Monday, July 31, 2017

Myanmar Cancels Taung Byone Nat Festival Over H1N1 Flu Fears


H1N1 lost its pandemic status, and became just another seasonal influenza virus in the summer of 2010.  While it tends to strike a younger cohort of people, and can sometimes cause serious illness, H1N1 flu seasons are generally less severe than H3N2. 
Despite all of this, in some parts of the world, H1N1 is still referred to as `swine flu' and carries a fearsome reputation.
Some of this concern is warranted, as H1N1 can be a serious infection, particularly in high risk patients. Like H3N2, H1N1 is continually evolving (see Nature Sci Rpts: Continued Evolution Of The 2009 H1N1 Virus), and for this reason a new H1N1 vaccine component (A/Michigan/45/2015 (H1N1)pdm09-like) has been added to this year's flu shot.

Last week, just as Myanmar was reporting a fresh outbreak of avian flu (see OIE Notification: H5N1 In Poultry - Myanmar), we began seeing reports of an outbreak of H1N1 in Yangon, Myanmar's largest city.   
Since then - amid a growing media frenzy - Myanmar's Ministry of Health and Sports has held daily meetings and has issued nearly a dozen press releases on the outbreak, and overnight Reuters is reporting at least 10 deaths from the virus.
While at this point there is nothing to suggest anything unusual about this H1N1 outbreak, The Irrawaddy is now reporting that the country's largest annual celebration - the Taung Byone Nat Festival - has been canceled to help prevent the spread of the virus.

H1N1 Halts Taung Pyone Nat Festival
By Zarni Mann 31 July 2017 

MANDALAY — Myanmar’s largest annual nat festival scheduled to begin on Monday in Taung Pyone near Mandalay has been cancelled over fears of spreading the H1N1 influenza outbreak currently rattling the country.

“The festival ground is always crowded and germs would spread easily, so we have decided to postpone the festival until the influenza is under control,” Mandalay Region Chief Minister U Zaw Myint Maung told reporters on Sunday.

Hundreds of thousands of people from across Myanmar flock to the annual festival in Taung Pyone village, 15 miles north of Mandalay. It is held in honor of two brothers—Min Gyi and Min Lay—who were believed to have become nat spirits after they were executed by King Anawrahta.

On Sunday, the health ministry announced 10 lives had now been claimed by the influenza from a total of 182 suspected cases since July 21. Parliament approved an urgent proposal to boost awareness of H1N1 influenza in an attempt to control the country’s outbreak last week.

(Continue . . . )

The use of NPIs - Non-Pharmaceutical Interventions -  such as the closing of schools, cancellation of large public events, and social distancing are a major part of any attempt to halt the transmission of a contagious illness like influenza.

The CDC’s Nonpharmaceutical Interventions (NPIs) web page defines NPIs as:
Nonpharmaceutical interventions (NPIs) are actions, apart from getting vaccinated and taking medicine, that people and communities can take to help slow the spread of illnesses like influenza (flu). NPIs are also known as community mitigation strategies.
You'll find an in-depth discussion of NPIs, along with excerpts from the recently released 2017 HHS Pandemic Plan, in Community Pandemic Mitigation's Primary Goal : Flattening The Curve.

In low resource countries like Myanmar - where vaccines, antivirals, and hospital beds are in limited supply - the early and judicious use of NPIs may be their most effective tool to contain this outbreak.

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