has risen to 31. As a result, DEFRA announced that the entire nation is now declared a bird flu prevention zone.
— News story

Bird flu prevention zone extended to cover whole of England

Legal requirement for all bird keepers in England to follow strict biosecurity measures.
A bird flu prevention zone has been declared across the whole of England, Chief Veterinary Officer Nigel Gibbens has confirmed today.

This means it is a legal requirement for all bird keepers to follow strict biosecurity measures. It comes as 13 dead wild birds were confirmed to have the virus in Warwickshire.

Last week 17 wild birds tested positive in Dorset and a total of 31 infected birds have now been identified at that site. Defra took swift action to put a local prevention zone in the area on Friday (12 January). However, as these latest results show the disease is not isolated to a single site the decision has been taken to extend the prevention zone across the country on a precautionary basis.

Testing of the birds found in Warwickshire is ongoing, however, it is highly expected that this will be the same H5N6 strain of the virus which has been circulating in wild birds across Europe in recent months. Public Health England have advised the risk to public health remains very low and the Food Standards Agency have said that bird flu does not pose a food safety risk for UK consumers.
        (Continue . . . .)

The UK has joined The Netherlands, Germany, and Switzerland in reporting this recently arrived H5N6 (reassorted from last year's H5N8 epizootic) virus, along with similar reassorted H5N6 viruses reported in Japan, South Korea, and Taiwan.

Three days ago DEFRA released a detailed Rapid Risk Assessment On H5N6 In Wild Birds In Dorset which drew comparisons to this year's relatively slow spread of H5N6 (at least compared to H5N8 during the winter of 2016-17) to H5N8's subdued first appearance in Europe four winters ago.

Wednesday, January 17, 2018

The Return Of Scott McPherson


One of the OG's (original gangsters) of Flublogia, and sorely missed for the past few years, is Scott McPherson whose blog wound down in 2013 and finally ground to a halt in 2014.  He, along with Crof, Revere at Effect Measure, and myself were the primary flu-centric bloggers from about 2005-2006 onward.
I'm therefore please to announce that Scott just contacted me, and he has posted a new blog, with promises of more to come. 
I hope so.  Scott is a talented (if slightly irreverent) writer, who is well plugged into Florida state government, knows his way around pandemic flu preparedness, and can add a lot to  the conversation. 
I've added his blog back into my sidebar, so you'll see when he posts new material.
Scott and I spend two madcap days together as presenters at a CIDRAP Pandemic H1N1 conference in 2009, which is sadly our only in-person meetup so far.  Hopefully we can rectify that glaring deficit at some point.

For now, I'm delighted to refer you to his latest post, which astutely looks at the supply chain failures during our current flu season.

US Health Care Earns an "F" for poor flu supply chain practices

Posted on Wednesday, January 17, 2018 at 10:32AM by Registered CommenterScott McPherson  

Japan Reports H5N6 In Wild Birds In Tokyo & H5 In Shimane Prefecture


Compared to last winter, Japan has had a relatively easy time with bird flu this year - with only a dozen environmental and wild bird detections and 1 poultry outbreak reported since November - all of which have stemmed from the recently arrived reassorted H5N6 virus of European origin (see Tottori University: Shimane HPAI H5N6 A New Reassortment).
All of this year's reports have come from the far south of the country. At least, until today. 
Japan's Ministry of Environment is reporting the discovery of a dead Goshawk in a Tokyo park, and has raised the surveillance level to 3 for the country.  Three reports, the first a translation of a PDF from the MOE.

January 17, 30, 2007
Department of Dean and Wildlife Administration
Wildlife Division, Ministry of Natural Environment
Managing Director of Wildlife protection

Confirmation of highly pathogenic avian influenza virus (H5N6 subtype) in Japan
Raising the level of support for bird surveillance

Today, in the death bird of Ota ward, Tokyo, highly pathogenic avian influenza virus (H5N6Subtype) has been detected.
Based on the occurrence of poultry in Sanuki City, Kagawa Prefecture on  January 12, The technical manual for high-pathogenic avian influenza in birds The nationwide response level in the current bird surveillance Level 3.

 In case of reinforcement or abnormality of monitoring system, I have recently asked for a thorough period, but based on the current situation, Thank you for the bottom.

