Tuesday, December 12, 2017

DEFRA: HPAI in Europe - Outbreak Assessment #17















#12,960


After last winter's record avian epizootic in Europe we've yet to see the highly anticipated return of HPAI H5N8 via migratory birds, but we have been thrown a bit of a curve ball with the detection of a reassorted H5N6 virus which turned up in the Netherlands last week.
This virus appears closely related to a similar reassortment first reported in Greece last spring, and reported for the first time in Japan, South Korea, and Taiwan over the past month (see OIE: Taiwan H5N6 Identified As Similar To New Reassortant Reported In Japan).
This newly reassorted H5N6 virus is of a different lineage than the Asian H5N6 virus which circulates in China, and that impacted Japan, South Korea, and Taiwan last winter. It has been described as being a combination of the H5N8 virus that arrived in Europe last year and a European LPAI HxN6 virus.
While scattered reports of H5N8 have continued to come in from Italy, Germany, Bulgaria, and Russia - this newly reassorted H5N6 virus turning up in 4 countries nearly 10,000 miles apart raises fresh questions about what to expect the rest of this winter.
The UK's DEFRA has published a new analysis, which describes Europe's recent HPAI activity in general - and the arrival of H5N6 in particular - and ponders these questions.

Updated Outbreak Assessment #17
Highly Pathogenic Avian Influenza in Europe
11 December 2017 Ref: VITT/1200 Avian Influenza in Europe

Disease report
On the 8th December, Netherlands reported an outbreak of H5 Highly Pathogenic Avian Influenza (HPAI) in ducks in Flevoland. The virus has since been confirmed as H5N6 HPAI a probable new incursion to Europe since the only previous report of this virus subtype was in February 2017 in a single poultry outbreak in Greece. According to the national reference laboratory, the farm was also infected last year, with H5N8 HPAI.
Further definitive analyses of the virus is awaited to identify precise origins and possible zoonotic risk but preliminary genetic analysis shows this virus is not closely related to sporadic zoonotic H5N6 HPAI strains which have been circulating in poultry and wild birds in Eastern Asia, instead this is a reassortant between H5N8 and a low pathogenicity H5N6 virus (Wageningen University, 2017).
Sixteen thousand meat ducks (both 4-week-old and 4 day old) were present at the premises and disease control measures have been put in place including stamping out, cleansing and disinfection and 3 /10 km restriction zones. Other premises in the 3km zone were immediately tested and all results are negative.
In addition, the Dutch Authorities have required all commercial poultry premises to house birds, for owners of hobby and captive birds to prevent contact with wild birds and for additional biosecurity for transport (including a ban in the 10km zone for movement of poultry products, manure or live birds) and other potential risk pathways. There is also a ban on the shows and exhibitions of ornamental poultry and waterfowl. The map above also indicates the major water sites in the region where wild waterfowl are likely to congregate.
Situation assessment
Since our last update on 22nd October 2017 reports of H5N8 HPAI in Europe have continued albeit at a reduced rate in just four countries including Russia. Italy has been most affected with 27 more outbreaks of H5N8 HPAI in November, 18 of which were in a cluster in Brescia. The majority of these outbreaks were in the north of Italy, but one was further south in central Italy (Roma) involving a flock of backyard layers. In all cases, disease control measures were rapidly put in place. The two cases in Ferrara involved wild birds, including a Greylag goose (Anser anser), a feral pigeon (Colomba livia) and a kestrel (Falco tinnunculus). More information on the individual infected premises can be found at the website of the Italian national laboratory (IZSV, 2017).
Germany last reported H5N8 HPAI on the 23rd October with a finding in a wild Mallard near the border with the Netherlands. Encouragingly no further cases have been reported. Bulgaria reported three more outbreaks in commercial ducks in November. Russia reported an outbreak of H5N8 HPAI in village birds in Rostov (just east of the Ukraine) in mid-November (not within the scale of the map below).
Many of the wild migratory waterfowl have now arrived to overwinter in northern Europe and the UK from their breeding grounds in Central and North Eurasia. Indeed many wigeon started arriving in the UK in September. Compared to the situation at this time in 2016, the outlook for H5N8 in Central Europe is much more favourable with relatively fewer cases in wild birds. With the exception of the wild duck case in Germany on the 23rd October, all the wild bird outbreaks (and poultry outbreaks) reported in Europe since the last report are south of the main migratory waterfowl flyway to the UK (see map).
Thus, on this basis, it appears less likely that wild birds will bring H5N8 to the UK from these southerly regions of Europe. However we cannot rule out that the wild birds are succumbing to infection but outcomes such as high mortality (as observed last year) is not occurring because many birds in the population are likely to have been exposed last year and survived infection.
Although new incursions of H5N8 HPAI through wild bird migration to Europe remain a continuous risk up until February, the increase in detections anticipated since the last report has not materialised in November at least but other factors such as cold weather movement also need to be considered. It is possible that local maintenance of H5N8 virus could still be occurring at sites in northern Europe from October and spread via other routes such as ongoing outbreak locations in Italy and Bulgaria.
The latest case of H5N6 in the Netherlands is a significant new event that merits close monitoring of any developments. Furthermore, a cold winter in Central Europe would encourage more waterfowl to migrate west and into the UK up until February and freezing temperatures in the UK (as being experienced at present) could mean waterfowl move away from coastal sites to more sheltered inland areas.
Conclusion
The EURL at Weybridge has the necessary diagnostic capability for this strain of virus.
Given the uncertainty in the distribution and prevalence of H5N8 in wild birds in northern Europe and the new evidence of a single outbreak with H5N6, it is appropriate to keep the risk level at “MEDIUM” for the present but keep under continuous review. The risk for poultry remains “LOW” for introduction of infection onto individual premises, but will depend on levels of biosecurity which we recommend should be increased, particularly for seasonal fattening farms of poultry.
We strongly recommend that all poultry keepers (including backyard keepers) review their biosecurity measures and business continuity plans now, as the risk level may well increase in the coming weeks. They should familiarise themselves with government guidance on good biosecurity and how to report suspicion of disease appropriately.
Further information is available here: https://www.gov.uk/guidance/avian-influenza-bird-flu including updated biosecurity advice for poultry keepers for England; http://gov.wales/topics/environmentcountryside/ahw/poultry/bird-gatherings-advice/?lang=en for Wales and; http://gov.scot/avianinfluenza for Scotland
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Taiwan CDC: Late Season Surge In EV-D68 Cases















