Flu Scan for Jan 13, 2016

News brief

China reports H5N1 case in Sichuan province man

Officials have confirmed a severe case of H5N1 avian flu in a man in Chengdu, the capital of Sichuan province in south central China, according to a statement from the Sichuan Health and Family Planning Commission translated and posted today by Avian Flu Diary (AFD), an infectious disease news blog.

The patient, age 42, is hospitalized in Chengdu in "extremely critical" condition. He developed a fever and other symptoms on Dec 27, but his condition recently deteriorated and includes severe pneumonia and respiratory failure, the statement said.

He had contact with live poultry before falling ill, officials said. He tested positive for H5N1 today. Fifty-eight of his close contacts are under observation, with no further cases noted so far.

This appears to be the world's first H5N1 case of the year. Last year the country reported five cases to the World Health Organization (WHO), according to WHO data, one of which was fatal. Since 2003 the country has confirmed 52 cases and 31 deaths. As of Dec 14, the WHO had confirmed 844 cases, including 449 deaths, for a case-fatality rate of 53%.
Jan 13 AFD blog post
Dec 14, 2015, WHO global H5N1 cases count

France confirms 2 new high-path avian flu outbreaks, 69 total

France has now confirmed 69 outbreaks of highly pathogenic avian influenza (HPAI) with two new events, one in a newly affected region, while a report filed with the World Organization for Animal Health (OIE) detailed two previous outbreaks.

In related news, the H5N1 strain involved in a Scottish outbreak has been confirmed to be low-pathogenic.

The first new HPAI outbreak in France is in Haute-Garonne department, bringing to eight the number of affected departments, according to a regional statement translated and posted today by AFD. It involves the H5N1 strain on a farm near the town of Lafitte-Vigordane.

Officials did not specify how many poultry are involved, but they said all surviving birds will be culled to prevent disease spread. They have established a 3-kilometer (km) protection zone and a 10-km zone of heightened surveillance, according to the statement.

The other outbreak, which was confirmed by France's agriculture ministry, is in Pyrenees-Atlantiques department. It involves HPAI H5N2 on a farm with 1,280 ducks.
Jan 13 AFD blog post

The two HPAI outbreaks detailed in a Jan 11 OIE report were in Landes and Pyrenees-Atlantiques departments, both in far southwestern France.

In the Landes outbreak, which began on Dec 24, 2,500 of 4,400 chickens died, and lab tests on Jan 5 confirmed H5N2. The remaining chickens, plus 950 foie gras ducks and 100 egg-laying hens were euthanized to contain the outbreak.

In the other outbreak, which began Jan 2, 4,000 broiler chickens out of 12,000 died. On Jan 6 a national reference lab confirmed an H5 HPAI virus without subtyping the strain. The remaining broilers plus 6,750 foie gras ducks were culled the next day.

In the two outbreaks combined the disease killed 6,500 out of 24,200 birds, or 27%.
Jan 11 OIE report

In Scotland, meanwhile, lab tests have confirmed that the H5N1 strain that caused an outbreak on a farm near Dunfermline is of the low-pathogenic variety, according to a Scottish government news release today. Agriculture officials are now culling almost 40,000 poultry on the farm and have established a 1-km restriction zone around the premises.

Chief veterinarian Sheila Voas, DVM, said, "It is important to stress that this strain is quite distinct from the highly pathogenic form of H5N1 that has caused significant problems over the past decade or so around the world. Robust precautionary measures have been in place since suspicion of disease was first reported, in line with our well-rehearsed contingency plans for dealing with avian influenza."
Jan 13 Scottish government news release

Study shows high levels of 3 swine flu strains on outbreak pig farms

Three separate strains of influenza A virus (IAV) were detected in animal and environmental samples taken from six swine farms in southern Minnesota and northern Iowa with suspected flu outbreaks, according to a study yesterday in PLoS One.