In the case of a change in the situation related to avian influenza in your prefecture , please inform us promptly.
In charge of Wildlife conservation Management Office Nishiyama, Iwano, Suzuki
Phone 03 (5521) always

Reuters' Japan has the story as well, with this translation:
 Also bird flu Goshawk of Tokyo

The Ministry of the Environment 17 days, announced that from Goshawk one bird carcasses found in the park of the Ota-ku, Tokyo, detected the highly pathogenic avian influenza virus of the highly virulent (H5N6 type). In response to this, Tokyo zoo Association the same day, at the Metropolitan 4 facilities, including Ueno Zoo (Taito), decided the immediate exhibition discontinuation of rare species and susceptible to infection by some birds from 18 days.

 According to the city, including the giant panda at Ueno Zoo, animals other than birds continue the exhibition.

 Given that it has been detected in Japan plurality of positions, the Ministry of Environment raised the three stages is alert level from "Level 2" to which the "Level 3". In the future, newly when the wild bird carcasses were found, to finely perform the virus inspection.

And this from the Yomiuri Online.

Bird flu confirmed in Tokyo, the exhibition discontinuation of birds at the zoo

At 18:34 on January 17, 2018

 Tokyo Metropolitan Government and the Ministry of the Environment has 17 days, was released from the carcasses of Goshawk of wild birds found in Ota Ward in this month five days, a highly toxic highly pathogenic avian influenza virus has been confirmed.

 Detection second case since last February in Tokyo. In order to prevent the spread of infection, the city will cease from 18 days the exhibition of some birds that are kept in Metropolitan zoo and water aromatic garden, such as Ueno Zoo.

(Continue . . . .)

Meanwhile the MOE is also reporting a positive field test on a Great Crested Grebe from Shimane Prefecture.

Conflicting Bird Flu Reports From Iraq


It isn't uncommon for us to see a wide divergence between press accounts and government admissions about disease outbreaks around the world. With avian flu, we've seen this schism most often in hard-hit places like Egypt, Indonesia, and China. 
Governments are often keen to suppress `bad news' and quash rumors - while the press - which can run anywhere from being tightly controlled to being fiercely independent and openly hostile to the government, have their own agendas.
As a result we see a lot of unverified media reports followed by government denials and then social media uproar whenever there is even a hint of an avian flu outbreak (or some other dreaded disease) in many of these countries.

While some of these stories are undoubtedly false, a few notable govermental attempts to hide the existance, or impact, of avian flu over the years include:
WHO: Indonesia Agrees To Resume Bird Flu Notifications
Regarding The Silence Of The Egyptian MOH

Revisiting Egypt’s Murky H5N1 Battle
H7N9: No News Is . . . . Curious
A lot of these media reports are either deliberately misleading or completely false. Often  these stories are nothing more than clickbait, or filler for a slow news day. It isn't unsual to see old news recycled as new - something I'm seeing more and more out of China.  
As with everything you read, Caveat Lector.
We continue to see H1N1, `swine flu' and sometimes even `bird flu' used as interchangable terms by the media in many Middle Eastern and Asian countries, and H1N1 seasonal flu is often spoken of as if it were still a pandemic strain.

The upshot is, taking media headlines - or even `facts' from the body of these reports - verbatim is fraught with danger. Add in the vaguaries introduced by machine translations, and you have a recipe for genuine confusion.

Over the past 15 hours we've been watching a similar series of `alarmist' media reports - followed by government denials - coming out of Iraq. And as always, getting to the truth of the matter isn't going to be easy.

We do know that Iraq admitted in the spring of 2016 to the return of avian flu after nearly a decade (see OIE Notification: Multiple H5N1 Outbreaks In Iraq), and while reports had tapered off by the middle of 2017, last week Iraq notified the OIE of new outbreaks of H5N8 in Diyala.
H5N8, which has recently turned up in Saudi Arabia, Iran, and Egypt has never been linked to human infection, but is very virulent in poultry.  There are some concerns it could someday adapt to humans (see J. Virulence Editorial: HPAI H5N8 - Should We Be Worried?), but so far, we haven't seen any evidence of that.
Yesterday afternoon (EST) numerous reports began to appear in Arabic media outlets describing either one or four  `bird flu cases' (or deaths) in Mosul. While dozens of stories have been published in the past 24 hours, most appeared to be `echo chamber' reports, not individual confirmations.