#12,959

 
Non-polio Enteroviruses (NPEV's) - of which there are literally dozens - typically spread in the summer and early fall, and generally produce mild or asymptomatic infections, mostly in children under the age of 10.
Symptomatic cases can range from a mild fever or a runny nose - to HFMD (Hand Foot Mouth Disease) - a generally mild childhood disease characterized by blisters on the hand, feet, and mouth.
In North America HFMD is usually caused by the Coxsackie A16 virus, or less commonly, the Coxsackie A10 virus. In recent years, we’ve also seen the emergence of the Coxsackie A6 virus (see MMWR: Coxsackievirus A6 Notes From The Field) which has been associated with more severe illness.

But for several decades - particularly in Asian and Western Pacific nations - we've monitored yearly NPEV epidemics of a much more serious nature, with the most severe illness linked to Human Enterovirus 71 (EV-71), and over the past couple of years, to EV-D68.
Among the more serious presentations of NPEV infection is Acute flaccid myelitis (AFM) - a rare polio-like illness that affects a person’s nervous system (specifically the spinal cord) - and is characterized by sudden weakness in one or more arms or legs, along with loss of muscle tone and decreased or absent reflexes.
In August of 2014 the United States saw a large increase in AFM cases tentatively linked to EV-D68, a relatively rare non-polio enterovirus that caused a nationwide outbreak of mild to moderate respiratory illness, mostly among children and teenagers (see Kansas City Outbreak Identified As HEV 68).

