Avian influenza, human (35): Indonesia (BA), susp

Date: Wed 11 Feb 2009
Source: The Jakarta Post [edited]
<http://www.thejakartapost.com/news/2009/02/11/avian-flu-detected-cockfighting-village.html>


Avian flu detected in cockfighting village
------------------------------------------
A local man suspected of having bird flu rested in his home in Jagapati
village, Badung, [island of Bali] a place well known for cockfighting,
while officials continued to cull fowls in the area. The 20 year old man
was resting in his bedroom when The Jakarta Post visited. A field doctor
who has been treating and observing the man, said he began showing symptoms
of influenza Monday [9 Feb 2009], just a few days after the report of a
possible bird flu outbreak in the area. "We've given him Tamiflu "the
medicine required to treat bird flu suspects" and we'll continue to observe
him every 5 hours," the doctor Tresna said Tuesday [10 Feb 2009]. She said
her patient seemed to be getting better but declined to rule out the
possibility of bird flu, saying that she was still waiting for results of
blood tests, which were sent to Jakarta on Monday [9 Feb 2009]. "We can't
know for sure until we've received the results of his blood tests, which we
will get in 2 weeks," she said.

It is the latest resurgence of the much-dreaded avian flu in Bali since the
death of a 29 year old woman, who allegedly died after being infected by
the H5N1 virus on August 2007. The virus was first detected on Wednesday
last week [4 Feb 2009], when a villager reported the sudden and nearly
simultaneous death of 15 fowls in the area to the Badung Animal Husbandry
and Fisheries Agency. The dead fowl tested positive of bird flu. The agency
has since culled as many as 133 fowls in the district, with further culling
to continue in the days to come until all the villages' estimated 180-fowl
population has been eliminated. "We have culled 133 fowls so far, including
the 40 we aim to finish off today [11 Feb 2009]. We'll continue the
elimination for as long as it takes," said I Made Badra, head of the Badung
Animal Husbandry and Fisheries Agency, in Jagapati on Tuesday [10 Feb 2009].

According to Badra, the resurgence of the virus was related to the wet
season, which may have weakened a certain fowl's immune system enough to
catch bird flu, quickly spreading to others. Another possibility, he said,
was the transportation of an infected chicken from Java to Jagapati to use
for cockfighting.

The Bali government has banned unlicensed live animal transportation into
Bali and cockfighting, but the latter remains a staple in the island due to
the religious and traditional nature of the so-called sport. On the other
hand, the ban on animal transportation seems to have been fully implemented
since the detection of rabies virus late last year [2008]. However, Badra
said there was a good chance that infected fowls escaped detection because
they might have been transported before the rabies scare. "For now we'll
continue to urge the public to not transport live animals into Bali," he
said. "We should all really learn from what happens to people who come in
contact with sick animals," he said, referring to the alleged death of the
29 year old woman from bird flu and the recent alleged deaths from rabies.

[byline: Andra Wisnu]

--

[This suspected human case of avian influenza on the island of Bali is the
first since 2007. The results of laboratory tests are not available yet and
the patient is not seriously ill. The presence of avian influenza in
poultry in the area is the main reason for the diagnosis of suspected avian
influenza.

The location of Bali in the Indonesian archipelago can be found by
accessing the HealthMap/ProMED-mail interactive map of Indonesia at
<http://healthmap.org/promed/en?g=1650535&v=-2.6,120.9,5>. The location of
Badung district in the centre of the island of Bali can be seen on the map
at <http://www.baliguide.com/bali_map.html>. - Mod.CP]

Avian influenza, human (34) - Viet Nam, WHO

Date: Wed 11 Feb 2009
Source: World Health Organization (WHO), Epidemic and Pandemic Alert and
Response (EPR) disease outbreak news [edited]
<http://www.who.int/csr/don/2009_02_11/en/index.html>


Viet Nam: avian influenza situation - WHO update
------------------------------------------------
The Ministry of Health in Viet Nam has reported a new confirmed case of
human infection with the H5N1 avian influenza virus. The case has been
confirmed at the National Institute of Hygiene and Epidemiology (NIHE).

The case is a 23 year old woman from Dam Ha district, Quang Ninh province.
She developed symptoms on 28 Jan 2009 and was hospitalized on 31 Jan 2009.
She is currently in a serious condition and is known to have had recent
contact with sick and dead poultry prior to the onset of her illness.
Further investigations are currently underway. Control measures have been
implemented and close contacts are being identified and monitored.

Of the 108 cases confirmed to date in Viet Nam, 52 have been fatal.

--
communicated by:
ProMED-mail rapporteur Marianne Hopp

[This the official WHO confirmation of the 52nd human case of avian A/H5N1
influenza in Viet Nam. The female patient remains alive although in serious
condition.

A map of the provinces of Viet Nam can be accessed at
<http://www.angelfire.com/co/hongnam/vnmap.html>. Quang Ninh is a coastal
province located in the northern area. The HealthMap/ProMED-mail
interactive map of Viet Nam showing the northern, central, and southern
areas is available at <http://healthmap.org/promed/en?v=14.9,108.5,5>. -
Mod.CP]

Avian influenza, human (33): Egypt (MN), WHO

Date: Mon 9 Feb 2009
Source: World Health Organization (WHO) Epidemic and Pandemic Alert and
Response (EPR) disease outbreak news [edited]
<http://www.who.int/csr/don/2009_02_09/en/index.html>


Egypt: avian influenza situation - WHO update 4
-----------------------------------------------
The Ministry of Health and Population of Egypt has announced a new human
case of avian influenza A(H5N1) virus infection. The case is a one and a
half year old boy from the Maghagha District of Menia [Al Minya]
Governorate. His symptoms began on Fri 6 Feb 2009 and he was hospitalized
at the Maghagha Fever Hospital on 7 Feb 2009 where he remains in a stable
condition. Infection with the H5N1 avian influenza virus was confirmed by
the Egyptian Central Public Health Laboratory.

Investigations into the source of his infection indicate a history of close
contact with dead poultry prior to becoming ill.

Of the 55 cases confirmed to date in Egypt, 23 have been fatal.

[This is the official WHO confirmation of the 55th human case of avian
A/H5N1 influenza in Egypt and the 406th globally
(<http://www.who.int/csr/disease/avian_influenza/country/cases_table_2009_02_09/en/index.html>).