US researchers took oral fluid, pen railing, and indoor air samples from farms that were identified by area veterinarians as likely hit by flu. Five of the outbreaks were confirmed to be caused by IAV. Of those, 48% (47/98) of oral fluid, 38% (32/84) of pen railing, and 43% (35/82) of indoor air samples tested positive for influenza A by polymerase chain reaction.

Among the five outbreak farms, H1N1 was confirmed on one, H3N2 on one, both H1N1 and H1N2 on two farms, and both H1N1 and H3N2 on one farm.

The authors concluded, "We found that IAV could be isolated from indoor air of commercial swine production facilities, that airborne IAV levels were sustained for periods of 20 days and that there was a correlation between the number of positive samples of each type and the quantity of virus in the swine oral fluids and in the air.

"Our results provide a first estimation on levels of environmental IAV in swine commercial production facilities, and thus an assessment of potential sources of IAV exposure to swine workers or other pigs."
Jan 12 PLoS One study

News Scan for Jan 13, 2016

News brief

MERS infects another Saudi man who had camel contact

For the second day in a row, Saudi Arabia's Ministry of Health (MOH) reported a new MERS-CoV case, and like yesterday the patient is a man who had contact with camels before he got sick.

The 50-year-old man is a Saudi citizen from Medina, located in the western part of the country. The man is hospitalized in stable condition for his MERS-CoV (Middle East respiratory syndrome coronavirus) infection.

His illnesses boosts Saudi Arabia's total for the disease to 1,281 cases, 551 of them fatal, according to today's MOH statement. Five people are still being treated for their infections.
Jan 13 Saudi MOH statement

Brazil reports more microcephaly cases, shares new lab findings

Brazil's health ministry yesterday said that 3,530 microcephaly cases possibly linked to maternal Zika virus infections have been reported, an increase of 356 cases from the last report on Jan 5.

Health officials also confirmed Zika virus in four microcephalic infants, two who were stillborn and two who died within a day of birth, according to a ministry statement translated and posted by Avian Flu Diary, an infectious disease news blog.

The number of Brazilian states reporting microcephaly cases remained the same, at 21, but 724 cities are now reporting cases, a rise of 40.

Though the link between Zika virus and microcephaly hasn't been definitively proven, today's ministry statement highlights lab findings from the US Centers for Disease Control and Prevention (CDC) that seem to strengthen the connection.

Lab samples from the four microcephalic infants, all from Rio Grande do Norte state, were positive for Zika virus on polymerase chain reaction testing. Tissue samples from the two newborns were positive on immunohistochemistry testing, according to the report. Earlier investigations by the Federal University of Rio Grande do Norte had found that all of the mothers had fever and rash—both of which are Zika infection symptoms—during their pregnancies.

The ministry said that, taken together, the findings reinforce the suspected link between Zika virus infection and microcephaly, but further investigation is needed.
Jan 13 Avian Flu Diary post
Jan 6 CIDRAP News scan on microcephaly in Brazil

NIH awards $5 million for developing alternative antibiotics

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, this week awarded about $5 million for 24 research projects to develop "non-traditional therapeutics" for bacterial infections to help address antibiotic resistance.

NIAID Director Anthony S. Fauci, MD, said in an NIAID press release, "New strategies are desperately needed to treat patients with antibiotic-resistant infections that often are deadly. These new NIAID grants will provide funding to researchers developing unique, non-traditional therapies that could complement or even replace currently available antibiotics that are losing effectiveness.”

Advancing new therapeutic options to combat drug-resistant bacteria is a key goal of the President Barack Obama's National Action Plan for Combating Antibiotic-Resistant Bacteria.

Non-traditional therapeutics include good bacteria added to the human microbiome, bacteriophage or phage therapy, adding decoy targets to prevent harmful bacteria from producing disease, enhancing human immune responses to pathogens, and developing drugs that incapacitate the pathogen's ability to adapt and compete, the NIAID said.

The 24 innovation awards were made to 18 universities and 3 businesses. The awards provide support for 2 years, with the possibility of 3 additional years for the most accomplished projects.
Jan 11 NIH press release