While a circumstantial case has been made over the past couple of years (see EID Journal Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014), no definitive causal link to EV-D68 has been established. Some AFM cases have tested positive for EV-D68, while others have not (cite)
Similar outbreaks have occurred around the world, with PAHO issuing an epidemiological  alert a little over a month ago after a cluster of AFM cases were reported in Argentina concurrent to an outbreak of EV-D68.
Although Taiwan's NPEV season has passed its peak, their CDC today is reporting on an increase in EV-D68 cases - including a couple of serious cases involving limb weakness. 
Parents and child care providers urged to stay vigilant for enterovirus infection as Taiwan CDC confirms 2 new cases of enterovirus D68 infection with severe complications ( 2017-12-12 )

Although the enterovirus epidemic has passed its peak, the number of enterovirus D68 infection cases has continued to increase and the majority of the infected individuals are children aged below 5. Moreover, the primary symptoms of enterovirus D68 infection are fever, runny nose and cough and infected individuals rarely develop typical symptoms of enterovirus infection such as herpangina and hand, foot, and mouth disease. Therefore, the public is urged to remain vigilant of the health of the children and infants in their family and ensure a child receives immediate medical attention if he/she develops symptoms such as acute limb weakness.

Last week, the Taiwan Centers for Disease Control (Taiwan CDC) confirmed 2 new cases of enterovirus D68 infection with severe complications respectively in a 4-year-old boy and a 9-year-old girl who reside in central Taiwan. Both of them developed symptoms, including fever, runny nose, fever, and upper/lower limb weakness on one side of the body in late November. Infection with enterovirus D68 was confirmed in both cases by the Taiwan CDC laboratory. As of now, the cases are still hospitalized for treatment.
 A cumulative total of 15 cases of enterovirus D68 infection have been confirmed in Taiwan thus far this year. Among them, 4 were found to be cases of enterovirus infection with severe complications after case review. In light of the recent increase in the number of cases of enterovirus D68 infection, Taiwan CDC would be convening an expert meeting on December 13 to discuss relevant control strategies and response measures that reinforce surveillance in order to reduce the risk of transmission among children.
Thus far this year, 13 cases of enterovirus infection with severe complications, including 1 death, respectively caused by enterovirus D68 (4 cases), CA 6 (3 cases), CB3 (2 cases), echovirus 5 (2 cases), CA 2 (1 case), and enterovirus 71 (1 case) have been confirmed. 

In terms of international outbreaks, a nationwide outbreak of enterovirus D68 infection occurred in the United States during August 2014 and January 2015 and a cumulative total of 1,153 cases of cases with a significant number of severe cases were confirmed during that outbreak. Canada and Argentina respectively isolated enterovirus D68 in 2014 and 2016, and only a few sporadic cases developed severe complications. Over 15 countries in Europe isolated enterovirus D68 during 2010 and 2016. Among those countries, Germany, the United Kingdom, France, Italy, the Netherlands, Portugal, Norway and Sweden reported sporadic cases that developed severe complications. Countries in Southeast Asia observed an increase in the number of acute respiratory infection cases caused by enterovirus 68 during 2005 and 2014 and all of them were mild cases. Japan confirmed 258 mild cases of enterovirus D68 infection and 9 severe cases in 2015.
Enterovirus D68 infection is transmitted through the fecal-oral route, respiratory droplets and direct contact. The primary symptoms include, fever, runny nose, and cough. A few infected individuals may develop complications such as pneumonia, encephalitis and limb weakness. Currently, there is no effective vaccine to prevent or drug to treat the infection. Hence, the public is urged to practice good personal hygiene, wash hands with soap and water properly and frequently. If a child in the family develops limb weakness, please ensure the child receive medical assistance as soon as possible. 

The most effective ways to ward off enterovirus D68 and other enteroviruses are to practice good hand hygiene and cough etiquette, avoid visiting crowded public places, and rest at home when sick. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).


Last modified at 2017-12-12


Complicating matters slightly, reports of seasonal flu are on the rise in Taiwan (see CDC statement Domestic flu epidemic rise, reminding people to enhance personal protection ), which may make early diagnosis of NPEVs more challenging.

