Tuesday, January 15, 2019

Mongolia Reports The Arrival Of African Swine Fever


Mongolia (not to be confused with already affected Inner Mongolia, a province of China) has reportedly detected African Swine Fever - at least based upon local media reporting and an emergency meeting held yesterday by a Special Committee of their Ministry of Agriculture.  
The machine translation of Mongolian, unfortunately, doesn't always produce the clearest syntax, and the use of local idioms - which may have multiple meanings - complicates matters further. 
While we will probably need to wait for the OIE notification to get solid details, - based on overnight reports online - it appears that the ASF virus has been detected in multiple locations, and apparently both in live pigs and in (possibly imported) food products.

First, this report from the UB Post.

Four provinces myalzan pig disease has been found spreading rapidly

In the four provinces of Bulgan, Tuv and Dundgovi, throughout Mongolia, rapidly spreading pork and diseases, the Emergency Commission of Bayankhongor aimag has urgently called for the prevention of this disease.

In the presence of the disease, the pig is initially manifested by symptoms such as blue spots, high fever, and swine transmitted from swine to pig. In this way, it is possible to intercept the disease and become a carrier. In Bayankhongor aimag there are 4 units of pig farming.

The emergency committees are not allowed to introduce pigs and pork products to the provincial level, shop and service centers prohibit the sale of semi- and pork meat products, not to use pork and meat products for any food industry, and to control the operation of pork traders organizations should be monitored and monitored regularly, not to use pork meat products, Regional governor with a pig head to the Commission was an exceptional decision to conduct detailed surveillance of wild pigs in the land.

The decision was made by Bayankhongor aimag to be appointed by the Deputy Governor of Aimag B.Batsuuri to the relevant authorities or members of the Special Commission.

The term `myalzan' in Mongolia used to refer to Rinderpest (declared eradicated in 2011), but is now apparently being used for African Swine Fever, as in this September media report in Mongolia Today on China's ASF outbreak (see Pork myalzan increasing prevalence of the disease!)

Another media report from Eagle news.

There was a swelling of pigs in Ulaanbaatar

Eaglenews 2019-01-15 11:26:00

There was a swelling of pigs in Ulaanbaatar

In Ulaanbaatar, pork disease has been detected.

"In the capital city there are samples of pork supply at 74 points, a total of 100 samples taken over a three day period, and 50% of them have been detected, and some of the enterprises have been detected," said L.Erdenechuluun, Head of the Specialized Inspection Agency of the Capital City. He said,

"At the national level, 31 thousand pigs are counted, of which 17,000 are in the capital and currently have 17 thousand pigs of 130 enterprises in detention centers, decontamination, and imports should be stopped for a certain period of time.

In addition, the catering and trade organizations need to limit consumption.

Initially, importers sent a declaration to stop distribution and sealed warehouses. 300 tons of reserves in warehouse in Ulaanbaatar and over 1,000 tons of reserves.

The Veterinary Department will be removed from the Veterinary Department because of the positive results of the sample. Our organization will monitor this. According to the General Department of Veterinary Services, it is risky for human beings to be infected with this disease as a carrier. "

In China last November, pig disease has begun. In China, there are quarantine restrictions in the prevalence of epidemic swine flu in Africa.
And finally, this (translated) report from Mongolia's Ministry of Agriculture,
which names ASF directly. 

The State Special Committee convened a duty to ban import of pork and fat temporarily

Source: Ministry of Food and Agriculture

Munkhtuya | 8 hours ago

(2019.01.15) Deputy Prime Minister of Mongolia and State Special Emergency Commission ¹ of Ulaanbaatar, Bulgan, Dundgovi, Tuv, Orkhon Aimag, Ulaanbaatar, Trade, Food Service, Service, Live Pork, Pork and Meat Products .Enkhtuvsh summoned the State Special Emergency Committees.
The meeting discussed the effects of pork disease, measures, and outbreaks of influenza and influenza-like illnesses, as well as ongoing and ongoing measures to be taken.