I discussed these reports with Sharon Sanders at FluTrackers, and we both agreed these reports were `iffy' at best. Sharon started a thread to track these reports (see Iraq - Media report: Human seasonal or avian flu death in Mosul? January 16, 2018) with the disclaimer that this could well be seasonal flu, not bird flu. 
A few hours after these reports appeared, there was a `denial' by local health officials of any human `bird flu' infections anywhere in the country, but the media reports have persisted overnight.
This morning, reports have `morphed' a bit away from `bird flu', and some now describe these 4 supposed cases (or deaths) as possibly due to `pandemic flu'.  A genuine misnomer since there is no pandemic right now, but possibly refers to seasonal H1N1
Nineveh suspects new infections of pandemic flu and awaits Baghdad result

Twilight News
3 hours ago

Shivak News / Director of the General Health of Nineveh, the registration of four cases suspected of suffering from pandemic flu.

The city of Mosul was recorded yesterday evening, the first case of death from the pandemic flu, the holder was a detainee with the organization of an advocate.

"There are four suspected cases of pandemic or seasonal influenza in Mosul hospitals," said Dr. Falah al-Taei, director general of Nineveh Health.

He said swabs and samples had been sent to Baghdad laboratories to confirm the outcome and whether the flu was epidemiological or seasonal and the result would appear after three days.

The Iraqi Minister of Agriculture, Falah Hassan Thursday, the injury of one field to raise poultry in the province of Babylon, central Iraq, bird flu, and days after controlling the focus of the disease in Diyala province.

The World Organization for Animal Health announced on Monday that Iraq reported the outbreak of the H5N1 strain of highly pathogenic avian flu in Diyala in the center of the country.

The virus was discovered on December 27 at a farm of 43,000 birds, killing 7250, the Paris-based group said in a report on its website, citing the Iraqi Ministry of Agriculture.

Also of note, while this report refers to the recent outbreak of avian flu in Diyala, they call it H5N1, while the OIE reports shows H5N8.

While the Iraqi Ministry of Health website has been silent on all of this, they do have a high profile report today on flu vaccination campaign for the Iraqi media, which suggests the `pandemic' flu mentioned above may actually refer to seasonal H1N1.

The Ministry of Health implements a vaccine campaign against seasonal flu in the Iraqi Media Network

Implementation of the directives of the Minister of Health and Environment, Dr. Adila Hammoud Hussein to implement preventive health campaigns for citizens and the Ministry of Health has implemented a vaccine campaign against seasonal flu to employees of the Iraqi Media Network and the presence of a media team chaired by the official spokesman of the Ministry of Health, Dr. Saif Al-Bader.

He said Al-Bader said the vaccination campaign influenza vaccine Amoosamh implemented throughout Baghdad, where he embarked on the health of Baghdad, the Department of Rusafa and Gaza Adhamiya vaccination campaign vaccine seasonal flu in the Iraqi media network, indicating that the vaccination campaign in the Iraqi media network came to support and promote the media about the availability of flu vaccine in all centers health and to urge citizens and invite them to review near the center of their home to take the vaccine, which the ministry was keen to import it from a global Menashe solid.

(Continue . . . )

While seasonal H1N1 seems the most likely explanation, it isn't the only possibility, and so we'll keep a close eye on any developments in the days ahead.

Meanwhile, the media continues to describe the bird flu outbreaks in `aflockalyptic' terms (see report below), while the Ministry of Agriculture appears eager to downplay the impact.  Two (translated) reports:
Bird flu sweeping Diyala, Babil and losses in billions
The head of the Committee on Agriculture and Water Parliament MP Furat al-Tamimi said poultry farmers losses in the provinces of Diyala and Babil due to bird flu, more than five billion dinars barrier, while the government has called for accelerating the pace of compensation.

Tamimi said in a statement , "pride" got a copy of " The outbreak of bird flu in poultry farms in Diyala and Babil liver owners huge material losses exceeded five billion dinars barrier," adding that "most of them can no longer re - production because of the accumulated debt."

He called Tamimi, the central government to " the formation of committees for urgent compensation to accelerate the payment of compensation to the owners of the affected fields of bird flu in order to re - start production again to support the local economy."

The Veterinary Department had previously announced the emergence of bifocal disease pathologies of bird flu strain {H5N8} in the provinces of Diyala and Babil time.