Some earlier blogs on EV-D68 and other NPEVs include:
MMWR: Cluster of Acute Flaccid Myelitis in Five Pediatric Patients - Arizona, 2016
CDC Acute Flaccid Myelitis Update - January 2017

EID Journal Upsurge In EV-D68 In The Netherlands, 2016


Taiwan CDC: 1st Case Of EV-D68 With Acute Flaccid Paralysis 


ECDC: Rapid Risk Assessment On Recent Enterovirus Outbreaks In Europe

 

Lancet: Case-Control Study Confirms Association Between Zika and Microcephaly











#12,958

Despite an abundance of anecdotal data and the results of preliminary case-control studies linking maternal Zika infection to the sharp increase in microcephalic births in Brazil in 2015-2016, there have been competing theories that vaccines, the release of GM mosquitoes  or the use of larvicides in drinking water, may have been responsible (see WHO: Dispelling Rumors Surrounding The Zika Virus & Microcephaly).
In August of 2016, the Lancet published Association between Zika virus infection and microcephaly in Brazil, January to May, 2016: preliminary report of a case-control study by Thalia Velho Barreto de Araújo, PhD et al. which found that the `data suggest that the microcephaly epidemic is a result of congenital Zika virus infection.'
As cases of microcephaly began to be reported following Zika outbreaks outside of Brazil, concerns over the role of GM mosquitoes and exposure to the larvacide pyriproxyfen have lessened somewhat.

Yesterday The Lancet published a follow-up final report on the case control study mentioned above, which presents evidence of an `absence of an effect of other potential factors, such as exposure to pyriproxyfen or vaccines', and confirms maternal Zika virus infection as the cause of increased microcephaly in Brazil.
Association between microcephaly, Zika virus infection, and other risk factors in Brazil: final report of a case-control study

Thalia Velho Barreto de Araújo, PhD, Prof Ricardo Arraes de Alencar Ximenes, PhD, Demócrito de Barros Miranda-Filho, PhD, Wayner Vieira Souza, PhD, Ulisses Ramos Montarroyos, PhD, Ana Paula Lopes de Melo, MSc, Sandra Valongueiro, PhD, Maria de Fátima Pessoa Militão de Albuquerque, PhD, Cynthia Braga, PhD, Sinval Pinto Brandão Filho, PhD, Marli Tenório Cordeiro, PhD, Enrique Vazquez, PhD, Danielle di Cavalcanti Souza Cruz, MD, Claudio Maierovitch Pessanha Henriques, MSc, Luciana Caroline Albuquerque Bezerra, MSc, Priscila Mayrelle da Silva Castanha, PhD, Rafael Dhalia, PhD, Ernesto Torres Azevedo Marques-Júnior, PhD, Prof Celina Maria Turchi Martelli, PhD
, Prof Laura Cunha Rodrigues, PhD 


Published: 11 December 2017

DOI: http://dx.doi.org/10.1016/S1473-3099(17)30727-2 |

Summary


Background

A Zika virus epidemic emerged in northeast Brazil in 2015 and was followed by a striking increase in congenital microcephaly cases, triggering a declaration of an international public health emergency. This is the final report of the first case-control study evaluating the potential causes of microcephaly: congenital Zika virus infection, vaccines, and larvicides. The published preliminary report suggested a strong association between microcephaly and congenital Zika virus infection.


Methods


We did a case-control study in eight public maternity hospitals in Recife, Brazil. Cases were neonates born with microcephaly, defined as a head circumference of 2 SD below the mean. Two controls without microcephaly were matched to each case by expected date of delivery and area of residence. We tested the serum of cases and controls and the CSF of cases for detection of Zika virus genomes with quantitative RT-PCR and for detection of IgM antibodies with capture-IgM ELISA. We also tested maternal serum with plaque reduction neutralisation assays for Zika and dengue viruses. We estimated matched crude and adjusted odds ratios with exact conditional logistic regression to determine the association between microcephaly and Zika virus infection.