The HealthMap/ProMED-mail interactive map of Egypt is available at
<http://healthmap.org/promed/en?g=353183&v=26.5,29.9,5>, and a map of the
governorates of Egypt can be accessed at
<http://en.wikipedia.org/wiki/Governorates_of_Egypt>. Al Minya governorate
is located at 15 on this map. - Mod.CP]

Avian influenza, human (32): Viet Nam

Date: Sun 8 Feb 2009
Source: Thanhnien News [edited]
<http://www.topix.com/vn/thanh-hoa/2009/02/quang-ninh-woman-suspected-of-contracting-bird-flu>


[In ProMED-mail post "Avian influenza, human (30): Viet Nam 20090207.0557",
the 2nd confirmed case of human avian A/H5N1 influenza was described as a
male patient. Several other reports which have now appeared describe the
patient as a female and rank the case as suspected only. One of these
reports is reproduced below. - Mod.CP]

A 23 year old woman is suspected of contracting the H5N1 strain of bird flu
after suffering severe respiratory problems in northern Quang Ninh Province
on Saturday [7 Feb 2009], health officials said. The woman of Quang Ninh
Dam Ha District was admitted to the Quang Ninh General Hospital on Tuesday
[3 Feb 2009] with high fever, low blood pressure, and severe respiratory
problems, doctors said.

But doctors reported they were unable to conclude whether she had been
infected with the H5N1 virus. One test showed she carried it, but another
was negative. Health experts were dispatched on Saturday [7 Feb 2009] to
Quang Ninh to carry out further examinations. Work to disinfect Dam Ha
District also began Saturday. Quang Ninh, where the world renowned Ha Long
Bay is located, is about 150 km (93 miles) from Hanoi.

Before this latest case, an 8 year old girl in the northern province of
Thanh Hoa who fell sick after eating duck and chicken raised on her
family's farm was diagnosed with the bird flu. She has since recovered, but
her 13 year old sister died in the hospital earlier without being tested
for the virus before her burial, health officials said.

The Mekong Delta province of Ca Mau reported Saturday [7 Feb 2009] that
bird flu has spread among 4 local communes, prompting the culling of 3250
birds to contain the epidemic. The Ca Mau government also asked agencies
concerned to take further measures against the spread of the disease in the
province.

The Mekong Delta province of Soc Trang began disinfection work Saturday [7
Feb 2009] after 700 birds were recently reported to have died of the flu.

The avian flu has thus far infected poultry in 4 provinces in the country:
Ca Mau, Bac Lieu, and Soc Trang in the Mekong Delta region and Nghe An in
the north. H5N1 remains largely confined to birds, but experts fear it
could mutate into a form that is easily transmitted by humans and spark a
pandemic that could kill millions worldwide. Since 2003, Viet Nam has
recorded 52 human deaths from bird flu, the 2nd highest toll after
Indonesia, where the virus has killed 115 people.

--
communicated by:
ProMED-mail rapporteur Mary Marshall

[A map of the provinces of Viet Nam can be accessed at
<http://www.angelfire.com/co/hongnam/vnmap.html>. Quang Ninh is a coastal
province located in the northern area. The HealthMap/ProMED-mail
interactive map of Viet Nam showing the northern, central and southern
areas is available at <http://healthmap.org/promed/en?v=14.9,108.5,5>. -
Mod.CP]

Panasonic Orders Some Expatriate Families Home on Concern of Flu Pandemic

Feb. 10 (Bloomberg) -- Panasonic Corp., the world's largest maker of consumer electronics, ordered Japanese employees in several emerging markets to send their families back to Japan on concern of a potential influenza pandemic.

The company in December instructed staff assigned to parts of Asia, Africa, eastern Europe and South America to repatriate their families by September, Akira Kadota, a spokesman for Osaka- based Panasonic, said by telephone today. He declined to comment on the number of employees or households affected.

Panasonic said last week it will cut about 15,000 jobs and report a loss this year. More than half of the company's 209 subsidiaries outside Japan as of April 2008 were in the Asia- Pacific region.

"It's a bit of a surprise," said Naoteru Teraoka, who helps oversee $21 billion at Chuo Mitsui Asset Management Co. in Tokyo. "I would understand if there was a sudden outbreak that warranted concern, but there don't seem to be any recent developments."

Panasonic may be the first major company to order families home on concern people wouldn't receive needed health care in case of a widespread flu outbreak. A pandemic could kill 71 million people worldwide and lead to a "major global recession" costing $3 trillion, according to a worst-case scenario outlined by the World Bank in October.

"This is part of our preparations for a new type of influenza," Kadota said by telephone. "We chose areas after considering the prevalence of bird flu, and the capability of medical facilities and access to them. This is not part of the cost cutting."

Singapore Staff Spared

The world is closer to another influenza pandemic than at any time since 1968, when the last of the previous century's three pandemics occurred, according to the World Health Organization.

The company has been reviewing how to handle a pandemic, and decided to repatriate families after consulting Japan's government and the Geneva-based WHO, Kadota said.

Honda Motor Corp., Japan's second-biggest carmaker, considered bringing home families of expatriates in China after a woman in Beijing infected with bird flu died on Jan. 5, said Hideto Maekawa, a spokesman for the company. The carmaker has advised employees to cut down on "unnecessary and non-urgent" business trips, he said.

Panasonic isn't concerned about any single country more than others, and Singapore staff won't be affected by the repatriation, he said. The Nikkei newspaper reported the plans earlier.

International health officials have been monitoring the H5N1 strain of avian influenza for more than a decade for signs it could mutate into a form that is easily spread between humans. H5N1 has infected at least 406 people in 15 countries since 2003, killing 63 percent of them, according to the WHO's Web site. The organization lists 11 cases of the virus in humans this year.

Panasonic shares added 0.9 percent to 1,130 yen. The stock plunged 52 percent last year.

To contact the reporter on this story: Kanoko Matsuyama in Tokyo at kmatsuyama2@bloomberg.net .

Avian influenza (13): Viet Nam (BL, CM)

Date: Sat 7 Feb 2009
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5gOqW_oyU7KRlA57WotO56ldQYi7g>


The H5N1 strain of bird flu has been reported in more localities
across Viet Nam, raising fears of a possible epidemic, official and
media reports said Friday [6 Feb 2009]. The latest outbreak occurred
on a farm in Mekong delta's Ca Mau province, where 300 unvaccinated
ducklings died of the virus, said the national animal health department.

The Hanoi-based office in its earlier reports said avian influenza
had been found in ducks in nearby Soc Trang province and Nghe An
province in the country's central region. The state-run Thanh Nien
newspaper said Friday [6 Feb 2009] that southern Bac Lieu has been
added to the list of bird-flu hit provinces.

"Epidemics could spread easily because of cold weather and local
residents' habit of letting the ducks run around in rice fields,"
Thanh Nien said, adding that thousands of infected poultry have died
or been culled this year [2009].

Earlier this month [February 2009], Viet Nam's capital Hanoi issued a
ban on the widespread use of motorbikes or bicycles to transport
poultry and livestock for fear it could help trigger an epidemic.

However, state media has frequently reported that meat products
continued to be transported by motorbike into the city daily despite the ban.

The communist state, which has been hit by bird flu since 2003,
reported a human case this year [2009], an 8-year-old girl from
northern Thanh Hoa province who has now recovered.

