Dossier H5N8: H5N8 and a novel H5N2 virus found in Taiwan

Focus Taiwan, Taipei, by Yang Shu-min and Elizabeth Hsu. Jan. 11 2015. A new type of the H5N2 avian influenza virus detected at goose farms in southern Taiwan has never been seen before, the director-general of Taiwan’s government-run Animal Health Research Institute said Sunday.

Tsai Hsiang-jung said the H5N2 subtype flu strain is a recombinant virus, and “after reporting the case to the World Organization for Animal Health, it will be the first of its kind in the world.” The Bureau of Animal and Plant Health Inspection and Quarantine under the Cabinet-level Council of Agriculture confirmed Sunday an outbreak of the new H5N2 strain at four goose farms in Yunlin County and a duck egg farm in Pingtung County.

It also confirmed an outbreak of H5N8 avian flu at a goose farm in Chiayi County. A total of 24 farms raising ducks and geese around Taiwan sent tissue samples to be tested amid suspicions that their birds may have been infected with avian flu. The outbreak started on Jan. 8 at a farm in Da-Lin Township, Chiayi County and killed 3,683 out of 5,200 birds, the Taiwanese authorities said in a report to the Paris-based OIE. The strain is the same as in other cases found in Europe, North America and elsewhere in Asia in the past year.

Six farms were found to be infected by two viruses that had never been detected in Taiwan before, the bureau said. After analyzing the new H5N2 subtype, the bureau said the H5 subtype was 99 percent similar to that seen in the H5N8 flu virus that attacked South Korea in 2014, while the N2 subtype was 96 percent similar to the virus that hit China’s Jilin Province in 2011.

The H5N8 infection found in tissue samples from geese raised on a farm in Dalin Township in Chiayi County was identified as similar to the South Korean H5N8 avian flu virus, according to the bureau. The H5 subtype is 99 percent similar to the Korean strain, while the N8 subtype is 98 percent similar, the bureau said. Both the new H5N2 and the H5N8 virus strains are highly pathogenic, the bureau noted.

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Dossier H5N8; Outbreak of High Patogen Avian Influenza H5N8 in Germany

Germany has reported an outbreak of highly pathogenic avian influenza, H5N8 in fattening turkeys in North East Germany (Mecklenburg – Western Pomerania). Increased mortality was observed in one of the six sheds of 15 week old birds for fattening (total number of turkeys on the premises ~ 31,000 of which each shed contained 5,000).

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Outbreak HPAI in Japan (14 April 2014): What goes wrong here?

Outbreak of H5N1 in Japan: what could go possibly wrong that would cause reintroduction of the virus in other parts of Japan?

Viruses are mostly spread through the air, transmitting from wild birds into farms, due to lack of bio security; or by people and materials that have been involved in the eradication of the infected animals. Weather conditions also play an important role, like wind direction and temperature.

So once a farm is infected, the number of people and the materials needed for the eradication has to be limited to the minimum.

What goes wrong in many cases is that governments are not prepared because they didn’t want to invest in the correct techniques.

So when it happens, they are doomed to bring in as many people as they can, causing an enormous risk of reintroduction of the viruses.

Most of these people are poorly trained in bio security and using personal protection equipment correctly. If something goes wrong, they may become the next source of infection.

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Novel Reassortant Influenza A(H5N8) Viruses, South Korea, April 2014

The latest outbreak of bird flu in South Korea, which has spread across the country from Gochang, North Jeolla Province since mid-January, will be completely eradicated in late May, the South Korean authorities promise. In a National Assembly committee on Monday, South Korean Minister of Agriculture, Food and Rural Affairs Lee Dong-phil said, “It’ll be possible to declare eradication of bird flu around late May unless there’s further outbreak.”

A ministry official said it would be safe to declare the country free from bird flu 40 days after all preventive culling of poultry is complete, provided there are no further suspected cases. Only one report of a suspected case of bird flu came in from Gochang this month.

The latest outbreak of bird flu will go down in South Korea’s history as the most devastating so far. Until Monday, a total of 12.36 million chickens and ducks had been culled and buried. The outbreak also spread more widely than any other, affecting some 70 municipalities compared to the earlier record of 25 in 2010. The longest epidemic lasted for 139 days in 2010.

The ministry told the committee that migratory birds from China probably carried the latest outbreak. An official with the Animal and Plant Quarantine Agency said, “We believe that the H5N8 virus came from China, given that it was first discovered in Zhejiang Province.”

Visit the CDC website for more detailed information.

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Dossier H7N9: Chickens can’t talk

AFP, March 11, 2014. Poultry dealers in Hangzhou (China) accuse the government of shutting the markets without scientific evidence and demand compensation for the birds they were forced to slaughter or sell at rock-bottom prices. “Chickens can’t talk. Ducks can’t talk. We don’t know where bird flu came from: chickens, ducks or other birds,” said Li, at the Chengbei market in Hangzhou.