Findings

We screened neonates born between Jan 15 and Nov 30, 2016, and prospectively recruited 91 cases and 173 controls. In 32 (35%) cases, congenital Zika virus infection was confirmed by laboratory tests and no controls had confirmed Zika virus infections. 69 (83%) of 83 cases with known birthweight were small for gestational age, compared with eight (5%) of 173 controls. The overall matched odds ratio was 73·1 (95% CI 13·0–∞) for microcephaly and Zika virus infection after adjustments. Neither vaccination during pregnancy or use of the larvicide pyriproxyfen was associated with microcephaly. Results of laboratory tests for Zika virus and brain imaging results were available for 79 (87%) cases; within these cases, ten were positive for Zika virus and had cerebral abnormalities, 13 were positive for Zika infection but had no cerebral abnormalities, and 11 were negative for Zika virus but had cerebral abnormalities.


Interpretation


The association between microcephaly and congenital Zika virus infection was confirmed. We provide evidence of the absence of an effect of other potential factors, such as exposure to pyriproxyfen or vaccines (tetanus, diphtheria, and acellular pertussis, measles and rubella, or measles, mumps, and rubella) during pregnancy, confirming the findings of an ecological study of pyriproxyfen in Pernambuco and previous studies on the safety of Tdap vaccine administration during pregnancy.

Funding

Brazilian Ministry of Health, Pan American Health Organization, and Enhancing Research Activity in Epidemic Situations.

Some earlier studies also linking Zika infection to microcephaly and other neurological and developmental disorders includes:

MMWR: Review Of 13 Infants Born with Congenital Zika Virus Infection But Without Microcephaly
MMWR: Hearing Loss In Infants With Zika Related Microcephaly

BMJ: Congenital Zika Syndrome with Arthrogryposis


The Lancet: Two Congenital Zika Virus Studies


NEJM: Zika Virus And The Risk Of Microcephaly 
Brazil: Expanded Spectrum of Congenital Ocular Findings in Microcephaly

Monday, December 11, 2017

South Korea: 76,000 Birds Culled Due to H5N6 In South Jeolla



















#12,957


While (so far, at least), we're not seeing the same level of avian flu activity this fall in Asia and Europe as we did last year, we continue to see sporadic outbreaks (or detections in wild birds) in a number of countries Including Japan, Italy, the Netherlands, Taiwan, and South Korea.
We've also seen the arrival of a new version of H5N6 on both continents, derived from reassortment of  HPAI H5N8 that spread across Europe and Africa last fall, and a European HxN6 virus.
Credit Tottori University

During the month of November South Korea reported several outbreaks/detections of avian flu, including both LPAI and HPAI H5 and H7 viruses.  Two weeks ago, they reported an outbreak of this newly reassorted H5N6 virus at a Gochang duck farm.

Today we are learning of a new outbreak on a large duck farm in  Yeongam, South Jeolla (about 50 miles south of Gochang) of an H5N6 virus - suspected to be HPAI - on which we are awaiting further genetic analysis. 
We'll have to wait to find out whether it is HPAI, and whether it is the classic Asian H5N6 virus which first arrived in South Korea last year, or the the new European reassortment. 
The slightly syntax-challenged translation of the announcement from South Korea's Ministry of Agriculture (MAFRA) reads:
Confirmation of H5 type AI and H5N6 type virus of Jeonnam Yeongam species duck 

2017-12-11 11:00:00

The Ministry of Agriculture, Forestry and Livestock Food and Beverage (Minister of Agriculture and Rural Affairs) said that H5N6 strain was confirmed as a result of additional close inspection of the agricultural, livestock and livestock quarantine headquarters of Chonglian farms.


The H5N6 strain is the same type as the high-fever AI virus that was confirmed as a highly pathogenic AI for the first time at the poultry farm. Whether the disease is highly pathogenic will be confirmed late this evening.

A bit more intelligible is the following English language report from Yonhap News.
Korea confirms H5N6 bird flu at duck farm
By Yonhap
Updated : Dec 11, 2017 - 15:11

South Korea confirmed an outbreak of avian influenza at a duck farm in the southwestern region and culled some 76,000 ducks to prevent the further spread of the virus, the agriculture ministry said Monday.

The H5N6 bird flu was discovered on a farm in Yeongam, some 380 kilometers south of Seoul, on Sunday, the Ministry of Agriculture, Food and Rural Affairs said.

The ministry said 76,000 ducks were slaughtered at five duck farms located within a 3 kilometer radius of the site to prevent a wider spread of the highly contagious virus. 