D.Tumendemberel, head of the General Department of Veterinary Services, said: "Sample of the dead pigs from the state veterinary clinic sanatorium laboratories has proved to be a disease of Pig African. The joint working group of the relevant agencies is working with the Pig African Crisis. There are 10 entities importing pork and meat products in Mongolia. Analyze the warehouse of four organizations. "

Following the report, the Deputy Prime Minister of Mongolia and the President of the State Emergency Commission O.Enkhtuvshin gave directions to the relevant authorities.

Ch.Ulaan Minister of Food and Agriculture and Light Industry:

- Prohibit the import of pork and fat imported from China, Russia, Germany and Poland temporarily by the state border;

- Introduce active surveillance and detection of pig fungus at the national level within 30 days and plan for further action;

- Provide reserves of disinfectants such as "iodine and lemon" with selective services for the disease and organize disinfection of pigs and fodder stores, shelters and fences;

- Provide proper management of burrows of pork Africa with appropriate regulations and guidelines, and organize burying in integrated zones.

D.Tumendemberel, head of the General Department of Veterinary Services:

- The Government of Mongolia's Resolution 266 of 2018 shall organize and supervise all the necessary measures in accordance with the approved procedure during the quarantine and restriction regime;

- Provide information on prevention and prevention of pig disease in the public, and collaborate with the media in collaboration with the State Professional Inspection Agency (GASI) in order to deliver information from one point to another.

- Conduct a risk assessment of animal infectious diseases and identify ways to plan and implement responses to the outcomes.

Governor of aimags and the Capital City and the Special Appellate Committees:

- Disbursement of disinfection and disinfection required for preventive diseases of the pig and infectious diseases of the pig, financed by the capital of aimags and capital city approved by 2019;

- Provide aimag and city Veterinary organizations in the area of ​​disinfecting and disinfection;

- Take necessary measures to temporarily ban migration of humans, animals, animals and vehicles from the epidemic of infectious diseases in Africa,

- Conduct sterilization and disinfection in accordance with relevant instructions and procedures for business entities, organizations, citizens and service establishments;

Head of the Customs General Administration B. Appendix, Chief of the General Agency for Specialized Inspection N. Tsagaankhuu:

- Provide a notice of intensification of inspections on domestic freight and freight on border, customs and border ports;

- Introducing travelers to the border with the purpose of introducing the pork and meat products for their food and luggage.

While hardly a surprise (see last August's FAO: African swine fever (ASF) threatens to spread from China to other Asian countries), these latest developments are nevertheless a sobering reminder of the ongoing threat from ASF, and how quickly it can spread across the region.

Saudi MOH: Another Household Cluster of MERS - Jeddah


While the overall number of new MERS cases reported by the Saudi MOH has been pretty low the past couple of months, for the third time in 4 weeks we have a reported household cluster.
Today, the Saudi MOH is reporting the third household cluster in the past month, this time the primary case being the 75 y.o. male reported from Jeddah on January 10th, and a 52 y.o. (secondary, household) male reported today.

Household clusters of MERS are not particularly rare, although 3 in just over a month is a bit unusual, particularly given 70% of the cases over that time period are part of one of these clusters.
Clusters - whether in homes or healthcare settings - illustrate that in close quarters and under the right conditions, MERS transmits reasonably well between humans.
The saving grace so far has been that in the broader community, overt transmission appears far less common, although there are concerns over undetected chains of (asymptomatic or mildly symptomatic) transmissions.

The yardstick by which disease transmissibility is measured is its R0 (pronounced R-nought) or Basic Reproductive Number. Essentially, the number of new cases in a susceptible population likely to arise from a single infection. 
In the simplest of terms, with an R0 below 1.0, a virus (as an outbreak) begins to sputter and dies out. Above 1.0, and an outbreak can have `legs’. 