Authorities in the city, capital of the eastern province of Zhejiang, the centre of the current outbreak, shut down the market in January. The province has announced radical plans to ban — forever — all live poultry trading in urban areas, according to state media, and replace it with factory-slaughtered and frozen meat.

The handful of poultry dealers lingering at Chengbei Market have had little to do since Chinese authorities shut down their livelihoods after H7N9 bird flu began stalking the country again, killing scores of people this year. They spend their days counting the losses to their business, gambling at cards and cleaning the cages which once held thousands of live birds, hoping the government will allow the trade to resume. “The chickens lay every day and I can’t sell the eggs. We are losing money,” said Li Guiying, local boss of the Xuancheng Shandi Poultry Co.

H7N9 avian influenza has returned to China with a vengeance, sickening 226 people and killing 72 so far this year, as the government girds for what is likely to be a long battle to contain what one World Health Organization (WHO) official has labelled an “epidemic”. China has responded by aggressively closing down poultry markets in locations believed to be at threat from the virus, raising an outcry from the agricultural industry and consumers with a taste for freshly slaughtered food. But in the longer term the government needs to encourage a shift in behaviour of consumers and clean up the nation’s food supply chain, experts say, which has been hit by a series of health safety scandals.

Ultimately, fears exist that the H7N9 virus could mutate and become easily passed between people, rampaging through the world’s most populous country and crossing its borders to spread around the planet. After subsiding following the first outbreak early last year, H7N9 resurfaced in the autumn, then boomed. The figures for the first two months of the year exceed the tallies of 144 infections and 46 deaths for the whole of 2013.

The WHO and Chinese authorities maintain there is no evidence of “sustained” human transmission with H7N9, though there have been cases of family members in close contact infecting each other. But they acknowledge a seasonal spike in cases, possibly caused by the affinity of the virus for colder temperatures and humans’ greater susceptibility to illness in winter. “The big question always is, ‘does it go down as the season goes away or does it continue?'” said the WHO Representative in China, Bernhard Schwartländer. “We seem to start seeing a decrease again, which confirms the seasonal patterns, but there is of course no reason and no space to relax,” he said.

China’s National Poultry Industry Association estimates the sector has lost more than $3.0 billion so far this year, on top of the impact of the outbreak last year as consumers shunned fowl and markets stopped business. “Within the industry we call it a devastating hit, a crowning calamity. With our backs to the wall, it seems one cannot adequately depict the severity of the situation,” said the association’s secretary general Gong Guifen. “The selling of frozen chicken is more like an emergency response, whereas the industry as well as the public’s consumption habits cannot be changed overnight,” she said.

But poultry market closures were the most important measure to contain the virus, said WHO’s Regional Director for the Western Pacific Shin Young-soo. “Of course, I think the Chinese government should consider many other things. This has a huge impact on our daily life… on farmers, market people,” he said. In contrast to H5N1, a different strain of avian influenza which affected China earlier, H7N9 is harder to detect because it does not kill the birds that can pass it to humans, he pointed out. “H7N9 is more difficult because actually the bird and ducks, they’re… not really sick. It’s more difficult to control,” he said. “It’s very fatal to human beings,” he added. “We know that this virus (is) never going again. It’s coming back.”

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Red flags in china’s disease control

H7N9 bird flu is back in China. Since last October, more than 165 new human H7N9 cases have been reported, compared with 136 last spring. At least 115 cases (with 25 fatalities) have been confirmed this year.

While the mortality rate of H7N9 is not as high as that of H5N1, the total number of H7N9 cases identified in the past month equals the number of H5N1 cases reported in 2006 (the most active calendar year for H5N1).

In contrast to the systematic cover-up and inaction during the initial stage of the 2002–03 SARS outbreak, the Chinese government has handled the outbreak in a more transparent and decisive manner. It updates bird flu data on a regular basis. Live poultry trading was halted in many cities of Eastern China.

Central health authorities have dispatched expert teams to affected provinces to supervise local hospitals in diagnosing and treating H7N9 patients. Most confirmed human cases of H7N9 have been isolated. In so doing, China has benefited from an enhanced disease surveillance and reporting system and improved surge response capacity.

Note from the N2GF team: Harm Kiezebrink and Derk van Wijk joined the WHO SARS team end of 2003 to advise China’s Minister of Agriculture and the Minister of Health on outbreak management of infectious animal diseases. Today, Harm is still advising the Chinese government on developing new strategies for culling & disposal of diseased animals.

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China reports 14 more H7N9 cases, 3 fatal

Lisa Schnirring | Staff Writer | CIDRAP News | Feb 03, 2014 Over the past 3 days, China reported 14 new H7N9 influenza infections, including 4 in children and 3 fatal cases.