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Another report indicates that a a 24-hours standstill order has been issued for 6 provinces (Daejeon, Gwangju, Sejong, South Chungcheong Province, and South and North Jeolla).


South Korea has issued a 24-hour standstill order for poultry farms in six cities and provinces after a duck farm in South Jeolla Province has been confirmed to be infected with the H5 type of avian influenza.

(Continue . . . )

With the 2018 Winter Olympic Games - which will be held in Pyeongchang County - now just two months away (Feb 9th-25th), the South Korean government is doing everything they can to head off any avian flu `distractions'  that could affect the attendance or enjoyment of the games.

While the relatively low number of avian flu outbreaks this fall has been welcome, a lot can happen over  the next 60 days.

Saturday, December 09, 2017

Media Reports Of H5N1 Outbreak In Cambodia













#12,956

Although largely overshadowed the past couple of years by the globe-trotting dual threat from HPAI H5N8 and H5N6, along with China's ominous array of evolving LPAI and HPAI H7N9 viruses,  venerable H5N1 - the OG of the bird flu world - has been around for two decades, has killed more than 450 people, and remains endemic in several parts of the world.
Today, the sharp-eyed newshounds on FluTrackers (h/t Commonground) have picked up media reports of a fresh H5N1 outbreak in east-central Cambodia (see Cambodia: Bird Flu Returns in Poultry (Media Report)).
The last report out of Cambodia came in January of this year (see OIE Notification), and while bird flu activity has been slow there the past few years, Cambodia has the 4th highest total of H5N1 human infections and deaths (56/37) globally - with the bulk of those cases recorded between 2012 and 2014.
Reporting, testing, and surveillance are limited in this part of the world, and so these numbers are likely under counts. 
First a sample of today's reportage, then I'll be back with a postscript.
December 9, 2017
Bird flu outbreak in Kampong Cham

Ros Chanveasna / Khmer Times Share:
Ducks hang at a farm on the outskirts of Phnom Penh. Thousands of ducks were culled in November 2015 after many became sick from a mysterious illness. Reuters

The Ministry of Agriculture, Forestry and Fisheries has reported that in early December the bird flu (H5N1 virus) appeared in Kampong Cham province. The ministry informed Prime Minister Hun Sen on Friday, of the outbreak.

Prey Chor district’s Trapaeng Preah commune was hardest hit, with some 200 chickens perishing.

After the alert from local authorities, the ministry immediately dispatched experts to inspect the site in Trapaeng Preah, and they took away two dead chickens to be sent to a laboratory in Phnom Penh.
“The tests on Wednesday [Dec. 6] confirmed that those chickens had contracted the avian influenza H5N1,” the lab report said.
(Continue . . .)

This is a seemingly small, probably inconsequential report of a local event in a very remote part of the world - and as such is not the sort of thing most people would even notice.  Like so many other reports we see like this, it will probably fade from memory in a matter of days.
But every so often, a seemingly insignificant news item signals the start of a much bigger event. Often we only realize the significance of these items in retrospect. 
While I try to blog those infectious disease stories I think are important, I can only cover a small percentage of the daily wealth of information that comes over the transom.  For every blog I write, there are probably 10 or 20 potentially newsworthy stories I take a pass on.
Luckily, I'm not alone in this endeavor.
Crof blogs on a variety of infectious disease and societal issues every day while CIDRAP News provides both terrific long form articles and news briefs 5 days each week.

The bulk of the flu news gathering, however, is being done quietly by a group of volunteer newshounds at FluTrackers, who gather and collate infectious disease information - both important and obscure - from every corner of the globe.
Their members are an eclectic group - ranging from knowledgeable lay people to research  professionals - who reside in the United States, Europe, Australia/NZ, and Asia. They speak and write in multiple languages, work in different time zones, and many of them have been doing this unsung work for more than a decade. 
While I hope my blog provides context, and details on the `big' stories of the day - if you want to see the big picture - you really need to be a regular visitor to FluTrackers. Everything you read might not seem important at the time, but in retrospect, those puzzle pieces can often prove to be important tipping points. 
Hopefully, if you are not a regular visitor, I've piqued your interest enough that  you'll make the FT repository a daily stop. Just click the Latest Activity button.
As I've stated before, I couldn't do what I do with this blog if it were not for the efforts of Sharon Sanders and her team at FT.  They not only provide me with leads for many of my daily blogs, they free me up to do the more in-depth style of writing I enjoy.