Her 13-year-old sister died in hospital earlier but was not tested
for H5N1 before the burial, health officials said.

Viet Nam has recorded 52 human deaths of bird flu, the 2nd highest
toll after Indonesia, where the virus has killed 115 people.


[The following information is derived from the commentary by
moderators YMA/MPP in PRO/MBDS posting 20090207.0556 (Avian influenza
- MBDS region (06): Viet Nam):

At present, the provinces in Viet Nam affected by H5N1 infection in
poultry within the last 21 days are Ca Mau, Soc Trang, Nghe An and
Bac Lieu provinces. Bac Lieu is the latest province reporting an H5N1
outbreak, while this outbreak is likely to spread from the
neighboring provinces, Ca Mau and Soc Trang, which reported the H5N1
outbreak recently and are under quarantine.

In the meantime, Ca Mau province has reported new H5N1 outbreaks in 5
hamlets. The previous outbreak was on 2 Feb 2009. Current updates on
the H5N1 situation in Viet Nam are available (in Vietnamese) on the
Ministry of Agriculture and Rural Development website at
<http://www.mard.gov.vn/portal/page?_pageid=35,1&_dad=portal&_schema=PORTAL>.

Information on the recent H5N1 outbreaks from Ca Mau, Soc Trang and
Nghe An provinces reported to the World Organisation for Animal
Health (OIE) is available at
<http://www.oie.int/wahis/reports/en_fup_0000007775_20090206_171401.pdf>.

For maps of Viet Nam with provinces, see
<http://www.lib.utexas.edu/maps/middle_east_and_asia/vietnam_admin01.jpg> and
<http://www.angelfire.com/co/hongnam/vnmap.html>.

The HealthMap/ProMED-mail interactive map of Viet Nam can be accessed
at <http://healthmap.org/promed?v=14.9,108.5,5>. This map shows other
outbreaks in Viet Nam and surrounding countries that have been
reported on ProMED-mail. The postings can be directly accessed
through this map. - Mod.AS]

Avian influenza, human (31): Egypt (MN)

[1]
Date: Date: Sun 8 Feb 2009
Source: Reuters [edited]
<http://www.reuters.com/article/asiaCrisis/idUSL8703822>


An Egyptian boy has contracted the bird flu virus, the state-run news
agency quoted the Health Ministry as saying on Sunday [8 Feb 2009],
the 2nd such case in the last week and the 55th case since the virus
reached Egypt in 2006. The 18-month-old boy from the province of
Minia in central Egypt 1st showed symptoms on Friday [6 Feb 2009]
after coming into contact with dead birds and was admitted to
hospital on Saturday. He was administered the antiviral drug Tamiflu
and is now in a stable condition, the health ministry said.

On Wednesday [4 Feb 2009], the ministry reported a 2-year-old boy in
the Suez province was in hospital after contracting the virus.

Egypt is one of the only countries affected by bird flu that does not
offer compensation for farmers when poultry is destroyed, which many
experts say is the best way to ensure rapid detection of new
outbreaks. Some 5 million Egyptian households depend on poultry as a
main source of food and income.

Since 2003, the virus has infected 404 people in 15 countries and
killed 254 of them. It has killed or forced the destruction of more
than 300 million birds. Egypt has had the most cases outside of Asia.

[2]
Date: Sun 8 Feb 2009
Source: China view, Xinhua News Agency [edited]
<http://news.xinhuanet.com/english/2009-02/09/content_10784501.htm>


A baby from southern [central?] Egypt has contracted the bird flu
virus, which brings the number of human cases to 55 in the country,
the Health Ministry announced Sunday [8 Feb 2009]. The
one-and-a-half-year-old boy showed symptoms on Friday [6 Feb 2009]
after he had contact with infected birds, the ministry said in a statement.

The boy from the Upper Egyptian governorate of Minia, some 220 km
south of Cairo, is now in a stable condition after being treated with
the antiviral drug Tamiflu, according to the statement.

Egypt is the most affected country by the deadly avian influenza
outside Asia. It reported its 1st H5N1 virus in dead poultry in
February 2006 and the 1st human case in March of the same year. The
death toll of the human cases of bird flu in the populous country is 23.

The World Health Organization (WTO) has said that as of 5 Feb 2009,
some 405 people in 15 countries have contracted the virus, and 254 of
them died of the disease.

[The most recent 3 human cases in Egypt have all been young children
living in different provinces who have had contact with diseased poultry.

The HealthMap/ProMED-mail interactive map of Egypt is available at
<http://healthmap.org/promed/en?g=359796&v=26.5,29.9,5>, and a map of
the governorates of Egypt can be accessed at
<http://en.wikipedia.org/wiki/Governorates_of_Egypt>. Al Minya
governorate is located at 15 on this map.  - Mod.CP]

Avian influenza, human (30): Viet Nam

Date: Sat 7 Feb 2009
Source: Reuters UK [edited]
<http://uk.reuters.com/article/homepageCrisis/idUKHAN433627._CH_.2420>


Viet Nam has new human bird flu case
------------------------------------
A 23-year-old man has tested positive for the deadly H5N1 virus in
northern Viet Nam, a state-run newspaper reported on Saturday [7 Feb
2009]. The online Lao Dong newspaper (<http://www.laodong.com.vn>)
quoted health officials as saying the man from Dam Ha district in the
northern province of Quang Ninh, about 150 km (93 miles) from Hanoi
had fallen ill and tests showed he carried the bird flu virus. The
report quoted doctors as saying the man had high fever and severe
respiratory problem.

Prior to this case, Viet Nam has this year confirmed one case of
human infection in the northern province of Thanh Hoa, involving an
8-year-old girl who fell sick after eating duck and chicken raised on
her family's farm. She has recovered.

On Saturday, the agriculture ministry said bird flu had infected
poultry in 3 provinces in the country, Ca Mau and Soc Trang in the
south and Nghe An in the central region.

The H5N1 flu remains largely a virus among birds, but experts fear it
could mutate into a form that is easily transmitted by humans and
spark a pandemic that could kill millions worldwide.

[Byline: Nguyen Nhat Lam and Sugita Katyal]

--
Communicated by
ProMED-mail Rapporteur Mary Marshall

[This is the 2nd case of avian A/H5N1 influenza virus infection
recorded in Viet Nam in 2009, bringing the total number of cases
since 2003 to 108 (with 52 fatalities). The present condition of the
patient and the circumstances of his exposure to avian influenza
virus infection are not stated. Outbreaks of avian influenza in
poultry have not been reported in Quang Ninh province so far. The
preceding case was an 8-year-old girl in Thanh Hoa province who
survived. Her 13-year-old sister was a suspected case of avian
influenza virus infection, but this has not been confirmed as she
died subsequently and apparently no diagnostic materials are available.