While MERS has yet to become transmissible enough (at least in a community setting) to spark a genuine epidemic, a 2017 study (see A Pandemic Risk Assessment Of MERS-CoV In Saudi Arabia) provided a detailed statistical analysis of MERS-COV cases reported in Saudi Arabia from May 2013 to May 2015
This study reported a sub-critical R0 (R: 0.85–0.97) across all regions, but found in central and western regions that at times the R0 flirted with epidemic sustaining numbers. 
All of which means - while apparently still not ready for prime time - MERS-CoV wouldn't need to gain a whole lot more transmissibility to become a genuine pandemic threat.

Three small household clusters in a month does not an epidemic make, but we need to remain vigilant, keeping watch for any signs that the virus might be evolving into more of a threat. 

Monday, January 14, 2019

Argentina's Growing Hantavirus Outbreak

Credit Wikipedia


Hantaviruses - which are carried by rodents in many parts of the world - are contracted by humans primarily through the inhalation or ingestion of aerosolized rodent feces, urine, saliva.
Once infected, however, humans are sometimes able to transmit the virus to those they are in close contact with. 
Scientists have identified dozens of viruses within the genus Hantavirus (named after the Hantaan River of Korea), with mortality that varies from 1%-2% for some varieties (i.e. Seoul Virus, Puumala Virus) to more than 30% for the North American Sin Nombre and South American Andes Virus.
In humans, there are two severe (sometimes fatal) diseases caused by Hantavirus: Hemorrhagic Fever with Renal Syndrome (HFRS) and Hantavirus Pulmonary Syndrome (HPS). 
HFRS is found in Europe, Asia, and Africa, while HPS is found in the Americas (North, Central and South).  
While relatively rare, every year the U.S. reports between 10 and 50 Hantavirus Pulmonary Syndrome (HPS) cases, of which, roughly 35% prove fatal. Cases have been reported in 35 states (see map below), with 96% of all cases reported west of the Mississippi River.

For the past few days there have been reports of an unusually large outbreak of Hantavirus in the small village of Epuyén in the Patagonian province of Chubut.  The local provincial government's website (Gobierno del Chubat) front page prominently displays the following warning:


Argentina's Ministry of Health website shows their last update on January 11th, where they talk in general terms about their response and identify the virus as the Southern Andes strain.  

They state the National Administration of Laboratories and Health Institutes (ANLIS) has `. . .  also initiated studies of viral genome sequencing entire human genome and to identify whether there are mutations that increase the transmissibility and lethality'.

Health continues to work with Chubut coordinated by the outbreak of hantavirus in Epuyén
In order to study and contain the outbreak, authorities and technical teams from both jurisdictions held meetings to assess the evolving outbreak affecting the Patagonian locality.

Published on Friday January 11, 2019

Meanwhile, media reports indicate there are now 28 cases and 10 deaths, including reports of a 29 year-old nurse who died in neighboring Santiago, Chile.

This (translated) report from LaRepublica.pe:
Hantavirus travels to Argentina and arrives in Chile: nurse dies in Santiago

The 29-year-old woman died in Santiago de Chile and joins the nine fatalities of the Hantavirus outbreak that originated in Argentina.

The Republic

13 Jan 2019 | 9:21 pm

The Hantavirus caused the death of a person in Chile. A 29-year-old nurse had contact with a person from Epuyén, the town where the outbreak of the viral disease began, and died at a health center in her country. In addition, there are two more cases of contagion.

The woman, identified by Chilean media such as Patricia Martínez, was an officer of the Hospital de Palena, an area where there were conflicts bordering Argentina and Chile. She is the first victim of the Chilean Los Lagos region. He died of a cardiopulmonary picture caused by the Hantavirus in Santiago.
According to the authorities of Los Lagos, his death is related to infections in Epuyen, Argentina. The woman would be the tenth mortal victim of the Hantavirus. The Government of Chile would have imposed the sanitary barrier.

"We were informed of the death of the patient from Palena, as a result of her case of cardiopulmonary syndrome due to hantavirus," said José Antonio Vergara, the Epidemiology physician at the Los Lagos health center, according to Clarín. It was linked to the outbreak that originated in the town of Epuyen, in the province of Chubut, "he said.