I strongly suspect, whoever ends up writing the history of the next pandemic, will find everything they need to know about how and when it began had been posted the FluTrackers site before the first official alarms were raised.

Netherlands Bird Flu Identified As Reassorted H5N6
















#12,955


The plot thickens. 

As I alluded to in yesterday's blog, while H5N8 was the `prime suspect' in the bird flu outbreak just reported in the Netherlands, over the past month we've seen the unexpected emergence of a reassorted H5N6 virus in the Far East (Japan, South Korea, Taiwan), and that its arrival in Europe could not be ruled out.
Today, based on a report issued by the Wageningen Bioveterinary Research Institute, we learn that this latest outbreak is indeed due to a reassorted H5N6, which is described much in the same way as the viruses detected in recent weeks more than 9,000 miles to the east.
Some excerpts from the statement, then I'll return with more.

Bird flu in Biddinghuizen

Published on
 

December 8, 2017

In Biddinghuizen (municipality of Dronten, Flevoland Province) bird flu has been demonstrated by Wageningen Bioveterinary Research (WBVR) at a company with meat ducks on Friday, December 8, 2017. The virus has been classified as a high pathogen H5N6. This company was also one of the first to be infected last year.
High-pathogenic H5N6 virus

A first genetic analysis shows that the virus is not related to the zoonotic H5N6 strain, which circulates in Asia and can also make people ill.

  • The H5 is related to the highly pathogenic H5N8 virus that was found in the Netherlands in 2016.
  • The N6 is related to low-pathogenic viruses previously found in wild birds in Europe.
The H5N6 virus was created by exchange of genetic material, or reassortment. WBVR carries out follow-up research to gain further insight into the origin and genetic composition of this virus.
Measures against the spread of bird flu

To prevent further spread of the virus, the company is cleared by the Dutch Food and Consumer Product Safety Authority (NVWA). In total, about 16,000 meat ducks are involved. In the area of ​​one kilometer around the company in Biddinghuizen there are no other companies that have to be disposed of preventively. In the area of ​​three kilometers around the infected company, there are four other companies. These last poultry farms are sampled and examined by WBVR for avian influenza.

WBVR will determine the characterization of the H5 avian influenza virus in follow-up research.
         (Continue . . . )


Last winter's record setting avian epizootic in Europe was caused by the arrival of an (also recently reassorted) HPAI H5N8 virus, which spread rapidly across Western Europe, into the Middle East, and into Africa.  While 99% of the outbreaks were caused by this H5N8 virus, a small number of reassorted H5N5 viruses were detected; new reassortments spun off from H5N8.
Towards the end of the season, a lone reassorted H5N6 virus (see CIDRAP: Greek H5N6 Virus Appears Distinct From Asian Strain) was also reported.  At the time, this appeared to be an isolated incident.
It now appears this reinvented `European' H5N6 virus was able to thrive and compete successfully with other avian viruses in migratory birds over the summer, and has become a new player in the evolution of HPAI H5.
We'll have to wait for a full analysis to find out just how close this latest virus is to those detected in the Far East, but the preliminary description is very similar.
Since H5N8 still circulates in Italy and Africa, and the Asian version of H5N6 continues to plague Chinese poultry, it is far too soon to declare this new H5N6 virus the new heir apparent in the bird flu world.
But its ability to show up on two continents within a span of 3 weeks is pretty impressive. 
Avian flu continues to evolve at a rapid, and unpredictable rate. Unlike 6 years ago, when we really only had one HPAI avian flu virus (H5N1) to worry about, the roster of new viruses has grown to include H5N8, H5N6 (Asian), H5N6 (European), H5N5, and H7N9.

Given the ability for avian viruses to swap gene segments, and to continually re-invent themselves, the expectation is that we'll see more reassortments emerge in the months and years ahead.