Lunar New Year celebrations are winding down in China, and health officials are watching to see what impact that might have on the pace of human cases. Global health groups have warned that the surge of human cases could continue, fueled by increases in poultry trade and transport, as well as heavy volume of travel as families gather to observe the holiday season.

Southern provinces lead second-wave cases
Six of the latest cases are from Guangdong province, continuing a strong second-wave tilt toward the mainland’s southernmost areas. In the first wave, locations north of that area were driving most of the outbreak activity: Shanghai, Jiangsu province, and Zhejiang province. China’s steady stream of H7N9 cases has averaged about 5 to 7 a day over the past few weeks, and the latest reports puts the total close to the 300 case mark since the disease was first detected in people last spring. For comparison, it took H5N1 avian flu—another closely watched virus that can pass from poultry to people—4 years for the global total to reach 263 cases. China passed that mark for H7N9 last week after less than a year of outbreak activity.

Latest case announcements
News of the latest 14 cases appeared in provincial health ministry announcements translated and posted by Avian Flu Diary (AFD), an infectious disease blog, and five of the cases were also covered in the latest disease update today from the World Health Organization (WHO). Three more deaths were included in the reports: in a 63-year-old man and a 48-year-old man from Guangdong province, and in a 59-year-old man from Hunan province. The 48-year-old’s infection was first confirmed on Jan 15, according to the FluTrackers infectious disease news message board. Six of the latest case-patients are from Guangdong province, and three of them are children, a 2-year-old girl, a 5-year-old boy, and a 6-year old boy. Aside from the 63-year-old man who died from his infections, the other cases involve a 37-year-old man and a 76-year-old woman. The 6-year-old boy’s illness was detected on Jan 28 as he was traveling through a border point between Shenzhen and Hong Kong, according to the WHO report. He lives in Shenzhen and started having symptoms on Jan 27. His symptoms are described as mild, and he is in stable condition and is being treated and isolated at home. The investigation shows that he had been exposed to live poultry.

Meanwhile, the 5-year-old boy, from the city of Zhaoquing, got sick on Jan 29 and was hospitalized the same day. He is in stable condition. The WHO said he had been exposed to a live poultry market. The 2-year-old girl, whose illness was confirmed yesterday, is from Zhongshan City, where she is hospitalized in stable condition, according AFD’s translation of today’s health ministry report. The fourth child—an 8-year-old girl—is from Hunan province, which also reported two adult case-patients, a 38-year-old man and a 59-year-old man who died from his infection. Zhejiang province reported three new cases, all involving adult men, ages 80, 54, and 44. Fujian province also reported two more lab-confirmed cases, also in men, ages 27 and 35.

The 14 new cases boost the H7N9 outbreak’s total to 291, according to a running total compiled by FluTrackers. Of those, 155 have come in the second outbreak wave since October, compared with 136 in the first wave last spring. The three latest deaths lift the unofficial fatality total to 64.

WHO reports add to outbreak, case profiles
The WHO’s statement today also includes details on five case notifications it received from China on Jan 31. In addition, a separate statement from the agency on Feb 1 fleshes out new details on seven cases reported from China on Jan 30. Of the 16 patients reported in the two WHO statements, 11 had been exposed to live-poultry markets, three had been exposed to live poultry, and the source wasn’t known for two. Ages range from 5 years to 82 years. Twelve of the patients are male, and four are female. Eleven of the patients are in critical condition, one is serious, one is stable, and one has a mild infection. Two of the patients died from their illnesses. Illness-onset dates range from Jan 13 through Jan 29. The patients in the two WHO reports are from five different Chinese provinces, all in the southeastern part of the country. They include seven from Guangdong, 6 from Zhejiang, and 1 each from Guangxi, Hunan, and Jiangsu.

See also:
Feb 3 WHO statement

Feb 1 WHO statement

FluTrackers post on H7N9 death

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Chinese scientists sound warning over new H10N8 bird flu

France-Presse, Tuesday, February 4, 2014. Chinese scientists sounded the alarm Wednesday after a new bird flu virus, H10N8, killed an elderly woman in December and infected another individual last month. The fifth novel influenza strain to emerge in 17 years, the virus has a worrying genetic profile and should be closely monitored, they reported in The Lancet medical journal.

It appears to be able to infect tissue deep in the lung and may have features allowing it to spread efficiently among humans, they said. “The pandemic potential of this novel virus should not be underestimated,” said the team headed by Yuelong Shu from the Chinese Centre for Disease Control and Prevention (CDC) in Beijing. The warning stems from analysis of a virus sample taken from a 73-year-old woman who died in Nanchang, in southeastern Jiangxi province, on December 6 after being diagnosed with severe pneumonia and respiratory failure. The Chinese authorities announced her death from H10N8 on December 18.