A map of the provinces of Viet Nam can be accessed at:
<http://www.angelfire.com/co/hongnam/vnmap.html>. Quang Ninh is a
coastal province located in the the northern area. The
HealthMap/ProMED-mail interactive map of Viet Nam showing the
northern, central and southern areas is available at:
<http://healthmap.org/promed/en?v=14.9,108.5,5>. - Mod.CP]

Avian influenza (12): China, human, animal infections

Date: Fri 6 Feb 2009
Source: Reuters [edited]
<http://uk.reuters.com/article/middleeastCrisis/idUKPEK142436>


China defends bird flu vaccination plan despite deaths
------------------------------------------------------
China's Ministry of Agriculture on Friday [6 Feb 2009] defended its
bird flu vaccination programme, stating there had been no outbreaks
since last June [2008] despite a number of human cases, some fatal,
this year. Human cases and the appearance of dead wild birds in Hong
Kong have caused some experts and media reports to question whether
the virus is widespread but undetected in China.

A total of 5 people died of bird flu in China in January [2009], in
regions far removed from each other and in which there were no
reported cases of bird flu in birds. In addition, 3 others have
become ill, of which 2 have recovered, a toddler infected in Hunan
and a young man in Guizhou. Apart from the discovery of a case during
routine sampling in eastern China's Jiangsu province in December
[2008], Chinese testing has not detected any bird flu since June [2008].

The Ministry of Agriculture said in a report on its Web site that the
strain found in Jiangsu was a variant, requiring the modification of
the vaccine programme in the surrounding provinces of Zhejiang,
Shanghai, Anhui and Shandong.

Meanwhile, 2 ducks and a goose found in Hong Kong have tested
positive for H5N1, the strain of bird flu that can infect humans.
Hong Kong closed its Mai Po nature preserve as a precaution for 21
days from Friday [6 Feb 2009], after a dead grey heron found there
also tested positive for bird flu.

Hong Kong authorities are still testing 14 other dead birds found
last week on Lantau Island. "We're checking water currents" to see if
the birds were washed ashore from mainland China, a government
spokeswoman said.

China has vaccinated aggressively since bird flu first reappeared
among humans in Asia in 2003. But vaccination does not eliminate the
virus. In 2008, China reported 6 outbreaks of bird flu that killed
9000 birds and led to the culling of 590 000 birds.

[Byline: Lucy Hornby and Tan Ee Lyn]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Following the information on human cases in China without data on
animal outbreaks, and the suspicion that dead infected birds were
being washed ashore in Hong Kong from mainland China (allegedly
coming from China's Pearl River Delta), ProMED-mail included, in its
posting 20090205.0514 of 5 Feb 2009, the following comment: "The
Chinese authorities may consider publishing details of their recent
active surveillance activities undertaken to investigate the source
of said human infections." The current posting may be seen as China's
initial response. Additional details on the number and locations of
investigations applied and samples tested, will help.

China's last (2) reports to the OIE on H5N1 in animals date back to
19 Dec 2008 (Immediate Notification) and 26 Dec 2008 (Follow-up
Report 1). They addressed 2 outbreaks in Jiangsu; see, including map, at
<http://www.oie.int/wahis/public.php?page=event_summary&reportid=7623>.
- Mod.AS

The presence of human cases in the absence of reported avian
outbreaks may be seen as a discrepancy that needs to be addressed --
unless they are claiming that all the human cases were related to
exposure to healthy appearing poultry that were H5N1 infected and
excreters.... - Mod.MPP]

Seasonal influenza, vaccine mismatch - Taiwan

[1]
Date: Tue 3 Feb 2009
Source: Taiwan Times [edited]
<http://www.etaiwannews.com/etn/news_content.php?id=855358&lang=eng_news>


Flu vaccines not as effective this year as in the past
------------------------------------------------------
Influenza vaccines that proved to be effective late last year have
failed to live up to expectations early this year, the Department of
Health (DOH) said Tuesday [3 Feb 2009]. Chou Jih-haw, Deputy
Director-general of the DOH's Centers for Disease Control, said more
than 3.2 million free flu shots were given to the public in autumn
and winter last year. "Judging from the number of influenza cases in
the fourth quarter of 2008, it was significantly lower than in the
same period the previous year," Chou said. "But this year, tests of
flu viruses on the patients showed that the results have not been as
good as expected," he continued.

Chou said influenza vaccines given in autumn 2008 and this winter
should be effective against the H1N1 and H3N2 viruses, and tests
taken from patients who were inoculated last year proved their
effectiveness. But in January [2009], tests found the vaccines did
not work [were not protective?] on 70 percent of those with H1N1
viruses and 40 percent of those with the H3N2 virus. A vaccine is
considered effective if it controls the virus in 80 percent to 90
percent of those inoculated. Chou would not categorize the vaccines
as ineffective, however, because influenza viruses are "prone to
mutation," meaning that the virus formula for producing vaccines must
be changed on a yearly basis.

A former CDC Director suggested Tuesday that part of the problem may
be that flu viruses tend to strike Taiwan between 6 months and 2
years earlier than European countries and the United States. Su
Ih-jen, Director of the Division of Clinical Research of the National
Health Research Institutes, said that because of the time lag,
influenza vaccines produced by European and American pharmaceutical
makers based on data provided by the World Health Organization could
not keep up with the outbreak of flu in Asia. Su noted that with
close exchanges between Taiwan and China, Taiwan has become an
outpost of influenza outbreaks.

The World Health Organization began to address the issue of different
prevalent viruses in Asia and Europe last April [2008]. Currently, 2
out of 5 major vaccine manufacturers have made inroads into China,
and the production of Asian influenza vaccines "has become a trend,"
he said. Su suggested that the virus in every influenza outbreak is
slightly different, and that "it can show major changes about every 5
years, so the effectiveness of vaccines can diminish."

[Byline: Lilian Wu]

[2]
Date: Thu 5 Feb 2009
Source: Taipei Times [edited]
<http://www.taipeitimes.com/News/taiwan/archives/2009/02/05/2003435334>


Experts recommend switching to Asian-made flu vaccines
------------------------------------------------------
Anticipating a bigger wave of flu infections caused by a form of the
virus that has become resistant to medication and vaccines, doctors
and academics urged the government to switch to Asian versions of the
flu vaccine. Health officials last week said that with employees
returning to work en masse after the Lunar New Year holiday, flu
infections from increased human interaction in crowded places could
spread fast.

Fear of the flu heightened when the Centers for Disease Control (CDC)
said on Tuesday [3 Feb 2009] that 2 strains of the influenza type A
had mutated slightly and developed resistance to the flu medication
Tamiflu [oseltamivir]. Tamiflu was still 30 percent effective in
fighting the virus in October [2008], but the virus has recently
developed 100 percent resistance against the drug, the CDC said.