(Continue . . . )

A summary of the outbreak was published yesterday by Navva.org.

The first people affected by the virus were people who attended a birthday party on 24 November in an event hall, reported the mayor of Epuyen, Antonio Reato.
A field spy from the area was the first to be infected after cleaning a shed where he would have been in contact with an infected mouse. Later the man attended the celebration in which he infected his wife and other assistants.

The outbreak is motivated safety precautions in the Patagonian city that has already been proclaimed quarantine. Meetings are forbidden and even to view the deceased.

A court decision ordered the insulation for 30 days to 85 residents who had contact with neighbors tested positive for Hantavirus or suspected of having it. Isolated people are not allowed to leave their homes and receive visitors.
Complicating matters is the potentially long incubation period for the virus.  A 2006 EID Journal Dispatch (below) suggests - that with new cases still being identified  - it could be some time before this outbreak can be resolved.

Volume 12, Number 8—August 2006

Incubation Period of Hantavirus Cardiopulmonary Syndrome

Pablo Vial* , Francisca Valdivieso*, Gregory Mertz†, Constanza Castillo‡, Edith Belmar*, Iris Delgado*, Mauricio Tapia§, and Marcela Ferrés¶

The potential incubation period from exposure to onset of symptoms was 7–39 days (median 18 days) in 20 patients with a defined period of exposure to Andes virus in a high-risk area. This period was 14–32 days (median 18 days) in 11 patients with exposure for < 48 hours.

Given its unusual size and duration, we'll be keeping an eye on this outbreak in the days and weeks ahead.

Hong Kong's Overnight MERS Scare


The 2003 SARS epidemic left an indelible mark on Hong Kong's Psyche (see SARS And Remembrance) - as between March 11th and June 6th of that year  a total of 1750 cases were identified in the city, and of those, 286 died.
Having also experienced the first human outbreak of H5N1 in 1997, and having dealt with the arrival of more than 2 dozen avian flu infected cases from the mainland over the years, Hong Kong's Centre for Health Protection (CHP) understandably takes their vulnerability to infectious disease outbreaks very seriously.
After a very SARS-like MERS coronavirus emerged in the Middle East in 2012,  the CHP began to proactively test anyone with recent travel history to the region with flu-like symptoms for the virus. 
We often see 2 or 3 tests announced each week by Hong Kong's CHP, and to date, all have come back negative.
Hong Kong also took sharp notice of South Korea's MERS epidemic in 2015 - which was sparked by a single infected traveler - and eventually infected 185 people across 16 hospitals, and claimed 38 lives (see Superspreaders & The Korean MERS Epidemiological Report).

All of which explains the prominent headlines overnight in Hong Kong's Chinese and English language media of a swift response to a suspected MERS case in the city. This headline from the South China Morning Post.
Express rail train taken out of service after passenger intercepted in Hong Kong with suspected Mers symptoms
  • Man in question, a foreign national, was sent to hospital by ambulance
  • Areas he passed through in West Kowloon terminus were cleaned and disinfected
PUBLISHED : Monday, 14 January, 2019, 10:47am

A few hours later, the CHP published:
The Centre for Health Protection of the Department of Health today (January 14) reported that the suspected case of Middle East Respiratory Syndrome (MERS) pending results earlier today, upon preliminary testing, tested negative for MERS Coronavirus.

Ends/Monday, January 14, 2019

Issued at HKT 14:53
Good news, although it will require a follow up test in 48 hours to confirm this patient's negative diagnosis (see AJIC: Intermittent Positive Testing For MERS-CoV).
While there is a good chance this patient will continue to test negative, health authorities recognize that it only takes one infected case to slip through to spark a much larger outbreak.
And so it is not terribly surprising to see that another (apparently unrelated) suspect case has been announced in the past few hours by the CHP (see below). While this one will likely prove negative as well, protecting the public against threats like these is a never ending job.


 A reminder of the old adage, when public health works . . . nothing happens.