The Lancet study disclosed that a second case of H10N8 was recorded in Nanchang, on January 26. It did not give further details. They are the first known human cases of H10N8, a virus that has been found only twice before in China — once in a water sample from a lake in Hunan in 2007, and the second time in live poultry in Guangdong province in 2012. But this particular strain is different from the ones found in those two samples, the study said.

Genetic profile of virus
The big contributors to its genome are reshuffled genes from the H9N2 virus, the authors said. This is a bird virus that erupted in Hong Kong in 1999 and has also contributed to the dangerous H5N1 and H7N9 flu viruses, the probe said. Avian flu viruses pass from infected birds to humans in close proximity but typically do not transmit easily between humans. The worry for health watchdogs is their potential to acquire an ability to jump easily from person to person. H7N9, which emerged last year, has led to 159 human infections in China, including 71 deaths, according to a combined toll of official figures and an AFP tally of reports by local authorities. H5N1, which first occurred among humans in Hong Kong in 1997, has caused 648 infections with 384 deaths since 2003, according to figures cited in The Lancet study. The genome of H10N8, it said, pointed to a mutation in its so-called PB2 protein that, previous research has found, suggests an ability to adapt to mammals.

The virus also has a mutation in its haemagglutinin protein — a spike on the virus surface that enables it to latch onto other cells — that suggests it can infect deep in the lung, like H5N1, rather than the upper respiratory tract, the trachea. Lab tests on the sample showed it could be attacked by Tamiflu, the frontline anti-viral drug. Many questions remain, including how the woman was infected. She had bought a live chicken at a poultry market several days before falling sick. But she may have become infected beforehand, the scientists said. She did not handle the bird and no virus traces were found in poultry at the market. In addition, the woman may have been an easy target for the virus because of poor health — she had coronary heart disease, high blood pressure and a muscle-weakening disease called myasthenia gravis. Tests on people who had been in close contact with her concluded that no one else had been infected. The second case of H10N8 “is of great concern”, said co-author Mingbin Liu of the Nanchang branch of China’s CDC. “It reveals that the H10N8 virus has continued to circulate and may cause more human infections in the future.”

See Article:

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H7N9 case reported in Zhejiang, China

China.org.cn, January 6, 2014. The Centre for Health Protection received notification today from the National Health & Family Planning Commission of an additional human case of avian influenza A(H7N9) in Zhejiang affecting a 34-year-old woman. The patient fell ill on December 29, and tested positive for H7N9 on January 4. Her current condition is critical.

So far, a total of 146 human cases of H7N9 have been confirmed in the Mainland, including Zhejiang (52 cases), Shanghai (34 cases), Jiangsu (28 cases), Guangdong (six cases), Jiangxi (six cases), Fujian (five cases), Anhui (four cases), Henan (four cases), Beijing (two cases), Hunan (two cases), Shandong (two cases) and Hebei (one case). The centre will follow up with Mainland health authorities for more details.

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Shanghai confirms winter’s first H7N9 case

Source: Shanghai Daily | January 5, 2014. Shanghai yesterday confirmed the city’s first H7N9 case this winter after the Shanghai Health and Family Planning Commission said an 86-year-old man was infected. The elderly patient, surnamed Zhou, had been in contact with live poultry, officials said. His infection was confirmed on Friday and has since been hospitalized for treatment.

According to Dr Lu Hongzhou, director of local H7N9 experts group, the patient is in critical condition battling serious pneumonia and shock. Lu took part in group consultation for the patient on Friday. Zhou had gone to the wet market with his wife to buy live chicken and stood by as the stall owner slaughtered the chicken in front of them. He had fever and was coughing before the trip to the market, Lu said. Those in close contact with him have also been kept under medical observation. His wife is also reported to be in good health, Lu said. Lu said autumn and winter are the peak seasons for respiratory diseases. Human infection of the H7N9 virus is still sporadic but may last for a long time.

Good personal hygiene, proper nutrition, exercise and avoiding contact with live poultry or wild birds have been effective in stemming the spread of the virus. Lu has called for a complete closure of live poultry market to prevent the spread of infectious diseases. Shanghai shut live poultry markets and businesses on April 6 last year to control the spread of H7N9. The markets reopened on June 20 with strict rules in place for disinfection and management. Live poultry business will be shut from January 31, when the Chinese Lunar New Year falls, to April 30 this year to prevent recurrence of the virus.

The H7N9 strain was first reported in humans in March last year on the Chinese mainland and infected over 140 people on the mainland, Taiwan and Hong Kong. More than 40 people have died from the virus. Between March 31 and April 21 last year, Shanghai reported 33 cases, but no new cases were reported after that. By June 26, the last available report said 16 people had succumbed to the virus.

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