"The H1N1 strain [of the flu virus] has mutated into a form that is
70 percent variant from the vaccine, and the H3N2 strain is 40
percent variant," said CDC Deputy Director-general Chou Jih-haw,
referring to the government-funded vaccine inoculation offered free
of charge last year to children, the elderly and other high-risk
groups. CDC statistics showed that influenza type A comprised about
80 percent of all reported cases this winter. The type A H1N1 and
H3N2 strains are currently circulating among flu victims.

"The H1 strain is weaker than the H3 strain. Although the H1 strain
may infect more people [because of its mutation], it is less likely
to make patients critically ill," said Huang Li-min, a pediatrician
at National Taiwan University Hospital.

However, Huang said that he was not sure whether the H1N1 strain
would mutate into a form that could result in critical conditions. He
recommended that doctors prescribe 2 types of flu medication
simultaneously, such as Tamiflu [oseltamivir] combined with
amantadine, another type of flu treatment. This way, in case the
virus strain has developed resistance to certain drugs, the
medication may still be effective in controlling the disease, he said.

The flu virus undergoes minor changes from time to time, and a major
variant emerges about every 5 years, said Su Ih-jen, Director of the
National Health Research Institute's division of clinical research.
Su urged the government to switch from European-made vaccines to
Asian-made ones, saying the latter was more "up to date" with new
virus strains. "In 2005, we published research showing that the virus
strains in Taiwan were 2 years ahead of Europe," he said. "We should
be using Asian versions of the vaccine to stay up to date with the
disease." In response, Chou said the CDC would assess the need to
switch to the vaccines used in China, which he said would be more
effective in combating the ever-changing virus.

[Byline: Shelley Huang]

[Vaccine mismatch is being invoked to explain the relatively poorer
protective response obtained by vaccination in Taiwan in the current
year compared to that obtained in the preceding year. This is
attributed to progressive change in the epidemic virus as a
consequence of accumulation of mutations in the viral genome.
According to the above reports previous research in Taiwan has
suggested that: "virus strains in Taiwan were 2 years ahead of
Europe." On this basis it is proposed that vaccines more in harmony
with requirements in south and southeast Asia should be developed locally.

Increasing resistance of current epidemic strains to the antiviral
drugs Tamiflu and amantadine in Taiwan is considered to be another
consequence of the mutability of the virus rather than a consequence
of the enhanced use of these drugs in clinical practice. In contrast
a recent study in Europe (Kramarz et al., Eurosurveillance, Vol. 14,
Issue 5, 2009
(<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19112>)
based on analysis of prescription data concluded that while the
precise relationship between oseltamivir [Tamiflu] use and resistance
of influenza A(H1N1) to oseltamivir remains uncertain, the available
data do not suggest a link between the rapid rise in the proportion
of the resistant A(H1N1) and the use of oseltamivir in Europe. - Mod.CP]

[A map showing the location of Taiwan is available at:
http://www.worldatlas.com/webimage/countrys/asia/tw.htm> -CopyEd. EJP]

Avian influenza (11): France (VD), LPNAI H5N3

Date: Tue 3 Feb 2009
Source: DEFRA, International disease monitoring - Preliminary
outbreak assessment, Ref: VITT 1200/LPAI - France [edited]
<http://www.defra.gov.uk/animalh/diseases/monitoring/pdf/ai-france-090203.pdf>


Low Pathogenic Avian Influenza in France: H5 non-N1
-----------------------------------------------
1. Disease Report
The French authorities have recently reported an outbreak of Low
Pathogenicity Avian Influenza (LPAI) on a duck breeding farm in
Vendee region [see map at the above URL. - Mod AS]. The birds were 12
months old and at the end of their moult. Preliminary testing
confirmed the virus to be of the H5 type (but not N1) [later
identified as H5N3; see commentary. - Mod.AS]. Disease control
measures have been put in place, including a 1 km restriction zone.

2. Situation assessment
Sporadic findings of LPAI are not uncommon across the EU. This
particular [H5N3] strain in France appeared to have caused about one
percent mortality in the affected flock. Infection with LPAI in ducks
and geese is generally asymptomatic. However, in this specific case,
the ducks may have been more susceptible to infection due to stress
associated with moulting. According to TRACES (the EU electronic
trade notification system), there have been 24 consignments of live
poultry from France to the UK since 1 Jan 2009. One consignment
originated from the Vendee region; however, it came from a holding at
least 45 km away from the affected premises, and it was for turkeys.

[According to the French notification to the OIE submitted on Wed 4
Feb 2009, the mentioned outbreak, caused by LPAI serotype H5N3, had
started on 29 Jan 2009 and resolved already on 1 Feb 2009, when the
entire affected holding was stamped out. The final diagnosis was
confirmed on 1 Feb 2009 by AFSSA's (France's food safety agency)
national laboratory at Ploufragan. The location was Les Brandes, La
Garnache, Vendee. A map is included; see
<http://www.oie.int/wahis/public.php?page=single_report&pop=1&reportid=7764>.
The notification included the following description of the affected
population: "The affected farm has only one closed premises with
about 5000 breeding ducks in late moult (no lay) and aged 12 months.
Thu 29 Jan 2009: signs of prostration. 50 birds found dead. Fri 30
Jan 2009: 25 birds found dead. Sat 31 Jan 2009: 15 birds found dead.
Sun 1 Feb 2009: slaughter at the premises." The notification included
the following epidemiological comments: "Source of the outbreak(s) or
origin of infection - unknown or inconclusive. No recent entry of
poultry on the farm. No recent exit of poultry or eggs from the farm."

Germany has also reported recently outbreaks of LPAI H5N3 (see
<http://www.defra.gov.uk/animalh/diseases/monitoring/pdf/poa-ai-gp.pdf>).
The total number of reported outbreaks in Germany currently stands at
33. - Mod.AS]

Avian influenza (10): China (HK)

[1]
Date: Thu, 5 Feb 2009
Source: Xinhua [edited]
<http://news.xinhuanet.com/english/2009-02/05/content_10766219.htm>


A spokesman for Hong Kong's Agriculture, Fisheries and Conservation
Department (AFCD) said Wednesday [4 Feb 2009] that the dead goose and
2 dead ducks found in Sha Lo Wan, Lantau Island in Hong Kong last
week were confirmed to be H5N1 positive after a series of laboratory tests.

AFCD staff collected the carcasses of a goose and a duck on 29 Jan
2009 at a beach near Sha Lo Wan football pitch. Another dead duck was
found on 31 Jan 2009 at the same location.

The spokesman said that 2 more dead chickens were collected on the
coast opposite Yeung Hau Temple in Tai O, Lantau on Wednesday [4 Feb
2009], adding that preliminary tests for the H5 virus are being arranged.

AFCD will continue to closely monitor the situation and investigate
into the possible causes of the recent discovery of bird carcasses,
said the spokesman.