With an exchange rate of roughly 1200 dinars to 1 USD, the `5 billion' number works out closer to 4 million US dollars, but still a hefty loss.   By contrast, the MOA today reports that bird flu is `fully controlled'.

The Ministry of Agriculture conducts veterinary health measures to reduce bird flu disease and prevent its spread
Mr. Technical Undersecretary of the Ministry of Agriculture, Dr. Mehdi ligature Qaisi confirmed the full control of the disease of bird flu, which appeared in small spots in the provinces of Diyala and Babil through the veterinary health methods necessary action to prevent its spread to other regions

 Qaisi said that the rapid spread of viral diseases affecting livestock, especially poultry, have been identified where the injury area and take appropriate veterinary measures and rapid control it and prevent its spread.

Indicating that the focus of disease has been controlled completely through the landfilling process and assure that citizens and livestock breeders that the disease is not dangerous or leakage to other areas, and that the cadres of the Veterinary Department continuing its campaign to contain and control it and determine the movement of poultry and poultry products
As to what is the real truth in all of this, there is a pretty good chance we'll never find out.  At least, that has been the outcome of previous reports like these around the world.

But, if anything does develop, FluTrackers will be on it, as shall I.

Tuesday, January 16, 2018

Reminder: CDC Grand Rounds Today - Public Health Response to Severe Influenza


Although I blogged on it in some detail on Saturday (see CDC Grand Rounds: Nuke Detonation Postponed, Severe Flu Response Instead), a quick reminder that the presentation will be held live today at 1pm EST. 

Public Health Response to Severe Influenza

January 16, 2018 at 1:00 p.m. (ET)

Note: January 16 CDC Public Health Grand Rounds topic change to: “Public Health Response to Severe Influenza”

Registration is not required to watch our free Grand Rounds presentations. The webcast link below is only active during the date and time of the session, but all sessions are archived for future viewing.

CDC Grand Rounds Live Web stream

The topic for CDC’s Public Health Grand Rounds on January 16 will now focus on influenza. With the spike in flu cases around the country, this Grand Rounds will provide key and timely information for public health professionals on how to reduce the spread of seasonal flu in communities and adjust to spot shortages in antiviral drugs because of high influenza activity in some areas.

To date, this influenza season is notable for the sheer volume of flu that most of the United States is seeing at the same time which can stress health systems. The vast majority of this activity has been caused by influenza A H3N2, associated with severe illness in young children and people 65 years and older.

Join us for this session of Grand Rounds to learn what steps can be taken to reduce the spread of flu in communities and adjust to spot shortages in antiviral drugs in some places experiencing high influenza activity.

Note: The previous public health topic will be rescheduled for a future Grand Rounds.

CDC’s Public Health Grand Rounds Presents:

“Public Health Response to a Sharp Increase in Severe Seasonal Influenza”
Tuesday, January 16, 2018
1:00 p.m. – 2:00 p.m. (ET)

Global Communications Center (Building 19)
Alexander D. Langmuir Auditorium
Roybal Campus
Presented By:

Anne Schuchat, MD (RADM, USPHS)
Principal Deputy Director
Centers for Disease Control and Prevention

Dan Jernigan, MD, MPH, Captain, USPHS
Director, Influenza Division
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention
“Chasing Flu”

David Wentworth, PhD
Chief, Virology, Surveillance, and Diagnosis Branch, Influenza Division
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention
“The Problem of H3N2”

Alicia Fry, MD, MPH, Captain, USPHS
Chief, Epidemiology and Prevention Branch, Influenza Division
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention
“Mitigating Influenza with Vaccines and Antivirals”

WHO: Yellow Fever In Brazil - Vaccination Recommended For Visitors to São Paulo State


Last year's Yellow Fever epidemic in Brazil was the worst in years, with the virus turning up in urban areas that had not experienced outbreaks in decades (see Brazil: Yellow Fever Updates From The MOH, The CDC, and University of Wisconsin).  
Complicating matters, there is serious shortage of the Yellow Fever Vaccine (see CDC Announcement: Yellow Fever Vaccine Access) which is expected to continue well into 2018.
In November a WHO update noted 2 recent human infections in São Paulo, along with 580 epizootics in non-human primates reported since the previous July. 

Today, they are reporting increased levels of yellow fever activity across São Paulo, and have issued a recommendation that international travelers to that state get the yellow fever vaccine.