California: USDA Confirms 3rd Commercial Poultry Flock Hit With Virulent Newcastle Disease



Nearly 8 months ago (May 18th), in APHIS: USDA Confirms Virulent Newcastle Disease In Backyard Flock - California, we learned of the first outbreak of highly virulent Newcastle disease in U.S. poultry in 15 years.

Prior to that, the last poultry outbreak in the United States had been reported in 2003 (described below), although sporadic detections in wild birds have continued around the country.

This from the California Dept. of Food & Agriculture (Note: vND was called END or Exotic Newcastle Disease at the time)

The 2002-03 END outbreak, originally confirmed in backyard poultry in Southern California, spread to commercial poultry operations in California and backyard poultry in Arizona, Nevada and Texas.  The Governor of California declared a State of Emergency, the Secretary of the United States Department of Agriculture (USDA) declared an Extraordinary Emergency, and local emergencies were declared in San Diego, Riverside, Los Angeles, and San Bernardino Counties.
A USDA and the California Department of Food and Agriculture (CDFA) Task Force was formed that involved over 7,000 individuals rotating in and out over the course of the outbreak.  Trade restrictions resulting from the disease had negative impacts on California and U.S. poultry and egg producers.  The outbreak, from discovery to eradication, lasted eleven months.  The outbreak response led to the depopulation of 3.16 million birds at a cost of $161 million.
Prior to that - in 1971 - an outbreak that began in Southern California led to the culling of 12 million birds and a loss of tens of millions of dollars.

Although it poses only a minor threat to human health, Virulent Newcastle Disease can be up to 100% fatal in poultry, and is a serious threat to poultry interests world wide. In humans, the virus generally causes mild flu-like illness and/or conjunctivitis.

While concerning, up until mid-December all of the 200+ detections of the virus reported since May of 2018 had only been in backyard poultry. No commercial poultry producers had been affected.  
That changed on December 14th when the virus was discovered in commercial table egg pullets in Riverside county.  Early last week, in CDFA/USDA: 2nd Commercial Poultry Outbreak Of Virulent Newcastle Disease In California, we learned that a second commercial operation had been affected. 
In rapid succession we now learn that a third commercial flock has now been affected.  This from the USDA.
USDA Confirms Virulent Newcastle Disease in a Third Commercial Chicken Flock in California USDA

WASHINGTON, January 10, 2018 -- The United States Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS) confirmed virulent Newcastle disease in a third commercial poultry flock in California. The latest case is in a commercial layer flock in Riverside County. This finding is part of an outbreak in southern California that began in May 2018 in backyard exhibition birds.

Virulent Newcastle disease is not a food safety concern. No human cases of Newcastle disease have ever occurred from eating poultry products. Properly cooked poultry products are safe to eat. In very rare instances people working directly with sick birds can become infected. Symptoms are usually very mild, and limited to conjunctivitis and/or influenza-like symptoms. Infection is easily prevented by using standard personal protective equipment.

APHIS is working closely with the California Department of Food and Agriculture to respond to the finding, limit the disease’s spread in commercial poultry, and then eradicate it. Federal and State partners are conducting additional surveillance and testing in the area, and are working with nearby commercial farms to increase biosecurity to prevent additional disease spread.

It is essential that all bird owners follow good biosecurity practices to help protect their birds from infectious diseases. These include simple steps like washing hands and scrubbing boots before and after entering a poultry area; and cleaning and disinfecting tires and equipment before moving them off the property.

In addition to practicing good biosecurity, all bird owners should report sick birds or unusual bird deaths to State/Federal officials, either through their state veterinarian or through USDA’s toll-free number at 1-866-536-7593. Additional information on biosecurity for all poultry flocks can be f

ound at www.aphis.usda.gov/animalhealth/defendtheflock.

Additional background

Virulent Newcastle disease is a contagious and fatal viral disease affecting the respiratory, nervous and digestive systems of birds and poultry. The disease is so virulent that many birds and poultry die without showing any clinical signs. A death rate of almost 100 percent can occur in unvaccinated poultry flocks. Virulent Newcastle disease can infect and cause death even in vaccinated poultry.