The spokesman said a ban on backyard poultry has been in force since
2006. Unauthorized keeping of 5 kinds of poultry -- chickens, ducks,
geese, pigeons or quails -- is an offense with a maximum fine of 50
000 HK dollars [USD 6450]. Repeat offenders are subject to a maximum
fine of 100 000 HK dollars [USD 12 900].

[2]
Date: Wed 4 Feb 2009
Source: The Nation, Thailand [edited]
<http://www.nationmultimedia.com/worldhotnews/30094866/-Hong-Kong-expert-warns-of-%22terrible%22-China-bird-flu-outbreak>


Experts in Hong Kong were carrying out tests Tuesday [3 Feb 2009] on
dead birds washed up on beaches amid fears of a large unreported
avian-flu outbreak in neighbouring mainland China.

Three of 12 birds found on the Hong Kong island of Lantau in the past
5 days have so far tested positive for H5N1, the bird-flu strain that
can be deadly in humans.

Islanders said dead birds have been washing ashore in recent days and
they believe they come from China's Pearl River Delta, which flows
out into the South China Sea surrounding Hong Kong [map at
<http://www.photography.spentbrothers.com/China84/map.jpg>. - Mod.AS].

On Monday [2 Feb 2009] alone, the carcasses of one goose, 5 chickens,
a duck and 2 other birds were found, bringing to 12 the number of
dead birds found on Lantau since Thursday [29 Jan 2009].

Five people in China died of bird flu in January 2009 alone, 2 more
than in the whole of 2008. Three other people were infected.

However, speaking on Hong Kong's government-run radio station RTHK
Tuesday [3 Feb 2009], infectious diseases expert Lo Wing-Lok warned
that the outbreak in China could be far bigger than officials have admitted.

"This is suddenly something very serious," said Lo, a legislator and
chairman of the Hong Kong Medical Association. "We have to confirm
the source of these dead birds, whether it is local or from the mainland."

Lo said there were already indications that "something extraordinary"
was happening in China because of the large number of [human]
bird-flu cases reported in a short period of time.

"In January [2009], there were 8 human cases reported to have come
down with H5N1 infection," Lo said. "The source of the infection, of
course, is poultry. Poultry infection may be widespread in the
mainland, and, because of that, (infected) birds may find their way
across the border through the water currents, through fishing boats,
from visitors bringing a few birds at a time. These are all
possibilities we need to consider."

A Hong Kong government spokesman said officials were working with
mainland authorities to try to work out the source of the dead birds
on the island, which has no poultry farms.

He said the Hong Kong government would "conduct a study on water
currents and weather" to see whether the carcasses were being washed
ashore from China.

The World Health Organization said China has recorded 38 bird-flu
cases since the disease resurfaced in 2003, including 25 deaths.

Hong Kong saw the 1st outbreak in modern times of bird flu to infect
humans in 1997, when 6 people died and 12 others were infected but survived.

Since then, it has carried out 2 mass culls and introduced strict
market controls and border controls with China, avoiding human deaths
in any of the recent bird-flu outbreaks to sweep the region.

--
Communicated by:
David Cameron Duffy, PhD
Professor/PCSU Unit Leader/CESU Director
Department of Botany
University of Hawaii Manoa
Honolulu, HI, USA
<dduffy@hawaii.edu>

[The improved human surveillance in China has most likely been
reflected in the increased numbers of confirmed cases this year
(2009), which is definitely a sign of hard work and training of
health care professionals countrywide. One can only wonder that there
has been a similar lag in surveillance in the Agricultural section,
involving a lot of small farms with the population not reporting
poultry die offs. One suspects that the surveillance among the major
poultry breeders has improved significantly, but that the smaller
producers are still very much below the radarscope and are hiding
their flocks from the official sector when there are die offs. - Mod.MPP]

******
[3]
Date: Wed 4 Feb 2009
Source: AFP [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5iq8X_3NtMiA79Y46b2fmMxRsBjNA>


China may have experienced outbreaks of bird flu among poultry
recently, the UN's Food and Agriculture Organisation said Wednesday
[4 Feb 2009], even though the government had yet to report any cases
this year [2009].

The FAO's comments come after 8 people contracted the H5N1 bird flu
virus in China this year [2009] -- 5 of whom died -- compared with
just 3 cases in all of 2008.

"There must have been some virus circulation or possibly some
outbreaks lately," Vincent Martin, senior technical adviser on bird
flu for the FAO in China, told AFP.

But he said the FAO had received no reports of bird flu cases in
poultry from the agriculture ministry since December 2008, when an
outbreak occurred in the eastern province of Jiangsu.

"There must be some suspicions of the disease reported to the
Ministry of Agriculture, and some of those suspicions might have come
up positive," he said.

"We are waiting to receive some reports describing the overall
epidemiological situation and the results of investigations."

The number of cases in China this year [2009] has aroused some public
concern, although the World Health Organization has said the overall
situation is "within expectations at this time of the year."

Cold weather encourages the spread of the virus, and the Lunar New
Year holiday -- a risky period when hundreds of millions of people
move across the nation to see relatives and eat meals that include
poultry -- has just ended.

But Martin said the pattern this year [2009] was unusual. "There are
more cases than last year [2008], including in places where the
disease was not reported before, like in Jiangsu province (poultry
outbreak) or Shandong province (human case)," he said.

Lo Wing-lok, an infectious disease expert in Hong Kong, said that if
no poultry outbreak in China was accompanying the current human
cases, the latter could have been triggered by a mutation in the H5N1 virus.

"Maybe the virus has been changing so that it becomes a more easily
transmittable virus between bird and man," he said.

So far, 25 people have died from avian influenza in China since the
disease reemerged in 2003, according to World Health Organization figures.

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Hong Kong's HPAI surveillance and reporting records are rather
exemplary; the observations regarding possible unidentified or
unreported outbreaks in mainland China deserve serious attention.
Since, fortunately, no human to human infections are (yet?!) known to
occur, the source of the recent human infections must be sought in
the animal kingdom. The Chinese authorities may consider publishing
details of their recent active surveillance activities undertaken to
investigate the source of said human infections.

China's last (2) reports to the OIE on H5N1 date back to 19 Dec 2008
(Immediate Notification) and 26 Dec 2008 (Follow-up Report 1). They
addressed 2 outbreaks in Jiangsu; see, including map, at
<http://www.oie.int/wahis/public.php?page=event_summary&reportid=7623>.
- Mod.AS]

Avian influenza, human (29): Egypt (SUZ)

[1]
Date: Thu 5 Feb 2009
Source: Xinhua News Agency [edited]
<http://news.xinhuanet.com/english/2009-02/05/content_10764811.htm>


Egypt confirms 54th human case of bird flu
------------------------------------------
On Wed 4 Feb 2009 the Egyptian Health Ministry confirmed that a
2-year-old baby has been infected with bird flu virus, which brings
the number of human cases of bird flu to 54 in the populous country.