Updates on yellow fever vaccination recommendations for international travelers related to the current situation in Brazil

16 January 2018

This is an update to the WHO advice posted in the Disease Outbreak News of 27 January 2017, 6 March 2017, 20 March 2017, 4 April 2017, and 24 November 2017; and on the WHO International Travel and Health website on 31 January 2017, 14 February 2017, 6 March 2017, 17 March 2017, and 4 April 2017.

Since December 2016, Brazil is experiencing an upsurge of yellow fever virus activity. Between 1 December 2016 and 30 June 2017, 1,659 epizootics in non-human primates were registered in 21 states (Alagoas, Amazonas, Bahia, Goiás, Espírito Santo, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Paraíba, Paraná, Pernambuco, Rio Grande do Norte, Rio Grande do Sul, Rio de Janeiro, Rondônia, Roraima, Santa Catarina, São Paulo, Sergipe, and Tocantins), and in the Federal District; a total of 777 human cases were reported, including 261 fatal, in eight states (Espírito Santo, Goiás, Mato Grosso, Minas Gerais, Pará, Rio de Janeiro, São Paulo, and Tocantins), as well as in the Federal District. On 9 September 2017, the government of Brazil declared that seasonal yellow fever virus activity has subsided.

Following the 2017 winter season in the Southern hemisphere, an increased yellow fever virus activity was again observed. Between 1 July 2017 to 8 January 2018, yellow fever virus infection was confirmed in relation to 358 epizootics in non-human primates in the states of Mato Grosso do Sul (0.3% of cases), Minas Gerais (9%), Rio de Janeiro (0.7%), and São Paulo (90%). As of 8 January 2018, 687 epizootics were under investigation for yellow fever in 17 states (Alagoas, Bahia, Goiás, Espírito Santo, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Paraná, Pernambuco, Rio Grande do Norte, Rio Grande do Sul, Rio de Janeiro, Santa Catarina, São Paulo, Sergipe, and Tocantins), and in the Federal District.

Over the same period of time, yellow fever virus infection was laboratory confirmed in 11 human patients, including four who died, from the states of Minas Gerais (one fatal case), Rio de Janeiro (one case), São Paulo (8 cases, including two fatal), and the Federal District (one fatal case). As of 8 January 2018, 92 additional human cases were under investigation for yellow fever virus infection in 15 states (Bahia, Goiás, Espírito Santo, Mato Grosso do Sul, Minas Gerais, Pará, Paraíba, Paraná, Pernambuco, Piauì, Rio Grande do Norte, Rio Grande do Sul, Santa Catarina, São Paulo, and Tocantins), as well as in the Federal District.

Considering the increased level of yellow fever virus activity observed across the state of São Paulo, the WHO Secretariat has determined that, in addition to the areas listed in previous updates, the entire state of São Paulo should also be considered at risk for yellow fever transmission.

Consequently, vaccination against yellow fever is recommended for international travellers visiting any area in the state of São Paulo

The determination of new areas considered to be at risk for the yellow fever transmission is an ongoing process and updates will be provided regularly.

The current advice by the WHO Secretariat for international travellers going to areas in Brazil deemed to be at risk is the following:
  • Vaccination against yellow fever at least 10 days prior to the travel. Note that, as per Annex 7 of the International Health Regulations (2005), a single dose of a yellow fever vaccine approved by WHO is sufficient to confer sustained immunity and life-long protection against yellow fever disease. Travellers with contraindications for yellow fever vaccine (children below 9 months, pregnant or breastfeeding women, people with severe hypersensitivity to egg antigens, and severe immunodeficiency) or, over 60 years of age should consult their health professional for advice;
  • adoption of measures to avoid mosquito bites;
  • awareness of symptoms and signs of yellow fever;
  • seeking care in case of symptoms and signs of yellow fever, while travelling and upon return from areas at risk for yellow fever transmission.

For 2017, updates on country requirements for the International Certificate of Vaccination or Prophylaxis, with proof of vaccination against yellow fever, and WHO vaccination recommendations for international travellers, are available on the WHO International Travel and Health website: Annex 1 and country list . More specific information about requirements for the International Certificate of Vaccination or Prophylaxis, with proof of vaccination against yellow fever, implemented by Member States related to the current situation in Brazil in the Region of the Americas is available on the PAHO yellow fever website.