Clinical signs of virulent Newcastle disease include: sudden death and increased death loss in the flock; sneezing; gasping for air; nasal discharge; coughing; greenish, watery diarrhea; decreased activity; tremors; drooping wings; twisting of the head and neck; circling; complete stiffness; and swelling around the eyes and neck. Images of some of these signs are available here.
Due to the government shutdown, the USDA's Newcastle Disease Surveillance and reporting page has not been updated since December 20th, so the exact number of outbreaks to date remain unpublished.

 The most recent update reads:
Virulent Newcastle Disease (vND)

Last Modified: Dec 21, 2018
Virulent Newcastle disease, formerly known as exotic Newcastle disease, is a contagious and fatal viral disease affecting the respiratory, nervous and digestive systems of birds and poultry. The disease is so virulent that many birds and poultry die without showing any clinical signs.

Virulent Newcastle disease is not a food safety concern. No human cases of Newcastle disease have ever occurred from eating poultry products. Properly cooked poultry products are safe to eat. In very rare instances, people working directly with sick birds can become infected with mild symptoms, such as conjunctivitis. These are easily prevent with personal protective equipment.

Since May 18, USDA has confirmed 231 cases of vND in California, 104 in San Bernardino County, 87 in Riverside County, 39 in Los Angeles County and 1 in Ventura County:

Sunday, January 13, 2019

China MOA: Gansu Province Reports Their 1st ASF Outbreak


China's 10 day lull in reporting African Swine Fever outbreaks - which ended yesterday - continues today with the announced arrival of the virus to the 24th  Chinese Province and/or territory in just over 5 months; Gansu.
This is the first new territorial gain for the virus in nearly a month, with the last being the arrival of the virus in Guangdong province in mid-December.
 The very brief (translated) statement from China's MOA reads:
African swine fever epidemic in Qingcheng County, Gansu Province
Date: 2019-01-13 17:34 Author: Source: Ministry of Agriculture and Rural Press Office 

The Information Office of the Ministry of Agriculture and Rural Affairs was released on January 13th, and an African swine fever epidemic occurred in Qingcheng County, Gansu Province.

At 14:00 on January 13th, the Ministry of Agriculture and Rural Affairs received a report from the China Animal Disease Prevention and Control Center and was diagnosed by the China Center for Animal Health and Epidemiology. 

A case of African swine fever occurred in a farmer in Shuma Town, Qingcheng County, Qingyang City, Gansu Province. . Up to now, the farmer has 109 live pigs, 44 onset, and 9 deaths.

Immediately after the outbreak, the Ministry of Agriculture and Rural Affairs sent a steering group to the local area. The local authorities have started the emergency response mechanism as required, and adopted measures such as blockade, culling, harmless treatment, disinfection, etc., to treat all the sick and culled pigs harmlessly. At the same time, all pigs and their products are prohibited from being transferred out of the blockade, and pigs are prohibited from being transported into the blockade. At present, the above measures have been implemented.

The main drivers of the rapid spread of this devastating porcine virus across much of China remain - if not a mystery - a bit divided.  The government has targeted over the past few months the feeding of food scraps (`swill') to pigs, unsanitary (or illegal) transport of pigs, and contaminated commercial feed products.

It seems likely that all of the above are components, as is the continued sale and transport of ASF contaminated food products, which keep turning up in traveler's suitcases around the globe. See:
China: No ASF Reports For A Week - But Taiwan Continues To Intercept Contaminated Foodstuffs
Japan MAFF: ASF Virus Detected In Luggage At Hokkaido Airport
South Korea Detects ASF Gene In Chinese Food Products: Additional Testing Underway).
While ASF contaminated food products pose no health risk to humans, they can spread the virus to new regions, where they may make their way into either commercial or wild pigs.

All eyes will be on the upcoming Chinese New Year's and Spring Travel season - which each year inspires the largest human migration on the planet - to see how that affects the spread of the virus in China, and to other Asian countries.

Stay tuned.