The baby from the Suez governorate, some 120 km (75 mi) east of
Cairo, was admitted to hospital with a high temperature, the state
MENA news agency quoted Health Ministry spokesman, [Abdul Rahman
Shaheen], as saying. The baby contracted the deadly virus after being
in contact with infected birds, said [Shaheen].

This is the 3rd case of human bird flu in Egypt in 2009. On 25 Jan
2009, a 2-year-old baby from the Delta governorate of [Al-Minufiyah],
some 65 km (40 mi) north of Cairo, was hit by the deadly disease. On
12 Jan 2009, a 21-month-old baby girl from Kerdasa, 6th of October
governorate, was infected with the virus.

Egypt reported its 1st H5N1 virus in dead poultry in February 2006
and the 1st human case in March of the same year.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[2]
Date: Thu 5 Feb 2009
Source: Kuwait News Agency (KUNA) [edited]
<http://www.kuna.net.kw/NewsAgenciesPublicSite/ArticleDetails.aspx?id=1973620&Language=en>


Two-year-old struck with bird flu
--------------------------------
Health authorities [in Cairo] announced Wednesday [4 Feb 2009] that a
new case of bird flu has been discovered in the province of Suez
involving a male child, thus bringing the number of people struck by
this disease in the country to 54 since its appearance in Egypt in
February 2006.

The afflicted child is 2 years old, said Dr [Abdul Rahman Shaheen],
spokesman for the ministry of Health, adding that the flu symptoms
began to appear on the child last Monday [2 Feb 2009], following
which he was admitted to the hospital for observation. He had come in
contact with dead birds while playing which resulted in his running
up high fever and severe coughing and other symptoms normally
associated with the bird flu. This took place last Friday [30 Jan 2009].

The disease had struck dead 22 people in Egypt since its appearance,
and the authorities [in Cairo] fear its resurgence mainly because
poultry shops, chicken-coop keepers at home, and bird collectors
mishandle dead birds, which exposes these people to the deadly flu.

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Remarkably all 3 cases of avian A/H5N1 influenza recorded in Egypt
during the 1st few weeks of 2009 have been children 2 years of age or younger.

The HealthMap/ProMED-mail interactive map of Egypt is available at
<http://healthmap.org/promed/en?g=359796&v=26.5,29.9,5>
and a map of the governorates of Egypt can be accessed at
<http://en.wikipedia.org/wiki/Governorates_of_Egypt>. The Suez
governorate is located at 26 on this map. - Mod.CP]

AVIAN INFLUENZA, HUMAN (28): CHINA (HUNAN), WHO

Date: Mon 2 Feb 2009
Source: World Health Organization (WHO) Epidemic and Pandemic Alert
and Response (EPR) disease outbreak news [edited]
<http://www.who.int/csr/don/2009_02_02/en/index.html>


China: avian influenza situation - WHO update 4
-----------------------------------------------
The Ministry of Health in China has announced a new confirmed human
case of H5N1 infection. The case is a 21-year-old female from Xupu
County, Hunan province. She had onset of symptoms on 23 Jan 2009 and
remains in hospital in a clinically stable condition. Investigations
into the source of her infection indicate possible exposure to sick
and dead poultry.

Of the 38 cases confirmed to date in China, 25 have been fatal.

AVIAN INFLUENZA, HUMAN (23): EGYPT, WORLD HEALTH ORGANISATION

Date: Mon 26 Jan 2009
Source: World Health Organization (WHO) Epidemic and Pandemic Alert
and Response (EPR) disease outbreak news [edited]
<http://www.who.int/csr/don/2009_01_26/en/index.html>


Egypt: avian influenza situation - WHO Update 2
-----------------------------------------------
On 26 Jan 2009 the Ministry of Health and Population of Egypt has
announced a new human case of avian influenza A(H5N1) virus infection.
The case is a 2-year-old female from Manofia [Al-Minufiyah]
Governorate, Shebin Elkom District. Her symptoms began on 23 Jan 2009
and she was immediately hospitalized. She remains in a stable
condition. Infection with the H5N1 avian influenza virus was confirmed
by the Egyptian Central Public Health Laboratory.

Investigations into the source of her infection indicate a recent
history of contact with sick and dead poultry.

Of the 53 cases confirmed to date in Egypt, 23 have been fatal.

AVIAN INFLUENZA, HUMAN (20): NEPAL, SUSPECTED

[1]
Date: Sun 25 Jan 2009
Source: China View, Xinhua News Agency [edited]
<http://news.xinhuanet.com/english/2009-01/25/content_10717281.htm>

Nepal has found a patient from Damak, eastern Nepal, to be a
suspected case of human bird flu infection, the Nepali national news
agency RSS reported on Sunday [25 Jan 2009]. Damak of Jhapa district
is some 320 km east of the Nepali capital Kathmandu. In mid-January
2009, the 1st case of bird flu in poultry was detected in Kakarbhitta
of the same district.

According to the report, bird flu has been suspected to have infected
a patient from Damak, who was taken to nearby BP Koirala Institute
for Health Sciences (BPKIHS) in Dharan. Communication spokesperson
for BPKIHS Bijay Rimal said bird flu virus has been suspected to have
been found in the patient's blood sample during tests in the
institute's laboratory. He said the patient's blood sample has been
sent for further tests in a sophisticated laboratory. He said the
patient was showing symptoms of bird flu infection. The BPKIHS,
however, did not reveal where the patient's blood sample had been sent.

Rimal, however, said it cannot be officially confirmed whether the
patient is infected with bird flu yet as the institute lacked a
specific lab to test bird flu. The patient has been referred to
Dharan by Lifeline Hospital in Damak following 3-day treatment there.

AVIAN INFLUENZA, HUMAN - CHINA (05): XINJIANG, FATAL

Date: Sat 24 Jan 2009
Source: China View, Xinhua News Agency [edited]
<http://news.xinhuanet.com/english/2009-01/24/content_10714041.htm>


Another death from bird flu reported in China
---------------------------------------------
A 31-year-old woman has died of bird flu in northwest China's
Xinjiang Uygur Autonomous Region, becoming the 4th death from the
disease in the country so far this year [2009], the local health
department said Saturday [24 Jan 2009]. The woman, a resident in the
regional capital Urumqi, died at 4:40 a.m. Friday [23 Jan 2009]. She
had been to a poultry market before she fell ill on [10 Jan 2009],
said Wang Xiaoyan, deputy director of the regional health department.

She was confirmed to have been infected with the H5N1 strain of avian
influenza by the Chinese Center for Disease Control and Prevention on
Saturday [24 Jan 2009].

Before the death in Xinjiang, 3 others have died of bird flu and
another has been infected in the country so far this year [2009]. The
1st death was a 19-year-old woman in Beijing on [5 Jan 2009],
followed by a 27-year-old woman in Shandong on [17 Jan 2009] and a
16-year-old boy in Hunan on [20 Jan 2009].

A 2-year-old girl who was critically ill with the disease was out of
danger at a hospital in Shanxi on Friday [23 Jan 2009] after her
vital signs remained stable for 6 consecutive days. The death rate
for bird flu patients is above 60 percent.

[Byline: An, editor]

--
Communicated by:
PRO/MBDS
<promed-mbds@promedmail.org>

[Xinjiang Uygur Autonomous Region has reported a 31-year-old female
as a new death from H5N1 infection. Her death was the 4th death from
H5N1 avian influenza infection in China during 2009. The previous
death from H5N1 infection was a 16-year-old boy from Guizhou
province. He died at Huaihua city of Hunan province on 20 Jan 2009
(see prior PRO/MBDS posting Avian influenza, human - China (04):
Hunan ex Guizhou, fatal, WHO 20090121.0257).

The cumulative number of confirmed human cases of avian influenza
A/(H5N1) reported to the WHO, dated 22 Jan 2009, is available at:
<http://www.who.int/csr/disease/avian_influenza/country/cases_table_2009_01_22/en/index.html>
where 34 cases and 22 deaths in China had reported to WHO since 2003.
Of note is that 2 deaths from Xinjiang and Hunan provinces are not
included in this report yet.

For a map of China with provinces, see:
<http://www.lib.utexas.edu/maps/middle_east_and_asia/china_pol01.jpg>.

For the interactive HealthMap/ProMED map of China with links to other
ProMED-mail and PRO/MBDS postings in China and surrounding areas,
see: <http://healthmap.org/promed?v=36.5,103.9,4>. - Mod.YMA]

[see also:
Avian influenza, human - China (04): Hunan ex Guizhou, fatal,
WHO 20090121.0257
Avian influenza, human - China (03): Shandong, fatal 20090118.0219
Avian influenza, human - China (02): Shanxi ex Hunan 20090118.0218
Avian influenza, human - China: Beijing, WHO 20090108.0078
2008
----
Avian influenza, human - MBDS region (11): China (Guangxi), WHO 20080222.0726
Avian influenza, human - MBDS Region (10): China (Guangxi) 20080221.0705
Avian influenza, human - China (02): Guangdong, WHO 20080227.0797
Avian influenza, human - China: Guangdong 20080225.0764
Avian influenza, human: China (Jiangsu), Pakistan, WHO 20080110.0135
2007
----
Avian influenza, human (05): China (Fujian), WHO conf. 20070530.1749
Avian influenza, human (04): China, RFI 20070526.1683
Avian influenza, human (03): China (Anhui) 20070329.1077
Avian influenza, human: H9N2, China (Hong Kong SAR) 20070320.0980]

AVIAN INFLUENZA, HUMAN (14): INDONESIA, WORLD HEALTH ORGANIZATION

Date: Thu 22 Jan 2008
Source: World Health Organization (WHO), EPR, Disease Outbreak News [edited]
<http://www.who.int/csr/don/2009_01_22/en/index.html>


The Ministry of Health of Indonesia has announced 2 new confirmed
cases of human infection with the H5N1 avian influenza virus. A
29-year-old female from Tangerang District, Banten Province developed
symptoms on 11 Dec 2008, was hospitalized on 13 Dec 2008 and died on
16 Dec 2008. The investigation indicated that she visited a wet
market to buy fresh produce, including chicken meat, on a daily
basis. Household contacts were placed under medical observation, and
none developed illness.

The 2nd case, a 5-year-old female from Bekasi City, West Java
Province developed symptoms on 23 Dec 2008, was hospitalized on 27
Dec 2008 and died on 2 Jan 2009. The investigation indicated that she
visited a wet market to buy chicken meat and eggs 2 days prior to
symptom onset. Contacts were placed under medical observation, and
none developed illness.

Laboratory tests confirmed the presence of the H5N1 avian influenza
virus in both cases.

Of the 141 cases confirmed to date in Indonesia, 115 have been fatal.

AVIAN INFLUENZA (10): CHINA (GUIZHOU, SHANDONG)

[1] & [2] Guizhou province
[3] & [4] Shandong province

******
[1] Guizhou province
Date: Mon 19 2009
Source: Xinhua News Agency [Chinese, trans. Rapp.DS, edited]
<http://hn.rednet.cn/c/2009/01/19/1693505.htm>


On the afternoon of 16 Jan 2009, Huaihua City No. 1 People's Hospital
admitted a transfer patient from Guizhou Province. The preliminary
diagnosis was pneumonia of unknown origin, suspected avian influenza.
The patient is 16 years old, a male student. He is a resident of
Qiandongnanzhou in Guizhou Province. The patient fell ill on 8 Jan
2009 in Guizhou. Because his condition deteriorated, he was
transferred to Huaihua in Hunan Province for treatment on 16 Jan 2009.

After receiving a report, the provincial health bureau and provincial
CDC [Centre for Disease Control and Prevention] quickly sent experts
to Huaihua to provide guidance on treatment and prevention work.
Provincial CDC tests were positive for H5N1 avian influenza RNA. On
19 Jan 2009, China CDC ran confirmatory tests which were positive for
H5N1 avian influenza RNA. Epidemiological investigations found that
the patient had contact with diseased poultry carcasses prior to falling ill.

AVIAN INFLUENZA, HUMAN (11): CHINA, WORLD HEALTH ORGANIZATION UPDATE

Date: Mon 19 Jan 2009

Source: World Health Organization (WHO), EPR, Disease Outbreak News [edited]
<http://www.who.int/csr/don/2009_01_19/en/index.html>


As of Mon 19 Jan 2009, the Ministry of Health in China has reported 3
new cases of human infection with the H5N1 avian influenza virus.

The 1st case is a 27-year-old female from Jinan City, Shandong
Province. She developed symptoms on 5 Jan 2009, was hospitalized, and
died on 17 Jan 2009. The source of her infection is presently under
investigation.

The 2nd case is a 2-year-old female from Luliang City, Shanxi
Province. She developed symptoms on 7 Jan 2009, was hospitalized, and
is in a critical condition. The source of her infection is presently
under investigation. [Other accounts state that the child acquired
infection in Hunan province and was taken by her grandparents to
Shanxi province, where she was treated. - Mod.CP]

The 3rd case is a 16-year-old male from Huaihua City, Hunan Province.
He developed symptoms on 8 Jan 2009, was hospitalized on 16 Jan 2009,
and is in a critical condition. The case had exposure to sick and dead poultry.

All 3 cases were confirmed by the national laboratory. All contacts
have been placed under medical observation and remain healthy to date.

Of the 34 cases confirmed to date in China, 22 have been fatal.